Agreement av Ia- d7S
S
PROFESSIONAL SERVICES AGREEMENT
BETWEEN THE CITY OF MIAMI BEACH
AND
WORK INJURY SOLUTIONS OF DADE COUNTY, INC.
d /b /a ,HEALTH CARE CENTER OF MIAMI
FOR
MEDICAL SERVICES PURSUANT TO
REQUEST FOR PROPOSALS (RFP) NO. 46 -09/10
This Professional Services Agreement ( "Agreement ") is entered into this 1S day of
December, 2010, between the CITY OF MIAMI BEACH, FLORIDA, a municipal
corporation organized and existing under the laws. of the State of Florida, having its
principal offices at 1700 Convention Center Drive, Miami Beach, Florida, 33139
( "City "), and WORK INJURY SOLUTIONS OF DADE COUNTY, INC. d /b /a HEALTH
CARE CENTER OF MIAMI, a Florida CORPORATION, whose address is 7911 NW
72 " d AVENUE, SUITE 111, MIAMI, FL 33166 (Consultant)..
SECTION 1
DEFINITIONS
Agreement: This Agreement between the City and Consultant, including any
exhibits and amendments thereto.
City Manager: The chief administrative officer of the City.
Consultant: For the purposes of this Agreement, Consultant shall be deemed to be
an independent contractor, and not an agent or employee of the City.
Services: All services, work and actions by the Consultant performed or
undertaken pursuant to the Agreement.
Fee: Amount paid to the Consultant as compensation for Services.
Proposal Documents: Proposal Documents shall mean City. of Miami Beach RFP No. 46-
09/10 for a Medical Services Provider for the Provision of Various
Medical Services that may be Necessary or Required by the City of
Miami Beach, Local, State, and Federal Laws, together with all
amendments thereto issued by the City, and the Consultant's proposal
in response thereto (Proposal), all of which are hereby incorporated
and made a part hereof; provided, however, that in the event .of an
express conflict between the Proposal Documents and this Agreement,
the following order of precedent shall prevail: this Agreement; the
City's RFP; and the Proposal.
Risk Manager The Risk Manager of the City, with offices at 1700 Convention Center
Drive, Third Floor, Miami Beach, Florida 33139: telephone number
(305) 673- 7000, Ext. 6435: and fax number (305) 673 -7023.
SECTION 2
SCOPE OF SERVICES (SERVICES)
2.1 In consideration of the Fee to be paid to Consultant by the City, Consultant shall
provide the work and services described in Exhibit "A" hereto (the .Services).
SECTION 3
TERM
f
The term of this Agreement (Term) shall commence on December 1, 2010 (the Effective
Date) of. this Agreement by all parties hereto, and shall have an initial term of two (2) years,
with three (3) one year renewal options, to be exercised at the City Managers sole option
and discretion, by providing Consultant with written notice of same no less .than thirty (30)
days prior to the expiration of the initial term.
SECTION 4
} � � FEE
4:1 Consultant shall be compensated for the Services as set forth in accordance with its
Price as attached hereto and incorporated herein as Exhibit "B
4.2 INVOICING
Upon receipt of an acceptable and approved invoice, payment(s) shall be made within thirty
(30) days for that portion (or those portions) of the Services satisfactorily rendered (and
referenced in the particular invoice).
Invoices shall include a detailed description of the Services (or portions thereof) provided,
and shall be submitted to the City at the following address:
City of Miami Beach
Human Resources Department
Attn: Sue Radig; - HR Administration
1700 Convention Center Drive
Miami Beach, FL 33139
SECTION 5
TERMINATION
5.1 TERMINATION FOR CAUSE
If the Consultant shall fail to fulfill in a timely manner, or otherwise violates, any of the
covenants, agreements, or stipulations material to this Agreement, the City, through
its City Manager, shall thereupon have the right to terminate this Agreement for
cause. Prior to exercising its option to terminate for cause, the City shall notify the
Consultant of its violation of the particular term(s) of this Agreement, ,and shall grant
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I
Consultant ten (10) days to cure such default. If such default remains uncured after
ten (10) days, the City may terminate this Agreement without further notice to
Consultant. Upon termination, the City shall be fully discharged from any and all
liabilities, duties, and terms arising out of, or by virtue of, this Agreement.
Notwithstanding the above, the Consultant shall not be relieved of liability to the City
for damages sustained by the City by any breach of the Agreement by the
Consultant. The City, at its sole option and discretion, shall be entitled to bring any
and all legal /equitable actions that it deems to be. in its best interest in order to
enforce the City's'right and remedies against Consultant. The City shall be entitled to
recover all costs of such actions, including reasonable attorneys' fees.
5.2 TERMINATION FOR CONVENIENCE OF THE CITY
THE CITY MAY ALSO, THROUGH ITS CITY MANAGER, AND FOR ITS
CONVENIENCE AND WITHOUT CAUSE, TERMINATE THE AGREEMENT AT ANY
TIME DURING THE TERM BY GIVING WRITTEN NOTICE TO CONSULTANT OF
SUCH TERMINATION; WHICH SHALL BECOME EFFECTIVE WITHIN THIRTY (30)
DAYS FOLLOWING RECEIPT BY THE CONSULTANT OF SUCH NOTICE. IF THE
AGREEMENT IS TERMINATED FOR CONVENIENCE BY THE CITY,
CONSULTANT SHALL BE PAID FOR ANY SERVICES SATISFACTORILY
PERFORMED UP TO THE DATE OF TERMINATION; FOLLOWING WHICH THE
CITY SHALL BE DISCHARGED FROM ANY AND ALL LIABILITIES,. DUTIES, AND
TERMS ARISING OUT OF, OR BY VIRTUE OF, THIS AGREEMENT.
5.3 TERMINATION FOR INSOLVENCY
The City, also reserves the right to terminate the Agreement in the event the
Consultant is placed either in voluntary or involuntary bankruptcy or makes an
assignment for the benefit of creditors. In such event, the right and obligations for
the parties shall be the same as provided for in Section 5.2.
SECTION 6 .
INDEMNIFICATION AND INSURANCE REQUIREMENTS
6.1 INDEMNIFICATION
Consultant agrees to indemnify and hold harmless the City of Miami Beach.and its officers,
employees, agents, and contractors, from and against any and all actions (whether at law or
in equity), claims, liabilities, losses, and expenses, including, but not Limited to, attorneys'
fees and costs, for personal, economic or bodily injury, wrongful death, loss of or damage to
property, which may arise or be alleged to have arisen from the negligent acts, errors,
omissions or other wrongful conduct of the Consultant, its officers, employees, agents,
contractors, or any other person or entity acting under Consultant's control or supervision, in
connection with, related to, or as a result of the Consultant's performance of the Services
pursuant to this Agreement. To that extent, the Consultant shall pay all such claims and
losses and shall pay all such costs and judgments which may issue from any lawsuit arising
from such claims and losses, and shall pay all costs and attorneys' fees expended by the
City in the defense of such claims and losses, including appeals.
The parties agree that one percent (1%) of the total compensation to Consultant for
performance of the Services under this Agreement is the specific consideration from the City
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to the Consultant for the Consultant's indemnity agreement. The provisions of this Section
6.1 and of this indemnification shall survive termination or expiration of this Agreement.
6.2 INSURANCE REQUIREMENTS
The Consultant shall maintain and carry in full force during the Term, the following insurance;
1. Consultant General Liability, in the amount of $1,000,000;
2. Professional Liability /Medical Malpractice, in the amount of $300,000; and
: 3. Workers Compensation & Employers Liability, as required pursuant to Florida Statutes.
The insurance must be furnished by insurance - companies authorized to do business in the
State of 'Florida. All insurance policies must be issued by companies rated no.less than "B +"
as to management and not less than "Class VI" as to strength by the latest edition of Best's
Insurance Guide, published by A.M. Best Company, Oldwick, New Jersey, or its equivalent.
-All of Consultant's certificates shall contain endorsements providing that written notice shall
be given to the City at least thirty (30) days prior to termination, cancellation or reduction in
coverage in the policy.
Original certificates of insurance must be submitted to the City's Risk Manager for approval
(prior to any work and /or services commencing) and will be kept on file in the Office of the
Risk Manager. The City shall have the right to obtain from the Consultant specimen copies
of the insurance policies in the event that submitted certificates of insurance are inadequate
to ascertain compliance with required coverage.
The Consultant is also solely responsible for obtaining and submitting all insurance
certificates, for any sub - consultants.
Compliance with the foregoing requirements shall not relieve the Consultant of the liabilities
and obligations under this Section or under any other portion of this Agreement.
The Consultant shall not commence any work and or services pursuant to this Agreement
until all insurance required under this Section has been obtained and such insurance has
been approved by the City's Risk Manager.
SECTION 7
LITIGATION JURISDICTION/VENUE /JURY TRIAL WAIVER
This Agreement shall be construed in accordance with the laws of.the State of Florida. This
Agreement shall be enforceable in Miami -Dade County, Florida, and if legal action is
necessary by either party with respect to the enforcement of any or all of the terms or
conditions herein, exclusive venue for the enforcement of same shall lie in Miami -Dade .
County, Florida. By entering into this Agreement, Consultant and the City, expressly waive
any rights either party may have to a trial by jury of any civil litigation related to or arising out
of this Agreement.
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}
SECTION 8
LIMITATION OF CITY'S LIABILITY
The City desires to enter into this Agreement only if in so doing the City can place a limit on
the City's liability for any cause of action, for money damages due to an alleged breach by
the City of this Agreement, so that its liability for any such breach never exceeds the sum of
$10,000. Consultant hereby expresses its willingness to enter into this Agreement with
Consultant's recovery from the City for any damage action for breach of contract to be
limited to a maximum amount of $10,000.
Accordingly, and notwithstanding any other term or condition of this Agreement, Consultant
hereby agrees that the City shall not be liable to the Consultant for damages in an amount
in excess of $10,000 for any action or claim for breach of, contract arising out of the
performance or non - performance of any obligations imposed upon the City by this
'Agreement.
Nothing .contained in this section or elsewhere in this Agreement is in any way intended to
be a waiver of the Limitation placed upon the City's liability, as set forth in Section 768.28,
Florida Statutes.
SECTION 9
[INTENTIONALLY DELETED]
SECTION 10
GENERAL PROVISIONS
10.1 AUDIT AND INSPECTIONS
Upon reasonable verbal or written notice to Consultant, and at any time during normal
business hours (i.e. 9AM — 5PM, Monday through Fridays, excluding nationally recognized '
holidays), and as often as the City Manger may, in .his /her reasonable discretion and
judgment, deem necessary, there shall be made available to the City Manager, and /or such
representatives as the City Manager may deem to act on the City's behalf, to audit,
examine, and / or inspect, any and all other documents and /or records relating to all matters
covered by this-Agreement. Consultant shall maintain any and a.11 such records at its place
of business at the address set forth in the "Notices" section of this Agreement.
10.2. [INTENTIONALLY DELETETD]
10.3 ASSIGNMENT, TRANSFER OR SUBCONSULTING
Consultant shall not subcontract, assign, or transfer all or any portion of any work and /or
service under this Agreement without the prior written consent of the City Manager, which
consent, if given at all, shall be in the Manager's sole judgment and discretion. Neither this
Agreement, nor any term or provision hereof, or right hereunder, shall be assignable unless
as approved pursuant to this Section, and any attempt to make such assignment (unless
approved) shall be void.
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10.4 PUBLIC ENTITY CRIMES
Prior to commencement of the Services, the Consultant shall file a State of Florida Form
PUR 7068, Sworn Statement under Section 287.133(3)(a) Florida Statute on Public Entity
Crimes with the City's Procurement Division.
10.5 EQUAL EMPLOYMENT OPPORTUNITY
In connection with the performance of the Services, the Consultant shall not discriminate
against any employee or applicant for employment because of race,_ color, national origin,
religion, sex, gender identity, sexual orientation, disability, marital and familial status, or
age.
10.6 CONFLICT OF INTEREST
The Consultant herein agrees to adhere to and be governed by all applicable Miami -Dade
County Conflict of Interest Ordinances and Ethics provisions, as set forth in the Miami -Dade
County Code, and as may be amended from time to time; and by the City of Miami Beach
Charter and Code_ (as some may be amended from time to time); both of which are
incorporated by reference herein as if fully set forth herein.
The Consultant covenants that it presently has no interest and shall not acquire any
interest, direct or indirectly, which could conflict in any manner or degree with the
performance of the Services. The Consultant further covenants that in the performance of
this Agreement, no person having any such interest shall knowingly be employed by the
Consultant. No member of or delegate to the Congress of the United States shall be
admitted to any share or part of this Agreement or to any benefits arising there from.
SECTION 11
NOTICES
All notices and communications in writing required or permitted hereunder, shall be
delivered personally to the representatives of the Consultant and. the City listed below or
may be mailed by U.S. Certified Mail, return receipt requested, postage prepaid, or by a
nationally recognized overnight delivery service.
Until changed by notice in writing, all such notices and communications shall be addressed -
as follows:
TO CONSULTANT: Work Injury Solutions of Dade County, Inc.
d /b /a Health Care Center of Miami
Attn: Gustavo Gutierrez Jr., Vice - President
7911 NW 72I Avenue, Suite 111
Miami, FL 33166
TO CITY: City of Miami Beach
Human Resources Department
Attn: Sue Radig, HR Administrator
1700 Convention Center Drive
Miami Beach, FL 33139
6
Notice may also be provided to any other address designated by the party to receive notice if
such alternate address is. provided via U.S. certified mail, return receipt requested, hand
delivered, or by overnight delivery. In the event an alternate - notice address is properly provided,
notice shall be sent to such alternate address in addition to - any other address which notice
would otherwise be sent, unless other delivery instruction .as specifically provided for by the
party entitled to notice.
Notice shall be deemed given on the day on which personally served, or the day of receipt by
either U.S. certified mail or overnight delivery.
SECTION 12
MISCELLANEOUS PROVISIONS
12.1 CHANGES AND ADDITIONS
This Agreement cannot be modified or amended without the express written consent of the
parties. No modification, amendment, or alteration of the terms or conditions contained herein -
shall be effective unless contained in a written document executed with the same formality
and of equal dignity herewith.
12.2 SEVERABILITY
If any term or provision of this Agreement is held invalid or unenforceable, the remainder of
this Agreement shall not be affected and every other term and provision of this Agreement
shall be valid and be enforced to the fullest extent permitted by law.
12.3 ENTIRETY.OF AGREEMENT
The City and Consultant agree that this is the entire Agreement between the parties. This
Agreement supersedes all prior negotiations, correspondence, conversations, agreements or
understandings applicable to the matters contained herein, and there are no commitments,
agreements or understandings concerning the subject matter of this Agreement that are not
contained in this document. Title and paragraph headings are for convenient - reference and
are not intended to confer any rights or obligations upon the parties to this Agreement.
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IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be
executed by their appropriate officials, as of the date first entered above.
FOR CITY: CITY OF MIAMI BEACH, FLORIDA
ATTEST:
x
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By.
City Clerk or
FOR CONSULTANT WORK INJURY SOLUTIONS OF
DADE COUNTY, INC. d /b /a HEALTH
CARE CENTER OF MIAMI
ATTEST:
By: ✓2
Secretary President (i/+ct%
AS7,
Print Name Print Name / Title
APPROVED AS TO
FORM & LANGUAGE
t FOR ECUTION
, y Kttorne Date
8
Exhibit
RFP NO. 46 -09/10
9
REQUEST FOR PROPOSALS
.
FOR
A MEDICAL SERVICES PROVIDER FOR THE PROVISION OF
VARIOUS MEDICAL SERVICES THAT MAY BE REQUIRED
BY THE CITY OF MIAMI BEACH, AND OTHER LOCAL,
STATE, AND FEDERAL LAWS
RFP #46 -09/10
PROPOSAL DUE DATE: August 25, 2010 AT 3 :00 P.M.
PAMELA LEJAKATSARIS, CPPO, CPPB, SR. PROCUREMENT SPECIALIST
CITY HALL
PROCUREMENT DIVISION, 3RD Floor
1700 Convention Center Drive Miami Beach, FL 33139
Phone: 305.673.7490
Fax: 786.394.4006
E -mail: PamelaLeja @miamibeachfl.gov
F: \PURC \$ALL \PAMELA \RFP \RFP 46 -09 -10 Medical Services ProvideARFP- 46- 09- 1 0.doc
RFP No. 46 -09/10 City of Miami Beach Page 1 of 39
Medical Services Provider 7/28/2010
MIAMIBEACH
City of Miami Beath, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
PROCUREMENT DIVISION
Tel: 305- 673 -7490, Fax: 786 - 394 -4006
PUBLIC NOTICE
REQUEST FOR PROPOSALS (RFP) NO. 46 -09/10 FOR A MEDICAL SERVICES PROVIDER
FOR THE PROVISION OF VARIOUS MEDICAL SERVICES THAT MAY BE REQUIRED BY
THE CITY OF MIAMI BEACH, AND OTHER LOCAL, STATE, AND FEDERAL LAWS
The City has a need to establish an agreement with a professional medical services provider to
perform pre - employment physical examinations, drug and alcohol testing, fitness for duty
evaluations, and administer vaccines. The City seeks to retain the highest quality medical
provider services available. The selected provider will provide a physician to serve as City
Physician and Medical Review Officer. The provider will provide other medical services as may be
necessary or required by the City and local, state and federal laws. The selected provider will also
retain all related medical records.
The City currently has an Agreement for these various medical services with Mount Sinai Medical
Center that will expire on November 30, 2010, with no further options for renewal.
The City contemplates entering into an agreement with the selected Provider for an initial term of
two (2) years, with three (3) additional one (1) one -year renewal options, by mutual agreement
between both parties.
Sealed Proposals will be received until 3:00 PM on August 25, 2010 at the following address:
City of Miami Beach. City Hall
Procurement Division - Third Floor
1700 Convention Center. Drive
Miami Beach, Florida 33139
Any Proposal received after 3:00 PM on August 25, 2010 will be returned to the Proposer
unopened.,The responsibility for submitting Proposals before the stated time and date is
solely the responsibility of the Proposer.
The City will not be responsible for delays caused by mail, courier service, including U.S. Mail, or
any other occurrence.
A Pre - Proposal Submission Meeting is scheduled for 2:00 p.m. August 9, 2010, at the following
address:
City of Miami Beach
City Hall — 4 Floor
1700 Convention Center Drive
City Manager's Large Conference Room
Miami Beach, Florida 33139
Attendance (in person or via telephone) to this Pre - Proposal Submission Meeting is encouraged
and recommended as a source of information, but is not mandatory. Proposers interested in
participating in the Pre - Proposal Submission Meeting via telephone must follow these steps:
RFP No. 46 -09110 City of Miami Beach Page 2 of 39
Medical Services Provider 7/28/2010
(1) Dial the TELEPHONE NUMBER: 1- 877- 491 -3509 (Toll -free North America)
(2) Enter the MEETING NUMBER: 9020453# (note that number is followed by the pound ( #) key).
Proposers who are interested in participating via telephone, please send an e-mail to
PamelaLeja @miamibeachfl.gov expressing your intent to participate via telephone at least one
business day in advance of the meeting. The City of Miami Beach is using BidSync a central
notification system which provides bid notification services to interested vendors. BidSync allows
for vendors to register online and receive notification of new bids, amendments and awards.
Vendors with Internet access should review the registration options at the following website:
www.bidsync.com. If you do not have Internet access, please call the BidSync vendor support
group at 801 -765 -9245.
The City of Miami Beach also utilizes BidNet as a central bid notification system created
exclusively for state and local agencies located in South Florida. Created in conjunction with
BidNet(s), this South Florida Purchasing system allows for vendors to register online and receive
notification of new bids, amendments and awards. Vendors with Internet access should review
the registration options at the following website:
www.govbids.com/ scripts / southflorida /public /home1.asp If you do not have Internet access,
please call the BidNet(r) support group at 800 - 677 -1997 extension # 214.
THE CITY OF MIAMI BEACH RESERVES THE RIGHT TO ACCEPT ANY PROPOSAL DEEMED
TO BE IN THE ,BEST INTEREST OF THE ' CITY OF MIAMI BEACH, OR WAIVE ANY
INFORMALITY IN ANY PROPOSAL. THE CITY OF MIAMI BEACH MAY ALSO REJECT ANY
AND ALL PROPOSALS.
YOU ARE HEREBY ADVISED THAT THIS REQUEST FOR PROPOSALS IS SUBJECT TO THE
FOLLOWING ORDINANCES /RESOLUTIONS, WHICH MAY BE FOUND ON* THE CITY OF
MIAMI BEACH WEBSITE: http: / /www.miamibeachfl.gov
• CONE OF SILENCE -- ORDINANCE NO. 2002 -3378
CODE OF BUSINESS ETHICS -- RESOLUTION NO. 2000 - 23879.
• PROTEST PROCEDURES -- ORDINANCE NO. 2002 -3344.
• DEBARMENT PROCEEDINGS -- ORDINANCE NO. 2000 -321
LOBBYIST REGISTRATION AND DISCLOSURE OF FEES -- ORDINANCE NO. 2002-
3363.
• CAMPAIGN CONTRIBUTIONS BY VENDORS - ORDINANCE NO. 2003 -3389.
• EQUAL BENEFITS ORDINANCE — ORDINANCE NO. 2005 -3494.
Sincerely,
Gus Lopez, CPPO
Procurement Director
RFP No. 46 -09/10 City of Miami Beach Page 3 of 39
Medical Services Provider 7/28/2010
t
MIAMIBEACH
City of Miami Beath, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
PROCUREMENT Division
Tel: 305.673.7490 Fax: 786 -394- 4006
RFP No. 46 -09110
NOTICE TO PROSPECTIVE PROPOSERS
If not submitting a Proposal at this time, please detach this sheet from the RFP
documents, complete the information requested, and return to the address listed above.
NO PROPOSAL SUBMITTED FOR REASON(S) CHECKED AND /OR INDICATED:
Our Company does not handle this type of product/service.
We cannot provide the services requested in the scope of services.
Our Company is simply not interested in bidding at this time.
Due to prior commitments, 1 was unable to submit a proposal.
OTHER. (Please specify)
We do do not want to be retained on your mailing list for future Request for
Proposals (RFPs) for similar services outlined in this RFP.
Signature:
Title:
Company:
Note: Failure to respond, either by submitting a Proposal or this completed form,
may result in your company being removed from the City's bid list.
RFP No. 46 -09/10 City of Miami Beach Page 4 of 39
Medical Services Provider 7/28/2010 -
MI
City of Miami Beath, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
PROCUREMENT DIVISION
Tel: 305- 673 -7490, Fax: 786 -394- 4006
TABLE OF CONTENTS
PAGE
I. OVERVIEW AND PROPOSAL PROCEDURES 6 -11
II. SCOPE OF SERVICES 12 -16
III. PROPOSAL FORMAT 17
IV. EVALUATION PROCESS/
CRITERIA FOR EVALUATION 18
V. SPECIAL TERMS AND CONDITIONS- INSURANCE 19 -20
VI. PROPOSAL DOCUMENTS TO BE COMPLETED AND
RETURNED TO CITY WITH PROPOSAL SUBMISSION
- All items outlined as required under Proposal Format (Section 111)
And Scope of Services /Specifications (Section II)
- Signed Insurance Checklist 20
- Proposer Information 21
- Acknowledgment of Addenda 22
- Declaration 23
- Sworn Statement/Section 287.133(3) (a), Florida Statutes -
Public Entity Crimes 24 -25
- Questionnaire 26 -29
- Declaration: Nondiscrimination in Contracts and Benefits 30 -32
- Reasonable Measures Application (If Applicable) 33 -34
- Substantial Compliance (If Applicable) 35 -37
VII. DOCUMENTS TO BE COMPLETED BY CUSTOMERS OF THE RESPONDENTS
Performance Evaluation Letters 38
- Performance Evaluation Survey 39
RFP No. 46 -09/10 City of Miami Beach Page 5 of 39
Medical Services Provider 7/28/2010
SECTION I - OVERVIEW AND PROPOSAL PROCEDURES:
A. INTRODUCTION / BACKGROUND
The City has a need to establish an agreement with a professional medical services provider to
perform pre- employment physical examinations, drug and alcohol testing, fitness for duty
evaluations, and administer vaccines. The City seeks to retain the highest quality medical
provider services available. The selected provider will provide a physician to serve as City
Physician and Medical Review Officer. The provider will provide other medical services as may
be necessary or required by the City and local, state and federal laws. The selected provider will
also retain all related medical records. '
The City currently has an Agreement for these various medical services with Mount Sinai Medical
Center that will expire on November 30, 2010, with no further options for renewal.
The Mayor and City Commission at its July 14, 2010 meeting, authorized the Administration to
issue this RFP for a professional medical services. provider for the provision of medical services
as may be necessary or required by the City, and local, state and federal laws.
The City contemplates entering into an agreement with the selected Provider for an initial term of
two (2) years, with three (3) additional one (1) one -year renewal options, by mutual agreement
between both parties.
B. RFP TIMETABLE
The anticipated schedule for this RFP and contract approval is as follows:
RFP issued July 28, 2010
Pre- Proposal Submission Meeting August 9, 2010 at 2:00 p.m.
Deadline for receipt of questions August 11, 2010 by 5:00 pm
Deadline for receipt of Proposals August 25, 2010 no later than 3:00 p.m.
Evaluation Committee meeting September 2010
City Commission approval of award October 20, 2010
Contract negotiations October /November 2010
Projected contract start date December 1, 2010
C. PROPOSAL SUBMISSION
An original and ten (10) copies of complete Proposals must be received no later than 3:00 pm
on August 25, 2010 at the following address:
City of Miami Beach, City Hall
Procurement Division — 3rd Floor
1700 Convention Center Drive
Miami Beach, Florida 33139
The original and all copies must be submitted to the Procurement Division in a sealed envelope or
container stating on the outside the Proposer's name, address, telephone number, RFP number
and title, and due date. No facsimile, electronic, or e-mail responses will be considered.
The responsibility for submitting Proposals to the Procurement Division on or before the stated
time and date will be solely and strictly that of the Proposer. The City will in no way be responsible
for delays caused by the U.S. Post Office or caused by any other entity or by any other
RFP No. 46 -09/10 City of Miami Beach Page 6 of 39
Medical Services Provider 7/28/2010
occurrence. Proposals received after the RFP due date and time will not be accepted and will not
be considered.
D. REQUIREMENT FOR CITY CONTRACTORS TO PROVIDE EQUAL BENEFITS FOR
DOMESTIC PARTNERS
Proposers are advised that this RFP and any contract awarded pursuant to this procurement
process shall be subject to the applicable provisions of� Ordinance No. 2005 -3494, entitled
"Requirement for City Contractors to Provide Equal Benefits for Domestic Partners" (the
"Ordinance "). The Ordinance applies to all employees of a Contractor who works within the city
limits of the City of Miami Beach, and the Contractor's employees located in the United States,
but outside of the City of Miami Beach limits, who are directly performing work on the contract
within the City of Miami Beach.
All Proposers shall complete and return, with their Proposal, the "Declaration: Non - discrimination
in Contracts and Benefits" form contained herein. The City shall not enter into any contract
unless the Proposer certifies that it does not discriminate in the provision of Benefits between
employees with Domestic Partners and employees with spouses and /or between the Domestic
Partners and spouses of such employees.
Proposers may also comply with the Ordinance by providing an employee with the Cash
Equivalent of such Benefit or Benefits, if the City Manager or his designee determines that:
a. The Proposer shall complete and return the "Reasonable Measures Application"
contained herein, and the Cash Equivalent proposed; AND.
b. The Proposer shall complete and return the "Substantial Compliance Authorization
Form" contained herein.
It is important to note that Proposer is considered in compliance if Proposer provides
benefits neither to employees' spouses nor to employees' Domestic Partners.
E. PRE- PROPOSAL SUBMISSION MEETING
A Pre - Proposal Submission Meeting is scheduled for August 9, 2010 at 2:00 p.m. at the
following address:
City of Miami Beach, City Hall
City Manager's Large Conference Room — 4 Floor
1700 Convention Center Drive
Miami Beach, Florida 33139
Attendance (in person or via telephone) is encouraged and recommended as a source of
information, but is not mandatory. Proposers interested in participating in the Pre -RFP
Submission Meeting via telephone must follow these steps:
(1) Dial the TELEPHONE NUMBER: 877- 491 -3509 (Toll -free North America)
(2) Enter the MEETING NUMBER: 9020453# (note that number is preceded and followed by the
pound ( #) key).
i
Proposers, who are interested in participating via telephone, please send an e-mail to the contact
person listed below, expressing your intent to participate via telephone.
RFP No. 46 -09/10 City of Miami Beach Page 7 of 39
Medical Services Provider 7/28/2010
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I
F. CONTACT PERSON /ADDITIONAL INFORMATION /ADDENDA
The contact person for this RFP is Pamela Leja, Sr. Procurement Specialist, who may be reached
by phone: 305- 673 -7490; fax 786- 394 -4006; or e-mail: PamelaLeiaa- miamibeachfl.gov
Communications between a Proposer, bidder, lobbyist, and /or consultant and the Procurement
Director are limited to matters of process or procedure.
Requests for additional information or clarifications must be made in writing to the Procurement
Division. Facsimile or e-mail requests are acceptable. Please send all questions to
PamelaLeia(a-miamibecahfl.pov and copy the City Clerk's Office
RobertParcher(cb-miamibeachfl.gov no later than the date specified in the RFP timetable.
The Procurement Division will issue replies to inquiries and any other corrections or amendments,
as it deems necessary, in written addenda issued prior to the deadline for responding to the RFP.
Proposers should not rely on representations, statements, or explanations, other than those made
in this RFP or in any written addendum to this RFP. Proposers should verify with the
Procurement Division prior to submitting a Proposal that all addenda have been received.
Proposers are advised that oral communications between the Proposer, or their representatives,
and the Mayor and City Commissioners and their respective staff, or members of the City's
Administrative staff (including but not limited to the City Manager and his staff), or evaluation
committee members, is prohibited.
G. MODIFICATION/WITHDRAWALS OF PROPOSALS
A Proposer may submit a modified Proposal to replace all or any portion of a previously submitted
Proposal up until the Proposal due date and time. Modifications received after the Proposal due
date and time will not be considered.
Proposals shall be irrevocable until contract award unless withdrawn in writing prior to the
Proposal due date or after expiration of 120 calendar days from the opening of Proposals without
a contract award. Letters of withdrawal received after the Proposal due date and before said
expiration date and letters of withdrawal received after contract award will not be considered.
H. RFP POSTPONEMENT /CANCELLATION /REJECTION
The City may, at its sole and absolute discretion, reject any and all, or parts of any and all,
Proposals; re- advertise this RFP; postpone or cancel, at any time, this RFP process; or waive any
irregularities in this RFP, or in any Proposals received as a result of this RFP.
I. COSTS INCURRED BY PROPOSERS
All expenses involved with the preparation and submission of Proposals to the City, or any work
performed in connection therewith, shall be the sole responsibility of the Proposer and shall not
be reimbursed by the City.
J. EXCEPTIONS TO RFP
Proposers must clearly indicate any exceptions they wish to take to any of the terms in this RFP,
and outline what alternative is being offered; which exceptions and alternatives shall be included
and clearly delineated in Proposer's submittal response. The City, at its sole and absolute
discretion, may accept or reject any or all exceptions. In cases in which exceptions are rejected,
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the City shall require the Proposer to comply with the particular term and /or condition of the RFP
which Proposer takes exception to (as said term and /or condition was originally set forth on the
RFP).
K. SUNSHINE LAW
Proposers are hereby notified that all Proposals including, without limitation, any and all
information and documentation submitted therewith, will be available for public inspection after
opening of Proposals, in compliance with Chapter 286, Florida Statutes (the Florida "Government
in the Sunshine Law ").
L. NEGOTIATIONS
The City reserves the right to enter into further negotiations with the top- ranked Proposer, and /or
successful Proposer (following authorization of negotiations by the City). Notwithstanding the
preceding, the City is in no way obligated to enter into a contract with the top- ranked and /or
successful Proposer in the event the parties are unable to negotiate a contract. It is also
understood and acknowledged by Proposer's that by submitting a Proposal, no property interest
or legal right of any kind shall be created at any time until and unless a contract has been agreed
to and executed by the parties.
M. PROTEST PROCEDURE
Proposers that are not selected may protest any recommendation for selection of award in
accordance with the proceedings established pursuant to the City's bid protest procedures
(Ordinance No. 2002 - 3344), as codified in Sections 2 -370 and 2 -371 of the City Code. Protest(s)
not timely made pursuant to the requirements of Ordinance No. 2002 -3344 shall be barred.
N. OBSERVANCE OF LAWS
Proposers are expected to be familiar with, and comply with, all Federal, State, County, and City
laws, ordinances, codes, rules and regulations, and all orders and decrees of bodies or tribunals
having jurisdiction or authority which, in any manner, may affect the services and /or project
contemplated by this RFP (including, without limitation, the Americans with Disabilities Act, Title
VII of the Civil Rights Act, the EEOC Uniform Guidelines, and all EEO regulations and guidelines).
Ignorance of the law(s) on the part of the Proposer will in no way relieve it from responsibility for
compliance.
O. DEFAULT
Failure or refusal of the successful Proposer to execute a contract. following award by the City
Commission, or untimely withdrawal of a Proposal before such award is made and approved, may
result in forfeiture of that portion of any surety required as liquidated damages to the City. Where
surety is not required, such failure may result in a claim for damages by the City and may be
grounds for removing the Proposer from the City's vendor list.
P. CONFLICT OF INTEREST
All Proposers must disclose, within their Proposal, the name(s) of any officer, director, agent, or
immediate family member (spouse, parent, sibling, and child) who is also an employee of the City
of Miami Beach. Further, all Proposers must disclose the name of any City employee who owns,
either directly or indirectly, an interest of ten (10 %) percent or more in the Proposer entity or any
of its affiliates.
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Q. COMPLIANCE WITH THE CITY'S LOBBYIST LAWS
This RFP is subject to, and all Proposers are expected to be or become familiar with, all City
lobbyist laws, as amended from time to time. Proposers shall ensure that all City lobbyist laws are
complied with, and shall' be subject to any and all sanctions, as prescribed therein, including,
without limitation, disqualification of their Proposals, in the event of such non- compliance.
R. PROPOSER'S RESPONSIBILITY
Before submitting a Proposal, each Proposer shall be solely responsible for making any and all
investigations and examinations, as it deems necessary, to ascertain all conditions and
requirements affecting the full performance of the contract. Ignorance of such conditions and
requirements, and /or failure to make such investigations and examinations, will not relieve the
Proposer from any obligation to comply with every detail and with all provisions and requirements
of the contract, and will not be accepted as a basis for any subsequent claim whatsoever for any
monetary consideration on the part of the Proposer.
S. RELATIONSHIP TO THE CITY
It is the intent of the City, and Proposers hereby acknowledge and agree, that the successful
Proposer is considered to be an independent contractor and that neither the Proposer, nor the
Proposer's employees, agents, and /or contractors, shall, under any circumstances, be considered
- employees or agents of the City.
T. PUBLIC ENTITY CRIME
A person or affiliate who has been placed on the convicted vendor list following a conviction for
public entity crimes may not submit a bid on a contract to provide any goods or services to a
public entity, may not submit a bid on a contract with a public entity for the construction or repair
of a public building or public work, may not submit bids on leases of real property to public entity,
may not be awarded or perform work as a contractor, supplier, sub - contractor, or consultant
under a contract with a public entity , and may not transact business with any public entity in
excess of the threshold amount provided in Sec. 287.017, for CATEGORY TWO for a period of 36
months from the date of being placed on the convicted vendor list.
U. CONE OF SILENCE
Proposers are hereby advised that this RFP is subject to the City's Cone of Silence requirements,
as set forth in Section 2 -486 of the City Code.
V. DEBARMENT ORDINANCE
Proposers are hereby advised that this RFP is subject to the City's Debarment Ordinance
(Ordinance No. 200 - 3234), as codified in Section 2 -397 through 2 -406 of the City Code.
W. COMPLIANCE WITH THE CITY'S CAMPAIGN FINANCE REFORM LAWS
This RFP is subject to, and all Proposers are expected to be or become familiar with, the City's
Campaign Finance Reform -laws, as codified in Sections 2 -487 through 2 -490 of the City Code, as
amended from time to time. Proposers shall insure that all applicable provisions of the City's
Campaign Finance Reform laws are complied with, and shall be subject to any and all sanctions,
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as prescribed therein, including disqualification of their. Proposals, in the event of such non-
compliance.
X. CODE OF BUSINESS ETHICS
Pursuant to City Resolution No.2000 -23879 each person or entity that seeks to do business with
the City shall adopt a Code of Business Ethics ( "Code ") and submit that Code to the Procurement
Division with its bid /response or within five (5) days upon receipt of request.
The Code shall, at a minimum, require the Proposer, to comply with all applicable governmental
rules and regulations including, among others, the conflict of interest, lobbying and ethics
provision of the City of Miami Beach and Miami Dade County.
Y. AMERICAN WITH DISABILITIES ACT (ADA)
Call 305 - 673- 7490NOICE to request material in accessible format; sign Language interpreters
(five days in advance when possible), or information on access for persons with disabilities. For
more information on ADA compliance, please call the Public Works Department, at 305 - 673 -7080.
Z. ACCEPTANCE OF GIFTS, FAVORS, SERVICES
Proposers shall not offer any gratuities, favors, or anything of monetary value to any official,
employee, or agent of the City, for the purpose of influencing consideration of this Proposal.
Pursuant to Sec. 2 -449 of the City Code, no officer or employee of the City shall accept any gift,
favor or service that might reasonably tend improperly to influence him in the discharge of his
official duties.
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SECTION II -- SCOPE OF SERVICES
A. GENERAL
The Provider will conduct and review laboratory results, x -rays, and other medical reports;
evaluate reports and make appropriate recommendations as needed; review special medical
problems such as but not limited to contagious disease cases, return from sick leave, on -duty
injuries, disability, and other. medical issues as required; provide reports and medical opinions
when applicable; counsel personnel and job applicants about medical conditions and findings;
and refer to appropriate follow -up care when indicated.
The Provider will supply the City with a primary contact or Project Manager who will be assigned
to address all questions and concerns of the City. This contact will be available for pre-
employment issues during all business hours.
A back -up contact will be designated in case the Project Manager is unavailable. The designated
bank -up will be fully informed in all areas. All other staff providing services under this contract will
be properly informed and trained on procedures, forms, changes, and requirements. Any special
instructions will be communicated to all staff.
All medical evaluation results will be reported to the Human Resources Department within 48
hours from the time the applicant is first seen.
All services will be available a minimum of five (5) days per week during business hours. The
preferred hours are from 7:00 a.m. until 5:00 p.m. The actual service hours are subject to
negotiation.
The City will have the ability to schedule same day or next day appointments with the Provider for
all services if necessary.
r
In special cases, and with at least 3 days advanced notice by the City, the Provider will make
arrangements to provide services outside normal business hours, such as evenings and
weekends.
The Provider will provide convenient parking at no cost to applicants, employees, and the City for
individuals referred.
The Provider will set up and utilize an electronic mail system compatible with the City. If
requested by the City, all reports and other necessary communication will be utilized through this
system.
The Provider will utilize City forms where required. The Provider will review their own forms with
the City and allow for changes, as needed.
The Provider will assure that instructions, changes, and transfer of information and documents will
be only with those individuals or firms designated by the Human Resources Director.
Immediate notification will be made to designated City staff of "no- shows" or any problems with an
individual's cooperation or compliance.
The Provider will provide applicant deadlines for follow up as needed - as determined by City
policy.
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Individuals referred to the Provider must not have a waiting time that exceeds 30 minutes.
The Provider will assure confidentiality of all records, information, and correspondence, both
verbal and written.
The Provider will submit a quarterly utilization summary report to the City.
B. COMPREHENSIVE PHYSICAL EXAMINATIONS AND DRUG TESTING FOR PRE -
EMPLOYMENT AND PROMOTIONS
Based on the physical requirements of the job description provided by the City, the Provider will
conduct physical examinations and drug testing as required for pre - employment on all new hires
and .exams on promotional applicants where physical duties greatly vary.
Results of the applicant's physical examination will be reported to the Human Resources
Department within 48 hours from the time the applicant is seen for results of their tuberculosis
PPD test.
The Provider will permit at least 10 appointments per day and provide capacity for up to 20
appointments per day with 3 days advance notice from the City.
The City will have the ability to schedule same day or next day appointments for pre - employment
examinations.
Tuberculosis PPD tests are to be read by the Provider. Positive results will be handled by the
Provider and will not be referred to the Department of Health or other facility unless agreed to in
writing by the City. In any case, there will be no additional charge to the applicant for this service.
Police Officer applicants' physical examinations must include tests for heart disease evaluation.
Firefighter pre - employment examination must include tests for evidence of AIDS, Hepatitis,
Pulmonary Tuberculosis, or Meningococcal Meningitis.
C. .MEDICAL RECORDS
The Provider will maintain health files for all City employees and /or applicants. These files are to
include medical records regarding injuries and accidents related to employees in accordance with
all state and federal laws as applicable. Upon request of the Human Resources Director or their
designee, the Provider will provide medical records within 24 hours of request. Medical records
may only be released to the Human Resources Director, Claims Coordinator, or their designee.
All requests and designee's assignments must be made and in writing only (e -mail is
acceptable). The selected Provider, if different from the current Provider, will obtain all records
from the current Provider and will maintain such records.
If and when this contract is awarded to another Provider, all open medical and other records
related to this contract will be delivered to the new Provider within 30 days of the expiration of the
current Provider's contract. The Provider will give copies of closed records within twenty -four
hours of the request.
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D. PSYCHIATRIC SERVICES
The Provider may be requested to attend staff conferences and conduct on- site training and
observation of new Police.Officers and Firefighters and conduct ongoing meetings with all Police
Officers, other employees referred by the City, their supervisors, and top ranking officers.
The Provider may be requested to review and research psychological factors relating to personnel
especially public safety.
The Provider may be requested to conduct stress - reduction meetings with spouses of Police
personnel and other employees referred by the City. J
The Provider may be requested to conduct psychological or psychiatric consultations with general
City employees as requested by the City and prepare appropriate summary and recommendation
reports.
E. IMMUNIZATION PROGRAM
The Provider will administer an intradermal test for Tuberculosis exposure on all employees as
necessary and requested. A chest x -ray may be done in lieu of an intradermal test for
Tuberculosis.
The Provider will administer a Tetanus Toxoid Booster Immunization for Police Officers,
Firefighters, Waste Collectors, and Parks personnel. This may include other occupations
depending on the job specification and /or individual requirements.
The Provider will administer Hepatitis B vaccine for those City employees with a potential risk
exposure to infected blood or body fluids as determined by the City.
The Provider will administer other vaccines that may be required such as measles, mumps and
rubella vaccine, or any additional immunizations, tests, vaccines, as required by local, state, or
federal requirements, or by industry recommendations or guidelines.
The Provider will administer and make available anti -viral medications against the AIDS virus for
emergency responders according to current federal guidelines. These medications must be given
within two hours of a significant exposure to the AIDS virus. Employees must have access to the
administration of anti -viral medications for the AIDS virus on a twenty -four hour basis.
The Provider will administer HIV /AIDS baseline tests to sworn Fire Department employees and
perform other tests requested by the City to comply with future union contracts.
E. DRUG & ALCOHOL TEST PROGRAM
The Provider, will have the ability to conduct a Drug and Alcohol Test Program as required by
local state, and federal laws and regulations. This includes a certified. Substance Abuse
Professional, Breath Alcohol Technician, and Medical Review Officer.
The Provider will conduct pre - employment drug testing on all applicants, as' well as conduct
promotional drug and alcohol testing to all safety sensitive applicants before they actually perform
safety sensitive functions for the first time.
The Provider will test yearly approximately 350 Fraternal Order of Police, Williams Nichols Lodge,
No. 8 (FOP) employees, 60 Government Supervisors Association of Florida /OPEIU, Local 100
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(GSA) employees, 440 American Federation of State, County and Municipal Employees, Local
1554 (AFSCME), and 190 International Association of Firefighter, Local 1510 (IAFF) employees, .
and conduct other random drug and /or alcohol testing as may be specified by the City. This
includes full -time and part -time employees.
The Provider will conduct random testing on safety sensitive employees who drive vehicles that
require Commercial Driver Licenses in compliance with the U.S. Department of Transportation
(DOT).
49 CFR Part 40. The Provider will also conduct random testing all other City employees pursuant
to union contracts.
The Provider will conduct testing on employees whose performance could have contributed to an
accident even if the employee was not cited for a traffic violation. This would require Provider
access and availability 24 hours per day and 7 days per week.
The Provider will conduct testing on employees when the City observes behavior or appearance
that is characteristic of drug use or abuse or alcohol use or misuse.
The Provider will conduct return -to -duty and follow -up testing for employees who violate the
prohibited alcohol or drug conduct standards. At least six (6) unannounced tests must be
conducted in the first twelve (12) months after an employee returns to duty. Follow -up testing
may be extended for up to 60 months following return -to -duty.
The Provider will provide drug and alcohol testing services with licensed and certified personnel
and laboratories as required by local, state, and federal law. The Provider's drug and alcohol
testing services will be overseen by a Medical Review Officer (MRO).
The Provider will conduct annual training for designated City employees on the Drug Free
Workplace Act including training on signs and symptoms of drug and /or alcohol abuse if
requested by the City.
The Provider will insure proper and documented chain of custody during and after sample
collection and testing.
The Provider will provide private and appropriate facilities to conduct these tests. The Provider
will provide a locked, secured box for private articles and Police weapons.
G. WELLNESS PROGRAM
The. Provider will provide annual health screening and health education at a minimum of two (2)
job site areas within the City. Topics will be mutually agreed upon by the City and Provider.
H. FITNESS FOR DUTY EVALUATIONS
The Provider will evaluate employees' ability to continue employment in their current capacity and
to assess and recommend reasonable accommodation for other job opportunities for which they
may be qualified. This may include a physical examination, return to work evaluation,
psychological and /or psychiatric evaluation, and /or any reports to be completed as requested by
the City for fitness for duty.
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Evaluations are to be completed within two working days of the request and on the same day in
case of an emergency. A status report and recommendations will be forwarded to the City within
24 hours of the appointment.
The Provider will assist the City in the evaluation and verification of questionable family leave
requests.
I. PERFORMANCE CRITERIA AND EVALUATION
Each month, the City will evaluate the Provider's performance based on the scope of services and
feedback from employees, applicants, and the Human Resources Department. The criteria to be
rated will include but is not' Limited. to pre - employment, drug and alcohol screening, fitness for duty
determinations, communication on all requested results, and designated contact availability. The
criteria to be rated will change based upon the. needs of the City.
If the City finds the Provider to have less than an 80% compliance with any of the Scope of
Services over a 30 day period, the City may utilize a fifteen (15) day notice to correct such default.
J. COMMUNICATION
The Provider will set up and utilize an electronic mail system compatible with the City. All reports
and other necessary communication will be utilized through this system. Any and all associated
costs with the set up will be absorbed by the Provider.
The Provider will have qualified personnel available during all business hours to supply all
services including final physician sign -off for pre- employment examinations.
All test results under the Scope of Services and the Agreement will be communicated only to the
Human Resources Director or his /her designees.
K. STAFFING
The Provider will staff sufficiently to supply all services stated in the Scope of Services and the
Agreement. The Provider will increase staffing if they are unable to fully comply with what has
been stated herein.
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SECTION III — PROPOSAL FORMAT/ MINIMUM REQUIRMENTS
Proposals must contain the following documents, each fully completed and signed, as required. If
any items are omitted, Proposers must submit the documentation within five (5) calendar days
upon request from the City, or the Proposal shall be deemed non-responsive. The City will not
accept fee /cost information after deadline for receipt of Proposals.
1. Table of Contents
Outline in sequential order the major areas of the Proposal, including enclosures. All
pages must be consecutively numbered and correspond to the table of contents.
2. Proposal Points to Address:
Proposers must respond to all minimum requirements Fisted below. Proposals which do
not contain such documentation may be deemed non- responsive.
a) Introduction letter: outlining the Proposer's professional specialization; provide
past experience to support the qualifications of the Proposer.
b) Proposer's must provide documentation: Proposer's shall submit such
supporting documentation as they deem necessary to demonstrate the capability
to provide and implement the services that provide evidence as to the capability to
provide and implement the services as outlined in this RFP.
C) References: List at least three (3) client references, to include contact name, title,
company, address, telephone number, e-mail address, fax number.
d) Qualifications of Proposer/ Management Team and Key Personnel: Outline in
detail the experience and qualifications of the Proposers entity, and the Proposer's
management team, in providing similar projects /programs as outlined in this RFP.
e) Fee Information: Fee information must be submitted with Proposal, as requested
in the RFP. Notwithstanding any fee submitted, the City reserves the right to
further negotiate same with the successful Proposer.
f) Past Performance Client Survey Information: Past performance information will
be collected on all Proposers. Proposers are required to identify and submit their
best projects. Proposers will be required to send out Performance Evaluation
Surveys to each of their clients.
Please provide. your client with the Performance Evaluation, Letter and Survey
attached herein, and request that your client submit the completed survey to
Pamela Leja, at (Fax) 786- 394 -4006 or e-mail PamelaLeja @miamibeachfl.gov.
The City will not accept Client Surveys sent to the Procurement Division from
the office of the Proposer. Surveys must be sent to the Procurement Division
directly from your client's office(s). Proposers are responsible for making sure
their clients return the Performance Evaluation Surveys to the City. The City
reserves the right to verify and successful Proposer any information submitted in
this process. Such verification may include, but is not limited to, speaking with
current and former clients, review of relevant client documentation, site- visitation,
and other independent confirmation of data.
g) Methodology and Approach
3. Acknowledgment of Addenda: (IF REQUIRED BY ADDENDUM) and Proposer Information
4. Any other Documents Required by this RFP.
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SECTION IV — EVALUATION PROCESS /CRITERIA FOR EVALUATION
The procedure for Proposal evaluation and selection is as follows:
1. Request for Proposals issued.
2. Receipt of Proposals.
3. Opening of Proposals and determination if they meet the minimum standards of
responsiveness.
4. An Evaluation Committee, appointed by the City Manager, will meet to evaluate each
Proposal in accordance with the requirements of this RFP. Proposers may be requested
to make additional written submissions or oral presentations to the Evaluation Committee.
5. The Evaluation Committee shall recommend to the City .Manager the Proposal or
Proposals acceptance of which the Evaluation Committee deems to be in the interest
of the City.
6. The Evaluation Committee shall base its recommendations on the following factors, for a
total of 100 possible points:
• Ability to Provide All Requested' Services Within the Designated Timeframes 15 points
• Cost of Services Provided 15 points
• Convenience of Obtaining Service and Proximity to Miami Beach 15 points
• Overall Reputation Within the Community 10 points
• Experience Level and Credentials of Assigned Staff 15 points
• Designated Contact Availability 5 points
• Appointment and Next Day Scheduling for Each. Service 10 points
• Number of Appointments That Can Be Scheduled Daily for Each Service 15 points
Total 100 points
7. After considering the recommendation(s) of the Evaluation Committee, the City Manager
will recommend to the City Commission the response or responses, acceptance of which
the City Manager deems to be in the best interest of the City. The Committee's
recommendation(s) will adhere to the criteria in Item No. 6 above.
8. The City Commission will consider the City Manager's recommendation(s) (in light of the
recommendations(s) and evaluation of the Evaluation Committee) and, as appropriate,
approve the City Manager's recommendation(s); may reject the recommendations) and
select another proposal or proposals; or may reject all proposals.
9. Contract negotiations between the selected Proposer(s) and the City commence. If the
City Commission has so directed, the City may proceed to negotiate a contract with a
respondent other than the top- ranked Proposer, if the negotiations with the top - ranked
Proposer fail to produce a mutually acceptable contract within a reasonable period of time.
10. A proposed contract (or contracts) may be presented to the City Commission for approval,
modification and approval, or rejection.
11. If and when a contract (or contracts) acceptable to the respective parties is approved by
the Mayor and Commission, the Mayor and City Clerk sign the contract(s) after the
selected Proposer(s) has (or have) done so.
By submitting a Proposal, all Proposers shall be deemed to understand, and agree that no
property interest or- legal right of any kind shall be created at any point during the
aforesaid evaluation /selection process until and unless a contract has been agreed to and
signed by both parties.
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SECTION V — SPECIAL TERMS AND CONDITIONS: INSURANCE
INSURANCE: The successful Proposer shall obtain, provide and maintain during the term of
the contract the following types and amounts of insurance, which. shall be maintained with
insurers licensed to sell insurance in the State of Florida and have a B+ VI or higher rating in the
latest edition of AM Best's Insurance Guide.
Said policies of insurance shall be primary to and contributing with any other insurance
maintained by Proposer or City, and shall name the City of Miami Beach, as an additional
insured. No policy can be canceled without thirty (30) days prior written notice to the City.
The successful Proposer shall file and maintain certificates of all insurance policies with the
City's Risk Management Department showing said policies to be in full force and effect at all
times during the course of the contract. Such insurance shall be obtained from brokers of
carriers authorized to transact insurance business in Florida and satisfactory to City.
Evidence of such insurance shall be submitted to and approved by City prior to commencement
of any work or tenancy under the proposed contract.
If any of the required insurance coverages contain aggregate limits, or apply to other operations
or tenancies of Proposer outside the proposed contract, Proposer shall give City prompt written
notice of any incident, occurrence, claim settlement or judgment against such insurance which
may diminish the protection such insurance affords the City. Proposer shall further take
immediate steps to restore such aggregate limits'or shall provide other insurance protection for
such aggregate Limits.
FAILURE TO PROCURE INSURANCE: The successful Proposer's failure to. procure or
maintain required the insurance program shall constitute a material breach of the contract by
which City may immediately terminate same.
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f
INSURANCE CHECK LIST
XXX 1. Workers' Compensation and Employer's Liability per the statutory limits of the state of
Florida.
XXX 2. Comprehensive General Liability (occurrence form), limits of liability $ 1,000,000.00 per
occurrence for bodily injury property damage to include Premises/ Operations;
Products, Completed Operations and Contractual Liability. Contractual Liability and
Contractual Indemnity (Hold harmless endorsement exactly as written in "insurance
requirements" of specifications).
3. Automobile Liability - $1,000,000 each occurrence - owned /non- owned /hired
automobiles included.
4. Excess Liability - $ 00 per occurrence to follow the primary coverages.
XXX 5. The City must be named as and additional insured on the liability policies; and it must.
be stated on the certificate.
XXX 6. Other Insurance as indicated:
Builders Risk completed value $ .00
Liquor Liability $ .00
Fire Legal Liability $ . 00
Protection and Indemnity $ 00
XXX Professional Liability /Medical
Malpractice $ 300,000.00
Employee Dishonesty Bond $ .00
Theft Covering Money and /or Property
Of Others $ . 00
XXX 7. Thirty (30) days written cancellation notice required.
- XXX 8. Best's guide rating B +:VI or better, latest edition.
XXX 9. The certificate must state the RFP number and title
PROPOSER AND INSURANCE AGENT STATEMENT:
We understand the Insurance Requirements of these specifications and that evidence of this
insurance may be required within five (5) days after Proposal opening.
Proposer Signature of Proposer
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PROPOSER INFORMATION
Submitted by:
Proposer (Entity):
Signature:
Name (Printed:
Address:
City /State:
Telephone:
Fax:
E -mail:
Tax ID#
It is understood and agreed by Proposer that the City reserves the right to reject any and
all Proposals, to make awards on all items or any items according to the best interest of
the City, and to waive any irregularities in the RFP or in the Proposals received as a
result of the RFP. It is also understood and agreed by the Proposer that by submitting a
Proposal, Proposer shall be deemed to understand and agree than no property interest
or legal right of any kind shall be created at any time until and unless a contract has
been agreed to and signed by both parties.
For Proposer: (Authorized Signature) (Date)
(Printed Name)
RFP No. 46 -09/10 City of Miami Beach Page 21 of 39
Medical Services Provider 7/28/2010
REQUEST FOR PROPOSALS NO. 46 -09110
ACKNOWLEDGEMENT OF ADDENDA
Directions: Complete Part I or Part II, whichever applies.
Part I: Listed below are the dates of issue for each Addendum received in connection with this
RFP:
Addendum No. 1, Dated
Addendum No. 2, Dated
Addendum No. 3, Dated
Addendum No. 4, Dated
Addendum No. 5, Dated
Part II: No addendum was received in connection with this RFP.
Verified with Procurement staff
Name of staff Date
Proposer - Name Date
Signature
RFP No. 46 -09/10 City of Miami Beach Page 22 of 39
Medical Services Provider 7/28/2010
DECLARATION
TO: City of Miami Beach
City Hall
1700 Convention Center Drive
Procurement Division
Miami Beach Florida 33139
Submitted this day of , 2010
The undersigned, as Proposer, declares that .the only persons interested in this Proposal. are
named herein; that no other person has any interest in this responses or in the contract to
which this response pertains; that this response is made without, connection or, arrangement
with any other person; and that this response is in every respect fair and made in good faith,
without collusion or fraud.
The Proposer agrees if this response is accepted, to execute an appropriate City of Miami
Beach document for the purpose of establishing a formal contractual relationship between the
Proposer and the City, for the performance of all requirements to which the response pertains.
The Proposer sates that the response is based upon the documents identified by the following
number: RFP No. 46- 09/10..
WITNESS PROPOSER SIGNATURE t
PRINTED NAME PRINTED NAME
WITNESS TITLE
PRINTED NAME
RFP No. 46 -09/10 City of Miami Beach Page 23 of 39
Medical Services Provider 7/28/201.0
SWORN STATEMENT UNDER SECTION 287.133(3) (a),
FLORIDA STATUTES ON PUBLIC ENTITY CRIMES
THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY
PUBLIC OR OTHER OFFICER AUTHORIZED TO ADMINISTER OATHS.
This sworn statement is submitted to
[print name of public entity]
By
[print individual's name and title]
For
[print name of entity submitting sworn statement]
Whose business address is
And (if applicable) its Federal Employer Identification Number (FEIN) is (If the Entity has
no FEIN, include the Social Security Number of the individual signing this sworn statement:.
I understand that a "public entity crime" as defined in Paragraph 287.133(1)(g), Florida
Statutes, means a violation of any state or federal law by a person with respect to and directly
related to the transaction of business with any business with any public entity or with an agency
or political subdivision of any other state or of the United States, including, but not limited to, any
bid or contract for goods or services to be provided to any public entity or an agency or political
subdivision of any other state or of the United States and involving antitrust, fraud, theft, bribery,
collusion, racketeering, conspiracy, or material misrepresentation. -
1 understand that "convicted" or "conviction" as defined in Paragraph 287.133(1)(b), Florida
Statutes, means a finding of guilt or a conviction of a public entity crime, with or without an
adjudication of guilt, in any federal or state trial court of record relating to charges brought by
indictment or information after July 1, 1989, as a result of a jury verdict, nonjury trial, or entry of
a plea of guilty or nolo contendere.
I understand that an "affiliate" as defined in. Paragraph 287.133 (1)(a), Florida Statutes,
means:
1) A predecessor or successor of a person convicted of a public entity crime;
Or
2) An entity under the control of any natural person who is active in the
management of the entity and who has been convicted of a public entity crime,.
The term "affiliate" includes those - officers, directors, executives, partners,
shareholders, employees, members, and agents who are active in the
management of an affiliate. The ownership by one person of shares constituting
a controlling interest in another person, ' or a pooling of equipment or income
among persons when not for fair market value under an arm's length agreement,
shall be a prima facie case that one person controls another person. A person
who knowingly enters into a joint venture with a person who has been convicted
of a public entity crime in Florida during the preceding 36 months shall be
considered an affiliate.
RFP No. 46-09/10 City of Miami Beach Page 24 of 39 .
Medical Services Provider 7/28/2010
3) I understand that a "person" as defined in Paragraph 287:133 (1)(e), Florida
Statutes means any natural person or entity organized under the laws of any
state or of the United States with the legal power to enter into a binding contract
and which bids or applies to bid on.contracts for the provision of goods or services
let by a public entity, or which otherwise transacts or applies to transact business
with a public entity. The term "person" includes those 'officers,. directors,
executives, partners, shareholders,. employees, members, and agents who are
active in management of an entity.
Based on information and belief, the statement which I have marked below is true in relation to
the entity submitting this sworn statement. [Indicate which statement applies.]
Neither the entity submitting this sworn -statement, nor any officers, directors, executives,
partners, shareholders, employees; members, or agents who are active in neither the
management of the entity, nor any affiliate of the entity has been charged with and convicted of
a public entity crime subsequent to July 1, 1989.
The entity submitting this sworn statement, or one or more of its officers, directors, executives,
partners, shareholders, employees, members or agents who are active in management of the
entity or an affiliate of the entity has been charged with and convicted of a public entity crime
subsequent to July 1, 1989.
The entity submitting this sworn statement, or one or more of its officers, directors, executives,
partners, shareholders, employees, members, or agents who are active in the management of
the entity or an affiliate of the entity has been charged with and convicted of a public entity crime
subsequent to July 1, 1989. However, there has been a subsequent proceeding before a
Hearing Officer of the State of Florida, Division of Administrative 'Hearings and the Final Order
entered by the hearing Officer determined that it was not in the public interest to place the
entity submitting this sworn statement on the convicted vendor list. [Attach a copy of the final
order]
I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING
OFFICER FOR THE PUBLIC ENTITY IDENTIFIED IN PARAGRAPH 1 (ONE),ABOVE IS FOR
THAT PUBLIC ENTITY ONLY AND, THAT THIS FORM 1S VALID THROUGH DECEMBER 31
OF THE CALENDAR YEAR IN WHICH IT IS_FILED. I ALSO UNDERSTAND THAT I AM
REQUIRED TO INFORM THE PUBLIC ENTITY PRIOR TO ENTERING INTO A CONTRACT
IN EXCESS OF THE THRESHOLD AMOUNT PROVIDED IN SECTION 287.017, FLORIDA
STATUTES FOR CATEGORY TWO OF ANY CHANGE IN THE INFORMATION CONTAINED
IN THIS FORM.
[Signature]
Sworn to and subscribed before me this day of , 2010
Personally known
OR Prod,uced identification Notary Public - State of.
My commission expires
(Type of Identification)
(Printed typed or stamped Commissioned name of Notary Public)
'RFP,No. 46- 09/10 City of Miami Beach Page 25 of 39
Medical Services Provider 7/28/2010
QUESTIONNAIRE
Proposer's Name:
Principal Office Address:
Official Representative:
Individual
Partnership (Circle One)
Corporation
If a Corporation, answer this:
When Incorporated:
In what State:
If a Foreign Corporation:
Date of Registration with
Florida Secretary of State:
Name of Resident Agent:
Address of Resident Agent:
President's Name:
Vice- President's Name:
Treasurer's Name:
RFP 46 -09/10 City of Miami Beach Page 26 of 39
Medical Services Provider 7/28/2010
Questionnaire (continued)
Members of Board of Directors:
If a Partnership:
Date of organization:
General or Limited Partnership*
Name and Address of Each Partner:
NAME ADDRESS
* Designate general partners in a Limited Partnership
1. Number of years of relevant experience in operating same or similar business:
2. Have any agreements held by Proposer for a project ever been canceled?, Yes O No ( )
If yes, give details on a separate sheet. .
3. Has the Proposer or any principals of the applicant organization failed to qualify as a
responsible bidder /proposer, refused to enter into a contract after an award has been
made, failed to complete a contract during the past five (5) years, or been declared to be
in default in any contract in the last 5 years?
If yes, please explain:
RFP No. 46- 09/10 City of Miami Beach Page 27 of 39
Medical Services Provider 7/28/2010
Questionnaire (continued)
4. Has the Proposer or any of its principals declared bankrupt or reorganized
under Chapter 11 or put into receivership? Yes( )No(
)
If yes, give date, court jurisdiction, action taken, and any other explanation deemed
necessary on a separate sheet.
5. Person or persons interested in this RFP and Qualification form have.( ) have not
( ) been convicted by a Federal, State, County, or Municipal Court of any violation of
law, other than traffic violations. To include stockholders over ten percent (10 %). (Strike
out inappropriate words)
Explain any convictions:
6. Lawsuits (any) pending or completed involving the corporation, partnership or individuals
with more than ten percent (10 %o)'interest:
A. List all pending lawsuits:
1
B. List all judgments from lawsuits in the last five (5) years:
1
C. List any criminal violations and /or convictions of the Proposer and /or any of its
principals:
7. Conflicts of Interest. The following relationships are the only potential, actual, or
perceived conflicts of interest in connection with this Proposal: (If none, state same.)
8. Public Disclosure. In order to determine whether the members of the Evaluation
Committee for this Request for Proposals have any association or relationships which
would constitute a conflict of interest, either actual or perceived, with any Proposer
and /or individuals and entities comprising or representing such Proposer and in an
attempt to ensure full and complete disclosure regarding this contract, all Proposers are
required to disclose all persons and entities who may be involved with this Proposal.
This list shall include public relation firms, lawyers and lobbyists. The Procurement
Division shall be notified in writing if any person or entity is added to this list after
receipt of Proposals.
RFP No. 46 -09/10 City of Miami Beach Page 28 of 39
Medical Services Provider 7/28/2010
Questionnaire (continued)
The Proposer understands that information contained in this Questionnaire will be relied
upon by the City in awarding the RFP, and such information is warranted by the
Proposer to be true and accurate. The Proposer agrees to furnish such additional
information, prior to acceptance of any Proposal, relating to the qualifications of the
Proposer, as may be requested by the City Manager. The Proposer further understands
that the information contained in this Questionnaire may be confirmed through a.
background investigation conducted by the City, through the Miami Beach Police
Department. By submitting this Questionnaire the Proposer agrees to cooperate with
this investigation, including but not limited to, fingerprinting and providing information
for a credit check.
PROPOSER
WITNESS: IF INDIVIDUAL:
Signature Signature
Print Name Print Name
WITNESS: IF PARTNERSHIP:
Signature Print Name of Successful Proposer
Print Name Address
By:
General Partner
Print Name
ATTEST: IF CORPORATION:
Secretary Print Name of Corporation
Print Name Address
By:
President (Print Name)
(CORPORATE SEAL)
RFP No. 46 -09/10 City of Miami Beach Page 29 of 39
Medical Services_ Provider 7/28/2010
MIAM.IBEACH
CITY OF MIAMI BEACH
DECLARATION: NONDISCRIMINATION IN CONTRACTS AND BENEFITS
Section 1.•Vendor Information
Name of Company: Name of Company Contact Person:
Phone Number: Fax Number: E-mail
Vendor Number (if known):
Federal ID or Social Security Number:
'Approximate Number. of Employees in the U.S.: { If 50 or less, skip to Section 4, date and sign).
Are any of your employees covered by a collective bargaining agreement or union trust fund? Yes No
Union name(s):
Section 2. Compliance Questions
Question 1. Nondiscrimination - Protected Classes
A. Does your company agree to not discriminate against your employees, applicants for
employment, employees of the City, or members of the public on the basis of the 'fact or;
perception of a person's membership in the categories listed below? Please note: a "YES"
answer means your company agrees it will not discriminate; a "NO" answer means your,
company refuses to agree that it will not discriminate. Please answer yes or no to each
category.
❑ Race Yes No ❑ Sex Yes _ No
❑ Color — Yes _ No ❑ Sexual orientation _ Yes _ No
❑ Creed _ Yes — No Li Gender identity (transgender status) _ Yes _ No
El Religion Yes _ No ❑ Domestic.partner status _ Yes - No
❑ National origin — Yes _ No ❑ Marital status — Yes _ No
❑ Ancestry _ Yes _ No ❑ Disability _ Yes _ No
❑ Age _ Yes _ No ❑ AIDS /HIV status _ Yes _ No
❑ Height — Yes _ No ❑ Weight — Yes _ No
B. Does your company agree to insert a similar nondiscrimination provision in any
subcontract you enter into for the performance of a substantial portion of the contract you
have with the City? Please note: you must answer this question, even if you do not intend
to enter into any subcontracts.
Yes No
RFP No. 46- 09/10 City of Miami Beach, Page 30 of 39
Medical Services Provider. 7/28/2010
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Question 2. Nondiscrimination - Equal Benefits for Employees with Spouses and Employees with
Domestic Partners
Questions 2A and 2B should be answered YES even if your employees must
pay some or all of the cost of spousal or domestic partner benefits.
A. Does your company provide or offer access to any benefits to employees
with spouses or to spouses of employees?
Yes No
B. Does your company provide or offer access to any benefits to employees
with (same or opposite sex) domestic partners* or to domestic partners of
employees? Yes No
*The term Domestic Partner shall mean any two (2) adults 'of the same or
different sex, who have registered as domestic partners with a government
body pursuant to state or local law authorizing such registration, or with an`
internal registry maintained by the employer of at least one of the domestic
partners. A Contractor may institute an internal registry to allow . for the
provision of equal benefits to employees with domestic partner who do not
register their partnerships pursuant to a governmental body authorizing such
registration, or who are located in a jurisdiction where no such governmental
domestic partnership exists. A Contractor that institutes such registry shall
not impose criteria for registration that are more stringent than those
required for domestic partnership registration by the City of Miami Beach
If you answered "NO" to both Questions 2A and. 2B, go to Section 4 (at the
bottom of this page), complete and sign the form, filling in all items requested.
If you answered "YES" to either or both Questions 2A and 2B, please continue to
Question 2C below.
Question 2. (Continued)
C. Please check all benefits that apply to your answers above and list in the "other"
section any additional benefits not already specified. Note: some benefits are
provided to employees because they have a spouse or domestic partner, such as
bereavement leave other benefits are provided directly to the spouse or domestic
partner, such as medical insurance.
BENEFIT Yes for Yes for Employees No, this Documentation of this
Employees with with Domestic Benefit is Not Benefit is Submitted
Spouses Partners Offered with this Form
Health ❑ ❑ ❑ ❑
Dental - ❑ ❑ ❑
Vision ❑ ❑ ❑ ❑
Retirement (Pension, ❑ ❑ ❑ ❑
401 (k), etc.)
Bereavement ❑ ❑ ❑ ❑
Family Leave ❑ ❑ ❑ ❑
Parental Leave ❑ ❑ ❑ ❑
Employee Assistance ❑ ❑ ❑ ❑
Program
Relocation & Travel ❑ ❑ ❑ ❑
Company Discount, ❑ o ❑ ❑
Facilities & Events
Credit.Union ❑ ❑ ❑ o
Child Care ❑ ❑ ❑ ❑
Other ❑ ❑ ❑ ❑ — 7
Note: If you can not offer a benefit in a nondiscriminatory manner because of
reasons outside your control, (e.g., there are no insurance providers in your area
willing to offer domestic part ner coverage)' you may be eligible for Reasonable
RFP No. 46 -09/10 City of Miami Beach Page 31 of 39
Medical Services Provider 7128/2010
Measures compliance. To comply on this basis, you must agree to pay a cash I
equivalent, submit a completed Reasonable Measures Application with all
necessary attachments, and have your application approved by the City Manager,
or his designee.
Section 3. Required Documentation
YOU MUST SUBMIT SUPPORTING DOCUMENTATION to verify each benefit marked in Question 2C.
Without proper documentation, your company cannot be certified as complying with the City's Equal
Benefits Requirement for Domestic Partner Ordinance. For example, to document medical insurance
}
submit a statement from your insurance provider or a copy of the eligibility section of your plan
document; to document leave programs, submit a copy of your company's employee handbook. If
documentation for a particular benefit does not exist, attach an explanation.
Have you submitted supporting documentation for each benefit offered? _Yes — No
Section 4. Executing the Document
I declare under penalty of perjury under the laws of the State of Florida that the foregoing is
true and correct, and that I am authorized to bind this entity contractually.
Executed this day of in the year at
City State
Signature Mailing Address
Name of Signatory (please print) City, State, Zip Code
Title
RFP No. 46- 09/10 City of Miami Beach Page 32 of 39
Medical Services Provider 7/28/2010
MIAMIBEACH
CITY OF MIAMI BEACH
REASONABLE MEASURES. APPLICATION
Declaration: Nondiscrimination in Contracts and Benefits
Submit' this form and supporting documentation to the City's Procurement Division
ONLY IF you:
a. Have taken all reasonable measures to end discrimination in benefits; and
b. Are unable to do so; and
c. Intend to offer a cash equivalent for employees to whom equal benefits are not
available.
You must submit the following information with this form:
1. The names, contact persons and telephone numbers of benefits providers contacted
for the purpose of acquiring nondiscriminatory benefits;
2. The dates on which such benefits providers were contacted;
3. Copies of any written response(s) you received from such benefits providers, and if
written responses are unavailable, summaries of oral responses; and
4. Any other information you feel is relevant to documenting -your inability to end
discrimination in benefits, including, but not limited tojeference to federal or state laws
which preclude the ending of discrimination in benefits.
I declare (or certify) under penalty of perjury under the laws of the State of Florida that
the foregoing is true and correct, and that I am authorized to bind this entity
contractually.
Name of Company (please print) Mailing Address of Company
Signature City, State, Zip
Name of Signatory (please print) Telephone Number
Title Date
Definition of Terms
RFP No. 46 -09/10 City of Miami Beach Page 33 of 39
Medical Services Provider 712812010
j
1
A. REASONABLE MEASURES
The City of Miami Beach will determine whether a City Contractor has taken all reasonable
measures provided by the City Contractor that demonstrates that it is not possible for the .City
Contractor to end discrimination in benefits. A determination that it is not possible for the City,
Contractor to end discrimination in benefits shall be based upon a consideration 'of such
factors as:
(1) The number of benefits providers identified and contacted, in. writing, by the City
Contractor, and written documentation from these providers that they will not provide equal
benefits;
(2) The existence of benefits providers willing to offer equal benefits to the City Contractor;
and
(3) The existence of federal or state laws which preclude the City Contractor from ending
discrimination in benefits.
B. CASH EQUIVALENT
"Cash Equivalent" means the amount of money paid to an employee with a Domestic
Partner (or spouse, if applicable) in lieu of providing Benefits to the employees' Domestic
partner (or spouse, if applicable). The Cash Equivalent is equal to the employer's direct
expense of providing Benefits to an employee for his or her, spouse.
Cash Equivalent. The cash equivalent of the following benefits applies:
a. For bereavement leave, cash payment for the number of days that would be allowed as
- paid time off for death of a spouse. Cash payment would be in the form of wages of the
domestic partner employee for the number of days allowed.
b. For health benefits, the cost to the Contractor of the Contractor's share of the single
monthly premiums that are being paid for the domestic partner employee, to be paid on a
regular basis while the domestic partner employee maintains the such insurance in force for
himself or herself.
c. For family medical leave, cash payments for the number of days that would be allowed as
time off for an employee to care for a spouse that has a serious health condition. Cash
payment would be in the form of wages of the domestic partner employee for the number of
days allowed.
r
RFP No. 46 -09/10 City of Miami Beach Page 34 of 39
Medical. Services Provider 7/28/2010
MIAMIBEACH
CITY OF MIAMI BEACH
SUBSTANTIAL COMPLIANCE AUTHORIZATION FORM.
Declaration: Nondiscrimination in Contracts and Benefits
This form, and supporting documentation, must be submitted to the Procurement Division by
entities seeking to contract with the City of Miami Beach that wish to delay ending their
discrimination in benefits pursuant to the Rules of Procedure, as set out below. j
Fill out all sections that apply. Attach additional sheets as necessary.
A. Open Enrollment
Ending discrimination in benefits may be delayed until the first effective date after the first open
enrollment process following the date the contract with the City. begins, provided that the City
Contractor submits to the Procurement Division evidence that reasonable efforts are being
undertaken to end discrimination in benefits. This delay may not exceed two years from the date
the contract with the City is entered into, and only applies to benefits for which an open
enrollment process is applicable.
Date next benefits plan year begins:
Date nondiscriminatory benefits will be available:
Reason for Delay:
Description of efforts being undertaken to end discrimination in benefits:
B. Administrative Actions and Request for Extension
RFP No. 46 -09/10 City of Miami Beach Page 35 of 39
Medical Services Provider 7/28/2010
Ending discrimination in benefits may be delayed to allow administrative steps to be taken to
incorporate nondiscriminatory benefits into the City Contractor's infrastructure. The time allotted
for these administrative steps shall apply only to those benefits for which administrative steps
are necessary and may not exceed three months. An extension of this time may be granted at
the discretion of the Procurement Director, upon the written request of the City Contractor.
Administrative steps may include, but are not limited to, such actions as computer systems
modifications, personnel policy revisions, and the development and distribution of employee
communications.
Description of administrative steps and dates to be achieved:
If requesting extension beyond three months, please explain basis:
C. Collective Bargaining Agreements (CBA)
Ending discrimination in benefits may be delayed until the expiration of a City Contractor's
Current collective bargaining agreement(s) where all of the following conditions have been met:
1. The provision of benefits is governed by one or more collective bargaining agreement(s);
2. The City Contractor takes all reasonable measures to end discrimination in benefits either by
requesting' that the Unions involved agree to' reopen the agreements in order for the City
Contractor to take whatever steps necessary to end discrimination in benefits or by ending
discrimination in benefits without reopening the collective bargaining agreements; and
3. In the event that the City Contractor cannot end discrimination in benefits despite taking all
reasonable measures to do so, the City Contractor provides a cash equivalent to eligible
employees for whom benefits are not available. Unless otherwise authorized in writing by the
Procurement Director, this cash equivalent payment must begin at the time the Unions refuse to
allow the collective bargaining agreements to be reopened, or in any case no longer than three
(3) months from the date the contract with the City - is entered - into.
For a delay to be granted under this provision, written proof must be submitted with this form
that:
• The benefits for which the delay is requested are governed by a collective bargaining
agreement;
RFP No. 46 -09/10 City of Miami Beach Page 36 of 39
Medical Services Provider 7/28/2010
• All reasonable measures have been taken to end discrimination in benefits (see Section
C.2, above); and
• A cash equivalent payment will be. provided to eligible employees for whom benefits are
not available.
I declare (or certify) under penalty of perjury under the laws of the State of Florida that the
foregoing is true and correct, and that I am authorized to bind this entity contractually.
Name of Company (please print) Mailing Address of Company
Signature City, State, Zip
Name of Signatory (please print) Telephone Number
Title. Date
RFP No. 46 -09/10 City of Miami Beach Page 37 of 39
Medical Services Provider 7/28/2010
AMI
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
PROCUREMENT DIVISION
Tel: 305 -673 -7490, Fax: 786 -394 -4006
To:
Phone:
Fax:
E -mail:
Subject: Performance Evaluation of:
Number of pages including cover: 2
To Whom It May Concern:
The City of Miami Beach has implemented a process that collects past performance information.
pursuant to the submittal of responses to this Request for Proposals. The information will be
used to assist City of Miami Beach in the evaluation of Proposals received in response to the
RFP for providers of medical services.
The company listed in the subject line has chosen to participate in this RFP. They have Fisted
you as a past client for which they have provided services. Both the company and City of Miami
Beach would greatly appreciate you taking a few minutes of your time to complete the
accompanying questionnaire.
Please review all items in the following document and answer the questions to the best of your
knowledge. If you cannot answer a particular question, please leave it blank. Please return this
questionnaire to Pamela Leja by- August 25, 2010 via fax: 786 -394 -4006; or email:
PamelaLeja @miamibeachfl.gov.
l
Thank you for your time and effort.
Gus Lopez, CPPO
Procurement Director
I A M I B E A � '
RFP No. 46 -09/10 City of Miami Beach Page 38 of 39
Medical Services Provider 7/28/2010
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
PROCUREMENT DIVISION
- Tel: 305 -673 -7490, Fax: 786- 394 -4006
PERFORMANCE EVALUATION SURVEY
RFP 46- 09110
Company Name:
Point of Contact:
Phone and email:
Please evaluate the performance of the company (10 means you are very satisfied and have no
questions about hiring them again, and 1 is if you would never hire them again because of very
poor performance). Please leave blank if you don't know.
NO. CRITERIA UNIT
1 Ability to maintain courteous and professional service 1 -10
Communication, resolution of discrepancies, responsiveness
2 of personnel servicing the account [to include availability of (1 -10)
de si Hated contact person(s
3 Responsiveness to priorities for service (1 -10)
4 Meeting number of required appointments and scheduling (1 -10) .
requirements
Ability to provide requested services within the designated (1 -10)
5 timeframe
6 Cost of services provided (1 -10)
7 Experience level and credentials of assigned staff .(1 -10)
8 Overall customer satisfaction and hiring again based on
performance (comfort level in hiring medical provider again) (1 -10)
Overall Comments:
x .
Company providing Referral:
Contact Name:
Contact Phone and e-mail:
Date of Services:
Dollar Amount for Services:
Thank you for your time and effort. Please return this form via fax to 786 -394- 4006
Attn. Pamela Leja, or via e- mail: Pamela Leja(a-miamibeachfl.gov on or before August 25,
2010.
RFP No. 46 -09110 City of Miami Beach Page 39 of 39
Medical Services Provider 7/28/2010
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Exhibit B
Final Negotiated Fee Schedule
10
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CITY OF MB MEDICAL SERVICES SCHEDULE I
PRE- EMPLOYMENT PHYSICAL PRICE LIST
POLICE $180
FIRE $255
STD $80
FITNESS FOR DUTY (PE & DT) $90
FITNESS FOR DUTY (PE ONLY) $55
PPD $15
CHEST X -RAY $45
EKG $55
POST EXPOSURE EXAM $10
TETANUS $40
HEP B $180
HEP A/B (TWINRIX) $300
MMR $75
HIV EXP $150
DRUG TEST WITH MRO $35
BAT $20
SAP EVAL $50 MD/$125 DOT
RESP QUESTIONNAIRE $10
RESPIRATOR CLEARANCE $50
PSYCH SERVICES $175
ON SITE SERVICE TECH * *NO CHARGE ** DURING BUSINESS HOURS
MOBILE UNIT $200 /day
AFTER HOURS TECH $200 /HR + SERVICE
AFTER HOURS MED PERSONNEL $400 /HR + SERVICE
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