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2000-24067 RESO RESOLUTION NO. 2000-24067 A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, ACCEPTING THE RANKING OF PROPOSALS RECEIVED AND AUTHORIZING THE ADMINISTRATION TO ENTER INTO NEGOTIATIONS AND, IF SUCCESSFUL, AUTHORIZING THE MAYOR AND CITY CLERK TO EXECUTE A PROFESSIONAL SERVICES AGREEMENT, IN AN AMOUNT NOT TO EXCEED $166,140, WITH THE NUMBER-ONE RANKED PROVIDER, SUNSHINE MEDICAL CENTER, PURSUANT TO RFP NO. 98-99/00, PROVIDING FOR: (1) PHYSICAL EXAMINATIONS ON HIRES AND ON PROMOTIONS FOR CLASSIFICATIONS WHERE PHYSICAL DUTIES VARY GREATLY; (2) DRUG TESTS ON HIRES TO MAINTAIN A DRUG-FREE WORK ENVIRONMENT; (3) RETURN TO WORK CLEARANCE EVALUATIONS; (4) REHABILITATION EVALUATIONS; (5) ADMINISTRATION OF AN EMPLOYEE ASSISTANCE PROGRAM; (6) RETENTION OF ALL MEDICAL RECORDS; (7) EVALUATION OF APPLICANTS AND EMPLOYEES, AS REQUIRED BY THE CITY; (8) ADMINISTRATION OF VACCINES FOR CITY EMPLOYEES, AS NEEDED; (9) DESIGNATION AS THE CITY PHYSICIAN; (10) CONDUCT RANDOM DRUG AND ALCOHOL TESTING BASED ON THE FLORIDA DEPARTMENT OF TRANSPORTATION STANDARDS AND UNION CONTRACTS; AND (11) OTHER MEDICAL SERVICES, AS MAY BE NECESSARY AND/OR REQUIRED BY THE CITY AND LOCAL, STATE AND FEDERAL LAWS. WHEREAS, on May 25, 2000, the City issued Request for Proposals NO.98-99/00 (RFP), for a service provider to provide (1) physical examinations on hires and on promotions for classifications where physical duties vary greatly; (2) drug tests on hires to maintain a drug-free work environment; (3) return to work clearance evaluations; (4) rehabilitation evaluations; (5) administration of an employee assistance program; (6) retention of all medical records; (7) evaluation of applicants and employees, as required by the City; (8) administration of vaccines for City employees, as needed; (9) designation as the City physician; (10) conduct random drug and alcohol testing based on the Florida Department of Transportation standards and union contracts: and (11) other medical services, as may be necessary and/or required by the City and local, State and Federal laws, for an initial one-year period, with an option for four additional one-year renewal periods; and WHEREAS, the City received three responses to the RFP, which included two responses for the complete services requested and one for the employee assistance portion only; and WHEREAS, the Health Advisory Committee met on June 26, 2000, to consider the responses, and advised the Evaluation Committee to perform reference checks on Sunshine Medical Center; and WHEREAS. an Evaluation Committee. approved by the City Manager and by the Mayor and City Commissioners, met on June 28. 2000, performed satisfactory reference checks. participated in an oral presentation, and recommended Sunshine Medical Center as the top-ranked proposer; and WHEREAS, the City Manager reviewed the proposals, as well as the recommendations of the Health Advisory Committee and the Evaluation Committee. and concurred with their recommendations; and WHEREAS, provided negotiations are successful with Sunshine Medical Center, the Administration recommends that the Mayor and City Commission further approve and authorize the Mayor and City Clerk to execute a Professional Services Agreement with Sunshine Medical Center. as set forth in this Resolution. 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 ranking of proposals received and authorize the Administration to enter into negotiations and, if successful, authorize the Mayor and City Clerk to execute a Professional Services Agreement, in an amount not to exceed $166,140, with the number-one ranked provider, Sunshine Medical Center, pursuant to RFP No. 98-99/00, providing for: (1) physical examinations on hires and on promotions for classifications where physical duties vary greatly; (2) drug tests on hires to maintain a drug-free work environment; (3) return to work clearance evaluations; (4) rehabilitation evaluations; (5) administration of an employee assistance program; (6) retention of all medical records; (7) evaluation of applicants and employees, as required by the city; (8) administration of vaccines for City employees, as needed; (9) designation as the City physician; (10) conduct random drug and alcohol testing based on the Florida Department of Transportation standards and union contracts; and (11) other medical services, as may be necessary and/or required by the City and local, State and Federal laws. PASSED AND ADOPTED this 13th day of September, 2000. ATTEST: '1 JLr1,ad RILdtLi CITY CLERK fill MAYOR JMG:MG:TCA:LG .;'.i'J;:RC?IED .,':~ Tel f()R1A .i LAJ~GUP.,i..:,t 4 :-:C~,R EX;:C:)7:<:,N FIHUMA I$ALL ICOMM.RESISUNSHINE. WPD 4:1/ tJ(/~ <':::'fi'.;,,'_'''!''~/ i{ - 2-- Yr1Z, tcb . . ;ITY OF MIAMI BEACH Ity HALL 1700 CONVENTION CENTER DRIVE MIAMI BEACH, FLORIDA 33139 ~ :\\ci.miami-bea h_fl.u COMMISSION MEMORANDUM NO. 013- D D TO: Mayor Neisen O. Kasdin and Members of the City Commission DATE: September 13, 2000 FROM: Jorge M. Gonzalez \ City Manager I, l~ '- A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, ACCEPTING THE RANKING OF PROPOSALS RECEIVED AND AUTHORIZING THE ADMINISTRATION TO ENTER INTO NEGOTIATIONS AND, IF SUCCESSFUL, AUTHORIZING THE MAYOR AND CITY CLERK TO EXECUTE A PROFESSIONAL SERVICES AGREEMENT, IN AN AMOUNT NOT TO EXCEED $166,140, WITH THE NUMBER-ONE RANKED PROVIDER, SUNSHINE MEDICAL CENTER, PURSUANT TO RFP NO. 98-99/00, PROVIDING FOR: (1) PHYSICAL EXAMINATIONS ON HIRES AND ON PROMOTIONS FOR CLASSIFICATIONS WHERE PHYSICAL DUTIES VARY GREATLY; (2) DRUG TESTS ON HIRES TO MAINTAIN A DRUG-FREE WORK ENVIRONMENT; (3) RETURN TO WORK CLEARANCE EVALUATIONS; (4) REHABILITATION EVALUATIONS; (5) ADMINISTRATION OF AN EMPLOYEE ASSISTANCE PROGRAM; (6) RETENTION OF ALL MEDICAL RECORDS; (7) EVALUATION OF APPLICANTS AND EMPLOYEES, AS REQUIRED BY THE CITY; (8) ADMINISTRATION OF VACCINES FOR CITY EMPLOYEES, AS NEEDED; (9) DESIGNATION AS THE CITY PHYSICIAN; (10) CONDUCT RANDOM DRUG AND ALCOHOL TESTING BASED ON THE FLORIDA DEPARTMENT OF TRANSPORTATION STANDARDS AND UNION CONTRACTS; AND (11) OTHER MEDICAL SERVICES, AS MAY BE NECESSARY AND/OR REQUIRED BY THE CITY AND LOCAL, STATE AND FEDERAL LAWS. ADMINISTRA TION RECOMMENDATION SUBJECT: Adopt the Resolution. FUNDING Funds in the amount of $98,700 have been requested in the proposed Fiscal Year 2000/01 Risk Management Division (540.1791.000355) budget, the balance of $67,440 will be identified before the budget is adopted on September 27,2000. AGENDA ITEM C 10 DATE C-'j-I"",-~ BACKGROUND After review by the Group Insurance Board, the Health Advisory Committee, and the City Commission, RFP No. 98-99/00 was issued on May 25, 2000. Proposals were requested for a service provider to provide for (1) physical exarninations on hires and on promotions for classifications where physical duties vary greatly; (2) drug tests on hires to maintain a drug-free work environment; (3) return to work clearance evaluations; (4) rehabilitation evaluations; (5) administration of an employee assistance program; (6) retention of all medical records; (7) evaluation of applicants and employees as required by the City; (8) administration of vaccines for City employees. as needed; (9) designation as the City physician; (10) conduct random drug and alcohol testing based on the Florida Department of Transportation standards and union contracts; and (11) other medical services, as may be necessary and/or required by the City and local, State and Federal laws. On August 31, 1999, the City received notice from Mt. Sinai Medical Center that all services would be terminated effective September 30, 1999. Miami Heart, which was considered a suitable provider, was capable of performing the scope of services, and agreed to do so. On or about July 1, 2000, Mt. Sinai Medical Center bought Miami Heart Institute, and informed the City once again that all services would be terminated effective September 30, 2000. The City started the RFP process in May with the foresight that the purchase of Miami Heart would most probably lead to the contract cancellation. Responses were received by the Procurement Division from: Mount Sinai Medical Center Sunshine Medical Center EAPLUS (for Employee Assistance Program only) On June 26, 2000, the Health Advisory Committee reviewed all three proposals. The Health Advisory Committee pointed out (1) the significant difference in price between the two proposals; over $330,000 for Mt. Sinai Medical Center and $166,140 for Sunshine Medical Center and (2) advised the Evaluation Committee to check references on current clients at Sunshine Medical Center. The following significant attributes of Sunshine Medical Center were discussed: 1. Accessibility to pre-employment applicants at three locations, including Port of Miami, South Miami, and Port Everglades. (note: worker's compensation injures are not a part of this contract) 2. Hours of availability include Saturday and Sunday service, not an option at Mt. Sinai 3. Turn-around time for all results will be improved due to the Saturday/Sunday service 4. Executive physicals, psychiatric services, and well program are included in the Sunshine Medical Center proposal 6. The Employee Assistance Program and psychiatric services are administered through three staffed offices vs. a program with one local representative . . The Health Advisory Committee recommended that provided reference checks were positive, and based on the cost factor, that Sunshine Medical Center would be the more appropriate and preferred provider. On June 28, 2000, the RFP Evaluation Committee reviewed the proposals for the following items: I. Ability to provide all requested services within designated time frames 2. Cost of services provided 3. Convenience of obtaining service and proximity to Miami Beach 4. Overall reputation within the community 5. Experience level, credentials of assigned staff 6. Designated contact availability 7. Appointment/next day scheduling 8. Number of appointments that can be scheduled daily The Evaluation Committee reviewed the references that were researched as suggested by the Health Advisory Committee. Four municipalities, City of Oakland, City of Coral Gables, City of South Miami and Broward Sheriffs Office, were surveyed, and all highly recommended the services of Sunshine Medical Center. Recommendations were made based on the timeliness of their service, their expertise in the area of Occupational Health, personalized service that is provided, and good communication. The Evaluation Committee also agreed to visit Sunshine Medical Center at the Port of Miami for an oral presentation on August 4,2000. The Center is 6 miles from City Hall. The Committee found Sunshine Medical Center to be maintained in a professional manner, properly equipped, adequately staffed, with the ability to provide additional staffing if necessary, accessible and able to meet the needs of the City. The evaluation Committee also reviewed all bids based on the Employee Assistance Program as a separate entity, which included the review of the EAPL US bid. Sunshine Medical Center was ranked highest in this area also due to the quantity of professional staff that were provided and the availability of three locations and extended office hours. Providing negotiations are successful with Sunshine Medical Center, and due to the proposal price and services listed, the Administration recommends the City enter into an agreement commencing October 1,2000 for an annual fee of$166,140 and, at the City's option, it may be renewed at the same cost in each of the four years following the initial term. CONCLUSION It is recommended that the Mayor and City Commission of the City of Miami Beach, Florida, accepting the ranking of proposals received and authorizing the Administration to enter into negotiations and, if successful, authorizing the Mayor and City Clerk to execute a Professional Services Agreement, in an amount not to exceed $166,140, with the number-one ranked provider, Sunshine Medical Center, pursuant to RFP No. 98-99/00, providing for: (1) physical examinations on hires and on promotions for classifications where physical duties vary greatly; (2) drug tests on hires to maintain a drug-free work environment; (3) return to work clearance evaluations; (4) . rehabilitation evaluations; (5) administration of an employee assistance program; (6) retention of all medical records; (7) evaluation of applicants and employees, as required by the City; (8) administration of vaccines for city employees, as needed; (9) designation as the City physician; (10) conduct random drug and alcohol testing based on the Florida Department of Transportation standards and union contracts; and (11) other medical services, as may be necessary and/or required by the City and local, State and Federal laws. ~\'? m /- JMG:M~GL:JC:LG OJV F:\SALL\COMM.MEM\SUNSHfNE,WPD . ~ - ..... PROFESSIONAL SERVICES AGREEMENT BETWEEN THE CITY OF MIAMI BEACH, FLORIDA AND SUNSHINE MEDICAL CENTER, TO PROVIDE FOR: (1) PHYSICAL EXAMINATIONS ON HIRES AND ON PROMOTIONS FOR CLASSIFICATIONS WHERE PHYSICAL DUTIES VARY GREATLY; (2) DRUG TESTS ON HIRES TO MAINTAIN A DRUG-FREE WORK ENVIRONMENT; (3) RETURN TO WORK CLEARANCE EVALUATIONS; (4) REHABILITATION EVALUATIONS; (5) ADMINISTRATION OF AN EMPLOYEE ASSISTANCE PROGRAM; (6) RETENTION OF ALL MEDICAL RECORDS; (7) EV ALUA TlON OF APPLICANTS AND EMPLOYEES AS REQUIRED BY THE CITY; (8) ADMINISTRATION OF VACCINES FOR CITY EMPLOYEES, AS NEEDED; (9) DESIGNATION AS THE CITY PHYSICIAN; (10) CONDUCT RANDOM DRUG AND ALCOHOL TESTING BASED ON THE FLORIDA DEPARTMENT OF TRANSPORTATION STANDARDS AND UNION CONTRACTS; AND (11) OTHER MEDICAL SERVICES, AS MAY BE NECESSARY AND/OR REQUIRED BY THE CITY AND LOCAL, STATE AND FEDERAL LAWS. THIS AGREEMENT made this /3 ti day of .y;,J:MJ,yL ,2000, by and between the CITY OF MIAMI BEACH, FLORIDA (City), which term shall include its officials, successors, legal representatives, and assigns, and SUNSHINE MEDICAL CENTER (Provider). SECTION 1 DEFINITIONS Agreement: This written Agreement between the City and the Provider. City Manager: "City Manager" means the Chief Administrative Officer of the City. Provider: For the purposes of this Agreement, Provider shall be deemed to be an independent contractor, and not an agent or employee of the City. When the term "Provider" is used in this Agreement, it shall be deemed to include any sub-contractors and any other person or entity acting under the direction or control of the Provider. Fixed Fee: Fixed amount paid to the Provider to allow for its costs and margin of profit. ., _ _ f Project Coordinator: Proposal Documents: Risk Manager: An individual designated by the City to coordinate, direct and review on behalf of the City all technical matters involved in the Scope of Work and Services. Proposal Documents shall mean a) Request for Proposals No. 98-99/00 for Professional Services Agreement to provide for: (I) physical examinations on hires and on promotions for classifications where physical duties vary greatly; (2) drug tests on hires to maintain a drug-free work environment; (3) return to work clearance evaluations; (4) rehabilitation evaluations; (5) administration of an employee assistance prograrn; (6) retention of an medical records; (7) evaluation of applicants and employees as required by the City; (8) administration of vaccines for City employees, as needed; (9) designation as the City physician; (10) conduct random drug and alcohol testing based on the Florida Department of Transportation standards and union contracts; and (11) other medical services, as may be necessary and/or required by the City and local, state, and federal laws in contemplation of this Agreement, together with all Amendments thereto (if applicable); and, b) the Provider's proposal response thereto (Proposal); which are incorporated by reference in this Agreement and made a part hereof. The Risk Manager of the City, with offices at 1700 Convention Center Drive, Third Floor, Miami Beach, Florida 33139. -2- , _ _ t Services: Termination: Task: All services, work and actions by the Provider performed pursuant to or undertaken under this Agreement described in Section 2. Termination of Provider's Services as provided in Section 4.8 of this Agreement. A discrete portion of the Scope of Services to be accomplished by the Provider, as described in Section 2, if directed and authorized. -3- 1 _ _ f SECTION 2 SCOPE OF WORK AND SERVICES REOUIRED The scope of work to be performed by the Provider is generally set forth in the Proposal Documents (collectively, the Services), attached hereto as Exhibit A. SECTION 3 COMPENSATION 3.1 FIXED FEE Provider shall be compensated for providing the Services, as set forth in Exhibit A, on a set fixed fee basis throughout the initial term of this Agreement and any subsequent renewal terms; said fee not to exceed One Hundred Sixty Six Thousand One Hundred Forty Dollars ($166,140), per year. 3.2 METHOD OF PAYMENT Payment shall be made to the Provider on a monthly basis, pursuant to invoices submitted by the Provider, and shall contain a statement that the terms set forth therein are true and correct and in accordance with the Agreement. Payment of such invoices shall be made within thirty (30) days of receipt by City. [The remainder of this page is left intentionally blank] -4- , - - , 4.1 SECTION 4 GENERAL PROVISIONS RESPONSIBILITY OF THE PROVIDER With respect to the performance of the Services, the Provider shaH exercise that degree of skill, care, efficiency and diligence normally exercised by recognized professionals with respect to the performance of comparable Services. In its performance of the Services, the Provider shall comply with all applicable laws and ordinances, including but not limited to applicable regulations of the City, County, State, Federal Government, ADA, and EEO Regulations and Guidelines. 4.2 PUBLIC ENTITY CRIMES State of Florida Form PER 7068, Sworn Statement under Section 287.I33(3)(a) Florida Statute on Public Entity Crimes shall be filed by the Provider. 4.3 PROJECT MANAGEMENT The Provider shall appoint a qualified individual acceptable to the City to serve as Project Manager to oversee the Services and who shall be fully responsible for the day-to-day activities under this Agreement and shall serve as the primary contact for the City's Project Coordinator. 4.4 TERM OF AGREEMENT The term of this Agreement shall be for an initial term of one (1) year commencing on October 1,2000, and ending on October 1, 2001, and thereafter shall automatically renew, upon the sarne terms and conditions as set forth therein, for up to four (4) additional one (I) year renewal terms. Notwithstanding the foregoing, the City shall have the option, at it's sole discretion, to not renew this Agreement, at any time, and shall notify the Provider of same by providing written notice to Provider sixty (60) days prior to the date of expiration of the initial term, or any proceeding renewal term, as the case may be. -5- . - - 4.5 OWNERSHIP OF DOCUMENTS AND EOUlPMENT All documents prepared by the Provider pursuant to this Agreement are related exclusively to the Services, and are intended or represented for ownership by the City. Retention of records pursuant to this Agreement shall be governed in the manner set forth in Exhibit A hereto. 4.6 INDEMNIFICATION Provider agrees 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, errors, omissions or other wrongful conduct of the Provider, its employees, agents, sub-consultants, or any other person or entity acting under the Provider's control, in connection with the Provider's performance of the Services pursuant to this Agreement; and, to that extent, the Provider 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 reasonable attorney's 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 the Provider for performance of this Agreement is the specific consideration from the City to the Provider for the Provider's Indemnity Agreement. The Provider's obligation under this Section shall not include the obligation to indemnify the City of Miami Beach and its officers, employees and agents, from and against any actions or claims which arise or are alleged to have arisen from negligent acts or omissions or other wrongful conduct of the City and its officers, employees and agents, and, in such event, Provider shall no liability as to third party claims that may arise there from. The parties each agree to give the other party prompt notice of any claim coming to its knowledge that in any way directly or indirectly affects the other party. -6- 4.7 INSURANCE REOlJIREMENTS The Provider shall not commence any work pursuant to this Agreement until all insurance required under this Section has been obtained and certified copies of such insurance have been filed with and approved by the City's Risk Manager. The Provider shall maintain and carry in full force and effect during the term of this Agreement the following insurance: I. A policy of Professional Liability covering the services and activities required in this Agreement with minimum limits of $2,000,000. 2. Workers Compensation & Employers Liability as required pursuant to Florida Statute. Thirty (30) days' written notice of cancellation or substantial modification in any required insurance coverage must be given to the City's Risk Manager by the Provider and its insurance company. 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 City's Risk Manager. The Provider is responsible for obtaining and submitting all insurance certificates for its sub-contractors. 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 by 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 this Section or under any other portion of this 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. 4.8 TERMINATION. SUSPENSION AND SANCTIONS 4.8.1 Termination for Cause by the City -7- If, through any cause within the reasonable control of the Provider, the Provider shall fail to fulfill in a timely manner, or otherwise violates any of the covenants, agreements, or stipulations material to this Agreement, the City shall thereupon have the right to terminate the Services then remaining to be performed. Prior to exercising its option to terminate for cause, the City shall notify the Provider of its violation of the particular terms of this Agreement and shall grant the Provider thirty (30) days to cure such default. If such default remains uncured after thirty (30) days, the City may terminate this Agreement by giving written notice to the Provider of such termination, which shall become effective upon receipt by Provider of the written termination notice. In that event, all open medical and other records related to this Agreement will be immediately delivered to the new service provider, as directed by the City, within thirty (30) days of the termination notice of the Provider's Agreement. Notwithstanding the above, the Provider 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 Provider, and the City may reasonably withhold payments to the Provider for the purposes of set-off until such time as the exact amount of damages due the City from the Provider is determined. 4.8.2 Termination for Cause by the Provider If, through any cause within the reasonable control of the City, the City shall fail to fulfill in a timely manner, or otherwise violates any of the covenants, agreements, or stipulations material to this Agreement, the Provider shall thereupon have the right to terminate the Services then remaining to be performed. Prior to exercising its option to terminate for cause, the Provider shall notify the City of its violation of the particular terms of this Agreement and shall grant the City thirty (30) days to cure such default. If such default remains uncured after thirty (30) days, the Provider may -8- terminate this Agreement by giving written notice to the City of such termination, which shall become effective upon receipt by City of the written termination notice. In that event, all open medical and other records related to this Agreement will be immediately delivered to the new service provider, as directed by the City, within thirty (30) days of the termination notice ofthe Provider's Agreement. 4.8.3 Termination for Convenience of City The City may, without cause and for its convenience, terminate the Services then remaining to be performed at any time by giving 30 days prior written notice. At the City's option, the City may pay the provider in advance for 30 days services, and terminate this agreement immediately, (in addition to any other accrued amounts owed to the Provider). In that event, all open medical and other records related to this Agreement will be delivered to the new service provider within thirty (30) days of said termination notice. 4.8.4 Termination for Insolvency by the City The City also reserves the right to terminate the remaining Services to be performed in the event the Provider is placed either in voluntary or involuntary bankruptcy or makes an assignment for the benefit of creditors. In such event, the right and obligations of the parties shall be the same as provided for in Section 4.8.3. 4.8.5 Sanctions for NoncompIiance with Nondiscrimination Provisions In the event ofthe Provider's noncompliance with the nondiscrimination provisions of this Agreement, the City shall impose such 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 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 in Section 4.8.2. -9- 4.9 ASSIGNMENT. TRANSFER OR SUBCONTRACTING The Provider shall not subcontract, assign, or transfer any work under this Agreement without the prior written consent of the City. When applicable, and upon receipt of such consent in writing, the Provider shall cause the names of the consulting firms responsible for the major portion of each separate specialty of the Services to be inserted into the pertinent documents or data. The Provider shall include in such sub-contracts the appropriate versions of the Sections of this Agreement as are necessary to carry out the intent ofthis Agreement, as instructed by the City. SUB - CONTRACTORS The Provider shall be liable for all sub-contractors' services, responsibilities and liabilities under this Agreement and the services, responsibilities and liabilities of sub-contractors, and any 4.10 other person or entity acting under the direction or control of the Provider. When the term "Provider" is used in this Agreement, it shall be deemed to include any sub-contractors and any other person or entity acting under the direction or control of Provider. 4.11 EOUAL EMPLOYMENT OPPORTUNITY/ADA NON-DISCRIMINATION POLICY In connection with the performance of this Agreement, the Provider shall not discriminate against any employee or applicant for employment because of race, color, religion, ancestry, sex, age, national origin, place of birth, marital status, citizenship or intending citizenship status, or sexual orientation. The Provider shall take affirmative action to ensure that employees are treated during their employment without regard to their race, color, religion, ancestry, sex, age, national origin, place of birth, marital status, disability, or sexual 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. -'0- The Provider 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 ofl990 (ADA): Pub. L. 101-336, 104 Stat 327, 42 V.S.C. 12101-12213 and 547 V.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 V.S.C. Section 794. The Federal Transit Act, as amended: 49 V.S.C. Section 1612. The Fair Housing Act as amended: 42 V.S.C. Section 3601-3631. The Provider must complete and submit the City's Disability Non-Discrimination Affidavit (Affidavit). In the event Provider fails to execute the City's Affidavit, or 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 payments to Provider under the Agreement until compliance and/or cancellation, termination or suspension of the Agreement. In the event, the City cancels or terminates the Agreement pursuant to this Section, Provider shall not be relieved of liability to the City for damages sustained by the City by virtue of Provider's breach ofthe Agreement. [The remainder of this page is left intentionally blank] -11- , Notices hereunder shall be effective if delivered personally, delivery; if mailed to an address in the City of dispatch, on the day following the date mailed; and if mailed to an address outside the City of dispatch on the seventh day following the date mailed. 4.15 ENTIRETY OF AGREEMENT This writing and the Scope of Services set forth in Exhibit A embody the entire Agreement and understanding between the parties hereto, and there are no other agreements and understandings, oral or written with reference to the subject matter hereof that are not merged herein and superseded hereby. The Proposal Documents are hereby incorporated by reference into this Agreement to the extent that the terms and conditions contained therein are consistent with the Agreement. To the extent that any term in the Proposal Documents is inconsistent with this Agreement, this Agreement shall prevail. No alteration, change, or modification of the terms of this Agreement shall be valid unless amended in writing, signed by both parties hereto, and approved by the Mayor and City Commission of the City of Miami Beach. 4.16 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$30,000. The Provider hereby expresses its willingness to enter into this Agreement with the Provider's recovery from the City for any darnage action for breach of contract to be limited to a maximum amount of $30,000. -14- Accordingly, and notwithstanding any other term or condition of this Agreement, the Provider hereby agrees that the City shall not be liable to the Provider for damages in an amount in excess of $30,000, for any action or claim for breach of contract arising out of the performance or non-performance of any obligations imposed upon the City by this Agreement. Nothing contained in this paragraph or elsewhere in this Agreement is in any way intended to be a waiver of the limitation placed upon City's liability as set forth in Section 768.28, Florida Statutes. 4.17 VENUE This Agreement shall be enforceable in Dade County, Florida, and iflegal action is necessary by either party with respect to the enforcement of any or all of the terms or conditions herein, exclusive venue for the enforcement of sarne shall lie in Dade County, Florida. IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by their appropriate officials, as of the date first entered above. FOR CITY: CITY OF MIAMI BEACH, FLORIDA ATTEST: By: ~ (kL City Clerk By: ~jh Mayor FOR PROVIDER: SUNSHINE MEDICAL CENTER ATTEST: BY_~ lL'7~~ Dr. Alan K. Roberts, President BY:il~ LG: F :IHUMA I$ALL ICONTRACTlSUNSHINE.LEG APPROVED AS TO FORM & LANGUAGE & FOR EXECUTION -15- q;~#.->- LOt:.(d/ C Altomey EXHIBIT A SCOPE OF SERVICES SECTION I - OVERVIEW AND PROPOSAL PROCEDURES INTRODUCTIONIBACKGROUND: The City of Miami Beach, Florida (hereinafter referred to as "the City") has a need to contract a service (hereinafter referred to as "the Provider"), to provide physical examinations on hires and on promotions for classifications where physical duties vary greatly; drug tests on hires to maintain a drug free work environment; return to work clearance evaluations; rehabilitation evaluations; administration of an employee assistance program; retention of all medical records; evaluation of applicants and employees as required by the city; administration of vaccines for city employees, as needed; designation as the City physician; conduct random drug and alcohol testing based on the Florida Department of Transportation standards and union contracts; and other medical services, as may be necessary for approximately 1702 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. SECTION II - SCOPE OF SERVICES Per terms set forth in RFP No. 98-99/00 and in Sunshine Medical Center's response to our RFP#98-99/00, dated JuIy 12, 2000, is hereto attached as "Exhibit B" as a reference source for more detailed information. A. GENERAL See attached "Exhibit B" pages 4, 5. B. COMPREHENSIVE MEDICAL EVALUATIONS AND PRE-EMPLOYMENT DRUG TESTING See attached "Exhibit B" page 5. C. MEDICAL RECORDS See attached "Exhibit B" page 6. D. PSYCHIATRIC SERVICES See attached "Exhibit B" pages 6, 7. 1 E. IMMUNIZATION PROGRAM See attached "Exhibit B" page 7. F. DRUGS AND ALCOHOL TEST PRQGRAM See attached "Exhibit B" pages 7, 8. Plus a nine (9) panel format Urine Drug Screen for Police and Fire Departments Sworn personnel. G. WELLNESS PROGRAM See attached "Exhibit B" page 8. H. EMPLOYEE ASSISTANCE PROGRAM (EAP) See attached "Exhibit B" pages 8, 9. 1. FITNESS FOR DUTY/RETURN TO WORK/REHABILITATION EVALUATIONS See attached "Exhibit B" PAGE 9. J. EXECUTIVE PHYSICAL See attached "Exhibit B" page 10. K. PERFORMANCE CRITERIA AND EVALUATION N/A L. COMMUNICATION See attached "Exhibit B" page 10. M. STAFFING See attached "Exhibit B" page 10. LG: F:IHUMA I$ALL ICONTRACTlSUNSHINE.CON 2 r EXHIBIT B #._. -=;-:.,1.' SUNSHINE MEDICAL CENTER 907 S. AMERICA WAY MIAMI, FL 33132 (305)372-1930 (305)372-3708 FRP# 98-99/00 CITY OF MIAMI BEACH JULY 12, 2000 3:00 P.M. . , .' ~ )';.~ ;,)t~ .~ . ",.":T TABLE OF CONTENTS ~ I. INTRODUCTION II. SCQPE OF SERVICES 4 III. SECTION 1 II IV. FEE PROPOSAL FRQM 19 V. PROPOSER INFORMATION 20 VI. ACKNQWLEDGMENTQFADDENDA 21 VII. DISABILITY NONDISCRIMINATION AFFIDAVIT 22 VIII. DECLARATION 23 VIllI. QUESTIONNAIRE 24 ,I 'r' 'S c SUNSHINE MEDICAL CENTER City of Miami Beach Evaluation Committee 1700 Convention Center Drive Miami Beach, Florida 33139 July 12, 2000 RFP NO. 98-99/00 PROFESSIONAL SERVICES TO PROVIDE PHYSICAL EXAMINATIONS, DRUG TESTING, RETURN TO WORK CLEARANCE REHABILITATION EVALUATIONS. ADMINISTRATION OF AN EMPLOYEE ASSISTANCE PROGRAM, EVALUATION OF APPLICANTS AND EMPLOYEES, ADMINISTRATION OF VACCINES, ACT AS DESIGNATED CITY PHYSICIAN, AND TO CONDUCT RANDOM AND ALCOHOL TESTING. Dear Evaluation Committee Members: Thank you for the opportunity to bid on a contract to provide medical services for the City of Miami Beach. Sunshine Medical Center (SMC) is the right selection to be assured that pre-employment physicals for the City of Miami Beach will be provided in a cost effective and efficient manner. Same day scheduling" seven days a week, will be available to your employees who will receive personalized attention from our staff as they go through the pre-employment exam process. SMC was established 25 years ago by Dr. Alan Roberts to address the medical needs of industries and municipalities in Miami-Dade and Broward counties. Qver the years we have provided pre-employment exams ranging from the very basic to complex exams required by agencies whose employees work in environmental and physically challenging situations. Sunshine Medical Center gradually increased its scope of services to include Fitness For Duty Exams, Drug Testing For Cause and treatment of work related injuries. Dr. Roberts has also developed an audiovisual presentation used for OSHA training of employees exposed to bloodborne pathogens and on request can make it avaiIable to employees at risk. ., At our Port of Miami office we have been providing comprehensive pre-employment physical exams and drug testing for the employees' of clients such as Federal Express, United Airlines, Carnival Cruise Lines and Seaboard Marine. Our center at Port Everglades has been providing pre-employment physicals, pre-employment drug testing and random drug testing for the Broward Sheriff's office (BSO) since 1992 and the 6341 Sunset Drive South Mi.mi, Fl 331~3 (305) 666-5971 . Fax:. (305) 666-0496 Port of Miami 907 5. America way, Miami, Fl 33132 (305) 372-1930 . Fax: (305) 372-3708 Port Everglades 1750 S.E. 32nd Street, P.O. Box 165~6-4 Fort Lauderdale, Fl 33316 (95~) 767.9999 . Fax: (95~) 763-9828 www.sunshlnemedlealeenter.eom " ~ ~' City of Oakland Park for the past year. Our South Miami facility has been performing the same services for employees of the Cities of Coral Gables and South Miami since 1993. The pre-employment examination for these agencies require complete history & physical, lab work, chest x-rays, spirometry, audiogram, tuberculosis screening, EKG and urine drug screens in accordance with SAMSHA guidelines. These exams are performed on police officers, firefighters, correctional officers, sanitation workers, maintenance workers, clerical personnel and other laborers typically employed by a city agency. The staff at our Port Everglades office has extensive training in performing pre-employment physical examinations. All of our centers are fully outfitted with the most current medical and office equipment and quite capable of providing any computer interfacing for this contract. This results in an efficient and pleasant experience for your employee going through the pre-employment exam process. Dr. Roberts has more than twenty-five years of experience in Family and Occupational Medicine; he is Board Certified in Family Medicine and a member of the American College of Occupational and Environmental Medicine. In addition, Dr. Roberts. and Dr. Susan Diaz, who has been with Sunshine Medical Center for over three years, are Certified Medical Review Qfficers (MROs). Dr. Diaz is Board eligible in Family Practice and, like Dr. Roberts, also is a Federal Aviation Administrator Examiner. SMC plans to assign several key staff members to the City of Miami Beach account. Becky Stone, CMA, our on-site Staff Supervisor with over twenty years of clinical experience, will monitor our Quality Assurance Program to ensure the processing of pre-employment exams is done in a time efficient manner. Maria Gonzalez, Account Manager, will be assigned to this contract to ensure timely, accurate billing and handle any operational issues related to the billing process. Our support staff consisting of Certified Physician Assistants, Registered Medical Assistants and Licensed X-Ray Technicians will assist our Physicians in providing quality and efficient medical services. SMC has two other offices; our corporate site is located in South Miami and we have a third facility at the Port Everglades. All three sites provide the scope of services required for this contract and, in addition, provide both urgent and routine medical services for private and corporate patients. This includes treating workers' compensation injuries, providing medical services for employees/crew of port related companies (i.e. passenger and cargo shipping companies), and administering vaccines such as Tetanus, Hepatitis B, Hepatitis A, Yellow Fever and others to people who travel outside this country. .' The Port of Miami office, open 7 days a week, is only ten minutes away from Miami Beach City Hall. We are currently providing on-site and after-hours drug/alcohol testing for several of our clients. One of our providers is always on-call and can be easily reached for after-hours needs. 'r ,i ~, For the purpose of this contract, Sunshine Medical Center will sub-contract the services of The Psych Team, Inc. The Psych Team, Inc. has been in practice since 1990. A private group of practitioners in the mental health field, The Psych Team has its main offices in Miami Lakes, Cooper City and North Miami Beach. The clinical staff consists of multidisciplinary and multiethnic professionals including licensed Psychologists, licensed mental health counselors, and licensed social workers. The Psych Team also utilizes a highly trained team of intake specialists. Services include individual counseling, marital counseling and family counseling, with adults adolescents and children. Their clinical staff has extensive experience with employee assistant programs, corporate accounts, and chemical dependency issues. Sunshine Medical Center is a detail oriented company who firmly believes in providing service with a personal touch. Unlike large corporations, you will always be able to speak with one of our providers or key support staff regarding any questions or issues resulting from your contract. Sunshine Medical Center is confident that we have the experience, qualifications and staff required to furnish the City of Miami Beach the professional services required for this contract. I will serve as the contact person for this proposal. Please feel free to call me if you require further information to evaluate our proposal. Sincerely, ,~c~ ~ Sanford Cohen, PA-C, MBA ., t " SCOPE OF SERVICES (".,-.......1 1. PrimaJy Contlct: Sanford Cohen, PA-c, MBA - Project Manager. Mr. Cohen is a full time employee of Sunshine Medical Center (SMC) and is avaiIable during normal operational hours. He also is avaiIab1e to be reached by bccpcr during hours when SMC is nonna11y closed. His resume can be found in section 1. 2. Back-up contact name: Maria Gonzalez, Contracts Manager. Ms. Gonzalez is a full time employee of SMC and works in the corporate office located in South Miami. 3. SMC wi\l submit qualifications of new people working under this contract for approval by the City prior to them doing any work required for this contract. A list SMC's current employees who wi\l be working under this contract can be found in section 1 of this proposal. 4. Operational Hours. SMC has three locations; each site wi\l be avai1able to pctform the scope of services required by this contract. The locations and hours of operation are: Port of Miami 907 S. America Way Miami, Florida Hours: Monday - Friday 9:00 am - 6:00 pm Saturday 9:00 am - 2:00 pm, Sunday 9:00 am - 1:00 pm Port Everglades 1750 S.E. 32 NO Street FT. Laudcrdale, Florida 33316 Hours: Monday - Friday 9:00 am - 6:00 pm Saturday 9:00 am - 2:00 pm, Sunday 9:00 am - 1:00 pm South Miami 6341 Sunset Drive South Miami, Florida 33143 Hours: Monday - Friday 9:00 am - 6:00 pm Saturday 9:00 am - 2:00 pm, Closed Sunday 5. Ability to schedule appointments, number/day, same day. next day, appointments outside business hours. ., SMC will provide at least 10 appointments per day and provide for up to 20 appointments per day with 3 days advanced notice from the City. The City wi\l be able to schedule same day or next day appointments for pre-emp1oymcnt examinations at any one of SMC's three locations. With advance notice by the City. SMC wi\l also be able to provide appointments outside business hours. 6. Parking Availability. Adequate and free parlring can be found at all three of the SMC centers. 4 " , ~ 7. Electronic Mail Set Up. SMC will work with the City's lnfonnation Tecbno10gy Department in setting up an e1ecUonic mail system compaUb1e with the City. This system will be utilized to provide reports n:quested by the City. . 8. Applicant Wait Time. Individuals referred by the City will not have a waiting time exceeding 30 Minutes. 9. Quarterly Reports. SMC will furnish the Human Resources Department with a quarterly utilization summary report. B. COMPREHENSIVE MEDICAL EVAUIATlONS AND PRE-EMPLOYMENT DRUG TESTING. 1. In accordance with esrablished medical practice. SMC. based on the physical requirements of the job descriptions provided by the City. will perform physical examinations and drug testing as n:quired for Pre-Employment on all nw hires. SMC will also conduct Promotional exams for classifications where physical duties greatly vary. 2. SMC will conduct and review X-rays and all Laboratory tests n:quired for Pre-Employment or Promotional exams. 3. Results of the applicants pre~mployment physical exams can be telephoned. faxed or e-mailed within 48 hours after the evaluation to the Human Resources Department. 4. SMC currently. at each of its three locations, has the capability of permitting at least 10 appointments per day. 5. SMC is set up to allow for walk-in patients and is currently providing same daylnext day examination/drug tests. Staffing at each of our centers is planned to accomodate for same day or next day examinations/drug testing. 6. PPD tests will be administered on site to new applicants n:quiring confirmation that they are free from active Tuberculosis. A log will be kept which will record the names of applicants receiving PPDs. An applicant will be instructed to return in 48 hours to have the PPD evaluated, results will be recorded in the log book and on each applicants Pre-Employment Exam. Applicants returning with positive PPDs will be given a chest x-ray which can be read immediately to rule out active disease. All applicants will be advised to consult with their private physician to determine if either prophylaxis treatment (positive PPD, negative chest x-ray) or treatment for active disease is indicated. 7. All three SMC locations have the ability to perform heart disease evaluation for Police Officer applicants, including EKGs or Treadmill Stress Testing if indicated. 8. All three SMC locations have the ability to perform entIy level fire-fighting testing. including Pulmonary Testing if indicated. 9. Pre-Employment examinations can be performed at any time during operational hours at aU three SMC centers. 10. Primary Contact Name. Sanford Cohen, PA-C, MBA - Project Manager. 5 " I I, C. Mr.DlC'AL Rr.C'ORDS 1. The health filesJor all City Employees will be maintained in accordance with all State and Federal laws, as applicable. 2. Eacb new City applicant will have a file created and maintained in a section of medical records designated for City employees. SMC's clerical staffwill provide all necessary typing and preparation of all insurance fonDS as required. 3. Eacb City employee will have their own seperate medical record. All data pertinent to the employee will be collected and filed in their chart. The chart is obtained and returned after eacb visit to the medical record section designated for City employees. 4. Primary Contact Name. Sanford Coben, PA-C, MBA - Project Manager 5. The medical records of City employees will be kept in a secured area in the medical center. No unauthorized personnel are allowed admittance to the area wbere medical records are maintained. The medical record will be filed alphabetically. Old records from previous providers, if not required. will be stored at the SMC storage facility. 6. Medical records may only be released to the Human Resources Director, Claims Director or their designee and will be made available within 24 bours upon request. D. PSYCHIATRIC SERVICES 1. The Psych T earn, Inc. bas fifteen fully licensed mental bea1th professionals in three convenient locations. The Psycb Team' s Administrative staff are also licensed clinicians wbo are available 24 bours a day seven days a week. The administrative clinicians would be consulted in the case wbere the city requires an evaluation. The administrative c1inican would then assign the appropriate staff member and set up the evaluation in the appropriale office. 2. Administrative clinical staff would be available for con.11ltation. Normal office hours are from 9am to 9pm Monday through Thursday; 9am to 7pm Friday and 9am to 6pm on Saturday. The Psycb bas three locations. They are: Cooper City 9950 Stirling Road Suite 107 Cooper City, Florida 33024 Miami Lakes 6713 Main Street Suite 239 Miami Lakes, Florida 33014 North Miami Beacb 1011 Ives Dairy Road Bni1ding 2 Suite 208 North Miami Beach, Florida 33179 3. An administrative clinical staff member would be assigned to attend staff conferences. On site training would be assigned to staff on a needed basis dependent on the suhject area of the training. An administrative clinical staff member would be assigned to observe new employees on an as need basis. 6 ,01 " .1 .! 4. The psych Team, Inc. would assign an. adminiSlJative clinical Slaft'member to attend meetings as necessary. S. Rcscan:h would be provided as needed in areas specified by the city. The Psych Team's staft' has extensive background in research. 6. Consultations with general city employees would be provided by the Psych Team's clinical staff as requested by the city. Selections of clinical Slaft'to provide consultation would be made by the Psych Teams's administrative staft'in order to assign the most appropriate clinician. 7. The Psych Team's primary contact is Jay S. Woolfstead, M.S. E. IMMlIN1ZATION PROGRAM 1. Sunshine Medical Center wil1 administer intradermal testing for Tuberculosis exposure on all employees as requested. A chest x-ray wil1 be performed on employees with a history of a positive lest. 2. A Tetanus Toxoid Booster Immunization wil1 be administeted to Police Officers. Fire Rescue personnel. Waste Collectors and Parks personnel. Depending on other job classifications, a Tetanus Toxoid Booster. if indicated, will be provided. 3. Hepatitis B Vaccine wil1 be administered as determined by the City. SMC's comprehensive travel medicine program requires us to keep a large number of this vaccine and others on-site at all three locations. part of thi. contract. 4. SMC will administer other vaccines, such as measles, mumps and rubella, etc. as required by, local, state, or federal requirements or by industry recommendations of guide1ines. The fee . .. ..... S. SMC will make available and administer, according to current Federal guidelines anti-vira1 medications against the AIDS virus for emergency responders. These medications wil1 be given within two hours of a significant exposure to the AIDS virus. City employees will have access to the administration of anti-vira1 medications for the AIDS virus on a 24 hour basis. 6. Primary contact name: Sanford Cohen, PA-C. MBA . Project Manager F. DRUGS & Al.C~OHOI. TEST PROGRAM 1. SMC wil1 conduct a Drug and Alcohol Test Program as required by local, state and federal law regulation. SMC will only use laboratories for IImg testing that are currently certified to meet standards of Subpart C of Mandatory Guidelines for Federal Workplace Drug Testing Programs (S9 FR 29916, 2992S). ., 2. All three SMC locations currently provide on-going drug and alcohol testing for many of our clients. SMC is staffed to conduct IImg and alcohol testing at a yearly rate of approximately 930 Police officer personnel. 3. SMC wil1 utilize computer selection to conduct random WI8IIDOUIICed testing on aIll safety sensitive employees who drive or maintain vehicles that require commercial driver licenses. Approximately 160 employees sha1I be tested for IImg abuse and twenty five percent for alcohol misuse. 7 ,- 'I I ., ,......, 4. SMC wiJl have staff available 24 hours/day and 7 daysfweek to conduct testing on employees whose petfonnance could have contn'buted to an accident even if the employee was not cited for a traffic violation. 5. The City wiJl be able to bring an employee whose behavior or appearance is characteristic of drug or alcohol rrJsue to the closest SMC facility for drug testing. 6. SMC wiJl conduct return-to-duty and follow-up testing for employees who violate the prohibited alcohol Jr drug standards. At least 6 unannounced tests will be conducted in the first 12 months after the employee returns to duty. Follow-up testing may be extended for up to 60 months following return to duty. 7. Drug testing at each SMC facility is done in a bathroom that lacks an operational sink and has colored waler in the commode. The City employee is observed as he/she enters and leaves the bathroom. This ensures privacy and control of the test. 8. Urine Drug Screens wiJl consist of a five panel format. This test consists of and screens for: TEST CUTOFF: (NGIML) Amphetamine Screen 1000 Cannabinoids Screen 50 Cocaine Metabolites Screen 300 Opiates Screen 2000 Phencyclidine Screen 25 Testing wiJl be done foJlowing specimen collection procedures as outlined in "Mandatory Guidelines For Federal Workplace Drug Testing Programs". a document provided by the Substance Abuse and Mental Health Services Administration (SAMHSA). an agency of the Department Of Health And Human Services. All drug screen results wiJl be reviewed by SMC's Medical Review Officer. If negative. results will be reported to the City's HR Director or her designee. If positive, the Medical Review Of1icer will contact the employee to determine if !he test is a confirmed positive before reporting it to !he City's HR Director or her designee. G. WELI.NESS PROGRAM 1. SMC wiJl provide annual health screening programs that focus on education and prevention rather than treatment of disease. Examples of topics for health screenings include cholesterol testing, ergonomic assessments, blood pressure evaluations, information on blood borne pathogens and traveler's health/immunizations. Cholesterol testing would require a sma1l cost for !he lab work. 2. SMC providers will be available to provide annual health screening and health education at a minimum of (2) two job site areas within the city. Information announcing topics and meeting times will be provided to City Managers which can be distn'buted to their employees. 3. Primary Contact Person: Sanford Cohen, PA-C, MBA - Project Manager. H. EMPI.OYEE ASS5TANCE PROGRAM (J:AP) 1. The Psych Team, Inc. has a complete multi-discipJinary clinical team avaiJab1e to city of Miami Beach employees. When an employee needs assistance they would call The Psych Team, Inc. Their telephone call would be handled in a confidential manner by a fully trained intake specialist. The intake informaton would be reviewed by administrative clinical staff !hen 8 ,- " , assinged to the most appropriate clinical staff member in the appropriate office. On non-emergency cases the employees would be contacted within 24 hours and offered an appointment On emergency cases the employee or family member would be seen as soon 9S possible. . The Psaych Team, Inc. bas a "line" operator twenty four hours a day seven days a week. 2. The Psych Team. Inc. would provided appointments as snecessary when contacted by the city persosnnel. its employees. and/or their covered family members. All would be provided by their three covered EAP visits. The employee or family member would continue with the same clinician uuless a change needs to be made for treatment reasons. 3. The Psych Team, Inc. bas clinicians that are experts in all areas of treatment. The majority of the clinical staff have over fifteen years of experience each. The clinical staff all work with their sub-specialties. The Psych Team, Inc. clinical staJT have expertise in children, adolsecents, adults, chemical dependency. stress management, personal issues, anxiety, depression, family issues, marital issues, relationship issues. legal issues. credit issues, vocational issues. AIDS and other medical concerns. domestice violence, and trauma. The staff on The Psych Team, Inc. bas been involved with many police and lire departments providing critical incident stress debriefings. The Psych Team. Inc. is a long standing member of the Employee Assistance Professionals Association. 4. The Psych Team. Inc. has the ability to make any type of referral necessary to assist a city employee or their family member. The Psych Team, Inc. now provides this service routinely for employers clients, and insurance companies. Additionally The Psych Team, Inc. has an independent PsychologicaVPsychiatric network called Psy Net, Inc. this network has over 50 providers available for referral in Dade, Broward, and Palm Beach Counties. All referrals will be appropriately made on an as needed basis. 5. The Psych Team's administrative staff are available for emergency phone contact 24 hours a day 7 days per week. Appointments can be arranged for crisis services during working hours by calling any of the Psych Team's offices. Appointments with Psych Team Clinicians are available Monday through Saturday and would be arranged as soon as possible. 6. All employee records would be maintained as strictly confidential. Records would be in locked file cabinets in the offices where services were rendered. Records are released only when appropriate written authorization from the employee is obtained. 7. Employees would be able to reach an intake specialist by phone immediately or within one hour for emergency situations. An appointment with an approrpiate clinician would be arranged within 24 hours with a waiting lime of one week or less depending on the degree of urgency. 8. The Pysch Team's primary contact is Jay S. Woolf stead, M.S. L FlTNF~C;S FOR DUTYIRETURN TO WORKlREHABILITATION EVALUATIONS 1. SMC providers will perform evaluations to assess employees' ability to continue in their current capacity and to assess and recommend reasonable accomodation for other job opportunities for which they may be qualified. 2. SMC will provide complete evaluations within two working days of a request. 3. Primary Contact Name: Sanford Cohen, PA-C, MBA 9 " ", I J. 11.rr.nlTlVE PHYSICAL ,_.r:.,. ~"'f', c;~~. 1. SMC c:urrenUy provides annual medical examinations and wellness programs for several of its colJlOrate clients. These physicalslwellness programs will be submitted to the City for its approval for use on its executive staff. 2. PriIl13Jy Contact Name: Sanford Cohen, P A-C, MBA K. PERFORMANCE CRITERIA AND EVALUATION N/A L. COMMUNICATION I. SMC will provide test results, records. correspondence, etc. only to the Human Resources Director or her designee. 2. SMC will work with the City's Infonnation Technology Departrnentto set up and utilize an electronic mail system compatible with the City. 3. Primary Contact Name: Sanford Cohen. PA-C, MBA M. STAFFING 1. SMC currently has sufficient staff to begin work on this contract and supply all services stated in this agreement If needed, SMC will increase staff if we are unable to fully comply with what has been staled in the Scope of Services. 2. Primary Contact Name: Sanford Cohen. PA-C. MEA 10 .~ ~ SECTION 1 II ~ .t SUNSHINE MEDICAL CENTER - STAFF ROSTER NAME: POSITION: ALAN K. ROBERTS, M.D.,AAFP SUSAN F. DlAZ, D.O. SANDFORD CQHEN, PAC BRIDGETTE Y. FORGETTE, PAC JORGE RABINOVICH, PAC SCOTT HOWELL, PAC THERESA JOHNSON, PAC SHANNON GRIFFIN, PA SHIRLEY GIBSON MARIA GONZALEZ JUAN GAMAZQ DONNA LEA FONDA NIKKI WAKE SANDRA DAVIS EDNA RAMOS PAM WAKE JACKIE LINARES ZEYDA MEDINA ANN SMALL BECKY STONE RONDA SMITH ALFREDO SUAREZ AISSA MEDINA ISIS GARCIA LINDA BROOKINS ANGEL PERIl ERIC BRONSON MEDICAL DIRECTOR ASSOCIATE MED. DIRECTOR PHYSICIAN ASSIST ANT - CERT. PHYSICIAN ASSISTANT - CERT. PHYSICIAN ASSIST ANT - CERT. PHYSICIAN ASSISTANT - CERT. PHYSICIAN ASSISTANT - CERT. PHYSICIAN ASSIST ANT BOOK KEEPING CORPORATE ACCOUNTS WORKERS' CQMP ACCQUNTS INSURANCE ACCOUNTS BUSINESS OFFICE ASST. PQSTING CLERK POSTING CLERK RECEPTIONIST RECEPTIONIST RECEPTIONIST RECEIPTIONIST/MED ASST. MEDICAL ASSISTANT, CERT. MEDICAL ASSIST ANT MEDICAL ASSISTANT MEDICAL ASSISTANT MEDICAL ASSISTANT MEDICAL ASSISTANT MEDICAL ASSISTANT MEDICAL ASSISTANT ... 'I I; I CURRICULUM VITAE ALAN K. ROBERTS, M.D. UNDERGRADUATE B.S. Biology - Bucknell- University 'tewisburg, Pennsyl~ia CUM LAUDE GRADUATE - June 1970 MEDICAL Jefferson Medical College Thomas Jefferson University Philadelphia, Pennsylvania June 1974 F AMIL Y PRACTICE Residency Program - 51. Margaret Memorial Hospital Pittsburgh, Pennsylvania 1974-1977 Chief Resident Family Practice - 1976-1977 MEDICAL LICENSURE Pennsylvania - 1976 Florida - 1977 - License Number 30398 FAMILY PRACTICE 1977 - present - Medical J)jrector Sunshine Medical Center South Miami 6341 Sunset Drive South Miami, FL 33143 Port of Miami 907 S. America Way Miami, FL 33129 MEMBERSHIPS American Medical Association American Academy of Family Practice American Occupational Medical Association Board Certification Family Practice Dade County Medical Society Drug-Free Wmlcplace Medical Advisor Federal Certified MIlO - Medical Review Officer Florida Medical Society Medical Examiner - Cayman Airways Medical Examiner - United Airlines Medical Officer - City of Coral Gables Recertification Family Practice - 1997 Senior Federal Aviation Administration Flight Examiner University of Miami Clinical Instroctor Port Everglades 1750 SE 32 Street Port Everglades, FL 33316 ... ,. J "'~'J' ':.W0.~.l : "~' . .......... Susan F. Diaz, D.O. 12271 NW 8 Street Miami. F1.. 33 I 82 (305)220-659 I PRE-MEDICAL EDUCATION: State University of New York at Bingharnton August 1984 - May 1986 Degree - Bachelor of Science in Biology State University of New York at Stony Brook August 1982 - May 1984 MEDICAL EDUCATION: New York College of Osteopathic Medicine at New York Institute of Technology August 1987 - June 1991 Degree - Bachelor of Osteopathic Medicine INTERNSHIP: Westchester General Hospital July 1991 - June 1992 RESIDENCY: Westchester General Hospital July 1992 - June 1994 Specialt-f - Farnily Practice PRNATE PRACI'ICE: July 1994 - Decernber 1996 Westchester General Hospital January 1997 - Present Sunshine Medical Center PRIMARY SPECIALTY: Family Practice BOARD STATUS: Board Eligible - Farnily Practice March 2000 UCENSURE: State of Florida No. 6525 PROFESSIONAL MEMBERSHIP: American Osteopathic Association American College of Osteopathic General Practice .~ ,1. .f CURRICULUM VITAE SANFORD COHEN, PA-C, MBA UNDERGRADUATE Bachelor of Arts - Boston University Boston. Massachusetts June 1973 MEDlrAI. Bachelor of Science in Physician Assistant Studies - Tour Col1ege New York City, New York AUf;ust 1977 GRADlJATE Master in Business Administration - Loyola College Baltimore, Maryland May 1992 MEDlrAL LlCENSIJRE Florida - 1997 OCCUPATIONAl. HEALTHlFAMILYPRACTICE Sunshine Medical Center - May 1997 - Present South Miami Port of Miami South Miami, Florida Miami, Florida Glenwood Health Center: 1992 - 1997 Good Samaritan Hospital - 1995 - 1997 Emergency Room (Part-time) Baltimore Industrial Medical Center: 1990 - 1992 Columbia Internal Medicine: 1989.1990 GBMC.lnc.: 1987 - 1989 University of Maryland Department of Family Medicine: 1985. 1987 Spring Grove State Psychiatric Center: 1982 - 1985 Danville Orthopedic Clinic: 1980 . 1982 Cardiology Medicine: 1979 - 1980 Nichol's Clinic: 1977 . 1979 MEMBER5;HIP5; American Academy of Physician Assistants Florida Academy of Physician Assistants Port Everglades Fort Lauderdale, Fl Baltimore, Maryland Baltimore, Maryland Baltimore, Maryland Columbia, Maryland Baltimore, Maryland Baltimore. Maryland Baltimore, Maryland Danville, Vll'ginia Greensboro, North Carolina ApaJachico1a, Florida .~ .Y, " CURRICULUM VITAE REBECCA STONE CERTIFIED MEDICAL ASSISTANT EDUCATION Medical Assistant Program Linsley Hopkins Miami, Florida 1978 - 1979 CERTIFICA TraNS Certified Medical Assistant Basic X-ray - State of Florida license OCCUPATIONAL HEAL TH/F AMIL Y PRACTICE Sunshine Medical Center May 1995 to present OTHER MEDICAL EXPERIENCE Blechman & Zane M.D., PA Rheumatology I980-1994 MEMBERSHIPS American Association of Medical Assistants Florida Society of Medical Assistants . .. oJ ,r CURRICULUM VITAE MARIA GONZALEZ ACCQUNT MANAGER ED! ICA nON Morris Catholic High School Denville, NJ 1974-1978 WORK EXPERIENCE Sunshine Medical Center April 1998 to present Account Manager TRP Billing Services August 1995 to January I998 Account Manager Billing G. Systems, In.c February 1993 to May 1995 Office Manager Amcare Home Health Agency July 1991 to January I 993 Office Manager Denville Associates of Medicine November 1988 to May 199I Accounts Manager Cardiology Division Miami Children's Hospital January 1979 to November I988 Department of Pediatric Neurology Accounts Manager '. ., , ... t~ .t . . CvuIaJwM VrrAE JAY S. WOOLFSTEAD, M.S. RXPRRmNCR 1990-Present The Prych Team, Inc. Managing partner and psychotherapist. Responsibilities: Development and operation of a mental health private practice which includes: EAP. managed care, organizaIional consulting, and canrnunity relations. Professional responsibilities include therapy with individuals for anxiety, depression. relationship problems. and adolescents. 1990-Present Pry-Net. Inc. Senior Vice President. Responsible for the development and overa11 operation of a thirty member independent practice association of mental health practitioners with seventeen locations from Palm Beach to Homestead, Rorida. Currently providing services to twenty Employee Assistance Programs with a total of 500,000 lives. 1990-Present Comprehensive Psychotherapy Centas.lnc. PresidenlJOwner. . Responsibilities: Development and operation of a mental health private practice which includes: EAP. managed care, organizational consulting. and community relations. 1987-1990 Affiliates For Evaluation & Therapy. Inc. Senior Vice President. Responsibilities: Management of all day-to-day operations of a large mental health private practice. Supervision of all professional and support staff; review of legal contracts and materials pertaining to research and development; public relations and liaison to major corporations in establishing Employee Assistance Programs. Coordinator of Hospital Assessment Team which was responsible for the evaluation of necessity, financial matters. and implementation of cases where hospitalization was required. Re-Direction Partial Hospitalization Program (JCAHO accredited). Chief Executive Officer. Responsibilities: Management of all day-to-day operations inCluding general review and supervision of all professional and support staff pertaining to the hospitalization program. 1984-1987 Affiliates For Evaluation and Therapy. Chief of Staff.' Responsibilities: Coordination of all in-house support staff. as well as supervision of professional staff. Public relations liaison with community; responsible for coordination of all components of hospita1ization of all Affi1iates' patients. 1978-1990 Affiliates For Evaluation alld Therapy. Psychotherapist. Responsibilities: Therapy with individuals for anxiety, depression, relationship problems. and adolescents. 1981-1987 State of Florida Division of Health and Rehabilitative Services. Chairman. Case Review Committee (p.O.S.) for Emotionally Disturbed Youth - HRS District II. .1. .S ..' JAY S. WOOIJIS'IBAD, M.S. Page 2 1980-1981 1979.1980 1977-1980 1976-1977 1973-1975 INSTRIJCTOR: 1980-1983 F.mrf'ATION, 1979-1983 1977 1974 1972 State of FloridD Division of Health and ReluJbilitative Services. Member, Case Review Committee for Emotionally Disturbed Youth. HRS Disttictll. State of FloridD Division of Health and ReluJbilitativt Services. Case assignment and management system counselor. Speciality: Psychialric cases in juvenile coon. State ofFI<JridDDivision afHealth and ReluJbilitativt Services. Vocational rehabilitation counselor. Speciality: Adolescents from Liberty City and Overtown. State of FloridD Division of Health and Rehabilitative Services. Intern and counsc1or at Leon S.T.A.R. T. Center for female juvenile delinquents. University of Florida in Gainesville. Volunteer with S.A.M.S.O.N. Trenton Program at Lancaster Youth Development Center. Barry University, Psychology Department Adjunct Instructor. University of Miami. School of Medicine. Guest Instructor. Specialized Training in Cognitive Therapy through A.A.B.T. by Dr. Aron Beck via The American Association for Behavior Therapy. M.S. Degree in Counseling Psychology from Florida Slate University, TaIlahassee. Florida. B.A. Degree. with Honors. University of Florida. Gainesville. Florida. A.A. Degree, Miami Dade South. Miami, Florida. " , ., ,Ii, :r .' . JAY S. WOOUIS'I1W), M.S. ...;~ ., :ji, ; .':'\ " ""\,;,,,- Page 3 As.~or'A TlONS- Florida Licensed Menial Health Counselor Association for the Advancement of Behavior Therapy American Counseling and Development Association North American Ad1erian Society Dade County Menial Health Association Broward County Menial Health Association American Menial Health Counselors Association PF.RSONAI. DATA: Birthdate: Birth place: Health: 5/15/53 Pittsburgh, Pennsylvania Excellent RRFRRRNCF...C;;: A vaiIable upon request CORRF~ONnRNCR. Jay S. Woolfstead, M.S. 9950 Stirling Road, Suite 107 Cooper City, FL 33024 Broward: ~ 436- TEAM Dade: (305) 362- TEAM '. J .. Ii'RR PROPOSAL FORM SCOPE OF SERVICES: A. GENERAL/OTHER FEE: B. PRE-EMPLOYMENT PHYSICAL EXAMINATIONS/PROMOTIONAL EXAMINATIONS AND DRUG TEST $43. RQn no (approximately 500 applicants) (TESTS WILL VARY BASED ON JOB DESCRIPTION) C. MEDICAL RECORDS RETENTION D. PSYCHIATRIC SERVICES ~ lfin no $ 3.100 00 E. IMMUNIZATION PROGRAM $31 200 00 OTHER VACCINES.............S BXCLUDED PROM CONTRACT) F. DRUG AND ALCOHOL TEST PROGRAM G. WELLNESSPROGRAM H. EMPLOYEE ASSISTANCE PROGRAM (The City reserves the right to separate this service from the contract) I. FITNESS FOR DUTY/RETURN TO WORK/REHABILlT A TION EVALUATION J. EXECUTIVE PHYSICAL - SBE E4 $:j9. :ailO 00 $36,720.00 $ 6130_00 $ 7,ROO.OO ., .. K. PERFORMANCE CRITERIA n/a L. COMMUNICATION M. STAFFING ~ F..74n 00 TOTAL PROPOSAL PRICE: $166.140.00 RFP NO.: 9'.99100 May 26. 200n 19 '''' " .1 II A'~ PROPOSERINFO~ATION "~"Y " ~>;;)' .;, ... .j' ':. 5:7"..,,', " '.1 ,'; Submitted by: Sunshine Medical Center Proposer (Entity): Corporation Signature: " Name (Typed): Sa"~nrn ~nh~n PA_r. MRA Address: 907 S. America Way City/State: Miami, FL 33132 Telephone: (305)372-1930 Fax: (305)372-3708 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 d ~nless a co~t has been agreed to and signed by both parties. j( , f0~ June 12, 2000 (Authorized Signature) (Date) Alan K. Roberts, M.D.,AAFP (Printed Name) RFPNO.: 98-99/00 May 26, 2000 20 , ., .' , 04&" *" .,~ REQUEST FOR PROPOSALS NO. 98 - 99/00 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 .T11n" 14. :>000 Addendum No.2, Dated Jul y 5, 2000 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 John Ellis Name of staff June 22, 2000 Date Sunshine Medical Center (Proposer - Name) July 11, 2000 (Date) .. ~~~ (Signature) RFP NO.: 98-99/00 May 26. 2000 21 , .. ....... .' . " .. DISABILITY NONDISCRIMINATION AFFIDAVIT CONTRACT REFERENCE RFP NO qR_qq/OO NAME OF FIRM,CORPORATION,OR ORGANIZATION C::ll"l",hinp M"iH,..~l ('"nt"r AUTHORIZED AGENT COMPLETING AFFIDAVIT Sanford Cohen, PA-C, MBA POSITION Physician Assistant PHONE NUMBER \30~ 372-1930 L Sanford Cohen , being duly first swom state: That the above named firm, corporation or organi7.3tion 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 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 n, Public Services; Title Ill, 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. ~ c~ L~~ Signature ,7\]1 Y 11. 2000 Date SUBSCRIBED AND SWORN TO (or affirmed) before me on 7-11 - 00 (Date) by Sanford Cohen \ . (Affiant) He/"- is personally known to me or has presented identification. Dersonally Known (Type of identification) as JJLe- (Signature of Notary) #' C C Slf80Jf.S (Serial Number) ~ JI. ..2003 (Expiration Date) ., (prin ~. I !.f :.\ MY COMMISSION I CC 648045 . : . -' EXPIRES: June 21.2003 . . ," . BondId TlNU Noeuy NIlic.......,., Notary u IC tLo..~ (State) Notary Seal The City of Miami Beach will not award a contract to any finn, 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. RFP NO.: 98-99/00 May 26, 2000 22 0' :', .'.- DECLARATION TO: Lawrence A. Levy City Manager City ofM!ami Beach, Florida Submitted this 12 day of June ~, 2000 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 ocuments identified by the following number: RFP No. 98-99/00 Ii ,- --'~ C vL-ftFJ<) SIGNATURE Alan K. Roberts, M.D.,AAFP PRINTED NAME President TITLE (IF CORPORATION) RFP NO.: 98-99/00 May 26, 2000 23 '~ .' ,,) :"-l' Proposer's Name: PlincipaI Office Address: Official Representative: Individual Partnership (Circle One) Corporation If a Corporation. answer this: When Incorporated: In what State: If Foreien Corporation: Date of Registration with Florida Secretary of State: Name of Resident Agent: Address of Resident Agent: OUESTIONNAIRE Sunshine Medical Center. Q07 S. America Wav Mi ;omi. FT. 33132 Sanford Cohen, PA-C, MBA Auaust 1976 Florida President's Name: Alan K. Roberts. M.D.,AAFP Vice-President's Name: N/A Treasurer's Name: N 1/1, Members of Board of Directors: '" //1, RfP NO.: 98-99/00 May 26. 2000 24 .... ,.l . ,;/ ,~ J" Ouestionnalre (~ontlnuedl If a Partnership: Dllte of organization: MIll. . General or Limited Partnership.: Name and Address of Each Partner: NAME ADDRESS . Designate general partners in a Limited Partnership t Number of years of relevant experience in operating similar business: 74 YP~ r;; 2. Have any similar agreements held by proposer for a project similar to the proposed project ever been canceled? Yes ( ) NoJ(x) 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: Pi/A RFP NO.: 98-99/00 May 26. 2000 25 ',," T" I :~ ;.., '" '.. ,f' .~/ 4. Has the proposer or aay of its principals ever been declared bankrupt or reorganized under Chapter 11 or put lato receivership? NO If yes, give date, eourt jurisdietion, 'action taken, and any other expIana~ion deemed necessary. 5. Person or persons interested ia this bid aad Qualification Form (have) h"vp nnt (have not) been convicted by a Federal, State, County, or Municipal Court ofany violation oflaw, other than traffic violations. To include stockholders over ten percent (10%). (Strike out inappropriate words) Explain any convietions: 6. Lawsuits (any) pending or completed involving the corporation, partnership or individuals with more than ten percent (10%) interest: A. List all pending lawsuits: NnnjQI B. List all judgments from lawsuits in the last five (5) years: None C. List any criminal violations andlor convictions of the proposer and/or any of its principals: None RFP NO.: 98-99/00 May 26, 2000 26 ',; l-' v~ Ouestionnalre (continued) " ,If' .t.'; 7. Conflicts oflnterest. The following relationships are the only potential, actual, or perceived conflicts of interest in connection with this proposal: (If none, so state.) None RFP NO.: 98.99/00 May 26, 2000 27 \-. r' .. .:', .\Ddationnaire lrontinuecO 8. Public Disclosure. In order to determine whether the members of the Evaluation Committee for this Request for Proposals have any association or relationships which would constitute a conflict of interest, either actual or perceived, with any proposer and/or individuals and entities comprising or representing such proposer, and in an attempt to ensure full and complete disclosure regarding this contract, all Proposers are required to disclose all persons and entities who may be involved with this Proposal. This list shall include public relation firms. lawyers and lobbvists. The Procurement Division shall be notified in writinv if anv person or entitv is added to this list q/ter receipt Qforooosals. None RFP NO.: 98.99/00 May 26, 2000 28 ~ .,..~ . .....) /,; estlonnaire ~ontinDetO , ,. Tbe proposer Dadentllad. that inCormatioa coatained ia this Questioaaaire will be relied upoa by the City iu __rdlal the propoled Agreemeat and .uch iaCormatioa is warranted by the proposer to be true. The uadenigned proposer agrees to Curnish .uch adilltional inCormation, prior to acceptance oC any proposal relatiag to the qaallflcatioas orthe proposer, as may be required by the Executive Director. The proposer further uadentauds that the !nformatioa 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. Cl...LtA--. Signature ,~ IF INDIVIDUAL: !~ uP~ Signature WITNESSES: ., ~ M:=Ir;;:t ~()n7.t=l1P-''7. Print Name Sanford Cohen Print Name WITNESSES: IF PARTNERSHIP: Print Name of Firm Signature Print Name Address By: (General Partner) Signature (Print Name) (Print Name) WITNESSES: I -:J/U ('1 ~ 1 S;,;'hn ! q i IF CORPORATION: Sunshine Medical Center Print Name or Corporation Marij, CSR:lillfW:l Print Name gn7 ~ am~r;~~ W~y Address By: )~~p II pn'hor+-C:! M n..,AAFP President Attest: (CORPORA TF. SEAL) Secretary RFP NO.: 98-99/00 Moy 2~, 2000 29 , "->. .