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Resolution 2018-30483 RESOLUTION NO. 2018-30483 A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, ACCEPTING THE WRITTEN RECOMMENDATION OF THE CITY MANAGER, PURSUANT TO REQUEST FOR PROPOSALS (RFP) NO. 2017-002-JC, FOR EMERGENCY MEDICAL TRANSPORT BILLING AND COLLECTION SERVICES, APPROVING THE FINAL SELECTION AND TERMS OF AN AGREEMENT WITH ADVANCED DATA PROCESSING, INC., A SUBSIDIARY OF INTERMEDIX CORPORATION, AS SET FORTH IN EXHIBIT "A" TO THE COMMISSION MEMORANDUM ACCOMPANYING THIS RESOLUTION; AUTHORIZING THE CITY MANAGER AND CITY ATTORNEY TO NEGOTIATE A FINAL AGREEMENT WITH ADVANCED DATA PROCESSING, INC., INCORPORATING THE TERMS APPROVED HEREIN; FURTHER, AUTHORIZING THE MAYOR AND CITY CLERK TO EXECUTE THE FINAL AGREEMENT WITH .ADVANCED .DATA PROCESSING, INC., UPON CONCLUSION OF SUCCESSFUL NEGOTIATIONS; AND, FURTHER, AUTHORIZING THE CITY MANAGER TO NEGOTIATE AND EXECUTE -A MONTH-TO-MONTH EXTENSION OF THE CITY'S CURRENT AGREEMENT WITH ADVANCED DATA PROCESSING, INC., FOR A TERM NOT TO EXCEED NINETY (90) DAYS, FOR THE CONTINUATION OF CURRENT SERVICES, OR UNTIL SUCH TIME AS A NEW AGREEMENT IS EXECUTED, WHICHEVER OCCURS FIRST. WHEREAS, on January 11, 2017 the Mayor and City Commission approved the issuance of Request for Proposals (RFP) No. 2017-002-JC, for Emergency Medical Transport Billing and Collection Services; and WHEREAS, although the Evaluation Committee for the above-referenced RFP ranked PST Services, Inc., a subsidiary of McKesson Corporation ("PST Services"), and Advanced Data Processing, Inc., a subsidiary of Intermedix Corporation ("ADP"), as the two top-ranked proposers, on July 26, 2017, the Mayor and City Commission rejected all proposals received, pursuant to Request for Proposals No. 2017-002-JC (the RFP), Emergency Medical Transport Billing and Collection Services; and WHEREAS, the Mayor and City Commission authorized the City Manager to negotiate and approve the terms of a month-to-month agreement with ADP, commencing on September 16, 2017, for a term not to exceed one (1) year, for the continuation of current services, or until such time as a new agreement is executed, whichever occurs first; and WHEREAS, on October 18, 2017, the City Manager recommended, as being in the City's best interest, the waiver of the formal competitive bidding requirements with 'respect to the procurement of emergency medical transport billing and collections services, and recommended that the City Commission authorize the Administration to enter into simultaneous negotiations with PST Services and ADP; and WHEREAS, at the conclusion of the simultaneous negotiations by the Administration, the final selection of the vendor, and award of the contract, shall be subject to the prior approval of the Mayor and City Commission; and WHEREAS, on November 6, 2017, the Administration initiated the negotiations process with ADP and PST Services; and lI WHEREAS, the Administration determined on November 20, 2017, that in the City's best interests, a field testing and demonstration of software was required before proceeding with negotiations; and WHEREAS, on December 19, 2017 the Administration received a software demonstration from both ePCR vendors, ESO Solutions, Inc. and ImageTrend software systems; and WHEREAS, the Administration determined that additional hardware, including laptops, would be required to properly conduct the field testing portion of proposed software; and WHEREAS, the Administration placed an order for laptops and related hardware on February 5, 2018; and WHEREAS, the laptops supplier advised the Administration of a three (3) month leadtime due to manufacturing issues internationally; and WHEREAS, the laptops were delivered to the City June 4, 2018; and WHEREAS, the Administration began conducting a forty-five (45) day field testing program utilizing the received laptops in various emergency vehicles; and WHEREAS, on August 9, 2018 the Administration completed the field testing and recommended the preferred software vendor as ESO Solutions; and WHEREAS, on August 12, 2018 the Administration advised both ADP and PST Services that ESO Solutions, Inc. is the preferred ePCR software vendor to be utilized for inclusion into their Best and Final Offer("BAFO"); and WHEREAS, on August 24, 2018 the Administration requested both ADP and PST Services submit a BAFO by August 28, 2018, by 3:00 PM EST; and WHEREAS, on August 28, 2018 the Administration received a BAFO from both ADP and PST Services; and WHEREAS, on August 29, 2018 the Administration reviewed the BAFO from both firms, and determined that ADP provided the best offer for emergency medical transport billing and collection services to the City. NOW, THEREFORE, BE IT DULY RESOLVED BY THE MAYOR AND CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, that the Mayor and City Commission hereby accept the written recommendation of the City Manager pursuant to Request for Proposals (RFP) no. 2017-002-JC, for Emergency Medical Transport Billing and Collection Services, approving the final selection and terms of an agreement with Advanced Data Processing, Inc., a subsidiary of Intermedix Corporation, as set forth in Exhibit "A" to the Commission Memorandum accompanying this resolution; authorize the City Manager and City Attorney to negotiate the final agreement with Advanced Data Processing, Inc., incorporating the terms approved herein; further, authorize the Mayor and City Clerk to execute the final agreement with Advanced Data Processing, Inc. upon conclusion of successful negotiations; and further, authorize the City Manager to negotiate and execute the terms of a month-to-month extension of the City's current agreement with Advanced Data Processing, Inc., for a term not to exceed ninety (90) days, for the continuation of current services, or until such time as a new agreement is executed, whichever occurs first. 77 PASSED AND ADOPTED this /cd day of C?PT. 2018. ATTEST: �IMae_ RAF•EL E. RANAD., C TY CLERK DAN GELBER, MAYOR \ Mt 0 —7„,„_ ' n I* INCCRP ORATED; APPROVED AS TO FORM &LANGUAGE YA &FOR EXECUTION CH_ 1 7,v\ 4 Ic City Attorney P Date Resolutions - C7 AK MIAMI BEACH COMMISSION MEMORANDUM TO: Honorable Mayor and Members of the City Commission FROM: Jimmy L. Morales, City Manager DATE: September 12, 2018 SUBJECT: A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, ACCEPTING THE WRITTEN RECOMMENDATION OF THE CITY MANAGER, PURSUANT TO REQUEST FOR PROPOSALS (RFP) NO. 2017-002-JC, FOR EMERGENCY MEDICAL TRANSPORT BILLING AND COLLECTION SERVICES,APPROVING THE FINAL SELECTION AND TERMS OF AN AGREEMENT WITH ADVANCED DATA PROCESSING, INC.,A SUBSIDIARY OF INTERMEDIX CORPORATION, AS SET FORTH IN EXHIBIT "A" TO THE COMMISSION MEMORANDUM ACCOMPANYING THIS RESOLUTION; AUTHORIZING THE CITY MANAGER AND CITY ATTORNEY TO NEGOTIATE A FINAL AGREEMENT WITH ADVANCED DATA PROCESSING, INC., INCORPORATING THE TERMS APPROVED HEREIN; FURTHER, AUTHORIZING THE MAYOR AND CITY CLERK TO EXECUTE THE FINAL AGREEMENT WITH ADVANCED DATA PROCESSING, INC., UPON CONCLUSION OF SUCCESSFUL NEGOTIATIONS; AND, FURTHER, AUTHORIZING THE CITY MANAGER TO NEGOTIATE AND EXECUTE A MONTH-TO-MONTH EXTENSION OF THE CITY'S CURRENT AGREEMENT WITH ADVANCED DATA PROCESSING, INC., FOR A TERM NOT TO EXCEED NINETY (90) DAYS, FOR THE CONTINUATION OF CURRENT SERVICES, OR UNTIL SUCH TIME AS A NEW AGREEMENT IS EXECUTED, WHICHEVER OCCURS FIRST. RECOMMENDATION Adopt the Resolution. ANALYSIS Emergency medical transport billing and collection services are essential to the Administration's ability to provide the City's residents and visitors with comprehensive medical transport services, and with efficient, reliable billing and collection services thereafter. The services assists Fire Department staff in obtaining patient and insurance information for emergency medical transport services provided, verifying patient insurance and patient demographic information, filing claims and sending invoices to self-pay accounts, submitting claims to Medicare, Medicaid, insurance companies, processing third-party reimbursements, and providing specific management and financial reports on a monthly basis, as specified by the City. Currently,Advanced Data Processing, Inc. (ADP), a subsidiary of Intermedin Corporation is providing emergency medical transport billing and collection services to the City. The agreement expires on September 30, 2018. On October 18, 2017, the City Manager recommended, as being in the City's best interest, the waiver of the formal competitive bidding requirements with respect to the procurement of emergency medical transport billing and collections services, and recommended that the City Commission authorize the Administration to enter into simultaneous negotiations with PST Services and ADP, the two service providers with the strongest local presence. PST Services, Inc. (PST), a subsidiary of McKesson Corporation, has over 25 years of EMS billing experience, including a strong presence in Florida, with an EMS client base generating approximately one million billable EMS transports annually. As such, PST is one of the largest EMS revenue recovery companies in America. As a subsidiary of McKesson Corporation, PST benefits from the global pharmaceutical and medical products technology network, medical supplies, distribution management, business services, financial capacity, and care management tools, strengthened by over 68,000 dedicated employees. Advanced Data Processing, Inc. (ADP), a subsidiary of Intermedix Corporation, the City's incumbent contractor, has been a leader in the EMS billing industry for 38 years. ADP processes more than 15 million patient encounters annually, collecting more than $3 billion in revenue for clients and connecting more than 95% of the United States population through emergency preparedness and response technologies. Of their 675 EMS billing operations personnel, approximately 250 are based in Florida. ADP has a Florida client base of 55 customers, representing over 60 municipalities and equaling nearly 900,000 billable accounts annually. On November 6, 2017, the Administration initiated the negotiations process with ADP and PST. On November 20, 2017, the Fire Department determined that a field demonstration of Electronic Patient Care Reporting (ePCR) software system was required prior to proceeding with the Best and Final Offer ("BAFO"). Electronic Patient Care Reporting (ePCR) software is critical to the overall billing and collections solution. The Fire Department desires that the awarded contractor will partner with a single billing and collection software provider to provide the City with the requirements of the RFP. Therefore, on December 19, 2017, the Fire Department received a software demonstration from vendors, ESO Solutions and ImageTrend software systems, the two software providers that can work with either PST or ADP in providing the software requirements of the patient care reporting software. The Fire Department further determined that additional hardware, including laptops, would be required to properly conduct the field testing portion of the proposed patient care reporting software. The Fire Department placed an order for several "Toughbook" laptops and related hardware on February 5, 2018. Soon thereafter, the device and hardware supplier advised the Fire Department of a three (3) month leadtime due to manufacturing issues internationally. The laptops and related hardware were delivered to the City on June 4, 2018.Actual testing could not begin until these items were received by the City. The Fire Department began conducting a field testing program utilizing the Toughbook laptops, loaded with ESO Solutions, Inc. and ImageTrend software systems, in various emergency vehicles citywide. On August 9, 2018, the Fire Department completed the field testing and recommended the preferred patient care reporting software vendor as ESO Solutions, Inc. On August 12, 2018, the Fire Department advised both ADP and PST that ESO, Inc. is the preferred software, and requested that ADP and PST include the ESO Solutions, Inc. patient care reporting option in their Best and Final Offer ("BAFO"). On August 24, 2018, the Fire Department requested both ADP and PST submit a BAFO with a proposal deadline established of August 28, 2018 by 3:00 PM EST. On August 28, 2018 the City received a sealed BAFO from both ADP and PST . The Administration conducted its due diligence on the BAFOs received, which resulted in the following financial analysis: • ADP's BAFO Annual Cost to the City: $200,800 • PST's BAFO Annual Cost to the City: $273,570 • Annual Cost Difference Between ADP and PST: $72,770 • 3-Year Cost Difference Between ADP and PST: $218,310 Additionally, the ADP offer also includes the required eighteen (18) laptops for daily vehicle use, and fifteen (15) as-needed, special events laptops, at no additional cost to the City. Whereas, the offer Page 818 of 1802 submitted by PST would cost the City approximately $128,370 for annual hardware requirements. This alone is a significant, cost prohibitive consideration when comparing both offers. CONCLUSION Emergency medical transport billing and collection services are essential to the Administration's ability to provide the City's residents and visitors with comprehensive medical transport services, and with efficient, reliable billing and collection services thereafter. The services assists Fire Department staff in obtaining patient and insurance information for emergency medical transport services provided, verifying patient insurance and patient demographic information, filing claims and sending invoices to self-pay accounts, submitting claims to Medicare, Medicaid, insurance companies, processing third-party reimbursements, and providing specific management and financial reports on a monthly basis, as specified by the City. Currently, Advanced Data Processing, Inc. (ADP), a subsidiary of Intermedix Corporation is providing emergency medical transport billing and collection services to the City. The agreement expires on September 30, 2018. On October 18, 2017, the City Manager recommended, as being in the City's best interest, the waiver of the formal competitive bidding requirements with respect to the procurement of emergency medical transport billing and collections services, and recommended that the City Commission authorize the Administration to enter into simultaneous negotiations with PST Services and ADP, the two service providers with the strongest local presence. PST Services, Inc. (PST), a subsidiary of McKesson Corporation, has over 25 years of EMS billing experience, including a strong presence in Florida, with an EMS client base generating approximately one million billable EMS transports annually. As such, PST is one of the largest EMS revenue recovery companies in America. As a subsidiary of McKesson Corporation, PST benefits from the global pharmaceutical and medical products technology network, medical supplies, distribution management, business services, financial capacity, and care management tools, strengthened by over 68,000 dedicated employees. Advanced Data Processing, Inc. (ADP), a subsidiary of Intermedix Corporation, the City's incumbent contractor, has been a leader in the EMS billing industry for 38 years. ADP processes more than 15 million patient encounters annually, collecting more than $3 billion in revenue for clients and connecting more than 95% of the United States population through emergency preparedness and response technologies. Of their 675 EMS billing operations personnel, approximately 250 are based in Florida. ADP has a Florida client base of 55 customers, representing over 60 municipalities and equaling nearly 900,000 billable accounts annually. On November 6, 2017, the Administration initiated the negotiations process with ADP and PST. On November 20, 2017, the Fire Department determined that a field demonstration of Electronic Patient Care Reporting (ePCR) software system was required prior to proceeding with the Best and Final Offer ("BAFO"). Electronic Patient Care Reporting (ePCR) software is critical to the overall billing and collections solution. The Fire Department desires that the awarded contractor will partner with a single billing and collection software provider to provide the City with the requirements of the RFP. Therefore, on December 19, 2017, the Fire Department received a software demonstration from vendors, ESO Solutions and ImageTrend software systems, the two software providers that can work with either PST or ADP in providing the software requirements of the patient care reporting software. The Fire Department further determined that additional hardware, including laptops, would be required to properly conduct the field testing portion of the proposed patient care reporting software. The Fire Department placed an order for several "Toughbook" laptops and related hardware on February 5, 2018. Soon thereafter, the device and hardware supplier advised the Fire Department of a three (3) month leadtime due to manufacturing issues internationally. The laptops and related hardware were delivered to the City on June 4, 2018. Actual testing could not begin until these item were received by the City. The Fire Department began conducting a field testing program utilizing the Toughbook laptops, loaded with ESO Solutions, Inc. and ImageTrend software system, in various emergency vehicles citywide. On August 9, 2018, the Fire Department completed the field testing and recommended the Page 819 of 1802 preferred patient care reporting software vendor as ESO Solutions, Inc. On August 12, 2018, the Fire Department advised both ADP and PST that ESO, Inc. is the preferred software, and requested that ADP and PST include the ESO Solutions, Inc. patient care reporting option in their Best and Final Offer ("BAFO"). On August 24, 2018, the Fire Department requested both ADP and PST submit a BAFO with a proposal deadline established of August 28, 2018 by 3:00 PM EST. On August 28, 2018 the City received a sealed BAFO from both ADP and PST . The Administration conducted its due diligence on the BAFOs received, which resulted in the following financial analysis: • ADP's BAFO Annual Cost to the City: $200,800 • PST's BAFO Annual Cost to the City: $273,570 • Annual Cost Difference Between ADP and PST: $72,770 • 3-Year Cost Difference Between ADP and PST: $218,310 Additionally, the ADP offer also includes the required eighteen (18) laptops for daily vehicle use, and fifteen (15) as-needed, special events laptops, at no additional cost to the City. Whereas, the offer submitted by PST would cost the City approximately $128,370 for annual hardware requirements. This alone is a significant, cost prohibitive consideration when comparing both offers. After reviewing best and final offers from both firms, and conducting a significant level of due diligence with regard to the field testing and software demonstration process, I concur with the Fire Department's recommendation to award a contract for emergency medical transport billing and collection services to ADP, a subsidiary of Intermedix Corporation. In addition to the financial benefits that ADP's proposal represents over PST's, the Fire Department has determined that the following operational and logistics concerns also favor ADP over PST: • PST did not offer direct personnel or facilities to manage and support required laptops, which demand routine maintenance and repair. • ADP offers stronger local presence and service offerings, which will deliver a better, more reliable daily account support mechanism to the City's needs. • Given that ADP is the City's incumbent vendor for emergency medical transport billing and collection services, it is expected that operations will remain seamless during the contract transition, without disruption to the City's EMS billing services. Having taken all of the preceding items into careful consideration, I concur with Fire Department staff that ADP provides the best combination of services and cost benefit for emergency medical transport billing and collection services to the City of Miami Beach. While the primary services and cost negotiations have been finalized, minor negotiations relative to the terms of the Agreement must still be completed. Therefore, I recommend that the Mayor and City Commission adopt the Resolution approving the award of a contract to Advanced Data Processing, Inc., a subsidiary of Intermedix Corporation; and, authorize the City Manager and City Attorney to finalize the non-financial terms of the agreement with Advanced Data Processing, Inc., a subsidiary of Intermedix Corporation; and, further authorizing the Mayor and City Clerk to execute the final negotiated agreement with Advanced Data Processing, Inc., a subsidiary of Intermedix Corporation, upon approval of the City Manager and City Attorney; and, further, approve extension of the current month-to-month agreement with Advanced Data Processing, Inc., a subsidiary of Intermedix Corporation, for a term not to exceed ninety (90)days, for the continuation of current services, or until such time as a new agreement is executed. KEY INTENDED OUTCOMES SUPPORTED Enhance Public Safety and Emergency Preparedness Page 820 of 1802 FINANCIAL INFORMATION Funding is provided as part of the collection fees related to EMS Services. Legislative Tracking Fire/Procurement ATTACHMENTS: Description o Attachment A- Draft Agreement o Resolution Page 821 of 1802 PROFESSIONAL SERVICES AGREEMENT BETWEEN THE CITY OF MIAMI BEACH AND ADVANCED DATA PROCESSING, INC. D/B/A INTERMEDIX CORPORATION FOR EMERGENCY MEDICAL TRANSPORT BILLING AND COLLECTION SERVICES PURSUANT TO RFP 2017-002-JC This Professional Services Agreement ("Agreement") is entered into this day of , 2018, 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 ADVANCED DATA PROCESSING, INC. D/B/A INTERMEDIX CORPORATION whose address is 6451 N Federal Hwy#100, Fort Lauderdale, FL 33308, (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. Consultant Service Order: "Consultant Service Order" shall specifically describe and delineate the particular Services which will be required of Consultant for the Project that is the subject of such order using Exhibit "B" — Consultant Service Order Format, attached hereby and made part of this Agreement. Fee: Amount paid to the Consultant as compensation for Services. Contract Documents: Contract Documents shall mean this Agreement and City of Miami Beach RFP No. 2017-002-JC for EMERGENCY MEDICAL TRANSPORT BILLING AND COLLECTION SERVICES, together with all addenda thereto, issued by the City in contemplation of this Agreement, RFP, 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 Contract Documents and this Agreement, the following order of precedent shall prevail: this Agreement; the RFP; and the Proposal. Page 822 of 1802 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 2.1 In consideration of the Fee to be paid to Consultant by the City, Consultant hereby agrees to furnish all Services described in the Contract Documents and any Consultant Service Order issued to Consultant for any Services hereunder, and shall perform all Services in accordance with the requirements of the Contract Documents. Although Consultant may be provided with a schedule of the available hours to provide its services, the City shall not control nor have the right to control the hours of the services performed by the Consultant; where the services are performed (although the City will provide Consultant with the appropriate location to perform the services); when the services are performed, including how many days a week the services are performed; how the services are performed, or any other aspect of the actual manner and means of accomplishing the services provided. Notwithstanding the foregoing, all services provided by the Consultant shall be performed in accordance with the terms and conditions set forth in Exhibit "A" and to the reasonable satisfaction of the City Manager. If there are any questions regarding the services to be performed, Consultant should contact the following person: Fire Department City of Miami Beach 2300 Pinetree Dr. Miami Beach, FL 33140 Attn: Robert Bedell, Division Chief Email: RobertBedell(Wmiamibeachfl.gov 2.2 Consultant's Services and any deliverables incident thereto, shall be completed in accordance with the timeline and/or schedule in the Consultant Service Order. Consultant Service Orders must include a detailed list of tasks, sub-tasks, and deliverables (Collectively the Scope) that are consistent with the work and services described in Appendix "C" of the RFP and Exhibit"A" of this Agreement. 2.3 Consultant shall only commence any Services, or portions thereof, upon issuance of a Consultant Service Order executed by the City Manager or corresponding Department's Director pursuant to the requirements in section 4.2 of this agreement. For each proposed Consultant Service Order, Consultant shall provide the City with a cost proposal on a lump sum or not-to-exceed basis, based on the fee schedule set forth in Exhibit "C" hereto. A separate Consultant Service Order shall be required prior to commencement of any Services on any Project. The Consultant Service Order will not be issued until Consultant's submission to City of all required documents (including Certificate of Insurance) and after execution of the Contract by both parties. Consultant shall have no entitlement to perform (or be compensated for) any Services under this Agreement, unless such Services are authorized, at the City's sole discretion, by a Consultant Service Order. Page 2 Page 823 of 1802 SECTION 3 TERM The term of this Agreement ("Term") shall commence upon execution of this Agreement by all parties hereto, and shall have an initial term of three (3) years, with two (2), one (1) year renewal options, to be exercised at the City Manager's 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. Notwithstanding the Term provided herein, Consultant shall adhere to any specific timelines, schedules, dates, and/or performance milestones for completion and delivery of the Services, as same is/are set forth in the timeline and/or schedule referenced in Exhibit A hereto. SECTION 4 FEE 4.1 CONSULTANT SERVICE ORDER In consideration of the Services to be provided, Consultant shall be compensated through individual Consultant Service Order(s) issued for a particular Project, on a "Fixed Fee" or"Not to Exceed" basis determined by the rates established in Exhibit "C" of this Agreement, or by lump sum for the project determined by hourly rates not to exceed the rates established in Exhibit "C" of this Agreement. Notwithstanding the preceding, the total fee paid to Consultant pursuant to this Agreement shall be subject to funds availability approved through the City's budgeting process. At the time of negotiation of each Consultant Service Order, City and Contractor will determine the tasks, sub-tasks, and deliverables applicable to the Project based on the list of Services, and the lump sum or not-to-exceed amounts associated with each Consultant Service Order. To the extent any of the Services involve fees or costs for which billing rates are not specified in Exhibit "C," all such fees or costs must be specifically delineated in each Consultant Service Order and accepted by the City through execution of the Consultant Service Order, pursuant to section 4.2 of this agreement. Consultant shall not commence any Services or Additional Services unless approved in writing by the City Manager or the corresponding Department's Director. The corresponding Department Director shall have the delegated authority to execute Consultant Service Orders up to an amount not-to-exceed $50,000.00. Any Consultant Service Orders in excess of$50,000.00 must be executed by the City Manager. Any Consultant Service Order not executed in accordance herewith shall be null and void. Reimbursable Expenses are an allowance set aside by the City and shall include actual expenditures made by the Consultant in the interest of the Project, provided such expenses are authorized in advance by the City in a Consultant Service Order. The Reimbursable Expenses allowance, as specified herein, belongs to, and shall be controlled by the City (i.e. unused portions will be retained by the City and shall not be paid to Consultant). Only approved travel- Page 3 Page 824 of 1802 related expenses authorized by a Consultant Service Order will be reimbursed to the Consultant, in an amount not-to-exceed the agreed-upon amount reflected on the corresponding Consultant Service Order, and in accordance with City-wide Procedure OD. 20.01 (Travel on City Business), as may be updated by the City from time to time ("Reimbursable Expenses"). Notwithstanding the above, any Reimbursable Expenses must be authorized, in advance, in writing, by the City Manager or corresponding Department's Director. Invoices or vouchers for Reimbursable Expenses shall be submitted to the corresponding Department's Director (along with any supporting receipts and other back-up material required to support the amount invoiced, and as requested by the corresponding Department's Director). Consultant shall certify as to each such invoice and/or voucher that the amounts and items claimed as reimbursable are "true and correct and in accordance with the Agreement." Only actual amounts incurred and paid (requiring proof of payment) by the Consultant shall be invoiced, without any markups and/or additions. 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 FIRE DEPARTMENT; RESCUE DIVISION 2300 PINETREE DR. MIAMI BEACH, FL 33140 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 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. Page 4 Page 825 of 1802 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 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. Consultant Professional Liability, in the amount of$200,000; and Page 5 Page 826 of 1802 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. The insurance certificates for General Liability and Professional Liability shall include the City as an additional insured and shall contain a waiver of subrogation endorsement. 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 JURISDICTIONNENUE/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. 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. Page 6 Page 827 of 1802 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 Manager 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 all such records at its place of business at the address set forth in the "Notices" section of this Agreement. 10.2 CONTRACT DOCUMENTS. This Agreement is part of, and incorporated in, the Contract Documents. Accordingly, all of the documents incorporated by the Contract Documents shall govern any Consultant Service Order issued under this Contract. 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. 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 Page 7 Page 828 of 1802 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, intersexuality, 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, directly 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, Consultant shall not knowingly employ any person having such interest. 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: ADVANCED DATA PROCESSING, INC. D/B/A INTERMEDIX CORPORATION 6451 N FEDERAL HWY#100 FORT LAUDERDALE, FL 33308 TO CITY: CITY OF MIAMI BEACH FIRE DEPARTMENT; RESCUE DIVISION 2300 PINETREE DR, MIAMI BEACH, FL 33140 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. Page 8 Page 829 of 1802 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. 12.4 CONSULTANT'S COMPLIANCE WITH FLORIDA PUBLIC RECORDS LAW Pursuant to Section 119.0701 of the Florida Statutes, if the Consultant meets the definition of "Contractor" as defined in Section 119.0701(1)(a), the Consultant shall: a) Keep and maintain public records that ordinarily and necessarily would be required by the public agency in order to perform the service; b) Provide the public with access to public records on the same terms and conditions that the public agency would provide the records and at a cost that does not exceed the cost provided in this chapter or as otherwise provided by law; c) Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law; and d) Meet all requirements for retaining public records and transfer to the City, at no City cost, all public records created, received, maintained and/or directly related to the performance of this Agreement that are in possession of the Consultant upon termination of this Agreement. Upon termination of this Agreement, the Consultant shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. All records stored electronically must be provided to the City in a format that is compatible with the information technology systems of the City. Page 9 Page 830 of 1802 For purposes of this Article, the term "public records" shall mean all documents, papers, letters, maps, books, tapes, photographs, films, sound recordings, data processing software, or other material, regardless of the physical form, characteristics, or means of transmission, made or received pursuant to law or ordinance or in connection with the transaction of official business of the City. Consultant's failure to comply with the public records disclosure requirement set forth in Section 119.0701 of the Florida Statutes shall be a breach of this Agreement. In the event the Consultant does not comply with the public records disclosure requirement set forth in Section 119.0701 of the Florida Statutes, the City may, at the City's sole discretion, avail itself of the remedies set forth under this Agreement and available at law. [REMAINDER OF THIS PAGE LEFT INTENTIONALLY BLANK] Page 10 Page 831 of 1802 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: By: By: City Clerk Mayor Date: Date: FOR CONSULTANT: [INSERT NAME] ATTEST: By: Secretary President Print Name/Title Print Name/Title Date: Date: Page 11 Page 832 of 1802 EXHIBIT A SCOPE OF SERVICES The City's FIRE-RESCUE DEPARTMENT provides medical transportation for the residents and visitors transported from incident scenes to health care facilities in EMS transport vehicles requiring Basic Life Support (BLS) or Advanced Life Support (ALS). The individuals are charged a BLS or ALS transportation fee, a mileage fee, and other charges including, but not limited to, oxygen administration, cardiac monitoring, intubation and/or spinal immobilization fees. The services to be provided include, but are not limited to, obtaining patient and insurance information for emergency medical transport services provided, verifying patient insurance and patient demographic information, filing claims and sending invoices to self-pay accounts, submitting claims to Medicare, Medicaid, and insurance companies, processing third party reimbursements, and providing specific management and financial reports on a monthly basis,as specified by the City. The City of Miami Beach is seeking qualified firm(s) to provide Emergency Medical Services (EMS) ambulance billing and Electronic Patient Care Reporting (EPCR) services for the City's Fire- Rescue Department, in accordance with the terms, conditions and specifications contained in this Request for Proposals (RFP). Proposers shall demonstrate their experience in the area of Medicare and Medicaid billing, and propose to perform the work in a manner which shall meet or exceed the technical specifications herein contained. C3. Specifications General. The successful Proposer under this contract will provide all services necessary to report, bill and collect for services provided by the City's FIRE-RESCUE DEPARTMENT. Requirements include the acquisition, placement, support, maintenance and connectivity of rugged mobile computer laptop devices in fire rescue vehicle as well as desktop client software at all the City's Fire-Rescue Stations to capture, generate and modify patient care reports,gather and archive patient care data, gather and report performance statistics, generate and process insurance billing and payments, collect and remit funds to the City. The awarded Contractor shall set up, maintain and provide all comprehensive aspects of the EMS reporting, billing and collection services, as required by the scope of services herein contained. These services shall include but not necessarily be limited to: 1. Proposer shall provide sufficient staffing to ensure the smooth and efficient operation of Emergency Medical Transport Reporting, Billing and Collection Services contract. Page 12 Page 833 of 1802 2. Proposer shall provide full-time Project Manager and/or Customer Service Representatives ("CSR") assigned to the City's contract for EMS transport billing and collection services, available during normal business hours, Eastern Standard Time (EST) five (5) days a week, Monday through Friday, that are able to communicate (read, write and speak) fluently in English, Spanish and Creole; however, it is not required that each CSR speaks in all the three (3) languages, but there must be available CSRs to conduct business in each language,as necessary. 3. Proposer's computer help desk support, or approved third-party support, must be available seven (7) days a week, twenty-four (24) hours a day, with the ability to provide technical assistance, trouble shooting, and correcting issues that may arise with the computer laptop systems hardware, software and connectivity and provide application support to users entering EPCR reports and accessing the quality control application from desktop platforms. 4. Proposer shall have a local office within Broward County, FL., Palm Beach County, FL., Monroe County, FL., Collier County, FL., Lee County, FL., or Miami- Dade County, FL., as of the date of the issuance of this Request for Proposal. The local office should have staff capable of meeting with City staff on an as-needed basis. Statement of Work. 1. A comprehensive electronic patient care report that captures necessary patient care information and computer aided dispatch data required to fulfill the requirements of, FIRE- RESCUE DEPARTMENT, the receiving hospitals, insurance, Medicare, and Medicaid billing as well as capture the required data necessary to fulfill the State of Florida comprehensive EMS aggregate report requirements. 2. Access via the Internet a website that houses the FIRE-RESCUE DEPARTMENT's patient care procedures and protocols. 3. Connectivity via Bluetooth to Physio-Control's Lifepak 15 defibrillators. 4. Wireless connectivity between EPCR reports writing laptop computers, contractors servers, Physio Controls' LifeNet Internet gateway and FIRE-RESCUE DEPARTMENT patient care protocols. 5. In the event that the City requires additional laptops, any additional costs incurred, will be negotiated at time of necessity. 6. Perform invoicing, collection, and generation of any and all insurance forms and filings, record maintenance and preparation of standard and/or custom reports, as requested or required by FIRE-RESCUE DEPARTMENT. 7. Prepare quarterly State of Florida aggregate EMS reports. 8. Grant desktop computers at all FIRE-RESCUE DEPARTMENT fire stations access to patient care reports for statistical reporting and quality control processing. 9. Perform training for FIRE-RESCUE DEPARTMENT personnel on an as needed basis on desktop and laptop EPCR and quality control applications. 10. Maintain all thirteen (13) and five (5) spare rugged laptop computers in working condition. The contractor agrees to replace or correct any malfunctioning hardware or software within twenty-four hours of FIRE-RESCUE DEPARTMENT's written notification of failure or breakage. 11. Establish a two-way data exchange system with billing hospitals with the ability to Page 13 Page 834 of 1802 electronically transfer (e-Transfer) all EPCRs to the hospital and receive patient and related billing information back from the hospitals. Technical Specifications. Computer / Hardware / Software/ Report Writing and Computer Aided Dispatch ("CAD") Requirements: 1. Awarded Proposer shall be required to supply and maintain thirteen (13) primary and five (5) spare (total of 18 units) rugged and mobile tablets and/or laptops with cellular connectivity, capable of generating and capturing real- time patient care and computer aided dispatch data for the formulation of a comprehensive patient care report and for reporting purposes. 2. Systems shall be configured as follows: Win7 (Win8.1 Pro COA), Intel Core i5- 3610ME 2.7GHz, 10.1":XGA Multi Touch + Digitizer LCD, 128GB (or greater) Solid State Drive, 4GB, WiFi, Bluetooth, 4G LTE Multi Carrier, GPS Receiver, Dual Pass (Upper:WWAN/Lower:WLAN), TPM 1.2, 5MP or greater Camera, and Emissive Backlit Keyboard, or approved equal configurations. 3. Internet Explorer or equivalent with cellular connectivity to FIRE-RESCUE DEPARTMENT procedures and protocols site and any other websites requested by FIRE-RESCUE DEPARTMENT. 4. Connectivity via Bluetooth to EPCR client software and Physio Control's LifePak 15 manual cardiac defibrillators. 5. Device must have the ability to attach picture and documents to EPCR. 7. Contractor shall provide a stock of digitizer stylus/pens on a regular basis at no cost to the City. 8. Lifenet PC Gateway version 4.0 or 5.0 or current version for processing and transmission of code summary reports from Lifepak 15 defibrillators to receiving FIRE-RESCUE DEPARTMENT station computer(s). Prepare and process quarterly FIRE-RESCUE DEPARTMENT's State of Florida EMS pre- hospital data collection report, in a format designated by EMS Tracking and Reporting System (EMSTARS), 9. Process EPCR computer aided dispatch data generated from the current Miami Beach CAD by Tyler Technology(previously New World Systems)computer system using the current interface. 10. The ability to enter data on an EPCR while reviewing protocols, websites, etc., simultaneously on the tablet. 11. Contractor shall provide capabilities to change, modify, or add fields in underlying software. 12. Contractor shall provide the ability to add a field to document law enforcement case numbers on all motor vehicle accidents/incidents. Invoicing 1 Billing 1 Collections Requirements. 1. The Successful Contractor shall employ, maintain and assign an adequate number of competent and qualified professionals, as deemed necessary by the Department to meet the performance requirements. Contractor shall be responsible for the invoicing, collection, Page 14 Page 835 of 1802 and generation of any and all insurance forms and filings, record maintenance and preparation of standard and/or custom reports, as requested or required by the FIRE- RESCUE DEPARTMENT. 2. The invoices for services rendered shall contain the following information: a. Account number of Patient. b. Invoice number. c. Invoice date. d. Name of Patient. e. Name of responsible person if different from patient. f. Complete address of Patient. g. Date of transport. h. Cost of transport including cost breakdown (mileage&oxygen). i. Incident number. j. Transport mileage from and to. k. Insurance coverage and instructions(if applicable). I. Billing inquiry telephone number, 800-phone number if not local for satisfaction of the receivable and customer satisfaction. 3. Contractor shall mail bills/invoice forms to patients within five (5) days of receipt of the patient information. This is to include return envelope and address specified by the City of Miami Beach. 4. Patient invoices: All invoices and reporting shall be automated. 5. Contractor shall be responsible for sending follow up bills at thirty-day(30), sixty-day(60), and ninety-day(90) intervals. 6. Contractor shall mail proper insurance forms or electronically process to third party payer as required or requested by the patient. (This is to include envelope and address specified by the City of Miami Beach). 7. Contractor shall post all payments as received directly or electronically within one (1) business day. 8. The Contractor shall agree to make every effort to locate and correct any incorrect billing address for billable patients. 9. Contractor shall agrees to include in the invoice mailing a citizen satisfaction survey and a return, self-addressed and postage paid envelope that will be provided by the City of Miami Beach. Said survey is expected to be no more than one page in length and of a size not to exceed 8 1/2 x 11 inches. 10. Contractor will check hospital information twice per self-pay account(if necessary)to obtain/verify patient insurance and contact information. 11. Contractor shall conduct any follow-up required to obtain the necessary insurance information to process invoices for payment. Record of telephone calls and contact shall be maintained and any payment on an account shall be recorded per account. 12. Accept the hard copy or electronic information pertaining to patients' pay or billing documentation from FIRE-RESCUE DEPARTMENT for all patients transported by FIRE- RESCUE DEPARTMENT. 13. Patient invoices:All invoices and reporting systems shall be automated. 14. Contractor shall be responsible for all usual and customary costs incurred as a result of billing and collecting accounts, such as software, credit card processing fees, equipment and the installation of data and phone lines. 15. Contractor shall maintain and update all billings for ambulance services (accounts) to Page 15 Page 836 of 1802 include update of address and telephone numbers obtained through billing and collection efforts. Report shall be provided as necessary. 16. In the event Contractor received payment for services which are later disallowed(such as bad checks paid directly to FIRE-RESCUE DEPARTMENT, or adjustments)by FIRE- RESCUE DEPARTMENT, FIRE-RESCUE DEPARTMENT may offset the amount disallowed from any payment due Contractor. 17. Contractor shall not add a charge of any kind to a billed account. 18. To the extent necessary to fulfill its billing and collection efforts under the awarded contract, Contractor is granted limited authority to sign in an administrative capacity on behalf of FIRE-RESCUE DEPARTMENT the following types of standard forms and correspondence: probate claim filings; letters to patients and their representatives verifying that an account is paid in full; form verifying FIRE-RESCUE DEPARTMENT tax exempt status; and insurance filings and related forms. Contractor has no authority to sign any document on behalf of FIRE-RESCUE DEPARTMENT,which imposes liability on FIRE- RESCUE DEPARTMENT. 19. All written billing and collection correspondence must be approved by an FIRE-RESCUE DEPARTMENT designee. All payments and correspondence shall be directed to the mailing address designated by FIRE-RESCUE DEPARTMENT. 20. Contractor agrees to negotiate and arrange modified payment schedules for those individuals unable to pay the full amount when billed. 21. Contractor agrees to refund patient or insurance company refunds within forty-five (45) days of receipt and agrees to all applicable Florida Statutes. 22. Contractor must provide the City of Miami Beach with a refund request including all pertinent information relating to refund payments to patients and/or insurance company. (Contractor to describe procedure in their proposal submittal). 23. Contractor will process all third party reimbursements within one (1)week after receipt of appropriate billing information from primary payer. 24. Contractor shall not settle any accounts for less than the amount indicated by FIRE- RESCUE DEPARTMENT without the prior written approval of the FIRE-RESCUE DEPARTMENT designee. 25. Contractor shall provide copies of remittance advice as required by FIRE-RESCUE DEPARTMENT. 26. Contractor shall post all payments received directly or electronically within one (1) business day and process refund requests with the month following an overpayment. 27. Contractor shall maintain proper insurance forms used by third party payers as required or requested by the patient in either the manual or electronic method. Either way, the contractor shall include information on where to send payments to FIRE-RESCUE DEPARTMENT. 28. Contractor shall expeditiously begin the billing and collection process for those Accounts provided to Contractor by FIRE-RESCUE DEPARTMENT based upon established rates. The method utilized by Contractor to process the accounts shall be a means approved by FIRE-RESCUE DEPARTMENT Contract Administrator. 29. Contractor shall be responsible for contacting the sender of monies when there is insufficient information to identify which account the payment is being applied to. FIRE- RESCUE DEPARTMENT shall not be required to pay Contractor any collection fees on account until the corresponding account number can be identified. 30. Contractor shall reconcile the number of transports collected with those transmitted to Page 16 Page 837 of 1802 Contractor and contact a FIRE-RESCUE DEPARTMENT designee to report any discrepancies. 31. If this Agreement is terminated, all accounts will be returned to FIRE-RESCUE DEPARTMENT regardless of payments made on account or arrangement made. Upon termination, Contractor will inform any billed account with whom they are dealing to make future payments directly to FIRE-RESCUE DEPARTMENT or other firm identified by FIRE- RESCUE DEPARTMENT. 32. FIRE-RESCUE DEPARTMENT is the owner of all information submitted to the Contractor. If this Agreement is terminated, all accounts will be returned to FIRE-RESCUE DEPARTMENT regardless of payments made on account or arrangement made. 33. If this Agreement is terminated contractor agrees to provide a raw flat file containing all relevant data that would be needed to re-create an EPCR for any purpose. The contractor agrees to provide the City a one-time column header file w/ a brief description of each column's data and how it pertains to the formulation necessary to re-create the EPCR for the purposes mentioned above. 34. Contractor should include sample bill forms and the messages that will be used on each successive bill mailed, as part of the response. All text, format, and color of printing and stock are subject to approval by the City of Miami Beach. Billings should be at maximum intervals of thirty-five (35) days, except for the first invoice that should be rendered within ten (10)days of service. 35. Contractor shall be required to establish a method to accept and process credit card payments from patients through an online and a pay-by-phone solution. The City can be the merchant for the solution but the contractor shall be responsible for all fees associated with the credit card acceptance solution. 36. Contractor shall provide a process for collecting information from local law enforcement agencies and gross billable and payments on all incidents involving motor vehicles. 37. Contractor shall show the ability to increase collection rates annually. 38. Contractor shall have a mechanism in place to find a revenue source for all patients outside of contacting the hospitals. 39. Contractor shall be able to provide litigation services as it may relate to MVA (Motor Vehicle Accident/PIP Claims) incidents should the need arise. These services will only be executed based on direction from the City on an as-needed basis. Medicare and Medicaid Requirements. 1. Contractor shall provide prompt submission of Medicare, Medicaid and insurance claims within seventy-two (72) hours after receiving a completed EPCR, when all information necessary to file the claim is present. 2. Contractor will provide Medicare/Medicaid billings in accordance with all Federal, State and Local laws and Medicare/Medicaid rules and requirements. 3. Contractor shall provide Electronic Claims processing for Medicare and Medicaid and re- file Medicare, Medicaid or insurance claims, as necessary to obtain payment. 4. Contractor shall be prepared to assess service levels prior to billing and classify services into levels that meet Medicare and Medicaid transport criteria. These service levels may, in a limited number of cases, differ from what is indicated on internal documents based upon interpretation and must be brought to FIRE-RESCUE DEPARTMENT'S attention to Page 17 Page 838 of 1802 determine if changes may be necessary. 5. Contractor will provide support for Medicaid or Medicare audits. 6. Contractor shall provide Electronic Claims Processing for Medicare and Medicaid to the City's lock box. Compliance with Applicable Federal, State and Local Laws and Requirements. 1. Provide Health Insurance Portability and Accountability Act (HIPAA) privacy practice requirements to all patients transported in accordance with current regulatory requirements. 2. Comply with all applicable Federal, State, and local laws as they apply to the services being provided, such as but not limited to the Federal Debt Collection Practices Law. This further includes all requirements to maintain confidentiality for all medical and patient information as related in state and local laws or rules and regulations as well as HIPAA laws. 3. Contractor shall facilitate proper security of confidential information and proper shredding of all disposed materials containing such proprietary information in accordance with Florida Law regarding records retention privacy act. Customer Service. 1. Respond to all patients' requests and inquiries, either written or verbal, in a TIMELY manner not to exceed two(2) business days. 2. Agrees to provide and furnish all material and personnel required for the performance of the Agreement. 3. Contractor shall provide Customer Service Representative(CSRs), available during normal business hours, which are able to read, write and speak fluently in English, Spanish and Creole. These CSRs shall be able to assist patients and/or other third party payees in all billing inquiries in a timely and courteous manner. Customer calls will be facilitated as local within the County or through a "toll free" exchange, which will be published on all invoices. Contractor shall respond within three (3) business days to FIRE-RESCUE DEPARTMENT and patients on requests for information or records. All scripts and protocol for answering and placing calls shall be agreed upon prior to the commencement of services between Contractor and FIRE-RESCUE DEPARTMENT. A record of telephone calls and contacts shall be maintained. 4. Contractor shall be responsible for the mailing of all forms, i.e., HIPAA, customer survey and related forms. Contractor shall be responsible for all associated costs. 5. Contractor shall respond promptly to all patient requests and inquires, either written or verbally in a timely and courteous manner. This and all communications should be in a format that can be tracked by both City and Contractor and shall comply with all applicable Federal, State and Local laws as such laws apply to the services being provided. 6. Contractor shall provide and furnish all materials and personnel required for the performance of the Agreement. 7. Contractor shall provide a designated liaison for patient/payer concerns. 8. Contractor shall provide a 1-800 number and 24/7 (365 days) computer help desk support for the EPCR report writing laptop and desktop hardware, software and its connectivity. Page 18 Page 839 of 1802 Document Maintenance. 1. Contractor will maintain any and all documentation records and patient information in a safe and secure manner that will allow inspection and audit by the City of Miami Beach or its agents upon proper notification. 2. Any and all data created by FIRE-RESCUE DEPARTMENT and collected by the contractor is owned by the City of Miami Beach and shall be returned upon request in a format agreeable to City. 3. Contractor shall provide access to its database and a data dictionary for FIRE-RESCUE DEPARTMENT to use for report writing capabilities. Communications with City of Miami Beach Staff. 1. Contractor shall attend meetings with the FIRE-RESCUE DEPARTMENT staff when requested to review contract operations. 2. Contractor shall participate in a yearly audit conducted by FIRE-RESCUE DEPARTMENT consistent with Generally Accepted Accounting Principles- GAAP. This audit will cover the common set of accounting principles, standards and procedures used to compile annual financial statements. 3. Contractor will notify FIRE-RESCUE DEPARTMENT of any changes in federal, state or local laws, rules, regulations and codes that affect this subsequent agreement. 4. Contractor shall designate a Program Manager responsible for all matters related to the Contract, including performance. A toll free number and the name of the Project Manager shall be provided upon commencement of this Agreement. The Project Manager shall be available during FIRE-RESCUE DEPARTMENT business hours of 8:30 am to 5:00 pm, Monday through Friday, and shall respond to FIRE-RESCUE DEPARTMENT within one (1) hour. 5. Upon request by FIRE-RESCUE DEPARTMENT, a written response shall be provided to all complaints received by FIRE-RESCUE DEPARTMENT of any alleged actions taken by Contractor and/or its agents. The response shall be provided by Contactor's Project Manager and shall be received by FIRE-RESCUE DEPARTMENT within thirteen (13) days from the date the request is sent to Contractor. The response shall address all questions and statements made by FIRE-RESCUE DEPARTMENT concerning the alleged actions. 6. Contractor shall provide FIRE-RESCUE DEPARTMENT with a read-only access to accounts at locations determined by FIRE-RESCUE DEPARTMENT. 7. Contractor shall provide all necessary developing, copying, faxing, mailings, and all other such related services at no additional cost to FIRE-RESCUE DEPARTMENT. 8. Contractor shall maintain and inform FIRE-RESCUE DEPARTMENT regarding the following: 1. Records of current fees. 2. Industry approved billing codes. 3. Description files. 4. Current laws applicable to billing of patients for transports. 5. Records of nation-wide and local trends in transport fee schedule Page 19 Page 840 of 1802 and inform FIRE-RESCUE DEPARTMENT of any changes. 9. FIRE-RESCUE DEPARTMENT, its staff, consultant, and/or contractors shall have the right to visit the offices of Contractor and/or its agents periodically for inspection of the facilities and operations used in the performance of any resultant agreement. 10. For record keeping purposes (not related to billing/collection cycle), Contractor shall retain all account information for a minimum of three (3)years. Training for City of Miami Beach Staff. 1. Contractor shall provide training to appropriate FIRE-RESCUE DEPARTMENT personnel regarding the gathering of necessary information and proper completion of its EPCR laptop and desktop software. 2. Contractor shah provide minimum annual basic and on-going training to appropriate FIRE- RESCUE DEPARTMENT personnel regarding HIPAA compliance. Training may be in the classroom or electronically so long as it is consistent. Certificate must be supplied to employee upon completion of training. 3. Contractor shall provide a series of training programs at locations designated by the City to educate field personnel on the proper utilization of its quality control software application as well as other features available within the reporting software. 4. All training shall be at no charge to the City. Communications with Miami Beach Serviced Hospitals. 1. Contractor shall agree to maintain a working arrangement with all FIRE-RESCUE DEPARTMENT-serviced hospitals including Business Associates Agreement/Electronic Access with hospitals. 2. Contractor shall provide FIRE-RESCUE DEPARTMENT with a copy of all letters of complaint within ten (10)days of receipt, and indicate what action was taken to achieve an acceptable resolution. 3. Contractor shall maintain a working arrangement with all of the FIRE-RESCUE DEPARTMENT serviced hospitals and requests that hospitals provide a copy of patient fact sheets or be provided with demographic and insurance information. Electronic Data Transfer. 1. Electronic Data Transfer: Contractor shall be able to receive and send data electronically. All data being sent to FIRE-RESCUE DEPARTMENT should be transmitted electronically and shall ensure that such transmissions are in compliance with HIPAA and other federal, state and local laws, rules, regulations and codes. 2. Contractor will provide rugged mobile computer laptop specified EPCR units as field computer devices, perform all requisite software installation on such units, as well as facilitate web browser access from desktop units supplied by FIRE-RESCUE DEPARTMENT. Installation, access and units will be provided by qualified company representatives. 3. Contractor will provide support for additional modules that could be added to the system already installed without significant disruption to service. Should FIRE-RESCUE DEPARTMENT desire to modify hardware quantities, such changes will require written Page 20 Page 841 of 1802 notification. 4. Server maintenance, upgrades and software changes should all be administered automatically from Contractor's development facility (or alternate location at Contractor's discretion) and downloaded to field tablets during power up/down sequencing. 5. The Contractor must be able to provide up to fifteen (15) temporary laptop or similar devices upon request. The temporary units will be utilized for large events or during periods of peak staffing. 6. The PCR software must be able to verify and capture patient address from a driver's license or social security number via the cell connection. 7. The Successful Proposer will be required to update all hardware equipment provided to the City every three(3) years. EPCR Software and Patient Reporting Capabilities. Information to be gathered by EPCR software should include the following patient information, but not be limited to: 1. Incident Address with Zip Code. 2. Social Security Number. 3. Address. 4. Telephone Number. 5. Date of Birth, Weight,Age, Gender and Race. 6. Family Physician. 7. Medicaid State. 8. Medicaid Number. 9. Medicare Number. 10. Medicare Plus Plan Name. 11. Insurance Number. 12. Group Number. 13. Secondary Insurance Number. 14. Secondary Group Number. 15. Guarantor Information. 16. Documentation of patient or guardian release of patient information for billing, including a digitized patient or guardian signature captured in multiple languages, and supports hand writing recognition. 17. Supports additional billing inputs (i.e., additional supplies such as foam usage or additional medications). 18. Information about the medical condition and complaints of the patient including, but not limited to: a. Cause of injury. b. Trauma triage. c. Patient position information. d. Medical condition(s)and systems details. e. Narratives by the care providers regarding the incident. f. Ability to enter multiplies patients. 19. Unlimited primary and secondary assessment information including, but not limited to: a. Glasgow Coma Scale(GCS) scoring automatically calculates a total. b. Revised trauma score, scoring automatically calculates a total. Page 21 Page 842 of 1802 c. Pupil size and reaction. d. Capillary refill. e. Respiratory assessment. f. ECG. g. Ectopy. h. Blood glucose level. Skin color. j. Temperature. k. Moisture. Lung sounds. m. Times of vital signs. n. Appearance Pulse Grimace Activity Reparations (APGAR) scores (if applicable). o. Neurological assessment information. p. Medical history including, but not limited to: Prescription medications—with Pick List input. ii. Allergies. iii. Pre-existing conditions. iv. Current conditions. q. Blood pressure; be able to indicate Palp and Mast. r. SPAO2. s. LOC. t. Pulse Rate; strength and regularity. u. Allow the user to set either the "within normal limits" or "not assessed" value to each defined assessment area (body part) by dick of a single button. 20. All examination of and treatment provided to the patient including, but not limited to: a. Medical control contact name and time of contact physician. b. Patient protocol. c. Method of contact. d. Airway intervention. e. Breathing intervention. f. Circulatory intervention. g. Intravenous intervention. h. Input/output therapy. Provides patient weight conversion to metric for medications. j. Call summary information, including all patient information entered. 21. Data about the care providers including, but not limited to: a. Vehicle number. b. Primary attendant's(Attendant No. 1)name and license number. c. Attendant No. 2's name and license number. d. Attendant No. 3's name and license number. e. Attendant No.4's name and license number. f. Exposure information, including medic name, time,exposure type, description, supervisor notified,exposure report completed, loss of work. 22. Prehospital information including, but not limited to: a. Call times. Page 22 Page 843 of 1802 b. Scene location information, including County, zip code, response and scene. c. Response districts. d. Special scene conditions. 23. Patient destination information including, but not limited to: a. Receiving hospital with State of Florida four-digit identifier code. b. Reason for selecting a destination selected from pick list. c. Transport urgency(lights and siren, routine, etc.). d. Call disposition BLS,ALSI,ALSI I. a Refusal of care by patient 24. Odometer readings to determine distances including, but not limited to: a. From ambulance starting point to incident scene. b. From incident scene to patient destination. 25. Desk top software: a. Provide the exact same interface and functionality as the mobile software with the exception of any pen-based, character recognition functionality that cannot be supported on desktop computers. b. Software should provide for monitoring of all supplies utilized and give administration users the ability to access the data through report writing tools. Security Controls- User Access Control and Security. The software should allow for an array of user access control and security that can vary by module and security level from no access to complete insert/delete/edit capability anywhere in the software system. In addition,the system should: 1. Have a hierarchy of security (logon, record, field, function, object, and user-group) to allow or prevent specified users (or groups of users) to access specified programs at specified levels of data entry, editing, updating, deleting, and reporting functions. 2. The software should require a valid logon ID and possess two levels of security with different password levels. One is to be used for system administration and configuration and the other for field personnel. 3. The system should also provide a complete audit trail of every transaction or modification executed by each user. 4. System locks, which allow user to 'lock" terminal without shutting system down and "unlock" terminal with password, allowing users to step away from the terminal temporarily and prevent unauthorized use. 5. Restrict download of confidential data to high-level security-authorized users to prevent loss/misuse of confidential data and information. 6. Provide a means to print transaction error/alteration logs as needed and specified, depending on application. Page 23 Page 844 of 1802 7. Automatic timeout or keyboard lock after a defined period of inactivity. 8. List all users logged on to the system at any time, and track this usage by user, date, time, and station. 9. Log off users after specified number of unsuccessful log on attempts and display message for user to contact the system administrator. 10. Allow specified intervals for mandatory password changes. 11. Automatically log off users who have logged off improperly. 12. Revoke a user's access upon too many unauthorized logon attempts. 13. Validity test: critical fields can be checked against a format, a formula, or a table to see that data contained in a field is admissible. Examples: System requires all Advanced Life Support Calls have two vital signs. 14. Range checks: critical fields can be checked against a table or formula to determine if the data entered is within a given range of values. Examples: vehicle mileage not to exceed four digits. 15. Completeness check: critical fields can be checked for a non-empty range and processing action determined according to a specified table. Example: system will not allow the call to be closed without the patient name first and last being entered. 16. Real time error checking: error checking described above is done at the time of input and errors are flagged to operator either by a user understandable message or operation halt as specified. 17. Time Stamping: All transactions shall be time stamped by the internal clock of the system and this may be modified in the field and exists for all interventions. Reports. Pursuant to the Scope of Services, the Successful Proposer shall perform all services and/or work necessary to complete the following tasks and/or provide the following items: 1. Contractor to provide the City with monthly reports reflecting all new placements from the City, all accounts that are currently active with the contractor, the contractor's collection results, and aging reports reflecting the City's receivable in an aged format. 2. Records/Reports: Contractor will keep full and accurate accounts of services performed by FIRE-RESCUE DEPARTMENT, billing and collections received and other records related to the Emergency Medical Transport Billing and Collection Services. 3. Contractor will prepare and provide FIRE-RESCUE DEPARTMENT Administration monthly reports as required by FIRE-RESCUE DEPARTMENT. 4. Contractor shall provide, on a monthly basis, a copy of all monthly financial activity, billing and receivable reports, consistent with GMP on the account. Reports Compilation and Listing. The Successful Proposer shall maintain a computerized database of all accounts and shall provide the Department with reports to show management and financial information. The Successful Proposer at a minimum will provide all reports provided to the Department by the incumbent. The Department will provide samples of all current reports to the Successful Proposer. The format of reports required under this contract will be determined by the Department. In addition to the reports described below, the Successful Proposer shall provide any custom reports at the request of the Department in a mutually agreeable timeframe at no Page 24 Page 845 of 1802 additional cost to the City. Monthly reporting is produced after month closing and provided to FIRE-RESCUE DEPARTMENT no later than the 21st of each month. Contractor will generate reports within twenty-four (24) business hours of receiving and posting the last day of the month's receivables from the bank. All reporting will be in the manner as requested by FIRE-RESCUE DEPARTMENT. The following are major reports that Contractor shall produce for FIRE- RESCUE DEPARTMENT: 1. Collection Statistics—Gross/Net Consumption Shows overall monthly computation of gross collection percentages providing number of accounts billed and accounts not billable. The total amounts are summarized. 2. Billing and Collection Statistics— Monthly Summary Provides a running month summary of charge, aggregate transports by unit, aggregate percentage collection by unit, adjustments and payments for the closing month period showing gross and net collection percentages for each period. Summarizes totals for each type activity and computes average collections for both gross and net. Note: All payment activity is reflected against the original month billed in order to reflect true collection percentages. 3. Insurance Report—#of Bills with Outstanding Balance by Class Provides summary showing by running (billed) month the number of patient bills having an outstanding balance. Shows balance and number of bills outstanding by class. 4. Collections—by Payer Class, Unit and Geographic Area Provides a running month summary for the closing month period of collections by Payer Class (Self-Pay, Medicare, Medicaid and Private insurance), by Unit and by geographic area. The report also shows for each running month the mix or, percentage (%) of total collected against that month's billing for each class. Also shows number of accounts collected by class and percentage(%)of total. 5. Ambulance Unit Report—Gross Billings this Month by Ambulance Unit Shows all billing (new charges) processed and summarized total billing for period by transport unit. 6. Accounts Receivable—Summary Provides summary for period ending of Accounts Receivable showing gross billing, payments received/processed, reflected write-offs and adjustments, reversals and ending balance. 7. Account Activity—Monthly Billing Report(Charges) Shows all billing (new charges) processed alpha sorted by Last Name and summarized total billing for period. 8. Account Activity—Monthly Payment Report(Receivables) Provides a batch oriented listing of all payments processed including check number and type of payment (self-pay, Medicare, Medicaid, private insurance). Report reconciles against bank deposit and ties back to EOB detail for secondary filing, refund processing and adjustments. 9. Collections—Summary to Date, Monthly Running Shows receivables as applied to"original billed month." 10. Monthly Refund Schedule Page 25 Page 846 of 1802 Report provided by account detail of associated payments reflecting an overpayment and necessary refund to be processed. 11. Refund Request Provides for previous billing month, with a separate sheet per account, requesting refund on overpayment accounts. This includes all information pertinent to determining refund. 12. Distribution of Charges and Collections This report will track the charges. payments and financial class mix of all patients for a given month. 13. Aged Receivable Report This report will have outstanding invoices sorted by date for current, thirty, sixty, ninety and over ninety days.This report will provide totals for these categories. 14. Patient Alpha Listing This report lists all invoices alphabetically by patient name. 15. Monthly Payment Listing This report lists payments, bad checks, required charge offs, and refunds posted to each patient's account. 16. Overpayment Reports This report lists all patients due refunds as a result of overpayment of account. 17. Additional Information Reports may include any statistical information pertaining to medical calls including but not limited to - intubation analysis, IV success rates, chief complaint call volumes and number of cardiac arrests and trauma calls. Responsibilities of the City of Miami Beach. 1. The City of Miami Beach will comply with all Federal, State and Local laws, rules and regulations as applicable to the services being contracted. 2. The City of Miami Beach will agree to use the successful firm for all medical billings exclusively for the service specified herein as long as the contract agreement is in force. 3. The City of Miami Beach will make every effort to obtain the proper billing address for all billable patients prior to forwarding to the Contractor. 4. The City will pay the Contractor additional fees for any postage increases that may occur during the contract period. However, this fee will only be the actual cost of increase. Service Fees. The Selected Proposer shall perform EMS Billing and collection services on behalf of the FIRE-RESCUE DEPARTMENT, and shall conform to the following: 1. All monies collected by the Selected Proposer shall be deposited in the designated lockbox. 2. At the end of each calendar month Selected Proposer shall send an invoice to the Department with collection details of all Department transports entered in the Selected Proposer's billing system from the preceding month. 3. The fees shall be based upon contractor performance and expressed as a percentage of actual collections remitted to the City of Miami Beach. This fee shall be all-inclusive. No Page 26 Page 847 of 1802 additional payments shall fall due under this contract except for any refunds due contractor due to patient overpayment refunds. 4. The Successful Proposer shall be entitled to fees on all collections for billings during Contract term, up to six (6) months after expiration or termination of Contract. The Department will be entitled to a refund of fees due to refunds on collections for billings during Contract term, up to one (1) year after expiration or termination of Contract. Florida Certified Public Expenditure (CPE) Program. 1. At the request of the City, the Selected Proposer shall provide ongoing consulting/costing services to enroll and/or maintain the City of Miami Beach in the Florida Certified Public Expenditure (CPE) Program for Emergency Medical Transportation (PEMT) and the Intergovernmental Transfer(IGT) PEMT which includes Medicaid managed care transports revenue programs. Description of Consulting Services and Revenue Recognition Process Provide consulting services to enroll The City of Miami Beach in consulting/costing services for both the Florida Certified Public Expenditures (CPE) Program for Emergency Medical Transportation, and proposed GT (Intergovernmental Transfer)PEMT which includes Medicaid managed care transports revenue program. • Drafting application materials and responding to requests for additional information necessary for the provider to gain approval to participate in the Ambulance Supplemental Payment Programs. • Preparing a fiscal impact study and presenting results to department/state stakeholders to demonstrate benefits of a Continuing Public Expenditure ("CPE") Program, Medicaid Managed Care supplemental payment, and uninsured CPE (if applicable) program to the provider. • Identifying eligible costs and developing appropriate cost allocation methodologies to report only allowable costs for providing emergency medical services to Medicaid and,as applicable, uninsured populations. • Preparing the annual Medicaid cost report for EMS on behalf of provider. • Conducting analysis of the provider's financial and billing data in order to prepare and submit annual cost reports, the mechanism for providers to receive additional revenue under Ambulance Supplemental Payment Programs. • Providing comprehensive desk review support, including but not limited to conducting reviews of all cost settlement files, performing detailed analysis of billing reports generated by Medicaid agencies to ensure that all allowable charges and payments are encompassed in the calculation of the final settlement, and drafting letters and providing supporting documentation to meet Medicaid requirements and expedite settlement. • Performing relevant analysis to determine a viable Medicaid managed care supplemental payment methodology. Page 27 Page 848 of 1802 • Executing Medicaid managed care supplemental payment calculations in adherence with the approved methodology. • Determining enhanced supplemental payments realized by provider,as necessary. • Conducting comparative analysis to identify significant trends in billing and financial data. • Providing charge master review to ensure that the provider is optimizing charges to drive revenue generation. • Meeting with the Florida Agency for Health Care Administration (ARCA) and Client to further develop the supplemental payments program for both Medicaid managed care and uninsured patient transports. • Respond to, and represent Client on any AHCA or CMS audit, review or communication regarding any PEMT cost report prepared by Intermedix and delivered to AHCA on behalf of the Client. Section 2. Fees All revenue realized by the City from the Certified Public Expenditure (CPE) Program for Emergency Medical Services and Medicaid Managed Care Supplemental Payment Program shall be paid in full directly to Client. Revenue realized as a result of the Certified Public Expenditures (CPE)for Emergency Medical Services (EMS)shall be determined by the Medicaid cost settlement determined through the Medicaid cost report. Revenues realized through the Medicaid Managed Care Supplemental Payment Program will be defined through an additional amendment, if necessary, after the approval of the specific methodology as defined by the Flodda Agency for Healthcare Administration, and successfully implemented by Intermedix and City. Intermedix will not receive any compensation until the CPE for Emergency Medical Services settlement or Medicaid Managed Care Supplemental Payment revenues are received by the City. Intermedix will invoice and receive revenue upon the receipt of revenue received by City for either initiative, meaning revenue does not have to be generated for both the CPE for Emergency Medical Services and the Medicaid Managed Care Supplemental Payment program, rather revenue simply needs to be generated for either initiative to allow the Intermedix to generate invoices. Intermedix will invoice City based on the final CPE for Emergency Medical Services settlement or Medicaid Managed Care Supplemental payments within thirty(30) days of receipt of funds by the City. City will remit payment to Intermedix within thirty (30) days of invoice receipt.Additional revenues generated for the uninsured patient population, will also be invoiced within thirty (30) days of receipt of revenues by the City. The contingency fees to be paid associated with the respective successful implementation and generation of incremental Medicaid revenues as a result of the CPE for Emergency Medical Services and Medicaid Managed Care Supplemental Payment programs are in accordance with the percent of City revenues as indicated on the firm's BAFO Proposal Tender Form. Page 28 Page 849 of 1802 EXHIBIT B PROFESSIONAL SERVICES AGREEMENT BETWEEN THE CITY OF MIAMI BEACH AND ADVANCED DATA PROCESSING, INC. D/B/A INTERMEDIX CORPORATION CONSULTANT SERVICE ORDER FORMAT Service Order No._ for Consulting Services. TO: DATE: SCOPE OF SERVICES: Per attached proposal dated , to be considered part of this Agreement. Project Name and No: Estimated calendar days to complete this work: days Fee for this Service Order: $ The above fee is a Lump Sum or an Upset Limit (check one). Division Fire Chief Date Intermedix Corporation Date Deputy Fire Chief Date City Manager Date Page 29 Page 850 of 1802 EXHIBIT C CONSULTANT FEE SCHEDULE 'See next panel Page 30 Page 851 of 1602 EXHIBIT D ePCR Software Agreement ESO Solutions, Inc. fSee next page] Page 31 Page 852 of 1802 ORDER INSTRUCTIONS 1. Fill in Contact Info Below Contact Name Email Phone Primary Business Contact Invoicing Contact Legal Contact Software Administrator Contact Privacy/HIPAA Contact Tax Exempt? YES OR NO If YES,return Exempt Certificate with Agreement Purchase Order Required? YES OR NO If YES,return PO with Agreement 2. Sign page 8&the last page. 3. Email entire contract to legal@esosolutions.com and your sales representative. 4. Enjoy your ESO Software Page 32 Page 853 of 1802 MASTER SUBSCRIPTION AND LICENSE AGREEMENT This Master Subscription and License Agreement(the"Agreement")is entered into as of ("Effective Date"), by and between ESO Solutions,Inc.,a Texas corporation having its principal place of business at 11500 Alterra Parkway,Suite 100 Austin, IX 78758("ESO")and Miami Beach Fire Department("Customer")having its principal place of business at 2300 Pine Tree Drive Miami Beach,M. 33140.This Agreement consists olthe General Terms&Conditions below and any Addenda(as defined below)executed by the parties, including any attachments to such Addenda. The panes have agreed that ESO will provide Customer with certain technology products and/or services and that Customer will pay to ESO certain fees.Therefore in consideration of the covenants,agreements and promises set forth below,and for other good and valuable consideration,the receipt and sufficiency of which is hereby acknowledged,the parties,intending to he legally hound,hereby agree as set forth in the pages that follow_ GENERAL TERMS AND CONDITIONS 1. DEFINITIONS.Capitalized terms not otherwise 1.5. "Documentation" means user guides, defined in this Agreement shall have the operating manuals, and specifications meanings below: regarding the Software covered by this Agreement. 1.1. "Add-On Software" means any complementary software components or 1.6. "Feedback"refers to any suggestion or reporting service(s)that ESO makes idea for improving or otherwise modifying available to customer through its Licensed ESO's products or services. Software, Interoperability Software or SaaS. 1.7. "Intellectual Property" means trade secrets, copyrightable subject matter, 1.2. "Addendum"or"Addenda" means a patents,and patent applications and other writing addressing an order of a specific proprietary information,activities, and any set of products or services executed by ideas, concepts, innovations, inventions authorized representatives of each party. and designs. An Addendum may be (a)a Software Schedule(see Exhibit Al—A4), (b)a 1.8. "Interoperability Software" means Statement of Work, or(c)another writing software-as-a-service that ESO hosts the parties intend to be incorporated by (directly or indirectly)for Customer to reference into this Agreement. exchange healthcare data with others. Some of ESO's Reporting Services may be 1.3. "Customer Data"means data in electronic made available to Customer via the form managed or stored by ESO,which is Interoperability Software. For the entered into or transmitted through the avoidance of doubt, Interoperability Software. Software does not include Add-on Software, Licensed Software or SaaS. 1.4. "Deliverable" means software, report,or other work product created pursuant to a 1.9. "Licensed Software"means on premise Statement of Work. software that ESO provides to Customer for its reproduction and use. For the avoidance of doubt, Licensed Software ESO—MSLA v.20180409 Confidential&Proprietary Page 854 of 1802 does not include Add-on Software, 1.17. "Support Services" means those services Interoperability Software or SaaS. described in Exhibit B. 1.10. "Professional Services" means professional 1.18. "User" means any individual who uses the services that a Statement of Work calls on Software on Customer's behalf or through ESO to provide. Customer's account or passwords, whether authorized or not. 1.11. "Protected Health Information" or"PHI" shall have the meaning set forth in HIPAA. 2. SOFTWARE SCHEDULES. During the Term of All references herein to PHI shall be this Agreement,Customer may order Software construed to include electronic PHI, or from ESO by signing a Software Schedule. ePHI,as that term is defined by HIPAA. Customer's license to Licensed Software and its subscription to SaaS are set forth below. 1.12. "Reporting Services" means collectively Each such Software Schedule, Exhibits A-1,A-2, the different programs or tools ESO A-3, and A-4, are incorporated herein by provides for Customer to generate reference. compilations of data, including but not limited to ad-hoc reports,analytics, 3. LICENSE/SUBSCRIPTION TO SOFTWARE benchmarking or any other reporting tool provided through the Software. 3.1. Grant of License. In the case of Licensed Software, during the Term of this 1.13. "SaaS" means software-as-a-service that Agreement ESO hereby grants Customer a ESO hosts (directly or indirectly)for limited, non-exclusive,non-transferable, Customer's use. For the avoidance of non-assignable, revocable license to copy doubt,SaaS does not include Licensed and use the Licensed Software, in such Software, but does include Add-on quantities as are set forth on the Software and Interoperability Software. applicable Software Schedule and as necessary for Customer's internal business 1.14. "Software" means any computer program, purposes; provided that, Customer programming or modules specified in each complies with the Restrictions on Use Software Schedule or SOW. For the (Section 3.3) and other limitations and avoidance of doubt,Add-on Software, obligations contained in this Agreement. SaaS; Interoperability Software;and Such internal business purposes do not Licensed Software shall collectively be include reproduction or use by any parent, referred to as Software. subsidiary, or affiliate of Customer, or any other third party, and Customer shall not 1.15. "Software Schedule" refers to an permit any such use. Addendum in which Customer has ordered either Add-on Software, Licensed 3.2. Grant of Subscription. In the case of SaaS, Software, Interoperability Software or during the term of this Agreement SaaS, collectively Software.See Exhibits Al Customer may access and use the SaaS, in A4. such quantities as are set forth on the applicable Software Schedule; provided 1.16. "Statement of Work"or"SOW" refers to that,Customer complies with the an Addendum in which Customer has Restrictions on Use (Section 3.3)and other ordered Professional Services or a limitations contained in this Agreement. Deliverable from ESO. Page 2 Page 855 of 1802 3.3. Restrictions on Use. Except as provided in ("Third-Party Software"). ESO is licensed this Agreement or as otherwise authorized to sublicense and distribute Third-Party by ESO, Customer has no right to: (a) Software.All Third-Party Software falls decompile, reverse engineer, disassemble, under the scope of this Agreement. print, copy or display the Software or Moreover, ESO neither accepts liability, otherwise reduce the Software to a human nor warrants the functionality, reliability or perceivable form in whole or in part; (b) accuracy of Third-Party Software,including publish, release, rent, lease, loan,sell, but not limited to third-party mapping distribute or transfer the Software to applications. another person or entity; (c) reproduce the Software for the use or benefit of anyone 4. HOSTING,SLA&SUPPORT SERVICES other than Customer; (d) alter, modify or create derivative works based upon the 4.1. Hosting&Management. Customer shall be Software either in whole or in part; or(e) solely responsible for hosting and use or permit the use of the Software for managing the Licensed Software. ESO shall commercial time-sharing arrangements or be responsible for hosting and managing providing service bureau,data processing, the SaaS. rental, or other services to any third party. The rights granted under the provisions of 4.2. Service Level Agreement. No credits shall this Agreement do not constitute a sale of be given in the event Customer's access to the Software. ESO retains all right,title, SaaS is delayed, impaired or otherwise and interest in and to the Software, disrupted (collectively, an "Outage"). If including without limitation all software such Outage,excluding Scheduled used to provide the Software and all Downtime(as defined below), results in graphics, user interfaces, logos and the service level uptime falling below 99% trademarks reproduced through the for three consecutive months or three Software,except to the limited extent set months in any rolling twelve-month period forth in this Agreement.This Agreement (collectively,"Uptime Commitment"),then does not grant Customer any intellectual Customer shall have the option to property rights in the Software or any of its immediately terminate this Agreement; components,except to the limited extent and ESO will refund any prepaid, unearned that this Agreement specifically sets forth Fees to Customer.This is Customer's sole Customer's rights to access, use,or copy remedy for ESO's breach of the Uptime the Software during the Term of this Commitment. Agreement. Customer recognizes that the Software and its components are 4.3. Scheduled Downtime. In the event ESO protected by copyright and other laws. determines that it is necessary to intentionally interrupt the SaaS or that 3.4. Delivery. In the case of Licensed Software, there is a potential for the SaaS to be ESO shall provide the Licensed Software to interrupted for the performance of system Customer through a reasonable system of maintenance (collectively,"Scheduled electronic download. In the case of SaaS, Downtime"), ESO will use good-faith ESO shall grant Customer access to SaaS efforts to notify Customer of such promptly after the Effective Date. Scheduled Downtime at least 72 hours in advance and will ensure Scheduled 3.5. Third-Party Software.Software may Downtime occurs during non-peak hours incorporate software and other technology (midnight to 6 a.m. Central Time). In no owned and controlled by third parties Page 3 Page 856 of 1802 event shall Scheduled Downtime taxes of any kind, including sales, use, constitute a failure of performance by ESO. duty, customs,withholding, property, value-added,and other similar federal, 4.4. Support and Updates. During the Term of state or local taxes (other than taxes based this Agreement, ESO shall provide to on ESO's income) related to this Customer the Support Services, in Agreement. accordance with Exhibit B. Exhibit B is incorporated herein by reference. 5.4. Appropriation of Funds. If Customer is a city, county or other government entity, 5. FEES the parties accept and agree that Customer has the right to terminate the 5.1. Fees. In consideration of the rights granted Agreement at the end of the Customer's and except in the event there is a Third- fiscal term for a failure by Customer's Party Payer(as defined below), Customer governing body to appropriate sufficient agrees to pay ESO the fees for the funds for the next fiscal year. Software and/or Professional Services as Notwithstanding the foregoing,this set forth in the Software Schedule(s)or provision shall not excuse Customer from SOW(s) (collectively, "Fees").The Fees are past payment obligations or other Fees non-cancelable and non-refundable. earned and unpaid. Moreover, Customer Customer shall pay all invoices within agrees to provide ESO reasonable thirty(30)days of receipt. In the event a documentation evidencing such non- third-party is paying some or all of the Fees appropriation of funds. on behalf of Customer("Third-Party Payer"),the Software Schedule will state 5.5. Audit Rights. ESO may regularly audit that payment obligation.The parties agree Customer's use of the Software and charge that Customer may replace the Third-Party Customer a higher annual Fee if Payer by submitting to ESO written notice Customer's usage has increased beyond memorializing the change. However, no the tier contracted for in the current such change shall be made until the then- Software Schedule or otherwise assess current Term's renewal. Moreover, additional fees (for example, Customer is Customer is responsible for payment in the uploading more records into the Software event the Third-Party Payer does not pay than it has previously contracted for) the Fees and Customer continues using the (collectively, "Overages"). ESO may invoice Software. For the avoidance of doubt,any for Overages immediately. such Addenda will become part of this Notwithstanding the foregoing, it is solely Agreement. Customer's responsibility to report Overages to ESO in a timely manner. 5.2. Uplift on Renewal. Except in the instance of Overages(as defined below), Fees for 6. TERM AND TERMINATION Software,which recur annually, shall increase by three percent(3%)each year 6.1. Term.The term of this Agreement(the this Agreement is in effect. "Term")shall commence on the Effective Date and continue for the period set forth 5.3. Taxes and Fees. This Agreement is in the applicable Software Schedule or,if exclusive of all taxes and credit card none,for one year.Thereafter,the Term processing fees, if applicable. Customer is will renew for successive one-year periods, responsible for and will remit(or will unless either party opts out of such reimburse ESO upon ESO's request)all renewal by providing at least sixty days' Page 4 Page 857 of 1802 written notice before the scheduled Customer any prepaid Fees on a pro- renewal date.The license period or rata basis to the extent such Fees are subscription period shall begin on the date attributable to the period after the specified in the applicable Software termination date. Schedule, and this Agreement shall automatically be extended to ensure that 6.4.3.Upon termination of this Agreement the contract Term is coterminous with the or any Software Schedule,Customer subscription period or license period, as shall cease all use of the Software applicable. and delete,destroy or return all copies of the Documentation and 6.2. Termination for Cause. Either party may Licensed Software in its possession or terminate this Agreement or any individual control,except as required by law. Software Schedule for the other party's material breach by providing written 6.4.4.Termination of this Agreement is notice.The breaching party shall have without prejudice to any other right thirty days from receipt to cure such or remedy of the parties and shall breach to the reasonable satisfaction of not release either party from any the non-breaching party. liability(a)which at the time of termination, has already accrued to 6.3. Bankruptcy/Insolvency.This Agreement the other party, (b)which may and any applicable Software Schedule may accrue in respect of any actor be terminated immediately upon the omission prior to termination,or(c) following: (a)the institution of insolvency, from any obligation which is receivership or bankruptcy proceedings or intended to survive termination. any other proceedings for the settlement of debts of the other party; (b)the making 6.5. Delivery of Data. If Customer requests its of an assignment for the benefit of data within sixty(60) days of expiration or creditors by the other party;or(c)the termination of this Agreement, ESO will dissolution of the other party. provide Customer access to Customer Data in a searchable .pdf format within a 6.4. Effect of Termination. reasonable time frame thereafter. ESO is under no obligation to retain Customer 6.4.1.If this Agreement or any Software Data more than sixty(60)days after Schedule is terminated by Customer expiration or termination of this prior to the expiration of its then- Agreement. current term,for any reason other than ESO's breach,Customer agrees 7. REPRESENTATIONS AND WARRANTIES to immediately remit all unpaid Fees as set forth on the applicable 7.1. Material Performance of Software. ESO Software Schedule equal to the Fees warrants and represents that the Software that will become due during the will materially perform in accordance with remaining Term. the Documentation provided by ESO, if any. 6.4.2.If Customer terminates this Agreement or any Software Schedule 7.2. Warranty of Services. ESO warrants that its as a result of ESO's breach,then to personnel are adequately trained and the extent that Customer has prepaid competent to perform Professional any Fees, ESO shall refund to Services and/or Support Services and that Page 5 Page 858 of 1802 each will be performed in a professional five(5) business days; (c)the Software and and workmanlike manner. Documentation,whether or not designated confidential;and (d) any other 7.3. Due Authority. Each party's execution, nonpublic, sensitive information delivery and performance of this reasonably considered a trade secretor Agreement and each agreement or otherwise confidential. Notwithstanding instrument contemplated by this the foregoing,Confidential Information Agreement has been duly authorized by all does not include information that: (i)is in necessary corporate or government action. the other party's possession at the time of disclosure; (H) is independently developed 7.4. Customer Cooperation. Customer agrees without use of or reference to Confidential to reasonably and timely cooperate with Information; (iii) becomes known publicly, ESO, including but not limited to providing before or after disclosure, other than as a ESO with reasonable access to its result of a party's improper action or equipment,software, data and using inaction; (iv) is approved for release in current operating system(s). writing by the disclosing party; (v) is required to be disclosed by law;or(vi) PHI, 8. DISCLAIMER OF WARRANTIES. EXCEPT AS which shall be governed by the Business OTHERWISE PROVIDED IN SECTION 7, ESO Associate Agreement rather than this HEREBY DISCLAIMS ALL WARRANTIES, EXPRESS Section. OR IMPLIED, INCLUDING,WITHOUT LIMITATION,ALL IMPLIED WARRANTIES OF 9.2. Nondisclosure.The parties shall not use MERCHANTABILITY, FITNESS FOR A Confidential Information for any purpose PARTICULAR PURPOSE, PERFORMANCE, other than to fulfill the terms of this SUITABILITY,TITLE, NON-INFRINGEMENT,OR Agreement(the"Purpose"). Each party: (a) ANY IMPLIED WARRANTY ARISING FROM shall ensure that its employees or STATUTE,COURSE OF DEALING, COURSE OF contractors are bound by confidentiality PERFORMANCE,OR USAGE OF TRADE. obligations no less restrictive than those WITHOUT LIMITING THE GENERALITY OF THE contained herein and (b) shall not disclose FOREGOING: (a)ESO DOES NOT REPRESENT OR Confidential Information to any other third WARRANT THAT THE SOFTWARE WILL party without prior written consent from PERFORM WITHOUT INTERRUPTION OR the disclosing party.Without limiting the ERROR;AND(b) ESO DOES NOT REPRESENT OR generality of the foregoing,the receiving WARRANT THAT THE SOFTWARE IS SECURE party shall protect Confidential FROM HACKING OR OTHER UNAUTHORIZED Information with the same degree of care INTRUSION OR THAT CUSTOMER DATA WILL it uses to protect its own confidential REMAIN PRIVATE OR SECURE.CUSTOMER information of similar nature and THEREFORE ACCEPTS THE SOFTWARE "AS-IS" importance, but with no less than AND "AS AVAILABLE." reasonable care.A receiving party shall promptly notify the disclosing party of any 9. CONFIDENTIALITY misuse or misappropriation of Confidential Information of which it is aware. 9.1. "Confidential Information" refers to the following items: (a)any document marked 9.3. Disclosure of ESO's Security Policies. "Confidential"; (b)any information orally Customer acknowledges that any designated as"Confidential"at the time of information provided by ESO pertaining to disclosure,provided the disclosing party ESO's security controls, policies, confirms such designation in writing within procedures,audits,or other information Page 6 Page 859 of 1802 concerning ESO's internal security posture protective order.The receiving party shall are considered Confidential Information reasonably cooperate in this effort. In and shall be treated by Customer in addition,Customer may disclose the accordance with the terms and conditions contents of this Agreement solely for the of this Agreement. purpose of completing its review and approval processes under its local rules,if 9.4. Injunction. Customer agrees that breach of applicable. this Section would cause ESO irreparable injury, for which monetary damages would 10. INSURANCE.Throughout the term of this not provide adequate compensation, and Agreement, and for a period of at least three that in addition to any other remedy, ESO (3)years thereafter for any insurance written will be entitled to injunctive relief against on a claims-made form, ESO shall maintain in such breach or threatened breach,without effect the insurance coverage described below: ESO proving actual damage or posting a bond or other security. 10.1. Commercial general liability insurance with a minimum of$1 million per occurrence 9.5. Termination& Return. With respect to and $1 million aggregate; each item of Confidential Information,the obligations of nondisclosure will terminate 10.2. Commercial automobile liability insurance three (3)years after the date of disclosure; covering use of all non-owned and hired provided that, such obligations related to automobiles with a minimum limit of$1 Confidential Information constituting ESO's million for bodily injury and property trade secrets shall continue so long as such damage liability; information remains subject to trade secret protection pursuant to applicable 10.3. Worker's compensation insurance and law. Upon termination of this Agreement, employer's liability insurance or any a party shall return all copies of alternative plan or coverage as permitted Confidential Information to the other or or required by applicable law,with a certify, in writing,the destruction thereof minimum employer's liability limit of$1 million each accident or disease;and 9.6. Retention of Rights.This Agreement does not transfer ownership of Confidential 10.4. Computer processor/computer Information or grant a license thereto. professional liability insurance ("Technology Errors and Omissions') 9.7. Open Records and Other Laws. covering the liability for financial loss due Notwithstanding anything in this Section to to error,omission or negligence of ESO, the contrary,the parties expressly and Privacy and Network Security acknowledge that Confidential Information insurance ("Cyber")covering losses arising may be disclosed if such Confidential from a disclosure of confidential Information is required to be disclosed by information,with a combined aggregate law, a lawful public records request,or amount of$3 million. judicial order, provided that prior to such disclosure,written notice of such required 11. INDEMNIFICATION disclosure shall be given promptly and without unreasonable delay by the 11.1. IP Infringement. ESO shall defend and receiving party in order to give the indemnify Customer from any damages, disclosing party the opportunity to object costs, liabilities, expenses(including to the disclosure and/or to seek a reasonable and actual attorney's fees) Page 7 Page 860 of 1802 ("Damages") actually incurred or finally copies of any written documentation adjudicated as to any third-party claim or regarding the Claim received by the action alleging that the Software delivered Indemnified Party. The Indemnifying Party pursuant to this Agreement infringe or shall compromise or defend,at its own misappropriate any third party's patent, expense and with its own counsel, any copyright,trade secret,or other such Claim. The Indemnified Party will intellectual property rights enforceable in have the right, at its option,to participate the applicable jurisdiction (each an in the settlement or defense of any such "Indemnified Claim"). If an Indemnified Claim,with its own counsel and at its own Claim under this Section occurs or if ESO expense; provided, however, that the determines that an Indemnified Claim is Indemnifying Party will have the right to likely to occur, ESO shall at its option: (a) control such settlement or defense. The obtain a right for Customer to continue Indemnifying Party will not enter into any using such Software; (b) modify such settlement that imposes any liability or Software to make it a non-infringing obligation on the Indemnified Party equivalent or(c) replace such Software without the Indemnified Party's prior with a non-infringing equivalent. If(a), (b), written consent. The parties will or(c) above are not reasonably available, cooperate in any such settlement or either party may,at its option,terminate defense and give each other full access to this Agreement and/or relevant Software all relevant information, at the Schedule. ESO will refund any pre-paid Indemnifying Party's expense. Fees on a pro-rata basis for the allegedly infringing Software provided. 12. LIMITATION OF LIABILITY Notwithstanding the foregoing, E5O shall have no obligation hereunder for any claim 12.1. LIMITATION OF DAMAGES. UNDER NO resulting or arising from (x)Customer's CIRCUMSTANCES SHALL ESO OR breach of this Agreement; (y) CUSTOMER BE LIABLE FOR ANY modifications made to the Software that CONSEQUENTIAL, INDIRECT,SPECIAL, were not performed or provided by or on PUNITIVE OR INCIDENTAL DAMAGES, behalf of ISO or(z)the combination, INCLUDING CLAIMS FOR DAMAGES FOR operation or use by Customer or anyone LOST PROFITS,GOODWILL, USE OF acting on Customers behalf of the MONEY, INTERRUPTED OR IMPAIRED USE Software in connection with a third-party OF THE SOFTWARE,AVAILABILITY OF product or service (the combination of DATA,STOPPAGE OF WORK OR which causes the infringement).This IMPAIRMENT OF OTHER ASSETS. Section 11 states ESO's sole obligation and liability, and Customer's sole remedy,for 12.2. LIMITATION OF LIABILITY. WITH THE potential or actual intellectual property EXCEPTION OF SECTION 12.3 (EXCEPTIONS infringement by the Software. TO THE LIMITATION OF LIABILITY), ESO'S MAXIMUM AGGREGATE LIABILITY FOR ALL 11.2. Indemnification Procedures. Upon CLAIMS OF LIABILITY ARISING OUT OF OR becoming aware of any matter which is IN CONNECTION WITH THIS AGREEMENT, subject to the provisions of Sections 11.1 SHALL NOT EXCEED THE FEES PAID BY (a "Claim"),the party seeking CUSTOMER OR ON BEHALF OF CUSTOMER indemnification (the "Indemnified Party") IN THE CASE OF A THIRD-PARTY PAYER must give prompt written notice of such UNDER THE APPLICABLE SOFTWARE Claim to the other party(the SCHEDULE OR SOW GIVING RISE TO THE "Indemnifying Party"),accompanied by Page 8 Page 861 of 1802 CLAIM WITHIN THE PRECEDING 12- 12.5. THIS SECTION 12 SHALL SURVIVE MONTH PERIOD. EXPIRATION OR TERMINATION OF THE AGREEMENT. 12.3. EXCEPTIONS TO LIMITATION OF LIABILITY. NOTWITHSTANDING SECTION 12.2,A 13. CUSTOMER DATA&PRIVACY PARTY'S LIABILITY FOR CLAIMS INVOLVING A PARTY'S INDEMNIFICATION 13.1. Ownership of Data&Reports. As between OBLIGATIONS UNDER SECTION 11,SHALL ESO and Customer, all Customer Data shall BE LIMITED TO$250,000. IN ADDITION, be owned by Customer.Without limiting AND NOTWITHSTANDING SECTION 12.2,A the foregoing, ESO will own all right,title PARTY'S LIABILITY SHALL BE LIMITED TO and interest in all Intellectual Property in THE AMOUNT OF INSURANCE COVERAGE any aggregated and de-identified reports, REQUIRED BY SECTION 10 FOR THE summaries, compilations, analysis or other FOLLOWING TYPES OF CLAIMS: (I) CLAIMS information made available through ESO's ARISING FROM A PARTY'S GROSS Reporting Services. If subscribed to by NEGLIGENCE OR WILLFUL MISCONDUCT; Customer, ESO grants to Customer a AND(II) CLAIMS ARISING FROM A BREACH limited, non-exclusive license to use its OF CONFIDENTIAL INFORMATION, Reporting Services for Customer's internal INCLUDING A BREACH OF PROTECTED purposes only during the Term of this HEALTH INFORMATION. Agreement. No other third party shall rely on ESO's Reporting Services or the 12.4. THE FOREGOING LIMITATIONS, contents thereof. ESO disclaims all liability EXCLUSIONS, DISCLAIMERS SHALL APPLY for any damages related thereto. REGARDLESS OF WHETHER THE CLAIM FOR Customer acknowledges and agrees that SUCH DAMAGES IS BASED IN CONTRACT, any such license expires upon the WARRANTY,STRICT LIABILITY, expiration or termination of the applicable NEGLIGENCE,TORT OR OTHERWISE. Software Schedule granting a license to INSOFAR AS APPLICABLE LAW PROHIBITS ESO's Reporting Services. ANY LIMITATION HEREIN,THE PARTIES AGREE THAT SUCH LIMITATION SHALL BE 13.2. Use of Customer Data. Unless it receives AUTOMATICALLY MODIFIED, BUT ONLY TO Customer's prior written consent, ESO: (a) THE EXTENT SO AS TO MAKE THE shall not access, process, or otherwise use LIMITATION PERMITTED TO THE FULLEST Customer Data; and (b)shall not EXTENT POSSIBLE UNDER SUCH LAW.THE intentionally grant any third-party access PARTIES AGREE THAT THE LIMITATIONS to Customer Data, including without SET FORTH HEREIN ARE AGREED limitation ESO's other customers,except ALLOCATIONS OF RISK CONSTITUTING IN subcontractors that are subject to a PART THE CONSIDERATION FOR ESO'S reasonable nondisclosure agreement or SOFTWARE AND SERVICES TO CUSTOMER, authorized participants in the case of AND SUCH LIMITATIONS WILL APPLY Interoperability Software. Notwithstanding NOTWITHSTANDING THE FAILURE OF THE the foregoing, ESO may use and disclose ESSENTIAL PURPOSES OF ANY LIMITED Customer Data to fulfill its obligations REMEDY AND EVEN IF A PARTY HAS BEEN under this Agreement or as required by ADVISED OF THE POSSIBILITY OF SUCH applicable law or by proper legal or LIABILITIES. governmental authority. ESO shall give Customer prompt notice of any such legal or governmental demand and reasonably cooperate with Customer in any effort to Page 9 Page 862 of 1802 seek a protective order or otherwise to copyrights,and trademarks), as well as contest such required disclosure,at title to any copy of software made by or Customer's expense. for Customer(if applicable). Customer hereby explicitly acknowledges and agrees 13.3. Anonymized Data. Notwithstanding any that nothing in this Agreement or a provision herein, ESO may use, reproduce, separate SOW gives the Customer any license,or otherwise exploit Anonymized right,title, or interest to the intellectual Data; provided that Anonymized Data does property or proprietary know-how of the not contain and is not PHI. ("Anonymized Deliverables. Data" refers to Customer Data with the following removed: personally identifiable 15. GOVERNMENT PROVISIONS information and the names and addresses of Customer and any of its Users and/or 15.1. Compliance with Laws. Both parties shall Customer's clients.) comply with and give all notices required by all applicable federal,state and local 13.4. Risk of Exposure.Customer recognizes and laws,ordinances, rules, regulations and agrees that hosting data online involves lawful orders of any public authority risks of unauthorized disclosure and that, bearing on the performance of this in accessing and using the SaaS, Customer Agreement. assumes such risks. Customer has sole responsibility for obtaining, maintaining, 15.2. Business Associate Addendum.The parties and securing its connections to the agree to the terms of the Business Internet. ESO makes no representations to Associate Addendum attached hereto as Customer regarding the reliability, Exhibit C and incorporated herein by performance or security of any network or reference. provider. 15.3. Equal Opportunity.The parties shall abide 14. FEEDBACK RIGHTS&WORK PRODUCT by the requirements of 41 CFR 60-1.4(a), 60-300.5(a) and 60-741.5(a), and the 14.1. Feedback Rights. ESO does not agree to posting requirements of 29 CFR Part 471, treat as confidential any Feedback that appendix A to subpart A, if applicable. Customer provides to ES0. Nothing in this These regulations prohibit discrimination Agreement will restrict ESO's right to use, against qualified individuals based on their profit from,disclose, publish, keep secret, status as protected veterans or individuals or otherwise exploit Feedback,without with disabilities,and prohibit compensation or crediting Customer. discrimination against all individuals based Feedback will not constitute Confidential on their race, color, religion, sex, sexual Information,even if it would otherwise orientation, gender identity or national qualify as such pursuant to Section 9 origin. (Confidential Information). 15.4. Excluded Parties List. ESO agrees to 14.2. Work Product Ownership. In the event immediately report to Customer if an Customer hires ESO to perform employee or contractor is listed by a Professional Services, ESO alone shall hold federal agency as debarred,excluded or all right,title, and interest to all otherwise ineligible for participation in proprietary and intellectual property rights federally funded health care programs. of the Deliverables(including,without limitation, patents,trade secrets, 16. PHI ACCURACY&COMPLETENESS Page 10 Page 863 of 1802 16.1. ESO provides the Software to allow its own judgment and due diligence and Customer(and its respective Users)to expressly disclaims reliance upon any enter,document,and disclose Customer representations or statement not expressly Data,and as such, ESO gives no set forth in this Agreement. In the event representations or guarantees about the the Customer issues a purchase order, accuracy or completeness of Customer letter or any other document addressing Data (including PHI) entered, uploaded or the Software or Services to be provided disclosed through the Software, and performed pursuant to this Agreement, it is hereby specifically agreed 16.2. Customer is solely responsible for any and understood that any such writing is for decisions or actions taken involving patient the Customer's internal purposes only, and care or patient care management,whether that any terms, provisions,and conditions those decisions or actions were made or contained therein shall in no way modify taken using information received through this Agreement. the Software. 17.4. Severability.To the extent permitted by 17. MISCELLANEOUS applicable law,the parties hereby waive any provision of law that would render any 17.1. Independent Contractors.The parties are clause of this Agreement invalid or independent contractors. Neither party is otherwise unenforceable in any respect. If the agent of the other,and neither may a provision of this Agreement is held to be make commitments on the other's behalf. invalid or otherwise unenforceable,such The parties agree that no ESO employee or provision will be interpreted to fulfill its contractor is or will be considered an intended purpose to the maximum extent employee of Customer. permitted by applicable law, and the remaining provisions of this Agreement 17.2. Notices. Notices provided under this will continue in full force and effect. Agreement must be in writing and delivered by(a) certified mail, return 17.5. Assignment&Successors. Neither party receipt requested to a party's principal may assign,subcontract, delegate or place of business as forth in the recitals on otherwise transfer this Agreement or any page 1 of this Agreement, (b) hand of its rights or obligations hereunder, nor delivered, (c)facsimile with receipt of a may it contract with third parties to "Transmission Confirmed" perform any of its obligations hereunder acknowledgment, (d)e-mail,or(e)delivery except as contemplated in this Agreement, by a reputable overnight carrier service. In without the other party's prior written the case of delivery by facsimile ore-mail, consent. Except that either party may, the notice must be followed by a copy of without the prior consent of the other, the notice being delivered by a means assign all its rights under this Agreement to provided in (a), (b)or(e). The notice will (i) a purchaser of all or substantially all be deemed given on the day the notice is assets related to this Agreement,or(H) a received. third party participating in a merger, acquisition,sale of assets or other 17.3. Merger Clause. In entering into this corporate reorganization in which either Agreement, neither party is relying upon any representations or statements of the "Charty is in Control");nating(provided y, a "Change in provided however, other that are not fully expressed in this that the non-assigning party is given notice Agreement; rather each party is relying on of the Change in Control. Page 11 Page 864 of 1802 17.6. Modifications and Amendments.This 17.10. Survival of Terms. Unless Agreement may not be amended except otherwise stated,all of ESO's and through a written agreement signed by Customer's respective obligations, authorized representatives of each party. representations and warranties under this Agreement which are not, by the 17.7. Force Majeure. No delay,failure, or expressed terms of this Agreement, fully to default,other than a failure to pay Fees be performed while this Agreement is in when due,will constitute a breach of this effect shall survive the termination of this Agreement to the extent caused by acts of Agreement. war, terrorism, hurricanes,earthquakes, other acts of God or of nature,strikes or 17.11. Ambiguous Terms.This Agreement other labor disputes, riots or other acts of will not be construed against any party by civil disorder, embargoes, or other causes reason of its preparation. beyond the performing party's reasonable control (collectively, "Force Majeure"). In 17.12. Governing Law.This Agreement, such event, however, the delayed party any related Addenda, and any CLAIM, must promptly provide the other party DISPUTE,OR CONTROVERSY(WHETHER IN notice of the Force Majeure.The delayed CONTRACT,TORT,OR OTHERWISE, party's time for performance will be INCLUDING STATUTORY,CONSUMER excused for the duration of the Force PROTECTION,COMMON LAW, Majeure,but if the event last longer than INTENTIONAL TORT AND EQUITABLE thirty(30)days,the other party may CLAIMS) BETWEEN CUSTOMER AND ESO, immediately terminate the applicable including their affiliates, contractors,and Software Schedule. agents,and each of their respective employees,directors, and officers(a 17.8. Marketing. Customer hereby grants ESO a "Dispute")will be governed by the laws of license to include Customer's primary logo the State of Texas,without regard to in any customer list or press release conflicts of law. Notwithstanding the announcing this Agreement; provided ESO foregoing, in the event Customer is a U.S. first submits each such press release or city, county, municipality or other U.S. customer list to Customer and receives governmental entity,then any Dispute will written approval, which approval shall not be governed by the law of state where be unreasonably withheld.Goodwill Customer is located,without regard to its associated with the logo inures solely to conflicts of law.The UN Convention for the Customer, and ESO shall take no action to International Sale of Goods and the damage the goodwill associated with the Uniform Computer Information logo or with Customer. Transactions Act will not apply. In any Dispute,each party will bear its own 17.9. Waiver& Breach. Neither party will be attorneys'fees and costs and expressly deemed to have waived any of its rights waives any statutory right to attorneys' under this Agreement unless it is an fees under 4 38.001 of the Texas Civil explicit written waiver made by an Practices and Remedies Code. authorized representative. No waiver of a breach of this Agreement will constitute a 17.13. Venue.The parties agree that any waiver of any other breach of this Dispute shall be brought exclusively in the Agreement. state or federal courts located in Travis County,Texas.The parties agree to submit to the personal jurisdiction of such courts. Page 12 Page 865 of 1802 Notwithstanding the foregoing, in the the Software in, or export such software event Customer is a U.S. city, county, to,a country subject to a United States municipality or other U.S.governmental embargo (as of the Effective Date-Cuba, entity,then any Dispute shall be brought Iran, North Korea,Sudan, and Syria). exclusively in the state or federal courts located in the county where Customer is 17.19. Order of Precedence. In the event located. of any conflict between this Agreement, Addenda or other attachments 17.14. Bench Trial.The parties agree to incorporated herein, the following order of waive,to the maximum extent permitted precedence will govern: (1)the General by law, any right to a jury trial with respect Terms and Conditions; (2)any Business to any Dispute. Associate Agreement; (3)the applicable Software Schedule or SOW,with most 17.15. No Class Actions. NEITHER PARTY recent Software Schedule or SOW taking SHALL BE ENTITLED TO JOIN OR precedence over earlier ones; and (3) any CONSOLIDATE CLAIMS BY OR AGAINST THE ESO policy posted online,including without OTHER CUSTOMERS, OR PURSUE ANY limitation its privacy policy.No CLAIM AS A REPRESENTATIVE OR CLASS amendments incorporated into this ACTION OR IN A PRIVATE ATTORNEY Agreement after execution of the General GENERAL CAPACITY. Terms and Conditions will amend such General Terms and Conditions unless it 17.16. Limitation Period. NEITHER PARTY, specifically states its intent to do so and shall be liable for any claim brought more cites the section or sections amended. than 2 years after the cause of action for such claim first arose. 17.20. Counterparts.This Agreement may be executed in one or more counterparts. 17.17. Dispute Resolution. Customer and Each counterpart will be an original, and all ESO will attempt to resolve any Dispute such counterparts will constitute a single through negotiation or by utilizing a instrument. mediator agreed to by the parties, rather than through litigation. Negotiations and 17.21. Signatures. Electronic signatures mediations will be treated as confidential. on this Agreement or on any Addendum If the parties are unable to reach a (or copies of signatures sent via electronic resolution within thirty(30) days of notice means)are the equivalent of handwritten of the Dispute to the other party,the signatures. parties may pursue all other courses of action available at law or in equity. 17.18. Technology Export.Customer shall not: (a)permit any third party to access or use the Software in violation of any U.S. law or regulation; or(b) export any software provided by ESO or otherwise remove it from the United States except in compliance with all applicable U.S. laws and regulations. Without limiting the generality of the foregoing,Customer shall not permit any third party to access or use Page 13 Page 866 of 1802 IN WITNESS WHEREOF,the parties have executed this Agreement as of the Effective Date. Customer ESO Solutions,Inc. _ [Signature] [Signature] [Primed Name] [Printed Name] [Title] [Tide] 14 Page 867 of 1802 EXHIBIT A-I SAAS SOFTWARE SCHEDULE fApplications-ESO EIIR,ESO Fire,ESO I'M) 1. The General Terms &Conditions are incorporated herein by reference.The SaaS subscription term shall begin fifteen (15) calendar days after the Effective Date("SaaS Subscription Start Date").Customer shall be deemed to have accepted the SaaS on the SaaS Subscription Start Date.The parties will make reasonable efforts to ensure that Customer is live on the SaaS as quickly as possible, and in no event will the SaaS Subscription Start Date be modified for implementation delays. 2. The following SaaS may be ordered under this Exhibit: 2.1.ESO Electronic Health Record ("EHR")is a SaaS software application for prehospital patient documentation (http://www.esosolutions.com/software/ehr). 2.2.ESO Personnel Management("PM")is a SaaS software application for tracking personnel records,training courses and education history (http://www.esosol utions.com/softwa re/personnel-management). 2.3.ESO Fire is a SaaS software application for NFIRS reporting (http://www.esosolutions.com/software/fire). 3. Third-Party Payer is responsible for the following products and Fees: 15 Page 868 of 1802 Prer Product Name Product Description Quantity TOW unt 5Cs D2900 EHR Suite wl QM&Mobile Includes Quality Management Ad Hoc Reports,Analytics,Patient 18000/Calls $225,29000 Tracker.Allows for unlimited users,unlimited mobile applications,live support,state and federal data reporting,ongoing weekly web training. software updates and upgrades. Fee Type:Recurring EHR Suite wi QM&Mobile ($3,28]]0) Discount Fee Type:Recurring CAD Integration flows for integration of CAD data into EHR mobile and web 18000/Incidents $2,995.00 application.Ongoing maintenance included.Additional fees from your CAD vendor may apply. Fee Type:Recuning CAD Integration Discount ($389.35) Fee Type.Recurring Cardiac Monitor Unlimited cardiac monitors,allows for import of cardiac monitor data 18000/Incidents $1,295.00 via local or cloud integration.Ongoing maintenance included. Fee Type:Recuning Cardiac Monitor Discount (5Issas) Fee Type:Recuning EHR Billing Standard Allows for integration Of discrete oPCR data into third-party billing 18000/Incidents $795.00 Interface software.Ongoing maintenance included. Fee Type:Recuning EHR Billing Standard ($795.00) Interlace Discount Fee Type:Recurring EHR Training Daily Rate 3/Day $2,98500 Fee Type:OneTime EHR Training Travel Costs Onetime fee-covers all travel costs associated with on-site training 1500/Travel Cost $1.500.00 option. Fee Type:One-Time HDE-ESO EHR Bi-directional connection for an ESO EHR customer for HOE 1/Incidents $495.00 Connection Fee Type:Recurring List Price: $35.355.00 Discounts: ($4,64040) Tax: $D.00 Total: $30,714.60 4. Customer hereby agrees to timely pay for the following products according to the schedule below: N/A 5. All the Fees above will be invoiced by ESO as follows: 5.1.Training and Training Travel Fees shall be invoiced on the Effective Date. 5.2.Du ring the first year, 100%of the recurring Fees shall be invoiced on the Subscription Start Date. 5.3.During the second year and any renewal years thereafter, 100%of the Fees shall due on the anniversary of the SaaS Subscription Start Date. 16 Page 869 of 1802 EXHIBIT B SUPPORT SERVICES ADDENDUM 1. DEFINITIONS.Capitalized terms not defined below shall have the same meaning as in the General Terms&Conditions. 1.1."Enhancement" means a modification, addition or new release of the Software that when added to the Software, materially changes its utility,efficiency,functional capability or application. 1.2."E-mail Support" means ability to make requests for technical support assistance by e-mail at any time concerning the use of the then-current release of Software. 1.3."Error" means an error in the Software, which significantly degrades performance of such Software as compared to ESO's then-published Documentation. 1.4."Error Correction" means the use of reasonable commercial efforts to correct Errors. 1.5."Fix" means the repair or replacement of object code for the Software or Documentation to remedy an Error. 1.6."Initial Response" means the first contact by a Support Representative after the incident has been logged and a ticket generated.This may include an automated email response depending on when the incident is first communicated. 1.7."Management Escalation"means, if the initial Workaround or Fix does not resolve the Error, notification of management that such Error(s) have been reported and of steps being taken to correct such Error(s). 1.8."Severity 1 Error" means an Error which renders the Software completely inoperative(e.g.a User cannot access the Software due to unscheduled downtime or an Outage). 1.9."Severity 2 Error"means an Error in which Software is still operable; however,one or more significant features or functionality are unavailable(e.g.a User cannot access a core component of the Software). 1.1."Severity 3 Error" means any other error that does not prevent a User from accessing a significant feature of the Software (e.g. User is experiencing latency in reports). 1.2."Severity 4 Error" means any error related to Documentation or a Customer Enhancement request. 1.3."Status Update" means if the initial Workaround or Fix cannot resolve the Error, notification of the Customer regarding the progress of the Workaround or Fix. 1.4."Online Support" means information available through ESO's website (www.esosolutions.com),including frequently asked questions and bug reporting via Live Chat. 17 Page 870 of 1802 1.5."Support Representative shall be ESO employee(s)or agent(s)designated to receive Error notifications from Customer,which Customer's Administrator has been unable to resolve. 1.6."Update" means an update or revision to Software,typically for Error Correction. 1.7."Upgrade"means a new version or release of Software or a particular component of Software,which improves the functionality or which adds functional capabilities to the Software and is not included in an Update. Upgrades may include Enhancements. 1.8."Workaround" means a change in the procedures followed or data supplied by Customer to avoid an Error without substantially impairing Customer's use of the Software. 2. SUPPORT SERVICES. 2.1.Customer will provide at least one administrative employee(the"Administrator"or "Administrators")who will handle all requests for first-level support from Customer's employees with respect to the Software.Such support is intended to be the "front line"for support and information about the Software to Customer's Users. ESO will provide training,documentation, and materials to the Administrator to enable the Administrator to provide technical support to Customer's Users. The Administrator will notify a Support Representative of any Errors that the Administrator cannot resolve and assist ESO in information gathering. 2.2.ESO will provide Support Services consisting of(a) Error Correction(s); Enhancements, Updates and Upgrades that ESO, in its discretion, makes generally available to its customers without additional charge;and (c) E-mail Support,telephone support, and Online Support. ESO may use multiple forms of communication for purposes of submitting periodic status reports to Customer,including but not limited to, messages in the Software, messages appearing upon login to the Software or other means of broadcasting Status Update(s)to multiple customers affected by the same Error,such as a customer portal. 2.3.ESO's support desk will be staffed with competent technical consultants who are trained in and thoroughly familiar with the Software and with Customer's applicable configuration. Telephone support and all communications will be delivered in intelligible English. 2.4.Normal business hours for ESO's support desk are Monday through Friday 7:00 am to 7:00 pm CT.Customer will receive a call back from a Support Representative after-hours for a Severity 1 Error. 3. ERROR PRIORITY LEVELS.Customer will report all Errors to ESO via e-mail (support@esosolutions.com)or by telephone(866-766-9471,option 43). ESO shall exercise commercially reasonable efforts to correct any Error reported by Customer in accordance with the priority level reasonably assigned to such Error by ESO. 3.1.Severity 1 Error. ESO shall (i) commence Error Correction promptly; (ii) provide an Initial Response within four hours; (iii)initiate Management Escalation promptly; and (iv) provide Customer with a Status Update within four hours if ESO cannot resolve the Error within four hours. 18 Page 871 of 1802 3.2.Severity 2 Error. ESO shall (i)commence Error Correction promptly; (ii) provide an Initial Response within eight hours; (iii) initiate Management Escalation within forty-eight hours if unresolved; and (iv) provide Customer with a Status Update within forty-eight hours if ESO cannot resolve the Error within forty-eight hours. 3.3.Severity 3 Error. ESO shall (i)commence Error Correction promptly; (li) provide an Initial Response within three business days; and (iii) provide Customer with a Status Update within seven calendar days if ESO cannot resolve the Error within seven calendar days. 3.4.Severity 4 Error. ESO shall (i) provide an Initial Response within seven calendar days. 4. CONSULTING SERVICES, If ESO reasonably believes that a problem reported by Customer is not due to an Error in the Software, ESO will so notify Customer.At that time, Customer may request ESO to proceed with a root cause analysis at Customer's expense as set forth herein or in a separate SOW. If ESO agrees to perform the investigation on behalf of Customer,then ESO's then-current and standard consulting rates will apply for all work performed in connection with such analysis, plus reasonable related expenses incurred. For the avoidance of doubt,Consulting Services will include customized report writing by ESO on behalf of Customer. 5. EXCLUSIONS. 5.1.ESO shall have no obligation to perform Error Corrections or otherwise provide support for: (i)Customer's repairs, maintenance or modifications to the Software (if permitted); (II) Customer's misapplication or unauthorized use of the Software; (iii) altered or damaged Software not caused by ESO; (iv)any third-party software; (v) hardware issues; (vi) Customer's breach of the Agreement;and(vii)any other causes beyond the ESO's reasonable control. 5.2.ESO shall have no liability for any changes in Customer's hardware or software systems that may be necessary to use the Software due to a Workaround or Fix. 5.3.ESO is not responsible for any Error Correction unless ESO can replicate such Error on its own software and hardware or through remote access to Customer's software and hardware. 5.4.Customer is solely responsible for its selection of hardware,and ESO shall not be responsible the performance of such hardware even if ESO makes recommendations regarding the same. 6. MISCELLANEOUS.The parties acknowledge that from time-to-time ESO may update its support processes specifically addressed in this Exhibit and may do so by posting such updates to ESO's website or otherwise notifying Customer of such updates. Customer will accept updates to ESO's support procedures and any other terms in this Exhibit; provided however,that they do not materially decrease the level of Support Services that Customer will receive from ESO.THESE TERMS AND CONDITIONS DO NOT CONSTITUTE A PRODUCT WARRANTY.THIS EXHIBIT IS AN ADDITIONAL PART OF THE AGREEMENT AND DOES NOT CHANGE OR SUPERSEDE ANY TERM OF THE AGREEMENT EXCEPT TO THE EXTENT UNAMBIGUOUSLY CONTRARY THERETO. 19 Page 872 of 1802 EXHIBIT C HIPAA BUSINESS ASSOCIATE ADDENDUM Customer and ESO Solutions,Inc("Business Associate")agree that(I)this IIIPAA Business Associate Addendum is entered into for the benefit of Customer,which is a covered entity under the Privacy Standards("Covered Entity"7. Pursuant to the Agreement,Business Associate may perform functions or activities involving the use and/or disclosure of PHI on behalf of the Covered Entity,and therefore,Business Associate may function as a business associate.Business Associate,therefore,agrees to the following tenns and conditions set forth in this HIPAA Business Associate Addendum("Addendum'). 1. Scope. This Addendum applies to and is hereby automatically incorporated into all present and future agreements and relationships,whether written,oral or implied, between Covered Entity and Business Associate, pursuant to which PHI is created, maintained, received or transmitted by Business Associate from or on behalf of Covered Entity in any form or medium whatsoever. 2. Definitions. For purposes of this Addendum,the terms used herein, unless otherwise defined, shall have the same meanings as used in the Health Insurance Portability and Accountability Act of 1996("HIPAA"),or the Health Information Technology for Economic and Clinical Health Act ("HITECH"), and any amendments or implementing regulations,(collectively"HIPAA Rules"). 3. Compliance with Applicable Law.The parties acknowledge and agree that, beginning with the relevant effective date, Business Associate shall comply with its obligations under this Addendum and with all obligations of a business associate under HIPAA, HITECH,the HIPAA Rules,and other applicable laws and regulations, as they exist at the time this Addendum is executed and as they are amended,for so long as this Addendum is in place. 4. Permissible Use and Disclosure of PHI. Business Associate may use and disclose PHI as necessary to carry out its duties to a Covered Entity pursuant to the terms of the Agreement and as required by law. Business Associate may also use and disclose PHI (i)for its own proper management and administration, and (ii)to carry out its legal responsibilities. If Business Associate discloses Protected Health Information to a third party for either above reason, prior to making any such disclosure, Business Associate must obtain: (i) reasonable assurances from the receiving party that such PHI will be held confidential and be disclosed only as required by law or for the purposes for which it was disclosed to such receiving party;and (ii)an agreement from such receiving party to immediately notify Business Associate of any known breaches of the confidentiality of the PHI. 5. Limitations on Use and Disclosure of PHI. Business Associate shall not, and shall ensure that its directors,officers, employees, subcontractors,and agents do not, use or disclose PHI in any manner that is not permitted by the Agreement or that would violate Subpart E of 45 C.F.R. 164 ("Privacy Rule")if done by a Covered Entity.All uses and disclosures of, and requests by, Business Associate for PHI are subject to the minimum necessary rule of the Privacy Rule. 6. Required Safeguards to Protect PHI. Business Associate shall use appropriate safeguards, and comply with Subpart C of 45 C.F.R. Part 164("Security Rule")with respect to electronic PHI,to prevent the use or disclosure of PHI other than pursuant to the terms and conditions of this Addendum. 7. Reporting to Covered Entity. Business Associate shall report to the affected Covered Entity without unreasonable delay: (a) any use or disclosure of PHI not provided for by the Agreement of which it becomes aware; (b) any breach of unsecured PHI in accordance with 45 C.F.R.Subpart 20 Page 873 of 1802 D of 45 C.F.R. 164("Breach Notification Rule");and (c)any security incident of which it becomes aware. With regard to Security Incidents caused by or occurring to Business Associate, Business Associate shall cooperate with the Covered Entity's investigation,analysis, notification and mitigation activities, and except for Security Incidents caused by Covered Entity,shall be responsible for reasonable costs incurred by the Covered Entity for those activities. Notwithstanding the foregoing, Covered Entity acknowledges and shall be deemed to have received advanced notice from Business Associate that there are routine occurrences of: (i) unsuccessful attempts to penetrate computer networks or services maintained by Business Associate;and (ii) immaterial incidents such as"pinging" or"denial of services"attacks. 8. Mitigation of Harmful Effects. Business Associate agrees to mitigate,to the extent practicable, any harmful effect of a use or disclosure of PHI by Business Associate in violation of the requirements of the Agreement, including, but not limited to, compliance with any state law or contractual data breach requirements. 9. Agreements by Third Parties. Business Associate shall enter into an agreement with any subcontractor of Business Associate that creates, receives, maintains or transmits PHI on behalf of Business Associate. Pursuant to such agreement,the subcontractor shall agree to be bound by the same or greater restrictions,conditions,and requirements that apply to Business Associate under this Addendum with respect to such PHI. 10. Access to PHI.Within five (5) business days of a request by a Covered Entity for access to PHI about an individual contained in a Designated Record Set, Business Associate shall make available to the Covered Entity such PHI for so long as such information is maintained by Business Associate in the Designated Record Set,as required by 45 C.F.R. 164.524. In the event any individual delivers directly to Business Associate a request for access to PHI, Business Associate shall within five (5) business days forward such request to the Covered Entity. 11. Amendment of PHI.Within five(5)business days of receipt of a request from a Covered Entity for the amendment of an individual's PHI or a record regarding an individual contained in a Designated Record Set(for so long as the PHI is maintained in the Designated Record Set), Business Associate shall provide such information to the Covered Entity for amendment and incorporate any such amendments in the PHI as required by 45 C.F.R. 164.526. In the event any individual delivers directly to Business Associate a request for amendment to PHI, Business Associate shall within five(5) business days forward such request to the Covered Entity. 12. Documentation of Disclosures. Business Associate agrees to document disclosures of PHI and information related to such disclosures as would be required for a Covered Entity to respond to a request by an individual for an accounting of disclosures of PHI in accordance with 45 C.F.R. 164.528 and HITECH. 13. Accounting of Disclosures. Within five (5) business days of notice by a Covered Entity to Business Associate that it has received a request for an accounting of disclosures of PHI, Business Associate shall make available to a Covered Entity information to permit the Covered Entity to respond to the request for an accounting of disclosures of PHI,as required by 45 C.F.R. 164.528 and HITECH. 21 Page 874 of 1802 14. Other Obligations.To the extent that Business Associate is to carry out one or more of a Covered Entity's obligations under the Privacy Rule, Business Associate shall comply with such requirements that apply to the Covered Entity in the performance of such obligations. 15. Judicial and Administrative Proceedings. In the event Business Associate receives a subpoena, court or administrative order or other discovery request or mandate for release of PHI,the affected Covered Entity shall have the right to control Business Associate's response to such request, provided that, such control does not have an adverse impact on Business Associate's compliance with existing laws. Business Associate shall notify the Covered Entity of the request as soon as reasonably practicable, but in any event within seven (7)business days of receipt of such request. 16. Availability of Books and Records. Business Associate hereby agrees to make its internal practices, books, and records available to the Secretary of the Department of Health and Human Services for purposes of determining compliance with the HIPAA Rules. 17. Breach of Contract by Business Associate. In addition to any other rights a party may have in the Agreement, this Addendum or by operation of law or in equity,either party may: i) immediately terminate the Agreement if the other party has violated a material term of this Addendum; or ii) at the non-breaching party's option, permit the breaching party to cure or end any such violation within the time specified by the non-breaching party.The non-breaching party's option to have cured a breach of this Addendum shall not be construed as a waiver of any other rights the non- breaching party has in the Agreement,this Addendum or by operation of law or in equity. 18. Effect of Termination of Agreement. Upon the termination of the Agreement or this Addendum for any reason, Business Associate shall return to a Covered Entity or,at the Covered Entity's direction, destroy all PHI received from the Covered Entity that Business Associate maintains in any form, recorded on any medium, or stored in any storage system.This provision shall apply to PHI that is in the possession of Business Associate,subcontractors,and agents of Business Associate.Business Associate shall retain no copies of the PHI. Business Associate shall remain bound by the provisions of this Addendum,even after termination of the Agreement or Addendum, until such time as all PHI has been returned or otherwise destroyed as provided in this Section. For the avoidance of doubt,de-identified Customer Data shall not be subject to this provision. 19. Injunctive Relief. Business Associate stipulates that its unauthorized use or disclosure of PHI while performing services pursuant to this Addendum would cause irreparable harm to a Covered Entity,and in such event,the Covered Entity shall be entitled to institute proceedings in any court of competent jurisdiction to obtain damages and injunctive relief. 20. Owner of PHI. Under no circumstances shall Business Associate be deemed in any respect to be the owner of any PHI created or received by Business Associate on behalf of a Covered Entity. 21. Data Usage Provision. Business Associate may aggregate and de-identify PHI and/or create limited data sets for use in research,evaluation and for publication or presentation of patient care quality improvement practices and outcomes.The Parties understand and agree that such aggregated and de-identified data is no longer PHI subject to the provisions of HIPAA and agree that Business Associate may retain such limited data sets indefinitely thereafter. Business 22 Page 875 of 1802 Associate agrees that it will comply with all terms of this Agreement with respect to the limited data sets and that it shall not re-identify or attempt to re-identify the information contained in the limited data set, nor contact any of the individuals whose information is contained in the limited data set. 22. Safeguards and Appropriate Use of Protected Health Information. Covered Entity is responsible for implementing appropriate privacy and security safeguards to protect its PHI in compliance with HIPAA.Without limitation, it is Covered Entity's obligation to: 22.1. Not include PHI in information Covered Entity submits to technical support personnel through a technical support request or to community support forums. In addition, Business Associate does not act as, or have the obligations of a Business Associate under the HIPAA Rules with respect to Customer Data once it is sent to or from Covered Entity outside ESO's Software over the public Internet; and 22.2. Implement privacy and security safeguards in the systems,applications, and software Covered Entity controls, configures and connects to ESO's Software. 23. Third Party Rights.The terms of this Addendum do not grant any rights to any parties other than Business Associate and the Covered Entity. IN WITNESS WHEREOF,the parties have executed this Agreement as of the Effective Date. ESO Solutions,Inc. Customer [Signature] [Signature] [Printed Name] [Printed Name] [Title] [Title] 23 Page 876 of 1802