98-22729 RESO
RESOLUTION NO. 98-22729
A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF
THE CITY OF MIAMI BEACH, FLORIDA, AUTHORIZING THE
ADMINISTRATION TO PROCEED WITH THE ISSUANCE OF A
REQUEST FOR PROPOSALS SEEKING THE SERVICES OF A
PROVIDER TO SUPPLY COMPREHENSIVE MEDICAL
EVALUATIONS, MEDICAL RECORDS RETENTION,
PSYCHIATRIC SERVICES, AN IMMUNIZATION PROGRAM, A
DRUG AND ALCOHOL TESTING PROGRAM, A WELLNESS
PROGRAM, AN EMPLOYEE ASSISTANCE PROGRAM, AND TO
PROVIDE EVALUATION AND TREATMENT OF WORKERS'
COMPENSATION CLAIMS, FOR THE CITY OF MIAMI BEACH
EMPLOYEES AND/OR EMPLOYMENT APPLICANTS.
WHEREAS, in 1994, the City solicited proposals, pursuant to Request for Proposals
No. 33 - 94/97 (RFP), for a service provider to supply comprehensive medical evaluations,
medical records retention, psychiatric services, an immunization program, a drug and
alcohol testing program, a wellness program, an employee assistance program, and
evaluation and treatment of workers' compensation claims for the City of Miami Beach
employees and/or employment applicants, and;
WHEREAS, a contract was awarded to the top-ranked proposer pursuant to its
response to the RFP; and
WHEREAS, the City exercised the options to renew the contract; and
WHEREAS, said contract with the current provider expires on September 30, 1998;
and
WHEREAS, the City desires to continue to protect the psychological and physical
health of all employees and potential employees and to provide for the physical safety and
well being of citizens, visitors, and employees; and
WHEREAS, the City desires to continue to have a professional and experienced
provider perform comprehensive medical evaluations, psychiatric services, an
immunization program, drug and alcohol testing, a wellness program, an employee
assistance program, and to provide evaluation and treatment of workers' compensation
claims, for the City of Miami Beach employees and/or employment applicants; and
WHEREAS, the primary user of this contract, the City's Human Resources
Department, has recommended that the services be continued; and
WHEREAS, funding for the new contract has been requested in the Fiscal Year
1998/99 budget of the Risk Management Department.
PAGE TWO
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 authorize the Administration to proceed with the issuance of a
Request for Proposals seeking the services of a service provider to supply comprehensive
medical evaluations, medical records retention, psychiatric services, immunization
program, drug and alcohol testing program, a wellness program, an employee assistance
program, and to provide evaluation and treatment of workers' compensation claims, for the
City of Miami beach employees and/or employment applicants.
PASSED AND ADOPTED this 6th
day of May , 1998.
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CITY OF MIAMI BEACH
RFP NO. 42-97/02
REQUEST FOR PROPOSALS FOR
THE SERVICES OF A PROVIDER TO SUPPLY COMPREHENSIVE MEDICAL EVALUATIONS,
MEDICAL RECORDS RETENTION, PSYCHIATRIC SERVICES, AN IMMUNIZATION PROGRAM,
A DRUG AND ALCOHOL TESTING PROGRAM, A WELLNESS PROGRAM, AN EMPLOYEE
ASSISTANCE PROGRAM, AND TO PROVIDE EVALUATION AND TREATMENT OF
WORKERS' COMPENSATION CLAIMS, FOR THE CITY OF MIAMI BEACH EMPLOYEES
AND/OR EMPLOYMENT APPLICANTS.
A PRE-PROPOSAL CONFERENCE IS SCHEDULED FOR 10:00 A.M.
ON MAY 22, 1998, IN THE CITY HALL FIRST FLOOR CONFERENCE ROOM
PROPOSALS ARE DUE AT THE ADDRESS SHOWN BELOW
NO LATER THAN JUNE 9, 1998 AT 4:00 P.M.
CITY OF MIAMI BEACH
PROCUREMENT DIVISION
1700 CONVENTION CENTER DRIVE, THIRD FLOOR
MIAMI BEACH, FL 33139
PHONE: (305) 673-7490
FAX: (305) 673-7851
RFP NO.:
DATE:
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4 / 2 / 98
CITY OF MIAMI BEACH
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TABLE OF CONTENTS
Page
I. OVERVIEW AND PROPOSAL PROCEDURES 3
II. SCOPE OF SERVICES 8
III. PROPOSAL FORMAT 12
IV. EVALUATION/SELECTION PROCESS; CRITERIA FOR EVALUATION 13
V. GENERAL PROVISIONS 14
VI. SPECIAL TERMS AND CONDITIONS 17
VII. ATTACHMENTS 20
VIII. PROPOSAL DOCUMENTS TO BE COMPLETED AND RETURNED 26
TO CITY
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SECTION I - OVERVIEW AND PROPOSAL PROCEDURES:
A. INTRODUCTIONIBACKGROUND
The City of Miami Beach, Florida (hereinafter referred to as "the City") has a need to
contract a service provider to supply comprehensive medical evaluations, retention of
medical records, psychiatric services, immunization program, drug and alcohol testing
program, wellness program, and employee assistance program, and to provide evaluation and
treatment of workers' compensation claims, for approximately 1642 City employees and at
least 500 employment applicants.
The awarded contract will be for a one (1) year term with an option for a second, third,
fourth, and fifth year, at the City's discretion.
B. RFP TIMETABLE
The anticipated schedule for this RFP and contract approval is as follows:
Health Advisory Committee meeting
April 13, 1998
RFP issued
May 7, 1998
Deadline for receipt of questions
May 19, 1998
Pre- Proposal Conference
May 22, 1998, at 10:00 A.M.
Deadline for receipt of proposals
June 9, 1998, at 4:00 P.M.
Health Advisory Committee review
June 19, 1998
Evaluation Committee meeting
June 23, 1998
Commission approval and authorization
of negotiations
July 15, 1998
Contract negotiations
Week of: July 20, 1998
Projected award date
September 9, 1998
Projected contract start date
October 1, 1998
C. PROPOSAL SUBMISSION
An original and (8) eight copies of complete proposal must be received by 6/09/98 at 4:00
P.M. and will be opened on that day at that time. The original and all copies must be
submitted to the Procurement Division in a sealed envelope or container stating on the
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outside the proposer's name, address, telephone number, RFP number and title, and proposal
due date.
The responsibility for submitting a response to this RFP to the Procurement Division on or
before the stated time and date will be solely and strictly that of the proposer. The City will
in no way be responsible for delays caused by the U.S. Post Office or caused by any other
entity or by any occurrence. Proposals received after the proposal due date and time will not
be accepted and will not be considered.
D. PRE-PROPOSAL CONFERENCE
A pre-proposal conference is scheduled on May 21, 1998, at 10:00 A.M. in the City Hall
first floor conference room.
E. CONTACT PERSON/ADDITIONAL INFORMATION/ADDENDA
The contact person for this RFP is the Procurement Director at (305) 673-7490. Proposers
are advised that from the date of release of this RFP until award of the contract, no contact
with City personnel related to this RFP is permitted, except as authorized by the contact
person. Any such unauthorized contact may result in the disqualification of the proposer's
submittal.
Requests for additional information or clarifications must be made in writing to the
Procurement Director no later than the date specified in the RFP timetable. Facsimiles will
be accepted at (305) 673-7851.
The City will issue replies to inquiries and any other corrections or amendments it deems
necessary in written addenda issued prior to the deadline for responding to the RFP.
Proposers should not rely on representations, statements, or explanations other than those
made in this RFP or in any addendum to this RFP. Proposers are required to acknowledge
the number of addenda received as part of their proposals. The proposer should verify with
the Procurement Division prior to submitting a proposal that all addenda have been
received.
F. PROPOSAL GUARANTY
N one required.
G. MODIFICATION/WITHDRAWALS OF PROPOSALS
A proposer may submit a modified proposal to replace all or any portion of a previously
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submitted proposal up until the proposal due date and time. Modifications received after the
proposal due date and time will not be considered.
Proposals shall be irrevocable until contract award unless withdrawn in writing prior to the
proposal due date or after expiration of 120 calendar days from the opening of proposals
without a contract award. Letters of withdrawal received after the proposal due date and
before said expiration date and letters of withdrawal received after contract award will not
be considered.
H. RFP POSTPONEMENT/CANCELLATION/REJECTION
The City may, at its sole and absolute discretion, reject any and all, or parts of any and all,
proposals; re-advertise this RFP; postpone or cancel, at any time, this RFP process; or waive
any irregularities in this RFP or in any proposals received as a result of this RFP.
I. COST INCURRED BY PROPOSERS
All expenses involved with the preparation and submission of proposals to the City, or any
work performed in connection therewith, shall be the sole responsibility ofthe proposer(s)
and not be reimbursed by the City.
J. VENDOR APPLICATION
Prospective proposers should register with the City of Miami Beach Procurement Division;
this will facilitate their receipt of future notices of solicitations when they are issued. All
proposer(s) must register prior to award; failure to register will result in the rejection ofthe
proposal. Potential proposers may contact the Procurement Division at (305) 673-7490 to
request an application.
Registration requires that a business entity complete a vendor application and submit an
annual administrative fee of $20.00. The following documents are required:
1. Vendor registration form
2. Commodity code listing
3. Articles of Incorporation - Copy of Certification page
4. Copy of Business or Occupational License
5. Notarized Florida Public Entity Crime Affidavit
It is the responsibility of the proposer to inform the City concerning any changes, including
new address, telephone number, services, or commodities.
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K. EXCEPTIONS TO RFP
Proposers must clearly indicate any exceptions they wish to take to any of the terms in this
RFP, and outline what alternative is being offered. The City, after completing evaluations,
may accept or reject the exceptions. In cases in which exceptions are rejected, the City may
require the proposer to furnish the services or goods originally described, or negotiate an
alternative acceptable to the City.
L. SUNSHINE LAW
Proposers are hereby notified that all information submitted as part of a response to this RFP
will be available for public inspection after opening of proposals, in compliance with Chapter
286, Florida Statutes, known as the "Government in the Sunshine Law".
M. NEGOTIATIONS
The City may award a contract on the basis of initial offers received, without discussion, or
may require proposers to give oral presentations based on their proposals. The City reserves
the right to enter into negotiations with the selected proposer, and if the City and the selected
proposer cannot negotiate a mutually acceptable contract, the City may terminate the
negotiations and begin negotiations with the next selected proposer. This process may
continue until a contract has been executed or all proposals have been rejected. No proposer
shall have any rights in the subject project or property or against the City arising from such
negotiations.
N. PROTEST PROCEDURE
Proposers that are not selected may protest any recommendations for contract award by
sending a formal protest letter to the Procurement Director, which letter must be received no
later than 5 calendar days after award by the City Commission. The Procurement Director
will notify the protester of the cost and time necessary for a written reply, and all costs
accruing to an award challenge shall be assumed by the protester. Any protests received after
5 calendar days from contract award by the City Commission will not be considered, and the
basis or bases for said protest shall be deemed to have been waived by the protester.
O. RULES; REGULATIONS; LICENSING REQUIREMENTS
Proposers are expected to be familiar with and comply with all Federal, State and local laws,
ordinances, codes, and regulations that may in any way affect the services offered, including
the Americans with Disabilities Act, Title VII ofthe Civil Rights Act, the EEOC Uniform
Guidelines, all EEO regulations and guidelines, and the Omnibus Transportation Act
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349CFR40 and Department of Transportation (DOT) regulations regarding alcohol and drug
testing. Ignorance on the part of the proposer will in no way relieve it from responsibility
for compliance.
P. DEFAULT
Failure or refusal of a proposer to execute a contract upon award by the City Commission,
or untimely withdrawal of a proposal before such award is made and approved, may result
in forfeiture of that portion of any proposal surety required as liquidated damages to the City;
where surety is not required, such failure may result in a claim for damages by the City and
may be grounds for removing the proposer from the City's vendor list.
Q. CONFLICT OF INTEREST
All proposers must disclose with their proposal the name(s) of any officer, director, agent,
or immediate family member (spouse, parent, sibling, child) who is also an employee of the
City of Miami Beach. Further, all proposers must disclose the name of any City employee
who owns, either directly or indirectly, an interest of ten (10%) percent or more in the
proposer or any of its affiliates.
R. PROPOSER'S RESPONSIBILITY
Before submitting proposal, each proposer shall make all investigations and examinations
necessary to ascertain all conditions and requirements affecting the full performance of the
contract. Ignorance of such conditions and requirements resulting from failure to make such
investigations and examinations will not relieve the successful proposer from any obligation
to comply with every detail and with all provisions and requirements of the contract
documents, or will be accepted as a basis for any claim whatsoever for any monetary
consideration on the part of the proposer.
S. RELATION OF CITY
It is the intent of the parties hereto that the successful proposer be legally considered to be
an independent contractor and that neither the proposer nor the proposer's employees and
agents shall, under any circumstances, be considered employees or agents of the City.
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SECTION II - SCOPE OF SERVICES
A. COMPREHENSIVE MEDICAL EV ALUA TIONS AND DRUG TESTING FOR PRE-
EMPLOYMENT AND PROMOTIONS
In accordance with established medical practice, the service provider, based on the
physical requirements of the job description provided by the City will conduct physical
examinations and drug testing as required for pre-employment on all new hires,
promotional exams for classifications where physical duties greatly vary, return-to-work
clearance, rehabilitation consideration, and other special services as required by the City
and/or local, state and federal laws and regulations.
Conduct and review laboratory results, x-rays, and other medical reports. Evaluates
reports and makes appropriate recommendations as needed. Reviews special medical
problems such as return from sick leave, on-duty injuries, disability, etc. Provides reports
and medical opinions when applicable. Counsels personnel and job applicants about
medical conditions and findings, and refers to appropriate follow-up care, when indicated.
Provides the City with a quarterly utilization summary report.
Results of the applicants physical exams shall be reported to the Human Resources
Department within 48 hours from the time the applicant is first seen.
Provide the City with a primary contact, or Project Manager who will be assigned to
address all questions and concerns of the City. This contact will be available for pre-
employment issues during all business hours.
Pre-employment medical examinations and drug testing will be available a minimum
of (5) five days per week, during business hours.
The City will have the ability to schedule same day or next day appointments for pre-
employment examinations.
B. INITIAL CARE FACILITY - WORKER'S COMPENSATION CLAIMS
The City is self-insured for workers' compensation and all adjusting and medical
management is provided by a contracted claim administrator/adjuster. The service provider
will serve as the Initial Care Facility as defined by Workers' Compensation Managed Care.
Authorization for initial, follow up and referral treatment will be obtained through the City's
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contracted Claims Administrator. The appropriate Workers' compensation from (DWC-8)
will be processed for all treatment.
All evaluations of treatment provided will be included in the employee's medical file and a
City-provided Injury Status Report form will be completed and sent to the City with a copy
to the employee. The status report will document the employee's condition and their work
status (see page 23 for a copy).
The service provider will, at the request of the City, provide evaluations of an injured
employee's ability to perform physical job functions.
The service provider will communicate regularly with the City's claim
administrator/adjusters regarding the status of all workers' compensation injuries.
The service provider will meet with the City's Risk Manager as needed to discuss the status
of any employee's claim or medical issues affecting the City's workers' compensation
program.
The service provider will submit a monthly report, or as requested to the City's Risk
Manager on the number of employees treated indicating the name, date, diagnosis, and
status of each visit.
C. MEDICAL RECORDS
Maintenance of health files for all City employees. Establishment and maintenance of
medical records regarding injuries, accidents, etc. related to employees in accordance with
all State and Federal laws, as applicable. Upon request of the Human Resources
Director, or his designee, the service provider will provide medical records within 48
hours of request. Medial records may only be released to the Human Resources Director,
Claims Coordinator or their designee. All requests and designees assignments must be
made and accepted in writing only. The selected provider, if different from the current
provider, will obtain all records from the current provider, and will maintain such records.
D. PSYCHIATRIC SERVICES
May be requested to hold an open door walk-in psychiatric clinic for all City employees
one day per week and at other times if necessary.
May be requested to attend staff conferences and conduct on-site training and observation
of new Police Officers and Firefighters and conduct ongoing meetings with all Police
Officers, other employees referred by the City, their supervisors and top echelon
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officers.
May be requested to review and research psychological factors relating to personnel,
especially public safety.
May be requested to conduct stress-reduction meetings with spouses of Police Officer
personnel and other employees referred by the City.
May be requested to conduct psychiatric consultations with general City employees, as
requested by the City.
E. IMMUNIZATION PROGRAM
Administer an intradermal test for Tuberculosis exposure on all employees as necessary
and requested. A chest x-ray may be done in lieu of an intradermal test for Tuberculosis.
Administer a Tetanus Toxoid Booster Immunization for Police Officers, Firefighters, Fire
Rescue personnel, Waste Collectors and Parks personnel. May include other occupations
depending on the job specification and/or individual requirements.
Administer Hepatitis B vaccine for those City employees with a potential risk exposure to
infected blood or body fluids, as determined by the City.
Other vaccines that may be required are measles, mumps and rubella vaccine or any
additional immunizations, tests, vaccines, etc. as required by local, state, or federal
requirements or by industry recommendations or guidelines.
Administer and make available, according to current Federal guidelines anti-viral
medications against the AIDS for emergency responders. These medications must be given
within two hours of a significant exposure to the AIDS virus. Our employees must have
access to the administration of anti-viral medications for the AIDS virus on a twenty-four
hour basis.
F. DRUG & ALCOHOL TEST PROGRAM
Ability to conduct a Drug and Alcohol Test Program as required by local, state and federal
law and regulations. This includes a certified substance abuse professional.
Conduct pre-employment drug testing on all applicants. Conduct promotional drug and
alcohol testing to all safety sensitive applicants before they actually perform safety
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sensitive functions for the first time.
Conduct random Drug & Alcohol testing on Police Officer personnel. Service provider
shall test yearly approximately 400 Police Officer personnel and conduct other random
drug and/or alcohol testing as may be specified by the City.
Conduct random, unannounced testing on safety sensitive employees who drive or
maintain vehicles that require Commercial Driver Licenses to operate, in compliance with
the Omnibus Transportation Act 349CFR40. Fifty percent of these employees will be
tested for drug abuse and 25 % for alcohol misuse. Note, the random rate for testing is
subject to change based on the DOT standards and union contracts.
Conduct testing on employees whose performance would have contributed to an accident
even if the employee was not cited for a moving traffic violation.
Conduct testing on employees when the City observes behavior or appearance that is
characteristic of drug use or abuse or alcohol use or misuse.
Conduct return-to-duty and follow-up testing for employees who violate the prohibited
alcohol or drug conduct standards. At least 6 unannounced tests must be conducted in the
first 12 months after an employee returns to duty. Follow-up testing may be extended
for up to 60 months following return-to-duty.
Provide these drug and alcohol testing services with licensed and certified personnel and
laboratories as required by Local, State, and Federal Law including, but not limited to,
Medical Review Officer (MR), and Substance Abuse Professional who is Florida Certified
Addiction Professional (CAP) and National Certified Addiction Counselor II (NCACII)
as required by D.G.T.
Conduct annual training for designated City employees on the Drug Free Workplace Act.
G. WELLNESS PROGRAM
Provide annual health screening and health education at a minimum of (2) two job site
areas within the City. Topics to be mutually agreed upon by the City and medical facility.
Provides information on drug use and treatment resources to safety sensitive drivers.
H. EMPLOYEE ASSISTANCE PROGRAM (EAP)
The service provider shall, at a minimum, provide the following services: Comprehensive
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professional services directed towards diagnosis and resolution of emotional or behavioral
problems affecting our employees.
It is intended that the program provide up to a total of three (3) visits per employee and/or
immediate family member per year before invoking insurance coverage or other
appropriate resources. This may include counseling, diagnosis, referral, and/or follow-up
for adolescents, family crisis counseling, counseling on issues including, but not limited to
finances, illness, legal problems, marital, stress and anxiety, violence, vocational counseling, and
substance abuse counseling as well as customary psychological or medical counseling.
The designated program must maintain regular office hours, Monday through Friday, and
be available to respond to emergencies twenty four hours per day, seven days per week.
The personnel assigned to provide these services must be licensed in the State of Florida
under Chapter 491 as a Mental Health Professional to do counseling.
I. FITNESS FOR DUTY EV ALUA TIONS
Evaluate employees' ability to continue employment in their current capacity and to assess
and recommend reasonable accommodation for other job opportunities for which they may
be qualified. This may include a physical examination, return to work evaluation and/or
any reports to be completed as requested by the City for fitness for duty. Evaluations are
to be completed within seven working days of the request.
Assist the City in the evaluation and verification of questionable family leave requests.
SECTION III - PROPOSAL FORMAT
Proposals must contain the following documents, each fully completed and signed as required.
Proposals which do not include all required documentation or are not submitted in the required
format, or which do not have the appropriate signatures on each document, may be deemed to be
non-responsive. Non-responsive proposals will receive no further consideration.
A. CONTENTS OF PROPOSAL
1. Table of Contents
Outline in sequential order the major areas ofthe proposal, including enclosures. All
pages must be consecutively numbered and correspond to the table of contents.
2. Proposal Points to Address:
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Proposer must respond to all minimum requirements listed below, and provide
documentation which demonstrates ability to satisfy all of the minimum qualification
requirements. Proposals which do not contain such documentation may be deemed
non-responSIve.
3. Price Proposal
Proposer must include price which will be charged to the City.
3. Acknowledgment of Addenda and Proposer Information forms (Section VIII)
4. Any other document required by this RFP. such as a Questionnaire or Proposal
Guaranty.
B. MINIMUM REQUIREMENTS / QUALIFICATIONS:
Must provide all services as indicated under "scope of services" section.
SECTION IV - EVALUATION/SELECTION PROCESS: CRITERIA FOR EVALUATION
The procedure for proposal evaluation and selection is as follows:
1. Request for Proposals issued.
2. Receipt of proposals.
3. Opening and listing of all proposals received.
4. An Evaluation Committee, appointed by the City Manager, shall meet to evaluate each
proposal in accordance with the requirements of this RFP. If further information is desired,
proposers may be requested to make additional written submissions or oral presentations to
the Evaluation Committee.
5. The Evaluation Committee shall recommend to the City Manager the proposal or proposals
acceptance of which the Evaluation Committee deems to be in the best interest of the City.
The Evaluation Committee shall base its recommendations on the following factors:
Ability to provide all requested services within designated time frames.
Cost of services provided.
Convenience of obtaining service and proximity to Miami Beach.
Overall reputation within the community.
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Experience level, credentials of assigned staff.
Designated contact availability.
Appointment/next day scheduling.
Number of appointments that can be scheduled daily.
6. After considering the recommendation(s) ofthe Evaluation Committee, the City Manager
shall recommend to the City Commission the proposal or proposals acceptance of which the
City Manager deems to be in the best interest of the City.
7. The City Commission shall consider the City Manager's recommendation(s) in light of the
recommendation(s) and evaluation of the Evaluation Committee and, if appropriate, approve
the City Manager's recommendation(s). The City Commission may reject City Manager's
recommendation(s) and select another proposal or proposals. In any case, City Commission
shall select the proposal or proposals acceptance of which the City Commission deems to be
in the best interest of the City. The City Commission may also reject all proposals.
8. Negotiations between the selected proposer and the City Manager take place to arrive at a
contract. If the City Commission has so directed, the City Manager may proceed to negotiate
a contract with a proposer other than the top-ranked proposer if the negotiations with the top-
ranked proposer fail to produce a mutually acceptable contract within a reasonable period of
time.
9. A proposed contract or contracts are presented to the City Commission for approval,
modification and approval, or rejection.
10. If and when a contract or contracts acceptable to the respective parties is approved by the
City Commission, the Mayor and City Clerk sign the contract(s) after the selected
proposer(s) has (or have) done so.
Important Note:
By submitting a proposal, all proposers shall be deemed to understand and agree that no
property interest or legal right of any kind shall be created at any point during the aforesaid
evaluation/selection process until and unless a contract has been agreed to and signed by both
parties.
SECTION V - GENERAL PROVISIONS
A. ASSIGNMENT
The successful proposer shall not enter into any sub-contract, retain consultants, or assign,
transfer, convey, sublet, or otherwise dispose of this contract, or of any or all of its right,
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title, or interest therein, or its power to execute such contract to any person, firm, or
corporation without prior written consent of the City. Any unauthorized assignment shall
constitute a default by the successful proposer.
B. INDEMNIFICATION
The successful proposer shall be required to agree to indemnify and hold harmless the City
of Miami Beach and its officers, employees, and agents, from and against any and all actions,
claims, liabilities, losses and expenses, including but not limited to attorneys' fees, for
personal, economic or bodily injury, wrongful death, loss of or damage to property, in law
or in equity, which may arise or be alleged to have arisen from the negligent acts or
omissions or other wrongful conduct of the successful proposer, its employees, or agents in
connection with the performance of service pursuant to the resultant Contract; the successful
proposer 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
expended by the City in the defense of such claims and losses, including appeals.
C. TERMINATION FOR DEFAULT
If through any cause within the reasonable control of the successful proposer, it shall fail to
fulfill in a timely manner, or otherwise violate any of the covenants, agreements, or
stipulations material to the Agreement, the City shall thereupon have the right to terminate
the services then remaining to be performed by giving written notice to the successful
proposer of such termination which shall become effective upon receipt by the successful
proposer of the written termination notice.
In that event, the City shall compensate the successful proposer in accordance with the
Agreement for all services performed by the proposer prior to termination, net of any costs
incurred by the City as a consequence of the default.
Notwithstanding the above, the successful proposer shall not be relieved of liability to the
City for damages sustained by the City by virtue of any breach of the Agreement by the
proposer, and the City may reasomibly withhold payments to the successful proposer for the
purposes of set off until such time as the exact amount of damages due the City from the
successful proposer is determined.
D. TERMINATION FOR CONVENIENCE OF CITY
The City may, for its convenience, terminate the services then remaining to be performed at
any time without cause by giving written notice to successful proposer of such termination,
which shall become effective thirty (30) days following receipt by proposer of such notice.
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In that event, all finished or unfinished documents and other materials shall be properly
delivered to the City. If the Agreement is terminated by the City as provided in this section,
the City shall compensate the successful proposer in accordance with the Agreement for all
services actually performed by the successful proposer and reasonable direct costs of
successful proposer for assembling and delivering to City all documents. No compensation
shall be due to the successful proposer for any profits that the successful proposer expected
to earn on the balanced of the Agreement. Such payments shall be the total extent of the
City's liability to the successful proposer upon a termination as provided for in this section.
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SECTION VI - SPECIAL TERMS AND CONDITIONS
ACCEPTANCE OR REJECTION OF PROPOSALS
The City of Miami Beach reserves the right to reject the proposal from any person or firm who has
previously failed in the proper performance of an award or to deliver on time contracts of a similar nature
or who is not in a position to perform properly under this award.
AMERICAN'S WITH DISABILITIES ACT
The proposer agrees to adhere to and be governed by all applicable requirements of the laws listed below
including, but not limited to, those provisions pertaining to employment, provision of programs and services,
transportation, communications, access to facilities, renovations, and new construction.
The Americans with Disabilities Act of 1990 (ADA): Pub. L. 101-336, 104 Stat 327, 42 U.S.C. 12101-12213
and 47 U.S.c. Sections 225 and 611 including Title I, Employment; Title II, Public Services; Title III, Public
Accommodations and Services Operated by Private Entities; Title IV, Telecommunications; and Title V,
Miscellaneous Provisions.
The Rehabilitation Act of 1973: 29 U .S.C. Section 794.
The Federal Transit Act, as amended: 49 U.S.C. Section 1612.
The Fair Housing Act as amended: 42 U .S.C. Section 3601-3631.
The proposer must complete and submit the City's Disability Non-Discrimination Affidavit (Attachment D).
In the event Contractor is found to be in non-compliance with the provisions of the Affidavit, the City may
impose such sanctions as it may determine to be appropriate, including but not limited to, withholding of
payment to Contractor, under the Agreement until compliance and/or cancellation, termination or suspension
of the Agreement pursuant to this Section, Contractor shall not be relieved of liability to the City for damages
sustained by the City by virtue of Contractor's breach of the Agreement.
ASSIGNMENT
The successful proposer( s) shall not enter into any sub-contract, retain consultants, or assign,
transfer, convey, sublet or otherwise dispose of this contract, or of any or all of its right, title, or
interest therein, or its power to execute such contract to any person, company, or corporation without
prior written consent of the City.
AVAILABILITY OF FUNDS
The obligations of the City of Miami Beach under this award are subject to the availability of funds
lawfully appropriated for its purpose by the State of Florida and the City Commission.
EQUAL EMPLOYMENT AND OPPORTUNITY STATEMENT
The City of Miami Beach believes in Equal Opportunity practices which conform to both the spirit
and the letter of all laws against discrimination and is committed to nondiscrimination because of
age, citizenship or intending citizenship status, color, disability, familial status, gender, marital
status, national origin, race, religion, or sexual orientation.
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In connection with the performance of the Agreement, the provider shall not discriminate against
any employee or applicant for employment because of age, citizenship or intending citizenship
status, color, disability, familial status, gender, marital status, national origin, race, religion, or sex
orientation. Such action shall include, but not be limited to the following: employment, upgrading,
demotion, or termination; recruitment or recruitment advertising; layoff or termination; rates of pay,
or other forms of compensation; and selection for training, including apprenticeship.
ESTIMATES OF SERVICE
This RFP provides estimates of the anticipated volume of applicants to be tested. This is for the
proposer's guidance only and no guarantee is given or implied as to the actual number of individuals
to whom services may be provided. It should be clearly understood that these estimates in no way
constitute a guarantee of the level of effort that will be requested of the successful proposer.
INSURANCE REQUIREMENTS
The successful bidder/contractor will be required to maintain in full force and effect for the duration
of the contract:
I. A policy of professional liability covering the services and activities required in this contract
with minimum limits of $2,000,000.
2. Workers Compensation & Employers Liability as required per Florida statutes.
3. Thirty (30) days written notice of cancellation or substantial modification in the insurance
coverage must be given to the City by the provider and his insurance company.
4. The insurance must be furnished by insurance companies authorized to do business in the
State of Florida and approved by the City's Risk Manager.
5. Original certificates of insurance for the above coverage must be submitted to the City's Risk
Manager for approval prior to any work commencing. These certificates will be kept on file
in the office of the Risk Manager. Upon each anniversary or expiration of the policy, a new
certification and policy must be presented to the Risk Manager.
6. The provider is responsible for obtaining and submitting all insurance certificates.
7. Risk Management has the right to modify coverage as deemed necessary.
All insurance policies must be issued by companies authorized to do business under the laws of the
State of Florida. The companies must be 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 in the latest
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edition of A.M. Best Company, Oldwick, New Jersey, or its equivalent, subject to the approval of
the City's Risk Manager.
Compliance with the foregoing requirements shall not relieve the provider of the liabilities and
obligations under any portion of the Agreement, and the City shall have the right to obtain from the
provider, specimen copies of the insurance policies in the event that submitted certificates of
insurance are inadequate to ascertain compliance with required coverage.
All of provider's certificates, above, 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.
Unless directed by the City otherwise, the provider shall not commence any services pursuant to this
Agreement until the City has received and approved, in writing, certificates of insurance showing
that these requirements (in their entirety) have been met and provided for. Alternate coverage or any
changes to these requirements which may be necessary will be determined by and are subject to prior
approval ofthe City Manager and/or his/her designee. Insurance requirements are subject to change.
PROJECT MANAGEMENT
The provider shall appoint a qualified individual acceptable to the City to serve as Project Manager
for the services who shall be fully responsible for the day-to-day activities under this Agreement,
and who shall serve as the primary contact for the City's Project Coordinator.
PROPOSAL CERTIFICATION
Submission of a signed proposal is proposer's certification that the proposer will accept any awards
made as a result of said submission at the prices and terms contained therein. The prices quoted in
the proposal shall remain in effect for at least 120 days.
SANCTIONS FOR NONCOMPLIANCE WITH NONDISCRIMINATION PROVISIONS
In the event of the Provider's noncompliance with the nondiscrimination provisions of the
Agreement, the City shall impose such Agreement Sanctions as the City or the State of Florida may
determine to be appropriate, including but not limited to withholding of payments to the provider
under the Agreement until the provider complies and/or cancellation, termination or suspension of
the Services, in whole or in part. In the event the City cancels or terminates the services pursuant
to this Section the rights and obligations of the parties shall be the same as provided under
Termination for Convenience of City.
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SOLE PROPERTY
The successful proposer will be prohibited from publishing or releasing any information related to
the requested services without the prior written permission of the City. All tests, evaluations,
reports, and other materials and documents resulting from this contract will remain the sole property
of the City; shall not be disposed of without specific written authorization from the City; and shall
be used by the City in any manner without any additional charge. Such materials shall include, but
not be limited to, electronically produced and/or stored data, prepared by the provider pursuant to
the contract, and will be given to the City in a format suitable for reuse by the City.
TAXES
The City is exempt from Federal Excise and State of Florida Sales Tax. State Sales Tax and Use Tax
Certificate Number is 04-00097-09-23.
ADDITIONAL INFORMATION
Questions regarding these specifications must be in writing and submitted to:
Procurement Division Office
1700 Convention Center Drive
Miami Beach, FI 33139
Telephone - (305) 673-7490
Should any questions or responses require revisions to the specifications as originally published,
such revisions will be by formal amendment only.
SECTION VII - ATTACHMENTS
SUMMARY OF CURRENT SERVICES WHICH THE PROVIDER IS EXPECTED TO
ADMINISTER:
1. Physical Examination
Head and Neck
Breast
Chest and Lungs
Spine and Back
Cardiovascular
Abdomen
Rectal
Extremities
Skin
Neurological Examination
Male Genitalia
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Anthropometric Measurements
- Blood Pressure
- Heart Rate
- Height
- Weight
2. Laboratory Work-up
Hematology Panel
Blood Chemistry
Serology
Urinalysis
HBSAG (Hepatitis B screen
for certain positions)
3. Chest X-Ray
4. Electrocardiogram (EKG)
5. Vision Test
6. Colon-Rectal Cancer Screen
7. Tonometry Test
8. Audio Check (Hearing)
9. Pulmonary Function Test
(Vital lung capacity)
10. Functional Capacity Evaluation
11. Immunization Program
Intradermal Test for Tuberculosis
Exposure (PPD)
Tetanus Toxoid Booster
Hepatitis B Vaccine
Measles, Mumps and
Rubella Vaccine
12. Workers' Compensation Program
13. Psychiatric Services
14. Employee Assistance Program
15. Get Fit Program (Wellness Program)
16. Medical Record Services
17. Urinalysis Drug Testing
18. Drug Confirmation Test (GS/MS)
19. Blood Alcohol Test
20. Treadmill Stress Testing
21. Sigmoidoscopy
22. Special Examinations
Firefighters and Police*
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Applicant Examination*
Promotional Examination*
* Comprehensive physical exam per above with additional components according to state
standards.
HISTORY OF JOB-RELATED INJURIES
1986 / 87 527
1987 / 88 577
1988 / 89 524
1989/90 582
1990/ 91 497
1991 / 92 544
1992 / 93 561
1993 / 94 576
1994 / 95 618
1995 / 96 608
1996 / 97 598
* All job related injuries that required first aid or recorded for purposes of record keeping only.
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CITY OF MIAMI BEACH
MEDICAL TREATMENT PASS
(For Job Related Injury)
Date:
Time:
Employee:
( First
Middle Initial
Last )
Department:
Supervisor:
Phone:
Signature:
If any questions call Risk Management Division: 673-7014
CITY OF MIAMI BEACH
Date:
Employee:
( First
Middle Initial
Last)
Department:
Supervisor:
Phone:
Date of Accident:
Physician:
Diagnosis:
Work Status:
Return Visit or Referral:
SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(a),
FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES
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THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICIAL AUTHORIZED TO
ADMINISTER OATHS.
1. This sworn statement is submitted to
by
(print individual's name and title)
for
(print name of entity submitting sworn statement)
whose business address is
and (if applicable) its Federal Employer Identification Number (FEIN) is
(If the entity has no FEIN, include the Social Security Number of the individual signing this sworn
statement: .)
2. I understand that a "public entity crime" as defined in Paragraph 287.133(1)(g), Florida Statutes.
means a violation of any state or federal law by a person with respect to and directly related to the
transaction of business with any public entity or with an agency or political subdivision of any other
state or of the United States, including, but not limited to, any bid or contract for goods or services
to be provided to any public entity or an agency or political subdivision of any other state or of the
United States and involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or
material misrepresentation.
3. I understand that "convicted" or "conviction" as defined in Paragraph 287.133(1)(b), Florida Statutes.
means a finding of guilt or a conviction of a public entity crime, with or without an adjudication of
gui l t, in any federal or state trial court of record relating to charges brought by indictment or
information after July 1, 1989, as a result of a jury verdict, non-jury trial, or entry of a plea of
guilty or nolo contendere.
4. understand that an "affiliate" as defined in Paragraph 287.133(1)(a), Florida Statutes. means:
1. A predecessor or successor of a person convicted of a public entity crime; or
2. An entity under the control of any natural person who is active in the management of the
entity and who has been convicted of a publ ic entity crime. The term "affi l iate" includes those
officers, directors, executives, partners, shareholders, employees, members, and agents who
are active in the management of an affi l iate. The ownership by one person of shares
constituting a controlling interest in another person, or a pooling of equipment or income
among persons when not for fair market value under an arm's length agreement, shall be a prima
facie case that one person controls another person. A person who knowingly enters into a joint
venture with a person who has been convicted of a public entity crime in Florida during the
preceding 36 months shall be considered an affiliate.
5. I understand that a "person" as defined in Paragraph 287.133(1)(e), Florida Statutes. means any natural
person or entity organized under the laws of any state or of the United States with the legal power to
enter into a binding contract and which bids or applies to bid on contracts for the provision of goods
or services let by a public entity, or which otherwise transacts or applies to transact business with
a publ ic entity. The term "person" includes those officers, directors, executives, partners,
shareholders, employees, members, and agents who are active in management of an entity.
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6. Based on information and belief, the statement which I have marked is true in relation to the entity
submitting this sworn statement. (indicate which statement applies.)
Neither the entity submitting this sworn statement, nor any of its officers, directors,
executives, partners, shareholders, employees, members, or agents who are active in the
management of the entity, nor any affiliate of the entity have been charged with and convicted
of a public entity crime subsequent to July 1, 1989.
The entity submitting this sworn statement, or one or more of the officers, directors,
executives, partners, shareholders, employees, members, or agents who are active in the
management of the entity, or an affiliate of the entity has been charged with and convicted
of a public entity crime subsequent to July 1, 1989.
The entity submitting this sworn statement, or one or more of its officers, directors,
executives, partners, shareholders, employees members, or agents who are active in the
management of the entity, or an affiliate of the entity has been charged with and convicted
of a public entity crime subsequent to July 1, 1989. However, there has been a subsequent
proceeding before a Hearing Officer of the State of Florida, Division of Administrative
Hearings and the Final Order entered by the Hearing Officer determined that it was not in the
public interest to place the entity submitting this sworn statement on the convicted vendor
list. (attach a copy of the final order)
I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE PUBLIC ENTITY IDENTIFIED
IN PARAGRAPH 1 (ONE) ABOVE IS FOR THAT PUBLIC ENTITY ONLY AND, THAT THIS FORM IS VALID THROUGH DECEMBER 31
OF THE CALENDAR YEAR IN WHICH IT IS FILED. I ALSO UNDERSTAND THAT I AM REQUIRED TO INFORM THE PUBLIC ENTITY
PRIOR TO ENTERING INTO A CONTRACT IN EXCESS OF THE THRESHOLD AMOUNT PROVIDED IN SECTION 287.017, FLORIDA
STATUTES FOR CATEGORY TWO OF ANY CHANGE IN THE INFORMATION CONTAINED IN THIS FORM.
(Signature)
(date)
STATE OF
COUNTY OF
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
who, after first being sworn by me, affixed his/her signature
day of 19
in the space provided above on this
NOTARY PUBLIC
My Commission Expires:
FORM PUR 7068 (Rev. 06/05/91)
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SECTION VIII - PROPOSAL DOCUMENTS TO BE COMPLETED
AND RETURNED TO CITY
Please complete the following chart. Indicate whether these items will be included within the
contract price, offered at an additional cost to the contract price, or not provided by your
facility.
SERVICES
1. Physical Examination
Head and Neck
Breast
Chest and Lungs
Spine and Back
Cardiovascular
Abdomen
Rectal
Extremities
Skin
Neurological Examination
Male Genitalia
Anthropometric Measurements
- Blood Pressure
- Heart Rate
- Height
- Weight
2. Laboratory Work-up
Hematology Panel
Blood Chemistry
Serology
Urinalysis
HBSAG (Hepatitis B screen
for certain positions)
3. Chest X-Ray
4. Electrocardiogram (EKG)
5. Vision Test
6. Colon-Rectal Cancer Screen
7. Tonometry Test
Included in
Contract Price
Offered for
Additional Fee
(provide dollar
amount)
Not Provided
By This Facility
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8. Audio Check (Hearing)
9. Pulmonary Function Test
(Vital lung capacity)
10. Functional Capacity Evaluation
SERVICES
Included in
Contract Price
11. Immunization Program
Intradermal Test for Tuberculosis
Exposure (PPD)
Tetanus Toxoid Booster
Hepatitis B Vaccine
Measles, Mumps and
Rubella Vaccine
12. Workers' Compensation Program
13. Psychiatric Services
14. Employee Assistance Program
15. Get Fit Program (Wellness Program)
16. Medical Record Services
17. Urinalysis Drug Testing
18. Drug Confirmation Test (GS/MS)
19. Blood Alcohol Test
20. Treadmill Stress Testing
21. Sigmoidoscopy
22. Special Examinations
Firefighters and Police
Applicant Examination*
Firefighter and Police
Promotional Examination *
TOTAL COST OF CONTRACT:
Offered for
Additional Fee
(provide dollar
amount)
Not Provided
By This Facility
List any other special services, not stated which the service provider will supply:
* Comprehensive physical exam per above with additional components according to state
standards.
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OPERATIONAL PLAN OF PROVIDING SERVICES TO APPROXIMATELY 1,642 CITY
OF MIAMI BEACH EMPLOYEES, AND AT LEAST 500 POTENTIAL EMPLOYEES AS
FOLLOWS:
A. COMPREHENSIVE MEDICAL EVALUATIONS AND PRE-EMPLOYMENT DRUG
TESTING:
1. Physical Examinations for Pre-Employment on all new hires and Promotional
exams for classifications where physical duties greatly vary. (In 1997, there were
approximately 400 pre-employment examinations).
2. X-rays and all Laboratory tests as required (No estimates were available).
3. Ability to furnish the Human Resources Department with a quarterly utilization
summary report.
4. Ability to meet the 48 hours deadline for results to be reported to the Human
Resources Department.
5. Other optional services.
6. Primary contact name, title, availability, and resume.
7. Days, hours of availability of pre-employment examinations.
8. Ability to provide same day, next day appointment scheduling, and waiting time.
9. Approximate applicant waiting time. Maximum number of applicants that
can be seen daily for pre-employment/promotional testing.
B. EVALUATION & TREATMENT OF WORKERS' COMPENSATION CLAIMS
(OPTIONAL)
1. Describe your understanding of the authorization process before evaluating any
employee.
2. Explain what procedure will be followed in case the provider's Emergency Room
is the only office open.
3. Describe the process of including all evaluations of treatment in the employee's
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medical file and notifying the City.
4. Describe your understanding of return to full duty releases.
5. System for evaluating injured employee's ability to perform physical job functions.
6. Plans for communicating and obtaining approval from the City's claim
administrator / adjusters regarding all workers' compensation claims.
7. Plans for submitting monthly reports to the City's Risk Manager.
8. Primary contact name, title, availability, and resume.
C. MEDICAL RECORDS:
1. Description of System for Maintenance of health files for all City Employees.
2. Description for Establishment and Maintenance of all medical records; this
includes all necessary typing and preparation of all insurance forms, as required.
3. Description for Establishment and Maintenance of employee records; this includes
filing, maintaining and collecting all data pertinent to each employee.
4. Primary contact name, title, availability, and resume.
5. Description of procedures to ensure security, confidentiality, accuracy and space
that will be provided to store new records, and maintain all old records from
previous providers.
6. Record retrieval time for City requests.
D. PSYCHIATRIC SERVICES:
1. Plans to interview and evaluate Police Officers and Firefighters, and other
applicants, as required by the City.
2. Plan for providing open door walk-in psychiatric clinic care for all City employees.
Explain hours and days per week service is available and location of facility to
provide service.
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3. Ability to attend staff conferences and conduct on-site training and observation of
new Police Officers and Firefighters, as required by the City.
4. Program to conduct ongoing meetings with all Police Officers, supervisors, and top
echelon officers. Frequency of such to be no less than quarterly.
5. Ability to review and research psychological factors relating to personnel.
6. Plans to conduct psychiatric consultations with general City employees, as
requested by the City.
7. Primary contact name, title, availability, and resume.
E. IMMUNIZATION PROGRAM
1. Plans to administer intradermal testing for Tuberculosis exposure on all employees,
as requested.
2. Plans to administer a Tetanus Toxoid Booster Immunization Program. Please
specify what job classifications will be involved.
3. Plans to administer Hepatitis B vaccine, as determined by the City.
4. Explain what other vaccines may be available through the contract being offered.
5. Primary contact name, title, availability, and resume.
6. Plans to administer anti-viral medication for emergency responders. This plan
must comply with Federal guidelines, and include 24 hour access, and the ability
to start medication within two hours of a significant exposure to the AIDS virus.
F. DRUGS & ALCOHOL TEST PROGRAM
1. Describe your Drug & Alcohol Testing Program, as required by local, state and
federal law and regulations.
2. Plans for drug & alcohol testing at a yearly rate of approximately 400 Police
Officer personnel.
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3. Describe your plans for conducting random unannounced testing on all safety
sensitive employees who drive or maintain vehicles that require commercial driver
licenses. Fifty percent of the employees who are required to possess a commercial
driver's license, or approximately seventy-five employees, shall be tested for drug
abuse and twenty five percent for alcohol misuse.
4. Describe your testing procedures for employees whose performance would have
contributed to an accident even if the employee was not cited for a moving
violation.
5. Plans for testing employees which the City observes behavior or appearance that
is characteristic of drug user or abuse or alcohol use or misuse.
6. Describe how follow-up and return-to-duty testing will be administered.
7. Primary contact name, title, availability, and resume.
8. Physical description of facility and flow to ensure privacy and control of test.
9. Describe what will be tested for, at what levels, how the tests will be conducted,
and how the results will be reported, etc.
G. WELLNESS PROGRAM
1. Describe what types of health screenings are available to employees. Specify any
additional cost that may not be included in the contract.
2. Describe how lectures will be performed, location and method of publication used
to announce topics.
3. Primary contact name, title, availability, and resume.
H. EMPLOYEE ASSISTANCE PROGRAM lEAP):
1. Plans to provide comprehensive professional counseling directed towards diagnosis
and resolution of behavioral problems affecting City of Miami Beach employees.
2. Plans for providing up to three (3) visits per employee and/or immediate family
member per year before invoking insurance coverage or other appropriate
resources.
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3. Abilities to accommodate visits which include diagnosis, counseling, referral,
and/or follow-up for adolescent, family crisis counseling, counseling on issues
including, but not limited to finances, illness, legal problems, marital, stress and
anxiety, violence, substance abuse or vocational counseling as well as customary,
psychological or medical counseling.
4. Abilities for Referral Services to other appropriate professional services when
necessary.
5. Availability of crisis services to employees during non-working hours.
6. Ability for confidential maintenance of client records. Describe how this is to be
accomplished.
7. Primary contact name, title, availability, and resume.
8. Time it will take for an employee to reach someone, make an appointment,
waiting time at scheduled appointment.
I. NEW EMPLOYEES, CONFIDENTIALITY, AND COMMUNICATION
1. Qualifications of new people working under this contract will be submitted to the
City in writing for approval prior to them doing any work under this contract.
Submit list of all employees that will be working under the current contract and
any intention for additional personnel, and back-up personnel for each function.
2. Plans on how the provider will insure the security, confidentiality, chain of
custody of exams, tests, records, results, correspondence, etc. (especially records,
employee assistance program and drug testing)
3. For each section under scope of services, describe how results will be
communicated to the City.
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DISABILITY NONDISCRIMINATION AFFIDAVIT
CONTRACT REFERENCE
NAME OF FIRM, CORPORATION, OR ORGANIZATION
AUTHORIZED AGENT COMPLETING AFFIDAVIT
PHONE NUMBER (
POSITION
I,
, being duly first sworn state:
That the above named firm, corporation or organization is in compliance with and agrees to continue to comply with, and
assure that any subcontractor, or third party contractor under this project complies with all applicable requirements ofthe laws
listed below including, but not limited to, those provisions pertaining to employment, provision of programs and services,
transportation, communications, access to facilities, renovations, and new construction.
The Americans with Disabilities Act of 1990 (ADA): Pub. L. 101-336, 104 Stat 327, 42 U.S.C. 12101-12213 and 47 U.S.C.
Sections 225 and 611 including Title I, Employment; Title II, Public Services; Title III, Public Accommodations and Services
Operated by Private Entities; Title IV, Telecommunications; and Title V, Miscellaneous Provisions.
The Rehabilitation Act of 1973: 29 U.S.c. Section 794.
The Federal Transit Act, as amended: 49 U.S.c. Section 1612.
The Fair Housing Act as amended: 42 U .S.c. Section 3601-3631.
Signature
Date
SUBSCRIBED AND SWORN TO (or affirmed) before me on
by
(Date)
(Affiant)
He/She is personally known to me or has presented
identification.
as
(Type of identification)
(Signature of Notary)
(Serial Number)
(Print or Stamp Name of Notary)
(Expiration Date)
Notary Public
(State)
Notary Seal
The City of Miami Beach will not award a contract to any firm, corporation or organization that fails to complete and submit
this Affidavit with the firm, corporation or organization's bid or proposal or fails to have this Affidavit on file with the City
of Miami Beach.
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PROPOSER INFORMA TJON
Submitted by:
Proposer (Entity):
Signature:
Name (Typed):
Address:
City/State:
Telephone:
Fax:
It is understood and agreed by proposer that the City reserves the right to reject any and all proposals, to make
awards on all items or any items according to the best interest of the City, and to waive any irregularities in the
RFP or in the proposals received as a result of the RFP. It is also understood and agreed by the proposer that
by submitting a proposal, proposer shall be deemed to understand and agree than no property interest or legal
right of any kind shall be created at any point during the aforesaid evaluation/selection process until and unless
a contract has been agreed to and signed by both parties.
(Authorized Signature)
(Date)
(Printed Name)
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REQUEST FOR PROPOSALS NO. 42 - 97 / 02
ACKNOWLEDGMENT OF ADDENDA
Directions: Complete Part I or Part II, whichever applies.
Part I: Listed below are the dates of issue for each Addendum received in connection with this RFP:
Addendum No. I, Dated
Addendum No.2, Dated
Addendum No.3, Dated
Addendum No.4, Dated
Addendum No.5, Dated
Part II:
No addendum was received in connection with this RFP.
Verified with Procurement staff
Name of staff
Date
(Proposer - Name)
(Date)
(S ignature )
RFP NO.:
DATE:
42 - 97 / 02
4 / 2 / 98
CITY OF MIAMI BEACH
35
DECLARA nON
TO: Sergio Rodriguez
City Manager
City of Miami Beach, Florida
Submitted this _ day of
,1998.
The undersigned, as proposer, declares that the only persons interested in this proposal are named herein; that no other
person has any interest in this proposal or in the Contract to which this proposal pertains; that this proposal is made
without connection or arrangement with any other person; and that this proposal is in every respect fair and made in
good faith, without collusion or fraud.
The proposer agrees if this proposal is accepted, to execute an appropriate City of Miami Beach document for the
purpose of establishing a formal contractual relationship between the proposer and the City of Miami Beach, Florida,
for the performance of all requirements to which the proposal pertains.
The proposer states that the proposal is based upon the documents identified by the following number: RFP No.
42 - 97/02
SIGNATURE
PRINTED NAME
TITLE (IF CORPORATION)
RFP NO.:
DATE:
42 - 97 / 02
4 / 2 / 98
CITY OF MIAMI BEACH
36
Proposer's Name:
Principal Office Address:
Official Representative:
Individual
Partnership (Circle One)
Corporation
If a Corporation. answer this:
When Incorporated:
In what State:
If Foreil:n Corporation:
Date of Registration with
Florida Secretary of State:
Name of Resident Agent:
Address of Resident Agent:
President's Name:
Vice-President's Name:
Treasurer's Name:
Members of Board of Directors:
Ouestionnaire (continued)
If a Partnership:
Date of organization:
General or Limited Partnership*:
RFP NO.:
DATE:
42 - 97 / 02
4 / 2 / 98
QUESTIONNAIRE
CITY OF MIAMI BEACH
37
Name and Address of Each Partner:
NAME
ADDRESS
* Designate general partners in a Limited Partnership
I. Number of years of relevant experience in operating similar business:
2. Have any similar agreements held by proposer for a project similar to the proposed project ever been
canceled?
Yes ( )
No ( )
If yes, give details on a separate sheet.
3. Has the proposer or any principals of the applicant organization failed to qualify as a responsible
bidder, refused to enter into a contract after an award has been made, failed to complete a contract
during the past five (5) years, or been declared to be in default in any contract in the last 5 years?
If yes, please explain:
Ouestionnaire (continued)
4. Has the proposer or any of its principals ever been declared bankrupt or reorganized under Chapter
11 or put into receivership?
If yes, give date, court jurisdiction, action taken, and any other explanation deemed necessary.
5. Person or persons interested in this bid and Qualification Form _(have) (have not) been
convicted by a Federal, State, County, or Municipal Court of any violation of law, other than traffic
violations. To include stockholders over ten percent (10%). (Strike out inappropriate words)
Explain any convictions:
6. Lawsuits (any) pending or completed involving the corporation, partnership or individuals with more
than ten percent (10%) interest:
RFP NO.:
DATE:
42 - 97 / 02
4 / 2 / 98
CITY OF MIAMI BEACH
38
A. List all pending lawsuits:
B. List all judgments from lawsuits in the last five (5) years:
C. List any criminal violations and/or convictions of the proposer and/or any of its principals:
7. Conflicts of Interest. The following relationships are the only potential, actual, or perceived conflicts
of interest in connection with this proposal:
(If none, so state.)
RFP NO.:
DATE:
42 - 97 / 02
4 / 2 / 98
CITY OF MIAMI BEACH
39
The proposer understands that information contained in this Questionnaire will be relied upon by the City in
awarding the proposed Agreement and such information is warranted by the proposer to be true. The
undersigned proposer agrees to furnish such additional information, prior to acceptance of any proposal
relating to the qualifications of the proposer, as may be required by the City Manager.
The proposer further understands that the information contained in this questionnaire may be confirmed
through a background investigation conducted by the Miami Beach Police Department. By submitting this
questionnaire the proposer agrees to cooperate with this investigation, including but not necessarily limited to
fingerprinting and providing information for credit check.
WITNESSES:
IF INDIVIDUAL:
Signature
Signature
Print Name
Print Name
WITNESSES:
IF PARTNERSHIP:
Signature
Print Name of Firm
Print Name
Address
By:
Signature
(General Partner)
(Print Name)
(Print Name)
WITNESSES:
IF CORPORATION:
Signature
Print Name of Corporation
Print Name
Address
By:
President
Attest:
Secretary
(CORPORATE SEAL)
RFP NO.:
DATE:
42 - 97 / 02
4 / 2 / 98
CITY OF MIAMI BEACH
40
:;ITY OF MIAMI BEACH
:ITY HALL 1700 CONVENTION CENTER DRIVE MIAMI BEACH, FLORIDA 33139
. i . .
COMMISSION MEMORANDUM NO. ~ ~l.. -9..8
FROM:
Mayor Neisen O. Kasdin and
Members of the C~'ty Co '~sion
Sergio Rodriguez
City Manager
DATE: May 6,1998
TO:
SUBJECT: A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE
CITY OF MIAMI BEACH, FLORIDA, AUTHORIZING THE
ADMINISTRATION TO PROCEED WITH THE ISSUANCE OF A
REQUEST FOR PROPOSALS SEEKING THE SERVICES OF A PROVIDER
TO SUPPLY COMPREHENSIVE MEDICAL EVALUATIONS, MEDICAL
RECORDS RETENTION, PSYCHIATRIC SERVICES, AN
IMMUNIZATION PROGRAM, A DRUG AND ALCOHOL TESTING
PROGRAM, A WELLNESS PROGRAM, AN EMPLOYEE ASSISTANCE
PROGRAM, AND TO PROVIDE EVALUATION AND TREATMENT OF
WORKERS' COMPENSATION CLAIMS, FOR THE CITY OF MIAMI
BEACH EMPLOYEES AND/OR EMPLOYMENT APPLICANTS.
ADMINISTRATION RECOMMENDATION:
Adopt the resolution.
BACKGROUND:
In 1994, the City solicited proposals, pursuant to Request for Proposals No. 33 - 94/97 (RFP), for
a service provider to supply comprehensive medical evaluations, medical records retention,
psychiatric services, an immunization program, a drug and alcohol testing program, a wellness
program, an employee assistance program, and evaluation and treatment of workers' compensation
claims for the City of Miami Beach employees and/or employment applicants. A contract and its
extensions with the current provider will expire on September 30, 1998. On April 1, 1998 the
Request for Proposal went before the Commission. The Commission referred the Request for
Proposal to the Health Advisory Committee. The Committee suggested more general language be
added for random drug and a1chohol testing to include those employees involved in an accident,
regardless of whether or not they were ticketed. The Committee also suggested specific language
be added to include Federal guidelines for emergency responders who may require anti-viral
medication for exposure. These changes were incorporated into the current proposal.
The primary user of this contract, the City's Human Resources Department, has recommended that
the services be continued. These services allow the City to protect the psychological and physical
health of all employees and potential employees and to provide for the physical safety and well being
of citizens, visitors, and employees. Through this contract, a professional and experienced provider
AGENDA ITEM
~lI
5-L-9B-
DATE
will conduct physical examinations and drug testing on all hires, as required for pre-employment,
to maintain a drug-free work environment; promotional exams for classifications where physical
duties vary greatly; return to work clearance evaluations; rehabilitation evaluations; and other special
services as required by the City and/or local, state and federal laws and regulations. The successful
proposer will also provide for the maintenance and retention of all medical records, evaluate
applicants and employees as required by the City, administer vaccines for City employees as needed,
conduct random Drug and Alcohol testing based on the Department of Transportation standards and
union contracts, provide for a wellness program, provide for an Employee Assistance Program
(EAP) and evaluate and treat workers' compensation claims.
CONCLUSION:
It is recommended that the Mayor and Commission authorize the Administration to proceed with
the issuance of the Request for Proposals seeking the services of a provider to supply
comprehensive medical evaluations, medical records retention, psychiatric services, an immunization
program, a drug and alcohol testing program, a wellness program, an employee assistance program,
and evaluation and treatment of workers' compensation claims for the City of Miami Beach
employees and/or employment applicants.
SRJR WB/TCAlLG/lg
f:\huma\$all\comm. -mem \miahrt98. wpd