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CAG2020-416 - Original - Healthcare Delivery Systems - Inmate Healthcare Services - 12/15/2020
ApprovalOriginator:Department: Date Sent:Date Required: Authorized to Sign: Director or Designee Mayor Date of Council Approval: Grant? Yes No Type:Review/Signatures/RoutingDate Received by City Attorney: Comments: Date Routed to the Mayor’s Office: Date Routed to the City Clerk’s Office:Agreement InformationVendor Name:Category: Vendor Number:Sub-Category: Project Name: Project Details: Agreement Amount: Start Date: Basis for Selection of Contractor: Termination Date: Local Business? Yes No* *If meets requirements per KCC 3.70.100, please complete “Vendor Purchase-Local Exceptions” form on Cityspace. Notice required prior to disclosure? Yes No Contract Number: Agreement Routing Form For Approvals, Signatures and Records Management This form combines & replaces the Request for Mayor’s Signature and Contract Cover Sheet forms. (Print on pink or cherry colored paper) Visit Documents.KentWA.gov to obtain copies of all agreementsadccW22373_1_20 Budget Account Number: Budget? Yes No Dir Asst: Sup/Mgr: Dir/Dep: rev. 200821 FOR CITY OF KENT OFFICIAL USE ONLY JAIL MEDICAL SERVICES AGREEMENT - 1 (between City of Kent and Healthcare Delivery Systems) JAIL MEDICAL SERVICES AGREEMENT between the City of Kent and Healthcare Delivery Systems This HEALTH CARE SERVICES AGREEMENT (“Contract”) is made between the City of Kent, a Washington municipal corporation with principal offices at 220 Fourth Ave. S., Kent, WA 98032 (hereinafter "City") and Healthcare Delivery, Inc. (d.b.a Healthcare Delivery Systems), a Washington corporation with its principal offices at 9039 Silverspot Drive SE, Tumwater, WA 98501 (hereinafter "HDS" or “Vendor”). The City and HDS are sometimes referred to in this Agreement individually as "Party'' or, collectively, as the "Parties." RECITALS The City operates the Kent Corrections Facility at 1230 Central Ave. S. Kent, WA 98032 (hereinafter “Facility”), and is constitutionally responsible for the provision of adequate healthcare to all inmates in its custody. The Facility’s current contract for healthcare services is set to expire at the end of 2020. In June, the City published a Request for Proposals (“RFP”), seeking proposals for a new health care provider for the Facility. The initial deadline for proposals was July 27, 2020, but was extended to August 28, 2020, to allow additional competition. HDS has submitted a proposal for the provision of health care services, health care personnel and program support services to the inmate population at the Facility, and the City wishes to contract with HDS to be the sole supplier and/or coordinator of the health care delivery system at the Facility. NOW THEREFORE, in consideration of the mutual promises contained in and the mutual benefits contemplated by this Contract, the City and HDS agree as follows: 1. Services 1.1 Qualifications to Provide Services. HDS warrants that it is qualified and possesses the necessary expertise, knowledge, training, and skills, and has the necessary licenses and/or certifications to perform the Services, see Section 1.2, set forth in this Contract. Services provided by HDS will be consistent with state regulations and community standards of practice for correctional institution health care, including the Washington Association of Sheriffs & Police Chiefs (“WASPC”) Inmate Health Care standards. 1.2 Services Provided. HDS shall perform the following health care and administrative services (collectively, “Services”): A. Health Care Services - Provide inmate health care services, JAIL MEDICAL SERVICES AGREEMENT - 2 (between City of Kent and Healthcare Delivery Systems) including dental and mental health services, for the Facility. A detailed description of the scope of health care services to be performed by HDS is set forth in the attached and incorporated Exhibit B (“Scope of Service”). These Services include without limitation: (1) Intake screening review; (2) Health assessments; (3) Telephone consultation services for specialty appointments; (4) Patient referrals for specialized or hospital care; (5) Emergency care; (6) Palliative dental care; (7) Coordination and fees for pharmacy services (8) Mental health services; (9) Tuberculosis testing, Hepatitis B vaccines, and first aid services to facility staff; (10) Nursing services; sick call, medication pass, medical record documentation; (11) Reporting high cost or high-risk medical care needs to facility commander; (12) Equipment ordering and disposal coordination; (13) Detoxification monitoring and treatment; (14) Administration of Medicated Assisted Treatment (“MAT”) program to include continuing, induction, and release planning; (15) Reporting medical care needs to court when necessary; and (16) Prepare records and medication for continuance of care for transports and release. B. Commencement of Health Care Services. The responsibility of HDS for the health care of an inmate commences when HDS is first provided access to the inmate for health care purposes after the inmate enters the custody of the Facility. C. Provision of Labor and Materials. HDS will be responsible for providing all its own labor and materials to perform the Services, unless specifically provided otherwise by this Contract. D. Administrative Services. HDS shall provide administrative services. A detailed description of the scope of administrative services to be provided by HDS is also set forth in Exhibit B. These Services include without limitation: (1) Billing and medical records maintenance, management, storage, and scheduling; (2) Transfer of medical information; JAIL MEDICAL SERVICES AGREEMENT - 3 (between City of Kent and Healthcare Delivery Systems) (3) Medical director oversight; and (4) Administrative oversight. 2. Contract Term 2.1 Initial Term. The Contract’s initial term is five years, beginning on December 15, 2020 and ending on December 15, 2025. The initial term will begin with a transitionary period, in which service will overlap with the current provider. The Parties agree that the services described in Section 1 of this Contract will begin on December 15, 2020. 2.2 Renewal Term. Provided that neither party has provided notice of non-renewal pursuant to Section 2.3, after the initial term, the City may renew the Contract, at the City’s sole option, for up to three successive three-year renewal terms, not to exceed a total Contract term of 14 years. Each three-year renewal term will be accomplished by the City providing written notice to HDS. Each renewal shall be subject to the Parties’ mutual agreement regarding the compensation and level of service to be provided during each renewal term. 2.3 Notice of Non-Renewal. Should either party wish to not renew the Contract for a renewal term, the non-renewing party shall provide minimum notice to the other party at least 180 days prior to the expiration of the Contract’s then current term. In such an event, the Contract shall expire at the end of the Contract’s then current term. 2.4 Computing Time. When this Contract states a period of time in days, that period of time should be calculated using calendar days. 3. Compensation The City shall pay HDS a total amount not to exceed $628,919.00 annually, including any applicable Washington State sales tax, for the Services described in this Contract. This is the maximum amount to be paid under this Contract for the Services described in Section 1 above, and shall not be exceeded without the prior written authorization of the City. For Services provided under this Contract, the City shall pay HDS in accordance with this Section 3. 3.1 Health Care Services - Rates. The hourly rates charged for the health care services performed by HDS for this Contract are delineated in Table A below. As agreed to in the submitted proposal, the rates shall be the same for the first three years of the Contract, after which the rates for years four and five shall be increased (but never decreased) by the local Consumer Price Index on an annual basis. Any such increase will be expressed in a written amendment to this Contract executed by both parties. JAIL MEDICAL SERVICES AGREEMENT - 4 (between City of Kent and Healthcare Delivery Systems) Table A: Staff Position/Certification Level/Title Rate per hour Nursing/Registered Nurse/Staff Nurse $78 Nursing/LPN/Staff Nurse $55 Provider/MSN/Advanced Registered Nurse $125 Provider/MSN/ Psych Nurse Practitioner $125 Provider/MD/Medical Doctor $150 3.2 Staffing Plan. HDS will provide staff to perform the Contract in accordance with the annual Staffing Plan set forth in Table B below. HDS shall not bill hours in excess of the annual maximum staffing described by Table B without the written authorization of the City. The maximum staffing levels provided for by Table B may be altered at the request of either Party upon the requesting party providing thirty (30) days advance written notice to the other, and upon mutual agreement of the parties expressed in a written amendment to this Contract that is signed by both parties; provided, thirty (30) days advance written notice shall not be required for minor changes to staffing levels that are mutually agreed upon by the City and HDS. The Parties mutually recognize that due to the temporarily smaller inmate population caused by the ongoing pandemic that the initial level of staffing will be less than the maximum authorized by this Contract, and HDS will invoice accordingly. At all times, HDS is subject to the personnel requirements listed in Exhibit B, Scope of Service. HDS shall provide the following level of service on the days indicated and at the hourly rates indicated: Table B: Staff – Level of Service Annual Hours Position 3,510 Licensed Practical Nurse (LPN) @ $55.00/hr. 67.5 hours per week* Work performed Mon – Fri, 7:00 a.m. – 3:30 p.m.; and Sat – Sun 8:00 a.m. – 8:30 p.m. Total monthly cost: $16,087.5 Total annual cost: $193,050 85 Licensed Practical Nurse (LPN) @ $27.50/hr. Holiday bonus pay 10 days per year, in addition to normal pay. Total annual cost: $2,337 2,210 Registered Nurse (RN) @ $78.00/hr 42.5 Hours per week* Work performed Mon - Fri, 1:30 p.m. - 10:00 p.m. Total monthly cost: $14,365 JAIL MEDICAL SERVICES AGREEMENT - 5 (between City of Kent and Healthcare Delivery Systems) Total annual cost: $172,380 85 Registered Nurse (RN) @ $39/hr Holiday bonus pay 10 days per year, in addition to normal pay. Total annual cost: $3,315 78 Medical Doctor, (MD) @ $150.00/hr 1.5 Hours per week Maximum monthly cost: $975 Maximum annual cost: $11,700 78 Psych Nurse Practitioner @ $125/hr 6 Hours per month Maximum monthly cost: $750 Maximum annual cost: $9,750 156 Advanced Registered Nurse Practitioner (ARNP) @ $125.00/hr 3 Hours per week Total monthly cost: $1,625 Total annual cost: $19,500 8,736 Advanced Registered Nurse Practitioner (ARNP) @ ~$4.12/hr 24-hour phone coverage Total monthly cost: $3,000 Total annual cost: $36,000 The total annual expense HDS staff at the above levels of service and at the above hourly rates will be $448,032.00. * At the beginning of the performance of the Contract, it is expected that inmate populations will be below average due to the current COVID-19 pandemic. As a result, during the COVID-19 pandemic and until otherwise agreed to by the Parties, the weekly LPN and RN coverage will be provided for at the following reduced levels: _______ Licensed Practical Nurse (LPN) @ $55.00/hr. Average of 42 hours per week with a two week rotation 36 hours week one; 48 hours week two. Total monthly cost: $10,010 Total annual cost: $120,120 _______ Registered Nurse (RN) @ $78.00/hr Average of 42 hours per week with a two week rotation 36 hours week one; 48 hours week two. Total monthly cost: $14,196 Total annual cost: $170,352 The total annual expense HDS staff at the above reduced levels of will be $373,074.00. 3.3 Administrative Services Fee. HDS shall be compensated for administrative services through a flat annual fee of $180,887.00, including any applicable Washington State sales tax. This fee covers all costs associated with the JAIL MEDICAL SERVICES AGREEMENT - 6 (between City of Kent and Healthcare Delivery Systems) work described in the “Administration,” “Supplies,” and “Medical Records” Sections of Exhibit B, Scope of Services, as well as the costs of administrative duties performed by the Medical Director. The administrative fee shall be billed and paid in monthly installments, with the first monthly installment being billed at a rate of $15,075.75, and the remaining 11 monthly installments being billed at a rate of $15,073.75 each. 3.4 Billing. A. HDS shall accurately invoice the City monthly based on time and materials incurred during the preceding month. Monthly invoices shall be submitted within fifteen (15) calendar days of the conclusion of each month. Invoices shall be substantially in the form attached hereto as Exhibit G and by this reference incorporated here-in. B. HDS’s invoices shall describe and document the Services performed, and such Services must be solely for those identified in this Contract. HDS’s invoices shall: (1) Use billing rates which conform to the rates delineated above in Table A. (2) Not exceed the maximum annual hours listed for each position in Table B. (3) Include the monthly portion of the administrative fee due. C. HDS shall substantiate its invoices by providing to the City upon request: (1) A monthly schedule and a summary of any deviations from the monthly schedule that occurred. (2) A list of the inmates for whom HDS staff performed service and the type of Service provided. (3) A list of the times hospital and off-site health care services were utilized. D. The City shall provide payment within thirty (30) days of receipt of an accurate invoice. If the City objects to all or any portion of an invoice, it shall notify HDS and reserves the option to without penalty only pay that portion of the invoice not in dispute. In that event, the parties will immediately make every effort to settle the disputed portion. E. All invoices will be reviewed by the City's Contract manager or designee prior to payment. In order to be considered received by the City, invoices shall be sent to: JAIL MEDICAL SERVICES AGREEMENT - 7 (between City of Kent and Healthcare Delivery Systems) City of Kent Corrections Facility Attn: Accounts Payable 1230 Central Ave S Kent, WA, 98032 F. Certain costs related to the performance of this Contract may be reimbursed, as identified in Section 5 of Exhibit B, Scope of Service. Such costs shall be first approved for purchase by the City’s contract representative and should either be included in HDS’s monthly invoice for reimbursement, or should be billed directly to the City. Such allowable costs include: lab testing, emergency care, equipment, or pharmaceuticals. HDS shall review all charges from outside vendors for accuracy and appropriateness prior to requesting reimbursement from the City. G. In the event HDS has failed to perform any substantial obligation to be performed by HDS under this Contract and such failure has not been cured within ten (10) calendar days following notice from the City, then the City may, in its sole discretion and upon written notice to HDS, withhold any and all monies due and payable to HDS, without penalty until such failure to perform is cured or otherwise adjudicated. “Substantial” for purposes of this Contract means faithfully fulfilling the terms of the Contract with variances only for technical or minor omissions or defects. H. The City shall pay a late charge of 2% of any amounts not paid on or before the due date. In addition, any amounts not paid when due shall accrue interest at the rate of 1% per month starting on the payment due date and continuing until any overdue balance(s), including late charges, is/are received in full. 4. Incorporation of Contract Exhibits 4.1 Complete Contract. The following Exhibits are attached and incorporated into this Contract, and together, the Contract and its Exhibits shall constitute the entire agreement between the Parties regarding its subject matter and supersede all prior contracts, agreements, understandings, and discussions, whether oral or written: Exhibit A: Insurance Requirements for Inmate Medical Services Contract Exhibit B: Scope of Services Exhibit C: Proof of insurance Exhibit D: City of Kent Equal Employment Opportunity Policy Declaration Exhibit E: RFP 2020-01 Exhibit F: HDS’s proposal to RFP 2020-01 Exhibit G: Sample HDS Invoice JAIL MEDICAL SERVICES AGREEMENT - 8 (between City of Kent and Healthcare Delivery Systems) 4.2 Precedence of Documents. In the event of a conflict between the Contract and its Exhibits, this final signed Contract shall prevail over the Exhibits, and each Exhibit shall have precedence over the Exhibits that follow (e.g. Exhibit A has precedence over Exhibit B, which in turn has precedence over Exhibit C). 4.3 Authority to Bind City. The Mayor, or the Mayor’s designee, is the only individual who may legally commit the City to the expenditure of funds for a contract, and then only after the Mayor has first received authority to sign that contract from the Kent City Council. No cost chargeable to this Contract may be incurred before receipt of a fully executed contract. 5. Contract Representatives The following points of contact will be used by the Parties to communicate in the implementation of this Contract. Each Party may change its point of contact upon reasonable notice to the other Party. City of Kent: Commander Diane McCuistion City of Kent Corrections Facility 1230 Central Ave. S. Kent, WA 98032 Phone: 253-856-5940 Fax: 253-856-6961 Email: DMcCuistion@kentwa.gov Healthcare Delivery Systems: Shannon Slack Healthcare Delivery Systems 9039 Silverspot Drive SE, Tumwater, WA 98501 Phone: 360-791-7133 Fax: 360-688-1862 Email: jsyoung360@gmail.com All communications regarding this Contract shall be sent to the parties at the addresses listed above, unless notified to the contrary. Any written notice hereunder shall become effective three (3) business days after the date of mailing by registered or certified mail, and shall be deemed sufficiently given if sent to the addressee at the address stated in this Agreement or such other address as may be hereafter specified in writing. 6. Compliance with Laws 6.1 HDS shall comply with all applicable federal, state and local laws, rules, and regulations, affecting its performance under this Contract and hold the JAIL MEDICAL SERVICES AGREEMENT - 9 (between City of Kent and Healthcare Delivery Systems) City harmless against any claims arising from the violation thereof. This requirement includes HDS’s obligation to comply with: the Prison Rape Elimination Act of 2003, the Health Insurance Portability and Accountability Act of 1996, and the Washington Association of Sheriffs and Police Chiefs’ (“WASPC”) Inmate Health Care standards. 6.2 HDS must obtain and maintain a State of Washington and City business license and otherwise comply with Kent Municipal Code 5.02.020. 7. Records and Public Disclosure 7.1 The City is a public agency subject to the Washington State Public Records Act, Chapter 42.56 RCW. Records and information provided to or otherwise used by the City may be subject to a request submitted under the state Public Records Act. In such an event, HDS agrees to cooperate fully with the City in satisfying the City’s duties and obligations under the Public Records Act. HDS’s services related to records management are described in detail in Section 4.0 of Exhibit B, Scope of Service. 7.2 If a request is received for records HDS has identified as confidential, proprietary, or protected trade secret material, the City will use its best efforts to provide HDS with notice of the request in accordance with RCW 42.56.540 and a reasonable time within which for HDS to file for an injunction to prohibit the City’s disclosure of the requested record. The City will not assert any exemption based on trade secret, proprietary, or confidential information on behalf of HDS. 7.3 HDS shall defend, indemnify, and hold the City, its officers, officials, employees, agents, and volunteers harmless from any and all claims, injuries, damages, losses or suits, including all legal costs and attorney fees, arising out of or in connection with any public records request and any exemption claimed by HDS. 7.4 All medical and other records, policies and procedures, manuals, instructional books, orientation, and continuing education records and materials, and documentation of every sort, developed for or used in the operation of the health care program under the Contract shall be the property of HDS. 7.5 Relevant medical records shall be provided to any other health care provider contracted with by the City during or after any term of service with the Vendor. At the end of the Contract and subject to HIPAA requirements, the City shall take possession of the data in HDS’s electronic medical records system generated under this Contract. 7.6 The provisions of this section shall survive the expiration or termination of any executed contract. JAIL MEDICAL SERVICES AGREEMENT - 10 (between City of Kent and Healthcare Delivery Systems) 8. Indemnification The City agrees to indemnify, defend and hold HDS and its employees, agents and subcontractors harmless from and against any and all claims, damages, losses and expenses, including but not limited to court costs, attorney’s fees and alternative dispute resolution costs, for any personal injury, bodily injury, sickness, disease or death and for any damage or destruction of any property (including the loss of use resulting therefrom) (1) to the extent caused by any negligent or willful act or omission of the City or any of its elected or appointed officials, employees, agents, or volunteers; or (2) to the extent directly or indirectly arising out of, resulting from, or in connection with a breach of the City’s obligations under this Contract. HDS agrees to indemnify, defend and hold the City and its elected or appointed officials, employees, agents, or volunteers harmless from and against any and all claims, damages, losses and expenses, including but not limited to court costs, attorney’s fees and alternative dispute resolution costs, for any personal injury, bodily injury, sickness, disease or death and for any damage or destruction of any property (including the loss of use resulting therefrom) (1) to the extent caused by any negligent or willful act or omission of HDS or any of its employees, agents and subcontractors; or (2) to the extent directly or indirectly arising out of, resulting from, or in connection with a breach of HDS’s obligations under this Contract. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THIS INDEMNIFICATION CONSTITUTES THE PARTIES’ WAIVER OF IMMUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51, RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER. In the event either party refuses tender of defense in any suit or any claim, if that tender was made pursuant to this indemnification clause, and if that refusal is subsequently determined by a court having jurisdiction (or other agreed tribunal) to have been a wrongful refusal on either party’s part, then the party which wrongfully refused shall pay all of the other party’s costs for defense, including all reasonable expert witness fees and reasonable attorneys’ fees, plus the party’s legal costs and fees incurred because there was a wrongful refusal by the other party’s part. 9. Insurance HDS will procure and maintain insurance coverage consistent with the requirements described in Exhibit A. Proof of such insurance is attached as Exhibit C. 10. Termination 10.1 After commencement of this Contract with HDS, the Parties may terminate the Contract in whole or in part, in the event of: A. Default - HDS defaults by failing to provide required Services. If JAIL MEDICAL SERVICES AGREEMENT - 11 (between City of Kent and Healthcare Delivery Systems) the City believes HDS has substantially failed to provide Services, including a lack of staffing, the City shall provide written notice to HDS identifying deficiencies in the provision of Services. Unless otherwise agreed in writing, HDS shall have ten (10) calendar days from the date of the City’s written notice to cure any noticed deficiencies in Service, after which the City may terminate the Contract immediately by subsequent written notice. B. Loss of Funding - In the event funding is no longer available to the City for HDS’s Services under this Contract, the City shall notify HDS as soon as practical, and the Contract shall be terminated effective upon the earlier of the date authorized funding is no longer available to the City or the expiration of the sixty (60) days after the City has given written notice to HDS specifying the effective date of termination. C. Convenience - For any reason, by the City providing written notice to HDS ninety (90) calendar days prior to the effective date of termination. D. Mutual Agreement - The Contract may be terminated by written mutual agreement of the Parties. 10.2 Under all circumstances, after the expiration or termination of the Contract, the City, subject to HIPAA requirements, shall take possession of the data in HDS’s electronic medical record system generated under this Contract. 11. Independent Contractor HDS shall be an Independent Contractor, the City being interested only in the results obtained under this Contract. This Contract does not create an agency relationship between HDS and the City. HDS is not an agent or legal representative of the City for any purpose. HDS is not granted any express or implied right or authority to assume or create any obligation or responsibility on behalf of or in the name of the City or to bind the City in any manner. 12. Work Performed at HDS’s Risk 12.1 HDS shall take all necessary precautions and, in the absence of negligence or willful misconduct on the part of the City, shall be responsible for the safety of its employees, agents, and subcontractors in the performance of the Contract Services and shall utilize all protection necessary for that purpose. All work shall be done at HDS’s own risk, and HDS shall be responsible for any loss of or damage to materials, tools, or other articles used or held for use in connection with the work. 12.2 HDS acknowledges that the need for health care services in the Facility under this Contract must be continuous. HDS shall, in times of emergency, pandemic, or any force majeure event, or threats thereof, whether accidental, natural, or caused by other human beings or acts of God, use its commercially reasonable efforts to provide on-site health care services to the City in accordance JAIL MEDICAL SERVICES AGREEMENT - 12 (between City of Kent and Healthcare Delivery Systems) with this Contract. HDS warrants that its ability to perform under this Contract is not prevented, hindered, or delayed by any existing state or national declarations of emergency, or any current social distancing restrictions or personal protective equipment requirements that are required under federal, state, or local law in response to the current pandemic, and that HDS’s performance during the current COVID-19 pandemic is included with the Contract cost provided for herein. The parties agree to negotiate reasonable amendments to this Contract, including the type and frequency of services and the compensation payable to HDS should any future declarations, restrictions or requirements substantially prevent, hinder or delay the performance of this Contract as contemplated. 13. Limitation of Actions HDS must, in any event, file any lawsuit arising from or connected with this Contract within one (1) year from the date of the occurrence giving rise to such suit or HDS’s ability to file that suit shall be forever barred. This section, which was specifically bargained for by the Parties, limits any applicable statutory limitations period. 14. Discrimination In the hiring of employees for the performance of work under this Contract and any sub-contract, HDS, its sub-contractors, or any person acting on behalf of HDS or its sub-contractor shall not, by reason of race, religion, color, sex, age, sexual orientation, national origin, or the presence of any sensory, mental, or physical disability, discriminate against any person who is qualified and available to perform the work to which the employment relates. Prior to commencement of services, HDS shall execute a City of Kent Equal Employment Opportunity Policy Declaration, comply with City Administrative Policy 1.2, and upon completion of the Contract work, file a Compliance Statement. 15. Recyclable Materials Pursuant to Chapter 3.80 of the Kent City Code, the City requires its contractors and consultants to use recycled and recyclable products whenever practicable. 16. Non-Waiver of Breach The failure of either party to insist upon strict performance of any of the covenants and agreements contained in this Contract, or to exercise any option conferred by this Contract in one or more instances shall not be construed to be a waiver or relinquishment of those covenants, agreements or options, and the same shall be and remain in full force and effect. JAIL MEDICAL SERVICES AGREEMENT - 13 (between City of Kent and Healthcare Delivery Systems) 17. Resolution of Disputes and Governing Law This Contract shall be governed by and construed in accordance with the laws of the State of Washington. If the parties are unable to settle any dispute, difference, or claim arising from the parties’ performance of this Contract, the exclusive means of resolving that dispute, difference, or claim, shall only be by filing suit exclusively under the venue, rules, and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in writing to an alternative dispute resolution process. In any claim or lawsuit for damages arising from the Parties' performance of this Contract, each party shall pay all its own legal costs and attorney's fees incurred in defending or bringing such claim or lawsuit, in addition to any other recovery or award provided by law; provided, however, nothing in this paragraph shall be construed to limit the City's right to indemnification, discussed under Sections 7.3 and 8 of this Contract. 18. Assignment Any assignment of this Contract by either party without the written consent of the non-assigning party shall be void. If the non-assigning party gives its consent to any assignment, the terms of this Contract shall continue in full force and effect and no further assignment shall be made without additional written consent. 19. Change in Status 19.1 In the event of a bankruptcy, or any substantive change in its legal status, organizational structure, or fiscal reporting responsibility, HDS will notify the City of the change. 19.2 HDS must provide notice as soon as practicable, but no later than thirty (30) calendar days after such a change takes effect. 20. Modification No waiver, alteration, or modification of any of the provisions of the Contract shall be binding unless in writing and signed by a duly authorized representative of the City and Vendor. 21. Severability If any provision of this Contract or its application to any person or circumstance is held unenforceable, the remainder of this Contract, or the application of the provision to other persons or circumstances, shall not be affected, provided, that the essential purpose of this Contract is not thereby adversely affected or prevented. 12/23/2020 EXHIBIT A INSURANCE REQUIREMENTS FOR INMATE MEDICAL SERVICES CONTRACT -1- EXHIBIT A INSURANCE REQUIREMENTS FOR INMATE MEDICAL SERVICES CONTRACT INSURANCE The Vendor shall procure and maintain for the duration of the Contract, insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the Vendor, their agents, representatives, employees or subcontractors. A. Minimum Scope of Insurance Vendor shall obtain insurance of the types described below: 1. Commercial General Liability insurance shall be written on ISO occurrence form CG 00 01 and shall cover liability arising from premises, operations, independent contractors and personal injury and advertising injury. The City shall be named as an additional insured under the Contactor’s Commercial General Liability insurance policy with respect to the work performed for the City. Excess liability coverage is acceptable to provide coverage above the primary coverage layer in order to fulfill the limits of this agreement. 2. Healthcare Professional Liability insurance covering the Vendor for acts, errors and omissions of Vendor’s medical staff. 3. Workers’ Compensation coverage as required by the Industrial Insurance laws of the State of Washington. B. Minimum Amounts of Insurance Vendor shall maintain the following insurance limits: 1. Commercial General Liability insurance shall be written with limits no less than $1,000,000 each occurrence, $2,000,000 general aggregate. Coverage can be a provided through a combination of primary and excess coverages which amount to the required limits. Any excess coverage must “follow form” of the primary layer. 2. Healthcare Professional Liability insurance shall be provided with limits no less than $2,000,000 per occurrence, $4,000,000 annual aggregate. C. Other Insurance Provisions The insurance policies are to contain, or be endorsed to contain, the following provisions for Commercial General Liability: 1. The Vendor’s insurance coverage shall be primary insurance as respect the City. Any insurance, self-insurance, or insurance pool coverage -2- maintained by the City shall be excess of the Vendor’s insurance and shall not contribute with it. 2. The Vendor’s insurance shall be endorsed to state that coverage shall not be cancelled by either party, except after thirty (30) days prior written notice by certified mail, return receipt requested, has been given to the City. 3. The City of Kent shall be named as an additional insured on all policies (except Professional Liability) as respects work performed by or on behalf of the Vendor and a copy of the endorsement naming the City as additional insured shall be attached to the Certificate of Insurance. The City reserves the right to receive a certified copy of all required insurance policies. The Vendor’s Commercial General Liability insurance shall also contain a clause stating that coverage shall apply separately to each insured against whom claim is made or suit is brought, except with respects to the limits of the insurer’s liability. D. Vendor’s Insurance For Other Losses The Vendor shall assume full responsibility for all loss or damage from any cause whatsoever to any tools, Vendor’s employee owned tools, machinery, equipment, or motor vehicles owned or rented by the Vendor, or the Vendor’s agents, suppliers or contractors as well as to any temporary structures, scaffolding and protective fences. E. Waiver of Subrogation The Vendor and the City waive all rights against each other any of their Subcontractors, Sub-subcontractors, agents and employees, each of the other, for damages caused by fire or other perils to the extend covered by Builders Risk insurance or other property insurance obtained pursuant to the Insurance Requirements Section of this Contract or other property insurance applicable to the work. The policies shall provide such waivers by endorsement or otherwise. F. Acceptability of Insurers Insurance is to be placed with insurers with a current A.M. Best rating of not less than A:VII. G. Verification of Coverage Vendor shall furnish the City with original certificates and a copy of the amendatory endorsements, including but not necessarily limited to the additional insured endorsement, evidencing the Commercial General Liability and Healthcare Professional Liability insurance of the Vendor before commencement of the work. H. Subcontractors Vendor shall include all subcontractors as insureds under its policies or shall furnish separate certificates and endorsements for each subcontractor. All coverages for subcontractors shall be subject to all of the same insurance requirements as stated herein for the Vendor. EXHIBIT B SCOPE OF SERVICES EXHIBIT B SCOPE OF SERVICES This Exhibit outlines contract requirements for providing health care services to the Facility’s inmates. Service requirements have been divided into five sections: (1) Health Care Services, (2) Personnel, (3) Administrative Services, (4) Medical Records, and (5) Supplies. 1. Health Care Services The Vendor will provide the following health care services to all inmates in the Facility. 1.1 Service Level: The minimum requirements for providing health care services to the City’s inmates, is as follows: A. Vendor’s staff will provide inmate health care services, that include assessing inmates presenting health problems, gathering necessary health histories and records, dispensing medications, referring inmates for appropriate treatment of illness/injury per discussions with Corrections staff, documenting medical services, and maintaining the electronic medical records of inmates. B. The Vendor will provide an on-call healthcare provider for telephonic consultation, available 365 days per year whom Vendor and Corrections staff can contact 24/7 to assess the urgent health questions of inmates. The Vendor shall provide Corrections staff with a list of contact information for the primary on- call designated person, as well as have a secondary person who can be called if the primary person is not reachable. The Vendor will maintain updated contact information at all times and will inform Corrections staff of any changes. The Vendor shall be available for twenty-four (24) hours a day telephonic emergency health care services on an on-call basis. The Vendor must be able to provide these services on call, when outside normal operating hours. C. Nursing services must be available to provide services, including: (1) Physical assessments on all inmates within fourteen (14) days after booking; (2) Confirm prescriptions and dose medications as prescribed; (3) Injury/ illness treatment and follow-up care; (4) Sick call triage and follow-up on a daily basis to include weekends and holidays; (5) Appropriate and timely response to health care needs and emergencies; (6) Support services for healthcare providers; (7) Routine nurse rounds shall occur at least three times daily; (8) Assist with medical clearance at intake, as required; (9) Maintain appropriate medical health records for inmates; (10) Conduct blood sugar checks as required for diabetic inmates; (11) Administer DUI blood draws as required/review blood draw reports from Kent Police Department officers; (12) Coordinate offsite appointments for inmates as needed; (13) Work with health care providers for inmate continuance of care plan; (14) Detoxification monitoring and treatment; (15) Collect lab specimens as required; (16) Respond to inmate written medical requests, in a timely manner; (17) Confirm/approve special diet requests for inmates. D. At the request of the City, the Vendor will arrange for office visits at a clinic or other appropriate healthcare setting for those inmates requiring medical attention outside the Facility by a licensed physician, physician assistant, or advanced registered nurse practitioner, and discuss with Corrections staff before referring inmates for additional health services or treatment outside the Facility or beyond the scope of the contract. E. The Vendor must provide oversight of a complete pharmaceutical system for the Facility, including ordering medications, prescribing medications, dispensing of medications, and recordkeeping. The system shall include prescription medications and over-the-counter medications. All prescription medications shall be prescribed and dispensed by a licensed health care professional. The City shall be responsible for the costs of all drugs administered, but the Vendor is responsible for assisting with negotiating preferred provider rates for pharmacy services and shall purchase prescriptions at the lowest rate available. In the event it is determined that an inmate is in need of medication that exceeds a cost of $500 per month to provide, the Vendor shall place the City on notice. Pharmaceutical services include: (1) The Vendor shall assist with overseeing pharmaceutical services to assure the availability of prescribed medications within twenty-four (24) hours of the order of issue being written; (2) The Vendor will provide oversight of pharmaceutical services to ensure processes are consistent with State and Federal regulations, and must be monitored by a licensed, qualified pharmacist; (3) The Vendor will provide a health professional with prescription authority to approve all prescriptions for the inmates. This includes utilizing the provider’s name and DEA license on the facility pharmaceutical contract; to accommodate inmates who participate in the Medicated Assisted Treatment (MAT) program. The quarterly fees associated with this process will be paid for by the Vendor. (4) The Vendor shall provide for the ordering, dispensing, administering, disposal, and storage of all pharmaceuticals by qualified personnel and for the proper storage of psychotropic and controlled substance medications as prescribed to inmates; (5) The Vendor must administer an evidence-based Medication Assisted Treatment (“MAT”) program to inmates diagnosed with Opioid Use Disorder; (6) The Vendor shall provide for an electronic recording of the administration of medications in a manner and on a form approved by the health care authority to include documentation of the fact that inmates are receiving and ingesting their prescribed medications. Documentation will also be required when an inmate's ordered medication was not administered, and the reason given. F. The Vendor, with appropriate input from its licensed health care professionals with correctional experience, will develop and maintain specific medical protocols and procedures that address the services provided hereunder. The Vendor will inspect the medical area(s), medication storage, and office area. Facility medical protocols, policies and procedures will be reviewed and updated at least annually, and copies of such policies and procedures and any City-approved amendments shall be provided promptly to Corrections staff. These protocols, policies and procedures must be and remain consistent with current WASPC standards. Separately, the Vendor’s designated licensed health care professional will assist jail administration with writing and updating City jail medical policies and procedures. The Vendor’s designated licensed health care professional will meet with the Facility administrator at least once annually to discuss the status of the health care program. G. The Vendor shall coordinate necessary laboratory and x-ray services, which may be conducted off site. All abnormal laboratory and x-ray results are to be reviewed and signed by a healthcare provider with a follow-up plan of care outlined as needed. H. The Vendor shall provide a program for meeting the special needs of pregnant inmates. I. The Vendor shall perform documented inmate health reviews using the medical history intake form provided by the Facility. Corrections officers complete the initial medical screen, and nurses will respond immediately if the officer has a concern. If a nurse is not on duty the officer will contact the on-call provider. J. Inmate transportation for emergency care will be coordinated by the Vendor or corrections staff and paid for by the City; all other transportation relating to the provision of health services is provided by the City. K. Health services shall be provided in the form of emergency care for inmates assigned to the Alternative Sentencing programs, while the inmates are on site. Care should be for the purpose of stabilizing the condition and arranging for transport, if necessary. L. Non-inmate health services shall be provided in the form of emergency care for staff, Vendors, and visitors for the purpose of stabilizing the condition and arranging for transport. M. All controlled substances, syringes, needles and surgical instruments will be stored under secure conditions consistent with applicable regulations. N Inmates will not be allowed to assist in the provision of any health care services, including recordkeeping. O. Designated medical personnel will maintain complete and accurate medical records for all inmates, consistent with requirements of Section 4.0 of this Exhibit. The system the Vendor uses for storing medical records must be electronic. P. The Vendor shall, in times of emergency or threat thereof, whether accidental, natural, or caused by other human beings, provide onsite medical assistance to the City. Q. The Vendor will immediately notify Corrections staff of any inmate issue requiring special attention or isolation for communicable disease. R. The Vendor shall provide dental services sufficient to provide for emergency and medically required, i.e. palliative, dental care for inmates within a reasonable period. Attending medical staff will refer inmates for medically necessary dental treatment and may be required to administer medications as prescribed for dental infections. S. Mental health services are to be available 24/7, including by telephone or webcam, and shall include: (1) Administering medications as prescribed, and assisting inmates returning to a mental health medication regiment; (2) Maintenance of inmates' medical charts to include mental health information; (3) Assessment of inmates who claim to be or actually are suicidal, to include placement into and removal from suicide/enhanced watch, and to include suggested watch requirements; (4) The provision of a psychiatric specialist for a minimum of 1.5 hours a week onsite, at the Facility; and (5) Assist with the process of involuntary commitments of inmates experiencing a mental health crisis and/or help to stabilize the inmate through mental health medications. T. At the request of Corrections staff, the Vendor will provide for examinations and medical clearance for inmate workers prior to placement in an assignment. U. The Vendor will provide training to Corrections staff personnel in proper medication procedures and any other medical procedures as requested (i.e., blood sugar tests, etc.). V. For inmates being released into the community with serious health conditions that require medication, the Vendor will provide a prescription, a bridge-supply of medication, arrange transportation to a medical treatment facility, or document that the inmate has access to required medication upon release. For a non-serious health condition that requires medication, the Vendor will provide a supply of medications to an inmate being released or a prescription. W. For inmates who are being transferred to another facility, the Vendor will provide a discharge summary that includes information about the inmate’s medical and mental health condition, the current treatment plan, and any medications needed. Required medications will be transferred with the inmate. X. Vendor will provide medical and mental health intake screening services, including: (1) Intake assessment (as required) to ensure the inmate is medically stable at the time of admission; (2) Review medical intake forms for emergent care; (3) Organize after hour calls to the on-call medical provider; (4) Confirm pregnancy and drug use claims; (5) Stabilize wound care; (6) Confirm diabetic inmates have stable blood sugar levels. Y. The Vendor shall provide management of the Hepatitis B vaccination program for all designated City employees in the Operations and Detention divisions. The City will bear the cost of the vaccine. Z. The Vendor shall provide an annual tuberculosis (“TB”) screen for all designated City employees in the Operations and Detention divisions. AA. Except as otherwise specifically provided for herein (e.g., on-call telephone consultations, dental, tele-med psych), health care services are to be conducted in the Facility. A medical doctor or Advanced Registered Nurse Practitioner shall be onsite a minimum of once a week. 2. Personnel 2.1 Healthcare provider services must be sufficient to perform the required needs of the day and assure medical evaluation/follow up within a reasonable time of post nursing triage referral (including weekends and holidays). In addition, twenty-four (24) hour healthcare provider on-call services with the availability for consultation and the ability to meet the on-site needs are required. This shall include after hour and weekend needs for ordering and dispensing psychiatric medications. 2.2 The City may require replacement of any Vendor personnel believed unable to carry out the responsibilities of the contract at the sole discretion of the City. The Facility administrator shall approve all appointments. All medical personnel shall be subject to a facility background check and fingerprinting prior to Facility assignment. 2.3 Written job descriptions and protocols to define specific duties and responsibilities for all assignments must be provided to the City. 2.4 Intentionally Omitted. 2.5 Copies of staffing schedules encompassing all health care staff are to be submitted to the City on the fifteenth (15th) day of each month for the upcoming month. Daily updates should be supplied if there are changes. This includes the healthcare provider on-call schedule and contact information. 2.6 All medical personnel will attend and participate in an orientation/training session that will cover the Facility’s safety and security rules and regulations prior to work commencing. 2.7 All staff must have current state licenses and must attest to have never having had their professional license revoked. Copies of current professional licenses shall be kept on file with the Facility Accreditation Manager. All on-site staff must be CPR certified. In addition, consistent with Exhibit A, malpractice insurance must be on file for all medical personnel, and other employees, if applicable. 2.8 The City requires a staffing level capable of the adequate provision of the services described in Section 1.1 of this Exhibit. Adequate health care personnel required to provide those services listed in this Exhibit must be provided. 2.9 A singular designated licensed medical professional will be designated as a Medical Director, who will have the responsibility for assuring the appropriateness and adequacy of inmate health. The Medical Director will be responsible for: in- service training, quality assurance, and recruitment. 2.10 The Vendor will be required to provide full coverage for all vacant positions. The Vendor will be required to provide a candidate for the City’s approval for all vacancies as soon practical. 2.11 The Vendor will provide release coordinator services to assist inmates with continued medical care and mental health care. 3. Administration 3.1 The Vendor will provide administrative services, including: A. Being available for telephone consultation; B. Invoicing and billing oversight, records management retention, storage of records, and scheduling; C. Medical director oversight; D. Administrative oversight; E. Program support services; F. Provide additional or replacement staff coverage during vacations, sick and emergency leaves; and, G. Provide policy and protocol oversite and training. 3.2 The Vendor will designate part-time Health Services Administrator, who shall have the general responsibility for the successful delivery of administrative services. The Health Services Administrator need not perform all work at the Facility but may be required to come to the Facility periodically. 3.3 The Vendor will provide to the City reports of monthly and daily statistics as follows: A. A statistical report will be due on the fifth calendar day of each month to the City that includes, but is not limited to, the following: (1) Inmates seen at nurse rounds; (2) Inmates seen by healthcare provider; (3) Inmates seen by dentist; (4) Inmates seen by mental health provider; (5) Medical specialty consultation referrals; (6) Hospital admissions; (7) Emergency Room visits; (8) Intake medical screening review; (9) Fourteen (14) day physical assessments; (10) Inmates on Prescription medications; (11) Lab Work/DUI Blood Draws; (12) Blood sugar checks; (13) TB Test; (14) Blood pressure/Vital checks; (15) Inmates seen for substance abuse; (16) Inmates on a medicated treatment program; (17) All contractor absences by position and number of days vacant. B. A report for the previous twenty-four (24) hours that captures, but is not limited to, the following data. This report shall be submitted to the Jail Administrator on a daily basis: (1) Transfers to hospital emergency departments; (2) Communicable disease reporting; (3) Report of status of inmates in local hospitals; (4) Submit completed medical incident report copies. 3.4 The Vendor shall make the appropriate notifications, to the Public Health Authority and Jail Administrator, in the event of a communicable disease is identified. Precautions will be taken to minimize/prevent the spread of the infectious disease. 4. Medical Records 4.1 A medical record consistent with state regulations and community standards of practice shall be initiated and maintained for every inmate regarding medical, dental, or mental health services received as a result of the inmate screening process and for services rendered following the inmate's assignment to a housing area. These records shall be kept separate from the Facility confinement records of the inmate. 4.2 Confidentiality of medical records will be assured in accordance with HIPAA and other applicable state and federal laws and regulations, including those related to the disclosure of public records, also recognizing that relevant information or a copy of the records may be forwarded to appropriate facilities or to other health care providers as needed. All medical and psychiatric records will be maintained by the provider’s electronic medical records system and kept separate from custodial records. Data necessary for the classification, security, and control of inmates will be provided to the appropriate Corrections staff. Medical records will be made available to the City or its designee when required. 4.3 Adherence to applicable informed consent regulations and standards of the local jurisdiction must be maintained. 4.4 Inactive medical records will be maintained and retained in accordance with the retention laws and schedules of the State of Washington. Following the completion of the applicable retention period, inactive medical records not otherwise subject to a pending records request will be archived by a mutually agreed upon method consistent with state law and regulations. 4.5 All medical and other records, policies and procedures, manuals, instructional books, orientation, and continuing education records and materials, and documentation of every sort, developed for or used in the operation of the Health Care Program under the contract, shall be the property of the Vendor. Notwithstanding the ownership of the records, during the term of the contract, the Vendor, as part of its administrative duties, will be responsible for assisting the City with responding to public records requests, subpoena duces tecums, and medical releases the City may receive. 4.6 In any case where medical care is at issue, or in any criminal or civil litigation where the physical or mental condition of an inmate is at issue, the Vendor shall make accessible to the City’s Jail Commander or City Attorney such records and, upon request, provide copies. The Vendor acknowledges and agrees that all records prepared or acquired by the Vendor during performance of services under the Contract may be subject to the Public Records Act, see Section 7.0 of the Contract. Included in the inmate population are inmates incarcerated on behalf of the City of Maple Valley and the City of Federal Way. The Vendor shall promptly notify the Facility administrator if offsite treatment for such inmates is required. 4.7 The Vendor shall prepare health summaries to be sent with inmates being transferred to other facilities. The health staff will ensure that inmates and health summaries are appropriately prepared for transfer within twenty-four (24) hours of receiving the list of inmates being transferred, or as necessary. 4.8 The Vendor will examine and provide medical clearance for all inmate workers, as requested by the City. The medical clearance process will be completed within twenty-four (24) hours of receiving the trusty application, unless laboratory testing necessarily increases the time required to be cleared. 4.9 If an inmate medical record cannot be located within eight (8) hours of the discovered loss, the City shall be immediately notified. 4.10 Inactive medical records will be maintained in accordance with the laws of the State of Washington. Any and all legal actions or requests affecting inmates and/or the medical contract provider must be provided, in writing, to the City within five (5) days. 4.11 The Vendor shall maintain medical records in an electronic records system. 4.12 Relevant medical records shall be provided to any other health care provider contracted with by the City during or after any term of service with the Vendor. 4.13 At the end of the Contract, the City shall take possession of the data in the electronic medical record system generated under this Contract. 5. Supplies 5.1 The Vendor will coordinate the purchase of all necessary materials, supplies, and equipment necessary for performance of the services required hereunder. The Vendor will obtain cost effective supplies required to carry out its performance. Said supplies will include, but not be limited to: books, manuals, medical record folders and forms, pharmaceuticals, laboratory fees, hand instruments, needles and sharps, special medical items, testing devices, containers and clinical waste receptacles, individual and group materials, gloves and coverings, and disinfectants. Supplies to be purchased during the contract shall be first approved for purchase by the City, and the Vendor will have the City billed directly for such purchases. 5.2 The City agrees to provide the Vendor with office space or facilities, utilities, and office equipment reasonably necessary to enable the Vendor to perform its obligations, including but not limited to, a fax machine, copier, telephone services, office supplies, translation services as available, and medication cart. 5.3 The Vendor will supply, at its expense, on-site office equipment it needs such as cell phones for on call providers, computers for off-site review, and electronic medical records service. The City will continue to make available two computers and one printer which are connected to the in-house inmate records system and the City’s e-mail system. 5.4 All equipment, noted in below in Section 5.4.1, owned by the Facility may be used in conjunction with services furnished by the contract provider. Any additional equipment to be purchased during the contract shall be first approved for purchase by the City. A. The following is a list of medical equipment owned by the City which may be used by the Vendor: (1) AED machine; (2) Mobile blood pressure and vital machine; (3) Emergency first aid kit; (4) Narcotic locking medical; (5) Thermometer; (6) Blood drawing chair; (7) Medication cart; (8) Medical storage cabinets; (9) Wall storage unit; (10) Sonotron; (11) Examination table; (12) Centrifuge Triac control; (13) Refrigerator; (14) Nebulizer; (15) Wheel chair; (16) Walker; (17) Small medical refrigerator. 5.5 All equipment purchased under the Contract shall be the property of the City and shall remain on site at the termination of the contract. All supplies, including pharmaceuticals, purchased for use in the performance of the contract, shall be the property of the City and shall remain on site at the termination of the contract. 5.6 The City shall be responsible for maintenance and repair of all medical and office equipment supplied and owned by the City for use by the Vendor. Should such equipment become non-serviceable due to routine use, then the City will be responsible for its replacement. EXHIBIT C PROOF OF INSURANCE 11/06/2020 Nicholson & Associates Ins LLC 1802 Black Lake Blvd SW #301 Olympia, WA 98512 Tiffany Karpavicius (360)352-8444 (360)943-9712 tiffany@nichinsure.com 00001468-639062 3 Healthcare Delivery Inc 9039 Silverspot Dr SE Tumwater, WA 98501 Sentinel Insurance Co Ltd 11000 A Y 52SBMAC5488 07/01/2020 07/01/2021X X X 1,000,000 1,000,000 10,000 1,000,000 2,000,000 2,000,000 Sentinel Insurance Co Ltd 11000 A 52SBMAC5488 07/01/2020 07/01/2021 X X 1,000,000 Sentinel Insurance Co Ltd 11000 A 52SBMAC5488 07/01/2020 07/01/2021 X Stop Gap 1,000,000 1,000,000 1,000,000 Coverys Specialty Ins Co B Y 005WA000024978 07/01/2020 07/01/2021Professional Limit 2,000,000 Aggregate 4,000,000 Certificate Holder is included as Additional Insured as their interest may appear when required by written contract. City of Kent Corrections Facility 1230 Central Ave. S. Kent, WA 98032 (NTK) Printed by NTK on November 06, 2020 at 08:22AM ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? INSR ADDL SUBR LTR INSD WVD DATE (MM/DD/YYYY) PRODUCER CONTACT NAME: FAXPHONE (A/C, No):(A/C, No, Ext): E-MAIL ADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGG $JECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE $ CLAIMS-MADE AGGREGATE $ DED RETENTION $$ PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMIT $DESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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 REQUIREMENT, 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. 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 policy(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 rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORDACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE Form SS 00 08 04 05 Page 1 of 24 ©2005,The Hartford BUSINESS LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage.Read the entire policy carefully to determine rights,duties and what is and is not covered. Throughout this policy the words "you"and "your"refer to the Named Insured shown in the Declarations.The words "we","us"and "our"refer to the stock insurance company member of The Hartford providing this insurance. The word "insured"means any person or organization qualifying as such under Section C.-Who Is An Insured. Other words and phrases that appear in quotation marks have special meaning.Refer to Section G.-Liability And Medical Expenses Definitions. A.COVERAGES 1.BUSINESS LIABILITY COVERAGE (BODILY INJURY,PROPERTY DAMAGE,PERSONAL AND ADVERTISING INJURY) Insuring Agreement a.We will pay those sums that the insured becomes legally obligated to pay as damages because of "bodily injury", "property damage"or "personal and advertising injury"to which this insurance applies.We will have the right and duty to defend the insured against any "s uit" seeking those damages.However,we will have no duty to defend the insured against any "suit"seeking damages for "bodily injury","property damage"or "personal and advertising injury"to which this insurance does not apply. We may,at our discretion,investigate any "occurrence"or offense and settle any claim or "suit"that may result.But: (1)The amount we will pay for damages is limited as described in Section D.- Liability And Medical Expenses Limits Of Insurance;and (2)Our right and duty to defend ends when we have used up the applicable limit of insurance in the payment of judgments, settlements or medical expenses to which this insurance applies. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Coverage Extension -Supplementary Payments. b.This insurance applies: (1)To "bodily injury"and "property damage"only if: (a)The "bodily injury"or "property damage"is caused by an "occurrence"that takes place in the "coverage territory"; (b)The "bodily injury"or "property damage"occurs during the policy period;and (c)Prior to the policy period,no insured listed under Paragraph 1.of Section C.–Who Is An Insured and no "employee"authorized by you to give or receive notice of an "occurrence" or claim,knew that the "bodily injury" or "property damage"had occurred, in whole or in part.If such a listed insured or authorized "employee" knew,prior to the policy period,that the "bodily injury"or "property damage"occurred,then any continuation,change or resumption of such "bodily injury"or "property damage"during or after the policy period will be deemed to have been known prior to the policy period. (2)To "personal and advertising injury" caused by an offense arising out of your business,but only if the offense was committed in the "coverage territory" during the policy period. c."Bodily injury"or "property damage"will be deemed to have been known to have occurred at the earliest time when any insured listed under Paragraph 1.of Section C.–Who Is An Insured or any "employee" authorized by you to give or receive notice of an "occurrence"or claim: (1)Reports all,or any part,of the "bodily injury"or "property damage"to us or any other insurer; BUSINESS LIABILITY COVERAGE FORM Page 2 of 24 Form SS 00 08 04 05 (2)Receives a written or verbal demand or claim for damages because of the "bodily injury"or "property damage";or (3)Becomes aware by any other means that "bodily injury"or "property damage"has occurred or has begun to occur. d.Damages because of "bodily injury"include damages claimed by any person or organization for care,loss of services or death resulting at any time from the "bodily injury". e.Incidental Medical Malpractice (1)"Bodily injury"arising out of the rendering of or failure to render professional health care services as a physician,dentist,nurse,emergency medical technician or paramedic shall be deemed to be caused by an "occurrence",but only if: (a)The physician,dentist,nurse, emergency medical technician or paramedic is employed by you to provide such services;and (b)You are not engaged in the business or occupation of providing such services. (2)For the purpose of determining the limits of insurance for incidental medical malpractice,any act or omission together with all related acts or omissions in the furnishing of these services to any one person will be considered one "occurrence". 2.MEDICAL EXPENSES Insuring Agreement a.We will pay medical expenses as described below for "bodily injury"caused by an accident: (1)On premises you own or rent; (2)On ways next to premises you own or rent;or (3)Because of your operations; provided that: (1)The accident takes place in the "coverage territory"and during the policy period; (2)The expenses are incurred and reported to us within three years of the date of the accident;and (3)The injured person submits to examination,at our expense,by physicians of our choice as often as we reasonably require. b.We will make these payments regardless of fault.These payments will not exceed the applicable limit of insurance.We will pay reasonable expenses for: (1)First aid administered at the time of an accident; (2)Necessary medical,surgical,x -ray and dental services,including prosthetic devices;and (3)Necessary ambulance,hospital, professional nursing and funeral services. 3.COVERAGE EXTENSION - SUPPLEMENTARY PAYMENTS a.We will pay,with respect to any claim or "suit"we investigate or settle,or any "suit" against an insured we defend: (1)All expenses we incur. (2)Up to $1,000 for the cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which Business Liability Coverage for "bodily injury"applies.We do not have to furnish these bonds. (3)The cost of appeal bonds or bonds to release attachments,but only for bond amounts within the applicable limit of insurance.We do not have to furnish these bonds. (4)All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit",including actual loss of earnings up to $500 a day because of time off from work. (5)All costs taxed against the insured in the "suit". (6)Prejudgment interest awarded against the insured on that part of the judgment we pay.If we make an offer to pay the applicable limit of insurance,we will not pay any prejudgment interest based on that period of time after the offer. (7)All interest on the full amount of any judgment that accrues after entry of the judgment and before we have paid, offered to pay,or deposited in court the part of the judgment that is within the applicable limit of insurance. Any amounts paid under (1)through (7) above will not reduce the limits of insurance. BUSINESS LIABILITY COVERAGE FORM Form SS 00 08 04 05 Page 3 of 24 b.If we defend an insured against a "suit" and an indemnitee of the insured is also named as a party to the "suit",we will defend that indemnitee if all of the following conditions are met: (1)The "suit"against the indemnitee seeks damages for which the insured has assumed the liability of the indemnitee in a contract or agreement that is an "insured contract"; (2)This insurance applies to such liability assumed by the insured; (3)The obligation to defend,or the cost of the defense of,that indemnitee,has also been assumed by the insured in the same "insured contract"; (4)The allegations in the "suit"and the information we know about the "occurrence"are such that no conflict appears to exist between the interests of the insured and the interest of the indemnitee; (5)The indemnitee and the insured ask us to conduct and control the defense of that indemnitee against such "suit" and agree that we can assign the same counsel to defend the insured and the indemnitee;and (6)The indemnitee: (a)Agrees in writing to: (i)Cooperate with us in the investigation,settlement or defense of the "suit"; (ii)Immediately send us copies of any demands,notices, summonses or legal papers received in connection with the "suit"; (iii)Notify any other insurer whose coverage is available to the indemnitee;and (iv)Cooperate with us with respect to coordinating other applicable insurance available to the indemnitee;and (b)Provides us with written authorization to: (i)Obtain records and other information related to the "suit";and (ii)Conduct and control the defense of the indemnitee in such "suit". So long as the above conditions are met, attorneys'fees incurred by us in the defense of that indemnitee,necessary litigation expenses incurred by us and necessary litigation expenses incurred by the indemnitee at our request will be paid as Supplementary Payments. Notwithstanding the provisions of Paragraph 1.b.(b)of Section B.– Exclusions,such payments will not be deemed to be damages for "bodily injury"and "property damage"and will not reduce the Limits of Insurance. Our obligation to defend an insured's indemnitee and to pay for attorneys'fees and necessary litigation expenses as Supplementary Payments ends when: (1)We have used up the applicable limit of insurance in the payment of judgments or settlements;or (2)The conditions set forth above,or the terms of the agreement described in Paragraph (6)above,are no longer met. B.EXCLUSIONS 1.Applicable To Business Liability Coverage This insurance does not apply to: a.Expected Or Intended Injury (1)"Bodily injury"or "property damage" expected or intended from the standpoint of the insured.This exclusion does not apply to "bodily injury"or "property damage"resulting from the use of reasonable force to protect persons or property;or (2)"Personal and advertising injury"arising out of an offense committed by,at the direction of or with the consent or acquiescence of the insured with the expectation of inflicting "personal and advertising injury". b.Contractual Liability (1)"Bodily injury"or "property damage";or (2)"Personal and advertising injury" for which the insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages because of: (a)"Bodily injury","property damage"or "personal and advertising injury"that the insured would have in the absence of the contract or agreement;or BUSINESS LIABILITY COVERAGE FORM Page 4 of 24 Form SS 00 08 04 05 (b)"Bodily injury"or "property damage" assumed in a contract or agreement that is an "insured contract", provided the "bodily injury"or "property damage"occurs subsequent to the execution of the contract or agreement.Solely for the purpose of liability assumed in an "insured contract",reasonable attorneys'fees and necessary litigation expenses incurred by or for a party other than an insured are deemed to be damages because of "bodily injury"or "property damage" provided: (i)Liability to such party for,or for the cost of,that party’s defense has also been assumed in the same "insured contract",and (ii)Such attorneys'fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this insurance applies are alleged. c.Liquor Liability "Bodily injury"or "property damage"for which any insured may be held liable by reason of: (1)Causing or contributing to the intoxication of any person; (2)The furnishing of alcoholic beverages to a person under the legal drinking age or under the influence of alcohol;or (3)Any statute,ordinance or regulation relating to the sale,gift,distribution or use of alcoholic beverages. This exclusion applies only if you are in the business of manufacturing,distributing, selling,serving or furnishing alcoholic beverages. d.Workers'Compensation And Similar Laws Any obligation of the insured under a workers'compensation,disability benefits or unemployment compensation law or any similar law. e.Employer’s Liability "Bodily injury"to: (1)An "employee"of the insured arising out of and in the course of: (a)Employment by the insured;or (b)Performing duties related to the conduct of the insured’s business,or (2)The spouse,child,parent,brother or sister of that "employee"as a consequence of (1)above. This exclusion applies: (1)Whether the insured may be liable as an employer or in any other capacity; and (2)To any obligation to share damages with or repay someone else who must pay damages because of the injury. This exclusion does not apply to liability assumed by the insured under an "insured contract". f.Pollution (1)"Bodily injury","property damage"or "personal and advertising injury" arising out of the actual,alleged or threatened discharge,dispersal, seepage,migration,release or escape of "pollutants": (a)At or from any premises,site or location which is or was at any time owned or occupied by,or rented or loaned to any insured. However,this subparagraph does not apply to: (i)"Bodily injury"if sustained within a building and caused by smoke,fumes,vapor or soot produced by or originating from equipment that is used to heat, cool or dehumidify the building, or equipment that is used to heat water for personal use,by the building's occupants or their guests; (ii)"Bodily injury"or "property damage"for which you may be held liable,if you are a contractor and the owner or lessee of such premises,site or location has been added to your policy as an additional insured with respect to your ongoing operations performed for that additional insured at that premises,site or location and such premises,site or location is not and never was owned or occupied by,or rented or loaned to,any insured,other than that additional insured;or BUSINESS LIABILITY COVERAGE FORM Form SS 00 08 04 05 Page 5 of 24 (iii)"Bodily injury"or "property damage"arising out of heat, smoke or fumes from a "hostile fire"; (b)At or from any premises,site or location which is or was at any time used by or for any insured or others for the handling,storage, disposal,processing or treatment of waste; (c)Which are or were at any time transported,handled,stored, treated,disposed of,or processed as waste by or for: (i)Any insured;or (ii)Any person or organization for whom you may be legally responsible; (d)At or from any premises,site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured's behalf are performing operations if the "pollutants"are brought on or to the premises,site or location in connection with such operations by such insured,contractor or subcontractor.However,this subparagraph does not apply to: (i)"Bodily injury"or "property damage"arising out of the escape of fuels,lubricants or other operating fluids which are needed to perform the normal electrical,hydraulic or mechanical functions necessary for the operation of "mobile equipment"or its parts, if such fuels,lubricants or other operating fluids escape from a vehicle part designed to hold, store or receive them.This exception does not apply if the "bodily injury"or "property damage"arises out of the intentional discharge,dispersal or release of the fuels, lubricants or other operating fluids,or if such fuels, lubricants or other operating fluids are brought on or to the premises,site or location with the intent that they be discharged,dispersed or released as part of the operations being performed by such insured,contractor or subcontractor; (ii)"Bodily injury"or "property damage"sustained within a building and caused by the release of gases,fumes or vapors from materials brought into that building in connection with operations being performed by you or on your behalf by a contractor or subcontractor;or (iii)"Bodily injury"or "property damage"arising out of heat, smoke or fumes from a "hostile fire";or (e)At or from any premises,site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured’s behalf are performing operations if the operations are to test for,monitor,clean up,remove, contain,treat,detoxify or neutralize, or in any way respond to,or assess the effects of,"pollutants". (2)Any loss,cost or expense arising out of any: (a)Request,demand,order or statutory or regulatory requirement that any insured or others test for,monitor, clean up,remove,contain,treat, detoxify or neutralize,or in any way respond to,or assess the effects of, "pollutants";or (b)Claim or suit by or on behalf of a governmental authority for damages because of testing for, monitoring,cleaning up,removing, containing,treating,detoxifying or neutralizing,or in any way responding to,or assessing the effects of,"pollutants". However,this paragraph does not apply to liability for damages because of "property damage"that the insured would have in the absence of such request,demand,order or statutory or regulatory requirement,or such claim or "suit"by or on behalf of a governmental authority. BUSINESS LIABILITY COVERAGE FORM Page 6 of 24 Form SS 00 08 04 05 g.Aircraft,Auto Or Watercraft "Bodily injury"or "property damage"arising out of the ownership,maintenance,use or entrustment to others of any aircraft,"auto" or watercraft owned or operated by or rented or loaned to any insured.Use includes operation and "loading or unloading". This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision,hiring, employment,training or monitoring of others by that insured,if the "occurrence"which caused the "bodily injury"or "property damage"involved the ownership, maintenance,use or entrustment to others of any aircraft,"auto"or watercraft that is owned or operated by or rented or loaned to any insured. This exclusion does not apply to: (1)A watercraft while ashore on premises you own or rent; (2)A watercraft you do not own that is: (a)Less than 51 feet long;and (b)Not being used to carry persons for a charge; (3)Parking an "auto"on,or on the ways next to,premises you own or rent, provided the "auto"is not owned by or rented or loaned to you or the insured; (4)Liability assumed under any "insured contract"for the ownership, maintenance or use of aircraft or watercraft; (5)"Bodily injury"or "property damage" arising out of the operation of any of the equipment listed in Paragraph f.(2) or f.(3)of the definition of "mobile equipment";or (6)An aircraft that is not owned by any insured and is hired,chartered or loaned with a paid crew.However,this exception does not apply if the insured has any other insurance for such "bodily injury"or "property damage",whether the other insurance is primary,excess, contingent or on any other basis. h.Mobile Equipment "Bodily injury"or "property damage" arising out of: (1)The transportation of "mobile equipment" by an "auto"owned or operated by or rented or loaned to any insured;or (2)The use of "mobile equipment"in,or while in practice or preparation for,a prearranged racing,speed or demolition contest or in any stunting activity. i.War "Bodily injury","property damage"or "personal and advertising injury",however caused,arising,directly or indirectly,out of: (1)War,including undeclared or civil war; (2)Warlike action by a military force, including action in hindering or defending against an actual or expected attack,by any government, sovereign or other authority using military personnel or other agents;or (3)Insurrection,rebellion,revolution, usurped power,or action taken by governmental authority in hindering or defending against any of these. j.Professional Services "Bodily injury","property damage"or "personal and advertising injury"arising out of the rendering of or failure to render any professional service.This includes but is not limited to: (1)Legal,accounting or advertising services; (2)Preparing,approving,or failing to prepare or approve maps,shop drawings,opinions,reports,surveys, field orders,change orders,designs or drawings and specifications; (3)Supervisory,inspection,architectural or engineering activities; (4)Medical,surgical,dental,x-ray or nursing services treatment,advice or instruction; (5)Any health or therapeutic service treatment,advice or instruction; (6)Any service,treatment,advice or instruction for the purpose of appearance or skin enhancement,hair removal or replacement or personal grooming; (7)Optical or hearing aid services including the prescribing,preparation, fitting,demonstration or distribution of ophthalmic lenses and similar products or hearing aid devices; BUSINESS LIABILITY COVERAGE FORM Form SS 00 08 04 05 Page 7 of 24 (8)Optometry or optometric services including but not limited to examination of the eyes and the prescribing, preparation,fitting,demonstration or distribution of ophthalmic lenses and similar products; (9)Any: (a)Body piercing (not including ear piercing); (b)Tattooing,including but not limited to the insertion of pigments into or under the skin;and (c)Similar services; (10)Services in the practice of pharmacy; and (11)Computer consulting,design or programming services,including web site design. Paragraphs (4)and (5)of this exclusion do not apply to the Incidental Medical Malpractice coverage afforded under Paragraph 1.e.in Section A.-Coverages. k.Damage To Property "Property damage"to: (1)Property you own,rent or occupy, including any costs or expenses incurred by you,or any other person, organization or entity,for repair, replacement,enhancement, restoration or maintenance of such property for any reason,including prevention of injury to a person or damage to another's property; (2)Premises you sell,give away or abandon,if the "property damage"arises out of any part of those premises; (3)Property loaned to you; (4)Personal property in the care,custody or control of the insured; (5)That particular part of real property on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations,if the "property damage" arises out of those operations;or (6)That particular part of any property that must be restored,repaired or replaced because "your work"was incorrectly performed on it. Paragraphs (1),(3)and (4)of this exclusion do not apply to "property damage"(other than damage by fire)to premises,including the contents of such premises,rented to you for a period of 7 or fewer consecutive days.A separate Limit of Insurance applies to Damage To Premises Rented To You as described in Section D.-Limits Of Insurance. Paragraph (2)of this exclusion does not apply if the premises are "your work"and were never occupied,rented or held for rental by you. Paragraphs (3)and (4)of this exclusion do not apply to the use of elevators. Paragraphs (3),(4),(5)and (6)of this exclusion do not apply to liability assumed under a sidetrack agreement. Paragraphs (3)and (4)of this exclusion do not apply to "property damage"to borrowed equipment while not being used to perform operations at a job site. Paragraph (6)of this exclusion does not apply to "property damage"included in the "products-completed operations hazard". l.Damage To Your Product "Property damage"to "your product" arising out of it or any part of it. m.Damage To Your Work "Property damage"to "your work"arising out of it or any part of it and inc luded in the "products-completed operations hazard". This exclusion does not apply if the damaged work or the work out of which the damage arises was performed on your behalf by a subcontractor. n.Damage To Impaired Property Or Property Not Physically Injured "Property damage"to "impaired property" or property that has not been physically injured,arising out of: (1)A defect,deficiency,inadequacy or dangerous condition in "your product" or "your work";or (2)A delay or failure by you or anyone acting on your behalf to perform a contract or agreement in accordance with its terms. This exclusion does not apply to the loss of use of other property arising out of sudden and accidental physical injury to "your product"or "your work"after it has been put to its intended use. BUSINESS LIABILITY COVERAGE FORM Page 8 of 24 Form SS 00 08 04 05 o.Recall Of Products,Work Or Impaired Property Damages claimed for any loss,cost or expense incurred by you or others for the loss of use,withdrawal,recall,inspection, repair,replacement,adjustment,removal or disposal of: (1)"Your product"; (2)"Your work";or (3)"Impaired property"; if such product,work or property is withdrawn or recalled from the market or from use by any person or organization because of a known or suspected defect, deficiency,inadequacy or dangerous condition in it. p.Personal And Advertising Injury "Personal and advertising injury": (1)Arising out of oral,written or electronic publication of material,if done by or at the direction of the insured with knowledge of its falsity; (2)Arising out of oral,written or electronic publication of material whose first publication took place before the beginning of the policy period; (3)Arising out of a criminal act committed by or at the direction of the insured; (4)Arising out of any breach of contract, except an implied contract to use another’s "advertising idea"in your "advertisement"; (5)Arising out of the failure of goods, products or services to conform with any statement of quality or performance made in your "advertisement"; (6)Arising out of the wrong description of the price of goods,products or services; (7)Arising out of any violation of any intellectual property rights such as copyright,patent,trademark,trade name,trade secret,service mark or other designation of origin or authentic ity. However,this exclusion does not apply to infringement,in your "advertisement",of (a)Copyright; (b)Slogan,unless the slogan is also a trademark,trade name,service mark or other designation of origin or authenticity;or (c)Title of any literary or artistic work; (8)Arising out of an offense committed by an insured whose business is: (a)Advertising,broadcasting, publishing or telecasting; (b)Designing or determining content of web sites for others;or (c)An Internet search,access, content or service provider. However,this exclusion does not apply to Paragraphs a.,b.and c. under the definition of "personal and advertising injury"in Section G.– Liability And Medical Expenses Definitions. For the purposes of this exclusion, placing an "advertisement"for or linking to others on your web site,by itself,is not considered the busines s of advertising,broadcasting, publishing or telecasting; (9)Arising out of an electronic chat room or bulletin board the ins ured hosts, owns,or over which the insured exercises control; (10)Arising out of the unauthorized use of another's name or product in your e-mail address,domain name or metatags,or any other similar tactics to mislead another's potential customers; (11)Arising out of the violation of a person's right of privacy created by any state or federal act. However,this exclusion does not apply to liability for damages that the insured would have in the absence of such state or federal act; (12)Arising out of: (a)An "advertisement"for others on your web site; (b)Placing a link to a web site of others on your web site; (c)Content from a web site of others displayed within a frame or border on your web site.Content includes information,code,sounds,text, graphics or images;or (d)Computer code,software or programming used to enable: (i)Your web site;or (ii)The presentation or functionality of an "advertisement"or other content on your web site; BUSINESS LIABILITY COVERAGE FORM Form SS 00 08 04 05 Page 9 of 24 (13)Arising out of a violation of any anti- trust law; (14)Arising out of the fluctuation in price or value of any stocks,bonds or other securities;or (15)Arising out of discrimination or humiliation committed by or at the direction of any "executive officer", director,stockholder,partner or member of the insured. q.Electronic Data Damages arising out of the loss of,loss of use of,damage to,corruption of,inability to access,or inability to manipulate "electronic data". r.Employment-Related Practices "Bodily injury"or "personal and advertising injury"to: (1)A person arising out of any: (a)Refusal to employ that person; (b)Termination of that person's employment;or (c)Employment-related practices, policies,acts or omissions,such as coercion,demotion,evaluation, reassignment,discipline, defamation,harassment,humiliation or discrimination directed at that person;or (2)The spouse,child,parent,brother or sister of that person as a consequence of "bodily injury"or "personal and advertising injury"to the person at whom any of the employment-related practices described in Paragraphs (a),(b),or (c) above is directed. This exclusion applies: (1)Whether the insured may be liable as an employer or in any other capacity; and (2)To any obligation to share damages with or repay someone else who must pay damages because of the injury. s.Asbestos (1)"Bodily injury","property damage"or "personal and advertising injury" arising out of the "asbestos hazard". (2)Any damages,judgments,settlements, loss,costs or expenses that: (a)May be awarded or incurred by reason of any claim or suit alleging actual or threatened injury or damage of any nature or kind to persons or property which would not have occurred in whole or in part but for the "asbestos hazard"; (b)Arise out of any request,demand, order or statutory or regulatory requirement that any insured or others test for,monitor,clean up, remove,encapsulate,contain, treat,detoxify or neutralize or in any way respond to or assess the effects of an "asbestos hazard";or (c)Arise out of any claim or suit for damages because of testing for, monitoring,cleaning up,removing, encapsulating,containing,treating, detoxifying or neutralizing or in any way responding to or assessing the effects of an "asbestos hazard". t.Violation Of Statutes That Govern E- Mails,Fax,Phone Calls Or Ot her Methods Of Sending Material Or Information "Bodily injury","property damage",or "personal and advertising injury"arising directly or indirectly out of any action or omission that violates or is alleged to violate: (1)The Telephone Consumer Protection Act (TCPA),including any amendment of or addition to such law; (2)The CAN-SPAM Act of 2003,including any amendment of or addition to such law;or (3)Any statute,ordinance or regulation, other than the TCPA or CAN-SPAM Act of 2003,that prohibits or limits the sending,transmitting,communicating or distribution of material or information. Damage To Premises Rented To You – Exception For Damage By Fire,Lightning or Explosion Exclusions c.through h.and k.through o.do not apply to damage by fire,lightning or explosion to premises rented to you or temporarily occupied by you with permission of the owner.A separate Limit of Insurance applies to this coverage as described in Section D.-Liability And Medical Expenses Limits Of Insurance. BUSINESS LIABILITY COVERAGE FORM Page 10 of 24 Form SS 00 08 04 05 2.Applicable To Medical Expenses Coverage We will not pay expenses for "bodily injury": a.Any Insured To any insured,except "volunteer workers". b.Hired Person To a person hired to do work for or on behalf of any insured or a tenant of any insured. c.Injury On Normally Occupied Premises To a person injured on that part of premises you own or rent that the person normally occupies. d.Workers'Compensation And Similar Laws To a person,whether or not an "employee"of any insured,if benefits for the "bodily injury"are payable or must be provided under a workers'compensation or disability benefits law or a similar law. e.Athlet ics Activities To a person injured while practicing, instructing or participating in any physical exercises or games,sports or athletic contests. f.Products-Completed Operations Hazard Included with the "products-completed operations hazard". g.Business Liability Exclusions Excluded under Business Liability Coverage. C.WHO IS AN INSURED 1.If you are designated in the Declarations as: a.An individual,you and your spouse are insureds,but only with respect to the conduct of a business of which you are the sole owner. b.A partnership or joint venture,you are an insured.Your members,your partners,and their spouses are also insureds,but only with respect to the conduct of your business. c.A limited liability company,you are an insured.Your members are also insureds, but only with respect to the conduct of your business.Your managers are insureds,but only with respect to their duties as your managers. d.An organization other than a partnership, joint venture or limited liability company,you are an insured.Your "executive officers"and directors are insureds,but only with respect to their duties as your officers or directors. Your stockholders are also insureds,but only with respect to their liability as stockholders. e.A trust,you are an insured.Your trustees are also insureds,but only with respect to their duties as trustees. 2.Each of the following is also an insured: a.Employees And Volunteer Workers Your "volunteer workers"only while performing duties related to the conduct of your business,or your "employees",other than either your "executive officers"(if you are an organization other than a partnership,joint venture or limited liability company)or your managers (if you are a limited liability company),but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However,none of these "employees"or "volunteer workers"are insureds for: (1)"Bodily injury"or "personal and advertising injury": (a)To you,to your partners or members (if you are a partnership or joint venture),to your members (if you are a limited liability company),or to a co-"employee" while in the course of his or her employment or performing duties related to the conduct of your business,or to your other "volunteer workers"while performing duties related to the conduct of your business; (b)To the spouse,child,parent, brother or sister of that co- "employee"or that "volunteer worker"as a consequence of Paragraph (1)(a)above; (c)For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1)(a)or (b)above;or (d)Arising out of his or her providing or failing to provide professional health care services. If you are not in the business of providing professional health care services,Paragraph (d)does not apply to any nurse,emergency medical technician or paramedic employed by you to provide such services. (2)"Property damage"to property: (a)Owned,occupied or used by, BUSINESS LIABILITY COVERAGE FORM Form SS 00 08 04 05 Page 11 of 24 (b)Rented to,in the care,custody or control of,or over which physical control is being exercised for any purpose by you,any of your "employees","volunteer workers", any partner or member (if you are a partnership or joint venture),or any member (if you are a limited liability company). b.Real Estate Manager Any person (other than your "employee"or "volunteer worker"),or any organization while acting as your real estate manager. c.Temporary Custodians Of Your Property Any person or organization having proper temporary custody of your property if you die,but only: (1)With respect to liability arising out of the maintenance or use of that property;and (2)Until your legal representative has been appointed. d.Legal Representative If You Die Your legal representative if you die,but only with respect to duties as such.That representative will have all your rights and duties under this insurance. e.Unnamed Subsidiary Any subsidiary and subsidiary thereof,of yours which is a legally incorporated entity of which you own a financial interest of more than 50%of the voting stock on the effective date of this Coverage Part. The insurance afforded herein for any subsidiary not shown in the Declarations as a named insured does not apply to injury or damage with respect to which an insured under this insurance is also an insured under another policy or would be an insured under such policy but for its termination or upon the exhaustion of its limits of insurance. 3.Newly Acquired Or Formed Organization Any organization you newly acquire or form, other than a partnership,joint venture or limited liability company,and over which you maintain financial interest of more than 50%of the voting stock,will qualify as a Named Insured if there is no other similar insurance available to that organization.However: a.Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period,whichever is earlier;and b.Coverage under this provision does not apply to: (1)"Bodily injury"or "property damage" that occurred;or (2)"Personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. 4.Operator Of Mobile Equipment With respect to "mobile equipment"registered in your name under any motor vehicle registration law,any person is an insured while driving such equipment along a public highway with your permission.Any other person or organization responsible for the conduct of such person is also an insured,but only with respect to liability arising out of the operation of the equipment,and only if no other insurance of any kind is available to that person or organization for this liability. However,no person or organization is an insured with respect to: a."Bodily injury"to a co-"employee"of the person driving the equipment;or b."Property damage"to property owned by, rented to,in the charge of or occupied by you or the employer of any person who is an insured under this provision. 5.Operator of Nonowned Watercraft With respect to watercraft you do not own that is less than 51 feet long and is not being used to carry persons for a charge,any person is an insured while operating such watercraft with your permission.Any other person or organization responsible for the conduct of such person is also an insured,but only with respect to liability arising out of the operation of the watercraft,and only if no other insurance of any kind is available to that person or organization for this liability. However,no person or organization is an insured with respect to: a."Bodily injury"to a co-"employee"of the person operating the watercraft;or b."Property damage"to property owned by, rented to,in the charge of or occupied by you or the employer of any person who is an insured under this provision. 6.Additional Insureds When Required By Written Contract,Written Agreement Or Permit The person(s)or organization(s)identified in Paragraphs a.through f.below are additional insureds when you have agreed,in a written BUSINESS LIABILITY COVERAGE FORM Page 12 of 24 Form SS 00 08 04 05 contract,written agreement or because of a permit issued by a state or political subdivision,that such person or organization be added as an additional insured on your policy,provided the injury or damage occurs subsequent to the execution of the contract or agreement,or the issuance of the permit. A person or organization is an additional insured under this provision only for that period of time required by the contract, agreement or permit. However,no such person or organization is an additional insured under this provision if such person or organization is included as an additional insured by an endorsement issued by us and made a part of this Coverage Part, including all persons or organizations added as additional insureds under the specific additional insured coverage grants in Section F.–Optional Additional Insured Coverages. a.Vendors Any person(s)or organization(s)(referred to below as vendor),but only with respect to "bodily injury"or "property damage"arising out of "your products"which are distributed or sold in the regular course of the vendor's business and only if this Coverage Part provides coverage for "bodily injury"or "property damage"included within the "products-completed operations hazard". (1)The ins urance afforded to the vendor is subject to the following additional exclusions: This insurance does not apply to: (a)"Bodily injury"or "property damage"for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; (b)Any express warranty unauthorized by you; (c)Any physical or chemical change in the product made intentionally by the vendor; (d)Repackaging,except when unpacked solely for the purpose of inspection,demonstration,testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; (e)Any failure to make such inspections,adjustments,tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business,in connection with the distribution or sale of the products; (f)Demonstration,installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; (g)Products which,after distribution or sale by you,have been labeled or relabeled or used as a container,part or ingredient of any other thing or substance by or for the vendor;or (h)"Bodily injury"or "property damage"arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf.However,this exclusion does not apply to: (i)The exceptions contained in Subparagraphs (d)or (f);or (ii)Such inspections,adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business,in connection with the distribution or sale of the products. (2)This insurance does not apply to any insured person or organization from whom you have acquired such products, or any ingredient,part or container, entering into,accompanying or containing such products. b.Lessors Of Equipment (1)Any person or organization from whom you lease equipment;but only with respect to their liability for "bodily injury","property damage"or "personal and advertis ing injury" caused,in whole or in part,by your maintenance,operation or use of equipment leased to you by such person or organization. BUSINESS LIABILITY COVERAGE FORM Form SS 00 08 04 05 Page 13 of 24 (2)With respect to the insurance afforded to these additional insureds,this insurance does not apply to any "occurrence"which takes place after you cease to lease that equipment. c.Lessors Of Land Or Premises (1)Any person or organization from whom you lease land or premis es,but only with respect to liability arising out of the ownership,maintenance or use of that part of the land or premises leased to you. (2)With respect to the insurance afforded to these additional insureds,this insurance does not apply to: (a)Any "occurrence"which takes place after you cease to lease that land or be a tenant in that premises;or (b)Structural alterations,new construction or demolition operations performed by or on behalf of such person or organization. d.Architects,Engineers Or Surveyors (1)Any architect,engineer,or surveyor,but only with respect to liability for "bodily injury","property damage"or "personal and advertising injury"caused,in whole or in part,by your acts or omissions or the acts or omissions of those acting on your behalf: (a)In connection with your premises; or (b)In the performance of your ongoing operations performed by you or on your behalf. (2)With respect to the insurance afforded to these additional insureds,the following additional exclusion applies: This insurance does not apply to "bodily injury","property damage"or "personal and advertising injury" arising out of the rendering of or the failure to render any professional services by or for you,including: (a)The preparing,approving,or failure to prepare or approve, maps,shop drawings,opinions, reports,surveys,field orders, change orders,designs or drawings and specifications;or (b)Supervisory,inspection, architectural or engineering activities. e.Permits Issued By State Or Political Subdivisions (1)Any state or political subdivision,but only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit. (2)With respect to the insurance afforded to these additional insureds,this insurance does not apply to: (a)"Bodily injury","property damage" or "personal and advertising injury"arising out of operations performed for the state or municipality;or (b)"Bodily injury"or "property damage" included within the "products- completed operations hazard". f.Any Other Party (1)Any other person or organization who is not an insured under Paragraphs a. through e.above,but only with respect to liability for "bodily injury", "property damage"or "personal and advertising injury"caused,in whole or in part,by your acts or omissions or the acts or omissions of those acting on your behalf: (a)In the performance of your ongoing operations; (b)In connection with your premises owned by or rented to you;or (c)In connection with "your work"and included within the "products- completed operations hazard",but only if (i)The written contract or written agreement requires you to provide such coverage to such additional insured;and (ii)This Coverage Part provides coverage for "bodily injury"or "property damage"included within the "products- completed operations hazard". (2)With respect to the insurance afforded to these additional insureds,this insurance does not apply to: "Bodily injury","property damage"or "personal and advertising injury" arising out of the rendering of,or the failure to render,any professional architectural,engineering or surveying services,including: BUSINESS LIABILITY COVERAGE FORM Page 14 of 24 Form SS 00 08 04 05 (a)The preparing,approving,or failure to prepare or approve, maps,shop drawings,opinions, reports,surveys,field orders, change orders,designs or drawings and specifications;or (b)Supervisory,inspection, architectural or engineering activities. The limits of insurance that apply to additional insureds are described in Section D.–Limits Of Insurance. How this insurance applies when other insurance is available to an additional insured is described in the Other Insurance Condition in Section E.–Liability And Medical Expenses General Conditions. No person or organization is an insured with respect to the conduct of any current or past partnership,joint venture or limited liability company that is not shown as a Named Insured in the Declarations. D.LIABILITY AND MEDICAL EXPENSES LIMITS OF INSURANCE 1.The Most We Will Pay The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of: a.Insureds; b.Claims made or "suits"brought;or c.Persons or organizations making claims or bringing "suits". 2.Aggregate Limits The most we will pay for: a.Damages because of "bodily injury"and "property damage"included in the "products-completed operations hazard"is the Products-Completed Operations Aggregate Limit shown in the Declarations. b.Damages because of all other "bodily injury","property damage"or "personal and advertising injury",including medical expenses,is the General Aggregate Limit shown in the Declarations. This General Aggregate Limit applies separately to each of your "locations" owned by or rented to you. "Location"means premises involving the same or connecting lots,or premises whose connection is interrupted only by a street,roadway or right-of-way of a railroad. This General Aggregate limit does not apply to "property damage"to premises while rented to you or temporarily occupied by you with permission of the owner,arising out of fire,lightning or explosion. 3.Each Occurrence Limit Subject to 2.a.or 2.b above,whichever applies,the most we will pay for the sum of all damages because of all "bodily injury", "property damage"and medical expenses arising out of any one "occur rence"is the Liability and Medical Expenses Limit shown in the Declarations. The most we will pay for all medical expenses because of "bodily injury"sustained by any one person is the Medical Expenses Limit shown in the Declarations. 4.Personal And Advertising Injury Limit Subject to 2.b.above,the most we will pay for the sum of all damages because of all "personal and advertising injury"sustained by any one person or organization is the Personal and Advertising Injury Limit shown in the Declarations. 5.Damage To Premises Rented To You Limit The Damage To Premises Rented To You Limit is the most we will pay under Business Liability Coverage for damages because of "property damage"to any one premis es,while rented to you,or in the case of damage by fire, lightning or explosion,while rented to you or temporarily occupied by you with permission of the owner. In the case of damage by fire,lightning or explosion,the Damage to Premises Rented To You Limit applies to all damage proximately caused by the same event,whether such damage results from fire,lightning or explosion or any combination of these. 6.How Limits Apply To Additional Insureds The most we will pay on behalf of a person or organization who is an additional insured under this Coverage Part is the lesser of: a.The limits of insurance specified in a written contract,written agreement or permit issued by a state or political subdivision;or b.The Limits of Insurance shown in the Declarations. Such amount shall be a part of and not in addition to the Limits of Insurance shown in the Declarations and described in this Section. BUSINESS LIABILITY COVERAGE FORM Form SS 00 08 04 05 Page 15 of 24 If more than one limit of insurance under this policy and any endorsements attached thereto applies to any claim or "suit",the most we will pay under this policy and the endorsements is the single highest limit of liability of all coverages applicable to such claim or "suit".However,this paragraph does not apply to the Medical Expenses limit set forth in Paragraph 3.above. The Limits of Insurance of this Coverage Part apply separately to each consecutive annual period and to any remaining period of less than 12 months,starting with the beginning of the policy period shown in the Declarations,unless the policy period is extended after issuance for an additional period of less than 12 months.In that case,the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. E.LIABILITY AND MEDICAL EXPENSES GENERAL CONDITIONS 1.Bankruptcy Bankruptcy or insolvency of the insured or of the insured's estate will not relieve us of our obligations under this Coverage Part. 2.Duties In The Event Of Occurrence, Offense,Claim Or Suit a.Notice Of Occurrence Or Offense You or any additional insured must see to it that we are notified as soon as practicable of an "occurrence"or an offense which may result in a claim.To the extent possible,notice should include: (1)How,when and where the "occurrence" or offense took place; (2)The names and addresses of any injured persons and witnesses;and (3)The nature and location of any injury or damage arising out of the "occurrence"or offense. b.Notice Of Claim If a claim is made or "suit"is brought against any insured,you or any additional insured must: (1)Immediately record the specifics of the claim or "suit"and the date received; and (2)Notify us as soon as practicable. You or any additional insured must see to it that we receive a written notice of the claim or "s uit"as soon as practicable. c.Assistance And Cooperation Of The Insured You and any other involved insured must: (1)Immediately send us copies of any demands,notices,summonses or legal papers received in connection with the claim or "suit"; (2)Authorize us to obtain records and other information; (3)Cooperate with us in the investigation, settlement of the claim or defense against the "suit";and (4)Assist us,upon our request,in the enforcement of any right against any person or organization that may be liable to the insured because of injury or damage to which this insurance may also apply. d.Obligations At The Insured's Own Cost No insured will,except at that insured's own cost,voluntarily make a payment,assume any obligation,or incur any expense,other than for first aid,without our consent. e.Additional Insured's Other Insurance If we cover a claim or "suit"under this Coverage Part that may also be covered by other insurance available to an additional insured,such additional insured must submit such claim or "suit"to the other insurer for defense and indemnity . However,this provision does not apply to the extent that you have agreed in a written contract,written agreement or permit that this insurance is primary and non-contributory with the additional insured's own insurance. f.Knowledge Of An Occurrence,Offense, Claim Or Suit Paragraphs a.and b.apply to you or to any additional insured only when such "occurrence",offense,claim or "suit"is known to: (1)You or any additional insured that is an individual; (2)Any partner,if you or an additional insured is a partnership; (3)Any manager,if you or an additional insured is a limited liability company; (4)Any "executive officer"or insurance manager,if you or an additional insured is a corporation; (5)Any trustee,if you or an additional insured is a trust;or (6)Any elected or appointed offic ial,if you or an additional insured is a political subdivision or public entity. BUSINESS LIABILITY COVERAGE FORM Page 16 of 24 Form SS 00 08 04 05 This Paragraph f.applies separately to you and any additional insured. 3.Financial Responsibility Laws a.When this policy is certified as proof of financial responsibility for the future under the provisions of any motor vehic le financial responsibility law,the insurance provided by the policy for "bodily injury" liability and "property damage"liability will comply with the provisions of the law to the extent of the coverage and limits of insurance required by that law. b.With respect to "mobile equipment"to which this insurance applies,we will provide any liability,uninsured motorists, underinsured motorists,no-fault or other coverage required by any motor vehic le law.We will provide the required limits for those coverages. 4.Legal Action Against Us No person or organization has a right under this Coverage Form: a.To join us as a party or otherwise bring us into a "s uit"asking for damages from an insured;or b.To sue us on this Coverage Form unless all of its terms have been fully complied with. A person or organization may sue us to recover on an agreed settlement or on a final judgment against an insured;but we will not be liable for damages that are not payable under the terms of this insurance or that are in excess of the applicable limit of insurance.An agreed settlement means a settlement and release of liability signed by us,the insured and the claimant or the claimant's legal representative. 5.Separation Of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this policy to the first Named Insured,this insurance applies: a.As if each Named Insured were the only Named Insured;and b.Separately to each insured against whom a claim is made or "suit"is brought. 6.Representations a.When You Accept This Policy By accepting this policy,you agree: (1)The statements in the Declarations are accurate and complete; (2)Those statements are based upon representations you made to us;and (3)We have issued this policy in reliance upon your representations. b.Unintentional Failure To Disclose Hazards If unintentionally you should fail to disclose all hazards relating to the conduct of your business at the inception date of this Coverage Part,we shall not deny any coverage under this Coverage Part because of such failure. 7.Other Insurance If other valid and collectible insurance is available for a loss we cover under this Coverage Part,our obligations are limited as follows: a.Primary Insurance This insurance is primary except when b. below applies.If other insurance is also primary,we will share with all that other insurance by the method described in c. below. b.Excess Insurance This insurance is excess over any of the other insurance,whether primary,excess, contingent or on any other basis: (1)Your Work That is Fire,Extended Coverage, Builder's Risk,Installation Risk or similar coverage for "your work"; (2)Premises Rented To You That is fire,lightning or explosion insurance for premises rented to you or temporarily occupied by you with permission of the owner; (3)Tenant Liability That is insurance purchased by you to cover your liability as a tenant for "property damage"to premises rented to you or temporarily occupied by you with permission of the owner; (4)Aircraft,Auto Or Watercraft If the loss arises out of the maintenance or use of aircraft,"autos"or watercraft to the extent not subject to Exclusion g.of Section A.–Coverages. (5)Property Damage To Borrowed Equipment Or Use Of Elevators If the loss arises out of "property damage"to borrowed equipment or the use of elevators to the extent not subject to Exclusion k.of Section A.– Coverages. BUSINESS LIABILITY COVERAGE FORM Form SS 00 08 04 05 Page 17 of 24 (6)When You Are Added As An Additional Insured To Other Insurance That is other insurance available to you covering liability for damages arising out of the premises or operations,or products and completed operations,for which you have been added as an additional insured by that insurance;or (7)When You Add Others As An Additional Insured To This Insurance That is other insurance available to an additional ins ured. However,the following provis ions apply to other insurance available to any person or organization who is an additional insured under this Coverage Part: (a)Primary Insurance When Required By Contract This insurance is primary if you have agreed in a written contract, written agreement or permit that this insurance be primary.If other insurance is also primary,we will share with all that other insurance by the method described in c. below. (b)Primary And Non-Contributory To Other Insurance When Required By Contract If you have agreed in a written contract,written agreement or permit that this insurance is primary and non-contributory with the additional insured's own insurance,this insurance is primary and we will not seek contribution from that other insurance. Paragraphs (a)and (b)do not apply to other insurance to which the additional insured has been added as an additional ins ured. When this insurance is excess,we will have no duty under this Coverage Part to defend the insured against any "suit"if any other insurer has a duty to defend the insured against that "suit".If no other insurer defends,we will undertake to do so,but we will be entitled to the insured's rights against all those other insurers. When this insurance is excess over other insurance,we will pay only our share of the amount of the loss,if any,that exceeds the sum of: (1)The total amount that all such other insurance would pay for the loss in the absence of this insurance;and (2)The total of all deductible and self- insured amounts under all that other insurance. We will share the remaining loss,if any,with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c.Method Of Sharing If all the other insurance permits contribution by equal shares,we will follow this method also.Under this approach, each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares,we will contribute by limits.Under this method,each insurer’s share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. 8.Transfer Of Rights Of Recovery Against Others To Us a.Transfer Of Rights Of Recovery If the insured has rights to recover all or part of any payment,including Supplementary Payments,we have made under this Coverage Part,those rights are transferred to us.The insured must do nothing after loss to impair them.At our request,the insured will bring "suit"or transfer those rights to us and help us enforce them.This condition does not apply to Medical Expenses Coverage. b.Waiver Of Rights Of Recovery (Waiver Of Subrogation) If the insured has waived any rights of recovery against any person or organization for all or part of any payment, including Supplementary Payments,we have made under this Coverage Part,we also waive that right,provided the insured waived their rights of recovery against such person or organization in a contract, agreement or permit that was executed prior to the injury or damage. BUSINESS LIABILITY COVERAGE FORM Page 18 of 24 Form SS 00 08 04 05 F.OPTIONAL ADDITIONAL INSURED COVERAGES If listed or shown as applicable in the Declarations, one or more of the following Optional Additional Insured Coverages als o apply.When any of these Optional Additional Insured Coverages apply, Paragraph 6.(Additional Insureds When Required by Written Contract,Written Agreement or Permit) of Section C.,Who Is An Insured,does not apply to the person or organization shown in the Declarations.These coverages are subject to the terms and conditions applicable to Business Liability Coverage in this policy,except as provided below: 1.Additional Insured -Designated Person Or Organization WHO IS AN INSURED under Section C.is amended to include as an additional insured the person(s)or organization(s)shown in the Declarations,but only with respect to liability for "bodily injury","property damage"or "personal and advertising injury"caused,in whole or in part,by your acts or omissions or the acts or omissions of those acting on your behalf: a.In the performance of your ongoing operations;or b.In connection with your premises owned by or rented to you. 2.Additional Insured -Managers Or Lessors Of Premises a.WHO IS AN INSURED under Section C.is amended to include as an additional insured the person(s)or organization(s)shown in the Declarations as an Additional Insured - Designated Person Or Organization;but only with respect to liability arising out of the ownership,maintenance or use of that part of the premises leased to you and shown in the Declarations. b.With respect to the insurance afforded to these additional insureds,the following additional exclusions apply: This insurance does not apply to: (1)Any "occurrence"which takes place after you cease to be a tenant in that premises;or (2)Structural alterations,new construction or demolition operations performed by or on behalf of such person or organization. 3.Additional Insured -Grantor Of Franchise WHO IS AN INSURED under Section C.is amended to include as an additional insured the person(s)or organization(s)shown in the Declarations as an Additional Insured - Grantor Of Franchise,but only with respect to their liability as grantor of franchise to you. 4.Additional Insured -Lessor Of Leased Equipment a.WHO IS AN INSURED under Section C.is amended to include as an additional insured the person(s)or organization(s) shown in the Declarations as an Additional Insured –Lessor of Leased Equipment, but only with respect to liability for "bodily injury","property damage"or "personal and advertising injury"caused,in whole or in part,by your maintenance,operation or use of equipment leased to you by such person(s)or organization(s). b.With respect to the insurance afforded to these additional insureds,this insurance does not apply to any "occurrence"which takes place after you cease to lease that equipment. 5.Additional Insured -Owners Or Ot her Interests From Whom Land Has Been Leased a.WHO IS AN INSURED under Section C.is amended to include as an additional insured the person(s)or organization(s) shown in the Declarations as an Additional Insured –Owners Or Other Interests From Whom Land Has Been Leased,but only with respect to liability arising out of the ownership,maintenance or use of that part of the land leased to you and shown in the Declarations. b.With respect to the insurance afforded to these additional insureds,the following additional exclusions apply: This insurance does not apply to: (1)Any "occurrence"that takes place after you cease to lease that land;or (2)Structural alterations ,new construction or demolition operations performed by or on behalf of such person or organization. 6.Additional Insured -State Or Political Subdivision –Permits a.WHO IS AN INSURED under Section C.is amended to include as an additional insured the state or political subdivision shown in the Declarations as an Additional BUSINESS LIABILITY COVERAGE FORM Form SS 00 08 04 05 Page 19 of 24 Insured –State Or Political Subdivision - Permits,but only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit. b.With respect to the insurance afforded to these additional insureds,the following additional exclusions apply: This insurance does not apply to: (1)"Bodily injury","property damage"or "personal and advertising injury" arising out of operations performed for the state or municipality;or (2)"Bodily injury"or "property damage" included in the "product-completed operations"hazard. 7.Additional Insured –Vendors a.WHO IS AN INSURED under Section C.is amended to include as an additional insured the person(s)or organization(s) (referred to below as vendor)shown in the Declarations as an Additional Insured - Vendor,but only with respect to "bodily injury"or "property damage"arising out of "your products"which are distributed or sold in the regular course of the vendor's business and only if this Coverage Part provides coverage for "bodily injury"or "property damage"included within the "products-completed operations hazard". b.The insurance afforded to the vendor is subject to the following additional exclusions: (1)This insurance does not apply to: (a)"Bodily injury"or "property damage"for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; (b)Any express warranty unauthorized by you; (c)Any physical or chemical change in the product made intentionally by the vendor; (d)Repackaging,unless unpacked solely for the purpose of inspection, demonstration,testing,or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; (e)Any failure to make such inspections,adjustments,tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business,in connection with the distribution or sale of the products; (f)Demonstration,installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; (g)Products which,after distribution or sale by you,have been labeled or relabeled or used as a container,part or ingredient of any other thing or substance by or for the vendor;or (h)"Bodily injury"or "property damage"arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf.However,this exclusion does not apply to: (i)The exceptions contained in Subparagraphs (d)or (f);or (ii)Such inspections, adjustments,tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business,in connection with the distribution or sale of the products. (2)This insurance does not apply to any insured person or organization from whom you have acquired such products,or any ingredient,part or container,entering into, accompanying or containing such products. 8.Additional Insured –Controlling Interest WHO IS AN INSURED under Section C.is amended to include as an additional insured the person(s)or organization(s)shown in the Declarations as an Additional Insured – Controlling Interest,but only with respect to their liability arising out of: a.Their financial control of you;or b.Premises they own,maintain or control while you lease or occupy these premises. BUSINESS LIABILITY COVERAGE FORM Page 20 of 24 Form SS 00 08 04 05 This insurance does not apply to structural alterations,new construction and demolition operations performed by or for that person or organization. 9.Additional Insured –Owners,Lessees Or Contractors –Scheduled Person Or Organization a.WHO IS AN INSURED under Section C.is amended to include as an additional insured the person(s)or organization(s) shown in the Declarations as an Additional Insured –Owner,Lessees Or Contractors, but only with respect to liability for "bodily injury","property damage"or "personal and advertising injury"caused,in whole or in part,by your acts or omissions or the acts or omissions of those acting on your behalf: (1)In the performance of your ongoing operations for the additional insured(s);or (2)In connection with "your work" performed for that additional insured and included within the "products- completed operations hazard",but only if this Coverage Part provides coverage for "bodily injury"or "property damage"included within the "products-completed operations hazard". b.With respect to the insurance afforded to these additional insureds,this insurance does not apply to "bodily injury","property damage"or "personal an advertising injury"arising out of the rendering of,or the failure to render,any professional architectural,engineering or surveying services,including: (1)The preparing,approving,or failure to prepare or approve,maps,shop drawings,opinions,reports,surveys, field orders,change orders,designs or drawings and specifications;or (2)Supervisory,inspection,architectural or engineering activities. 10.Additional Insured –Co-Owner Of Insured Premises WHO IS AN INSURED under Section C.is amended to include as an additional insured the person(s)or Organization(s)shown in the Declarations as an Additional Insured –Co- Owner Of Insured Premises,but only with respect to their liability as co-owner of the premises shown in the Declarations. The limits of insurance that apply to additional insureds are described in Section D.–Limits Of Insurance. How this insurance applies when other insurance is available to an additional insured is described in the Other Insurance Condition in Section E.– Liability And Medical Expenses General Conditions. G.LIABILITY AND MEDICAL EXPENSES DEFINITIONS 1."Advertisement"means the widespread public dissemination of information or images that has the purpose of inducing the sale of goods, products or services through: a.(1)Radio; (2)Television; (3)Billboard; (4)Magazine; (5)Newspaper; b.The Internet,but only that part of a web site that is about goods,products or services for the purposes of inducing the sale of goods,products or services;or c.Any other publication that is given widespread public distribution. However,"advertisement"does not include: a.The design,printed material,information or images contained in,on or upon the packaging or labeling of any goods or products;or b.An interactive conversation between or among persons through a computer network. 2."Advertising idea"means any idea for an "advertisement". 3."Asbestos hazard"means an exposure or threat of exposure to the actual or alleged properties of asbestos and includes the mere presence of asbestos in any form. 4."Auto"means a land motor vehicle,trailer or semi-trailer designed for travel on public roads,including any attached machinery or equipment.But "auto"does not include "mobile equipment". 5."Bodily injury"means physical: a.Injury; b.Sickness;or c.Disease sustained by a person and,if arising out of the above,mental anguish or death at any time. 6."Coverage territory"means: BUSINESS LIABILITY COVERAGE FORM Form SS 00 08 04 05 Page 21 of 24 a.The United States of America (including its territories and possessions),Puerto Rico and Canada; b.International waters or airspace,but only if the injury or damage occurs in the course of travel or transportation between any places included in a.above; c.All other parts of the world if the injury or damage arises out of: (1)Goods or products made or sold by you in the territory described in a.above; (2)The activities of a person whose home is in the territory described in a. above,but is away for a short time on your business;or (3)"Personal and advertising injury" offenses that take place through the Internet or similar electronic means of communication provided the insured's responsibility to pay damages is determined in the United States of America (including its territories and possessions),Puerto Rico or Canada,in a "suit"on the merits according to the substantive law in such territory,or in a settlement we agree to. 7."Electronic data"means information,facts or programs: a.Stored as or on; b.Created or used on;or c.Transmitted to or from computer software,including systems and applications software,hard or floppy disks, CD-ROMS,tapes,drives,cells,data processing devices or any other media which are used with electronically controlled equipment. 8."Employee"includes a "leased worker". "Employee"does not include a "temporary worker". 9."Executive officer"means a person holding any of the officer positions created by your charter,constitution,by-laws or any other similar governing document. 10."Hostile fire"means one which becomes uncontrollable or breaks out from where it was intended to be. 11."Impaired property"means tangible property, other than "your product"or "your work",that cannot be used or is less useful because: a.It incorporates "your product"or "your work" that is known or thought to be defective, deficient,inadequate or dangerous;or b.You have failed to fulfill the terms of a contract or agreement; if such property can be restored to use by: a.The repair,replacement,adjustment or removal of "your product"or "your work"; or b.Your fulfilling the terms of the contract or agreement. 12."Insured contract"means: a.A contract for a lease of premises. However,that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning or explosion to premises while rented to you or temporarily occupied by you with permission of the owner is subject to the Damage To Premises Rented To You limit described in Section D.–Liability and Medical Expenses Limits of Insurance. b.A sidetrack agreement; c.Any easement or license agreement, including an easement or license agreement in connection with construction or demolition operations on or within 50 feet of a railroad; d.Any obligation,as required by ordinance, to indemnify a municipality,except in connection with work for a municipality ; e.An elevator maintenance agreement;or f.That part of any other contract or agreement pertaining to your business (including an indemnification of a municipality in connection with work performed for a municipality)under which you assume the tort liability of another party to pay for "bodily injury"or "property damage"to a third person or organization, provided the "bodily injury"or "property damage"is caused,in whole or in part,by you or by those acting on your behalf. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f.includes that part of any contract or agreement that indemnifies a railroad for "bodily injury"or "property damage"arising out of construction or demolition operations within 50 feet of any railroad property and affecting any railroad bridge or trestle,tracks,road-beds,tunnel, underpass or crossing. However,Paragraph f.does not include that part of any contract or agreement: BUSINESS LIABILITY COVERAGE FORM Page 22 of 24 Form SS 00 08 04 05 (1)That indemnifies an architect, engineer or surveyor for injury or damage arising out of: (a)Preparing,approving or failing to prepare or approve maps,shop drawings,opinions,reports, surveys,field orders,change orders,designs or drawings and specifications;or (b)Giving directions or instructions, or failing to give them,if that is the primary cause of the injury or damage;or (2)Under which the insured,if an architect,engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failure to render professional services,including those lis ted in (1)above and supervisory, inspection,architectural or engineering activities. 13."Leased worker"means a person leased to you by a labor leasing firm under an agreement between you and the labor leasing firm,to perform duties related to the conduct of your business."Leased worker"does not include a "temporary worker". 14."Loading or unloading"means the handling of property: a.After it is moved from the place where it is accepted for movement into or onto an aircraft,watercraft or "auto"; b.While it is in or on an aircraft,watercraft or "auto";or c.While it is being moved from an aircraft, watercraft or "auto"to the place where it is finally delivered; but "loading or unloading"does not include the movement of property by means of a mechanical device,other than a hand truck,that is not attached to the aircraft,watercraft or "auto". 15."Mobile equipment"means any of the following types of land vehicles,including any attached machinery or equipment: a.Bulldozers,farm machinery,forklifts and other vehicles designed for use principally off public roads; b.Vehicles maintained for use solely on or next to premises you own or rent; c.Vehicles that travel on crawler treads; d.Vehicles,whether self-propelled or not,on which are permanently mounted: (1)Power cranes,shovels,loaders, diggers or drills;or (2)Road construction or resurfacing equipment such as graders,scrapers or rollers; e.Vehicles not described in a.,b.,c.,or d. above that are not self-propelled and are maintained primarily to provide mobility to permanently attached equipment of the following types: (1)Air compressors,pumps and generators,including spraying, welding,building cleaning, geophysical exploration,lighting and well servicing equipment;or (2)Cherry pickers and similar devices used to raise or lower workers; f.Vehicles not described in a.,b.,c.,or d. above maintained primarily for purposes other than the transportation of persons or cargo. However,self-propelled vehicles with the following types of permanently attached equipment are not "mobile equipment"but will be considered "autos": (1)Equipment,of at least 1,000 pounds gross vehicle weight,designed primarily for: (a)Snow removal; (b)Road maintenance,but not construction or resurfacing;or (c)Street cleaning; (2)Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers;and (3)Air compressors,pumps and generators,including spraying, welding,building cleaning, geophysical exploration,lighting and well servicing equipment. 16."Occurrence"means an accident,including continuous or repeated exposure to substantially the same general harmful conditions. 17."Personal and advertising injury"means injury, including consequential "bodily injury",arising out of one or more of the following offenses: a.False arrest,detention or impris onment; b.Malicious prosecution; BUSINESS LIABILITY COVERAGE FORM Form SS 00 08 04 05 Page 23 of 24 c.The wrongful eviction from,wrongful entry into,or invasion of the right of private occupancy of a room,dwelling or premises that the person occupies, committed by or on behalf of its owner, landlord or lessor; d.Oral,written or electronic publication of material that slanders or libels a person or organization or disparages a person's or organization's goods,products or services; e.Oral,written or electronic publication of material that violates a person's right of privacy; f.Copying,in your "advertisement",a person’s or organization’s "advertising idea"or style of "advertisement"; g.Infringement of copyright,slogan,or title of any literary or artistic work,in your "advertisement";or h.Discrimination or humiliation that results in injury to the feelings or reputation of a natural person. 18."Pollutants"means any solid,liquid,gaseous or thermal irritant or contaminant,including smoke, vapor,soot,fumes,acids,alkalis,chemicals and waste.Waste includes materials to be recycled, reconditioned or reclaimed. 19."Products-completed operations hazard"; a.Includes all "bodily injury"and "property damage"occurring away from premises you own or rent and arising out of "your product"or "your work"except: (1)Products that are still in your physical possession;or (2)Work that has not yet been completed or abandoned.However,"your work" will be deemed to be completed at the earliest of the following times: (a)When all of the work called for in your contract has been completed. (b)When all of the work to be done at the job site has been completed if your contract calls for work at more than one job site. (c)When that part of the work done at a job site has been put to its intended use by any person or organization other than another contractor or subcontractor working on the same projec t. Work that may need service,maintenance, correction,repair or replacement,but which is otherwise complete,will be treated as completed. The "bodily injury"or "property damage" must occur away from premises you own or rent,unless your business includes the selling,handling or distribution of "your product"for consumption on premises you own or rent. b.Does not include "bodily injury"or "property damage"arising out of: (1)The transportation of property,unless the injury or damage arises out of a condition in or on a vehicle not owned or operated by you,and that condition was created by the "loading or unloading"of that vehicle by any insured;or (2)The existence of tools,uninstalled equipment or abandoned or unused materials. 20."Property damage"means: a.Physical injury to tangible property, including all resulting loss of use of that property.All such loss of use shall be deemed to occur at the time of the physical injury that caused it;or b.Loss of use of tangible property that is not physically injured.All such loss of use shall be deemed to occur at the time of "occurrence"that caused it. As used in this definition,"electronic data"is not tangible property. 21."Suit"means a civil proceeding in which damages because of "bodily injury","property damage"or "personal and advertising injury" to which this insurance applies are alleged. "Suit"includes: a.An arbitration proceeding in which such damages are claimed and to which the insured must submit or does submit with our consent;or b.Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent. 22."Temporary worker"means a person who is furnished to you to substitute for a permanent "employee"on leave or to meet seasonal or short-term workload conditions. 23."Volunteer worker"means a person who: a.Is not your "employee"; BUSINESS LIABILITY COVERAGE FORM Page 24 of 24 Form SS 00 08 04 05 b.Donates his or her work; c.Acts at the direction of and within the scope of duties determined by you;and d.Is not paid a fee,salary or other compensation by you or anyone else for their work performed for you. 24."Your product": a.Means: (1)Any goods or products,other than real property,manufactured,sold,handled, distributed or disposed of by: (a)You; (b)Others trading under your name; or (c)A person or organization whose business or assets you have acquired;and (2)Containers (other than vehicles), materials,parts or equipment furnished in connection with such goods or products. b.Includes: (1)Warranties or representations made at any time with respect to the fitness, quality,durability,performance or use of "your product";and (2)The providing of or failure to provide warnings or instructions. c.Does not include vending machines or other property rented to or located for the use of others but not sold. 25."Your work": a.Means: (1)Work or operations performed by you or on your behalf;and (2)Materials,parts or equipment furnished in connection with such work or operations. b.Includes: (1)Warranties or representations made at any time with respect to the fitness, quality,durability,performance or use of "your work";and (2)The providing of or failure to provide warnings or instructions. EXHIBIT D CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY DECLARATION DECLARATION CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY The City of Kent is committed to conform to Federal and State laws regarding equal opportunity. As such all contractors, subcontractors and suppliers who perform work with relation to this Agreement shall comply with the regulations of the City's equal employment opportunity policies. The following questions specifically identify the requirements the City deems necessary for any contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative response is required on all of the following questions for this Agreement to be valid and binding. If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the directives outlines, it will be considered a breach of contract and it will be at the City's sole determination regarding suspension or termination for all or part of the Agreement; The questions are as follows: 1. I have read the attached City of Kent administrative policy number 1.2. 2. During the time of this Agreement I will not discriminate in employment on the basis of sex, race, color, national origin, age, or the presence of all sensory, mental or physical disability. 3. During the time of this Agreement the prime contractor will provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 4. During the time of the Agreement I, the prime contractor, will actively consider hiring and promotion of women and minorities. 5. Before acceptance of this Agreement, an adherence statement will be signed by me, the Prime Contractor, that the Prime Contractor complied with the requirements as set forth above. By signing below, I agree to fulfill the five requirements referenced above. By: For:P�l�1�i"'�e Title: pre,<, Id2t:�%�'' 6Y,ce I, Date: EEO COMPLIANCE DOCUMENTS - 1 EEO COMPLIANCE DOCUMENTS - 2 CITY OF KENT ADMINISTRATIVE POLICY NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998 SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996 CONTRACTORS APPROVED BY Jim White, Mayor POLICY: Equal employment opportunity requirements for the City of Kent will conform to federal and state laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee equal employment opportunity within their organization and, if holding Agreements with the City amounting to $10,000 or more within any given year, must take the following affirmative steps: 1. Provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 2. Actively consider for promotion and advancement available minorities and women. Any contractor, subcontractor, consultant or supplier who willfully disregards the City’s nondiscrimination and equal opportunity requirements shall be considered in breach of contract and subject to suspension or termination for all or part of the Agreement. Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public Works Departments to assume the following duties for their respective departments. 1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these regulations are familiar with the regulations and the City’s equal employment opportunity policy. 2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines. EXHIBIT E RFP 2020-01 1 REQUEST FOR PROPOSALS ADVERTISED DATE: Request for Proposal Title: Inmate Medical Services Requesting Dept./Div.: City of Kent – Police Department – Corrections Facility RFP Number: # 2020-01 Due Date: August 28, 2020 RFP Coordinator: Diane McCuistion City of Kent – Corrections Facility Diane McCuistion 1230 Central Ave South Kent, Washington 98032 DMcCuistion@Kentwa.gov PROPOSERS MUST COMPLETE AND SIGN THE FORM BELOW (TYPE OR PRINT) Company Name Address City/State /Postal Code Signature Authorized Representative/Title (Print name and title) Email Phone Fax Company Headquarters Located in State/Province of 2 REQUEST FOR PROPOSALS Proposal: The City of Kent, Washington (“City”) is seeking proposals for a licensed health care provider to perform medical services for inmates of the City of Kent Corrections Facility (“Facility”) in accordance with this request. Responses to this RFP must not be more than 30 pages in length (15 double-sided or 30 single-sided pages). The City requires the proposer (“Proposer(s)”) to sign and return this entire Request for Proposal (“RFP”) document and submit their proposal by no later than 5:00 p.m. on August 28, 2020. ** This is a 30-day extension of original Request for Proposals The City prefers that proposals be submitted by email. Emailed proposals must be in MS Word or PDF format. They must include “Proposal-#2020-01” in the subject line and be addressed to Commander Diane McCuistion at DMcCuistion@Kentwa.gov. However, if a Proposer prefers to submit a paper proposal, the original plus four copies of all proposals in printed form shall be delivered and received, regardless of the delivery method, through August 28, 2020 up to 5:00 p.m., as shown on the clock on the east wall of the City Clerk’s Office, at the following location: City of Kent City Clerk’s Office 220 4th Avenue South Kent, WA 98032 Office Hours: 8:00 a.m. – 5:00 p.m., Monday – Friday The proposal must be submitted in a sealed envelope or box with the following words clearly marked on the outside of the envelope: Inmate Medical Services RFP ATTN: SEALED BID FOR PROJECT #2020-01, BID OPENING August 28, 2020 If a Proposer wishes to deliver a proposal in-person, due to impacts from COVID-19, the Proposer shall call the City Clerk at (253) 856-5725 to schedule a time to drop-off the proposal. The name of the Proposer and its address must also be clearly indicated on the envelope. Questions on RFP: Proposers should submit any questions regarding the RFP via e-mail directly to Commander Diane McCuistion. 3 1.0 GENERAL INFORMATION. 1.1 The City is an Equal Opportunity Employer and does not discriminate against individuals or firms because of their race, color, creed, marital status, religion, age, sex, national origin, sexual orientation, or the presence of any mental, physical or sensory handicap in an otherwise qualified handicapped person. 1.2 In addition to these nondiscrimination compliance requirements, the contractor ultimately awarded a contract shall comply with federal, state and local laws, statutes, regulations and ordinances relative to the execution of the services. This requirement includes, but is not limited to, protection of public and employee safety and health; disabilities; environmental protection; waste reduction and recycling; the protection of natural resources; permits; fees; taxes; and similar subjects. 1.3 All submitted proposals and evaluation materials become public information and may be reviewed by anyone requesting to do so at the conclusion of the evaluation, negotiation, and award process. This process is concluded when a signed contract is completed between the City and the selected Proposer. 1.4 By electing to participate in this RFP process, the Proposer agrees not to make a public records request for any documents or information submitted by any other proposer who responds to this RFP, and to the extent allowed by law, waives its right to make such a request until contract execution is complete. 1.5 The City reserves the right to reject any or all proposals that are deemed not responsive to its needs or this RFP. 1.6 If it becomes necessary to revise any part of this RFP, addenda may be created and distributed to all known potential Proposers providing an accurate e- mail address. 1.7 The City is not liable for any cost incurred by the Proposer in responding to this RFP or during the RFP review process. 1.8 A contract may be negotiated with the Proposer whose proposal, all factors considered, would be most advantageous in the opinion of the City. 1.9 The contents of the proposal of the selected Proposer shall become contractual obligations if a contract ensues. Failure of the Proposer to accept these obligations may result in cancellation of their selection. At the City’s discretion, specific provisions may be subject to further negotiation. If contract negotiations ensue, no language changes will be accepted to the City’s standard terms which are identified in Section 8.0 “Terms and Conditions” of this RFP. 4 1.10 A response from a Proposer which indicates that any of the information requested by the City in this RFP will be provided only if the Proposer is selected as the apparently successful Proposer is not acceptable, and, at the City’s sole discretion, such response may disqualify the proposal from consideration. 1.11 It is understood that the City Council of the City of Kent reserves the right to reject any and/or all qualifications and to waive irregularities and informalities and to accept the proposal that, in the opinion of the City, is in the best interest of the City. Any contract awarded pursuant to this RFP will only be entered into with a responsible Proposer, found to be satisfactory by the City, qualified by experience, and in a secure financial position to do the work specified. 2.0 GENERAL DESCRIPTION AND STATEMENT OF PURPOSE. The Facility is constitutionally responsible for the provision of adequate healthcare to all inmates in its custody. The City will be accepting proposals for the provision of health care services, health care personnel and program support services to the inmate population at the Facility. The successful Proposer shall be the sole supplier and/or coordinator of the health care delivery system at the Facility. The Proposer shall be responsible for all medical care for all inmates (except Alternative Sentencing inmates who shall, when on site, receive only emergency care from the provider) at the Facility. The term "Medical Care" includes "Dental Care," and “Mental Health Care.” The responsibility of the Proposer for the medical care of an inmate commences with the commitment of the inmate to the custody of the Facility and ends with the release of the inmate. The intent of the RFP is to solicit qualifications and proposals for the selection of an experienced correctional healthcare provider to provide medical services to inmates, utiltizing industry best practices. Except as otherwise specifically provided for herein (e.g., on-call telephone consultations, dental, tele-med psych), all health care services are to be conducted from the Facility in accordance with specifications detailed elsewhere in this solicitation. The Facility intends to explore the expansion of services from its current level – which will be described below. As described in Section 7.0 and Exhibit B, Proposers are to make proposals in the alternative for (1) matching the current staffing level contracted by the City, described in Sections 6.2.1.1 and 3.6, (2) their ability to provide an expanded staffing level, including potential services described in 6.2.2, and their proposal to so provide, and (3) any other feasible alternative staffing schedule that the Proposer believes could sufficiently meet the Facility’s healthcare needs. Alternative proposals are not required to be considered, though each proposal in the alternative will be reviewed by the City wholistically for the costs and benefits provided. 3.0 BACKGROUND. 5 The City is a code city with a strong mayor and is the sixth largest city in Washington State with a population nearing 130,000. 3.1 The Kent Corrections Facility: The Facility was opened in 1986 with a design capacity of 48 beds. The Facility was expanded in 1991, by double bunking the cells, bringing the design capacity to 96 beds. The Facility houses adult male and female inmates. The approximate current jail population is 90 male adult inmates and 20 female adult inmates. The average daily population including home detention and program inmates at the Facility was 119 in 2019, with a peak population of 133. Average daily population in 2020 is anticipated to be approximately 120 inmates, with a peak of 134 inmates. The average inmate length of stay is 11 days. The Facility is a combination of podular, remote surveillance housing areas and dorm style housing areas, and utilizes indirect supervision to manage inmates. The Facility consists of one building with seven inmate housing areas and six additional holding cells. A central area contains the kitchen, medical unit, laundry room, law library, outdoor recreation area, multi-purpose program room, and a phlebotomy/BAC room. There is no separate medical housing unit; however, the six holding cells are closely monitored and designed for air flow to vent directly outside. It contracts with the City of Maple Valley to house two inmates and the City of Federal Way to house five inmates. These inmates are included in the population counts above. There is a separate Alternative Sentencing unit attached to the Facility. The inmates in Alternative Sentencing are also included in the above stated inmate populations. Medical Care for some Alternative Sentencing inmates is generally limited to emergency care while the inmates are on site. 3.2 Medical Unit: Space in the Medical Unit is allocated as follows: 1 Medical Unit 1 Nursing work station with secure medical cart and active file storage 1 Medical supply storage wall organizer and cabinet space 1 Exam room with exam table 1 Staff toilet and lockers 2 Refrigerators for medicine and/or lab storage Medication Rounds: Medication rounds are currently made to every housing area at approximately 0700, 1500, and 1900 hours. Over the counter medications are not offered on an inmate commissary program and must be obtained through the nurse medical round process. 3.3 Medical Equipment Inventory: 6 The following is a list of medical equipment owned by the City which may be used by the successful Proposer: AED machine Mobile blood pressure and vital machine Emergency first aid kit Narcotic locking medical Thermometer Blood drawing chair Medication cart Medical storage cabinets Wall storage unit Sonotron Examination table Centrifuge Triac control Refrigerator Nebulizer Wheel chair Walker Small medical refrigerator 3.4 Current Provider: All health care services at the Facility are currently provided under a contract with Valley Medical Occupational Health Services. This contract expires December 31, 2020. The City intends for two weeks of overlap between the Proposer and the current provider to facilitate a transition of services. 3.5 Statistical Data: The following is an overview of statistical data for primary medical services for the period January 1, 2019 to January 1, 2020. This data is provided for informational purposes only and in no way is intended to limit, project, or predict the number of patient encounters to be provided by the vendor during the period of the contract. Nurse Intake Screening 4,505 Number of Medical Clinic Visits 5,210 Inmate Medical Clinic Visits Doctor/PA 1576 TB Tests Given 154 Dental Visits Outside Visits 24 Inmate on withdrawal protocol 729 Emergency Codes 48 Special Diets 241 Inmate Requests (Written) 3824 Emergency Room Visits 36 DUI Blood Draws 144 Lab Specimens 240 7 Reliability of information: The information in this RFP package has been taken from data available and is believed to be reasonably accurate. Proposers are requested to personally verify data wherever possible and to ask for any other information needed for the preparation of their response to the RFP. 3.6 Current Staffing Level: The staffing level which the City currently contracts for is as follows: Licensed Practical Nurse (LPN) 60 Hours per week Work performed Mon-Fri, 6:00 am–2:30 pm and Sat-Sun, 8:30 am-8:30 pm Registered Nurses (RN) 40 Hours per week Work performed Mon-Fri, 1:30 pm-10:00 pm Medical Doctor, Psychiatrist (MD) For 1.5 Hours per week Work performed as needed Physician Assistant (PA) 3 Hours per week in Facility Work performed in shifts of 1.5 hours On call PA available 24/7 remote assistance 4.0 RFP PROCESS TENTATIVE SCHEDULE. The City will attempt to follow this timetable, which should result in a final selection by August 2020: June 9, 2020 Issue RFP July 27, 2020 Issued RFP extension July 31, 2020 Issued 2nd RFP extension By appointment Walkthrough of Facility Medical Unit August 17, 2020 Deadline for questions August 21, 2020 Answers to questions released August 28, 2020 Deadline for submittal of proposals – 5:00 PM PST September 2, 2020 Invitational interviews of proposers September 11, 2020 Selection of apparently successful proposal October 2020 Contract award and execution These dates are tentative and subject to change by the City. 5.0 MINIMUM QUALIFICATIONS OF ORGANIZATION. To be considered for award of this contract, the Proposer must meet the following minimum qualifications: 8 a) The Proposer must be organized for the purpose of providing health care services, and have previous experience with proven effectiveness in administering correctional health care programs; b) The Proposer must carry insurance as detailed in the attached Insurance Requirements for Inmate Medical Services, Exhibit A; c) The Proposer must demonstrate its ability to provide a health care system specifically for the Facility; d) The Proposer must demonstrate that it has the ability to commence providing all services by December 15, 2020, that it has a proven system of recruiting staff, and that it has an adequate support staff in its central office capable of competently supervising and monitoring its operation in the Facility. 6.0 SCOPE OF SERVICES. This section outlines contract requirements for providing health services to the Facility’s inmates, as well as the optional services which the City is interested in exploring. Service requirements have been divided into five sections: (1) Medical Services, (2) Personnel, (3) Administrative Services, (4) Medical Records, and (5) Supplies. Section 6.2.2 below describes expanded staffing levels the City may be interested in adding to any contract that may come from this RFP. Proposers are to indicate whether they are able to provide the identified expanded staffing, and if so, it is the City’s desire that they identify their cost to provide the expanded staffing in the line item pricing in Exhibit B. While alternative staffing plans are not required for a proposal to be considered, their inclusion in a bid will be considered by the City. At a minimum, Proposers are required to indicate whether they have the present ability to provide the identified expanded staffing. The subsections of Section 6.0 that do not relate to alternative staffing should be considered minimum requirements. Proposers who wish to deviate from these requirements must explicitly say so in their proposals and may be subject to later negotiation at the discretion of the City. 6.1 Medical Services: The Proposer will provide adequate medical care to all inmates in the Facility as guaranteed under the 8th and 14th Amendments of the U.S. Constitution, the Washington State Constitution, Washington State law and regulations, and City ordinances and policies. 6.1.1 Minimum Service Level: 9 The minimum contract requirements for providing health services to the City’s inmates, is as follows: 6.1.1.1 Proposer’s staff will provide inmate medical services, that include assessing inmates presenting health problems, gathering necessary health histories and records, dispensing medications, referring inmates for appropriate treatment of illness/injury per discussions with Corrections staff, documenting medical services, and maintaining the electronic medical records of inmates. 6.1.1.2 The Proposer will provide an on-call physician assistant for telephonic consultation, available 365 days per year whom Corrections staff can contact 24/7 to assess the urgent health questions of inmates. The Proposer shall provide Corrections staff with a list of contact information for the primary on-call designated person, as well as have a secondary person who can be called if the primary person is not reachable. The Proposer will maintain updated contact information at all times and will inform Corrections staff of any changes. The Proposer shall be available for twenty-four (24) hours a day telephonic emergency health care services on an on-call basis. The Proposer must be able to provide these services on call, when outside normal operating hours. 6.1.1.3 Nursing services must be available to provide services, including: a) Physical assessments on all inmates within fourteen (14) days after booking; b) Confirm prescriptions and dose medications as prescribed; c) Injury/ illness treatment and follow-up care; d) Sick call triage and follow-up on a daily basis to include weekends and holidays; e) Appropriate and timely response to medical needs and emergencies; f) PA support services; g) Routine nurse rounds shall occur at least three times daily; h) Assist with medical clearance at intake, as required; i) Maintain appropriate medical health records for inmates; j) Conduct blood sugar checks as required for diabetic inmates; k) Administer DUI blood draws as required; 10 l) Coordinate offsite appointments for inmates as needed; m) Work with medical providers for inmate continuance of care plan; n) Detoxification monitoring and treatment; o) Collect lab specimens as required; p) Respond to inmate written medical requests, in a timely manner; q) Confirm/approve special diet requests for inmates. 6.1.1.4 At the request of the City, the Proposer will arrange for office visits at a clinic or other appropriate healthcare setting for those inmates requiring medical attention outside the Facility by a licensed physician, physician assistant, or advanced registered nurse practitioner, and discuss with Corrections staff before referring inmates for additional health services or treatment outside the Facility or beyond the scope of the contract. 6.1.1.5 The Proposer must provide a complete pharmaceutical system for the Facility, including providing medications, prescribing medications, dispensing of medications, and record keeping. The system shall include prescription medications and over-the-counter medications. All prescription medications shall be prescribed and dispensed by a licensed health care professional. The City shall be responsible for the costs of all drugs administered, but the Proposer is responsible for negotiating preferred provider rates for pharmacy services and shall purchase prescriptions at the lowest rate available and bill the City at that rate. Proposers should describe the rates they can obtain in Exhibit C, Statement of Qualifications. In the event it is determined that an inmate is in need of medication that exceeds a cost of $500 per month to provide, the Proposer shall place the City on notice. Pharmaceutical services include: a) The Proposer shall provide for pharmaceutical services to assure the availability of prescribed medications within twenty-four (24) hours of the order of issue being written; b) Pharmaceutical services shall be consistent with State and Federal regulations, and must be monitored by a licensed, qualified pharmacist; c) The Proposer will provide a health professional with prescription authority to approve all prescriptions for the inmates; d) The Proposer shall provide for the purchasing, dispensing, administering, disposal, and storage of all pharmaceuticals by qualified personnel and for the proper storage of psychotropic medications as 11 prescribed to inmates; e) The Proposer must administer an evidence-based Medication Assisted Treatment (“MAT”) program to inmates diagnosed with Opioid Use Disorder; f) The Proposer shall provide for the recording of the administration of medications in a manner and on a form approved by the health care authority to include documentation of the fact that inmates are receiving and ingesting their prescribed medications. Documentation will also be required when an inmate's ordered medication was not administered and the reason given. 6.1.1.6 The Proposer, with appropriate input from its licensed health care professionals with correctional experience, will develop and maintain specific medical protocols and procedures that address the services provided hereunder. The Proposer will inspect the medical area(s), medication storage, and office area. Facility medical protocols, policies and procedures will be reviewed and updated at least annually, and copies of such policies and procedures and any City-approved amendments shall be provided promptly to Corrections staff. These protocols, policies and procedures must be and remain consistent with current WASPC standards. Separately, the Proposer’s designated licensed health care professional will assist jail administration with writing and updating City jail medical policies and procedures. The Proposer’s designated licensed health care professional will meet with the Facility administrator at least once annually to discuss the status of the health care program. 6.1.1.7 The Proposer shall coordinate necessary laboratory and x-ray services, which may be conducted off site. All abnormal laboratory and x-ray results are to be reviewed and signed by a physician assistant with a follow-up plan of care outlined as needed. 6.1.1.8 The Proposer shall provide a program for meeting the special needs of pregnant inmates. 6.1.1.9 The Proposer shall perform documented inmate health reviews using the medical history intake form provided by the Facility. Corrections officers complete the initial pre-booking screen, and nurses will respond immediately if the officer has a concern. If a nurse is not on duty the officer will contact the on-call provider. 6.1.1.10 Inmate transportation for emergency care will be coordinated by the Proposer and paid for by the City; all other transportation relating to the provision of health services is provided by the City. 6.1.1.11 Health services shall be provided in the form of emergency care for inmates assigned to the Alternative Sentencing programs, while the inmates are on site. Care should be for the purpose of stabilizing the condition and arranging for 12 transport, if necessary. 6.1.1.12 Non-inmate health services shall be provided in the form of emergency care for staff, Proposers, and visitors for the purpose of stabilizing the condition and arranging for transport. 6.1.1.13 All controlled substances, syringes, needles and surgical instruments will be stored under secure conditions consistent with applicable regulations. 6.1.1.14 Inmates will not be allowed to assist in the provision of any health care services, including recordkeeping. 6.1.1.15 Designated medical personnel will maintain complete and accurate medical records for all inmates, consistent with requirements of Section 6.4 of this RFP. The system the Proposer uses for storing medical records must be electronic. 6.1.1.16 The Proposer shall, in times of emergency or threat thereof, whether accidental, natural, or caused by other human beings, provide onsite medical assistance to the City. 6.1.1.17 The Proposer will immediately notify Corrections staff of any inmate issue requiring special attention or isolation for communicable disease. 6.1.1.18 The Proposer shall provide dental services sufficient to provide for emergency and medically required, i.e. palliative, dental care for inmates within a reasonable period. Attending PA/RN will refer inmates for medically necessary dental treatment and may be required to administer medications as prescribed for dental infections. Currently, dental services are only offered off site. Please indicate in Exhibit C if Proposer is able to provide a dentist to perform palliative dental services in the Facility or in a mobile office provided by Proposer that comes to the Facility. 6.1.1.19 Mental health services are to be available 24/7, including by telephone or webcam, and shall include: a) Administering medications as prescribed, and assisting inmates returning to a mental health medication regiment; b) Maintenance of inmates' medical charts to include mental health information; c) Assessment of inmates who claim to be or actually are suicidal, to include placement into and removal from suicide/enhanced watch, and to include suggested watch requirements; d) The provision of a psychiatric specialist for a minimum of 13 1.5 hours a week onsite, at the Facility; and e) Assist with the process of involuntary commitments of inmates experiencing a mental health crisis and/or help to stabilize the inmate through mental health medications. 6.1.1.20 At the request of Corrections staff, the Proposer will provide for examinations and medical clearance for inmate workers prior to placement in an assignment. 6.1.1.21 The Proposer will provide training to Corrections staff personnel in proper medication procedures and any other medical procedures as requested (i.e., blood sugar tests, etc.). 6.1.1.22 For inmates being released into the community with serious health conditions that require medication, the Proposer will provide a prescription, a bridge-supply of medication, arrange transportation to a medical treatment facility, or document that the inmate has access to required medication upon release. For a non-serious health condition that requires medication, the Proposer will provide a supply of medications to an inmate being released or a prescription. 6.1.1.23 For inmates who are being transferred to another facility, the Proposer will provide a discharge summary that includes information about the inmate’s medical and mental health condition, the current treatment plan, and any medications needed. Required medications will be transferred with the inmate. 6.1.1.24 Proposer will provide medical and mental health intake screening services, including: a) Intake assessment to ensure the inmate is medically stable at the time of admission; b) Review medical intake forms for emergent care; c) Organize after hour calls to the on-call medical provider; d) Confirm pregnancy and drug use claims; e) Stabilize wound care; f) Confirm diabetic inmates have stable blood sugar levels. 6.1.1.25 The Proposer shall provide management of the Hepatitis B vaccination program for all designated City employees in the Operations and Detention divisions. The City will bear the cost of the vaccine. 6.1.1.26 The Proposer shall provide an annual TB screen for all designated City employees in the Operations and Detention divisions. 14 6.2 Personnel: 6.2.1 PA services must be sufficient to provide the required needs of the day and assure medical evaluation/follow up within a reasonable time of post nursing triage referral (including weekends and holidays). In addition, twenty-four (24) hour PA on-call services with the availability for consultation and the ability to meet the on-site needs are required. This shall include after hour and weekend needs for ordering and dispensing psychiatric medications. 6.2.2 The City may require replacement of any Proposer personnel believed unable to carry out the responsibilities of the contract at the sole discretion of the City. The Facility administrator shall approve all appointments. All medical personnel shall be subject to a facility background check and fingerprinting prior to Facility assignment. 6.2.3 Written job descriptions and protocols to define specific duties and responsibilities for all assignments must be provided to the City. 6.2.4 Personnel files (or copies thereof) of contract employees assigned to the Facility are to be maintained at the Facility and shall be available to the City. 6.2.5 Copies of staffing schedules encompassing all health care staff are to be submitted to the City on the fifteenth (15th) day of each month for the upcoming month. Daily updates should be supplied if there are changes. This includes the PA on-call schedule and contact information. 6.2.6 All medical personnel will attend and participate in an orientation/training session that will cover the Facility’s safety and security rules and regulations prior to work commencing. 6.2.7 All staff must have current state licenses and must attest to have never having had their professional license revoked. Copies of current professional licenses shall be kept on file with the Facility commander. All on-site staff must be CPR certified. In addition, consistent with Exhibit A, malpractice insurance must be on file for all medical personnel, and other employees, if applicable. 6.2.1 Minimum Medical Staffing Level: The City requires a staffing level capable of the adequate provision of the services described in Section 6.1. Any deviation in a proposal that proposes a lower level of service than set out in 6.1, must be noted and explained in Exhibit C. However, the City is considering different levels of medical staffing for the Facility; the exact level of staffing that will be required has yet to be determined. The City asks that the Proposer provide prices for multiple levels of staffing, including the cost to provide the same staff level that the City currently contracts for. Proposers may recommend a staffing level that the Proposer believes is appropriate for the 15 Facility. Innovative ideas that result in providing safe, efficient, and cost-effective medical care are requested. Staffing plans and annual cost information should be noted by Proposers in Exhibit B Section 6.2.1.1, below, describes the current level of medical staffing contracted for by the City. Also below, Section 6.2.2 includes examples of optional expanded staffing levels which may be included in a bid. Additional or reduced costs associated with alternative staffing levels should be noted in the proposals in Exhibit B, (“Proposal Price, Staffing Plan and Signature Sheet”). 6.2.1.1 Adequate health care personnel required to provide those services listed in this RFP must be provided. The City currently contracts for the following level of staffing: a) A Licensed Practical Nurse, 8.5 hours a day on weekdays, and 12 hours a day on weekends; b) A Registered Nurse, 8.5 hours a day on weekdays; c) A medical doctor, psychiatrist, or alternatively a qualified nurse specialized in psychology who is capable of writing prescriptions, for 1.5 hours a week; d) A physician assistant for three hours a week, split between two 1.5 hour shifts; e) A physician assistant on-call 24 hours a day seven days a week. 6.2.1.2 A singular designated licensed medical professional will be designated as a Medical Director, who will have the responsibility for assuring the appropriateness and adequacy of inmate health. The proposal should address what the Medical Director's responsibilities will be in regard to: in-service training, quality assurance, and recruitment. The proposal should also address what part of on-site time provided by the Medical Director will be committed to administrative duties, direct care, and involvement in quality assurance. The portions of the Medical Director’s duties which relate to administrative duties and quality assurance, see Section 6.3, should be accounted for in the flat annual administrative fee, described in Section 7.2 and Exhibit B. If the Medical Director is a part of the on-site medical staff performing direct care, those portions of the Medical Director’s duties shall be priced at an hourly rate in Exhibit B. 6.2.1.3 The Proposer will be required to provide full coverage for all vacant positions. The Proposer will be required to provide a candidate for the City’s approval for all vacancies as soon practical. 6.2.2 Optional or Expanded Medical Staffing Level: This section includes examples of expanded service levels the City may be 16 interested in adding to any contract that may come from this RFP. In responding to this portion of the RFP, Proposers are to indicate whether they have the present ability to provide the expanded staffing identified below, and if so, it is the City’s desire that they identify their cost to provide the expanded staffing in the line item pricing in Exhibit B (“Proposal Price, Staffing Plan and Signature Sheet”). While alternative staffing plans are not required for a proposal to be considered, their inclusion in a bid will be considered by the City. However, at a minimum, Proposers are required to indicate whether they have the present ability to provide the identified expanding staffing. 6.2.2.1 The Proposer will provide a nurse (LPN or RN) in the Facility 24 hours a day, seven days a week. 6.2.2.2 The Proposer will provide release coordinator services to assist inmate reentry into the community, by coordinating services for treatment, continued medical care, mental health care, housing, etc. 6.3 Administration: 6.3.1 The Proposer will provide administrative services, including: a) Being available for telephone consultation; b) Invoicing and billing oversight, records management retention, storage of records, and scheduling; c) Medical director oversight; d) Administrative oversight; e) Program support services; f) Provide additional or replacement staff coverage during vacations, sick and emergency leaves; and, g) Provide policy and protocol oversite and training. 6.3.2 The Proposer will designate part-time Health Services Administrator, who shall have the general responsibility for the successful delivery of administrative services. The Health Services Administrator need not perform all work at the Facility but may be required to come to the Facility periodically. The Proposer shall indicate the qualifications of the proposed candidate for this position in Exhibit C. 6.3.3 The Proposer will provide to the City reports of monthly and daily statistics as follows: 17 a) A statistical report will be due on the fifth calendar day of each month to the City that includes, but is not limited to, the following: 1) Inmates seen at nurse rounds; 2) Inmates seen by PA; 3) Inmates seen by dentist; 4) Inmates seen by mental health provider; 5) Medical specialty consultation referrals; 6) Hospital admissions; 7) Emergency Room visits; 8) Intake medical screening; 9) Fourteen (14) day physical assessments; 10) Inmates on Prescription medications; 11) Lab Work/DUI Blood Draws; 12) Blood sugar checks; 13) TB Test; 14) Blood pressure/Vital checks; 15) Inmates seen for substance abuse; 16) Inmates on a medicated treatment program; 17) All contractor absences by position and number of days vacant. b) A report for the previous twenty-four (24) hours that captures, but is not limited to, the following data. This report shall be submitted to the City on a daily basis: 1) Transfers to hospital emergency departments; 2) Communicable disease reporting; 3) Report of status of inmates in local hospitals; 18 4) Submit completed medical incident report copies. 6.3.4 The Proposer shall make the appropriate notifications, to the Public Health Authority and Jail Administrator, in the event of a communicable disease is identified. Precautions will be taken to minimize/prevent the spread of the infectious disease. 6.4 Medical Records: 6.4.1 A medical record consistent with state regulations and community standards of practice shall be initiated and maintained for every inmate regarding medical, dental, or mental health services received as a result of the inmate screening process and for services rendered following the inmate's assignment to a housing area. These records shall be kept separate from the Facility confinement records of the inmate. 6.4.2 Confidentiality of medical records will be assured in accordance with HIPAA and other applicable state and federal laws and regulations, including those related to the disclosure of public records, also recognizing that relevant information or a copy of the records may be forwarded to appropriate facilities or to other health care providers as needed. All medical and psychiatric records will be maintained by the provider’s electronic medical records system and kept separate from custodial records. Data necessary for the classification, security, and control of inmates will be provided to the appropriate Corrections staff. Medical records will be made available to the City or its designee when required. 6.4.3 Adherence to applicable informed consent regulations and standards of the local jurisdiction must be maintained. 6.4.4 Inactive medical records will be maintained and retained in accordance with the retention laws and schedules of the State of Washington. Following the completion of the applicable retention period, inactive medical records not otherwise subject to a pending records request will be archived by a mutually agreed upon method consistent with state law and regulations. 6.4.5 All medical and other records, policies and procedures, manuals, instructional books, orientation, and continuing education records and materials, and documentation of every sort, developed for or used in the operation of the Health Care Program under the contract, shall be the property of the Proposer. Notwithstanding the ownership of the records, during the term of the contract, the Proposer, as part of its administrative duties, will be responsible for assisting the City with responding to public records requests, subpoena duces tecums, and medical releases the City may receive. 6.4.6 In any case where medical care is at issue, or in any criminal or civil litigation where the physical or mental condition of an inmate is at issue, the Proposer shall make accessible to the City’s Jail Commander or City Attorney such records and, upon request, provide copies. The Proposer acknowledges and agrees 19 that all records prepared or acquired by the Proposer during performance of services under a subsequent contract may be subject to the Public Records Act, see Section 8.4 of this RFP. Included in the inmate population are inmates incarcerated on behalf of the City of Maple Valley and the City of Federal Way. The Proposer shall promptly notify the Facility administrator if offsite treatment for such inmates is required. 6.4.7 The Proposer shall prepare health summaries to be sent with inmates being transferred to other facilities. The health staff will ensure that inmates and health summaries are appropriately prepared for transfer within twenty-four (24) hours of receiving the list of inmates being transferred, or as necessary. 6.4.8 The Proposer will examine and provide medical clearance for all inmate workers, as requested by the City. The medical clearance process will be completed within twenty-four (24) hours of receiving the trusty application, unless laboratory testing necessarily increases the time required to be cleared. 6.4.9 If an inmate medical record cannot be located within eight (8) hours of the discovered loss, the City shall be immediately notified. 6.4.10 Inactive medical records will be maintained in accordance with the laws of the State of Washington. Any and all legal actions or requests affecting inmates and/or the medical contract provider must be provided, in writing, to the City within twenty-four (24) hours. 6.4.11 The Proposer shall maintain medical records in an electronic records system. 6.4.12 Relevant medical records shall be provided to any other health care provider contracted with by the City during or after any term of service with the Proposer. 6.5 Supplies: 6.5.1 The Proposer will coordinate the purchase of all necessary materials, supplies, and equipment necessary for performance of the services required hereunder. The Proposer will obtain cost effective supplies required to carry out its performance. Said supplies will include, but not be limited to: forms, books, manuals, medical record folders and forms, pharmaceuticals, laboratory fees, hand instruments, needles and sharps, special medical items, testing devices, containers and clinical waste receptacles, individual and group materials, gloves and coverings, and disinfectants. Supplies to be purchased during the contract shall be first approved for purchase by the City, and the Proposer will have the City billed directly for such purchases. 6.5.2 The City agrees to provide the Proposer with office space or facilities, utilities, and office equipment reasonably necessary to enable the Proposer to perform its obligations, including but not limited to, a fax machine, copier, 20 telephone services, office supplies, translation services as available, and medication cart. 6.5.3 The Proposer will supply, at its expense, on-site office equipment it needs such as cell phones for on call providers, computers for off-site review, and electronic medical records service. The City will continue to make available two computers and one printer which are connected to the in-house inmate records system and the City’s e-mail system. 6.5.4 All equipment, noted in Section 3.3 Medical Equipment Inventory, owned by the Facility may be used in conjunction with services furnished by the contract provider. Any additional equipment to be purchased during the contract shall be first approved for purchase by the City. 6.5.5 All equipment purchased under the contract shall be the property of the City and shall remain on site at the termination of the contract. All supplies, including pharmaceuticals, purchased for use in the performance of the contract, shall be the property of the City and shall remain on site at the termination of the contract. 6.5.6 The City shall be responsible for maintenance and repair of all medical and office equipment supplied and owned by the City for use by the Proposer. Should such equipment become non-serviceable due to routine use, then the City will be responsible for its replacement. 7.0 CONTENTS OF PROPOSAL. Proposals should include certain elements. In order to better facilitate a fair and complete evaluation, each of the following elements shall be contained in the proposal: (1) Qualification Details; (2) Proposed Price, Staffing Plan and Signature Sheet; and (3) completion of each remaining Exhibit attached to this RFP. Bids in the alternative for different levels of proposed staffing should be made clear in Exhibit B. The specific requirements for each element are described below. 7.1 Qualification Details consisting of: 7.1.1 Cover letter including statement of understanding and approach to the provision of inmate medical services; the statement should describe the Proposer’s understanding of the medical needs of inmates at the facility and describe the approach the Proposer would bring to the contract. The cover letter should include a description of the Proposer’s organization, years in existence, structure, composition, and qualifications – specifically identifying how the Proposer’s organization meets the minimum requirements listed in Section 5.0 of this RFP. Please include descriptions detailing completed, similar or relevant experience providing medical services in a correctional setting. Proposers are encouraged to include descriptions of other contracts that involved the staff proposed to work at 21 the Facility. 7.1.2 Page 1 of the RFP: Signed by an authorized representative of the Proposer attesting that all terms, conditions and procedures outlined in this RFP are understood and have been followed. 7.1.3 Answer each question and provide all documents listed in Exhibit C, “Statement of Qualifications.” 7.2 Price: The Proposer is required to provide, in its proposal, the following: 7.2.1 A base price on the Proposal Price, Staffing Plan, and Signature Sheet (Exhibit B). The basis of price should be a combination of: a) The annual cost of personnel under a proposed staffing plan, for the provision of services listed in Section 6.1, and; b) Flat annual cost for administrative services and other costs associated with the requirements of Sections 6.3, 6.4, and 6.5. 7.2.2 The price of the administrative services is to include the furnishing of all professional services, labor, materials, equipment, insurance, licenses and applicable taxes necessary or proper for the completion of the work described in this RFP that is not direct medical care. 7.2.3 Proposals must include a staffing plan, see Sections 6.2.1 and 6.2.2, which shows a complete and detailed staffing arrangement which shall provide adequate support for the operation of the health care program. a) Staffing plans should be included in Exhibit B which show the total number of employees, full and part-time; position titles and license/certification; total number and positions per shift; and the total hourly, weekly, and annual cost of each position. The City asks that Proposer provide at least one staffing plan that matches the current level of service contracted for by the City, see Section 3.6, and one staffing plan which includes the expanded staffing level described in Section 6.2.2. b) Proposers may recommend a staffing level that the Proposer believes is appropriate for the Facility. Innovative ideas that result in providing safe, efficient, and cost-effective medical care are requested. In the same manner as above, the Proposer may submit an alternative bid with a different proposed staffing level, noting any associated costs or savings. (Exhibit B). c) The Proposer should attach to Exhibit B an executive summary explaining its recommended staffing levels, and any additional or optional 22 services the Proposer may offer. In this summary the Proposer may provide any other information deemed necessary to address the requests of this RFP. 7.2.4 Proposers must sign Exhibit B, acknowledging the Proposer’s agreement that the annual price shall be the same for the first three years of the contract, after which annual rates may be adjusted by the local Consumer Price Index on an annual basis. 7.3 Exhibits to the RFP: The following Exhibits are attached to this RFP: Exhibit A: Insurance Requirements for Inmate Medical Services Contract Exhibit B: Proposal Price, Staffing Plan and Signature Sheet Exhibit C: Statement of Qualifications Proposals must include signed copies of Exhibits B and C along with any documents or answers requested therin. 8.0 TERMS AND CONDITIONS. This section, including Subsections 8.1 – 8.18, outlines terms which will not be subject to further negotiation, unless noted. 8.1 The Proposal By submitting a proposal, Proposers consent to the following terms: a) The City reserves the right both to reject any and all proposals, and to waive irregularities in any proposal; b) The City reserves the right to request clarification of information submitted, and to request additional information on any proposal; c) The City reserves the right to award any contract to another Proposer, if the successful Proposer does not execute a contract within a time frame as determined by the City; d) Any proposal may be withdrawn up until the date and time set above for opening of the proposals. Any proposal not so withdrawn shall constitute an irrevocable offer, for a period of 180 days, for the services described in the above-stated specifications, or until one or more of the proposals has been approved by the City, whichever occurs first; e) The contract resulting from acceptance of a proposal by the City shall be in a form supplied or approved by the City and shall reflect the specifications in this RFP, unless modifications are otherwise agreed to by the 23 parties. The Proposer agrees to be bound by, at a minimum, the terms contained in this Section 8.0; provided, however, that Proposers should note whether the City’s insurance requirements vary from current policies held by that Proposer. The City may accept current coverages at its discretion. If the Proposer takes exception to any other provisions in this RFP, they must be noted in the proposal, and the City reserves the right, in its sole discretion, to reject the proposal on that basis. The City reserves the right to reject any proposed agreement or contract that does not conform to the specifications contained in this RFP or which is not approved by the City Attorney’s office; f) The City shall not be responsible for any costs incurred by the Proposer in preparing, submitting or presenting its response to the RFP; g) After reviewing submitted proposals, at its discretion, the City will invite Proposers to an interview. 8.2 Contract: The contract shall consist of the following documents: the Request for Proposals (RFP), the accepted proposal, a Professional Services Agreement (as drafted by the City to incorporate the terms in Section 8.0 and any additional terms as may be negotiated) and any agreed upon written changes to any of the foregoing documents. The contract documents are complimentary and what is called for in any one document shall be binding as if called for by all. In the event of a conflict, the final signed contract shall prevail over the accepted proposal and the RFP. The Mayor, or the Mayor’s designee, is the only individual who may legally commit the City to the expenditure of funds for a contract resulting from this RFP, and then only after the Mayor has first received authority to sign that contract from the Kent City Council. No cost chargeable to the proposed contract may be incurred before receipt of a fully executed contract. 8.3 Compliance with Laws: The Proposer shall comply with all applicable federal, state and local laws, rules, and regulations, affecting its performance and hold the City harmless against any claims arising from the violation thereof. The Proposer must obtain a State of Washington and City business license and otherwise comply with Kent Municipal Code 5.02.020. 8.4 Public Disclosure: The City is a public agency subject to the Washington State Public Records Act, Chapter 42.56 RCW. Records and information provided to or otherwise used by the City may be subject to a request submitted under the state Public Records Act. In such an event, the Proposer agrees to cooperate fully with the City in satisfying the City’s duties and obligations under the Public Records Act. If a request is received for records the Proposer has identified as confidential, proprietary, or protected 24 trade secret material, the City will use its best efforts to provide the Proposer with notice of the request in accordance with RCW 42.56.540 and a reasonable time within which for the Proposer to file for an injunction to prohibit the City’s disclosure of the requested record. The City will not assert any exemption based on trade secret, proprietary, or confidential information on behalf of the Proposer. The Proposer shall defend, indemnify, and hold the City, its officers, officials, employees, agents, and volunteers harmless from any and all claims, injuries, damages, losses or suits, including all legal costs and attorney fees, arising out of or in connection with any public records request and any exemption claimed by the Proposer. The provisions of this section shall survive the expiration or termination of any executed contract. 8.5 Contract Term: It is the City’s intent that the agreement between the City and the Proposer who is awarded this Contract will be for an initial term of five years from the date of the initial signed Contract. After the initial term, the Contract may renew for a successive three-year term automatically every three years, not to exceed a total contract term of 14 years. Should the Proposer wish to not renew the Contract, a minimum notice of 180 days is required. Each renewal will be based upon a successful review of the services provided by the Proposer and agreement on any changes to the Contract. Further, the initial term is intended to begin with a transitionary period in December 2020, in which service will overlap with the current provider. 8.6 Indemnification: The successful Proposer (“Vendor”) shall defend, indemnify, and hold the City, its officers, officials, employees, agents, and volunteers harmless from any and all, claims, injuries, damages, losses or suits, including all legal costs and attorney’s fees, arising out of or in connection with the performance of the subsequent Contract, except for injuries and damages caused by the sole negligence of the City. The City’s inspection or acceptance of any of the Vendor’s work when completed shall not be grounds to avoid any of these covenants of indemnification. The provisions of this section shall survive the expiration or termination of the subsequent Contract. The obligation to indemnify, defend, and hold harmless the City and its agents and employees under this subparagraph extends, but shall not be limited to any claim, demand, or cause of action brought by or on behalf of any employee of the Vendor, against the City, its officers, agents, or employees and includes any judgment, award, and cost arising there from, including attorney’s fees. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THIS INDEMNIFICATION CONSTITUTES THE VENDOR’S WAIVER OF IMMUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51, RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER. 25 8.7 Insurance: Unless otherwise agreed to by the City, the Vendor will procure and maintain insurance coverage consistent with the requirements described in Exhibit A. 8.8 Termination: After commencement of a Contract with the Vendor, the City may, by written notice of default to the Vendor, terminate the Contract, in whole or in part, if the Vendor fails to provide the services called for in the Contract within the time specified therein, or if funding is no longer available for the services described herein. The City may terminate the Contract, in whole or in part, for any reason by providing written notice to the other party 90 days prior to the effective date of termination. 8.9 Independent Contractor: The Vendor shall be an Independent Contractor, the City being interested only in the results obtained under this Contract. Any Contract formed as a result of a proposal does not create an agency relationship between the Vendor and the City. The Vendor is not an agent or legal representative of the City for any purpose. The Vendor is not granted any express or implied right or authority to assume or create any obligation or responsibility on behalf of or in the name of the City or to bind the City in any manner. 8.10 Work Performed at Vendor’s Risk: The Vendor shall take all necessary precautions and shall be responsible for the safety of its employees, agents, and subcontractors in the performance of the contract work and shall utilize all protection necessary for that purpose. All work shall be done at the Vendor’s own risk, and the Vendor shall be responsible for any loss of or damage to materials, tools, or other articles used or held for use in connection with the work. 8.11 Limitation of Actions: The Vendor must, in any event, file any lawsuit arising from or connected with a Contract subsequent to the proposal within 120 calendar days from the date of the occurrence giving rise to such suit or the Vendor’s ability to file that suit shall be forever barred. This section, which was specifically bargained for by the parties, limits any applicable statutory limitations period. 8.12 Discrimination: In the hiring of employees for the performance of work under any subsequent Contract or any sub-contract, the Vendor, its sub-contractors, or any person acting on behalf of the Vendor or sub-contractor shall not, by reason of race, religion, color, sex, age, sexual orientation, national origin, or the presence of any sensory, mental, or physical disability, discriminate against any person who is qualified and 26 available to perform the work to which the employment relates. Prior to commencement of services, the Vendor shall execute a City of Kent Equal Employment Opportunity Policy Declaration, comply with City Administrative Policy 1.2, and upon completion of the contract work, file a Compliance Statement. 8.13 Recyclable Materials: Pursuant to Chapter 3.80 of the Kent City Code, the City requires its contractors and consultants to use recycled and recyclable products whenever practicable. A price preference may be available for any designated recycled product. 8.14 Non-Waiver of Breach: The failure of either party to insist upon strict performance of any of the covenants and agreements contained in this Contract, or to exercise any option conferred by this Contract in one or more instances shall not be construed to be a waiver or relinquishment of those covenants, agreements or options, and the same shall be and remain in full force and effect. 8.15 Resolution of Disputes and Governing Law: Any subsequent Contract shall be governed by and construed in accordance with the laws of the State of Washington. If the parties are unable to settle any dispute, difference, or claim arising from the parties’ performance of a subsequent Contract, the exclusive means of resolving that dispute, difference, or claim, shall only be by filing suit exclusively under the venue, rules, and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in writing to an alternative dispute resolution process. In any claim or lawsuit for damages arising from the parties' performance of a subsequent Contract, each party shall pay all its legal costs and attorney's fees incurred in defending or bringing such claim or lawsuit, in addition to any other recovery or award provided by law; provided, however, nothing in this paragraph shall be construed to limit the City's right to indemnification, discussed under Section 8.6 of this RFP. 8.16 Assignment: Any assignment of a subsequent Contract by either party without the written consent of the non-assigning party shall be void. If the non-assigning party gives its consent to any assignment, the terms of the subsequent Contract shall continue in full force and effect and no further assignment shall be made without additional written consent. 8.17 Modification. No waiver, alteration, or modification of any of the provisions of the subsequent Contract shall be binding unless in writing and signed by a duly authorized representative of the City and Vendor. 27 8.18 Quality of Work Services provided by the Vendor will be consistent with state regulations and community standards of practice for correctional institution medical care, including the WASPC Inmate Health Care standards. - 1 - EXHIBIT A INSURANCE REQUIREMENTS FOR INMATE MEDICAL SERVICES CONTRACT INSURANCE The Vendor shall procure and maintain for the duration of the Contract, insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the Vendor, their agents, representatives, employees or subcontractors. A. Minimum Scope of Insurance Vendor shall obtain insurance of the types described below: 1. Commercial General Liability insurance shall be written on ISO occurrence form CG 00 01 and shall cover liability arising from premises, operations, independent contractors and personal injury and advertising injury. The City shall be named as an insured under the Contactor’s Commercial General Liability insurance policy with respect to the work performed for the City. Excess liability coverage is acceptable to provide coverage above the primary coverage layer in order to fulfill the limits of this agreement. 2. Healthcare Professional Liability insurance covering the Vendor for acts, errors and omissions of medical staff. 3. Workers’ Compensation coverage as required by the Industrial Insurance laws of the State of Washington. B. Minimum Amounts of Insurance Vendor shall maintain the following insurance limits: 1. Commercial General Liability insurance shall be written with limits no less than $10,000,000 each occurrence, $10,000,000 general aggregate. Coverage can be a provided through a combination of primary and excess coverages which amount to the required limits. Any excess coverage must “follow form” of the primary layer. 2. Healthcare Professional Liability insurance shall be provided with limits no less than $10,000,000 per occurrence. C. Other Insurance Provisions The insurance policies are to contain, or be endorsed to contain, the following provisions for Commercial General Liability: - 2 - EXHIBIT A (Continued) 1. The Vendor’s insurance coverage shall be primary insurance as respect the City. Any insurance, self-insurance, or insurance pool coverage maintained by the City shall be excess of the Vendor’s insurance and shall not contribute with it. 2. The Vendor’s insurance shall be endorsed to state that coverage shall not be cancelled by either party, except after thirty (30) days prior written notice by certified mail, return receipt requested, has been given to the City. 3. The City of Kent shall be named as an additional insured on all policies (except Professional Liability) as respects work performed by or on behalf of the Vendor and a copy of the endorsement naming the City as additional insured shall be attached to the Certificate of Insurance. The City reserves the right to receive a certified copy of all required insurance policies. The Vendor’s Commercial General Liability insurance shall also contain a clause stating that coverage shall apply separately to each insured against whom claim is made or suit is brought, except with respects to the limits of the insurer’s liability. D. Vendor’s Insurance For Other Losses The Vendor shall assume full responsibility for all loss or damage from any cause whatsoever to any tools, Vendor’s employee owned tools, machinery, equipment, or motor vehicles owned or rented by the Vendor, or the Vendor’s agents, suppliers or contractors as well as to any temporary structures, scaffolding and protective fences. E. Waiver of Subrogation The Vendor and the City waive all rights against each other any of their Subcontractors, Sub-subcontractors, agents and employees, each of the other, for damages caused by fire or other perils to the extend covered by Builders Risk insurance or other property insurance obtained pursuant to the Insurance Requirements Section of this Contract or other property insurance applicable to the work. The policies shall provide such waivers by endorsement or otherwise. F. Acceptability of Insurers Insurance is to be placed with insurers with a current A.M. Best rating of not less than A:VII. G. Verification of Coverage Vendor shall furnish the City with original certificates and a copy of the amendatory endorsements, including but not necessarily limited to the additional insured endorsement, evidencing the Commercial General Liability and Healthcare Professional Liability insurance of the Vendor before commencement of the work. - 3 - EXHIBIT A (Continued) H. Subcontractors Vendor shall include all subcontractors as insureds under its policies or shall furnish separate certificates and endorsements for each subcontractor. All coverages for subcontractors shall be subject to all of the same insurance requirements as stated herein for the Vendor. EXHIBIT B PROPOSAL PRICE, STAFFING PLAN AND SIGNATURE SHEET The City of Kent (“City”) is using a forms-based approach for this RFP. The objective is to ensure that the responses are in a similar order and format to better facilitate a fair and complete evaluation of responses. Proposers must electronically complete the forms below, which in total will comprise the price proposal, the staffing plan, and the signature sheet. Proposers may include alternative bids with expanded or reduced services, and indicate their cost in the line item pricing in Exhibit B. Please provide an explanation of any deviation from the services described in Section 6. Alternative proposals are not required for a proposal to be considered, but their inclusion in a bid are invited and will be considered. Each alternative staffing plan proposal will be considered individually. Please provide the following contact information: Proposer Name: Contact Name: Mailing Address: Title: Phone Number: E-Mail Address: EXHIBIT B (Continued) PROPOSAL PRICE 1. Personnel Rates: In Table A, please list all titles (e.g. Registered Nurse, Physician Assistant, etc.) and not-to-exceed hourly rates for all staff positions that appear in any of proposed Staffing Plans below. Table A will be used as reference to calculate the total proposed annual cost of all proposed Staffing Plans. Proposed staffing schedules will be filled in in Tables B(1), B(2), and B(3), which will use the titles and rates in Table A to calculate total annual cost. Add more lines as necessary. Table A: Staff Position/Certification Level/ Title Rate per hour $ $ $ $ $ $ $ $ $ 2. Staffing Plan : Proposed staffing levels and annual rates should be filled in forth below. The proposed total cost should be consistent with the rates proposed above in Table A. Add additional lines, as necessary. Three tables have been provided: Table B(1), Table B(2), and Table B(3). Table B(1) should reflect the estimated cost to provide a staffing level comparable to what the City currently contracts for, as described in Sections 3.6 and 6.2.1.1 of the RFP. Table B(2) should reflect any additional staffing level that the Proposer is able to offer, as described in Section 6.2.2. of the RFP (such as 24-hour nursing). Table B(3) should reflect whatever other staffing level the Proposer believes can EXHIBIT B (Continued) adequately provide the medical services listed in Section 6.1. These proposals are in the alternative, only one will ultimately be selected – each proposal in the alternative must contain a staffing level capable of providing the minimum services described in this RFP. Table B(1): Staff Position Staff Schedule (Days and Time of Work Performed, e.g. M, W, F 1200-1500) Weekly Hours Annual Hours Total Annual Cost $ $ $ $ $ $ $ Table B(1) Annual Cost Total $ Table 2(a) Table B(2): Staff Position Staff Schedule (Days and Time of Work Performed, e.g. M, W, F 1200-1500 Weekly Hours Annual Hours Total Annual Cost $ $ $ $ $ $ Table B(2) Annual Cost Total $ Table B(3) Staff Position Staff Schedule (Days and Time of Work Performed, e.g. M, W, F 1200-1500 Weekly Hours Annual Hours Total Annual Cost $ $ $ $ $ Table B(3) Annual Cost Total $ EXHIBIT B (Continued) 3. Administrative Services: In the table below, enter a proposed annual fee for administrative services. This fee should cover all costs associated with the work described in Sections 6.3, 6.4, and 6.5 of the RFP. Ensure that all costs are appropriately listed. Table C Administrative Services Total Cost $ $ EXHIBIT B (Continued) PROPOSAL PRICE TOTALS RFP EXHIBIT B- TOTAL COST In the table below, please validate the total costs in your response. Proposal 1 Administrative Costs Table C Subtotal: $ Annual Personnel Costs Table B(1) Subtotal: $ Proposal 1 - TOTAL ANNUAL COST $ If applicable, in the table below please validate the total costs in your response for your alternative proposal. Proposal 2 Administrative Costs Table C Subtotal: $ Annual Personnel Costs Table B(2) Subtotal: $ Proposal 2 - TOTAL ANNUAL COST $ If applicable, in the table below please validate the total costs in your response for your alternative proposal. Proposal 3 Administrative Costs Table C Subtotal: $ Annual Personnel Costs Table B(3) Subtotal: $ Proposal 3 – TOTAL ANNUAL COST $ EXHIBIT B (Continued) SIGNATURE SHEET I/we make the following certifications and assurances as a required element of the proposal to which it is attached, understanding that the truthfulness of the facts affirmed here and the continuing compliance with these requirements are conditions precedent to the award or continuation of the related contract(s): 1. I/we declare that all answers and statements made in the proposal are true and correct. 2. The prices and/or costs data have been determined independently, without consultation, communication, or agreement with others for the purpose of restricting competition. However, I/we may freely join with other persons or organizations for the purpose of presenting a single proposal. 3. The attached proposal is a firm offer for a period of 180 days following receipt, and it may be accepted by the City of Kent, Washington without further negotiation (except where obviously required by lack of certainty in key terms) at any time within the 180-day period. 4. In preparing this proposal, I/we have not been assisted by any current or former employee of the City of Kent whose duties relate (or did relate) to this proposal or prospective contract, and who was assisting in other than his or her official, public capacity. (Any exceptions to these assurances are described in full detail on a separate page and attached to this document.) 5. I/we understand that the City of Kent will not reimburse me/us for any costs incurred in the preparation of this proposal. All proposals become the property of the City of Kent, and I/we claim no proprietary right to the ideas, writings, items, or samples, unless so stated in this proposal. 6. Unless otherwise required by law, the prices and/or cost data which have been submitted have not been knowingly disclosed by the Proposer and will not knowingly be disclosed by him/her prior to opening, directly or indirectly, to any other Proposer or to any competitor. 7. I/we agree that submission of the attached proposal constitutes acceptance of the solicitation contents and the terms listed in Section 8.0. If there are any exceptions to these terms, I/we have described those exceptions in detail on a page attached to this document. 8. No attempt has been made or will be made by the Proposer to induce any other person or firm to submit or not to submit a proposal for the purpose of restricting competition. 9. I/we grant the City of Kent the right to contact references and others, who may have pertinent information regarding the Proposer's prior experience and ability to perform the services contemplated in this procurement. 10. I/we represent that the RFP documents have been read in their entirety, are understood and we desire to submit to the City of Kent the following proposal that conforms to said RFP documents and further that by signature of this proposal we acknowledge all requirements. 11.I realize the final funding for any service is based upon budget levels and the approval of the City of Kent. 12. I affirm that the annual price shall be the same for the first three years of the contract, after which annual rates may be adjusted by the local Consumer Price Index on an annual basis. Signature of Proposer Title Date EXHIBIT C STATEMENT OF QUALIFICATIONS Please answer or provide the following: 1) Legal name of applicant entity as registered with the IRS and/or State of Washington. 2) Name of contact. 3) Title. 4) Address. 5) Telephone/email/fax. 6) Federal Tax Identification Number. 7) Washington State UBI Number if issued. 8) State Industrial Account Identification Number if issued. 9) Did outside individuals/agencies assist with preparation of this program? Yes /No a. If yes, please describe: 10) The names and number of years the firm has been in business under current or previous names or additional assumed business names. 11) The name and title of the person authorized to execute a contract on behalf of the firm. 12) The caption, cause number, court, legal counsel, and general summary of any litigation pending, or judgment rendered within the past seven years adverse to the Proposer, including individuals who would be performing services under the contract, and including all claims for medical negligence, malpractice and wrongful death. 13) Engagements the company has undertaken in the last five years which have resulted in: a. Claims being filed by the Federal Government or the Washington State Departments of L&I, Employment Security or Revenue. b. Liens or claims recorded with any government auditor by suppliers or subcontractors. List with whom, for what, and amount. c. Note the extent, if any, to which the firm, association or corporation or any person in a controlling capacity associated therewith or any position involving the administration of Federal, State or local funds, is currently under suspension, debarment, voluntary exclusion, or determination of eligibility by any agency; has been suspended, debarred, voluntarily excluded or determined ineligible by any agency within the past three years; does have a proposed debarment pending; has been indicted, convicted or has a civil judgement rendered against said person, firm, association or corporation by a court of competent jurisdiction in any matter involving fraud or misconduct with the past three years. 14) Proposers must demonstrate their legal ability to do business in the state of Washington and the City of Kent throughout the performance of any contact. Proposers must have and maintain an active business license. Please provide a copy of this license. 15) The Proposer is able to obtain professional liability insurance and catastrophic insurance per the minimum requirements in Attachment A? 16) Please describe how the Proposer has the ability to provide a system of medical support to the inmates which meets current WSPC standards? 17) Please describe how the Proposer has the ability to begin services at an acceptable contract start‐up time as determined by the City, which date shall be no later than December 15, 2020? 18) Please describe how the Proposer has the capability to supervise and monitor the program, ensuring satisfactory provision of services. 19) Is the Proposer able and willing to perform all the minimum specifications and program requirements outlined in Section 6.0 (Scope of Services)? 20) Attach a statement outlining any exceptions to the City’s requirements or clarifications to the requirements, if appropriate. 21) Does the Proposer intend to offer any of the additional services described in Section 6.2.2? 22) How would Proposer provide dental services? Is Proposer able to provide a dentist to perform palliative dental services in the Facility or in a mobile office provided by Proposer that comes to the Facility? 23) Please describe the process by which the Proposer would obtain prescription medication. Does the Proposer pay full or reduced rates? What are those rates? 24) Attach a statement with any additional services or procedures of benefit to the City not specifically required herein, which the Proposer offers to provide. If these additional costs will incur additional costs, please be sure to indicate so here, as well as in your response to Exhibit B. 25) Project Team Members: a. Clearly identify the Proposer’s designated Medical Director and Health Services Administrator. b. Please identify as well as the specific individuals who will be assigned to the work, their primary role(s) on the project, and their respective expertise in such work. c. Please provide resumes for Medical Director/Physician(s), PAs, RNs, and any additional staff who will be providing services related to this contract. d. Please provide a copy of relevant certifications and licenses for proposed staff. 26) List of references: Provide client references, with which the applicant has provided similar healthcare services within the last five years; at least one references should be municipal or state government entities. Include the name and telephone number of the contact person and a description of the role and services provided to that contact. The Proposer acknowledge that all employees providing service under this contract must be able to pass the appropriate criminal history check prior to commencement of services. 27) Partners / Sub-consultants: a. Does the Proposer intend to use any Partners or sub-contractors? b. If yes, please provide an explanation of any partnering arrangements that have been or will need to be made in order to complete the work. EXHIBIT F HDS’S PROPOSAL TO RFP 2020-01 REQUEST FOR K PROPOSALSENT ,a ADVERTISED DATE: Request for Inmate Medical Services Proposal Title: Requesting City of Kent - Police Department - Corrections Facility Dept./Div.: RFP Number: # 2020-01 Due Date: August 28, 2020 RFP Diane McCuistion Coordinator: City of Kent - Corrections Facility Diane McCuistion 1230 Central Ave South Kent, Washington 98032 DMcCuistion@Kentwa.gov PROPOSERS MUST COMPLETE AND SIGN THE FORM BELOW (TYPE OR PRINT) Company Name Address J City/State /Postal Code Signature T Authorized Representative/Title (Print name f and title) �� � / 1 iV�.a_/��•• �� �'l c:tt r`l �`l �` 9"l �J � f,�.�� � i,t�� h � !r"/ ��' i� Email Phone Fax Company adquarte`Located in State/Province of 1 ►LTHCARE DELIVERY SYSTEMS PROPOSAL FOR PROVIDING INMATE MEDICAL SERVICES FOR CITY OF KENT -- CORRECTIONS FACILITY RFP # 2020.01 KENT, WA SHANNON SLACK, RN, MSN, ARNP, CCHP PRESIDENTICHIEF EXECUTIVE OFFICER HEALTH CARE DELIVERY SYSTEMS (360) 742-6882 AUGUST 28,2020 CITY OF KENT — CORRECTIONS FACILITY Proposal for Inmate Medical Services HEALTHCARE DELIVERY SYSTEMS 9039 Silverspot Drive SE Tumwater WA 98501 August 28, 2020 Diane McCuistion RE: RFP # 2020-01 City of Kent -Corrections Facility 1230 Central Avenue South Kent, WA 98032 Dear Diane McCuistion Healthcare Delivery Systems is pleased to offer the following proposal to provide inmate medical services for the Kent Corrections Facility. Our company has a proven record in developing and managing complex correctional health care systems and looks forward to assisting in the growth and development of your program. At your request, we have developed a proposal that outlines the services that we offer. Healthcare Delivery Systems is confident that any monitoring or audits of our proposed system will fully support our design and staffing plans. All our designs fully comply with state and federal statutes. Full attempt will be made to model NCCHC standards. All proposed structure and fee schedules are subject to mutual negotiations. Thank you for considering Healthcare Delivery Systems for your correctional health care needs. We look forward to working with you and your staff. We are available for discussion at your convenience and welcome any questions. Sincerely, Shannon Slack, RN, MSN, ARNP, CCHP President and Chief Executive Officer Phone: (360) 742-6882 Fax: (360) 688-1862 jsyoung360@gmail.com CITY OF KENT — CORRECTIONS FACILITY Proposal for Inmate Medical Services COMPANY PROFILE Organization Healthcare Delivery Systems (HDS) is incorporated under Healthcare Delivery, Inc., and has been a Washington State corporation since August 1999. Shannon Slack, CEO/President became the Primary stockholder in September of 2012. Prior to that time stockholders were Kathleen Alves, CEO/President and David Alves, Secretary/Treasurer. Healthcare Delivery's history of ownership, Kathleen Alves, RN, MSN, ARNP, CCHP had been providing medical and mental healthcare and management services to correctional facilities and community health centers since 1992, initially as a Sole Proprietor. In 1997 she partnered with Marla Fredericks, RN, and began FA Enterprises. In February of 1999, the business incorporated as Fredericks -Alves, Inc., the corporation was dissolved in August of 1999. At that time FA Enterprises managed twelve corrections medical departments as well as staffing for dialysis units and providing interim staffing for four Department of Corrections facilities and the Pierce County Jail. Shannon Slack, RN, MSN, ARNP, CCHP has been providing medical and mental healthcare and management services to corrections facilities and community health centers since 2007. In December of 2011 Shannon partnered with Dave and Kathleen Alves. In September of 2012, Dave and Kathleen Alves chose to retire, at which time their shares were bought by Shannon Slack. At that time Healthcare Delivery, Inc. managed seven corrections medical departments. Healthcare Delivery Systems has provided services for thirteen facilities in Washington State. In addition, HDS owned and managed BigRock Health Clinic for seven years. HDS continues to provide consulting in the correctional setting as well as for Washington State Department of Health. Currently, HDS manages the health care for six correction facilities in western Washington and provides Diversion and Re -Entry services as well as Transition case management for TCCF. Current Management Structure: (1) President and CEO — Shannon Slack (2) Secretary/Treasurer - Shannon Slack (3) Operations Managers — Mary Feist, RN and Justina Fortney, RN (4) Diversion Re -Entry Manager — Kathleen Weakland Phone: (360) 742-6882 Fax: (360) 688-1862 jsyoung360@gmai1.com CITY OF KENT — CORRECTIONS FACILITY Proposal for Inmate Medical Services Experience Healthcare Delivery Systems has designed medical and mental health programs for county detention centers as well as state correctional facilities. Community outpatient and inpatient health care programs have also been designed by our staff. Managed care with emphasis on appropriate care for inmate populations is our specialty. All our design systems model National Commission on Correctional Health Care (NCCHC) and American Correctional Association (ACA) standards. Healthcare Delivery Systems is committed to quality programs that model community and national standards of health care. Currently, Healthcare Delivery Systems provides total managed medical and mental health care services twenty-four hours daily to six correctional facilities in Western Washington which include three county jails, one juvenile detention facilities, and 2 city jails. Target populations served vary from a 16 bed juvenile detention facility to a county correctional facility with more than 8000 annual bookings. a. HDS currently has twenty employees. b. Annualized payroll is $1,051,396.29. c. HDS has been in business for twenty years. d. current Contracts. FACILITY Puyallup City Jail 311 West Pioneer Puyallup, WA 98371 Ed Shannon (253) 841-5425 CONTRACT DATE Original Contract: 11-01-97 No Expiration RENEWAL Open Contract TYPE AND SIZE City Jail 30 Beds CONTRACT AMOUNT/SERVICES PROVIDED/STAFFING $92,440,00 annually for sick call two days a week by ARNP/RN. Average 40 hours per month. Psych ARNP 16 hours a month Phone triage 24 hours a day/seven days a week Thurston County Corrections Facility Original Annually County Jail 470 Beds $1,080,227.50 annually for sick call four days a week by ARNP (20 2000 Lakeridge Drive Contract: 03-01-98 hours week). MD 4 hours a week,18 Olympia, WA 98502 Expires: hours daily RN coverage 7 days a Todd Thoma (360) 709-5905 12-31-11 week. Psych ARNP 16 hours a week. RN coverage for 14-day physicals 4 hours week. Clerical support 20 hours week. 40 hours a week of Diversion/Re-Entry. 40 hours week of Transitions Case Administrative coverage 10- hours a week. Phone triage 24 hours a day/seven days a week. Mason County Juvenile Detention Original Open County Juvenile $13,732.50 annually for sick call one day a week by RN/ARNP. PO Box 1037 Contract: 03-01-98 Contract Detention Average 9 hours a month. Phone Shelton, WA 98584 No Facility triage 24 hours a day/seven days a Mike Dunn 360) 427-9670 EXT 739 Expiration Original Open 16 Beds County Jail week. $491,789.00 annually for sick call Mason County Jail PO Box 1037 Contract: Contract 150 Beds 30 hours a week by ARNP/ RN Shelton, WA 98584 05-13-98 Nursing coverage 16 hours a day. Ps ch ARNP 8 hours a week Phone Kevin Hanson Phone: (360) 742-6882 Fax: (360) 688-1862 jsyoung360@gmail.com CITY OF KENT — CORRECTIONS FACILITY Proposal for Inmate Medical Services (360) 427-9670 EXT 369 No Expiration triage 24 hours a day/ seven days a week. Olympia City Jail Original Annually City Jail $167,091.00 annually for sick call 900 Plum Street Contract: 28 Beds two 2 hours week by ARNP (average 10 hours per month). RN Olympia, WA 98507 04-01-01 Expires: coverage daily for four hours. Psych Chandra Brady 12/31/12 ARNP 4 hours a week Phone triage (360) 753-8042 24 hours a day/seven da s a week. on County Jail Original Open County Jail $142,990.00 annually for sick call ins Road rDavid Contract: Contract 80 Beds two days a week by ARNP. Average 40 hours a month. Psych adlock, WA 98507 06-13-01 15 hours a month. Phone Fortino 344-9743 NoARNP Expiration triage 24 hours a day/seven days a week. Organizational Structure. HEALTHCARE DELIVERY SYSTEMS Medical Director S. Slack, MSN, ARNP Proposed Organizational Structure, January 2021 Shannon Slack President/CEO ARNP Staff: Shannon Slack, ARNP J. Rice, ARNP Kaitlin Bock, ARNP David Guidry Psych Nursing Staff M. Feist, RN J. Fortney, RN S. Lawver, RN D. Shah, RN K. Pickering,LPN B. Olsen -Glavin LPN D. Franklin -Banks LPN Shannon Slack Secretary Clerical Staff: Shannon Slack Re -Entry Diversion Lead Kathleen Weakland Transition Coordinator Jaimie Sparks Phone: (360) 742-6882 Fax: (360) 688-1862 jsyoung360@gmail.com CITY OF KENT — CORRECTIONS FACILITY Proposal for Inmate Medical Services EXHIBIT A INSURANCE REQUIREMENTS FOR INMATE MEDICAL SERVICES CONTRACT Insurance The following is the current insurance and limits that HDS is currently required to carry. Medical Malpractice: HDS shall maintain coverage of not less than $2,000,000 per loss and $4,000,000 annual aggregate as an occurrence policy. The coverage shall apply to liability for a professional error, act or omission arising out of the scope of the health services defined in the Contract. Coverage shall not exclude bodily injury; property damage; hazards related to the work rendered as part of the Contract or within the scope of the services as defined by the Contract including testing, monitoring, measuring operations, or laboratory analysis where such services as rendered as part of the Contract. The policy will remain in effect for the duration of the contract. Commercial General Liability: HDS shall maintain coverage for bodily injury, personal injury and property damage, subject to limits of not less than $1,000,000 per occurrence and $2,000,000 annual aggregate. The Commercial General Liability insurance shall include the County, its officials, employees and agents with respect to performance of services, and shall contain no special limitations on the scope of protection afforded to the County as additional insured. HDS will furnish the County with the endorsement pages of the policy showing Thurston County as additional insured. Coverage shall include Employers Liability Coverage with a limit of not less than $1,000,000. Liability insurance policies shall be primary with respect to any insurance or self- insurance programs covering the County, its elected and appointed officers, officials, employees and agents. Failure to comply with reporting provisions of the liability insurance shall not affect coverage provided to the County, its officers, officials, employees or agents. All required insurance policies will be in force from the time services commence until services are completed and will only be place with insurers licensed to do business in the State of Washington and having A.M. Best Company ratings of no less than A. • HDS shall furnish Kent City with properly executed certificate of insurance and/or signed policy endorsement which shall clearly confirm all insurance required prior to commencement of services. Certificates of insurance shall show the Certificate Holder as Kent City and include c/o Kent City- Corrections Facility, 1230 Central Ave South, Kent, Washington 98032. Written notice of cancellation or change will be mailed to the City Risk Analyst. A copy of any and all insurance policies specified in the Contract will be provided upon request to the Kent City Risk Management Division. Phone: (360) 742-6882 Fax: (360) 688-1862 jsyoung360@glnai1.com CITY OF KENT — CORRECTIONS FACILITY Proposal for Inmate Medical Services EXHIBIT B PROPOSAL PRICE, STAFFING PLAN AND SIGNATURE SHEET Contact Information 1. Personnel Rates: Table A: I Provider/PHD/Medical Doctor 150.00 Phone: (360) 742-6882 Fax: (360) 688-1862 jsyoung360@gmai1.com CITY OF KENT — CORRECTIONS FACILITY Proposal for Inmate Medical Services Table B Staffing Registered Nurse (RN) M,T,W,TH, Fri 42.5 2210 $172,380.00 Licensed Practical Nurse (LPN) M,T,W,TH, Fri,Sat,Sun 66.5 3458 $190,190.00 Registered Nurse (RN) Holidays 10 days year 85 $5,312.50 Licensed Practical Nurse (LPN) Holidays 10 days year 85 $2,337.50 ARNP two days a week 3 156 $19,500.00 Medical Doctor (Physcian) off site; on site prn 1.5 78 $11,700.00 ARNP -Phone Coverage M,T,W,TH, Fri, Sat, Sun 168 8736 $36,000.00 Table C Administrative Services Medical Director $95,750.00 Administrator $65,750.00 Medical Records (EMR) $20,000.00 Supplies $10,000.00 RFP EXHIBIT B — TOTAL COST dministrative Cost nnual Personnel Costs able C Subtotal: able B Subtotal: Phone: (360) 742-6882 Fax: (360) 688-1862 jsyoung360@gmai1.c0m 9 Me EXHIBIT B (Continued) SIGNATURE SHEET I/we make the following certifications and assurances as a required element of the proposal to which it is attached, understanding that the truthfulness of the facts affirmed here and the continuing compliance with these requirements are conditions precedent to the award or continuation of the related contract(s): 1. I/we declare that all answers and statements made in the proposal are true and correct. 2. The prices and/or costs data have been determined independently, without consultation, communication, or agreement with others for the purpose of restricting competition. However, I/we may freely join with other persons or organizations for the purpose of presenting a single proposal. 3. The attached proposal is a firm offer for a period of 180 days following receipt, and it may be accepted by the City of Kent, Washington without further negotiation (except where obviously required by lack of certainty in key terms) at any time within the 180-day period. 4. In preparing this proposal, I/we have not been assisted by any current or former employee of the City of Kent whose duties relate (or did relate) to this proposal or prospective contract, and who was assisting in other than his or her official, public capacity. (Any exceptions to these assurances are described in full detail on a separate page and attached to this document.) 5. I/we understand that the City of Kent will not reimburse me/us for any costs incurred in the preparation of this proposal. All proposals become the property of the City of Kent, and I/we claim no proprietary right to the ideas, writings, items, or samples, unless so stated in this proposal. 6. Unless otherwise required by law, the prices and/or cost data which have been submitted have not been knowingly disclosed by the Proposer and will not knowingly be disclosed by him/her prior to opening, directly or indirectly, to any other Proposer or to any competitor. 7. I/we agree that submission of the attached proposal constitutes acceptance of the solicitation contents and the terms listed in Section 8.0. If there are any exceptions to these terms, I/we have described those exceptions in detail on a page attached to this document. 8. No attempt has been made or will be made by the Proposer to induce any other person or firm to submit or not to submit a proposal for the purpose of restricting competition. 9. I/we grant the City of Kent the right to contact references and others, who may have pertinent information regarding the Proposer's prior experience and ability to perform the services contemplated in this procurement. 10. I/we represent that the RFP documents have been read in their entirety, are understood and we desire to submit to the City of Kent the following proposal that conforms to said RFP documents and further that by signature of this proposal we acknowledge all requirements. 11.I realize the final funding for any service is based upon budget levels and the approval of the City of Kent. 12.I affirm that the annual price shall be the same for the first three years of the contract, after which annual rates may be adjusted by the local Consumer Price Index on an annual basis. Signature of Propose/r ? E, EVZC-) Title Date CITY OF KENT — CORRECTIONS FACILITY Proposal for Inmate Medical Services EXHIBIT C STATEMENT OF QUALIFICATIONS 1. Legal name of applicant entity as registered with the IRS and/or State of Washington. Healthcare Delivery Systems (HDS) is incorporated under Healthcare Delivery, Incorporated 2. Name of contact. Shannon Slack 3. Title Owner/President 4. Address. 9039 Silverspot Drive SE; Tumwater WA 98501 5. Telephone/emaiUfax. Telephone (360) 742-6882 Email jsyoun6360kgmail.com Fax (360) 688-1862 6. Federal Tax Identification Number. 91-1978110 7. Washington State UBI Number. 601-973-792-000 8. State Industrial Account Identification Number. 93 8,082-02 9. Did outside individuals/agencies assist with preparation of this program? No 10. The names and number of years the firm has been in business under the current or previous names or additional assumed business names. Healthcare Delivery Systems (HDS) is incorporated under Healthcare Delivery, Inc., and has been a Washington State corporation since August 1999 11. The name and title of the person authorized to execute a contract on behalf of the firm Shannon Slack, Owner/President 12. The caption, cause number, court, legal counsel, and general summary of any litigation pending, or judgement rendered within the past seven years adverse to the Proposer, including individuals who would be performing services under the contract, and including all claims for medical negligence, malpractice and wrongful death. Within the last three years HDS has been involved in the following litigation: Phone: (360) 742-6882 Fax: (360) 688-1862 jsyoung360@gmail.com CITY OF KENT — CORRECTIONS FACILITY Proposal for Inmate Medical Services Dahl vs. Mason County, et al. filed December of 2017. USDC Western District of Washington Case No. 3:16-cv-05719. Claim No. SM400973. This was Settled during mediation. Non -disclosures in regard to the settlement amounts paid by each involved parry were signed by all parties involved. John Coleman, Jr. vs Mason County Sheriff s Office; Mason County Jail. Was filed in November 2018. Cause No 18-2-00479. Case was dismissed without prejudice in regards to Healthcare Delivery. Gregory Ericsson vs Mason County Sheriff's Office; Mason County Jail. Was filed in November 2018. Cause No 18-2-0480-23. Case was dismissed without prejudice in regards to Healthcare Delivery. 13. Engagements the company has undertaken in the last five years which resulted in: There have been no engagements undertaken by Healthcare Delivery, Inc. in the last five years Copy of Business License to demonstrate their legal ability to do business in the state of Washington and the City of Kent. HDS has license to do business in Washington State. See attached documentation 14. The Proposer is able to obtain professional liability insurance and catastrophic insurance per the minimum requirements in Attachment A. Healthcare Delivery is able to obtain the required insurance. 15. Please Describe how the Proposer has the ability to provide a system of medical support to inmates which meets the current WSPC standards. Statement of Work Healthcare Delivery Systems will provide qualified health care professionals to provide comprehensive health services for the Kent City Corrections Facility. All aspects of our program will meet constitutional and community standards as well as NCCHC, WSPC, and ACA Standards regarding the provision of health service in Correctional facilities. Continuity of Service There will be absolute continuity of health services and existing nursing, physician, psychiatric, mental health and social services staff will remain as employees Receiving Screening A receiving screening will be performed on all new or transferred inmates by custody staff promptly upon their arrival at the facility. Findings of the preliminary screening will be Phone: (360) 742-6882 Fax: (360) 688-1862 jsyoung360@gmail.com CITY OF KENT — CORRECTIONS FACILITY Proposal for Inmate Medical Services recorded on the County approved form and a copy will be sent to Medical for inclusion into the Medical Record. Upon arrival to the facility, custody staff will provide oral and written explanation ` of procedure for accessing medical and dental services while incarcerated. Nursing staff will review the Receiving Screening promptly and appropriate disposition based on the findings shall occur and be documented. Health Appraisal A health appraisal will be completed on all inmates within fourteen days after arrival at the Corrections facility by a Registered Nurse with special Certification in providing health screenings. Health staff will maintain a computer log of completed health appraisals. The health appraisal will include: a. Review of the Receiving Screening b. Complete history and physical screening c. Recording of height, weight and vital signs d. Mental health screening e. Vision and hearing screening f. Dental screening g. Diagnostic tests as clinically indicated h. Referral to health provider for in depth evaluation as indicated. Sick Call Sick call will be conducted daily except for weekends and holidays. Additional sick calls will be scheduled to meet the demand of inmate population levels or acuity. Sick calls will be conducted by an on -site Registered Nurse, Nurse Practitioner, or Physician. Health care staff will utilize triage protocols and ensure that appropriate and timely follow up care is provided. Inmates will be seen within 48 hours (72 hours for weekends or holidays) of their submission of a kite. Sick call shall be between the hours of 0700 and 1600 daily and on weekends and holidays as deemed necessary. Two dedicated medical liaison custody staff is minimum to provide adequate inmate transport and on -site security. Three staff will allow for off -site appointments without interrupting the clinic flow. Custody staff will be needed for three designated medication deliveries and staffing may be staggered to accomplish clinic demands. for blood sugars and medication delivery, Phone: (360) 742-6882 Fax: (360) 688-1862 jsyoung360@gmai1.com CITY OF KENT — CORRECTIONS FACILITY Proposal for Inmate Medical Services security for blood sugars, administrative segregation rounds and urgent and emergent medical triage as well as dressing changes and treatments. Sick Call/Segregation Units Nursing staff will provide on -site assessments and administrative segregation rounds daily. Patient Referrals Referrals will be scheduled to specialty providers according to clinical priority. Hospital Care/Ancillary Services Outpatient/inpatient health services from hospitals and diagnostic facilities will be implemented to meet the health care requirements of the inmates. Medical staff will coordinate with custody staff in arranging transportation for hospitalization. All diagnostic results will be communicated to the health care provider promptly on receipt of test results to assess the need for follow up care as indicated and to screen for discrepancies between the clinical observations and laboratory reports. Health providers will be notified immediately of all STAT results. The Fiscal Department will be notified of inmates with personal health insurance. Typically, this is discovered at Booking but anyone (Custody or Medical) with this knowledge will make a positive effort to have the medical costs covered by insurance. Specialty Care and Referrals Referral arrangements for specialty care will be made for those inmates with health care problems that extend beyond the primary care services provided on -site. All outside referrals will be coordinated with the County for security arrangements. Whenever feasible, specialty clinics staffed by Board -certified health professionals may be operated on -site. The cost of staffing specialty clinics must be weighed by the numbers of inmates needing the services. Psychiatric clinics will be arranged to meet the needs of mentally inmates. Pregnant women will be scheduled for prenatal care at an obstetrician's office. They will also receive routine on -site monitoring to include: a. Routine urine testing for proteins, ketones, and glucose b. Vital signs and weight c. Assessment of fundal height and fetal heart tones d. Prenatal vitamins and milk with every meal e. Observation for signs of toxemia. Phone: (360) 742-6882 Fax: (360) 688-1862 jsyoung360@gmai1.com CITY OF KENT — CORRECTIONS FACILITY Proposal for Inmate Medical Services Chronic Care Patients Chronic care patients will have individualized treatment plans developed by the health provider which may include diet, medication and diagnostic diagnostic testing. Chronic care patients will be followed by health care staff minimally every three to six months as indicated. Emergency Care Emergency medical consultation will be provided by phone by licensed health care providers 24 hours a day, seven days a week. Treatment may consist of stabilization and referral to a local hospital or local physician. The Health Services Administrator or designee will be on -call 24 hours per day. Dental Care The following dental services will be provided on -site: a. Prevention of dental disease and oral hygiene education, b. Dental treatment for acute dental problems such as severe pain, infections, bleeding, or repair of broken dental prosthesis (if repairable) as necessary for eating. c. Referral to a dental specialist if needed, and d. Provision for emergency dental care. e. Therapeutic Diet Program Therapeutic diets will be monitored for efficacy and recommendations will be made as needed. Mental Health Mental health services consist of psychiatric services provided in accordance with NCCHC standards to include: a. Crisis intervention and referral for inmates who require more intense care than available at the facility, b. Individual treatment plans updated regularly, for inmates requiring ongoing monitoring and/or care, c. Psychiatric evaluation of inmates exhibiting unusual or bizarre behavior, d. Monitoring of all inmates receiving psychotropic medication, including appropriate lab studies, e. Development of policies and procedures for distribution of psychotropic medication to maximize the potential for safety and compliance, f. Assessment for tardive dyskinesia to be accomplished as necessary, g. Ongoing training of all institutional staff on relevant mental health topics, Phone: (360) 742-6882 Fax: (360) 688-1862 jsyoung360@gmail.com CITY OF KENT — CORRECTIONS FACILITY Proposal for Inmate Medical Services h. Thorough documentation of service delivery in the health record, i. Maintenance of logs and reports of service delivery, j. Participation in administrative meetings and Quality Improvement Program, Health Education of Inmates Develop and maintain an inmate health education program to include: a. HIV education and testing program, b. Handouts to promote smoking cessation and personal health management to be made available in the living units, classroom or medical units depending on security requirements, c. Substance abuse disorder. Education provided for MAT programs d. Teaching handouts available in medical for individual instruction. Transfer of Medical Information All inmate transfers into Kent City Corrections Facility shall be screened by Custody staff on arrival to the facility (Receiving Screening) for chronic conditions, communicable diseases, mental status and current medications. Medical staff will review the Receiving Screening and make certain that the urgent needs are met and current medications are provided. The inmate will be scheduled for a 14-day Health Assessment. HDS will develop a procedure in coordination with Custody to affect an efficient transfer of pertinent medical information to emergency facilities, outside specialty care providers and other correctional facilities. 16. Healthcare Delivery has the ability to begin services at an acceptable contract start- up as determined by the City, which date shall be no later than December 15, 2020. Healthcare Delivery Systems has designed medical and mental health programs for county detention centers as well as state correctional facilities. Community outpatient and inpatient health care programs have also been designed by HDS. Managed care with emphasis on appropriate care for inmate populations is our specialty. All our design systems model National Commission on Correctional Health Care (NCCHC), WSPC and American Correctional Association (ACA) standards. Healthcare Delivery Systems is committed to quality programs that model community and national standards of health care. Currently, Healthcare Delivery Systems provides total managed medical and mental health care services twenty-four hours daily to six correctional facilities in Western Washington which include three county jails, one juvenile detention facilities, and 2 city Phone: (360) 742-6882 Fax: (360) 688-1862 jsyoung360@gmail.com CITY OF KENT — CORRECTIONS FACILITY Proposal for Inmate Medical Services jails. Target populations served vary from a 16 bed juvenile detention facility to a county correctional facility with more than 8000 annual bookings. 17. The Prosper will demonstrate the capability to supervise and monitor the program, ensuring satisfactory provision of services. Continuous Quality Improvement Committee HDS will implement a continuous quality improvement (CQI) committee that will monitor the health service provided. Committee membership will consist of the Medical Director, HSA and a designated CQI chairperson who will meet quarterly to review collected data and formulate corrective action plans. Communication of results will take place at scheduled meetings with facility administration. Medical Audit Committee Regular chart review will be ongoing by all health providers to afford peer review. The reviews will be documented and included in the CQI review. Infection Control An infection control program shall be ongoing to include concurrent surveillance of patients and staff, preventive techniques and treatment and reporting of infections in accordance with local and state laws. The program will be in compliance with CDC guidelines and OSHA regulations. Inmate Grievances/Complaints All inmate grievances will be answered in accordance with City policy by Medical staff. Monthly statistics of all grievances filed (those with and without merit) will be maintained. HDS will implement City recommendations in any disputed grievances. Policy and Procedures HDS will develop, maintain, and annually review administrative and operational policies and procedures designed to meet NCCHC standards and Washington State Statutes in coordination with the City. Utilization Review HDS will implement a utilization and review program for the review and analysis of off - site referrals, including sub -specialty and inpatient stays. The program shall include non - urgent hospitalization, pre -certification, urgent hospital certification, concurrent review, prospective denial, discharge planning, and prior authorization of targeted procedures, CAT and MRI scans. The utilization management program will document that the use of Phone: (360) 742-6882 Fax: (360) 688-1862 jsyoung360@gmail.com CITY OF KENT — CORRECTIONS FACILITY Proposal for Inmate Medical Services the outside service was medically indicated and that the length of stay (if applicable) was appropriate. Strategic Planning and Consultation HDS has demonstrated the ability to provide strategic operation planning and medical and administrative consultation by successfully providing efficient and cost-effective health services to multiple corrections facilities since 1999. Risk Management and Mortality Review HDS has demonstrated and ongoing risk management plan successfully since 1999. Critical incidents are prevented by consistent and thorough monitoring of inmates at risk. Ongoing training for both Medical and Custody staff produce a team -oriented approach to risk identification and management. Communication is ongoing both written and verbally. The mortality review process has been identified in policy and procedure and has been implemented appropriately in the past including the City's Risk Manager. Safety and Sanitation Reports Monthly safety and sanitation inspections of the institution food service, housing and work areas are coordinated with City personnel. Appropriate recommendations for corrections of discrepancies will be made. Administrative Meetings and Reports. Healthcare Delivery Systems shall coordinate with the Chief Deputy of Corrections to discuss health care services. Minutes will be maintained and distributed to attendees with copies retained for future reference. HDS will participate in external reviews, inspections and audits as requested and shall participate in the preparation of responses to critiques. Identified deficiencies will be addressed and corrected. Monthly medical staff meeting minutes will be kept. Statistical Data. Healthcare Delivery Systems MIS consists of daily logs and monthly, quarterly, and annual statistics as per NCCHC requirements. Healthcare Delivery Systems will provide all required statistical data related to the health care delivery program which shall include utilization of service statistics and other areas that the City agrees would be useful to evaluate the program and anticipate future needs. 18. Is HDS able and willing to perform all the minimum specifications and program requirements outlined in Section 6.0 (Scope of Services)? Phone: (360) 742-6882 Fax: (360) 688-1862 jsyoung360@gmail.com CITY OF KENT — CORRECTIONS FACILITY Proposal for Inmate Medical Services HDS is able and willing to perform all the minimum specifications and program requirements outlined in Section 6.0 (see answer to question number 16). 19. Attach a statement outlining any exceptions to the City's requirements or clarifications to the requirements, if appropriate. No requirements or clarifications to the requirements are needed. 20. Does the Proposer intend to offer any of the additional services described in Section 6.2.2? HDS does not intend to offer any of the additional services at this time. The current minimums are adequate. In the future if additional services that the Correctional facility identifies, HDS would be happy to discuss the needs and how they can be met. 21. How will Proposer provide dental services? Is HDS able to provide a dentist to perform palliative dental services in the Facility or in a mobile office provided by HDS that comes to the Facility? Dental Care The following dental services will be provided on -site: f. Prevention of dental disease and oral hygiene education, g. Dental treatment for acute dental problems such as severe pain, infections, bleeding, or repair of broken dental prosthesis (if repairable) as necessary for eating. h. Referral to a dental specialist if needed, and i. Provision for emergency dental care. HDS does not have a dentist on staff nor a Facility or in a mobile office that would be able to provide dental care. 22. How will HDS obtain prescription medication. Does the HDS pay full or reduced rates? What are those rates? Pharmacy Services HDS will promote preferred provider rates for pharmacy services and will monitor the pharmacy for cost containment and efficient service in all phases of the pharmacy operation. The designated pharmacy shall provide on -site consultation quarterly with written reports by a registered pharmacist. Licensed nurses will administer medications as prescribed on a consistent schedule. HDS has adopted the Washington State Department of Corrections approved formulary. HDS does not pay for medications, the Corrections facilities pay for all medication. HDS assist in establishing a contract with the a pharmacy and the correctional facility. Phone: (360) 742-6882 Fax: (360) 688-1862 jsyoung360@gmai1.com CITY OF KENT — CORRECTIONS FACILITY Proposal for Inmate Medical Services 23. Attach a statement with any additional services or procedures of benefit to the City not specifically required herein, which HDS offers to provide. If these additional services or procedures will incur additional costs, please be sure to indicate so here, as well as in your response to Exhibit B. At this time HDS has no additional services or procedures to add to this proposal. 24. Project Team Members: a. Shannon Slack is the Medical Director with Dr. Miguel Balderrama providing oversight. b. See job descriptions attached c. Medical Directors resume is attached d. Certifications and licenses will be provided to the city of each employee that will work within their facility. e. 25. References: Reference Business Address PHONE/FAX Todd Thoma Thurston County Jail (360) 709-5905 Phone Chief 3491 Ferguson St SW (360) 754-2957 Fax Thurston County Jail Tumwater WA 98512 Ed Shannon Puyallup City Jail (253) 841-5425 Phone Lieutenant 311 West Pioneer (253) 841-5530 Fax Puyallup City Jail Puyallup, WA 98371 Kevin Hanson Mason County Jail (360) 427-8444 Phone Chief PO Box 1037 (360) 427-9197 Fax Mason County Jail Shelton, WA 98584 Chandra Brady Olympia City Jail (360) 753-8214 Phone Chief 900 Plum Street (360) 753-8275 Fax Olympia City Jail Olympia, WA 98507 Mark Stern, MD 1100 Surrey Trace Drive SE (360) 701-6520 Phone Correctional Consultant Tumwater, WA 98501 (360) 786-6537 Fax 26. Partners/ Sub -consultants HDS does not have any partners/sub-consultants at this time. Phone: (360) 742-6882 Fax: (360) 688-1862 jsyoung360@gmai1.com CARE DELIVERY SYSTEMS PORTING DOCUMENTS FOR CITY OF KENT -- CORRECTIONS FACILITY RFP # 2020-01 KENT, WA SHANNON SLACK, RN, MSN, ARNP, CCHP PRESIDENTICHIEF EXECUTIVE OFFICER HEALTH CARE DELIVERY SYSTEMS (360) 742-6882 Shannon Slack, BSN, MSN, ARNP, CCHP 9039 Silverspot Drive SE, Tumwater Wa 98501 360-791-7133: jsyoung360@gmail.com SUMMARY OF QUALIFICATIONS Sixteen years' experience in health care with ten years in corrections. Certified as a correctional health provider by the National Commission of Correctional Health Care. Experienced in evaluating and treating both medical and mental health issues in a community setting as well as in a correctional setting. Prescriptive privileges allow comprehensive management of both medical and mental health patients. Experienced in health care management for 10 years. EDUCATION Masters of Nursing Family Nurse Practitioner Program Gonzaga University, Spokane, WA 2015 Bachelor of Science in Nursing Chamberlain College of Nursing, Addison, IL 2011 ADN Program Pierce College, Puyallup, Wa 2006 Practical Nursing Program Clover Technical College, Lakewood, Wa 2003 Certificated Nursing Assistant Kalispell Regional Hospital, Kalispell, MT 1987 PROFESSIONAL WORK EXPERIENCE Advanced Registered Nurse Practitioner/Owner Healthcare Delivery Systems, Tumwater Wa 2015 to current Registered Nurse/Manager/Owner Healthcare Delivery Systems, Olympia Wa 2007 to 2015 Office Manager/Accounts Payable, Accounts Receivable/Payroll J&S Cutting, Olympia Wa 1990 to 2016 Registered Nurse, ICU Providence St. Peter's Hospital, Olympia Wa 2007 to 2009 Ranch Manager/Beef Production Young Ranch, Tenino, Wa 1996 to 2005 Data Tech/Photogrammatry WSDOT Geographic Services, Tenino, Wa 1994 to1996 Payroll Tech/Accounts Receivable Lacey Collision Center, Lacey, Wa 1993 CNA Kalispell Regional Hospital, Kalispell, Mt 1987 to 1989 LICENSURE Advanced Registered Nurse Practitioner, Washington Registered Nurse, Washington CERTIFICATIONS Family Nurse Practitioner, ARNP BLS for Health Care Providers Certified for Health Assessments in the Correctional Setting Certified for HIV Prevention Counseling Training Certified for Collection of DNA Collection for Convicted Offender Samples CCHP Certified Correctional Health Professional ADDITIONAL QUALIFICATIONS American Academy of Nurse Practitioners Certified Correctional Health Professional PROFESSIONAL AFFILIATIONS Academy of Correctional Health Professionals National Commission of Correctional Health Care REFERENCES Miguel Balderrama, MD Pierce County Medical Director (253) 988-0472 Julie Rice, ARNP, Medical Director for Rochester Family Practice (360) 481-6881 Terry Frasl, Lead Accountant for Tenino School District (360) 790-1176 �0m i m o_ 1 c') v CD sD ID CD CD C ICD 0 CD EL a) I 'COD 'COD Q0 n f v c CD CD y co t� CD =, a c m [ O O Z { D � cn CD CD A, m C> r ♦ Al P'F O cr a1 i..►. 3 m � N iut E ID Q" Q CA) 0 A POOL 10 CD CD CD MR 3 �-h cCD A }� n o N CCCil ;sti t O 15411 A � � b E I Print Certificate Checklist - American Association of Nurse Practitioners 5/31/18, 11:55 PM AAIlp" , Attlericatt atif�n of ACCREDITED N ISM: �'E�..N-CA ITIONERS" CONTINUING EDUCATION CERTIFICATE This is to certify Shannon Star Slack has successfully completed the education activity NP/PA 24-Hour Buprenorphine Waiver Training This activity has been approved for 24.00 Contact Hour(s) of CE; 18.00 of which may be applied towards Pharmacology by the American Association of Nurse Practitioners. Activity ID # 16122474 This activity was planned in accordance with AANP CE Standards and Policies. Date Completed: 6/1/2018 1:55 AM (GMT-06:00) Central Time (US & Canada) Anne Norman, DNP, APRN, FNP-C, FAANP Activity Sponsor/Provider: AANP Vice President of Education and Accreditation American Association of Nurse Practitioners P.O. Box 12846 Austin, TX 78711 (512) 4424262 cecenter@aanp.org https:llaanp.inreachce.com/Certificate/Generate/36fO9e5l-646a-4477-b43d-22c661lda7a3 Page 1 of 1 n� y �n o R. d� �x 14 b o N n n xr o �. M o p eD o � o � � cfl O rD 0909 0 rA fool,, � � o Mir b Criminal Justice Information System Security & Awareness Training a+k` This is to certify that Shannon Slack has successfully completed the Level 2 CJIS Security Training This cent f l'cal ion ex pimv two April 13, 2018 ,'ear'sf-oin the date of issitance. April 13, 2020 Certification Date Expiration Date MIGUEL ANGEL BALDERRAMA MD, MHA 5017 70111 ST. SOUTH TACOMA, WA 98409 Telephone (253) 472-6270 Office (253) 798-7402 2002 — Present Sea Mar Community Health Center, Tacoma, WA Physician (part-time) 2002- Present Medical Director, Corrections Health Clinic Pierce County Corrections and Detention Center Physician consultant for Thurston County Jail and Jefferson County Jail 1997 — 2002 Sea Mar Community Health Center, Tacoma, WA Clinical Director Responsible for the medical operation at the Tacoma clinic. 1994 —1997 Family Practice Residency at Sea Mar Community Health Center, Seattle and Providence Medical Center, Seattle, WA. 1990 — 1994 Sea Mar Community Health Center, Seattle, WA Director of Clinical Services/Clinic Manager. Responsible for the daily operation of an ambulatory care center with 17 Medical providers. Direct supervision of the activities of the departments of nursing, laboratory, reception, medical records, pharmacy, social work, health education, WIC and nutrition. 1987 —1990 Madigan Army Medical Center, Ft. Lewis, WA. Non -Commissioned Officer In Charge Responsible for the daily operation of the Audiology and Speech Pathology Clinic. Supervised, trained and evaluated personnel. Managed the laboratory for repairing hearing aid devices. 1985 —1986 Mexican Institute of Social of Social Security Medicine House Staff Provided direct patient care in a tertiary care hospital for the Department of Internal Medicine. 1983 —1984 Mexican Department of Health and Welfare Physician responsible for the operation of an out -patient rural facility providing primary care and implementing programs in preventive medicine. EDUCATION: Family Practice Residency, U. of WA at Providence Medical Center, Seattle, 1997 Masters Degree in Health Administration, Chapman College, 1990 Medical Degree, Autonomous University Of Coahuila Mexico, 1982 Educational Commission for Foreign Medical Graduates Certification, 1984 CERTIFICATION: American Board of Family Medicine LICENSURE : Washington State Medical License OTHER PROFESIONAL ACTIVITIES Served as Chair of the Family Practice Committee at Multicare System from 2002 to 2004 Member of the American Academy of Family Medicine LANGUAGES Fluent in Spanish and English. PERSONAL Married with two children. Enjoy fishing, hiking and playing guitar. DELIVERY SYSTEMS REQUIREMENTS t employees of Healthcare Delivery Systems meet State and company standards while employed as staff in correctional institutions POLICY: A. Correctional health care can offer unique challenges to the healthcare professional. Healthcare Delivery Systems expects the highest standards of professionalism from the staff. The following standards will be adhered to at all times while on duty. a. Staff will maintain absolute confidentiality in caring for inmates and the medical record will be available on to health care staff. b. Staff will provide expert health care to all inmates without regard for race, color, religion, sex, sexual orientation, national origin, HIV status, or handicap. c. Staff will not form any personal friendships with inmates or perform any special services or favors for inmates. Boundary issues are important to ensure staff s safety and facility security. d. Staff will comply with all facility entrance requirements, and adhere to all facility standards, policies and procedures. Corrections officers oversee all security issues. B. It is the policy of Healthcare Delivery Systems to employ only those individuals who have the following attributes: a. A photocopy of current and proper licensure certification, or registration by the appropriate state agency. b. Proof of current CPR certification. c. Proof of annual PPD skin testing or negative chest x-ray. d. Pass background screening as required by facility. e. Proof of Hepatitis B immunization with adequate titer or a signed refusal of immunization. f. Proof of United States citizenship g. Documentation of annual OSHA training in prevention of communicable disease in a health care setting. h. Proof of annual review of company policies and procedures. DELIVERY SYSTEMS RESPONSIBILITIES FOR NURSES 1) Maintain professional licensure and continuing education. 2) Deliver medications legally a) Know medication interactions and research side effects for all medications delivered. b) Sign all medications off when delivered (NOT later — this causes errors). c) When medication is refused document it on the MAR at the time of refusal. d) If the medication is an important medication (anti -seizure, psychiatric, anti -coagulant, cardiac, antibiotic or HIV medication) it needs to be reported to the provider either verbally or in writing. 3) Document all interactions in chart with inmates and log statistics on the day sheet. 4) All inmates (male and female) must have custody staff with them at all times you are interacting with them. NO EXCEPTIONS. 5) You must leave the facility no later than your scheduled shift allows unless you contact the supervisor to explain the emergency/crisis and to receive permission to stay over the clock. KEEPING THE TEAM TOGETHER (Make points with your supervisor) 1) Contact the scheduler to make certain that ANY schedule changes are approved. It is much appreciated that staff work to fill their own absences. Without checking with the supervisor, the schedule change can impact other staff and the budget. 2) Give requested days off by the first day of the month prior — this allows the scheduler to get you the days off you need and the rest of the staff to have equal opportunity for hours and to avoid overtime. 3) Make certain your time is submitted by the 15th and the end of the month as well as the end of the week. This allows for timely billing and a timely paycheck. HEALTHCARE DELIVERY, INC HEALTH PROGRAM PERSONNEL : Registered Nurse JOB The Registered Nurse (RN) in the correctional setting provides expert professional nursing care for the incarcerated patient. The RN assesses, plans, implements, and evaluates the care of the patient, and provides for continuity of care as needed for transfer or discharge from the facility. QUALIFICATIONS: Minimum requirements include graduation from an accredited school of nursing; current State licensure; and CPR certification. Prior experience in a correctional setting is desirable. The preferred applicant will be able to communicate effectively, and have an ability to work compatibly with corrections staff, inmates, and other medical personnel. The nurse will possess strong organizational skills, and a clear understanding of the importance of personal and facility security, efficiency and cost effectiveness in the correctional environment. The applicant must be able to make quick assessments of patients and be able to handle emergency situations appropriately. The nurse must be aware of boundary issues when working with inmates and be alert to discern inmates demeanor and potential for manipulation or violence in all interactions. Physical guidelines include ability to stand/walk for up to twelve hours per day; bend, stoop, twist; assist patients on and off exam tables, and in and out of wheelchairs; and turn and reposition patients as needed. Ability to lift up to 25 pounds and carry materials weighing up to 25 pounds. JOB RESPONSIBILITIES: 1. Maintain absolute confidentiality in caring for inmates. 2. Work with all members of the health care team and corrections staff to provide optimal care to the patient, and communicate with other health team members to assure continuity of care. 3. Maintain a positive and caring attitude with all patients and staff. 4. Provide expert nursing care to all inmates without regard for race, color, religion, sex, sexual orientation, national origin, HIV status, or handicap. HEALTHCARE DELIVERY, INC P � � .4r Maintain e Aent physical and mental health. st in assuring that equipment is functioning properly, and that proper -upplies,� available for optimal patient care. appropriately the care that is delivered to the patient, and guard the ntialitv of the medical record.. 8. Identify actual and potential risk to patients and others and take action to minimize or eliminate risk and maximize safety. 9. Continuing education to meet State requirements and maintain current State licensure. JOB DUTIES: 1. As assigned by facility needs according to contract, and to include: (a.) assessing the patient's needs. (b.) planning the care to be received taking into consideration security issues. (c.) implementing the care according to established nursing practice and specific protocols as available. (d.) evaluating the care for adequacy and outcomes. 2. Refer inmates to health care practitioners as deemed necessary, 3. Clear all personal medications brought into the facility. 4. Provide inmates access to health promotion and disease prevention information. HEALTHCARE DELIVERY, INC inmates responding inmate to gain perti HEALTHCARE DELIVERY, INC. JAIL NURSE — LPN -loordination of the Charge Nurse, assists in the provision of health services to zg medical assessments of inmates. Assists healthcare providers in examining Addresses medical issues by reviewing each medical kite, speaking with jail .ion. Calls on -call provider to report information and receive orders if necessary. Administers medications. Essential Functions: 1. Transcribes healthcare providers' orders into computer, fills prescriptions, and dispenses to medical boxes. 2. Reviews the medical background and condition of new inmates including physicals, administration of TB skin tests, and other testing. Determines the need for the attention of a healthcare provider, sets priorities and schedules visits with the healthcare provider. Consults with on -call provider as necessary on health care issues. 3. Assists healthcare provider and other medical professionals engaged in providing health care services to inmates. Schedules tests and appointments with other health agencies including dentist, xray, laboratories and others. 4. Assists with and examines inmates reporting for sick call, includes gathering medical information from the inmate, taking vital signs, drawing blood as necessary, and otherwise assisting the healthcare provider. Works with other medical staff in developing special treatment plans for inmates with various health conditions. 5. Sees patients for medical emergencies and determines appropriate follow-up. Changes bandages and provides other immediate assistance. 6. Responsible for obtaining blood and other specimens and packaging and transportation of specimens. 7. Coordinates referrals to mental health staff for crises and chronic care. 8. Checks medication in when received from pharmacy or brought in with the inmate. Dispenses over-the- counter medicines, creams and lotions after receiving a verbal order from on -call provider. 9. Assists in the maintenance of inmate health records. 10. Assists food service staff in dealing with special dietary issues. 11. Conducts on -call consultations with jail personnel for non -routine inmate health needs. Makes recommendations for health care and/or referral according to nursing protocols. 12. Restocks supplies, including insulin supplies, exam room supplies, and medical kits. Brings supply shortages to the attention of the Charge Nurse. Healthcare Delivery, Inc. Other Function Performs other duties as assigned during a public health emergency, the employee may be required ttx perform duties similai;to'but not limited to those in his/her job description. (The above statements are intended to describe the general nature and level of work being performed by people assigned this dlassif c4*. They, ore-no,t to be construed as an exhaustive list of all job duties performed by personnel sn Employment Qualifications: education: Completion of the curriculum as a Licensed Practical Nurse from an accredited college Experience: Prefer one'year of experience in medical nursing. Other Requirements: Licensed as a Practical Nurse in the State of Washington. (The qualifications listed above are intended to represent the minimum skills and experience levels associated with performing the duties and responsibilities contained in this job description. The qualifications should not be viewed as expressing absolute employment or promotional standards, but as general guidelines that should be considered along with other job -related selection or promotional criteria.) Physical Requirements: Stooping and bending to conduct physicals, stock and retrieve supplies and other functions. Ability to access medical and other office files. Ability to enter and access information using a computer. Ability to lift and carry supplies weighing up to 201bs. (This job requires the ability to perform the essential functions contained in this description. These include, but are not limited to, the following requirements. Reasonable accommodations will be made for otherwise qualified applicants unable to fulfill one or more of these requirements.) Working Conditions: Works in clinic and office conditions within a jail. Exposure to sharp needles, syringes and scalpels. Regular exposure to inmates, will always have security provided by custody when inmate is present. Exposure to communicable diseases, blood and other bodily fluids. Healthcare Delivery, Inc. V STATE OF WASHINGTON BUSINESS LICENSING SERVICE Thank you for filing online Our processing time generally takes up to 10 business days. Some endorsements may take more time for state or city approval. You will receive your business license with approved endorsements in the mail. An updated business license will be mailed to you when additional endorsements are approved. Confirmation Number: 0-015-957-890 Filing Date and Time: 08/28/2020 09:55:46 AM Payment Method: ACH Debit/E-Check Business Entity Information Entity Type: Corporation Name of Entity: HEALTHCARE DELIVERY INC AccountlD: 601973792-001-0002 Firm Name: HEALTHCARE DELIVERY INC Location Change Location Address: 9039 SILVERSPOT DR SE TUMWATER WA 98501-5575 Mailing Address: 9039 SILVERSPOT DR SE TUMWATER WA 98501-5575 Endorsement(s) Applied For Begin End Count Fee Tumwater General Business 08/28/2020 08/31/2021 1 $50.00 Olympia General Business - 08/28/2020 08/31/2021 1 $30.00 Non -Resident 80.00 Fee Type Begin End Count Fee BLS Processing Fee 08/28/2020 1 $0.00 $0.00 Grand Total: $80.00 bcL0004 8/28/2020 Gmail - BLOC-2200821 BLOC-2200821 1 message donotreply@kentwa.gov <donotreply@kentwa.gov> To: jsyoung360@gmail.com EXTERNAL EMAIL *** PLEASE DO NOT REPLY *** WA S HIN0T0fat 8/28/2020 12:54 PM 1067 10 ----------------------------------------- ----------------------------------------- Permits Healthcare Delivery System Receipt # 00071727 DEPT#: 144 New Business Comm. - Half Year $50.00 Permit ID Number:221895 DEPT#: 1473 Permit Tech Fee For Business License $1.00 Shannon Slack <jsyoun9360@gmail.com> Fri, Aug 28, 2020 at 12:55 PM https://mail.google.com/mail/u/O?ik=0241463034&view=pt&search=all&permthid=thread-f%3A1676300318901452352&simpi=msg-f%3A16763003189... 1 /2 8/28/2020 Gmail - BLOC-2200821 Permit ID Number:221895 Service Fee $1.35 Healthcare Delivery Total: $52.35 Credit Card $51.00 Service Fee $1.35 City of Kent 220 Fourth Avenue South Kent,WA98032 253-856-5201 customerservice@kentwa.gov Pay Your Utility Bill Online Pay.KentWA.gov Movah Receipt.pdf 25K hftps://mail.google.com/mail/u/0?ik=0241463034&view=pt&search=all&permth id=thread-f%3Al 676300318901452352&simpl=msg-f%3A 16763003189... 2/2 EXHIBIT G SAMPLE HDS INVOICE SAMPLEInvoice Date 11/4/2020 Invoice # KCJ Sample Bill To City of Kent Jail Diane Mc Cuistion 1230 Central Ave So Kent Wa 98032 HEALTHCARE DELIVERY SYSTEMS 9039 Silverspot Drive SE Tumwater Wa 98501 P.O. No.Terms Project Total DescriptionQuantity Rate Amount LPN Services (may vary based on calendar days) 01-01 thru 01-31-2021270 55.00 14,850.00 RN Services 01-01 thru 01-31-2021170 78.00 13,260.00 Medical Doctor Oversite 01-01 thru 01-31-20216 150.00 900.00 Psych ARNP Services 01-01 thru 01-31-20216 125.00 750.00 ARNP Services 01-01 thru 01-31-202112 125.00 1,500.00 Administrative Fees 01-01 thru 01-31-2021 15,073.75 15,073.75 PHONE TRIAGE 3,000.00 3,000.00 $49,333.75