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2025-05-13 - AGENDA REPORTS - OCCUPATIONAL HEALTH SERVICES CONTR
Agenda Item• 19 CITY OF SANTA CLARITA AGENDA REPORT CONSENT CALENDAR CITY MANAGER APPROVAL: Li ` DATE: May 13, 2025 SUBJECT: OCCUPATIONAL HEALTH SERVICES CONTRACT DEPARTMENT: Human Resources and Library Services PRESENTER: Andrew Barth RECOMMENDED ACTION City Council: Award a one-year contract to Concentra Medical Centers and AFC Urgent Care of Santa Clarita to provide occupational health services for a combined annual amount not to exceed $76,186. 2. Authorize the City Manager or designee to execute up to three additional one-year renewal options beginning in year two, not to exceed the annual contract amount, plus an adjustment in compensation consistent with the appropriate Consumer Price Index, upon request of the contractor, and contingent upon the appropriation of funds by the City Council in the annual budget for such fiscal year. 3. Authorize the City Manager or designee to execute all contracts and associated documents, subject to City Attorney approval. BACKGROUND The City of Santa Clarita (City) outsources occupational health services to provide pre- employment physicals, screenings, and assessments. Annually, Human Resources manages the processing of over 300 new and returning employees who require pre -employment physicals to ensure candidates have the physical capabilities to perform the j ob as outlined in the j ob bulletin. In addition, occupational health services are also utilized to maintain compliance under the Department of Transportation (DOT) program that mandates random testing for individuals operating commercial motor vehicles on behalf of the City. The City conducted a Request for Proposal (RFP) to solicit proposals from qualified vendors to provide occupational health services. The RFP was published and circulated via the City's e- Page 1 Packet Pg. 406 procurement system, BidNet, on October 11, 2024. The City transmitted the solicitation to 1,118 vendors on BidNet, of which 51 vendors downloaded the RFP. Three vendors provided proposals for consideration. These proposals were reviewed and evaluated based on each vendor's ability to meet the specific needs of the City. An evaluation panel comprised of staff from the Human Resources and Recreation and Community Services divisions scored the responses using the following categories of weighted criteria: • Qualifications (25 points) • Experience with similar services (20 points) • Business locations and hours (20 points) • Thoroughness of proposal, approach to providing services, and ability to provide services (15 points) • Cost of services provided (20 points) The evaluation team scored the responses based on a 100-point system, with the results outlined below: RANK VENDOR LOCATION SCORE 1 Concentra Medical Centers Santa Clarita, CA 83 2 AFC Urgent Care of Santa Clarita Santa Clarita, CA 71 3 Fastest Labs of Santa Clarita Santa Clarita, CA 64 In reviewing proposals, the evaluation team recommends awarding the contract to the two highest scores of Concentra Medical Centers and AFC Urgent Care of Santa Clarita. The evaluation team determined that the proposals from Concentra Medical Centers and AFC Urgent Care of Santa Clarita offered the best overall services to meet the City's occupational health needs. Additionally, the City's needs vary in terms of volume, hours of availability, and locations. By utilizing the services offered by both vendors, staff will have the flexibility to refer candidates and employees based on the services due to the different operating hours and locations of both vendors. Staff has completed a due -diligence review of Concentra Medical Centers and AFC Urgent Care of Santa Clarita professional references and determined their work history meets the City's standards and performance expectations. Additionally, the City has previously worked with both vendors, resulting in positive outcomes and work that adhered to the City's standards. Based on the above, staff recommends awarding contracts to Concentra Medical Centers and AFC Urgent Care of Santa Clarita. Contracts entered into pursuant to the RFP may be renewed annually, up to three times beginning in year two. ALTERNATIVE ACTION Other action as determined by the City Council. Page 2 Packet Pg. 407 FISCAL IMPACT Upon adoption of the Fiscal Year 2025-26 budget, adequate funds will be available in expenditure accounts 1008100-516102 (General Fund), 7218101-515103 (Self Insurance Fund), and 3098200- 516102 (Public Library Fund) to support the recommended action. ATTACHMENTS HR-24-25-13 - Occupational Health Services - Published Bid Documents (available in the City Clerk's Reading File) HR-24-25-13 - Occupational Health Services - Concentra Response File (available in the City Clerk's Reading File) HR-24-25-13 - Occupational Health Services - AFC Urgent Care of Santa Clarita Response File (available in the City Clerk's Reading File) Page 3 Packet Pg. 408 .� --"MEN ja mo Awl "LZ-6ar. a M' �' J % k A Occupational Health Services PROPOSAL # HR-24-25-13 TABLE OF CONTENTS PROPOSAL # HR-24-25-13 Occupational Health Services City of Santa Clarita, California SECTION A NOTICE INVITING PROPOSALS PROPOSAL INSTRUCTIONS DOCUMENT CHECKLIST SECTION B SCOPE OF WORK RESPONSE FORMAT AND SELECTION CRITERIA SECTION C NOTICE TO PROPOSERS REGARDING CONTRACTUAL REQUIREMENTS REFERENCES ACKNOWLEDGEMENT AND ACCEPTANCE OF SCOPE OF WORK CITY OF SANTA CLARITA DISCLOSURE STATEMENT SECTION D SAMPLE PROFESSIONAL SERVICES AGREEMENT — STANDARD EXHIBIT A CURRENT CONTRACT RATES SECTION A RFP Information & Instructions CITY OF SANTA CLARITA REQUEST FOR PROPOSALS Project Name: Occupational Health Services Proposal #: HR-24-25-13 Dates Published: October 11, 2024 Last Day for Questions: November 12, 2024 before 11:00 AM (PT) Proposal Closing: November 25, 2024 before 11:00 AM (PT) Estimated Contract $ 305,000 Value: Project Description: The City of Santa Clarita (City) is seeking a provider/providers of occupational health services to meet the occupational health needs of the organization. Proposers must be equipped to provide occupational health services as outlined in this request for proposals. The contract for these services is expected to begin July 1, 2025. Contact Information: Jaclyn Abston I jabston@santaclarita.gov Specifications for this request for proposals (RFP) may be downloaded from the City's Purchasing website at: www.bidnetdirect.com//cityofsantaclarita. Please refer to specifications for complete details and RFP requirements. The specifications in this notice shall be considered a part of any contract made pursuant thereto. A paper copy of the RFP documents is available upon request in the City Clerk's office, suite 120. RFP Questions must be submitted electronically via the BidNet "Question and Answer" tab. Addenda, if issued by the CITY, will be transmitted on BidNet. Addenda must be digitally acknowledged via BidNet in addition to a printed and signed version submitted with the proposal response. If addenda are not signed and submitted with the proposal response, the submission may be deemed non- responsive and rejected. PROPOSAL INSTRUCTIONS PROPOSAL # HR-24-25-13 Occupational Health Services City of Santa Clarita, California 1. SUBMITTING PROPOSALS. 1.1. The response must be submitted on this form and include all forms provided or information requested or required by the scope of work or specifications, (uploaded via BidNet). 1.2. All documentation of unit pricing or other cost breakdowns as outlined in this proposal must be submitted to support the total proposed price. 1.3. Proposals/corrections received after the closing time will not be accepted. The City will not be responsible for proposals not properly or timely, uploaded. Upon award, all submissions become a matter of public record. 2. ADDENDA. The City will not accept responsibility for incomplete packages or missing addenda. It is the vendor's responsibility to monitor BidNet for release of the addenda prior to submission of the quote to make certain the package is complete and all required addenda are included. This information will be available via BidNet. Vendors are cautioned against relying on verbal information in the preparation of proposal responses. All official information and guidance will be provided as part of this solicitation or written addenda. Addenda, if issued by the Agency, will be transmitted via BidNet. Addenda must be digitally acknowledged through BidNet in addition to a printed and signed version submitted with the proposal. If addenda are not signed and submitted with the proposal response, the proposal may be deemed non -responsive and rejected. 3. AWARDS. 3.1. The City reserves the right to waive any informality in any proposal. 3.2. This RFP does not commit the City to award a contract, or to pay any amount incurred in the preparation of the proposal. The City reserves the right to accept or reject all proposals received as a result of this request, to negotiate with any qualified consultant, or to cancel this RFP in part or in its entirety. The City may require the selected consultant to participate in negotiations and to submit such technical, price, or other revisions of the proposal as may result from negotiations. The City reserves the right to extend the time allotted for the proposal, and to request a best and final offer, should it be in its best interest to do so. 3.3. The proposal may be awarded in its entirety as proposed; however, the City reserves the right to award elements of the work, independently, and to do portions "in-house." Additionally, the City reserves the right to award subsequent work on this project based on information presented in this proposal, without recourse to a separate or subsequent RFP process, should it be in its best interest to do so. 3.4. The City may make an award based on partial items unless the proposal submitted is marked "All or none." Where detailed specifications and/or standards are provided the City considers them to be material and may accept or reject deviations. The list of proposals submitted will be posted on BidNet, normally within 24 hours. 4. BONDS. 4.1. When deemed necessary by the City, proposal bonds shall be furnished by all vendors in the amount of at least 10% of the total value of the proposal OR 10 % of the value of the 1st year of service for service projects, to guarantee that proposers will enter into contract to furnish goods or services at prices stated. The bonding company must be listed on Treasury Circular 570 and licensed to operate in the state of California. 4.2. Likewise, when deemed necessary, a Performance Bond and/or Material and Labor bonds may be required of the successful vendor when stated in the specification. 4.3. Original Bond or Cashier's Check MUST be received AT CITY HALL, 23920 Valencia Blvd., Santa Clarita, CA 91355, ATTENTION SUITE 120 and marked with the words "PROPOSAL BOND FOR" and the proposal #, NO LATER THAN the proposal due date and time, for the vendor to be considered responsive. 5. BRAND NAMES, ALTERNATIVES, OR EQUIVALENTS. 5.1. In the bid documents, the use of a specific manufacturer, brand or make does not restrict Bidders in their proposed solution. When brand names are used, it indicates the quality and utility of the article desired; thus, the bids submittal shall in all cases propose goods equal in quality and utility. 5.2. If Materials differing from stated specifications may be considered, provided such differences are clearly noted and described. The City shall make the final determination of compliance with the specifications. If proposing an alternative or equivalent product, the Bidder shall provide the cut sheet/spec sheet or detailed product description for the proposed product via email to purchasing@santa-clarita.com prior to the last day for questions. For each product proposed documentation provided must include a description reflecting the characteristics and level of quality that will satisfy the salient physical, functional, or performance characteristics of "equal" products specified in the solicitation. The proposal must clearly identify the item by brand name (if any), and make/model number, and may include descriptive literature such as illustrations, drawings, or a clear reference to previously furnished descriptive data or information available to the City. The proposal shall clearly describe any modifications the Bidder plans to make in a product to make it conform to the solicitation requirements. 5.3. The City has the option of accepting or rejecting any alternative or equivalent product. Exception is made on those items wherein identical supply has been determined a necessity and the notation NO SUBSTITUTE has been used in the specification section. 6. COOPERATIVE BIDDING. Other public agencies maybe extended the opportunity to purchase off this solicitation with the agreement of the successful vendor(s) and the City. The lack of exception to this clause in vendor's response will be considered agreement. However, the City is not an agent of, partner to or representative of these outside agencies and is not obligated or liable for any action or debts that may arise out of such independently negotiated "piggy -back" procurements. 7. DELIVERY. Unless otherwise specified, delivery shall be D.D.P., the City of Santa Clarita, site of user division and contract delivery may begin no later than fifteen (15) calendar days from receipt of order. 8. INVOICES. Invoices will be forwarded to: City of Santa Clarita HR - Human Resources Attn: Jacqueline Huitink 23920 Valencia Blvd. Ste. 295 Santa Clarita, CA 91355-2196 Invoices will reflect the purchase order # and goods or service delivered in accordance with the terms of the contract. Invoice processing begins on receipt of the material or invoice, whichever is later. 9. DEPARTMENT OF INDUSTRIAL RELATIONS REQUIREMENTS. No proposer or subcontractor/subconsultant may be listed on a bid proposal for a public works project (submitted on or after March 1, 2015) unless registered with the Department of Industrial Relations pursuant to Labor Code Section 1725.5 [with limited exceptions from this requirement for proposal purposes only under Labor Code Section 1771.1(a)]. No proposer or subcontractor/subconsultant may be awarded a contract for public work on a public works project (awarded on or after April 1, 2015) unless registered with the Department of Industrial Relations pursuant to Labor Code Section 1725.5. This project is subject to compliance monitoring and enforcement by the Department of Industrial Relations. 10. PREPARATION. All proposals and required forms must be uploaded as laid out in the BidNet General Attachments Section. 10.1. For hard copy submissions, proposals must be typed or written in black ink except signatures. Errors may be crossed out and corrected in ink, then initialed in ink by the person signing the proposal. In compliance with Resolution 93-9, all hard copy proposals and attachments must be submitted double -sided on recycled paper. 11. REJECTION. The City reserves the right to reject any or all proposals and to waive any informality in any proposal. The City may reject the proposal of any vendor who has previously failed to perform properly, or complete on time, contracts of a similar nature, or to reject the proposal of a vendor who is not in a position to perform such a contract satisfactorily. The City may reject the proposal of any vendor who is in default of the payment of taxes, licenses or other monies due to the City of Santa Clarita. 12. RENEWAL AND PRICING ADJUSTMENT. Contracts entered into pursuant to this RFP may be renewed annually, up to three times, in accordance with the terms of the contract. If not otherwise stated, the contract may be renewed if the new pricing of the contract does not change more than the Consumer Price Index - All Urban Consumers (not seasonally adjusted), Los Angeles Area -Riverside -Orange county area and prevailing wage rates, if applicable. The index level for the month preceding the month of solicitation advertisement will become the beginning index. The price adjustment limit will be the percentage change based on the difference between the beginning level or the adjustment level last used and the index level for the period 90 days prior to the award anniversary. The final adjusted amount will be determined by Purchasing staff. If a price adjustment is not requested prior to the award anniversary date, the previous year's rates will apply. Proposer shall honor proposal prices for One -Hundred and Twenty Days (120 days) or for the stated contract period, whichever is longer. 13. LITIGATION WARRANTY. The bidding vendor, by bidding, warrants that the vendor is not currently involved in litigation or arbitration concerning the vendor's performance concerning the same or similar service to be supplied pursuant to this RFP and that no judgments or awards have been made against bidding vendor on the basis of vendor's performance in supplying the same or similar service, unless such fact is disclosed to the City in the responding proposal. Disclosure may not disqualify the bidding vendor. The City reserves the right to evaluate proposals on the basis of the facts surrounding such litigation or arbitration and to require the selected vendor to furnish the City with a surety bond executed by a surety company authorized to do business in the State of California and approved by the City of Santa Clarita in a sum equal to one hundred percent (100%) of the contract price conditional on the faithful performance by selected vendor of the contract in the event the contract is awarded to selected vendor, notwithstanding the litigation or arbitration. 14. BEST AND FINAL OFFER. The City may request Best and Final offers based upon improved understanding of the offers or changed Scope of Work. Based on the initial proposals, the pre - proposal meeting, and Best and Final offers, if requested, the panel will select the proposal which best fulfills the requirements and is the best value to the City. The City will negotiate with that seller to determine final pricing, and contract form. Because this proposal is negotiable, all pricing data will remain confidential until after award is made, and there will be no public opening and reading of Proposals. Overall responsiveness to the Request for Proposals is an important factor in the evaluation process. 15. SUBCONTRACTORS. For all projects, the vendor must list any subcontractors/subconsultants that will be used, the work to be performed by them, and total number of hours or percentage of time they will spend on the project. Each proposer must submit with their proposal the following: • The Full name of each subcontracting firm as required by Government Code, Sec. 4201, typed or legibly printed. • The address of each firm. • The telephone number at the place of business. • Work to be performed by each subcontracting firm. • Total approximate dollar amount of each subcontract. Copies of subcontracts will be provided to the City Engineer upon their request. 16. TERMINATION. The City may terminate any purchase, service or contract with or without cause either verbally or in writing at any time without penalty. The City of Santa Clarita's "Terms and Conditions" is found on a separate attachment in BidNet. DOCUMENTS CHECKLIST PROPOSAL # HR-24-25-13 Occupational Health Services City of Santa Clarita, California In addition to the items requested for the proposal the following documents are required to be completed and submitted by the proposer. The following documents must be provided by ALL proposers: Uploaded via BidNet (see Section C) ❑ Response File ❑ Cost File (to be submitted separately from Response File) ❑ Notice to Proposers Regarding Contractual Requirements ❑ Designation of Subcontractors/Subconsultants ❑ References ❑ Acknowledgement and Acceptance of Scope of Work ❑ City of Santa Clarita Disclosure Statement ❑ All signed addendums (if any) — Digitally acknowledged on BidNet in addition to uploaded via BidNet The following documents must be provided by the AWARDEE ONLY (With Agreement) Delivered to City Hall, Attn: Jacqueline Huitink ❑ Professional Services Agreement ❑ Insurance Required by Contract ❑ W-9 Form SECTION B Solicitation Information SCOPE OF WORK PROPOSAL # HR-24-25-13 Occupational Health Services City of Santa Clarita, California EVENT Solicitation advertisement Last day for questions Return of proposals Evaluations of proposals Contract award *Dates are subject to change at the City's discretion* Scope of Work 1. BACKGROUND DATE October 11, 2024 November 12, 2024 November 25, 2024 November 25, 2024 January 28, 2025 The City of Santa Clarita (City) is looking for an agency or agencies to provide occupational health services to meet the occupational health needs of our organization. Proposers must be equipped to provide the majority of occupational health services, as required per these specifications, and must meet and adhere to all relevant local, state, and federal laws and regulations along with any other requirements included in this solicitation. This contract is expected to begin July 1, 2025. 2. OBJECTIVES The purpose of this Request for Proposals (RFP) is to provide occupational health services in compliance with City policies and any applicable local, state, and federal laws and regulations. 3. DEFINITION OF ACRONYMS 3.1. "City" means the municipal corporation of the City of Santa Clarita, California. 3.2. "Contract" meansthe agreementforthe procurement of goods, equipment, materials, software, maintenance, contracted services, professional services, or concessions. 3.3. "Services" means and refers to all services listed in, but not limited to, Section 4.1 3.4. Department of Transportation (DOT) Regulations: refers to PUB. L. No. 102-143, 105 Stat. 952, as amended 3.5. "Contractor" means the agency providing occupational health services 3.6. "Summer hiring" refers to the influx hiring (150 to 200 candidates) of candidates for designated recreation programs or roles that are typically hired during a specific time of year (March through June). 4. SUPPLIER RESPONSIBILITIES 4.1. The contractor must be equipped to provide the services listed in accordance with applicable local, state, and federal laws and regulations. 4.1.1. Pre -employment physical examinations based on job descriptions, including but not limited to, whisper and basic vision tests. 4.1.2. Special summer hiring pre -employment physical examination annual rates due to the hiring volume between the months of March and June. The volume ranges between 150 to 200 candidates approximately per year. 4.1.3. Drug Screening: Performing drug testing for non -Department of Transportation related purposes. 4.1.4. Medical Review Officer (MRO) Services: MRO services for drug test result verification when a positive result occurs from a drug screen. Results must be made available to the City within 24 hours of the MRO verifying results. 4.1.5. Tuberculosis (TB) Skin Test: Administering and reading TB skin tests. 4.1.6. Chest X-Ray (single view for TB): Providing chest X-ray services for TB screening. 4.1.7. Hepatitis B Vaccine (3 Short Series): Administering Hepatitis B vaccination in a 3- dose series. 4.1.8. Fit for Duty Examination: Evaluating employees' fitness to perform specific job duties. 4.1.9. Department of Transportation (DOT) Physical Recertification: Conducting physical examinations required for DOT certification, including vision screening. (PUB. L. No. 102-143, 105 Stat. 952, as amended). 4.1.10. DOT Drug Screen: Performing drug testing as per DOT regulations. (PUB. L. No. 102-143, 105 Stat. 952, as amended). 4.1.11. Regulated DOT Breath Alcohol Test: Administering breath alcohol tests in compliance with DOT requirements. (PUB. L. No. 102-143, 105 Stat. 952, as amended). 4.1.12. Non -Regulated Breath Alcohol Test: Conducting breath alcohol tests for non -DOT related testing. 4.1.13. DOT Random Selection Testing: Conducting Random Selection Testing for the City's DOT Program in compliance with the Federal Motor Carrier Safety Administration (FMCSA) via a scientifically valid method (66 FIR 43103, Aug. 17, 2001, as amended at 67 FIR 61821, Oct. 2, 2002; 68 FIR 75459, Dec. 31, 2003; 81 FIR 68346, Oct. 4, 2016; 86 FIR 57069, Oct. 14, 2021) 4.2. Special Summer Hiring Events: Contractor shall be available to the City for one to three special onsite events per fiscal year (July 1- June 30). During the onsite event, physical examinations, drug screens, and TB testing services will be provided. The event date and location shall be determined by the City and coordinated with contractor. Events are expected to occur between the months of March and June. 4.3. Availability: The contractor must have availability for these services on weekdays and weekends. Contractor shall have appointment availability and walk-in services. 4.4. Timely Service Delivery: The contractor must perform all requested services in a timely manner, adhering to mutually agreed -upon schedules and timelines. The contractor shall exert reasonable efforts to accommodate the City's preferred timeframes for service delivery. Appointments shall be available to referred candidates to minimize wait times at clinics. 4.5. Notification of Service Delays: In the event any unforeseen circumstances lead to a delay in providing services and/ or results, the contractor shall promptly notify the City within 48 hours of the delay via email notification. The notification must include the reasons for the delay and an updated timeline for service delivery. 4.6. Additional Services and Cost Notification: If, during the course of providing the agreed - upon services, the contractor identifies the need for any additional services beyond what is originally requested, they shall inform the City promptly. Furthermore, the provider must provide a detailed breakdown of the additional services' costs and obtain approval from the City before proceeding with the services. 4.7. Records: Contractor must maintain accurate and confidential records of employee health assessments and services provided. Records shall be made accessible to the City for audit and compliance reviews. 4.8. Licensing and Permits: The contractor shall be responsible for acquiring and maintaining all necessary permits, licenses, and certificates required to perform the specified services. The provider must keep these documents up to date and available for inspection by the City or relevant regulatory authorities upon request. 4.9. Staff: Contractor must train all occupational health staff appropriately to ensure protocols, policies, laws, and regulations are followed and ensure high quality service delivery. Additionally, contractor must ensure only qualified personnel are assigned to perform required services. 5. DELIVERABLES AND TIMELINES 5.1. Contractor personnel must be available to meet with City staff quarterly to discuss operations, evaluate strategies for improvement, business hours, pricing schedules, state and federal law changes and requirements, and other topics as necessary. Contractor must notify the City of any business hour changes seven days in advance of the change and provide a new schedule to City staff/representatives. 5.2. Billing: Invoices shall be provided to City representatives with details of services acquired per candidate, charges, and grand total. Invoices shall be sent no more than ten (10) calendar days following the end of each month. If an invoice requires adjustments, the contractor shall provide a corrected invoice within 48 hours of requested correction. 5.3. Locations: Contractor must provide a list of all clinic locations, including, but not limited to those in the State of California. 5.4. Health Assessments and Test Results: Contractor staff shall provide forms and results completed to its entirety to the City 24 hours after a result is available for each service requested. Should the contractor have a delay in providing services and/ or results, the contractor shall promptly notify the City within 48 hours of the delay. The notification must include the reason(s) for the delay and an updated timeline for service delivery. Health assessments and test results shall be made accessible to City representatives preferably through an online portal or another confidential method. 6. REPORTS AND MEETINGS 6.1. Contractor shall provide a list of appropriate contacts to City representatives. Contacts provided shall be available to answer questions or concerns during the City's business hours, 7:30 a.m. to 5:30 p.m., Monday through Thursday, 8:00 a.m. to 5:00 p.m., Fridays, and the business hours of the contractor's clinic site(s). Contractor shall attend quarterly meetings with City representatives to discuss operations, evaluate strategies for improvement, pricing schedules, business hours, federal and state law changes and requirements, and other topics, as necessary. A schedule of meetings will be distributed and agreed upon prior to the start of the new calendar year. 7. CITY RESPONSIBILITIES 7.1. The City shall provide appropriate job descriptions for the purpose of physical examinations. 7.2. The City shall provide signed health authorizations that include necessary authorized health services for the purpose of the occupational health visit. 7.3. The City shall provide access to a facility for summer events, when needed. 7.4. The City shall provide a list of City representatives to contractor. RESPONSE FORMAT AND SELECTION CRITERIA PROPOSAL # HR-24-25-13 Occupational Health Services City of Santa Clarita, California 1. RESPONSE FORMAT -The organization of the response and cost files is described in this section of the Request for Proposals (RFP). All potential vendors must follow this format. 2 1.1. RESPONSE FILE: 1.1.1.Introduction - A general introduction and description of the proposal shall be provided. The introduction shall include background information, including experience, qualifications, and details of any similar contracts. This section should also include business locations and hours of operation. The format of the introduction is at the discretion of the proposer. 1.1.2.References - The respondent shall provide a contact information for a minimum of two references. References shall be similar clients. 1.1.3.Scope of Work Response - Narrative plans shall be prepared for each supplier responsibilities, deliverables, due dates, schedules, and timelines identified in the Scope of Work. Plans shall be clear of how expectations will be met by respondent. 1.1.4.Contractor Personnel - A list of personnel who will be involved in providing services to the City. The list must include name, qualifications, and experience. 1.2. COST FILE — Statement of Offer and Signature - The proposal shall be signed by an individual authorized to bind the consultant, shall contain a statement to the effect that the proposal is a firm offer for a 120-day period, and shall contain a statement that the proposed work will be performed at the "not -to -exceed" price. This will include all deliverables and meeting attendance as laid out in the scope of work. 1.2.1 Costs: Respondent must provide a detailed cost proposal, including fees for all services listed in section 4.1, outlined in the RFP. 1.2.2 Respondent must provide a list of any additional costs or potential cost variations. SELECTION CRITERIA - The overall criteria are listed below. As proposals are considered by the City to be more equal in their technical merit, the evaluated cost or price becomes more important so that when technical proposals are evaluated as essentially equal, cost or price may be the deciding factor. 2.1. SCORING CRITERIA: 2.1.1.Respondent qualifications 2.1.2.Experience on similar services 2.1.3.Cost of services provided 2.1.4.Business locations and hours 2.1.5.Thoroughness of proposal, approach to providing services, and ability to provide services to meet objectives and supplier responsibilities. 2.2. During the selection process, the evaluation panel may wish to interview bidders with scores above a natural break. Should an interview process take place, the results of the interview will carry greater weight in the selection process. The City reserves the right to make a selection solely on the basis of the proposals without further contact. SECTION C Form NOTICE TO PROPOSERS REGARDING CONTRACTUAL REQUIREMENTS PROPOSAL # HR-24-25-13 Occupational Health Services City of Santa Clarita, California 1. SUMMARY OF CONTRACTUAL REQUIRMENTS a. A contract is required for any service performed on behalf of the City of Santa Clarita (City). b. By submitting a proposal, you have reviewed the sample contract documents contained within this request for proposals and agree to be bound by the requirements set forth. c. Questions and requests for modification of these terms must be negotiated and approved prior to proposal submission and are at the full discretion of the City. 2. SUMMARY OF INDEMNITY AND INSURANCE REQUIREMENTS a. These are the Indemnity and Insurance Requirements for Contractors providing services or supplies to City of Santa Clarita (City). By agreeing to perform the work or submitting a proposal, you verify that you comply with and agree to be bound by these requirements. If any additional Contract documents are executed, the actual Indemnity language and Insurance Requirements may include additional provisions as deemed appropriate by City's Purchasing Agent. b. You should check with your Insurance advisors to verify compliance and determine if additional coverage or limits may be needed to adequately insure your obligations under this agreement. These are the minimum required and do not in any way represent or imply that such coverage is sufficient to adequately cover the Contractor's liability under this agreement. The full coverage and limits afforded under Contractor's policies of Insurance shall be available to Buyer and these Insurance Requirements shall not in any way act to reduce coverage that is broader or includes higher limits than those required. The Insurance obligations under this agreement shall be: 1—all the Insurance coverage and limits carried by or available to the Contractor; or 2—the minimum Insurance requirements shown in this agreement, whichever is greater. Any insurance proceeds in excess of the specified minimum limits and coverage required, which are applicable to a given loss, shall be available to City. c. Contractor shall furnish the City with original Certificates of Insurance including all required amendatory endorsements and a copy of the Declarations and Endorsement Page of the CGL policy listing all policy endorsements to City before work begins. City reserves the right to require full -certified copies of all Insurance coverage and endorsements. 3. INDEMNIFICATION a. To the fullest extent permitted by law, CONSULTANT shall defend (with legal counsel reasonably acceptable to CITY), indemnify and hold harmless CITY and its officers, agents, departments, officials, representatives and employees (collectively "Indemnitees") from and against any and all claims, loss, cost, damage, injury (including, without limitation, economic harm, injury to or death of an employee of CONSULTANT or its subconsultants), expense and liability of every kind, nature and description that arise from or relate to (including, without limitation, incidental and consequential damages, court costs, attorneys' fees, litigation expenses and fees of expert consultants or expert witnesses incurred in connection therewith and costs of investigation) that arise from or relate to, directly or indirectly, in whole or in part, from: (1) CONSULTANT's performance of Services under this Agreement, or any part thereof; (2) any negligent act or omission of CONSULTANT, any subconsultant, anyone directly or indirectly employed by them, or anyone that they control; (3) any actual or alleged infringement of the patent rights, copyright, trade secret, trade name, trademark, service mark or any other intellectual or proprietary right of any person or persons in consequence of the use by CITY, or any other Indemnitee, of articles or Services to be supplied in the performance of this Agreement; or (4) any breach of this Agreement (collectively "Liabilities"). Such obligations to defend, hold harmless and indemnify any Indemnitee shall not apply to the extent such Liabilities are caused by the sole negligence or willful misconduct of such Indemnitee, but shall apply to all other Liabilities. The foregoing shall be subject to the limitations of California Civil Code section 2782.8 as to any design professional services performed by CONSULTANT and in particular the limitation on CONSULTANT's duty to defend whereby such duty only arises for claims relating to the negligence, recklessness or willful misconduct of CONSULTANT as well as the limitation on the cost to defend whereby CONSULTANT will only bear such cost in proportion to CONSULTANT's proportionate percentage of fault (except as otherwise provided in section 2782.8). b. The foregoing indemnification provisions will not reduce or affect other rights or obligations which would otherwise exist in favor of the CITY and other Indemnitees. c. CONSULTANT shall place in its subconsulting agreements and cause its subconsultants to agree to indemnities and insurance obligations in favor of CITY and other Indemnitees in the exact form and substance of those contained in this Agreement. 4. INSURANCE a. Before commencing performance under this Agreement, and at all other times this Agreement is effective, CONSULTANT will procure and maintain the following types of insurance with coverage limits complying, at a minimum, with the limits set forth below: Type of Insurance Limits Commercial general liability: $1,000,000 Professional liability $1,000,000 Business automobile liability $1,000,000 Workers compensation Statutory requirement b. Commercial general liability insurance will meet or exceed the requirements of ISO-CGL Form No. CG 00 011185 or 88. The amount of insurance set forth above will be a combined single limit per occurrence for bodily injury, personal injury, and property damage for the policy coverage. Automobile coverage will be written on ISO Business Auto Coverage Form CA 00 0106 92, including symbol 1 (Any Auto). Liability policies will be endorsed to name CITY, its officials, and employees as "additional insureds" under said insurance coverage and to state that such insurance will be deemed "primary" such that any other insurance that may be carried by CITY will be excess thereto. Such endorsement must be reflected on ISO Form No. CG 20 10 1185 or 88, or equivalent. Such insurance will be on an "occurrence," not a "claims made," basis and will not be cancelable or subject to reduction except upon thirty (30) days prior written notice to CITY. c. Professional liability coverage will be on an "occurrence basis" if such coverage is available, or on a "claims made" basis if not available. When coverage is provided on a "claims made basis," CONSULTANT will continue to renew the insurance for a period of at least three (3) years after this Agreement expires or is terminated. Such insurance will have the same coverage and limits as the policy that was in effect during the term of this Agreement, and will cover CONSULTANT for all claims made by CITY arising out of any errors or omissions of CONSULTANT, or its officers, employees or agents during the time this Agreement was in effect. d. CONSULTANT will furnish to CITY duly authenticated Certificates of Insurance evidencing maintenance of the insurance required under this Agreement, including endorsements, and such other evidence of insurance or copies of policies as may be reasonably required by CITY from time to time. Insurance must be placed with California -admitted insurers with (other than workers compensation) a current A.M. Best Company Rating of at least "A:VII." e. Waiver of Subrogation: The insurer(s) agree to waive all rights of subrogation against CITY, its elected or appointed officers, officials, agents, volunteers and employees for losses paid under the terms of the workers compensation policy which arise from work performed by CONSULTANT for CITY. f. Should CONSULTANT, for any reason, fail to obtain and maintain the insurance required by this Agreement, CITY may obtain such coverage at CONSULTANT's expense and deduct the cost of such insurance from payments due to CONSULTANT under this Agreement or terminate pursuant to TERMINATION section. In the alternative, should CONSULTANT fail to meet any of the insurance requirements under this Agreement, City may terminate this Agreement immediately with no penalty. g. Should CONSULTANT'S insurance required by this Agreement be cancelled at any point prior to expiration of the policy, CONSULTANT must notify City within 24 hours of receipt of notice of cancellation. Furthermore, CONSULTANT must obtain replacement coverage that meets all contractual requirements within 10 days of the prior insurer's issuance of notice of cancellation. CONSULTANT must ensure that there is no lapse in coverage. h. The CITY shall be entitled to any coverage in excess of the minimums required herein. I have read and understand the above requirements and agree to be bound by them for any work performed for the City. Authorized Signature: Printed Name: Date: DESIGNATION OF SUBCONTRACTORS/SUBCONSULTANTS PROPOSAL # HR-24-25-13 Occupational Health Services City of Santa Clarita, California Listed below are the names and locations of the places of business of each subcontractor, supplier, and vendor who will perform work or labor or render service in excess of Y: of 1 percent, or $10,000 (whichever is greater) of the prime contractor's total bid. If no Subcontractors will be used fill out the form with NA. Please add additional sheets if needed. Subcontractor DIR Registration No. Dollar Value of Work Location and Place of Business Bid Schedule Item No's: Description of Work License No. Exp. Date: / / Phone ( ) Subcontractor DIR Registration No. Dollar Value of Work Location and Place of Business Bid Schedule Item No's: Description of Work License No. Exp. Date: / / Phone ( ) Subcontractor DIR Registration No. Dollar Value of Work Location and Place of Business Bid Schedule Item No's: Description of Work License No. Exp. Date: / / Phone ( ) NOTE: A contractor or subcontractor shall not be qualified to propose on, be listed in a proposal, subject to the requirements of Section 4104 of the Public Contract Code, or engage in the performance of any contract for public work, as defined in this chapter, unless currently registered and qualified to perform public work pursuant to Section 1725.5 of the Labor Code. It is not a violation of this section for an unregistered contractor to submit a proposal that is authorized by Section 7029.1 of the Business and Professions Code or by Section 10164 or 20103.5 of the Public Contract Code, provided the contractor is registered to perform public work pursuant to Section 1725.5 of the Labor Code at the time the contract is awarded. REFERENCES PROPOSAL # HR-24-25-13 Occupational Health Services City of Santa Clarita, California The following are the names, addresses, and telephone numbers of three public agencies for which proposer has performed work of a similar scope and size within the past 3 years. If the instructions on this form conflict with the references requested in the scope of work, the scope of work shall govern. Complete this form out accordingly. Fill out this form completely and upload it with your proposal. 1. Name and Address of Owner / Agency Name and Telephone Number of Person Familiar with Project Contract Amount Type of Work Date Completed 2. Name and Address of Owner / Agency Name and Telephone Number of Person Familiar with Project Contract Amount Type of Work Date Completed 3. Name and Address of Owner / Agency Name and Telephone Number of Person Familiar with Project Contract Amount Type of Work Date Completed ACKNOWLEDGEMENT & ACCEPTANCE OF SCOPE OF WORK PROPOSAL # HR-24-25-13 Occupational Health Services City of Santa Clarita, California By providing the three (3) required signatures below, the Contractor acknowledges full understanding, complete agreement to, and accepts in its entirety, all Scope of Work for the Occupational Health Services. The Contractor will be expected to perform maintenance practices and uphold the standards herein to the established Scope of Work throughout the length of the contract. *Supervisor's Signature: Date: *Estimator's Signature: Date: *Owner's Signature: Date: *All three signatures required CITY OF SANTA CLARITA DISCLOSURE STATEMENT PROPOSAL # HR-24-25-13 Occupational Health Services City of Santa Clarita, California The following information must be disclosed: 1. List the names of all persons having a financial interest in the Request for Proposals. 2. If any person identified pursuant to No. 1 above is a corporation or partnership, list the names of all individuals owning more than ten percent of the shares in the corporation or owning any partnership interest in the partnership. 3. If any person identified pursuant to No. 1 above is a non-profit organization or a trust, list the names of any persons serving as a director of the non-profit organization or as a trustee or beneficiary or trustor of the trust. 4. Has the offeror had more than $250.00 worth of business transacted with any member of the City of Santa Clarita staff, boards, commissions, committees, and Council within the past twelve months? If yes, please indicate the person(s) with whom you have conducted business. NOTE: Attach additional pages as necessary. Signature of Offeror Print or Type Name of Offeror Date SECTION D Sample Contra STANDARD AGREEMENT —SAMPLE ONLY CON-6 Council Approval Date: Agenda Item: Contract Amount: PROFESSIONAL SERVICES AGREEMENT BETWEEN THE CITY OF SANTA CLARITA AND FOR This AGREEMENT by and between the CITY OF SANTA CLARITA, a municipal corporation and general law city ("CITY") and , KI is dated CONSIDERATION. ("CONSULTANT"), and As partial consideration, CONSULTANT agrees to perform the Services listed in the SCOPE OF SERVICES, below; and As additional consideration, CONSULTANT and CITY agree to abide by the terms and conditions contained in this Agreement; and As additional consideration, CITY agrees to pay CONSULTANT a sum not to exceed dollars ($ ) for CONSULTANT's Services. CITY may modify this amount as set forth below. Unless otherwise specified by written amendment to this Agreement, CITY will pay this sum as specified in the attached Exhibit(s) " " which is/are incorporated by reference. SCOPE OF SERVICES. CONSULTANT will perform Services listed in the attached Exhibit(s) " " which is/are incorporated by reference. CONSULTANT will, in a professional manner, furnish all of the labor, technical, administrative, professional and other personnel, all supplies and materials, equipment, printing, vehicles, transportation, office space and facilities, and all tests, testing and analyses, calculation, and all other means whatsoever, except as herein otherwise expressly specified to be furnished by CITY, necessary or proper to perform and complete the Services and provide the professional Services required of CONSULTANT by this Agreement. PERFORMANCE STANDARDS. By executing this Agreement, CONSULTANT represents that it has demonstrated trustworthiness and possesses the quality, fitness and capacity to perform the Agreement in a manner satisfactory to CITY. CONSULTANT represents that its financial resources, surety and insurance experience, service experience, completion ability, personnel, current workload, experience in dealing with private consultants, and experience in dealing with public agencies all suggest that CONSULTANT is capable of performing the proposed contract and has a demonstrated capacity to deal fairly and effectively with and to satisfy a public CITY. CONSULTANT will perform its Services in a skillful manner, comply fully with all City established criteria, and with all applicable federal, state, and local laws, codes, and professional standards. CONSULTANT agrees to comply with all applicable federal and state employment laws regulations and rules including those that relate to minimum hours and wages, occupational health and safety, workers compensation insurance and state, county and local orders. CONSULTANT will staff this Agreement with personnel qualified to adequately and professionally perform the Services. CONSULTANT will not subcontract any portion of these Services without the CITY's prior written approval. CITY's approval of any payment, or conducting of any inspection, reviews, approvals, or oral statements, or any governmental entity's certification, will in no way limit the CONSULTANT's obligations under this Agreement or CONSULTANT's complete responsibility for all Services hereunder. PAYMENTS. For CITY to pay CONSULTANT as specified by this Agreement and as provided in attached Exhibit(s) " " , CONSULTANT must submit a detailed invoice to CITY which lists the hours worked and hourly rates for each personnel category and reimbursable costs (all as set forth in Exhibit(s) " " ) the tasks performed, the percentage of the task completed during the billing period, the cumulative percentage completed for each task, the total cost of that Services during the preceding billing month and a cumulative cash flow curve showing projected and actual expenditures versus time to date. CITY may withhold all or a portion of payment otherwise due in the event that Services are either improperly or not performed. PROJECT COORDINATION AND SUPERVISION. CONSULTANT will assign as CONSULTANT's Project Manager and will be responsible for job performance, negotiations, contractual matters, and coordination with CITY's Project Manager. CONSULTANT may change its Project Manager only with CITY consent. CITY will assign as CITY's Project Manager, will be personally in charge of and personally supervise or perform the technical execution of the project on a day-to-day basis on behalf of CITY, and will maintain direct communication with CONSULTANT's Proj ect Manager. CITY may change its Project Manager at any time with notice to CONSULTANT. NON -APPROPRIATION OF FUNDS. Payments due and payable to CONSULTANT for current Services are within the current budget and within an available, unexhausted and unencumbered appropriation of the CITY. In the event the CITY has not appropriated sufficient funds for payment of CONSULTANT Services beyond the current fiscal year, this Agreement will cover only those costs incurred up to the conclusion of the current fiscal year. FAMILIARITY WITH SERVICES AND SITE. By executing this Agreement, CONSULTANT represents that it has: i. Carefully investigated and considered the scope of Services to be performed; and ii. Carefully considered how the Services should be performed; and iii. Understands the facilities, difficulties, and restrictions attending performance of the Services under this Agreement. B. If the Services under this Agreement are to be performed upon any site, or otherwise require CONSULTANT to access a site, by executing this Agreement CONSULTANT represents that it has or will investigate the site and is or will be fully acquainted with the conditions there existing, before commencing the Services under this Agreement. TERM. B. The term of this Agreement will be from to Unless otherwise determined by written amendment between the parties, this Agreement will terminate in the following instances: Completion of the Services specified in Exhibit(s) " or ii. Termination pursuant to Section 17 TERMINATION. C. Except as otherwise separately and expressly provided by the CITY in writing, the provisions of this Agreement shall survive any expiration, breach, or termination of this Agreement, and any completion of the Services. TIME FOR PERFORMANCE. CONSULTANT will not perform any Services under this Agreement until: D. CONSULTANT furnishes proof of insurance as required under Section 24 INSURANCE; and E. CITY gives CONSULTANT a written notice to proceed. Should CONSULTANT begin Services on any phase in advance of receiving written authorization to proceed, any such professional Services are at CONSULTANT's own risk. SCHEDULE OF PERFORMANCE AND EXTENSIONS. F. Should the progress of the Services under this Agreement at any time fall behind schedule for any reason other than excusable delays CONSULTANT shall apply such additional manpower and resources as necessary to bring progress of the Services under this Agreement back on schedule and consistent with the standard of professional skill and care required by this Agreement. Time is of the essence in the performance of this Agreement. G. Should CONSULTANT be delayed by causes beyond CONSULTANT's control, CITY may grant a time extension for the completion of the contracted Services. If delay occurs, CONSULTANT must notify the CITY's designated representative within forty-eight hours (48 hours), in writing, of the cause and the extent of the delay and how such delay interferes with the Agreement's schedule. The CITY will extend the completion time, when appropriate, for the completion of the contracted Services. CHANGES. CITY may order changes in the Services within the general scope of this Agreement, consisting of additions, deletions, or other revisions, and the contract sum and the contract time will be adjusted accordingly. All such changes must be authorized in writing, executed by CONSULTANT and CITY. The cost or credit to CITY resulting from changes in the Services will be determined in accordance with written agreement between the parties. ADDITIONAL SERVICES. H. The CITY may request CONSULTANT to provide Services in addition to Scope of Services, called "Additional Services". Additional Services that incur additional costs (contingency) of up to 15% of the total contract amount must be authorized by CITY by change order or other documented means. Costs beyond this amount must first be approved by CITY in accordance with applicable thresholds and procedures. Additional Services must be authorized by CITY in writing prior to performance. CONSULTANT shall be compensated for Additional Services as set forth in Exhibit(s) " " or as specified in the written authorization. I. If CONSULTANT believes Additional Services are needed to complete the Scope of Services, CONSULTANT will provide the CITY with written notification that contains a specific description of the proposed additional Services, reasons for such additional Services, and a detailed proposal regarding cost. CITY is under no obligation to approve any increase in the agreed -upon costs for the performance of this Agreement. PERMITS AND LICENSES. CONSULTANT, at its sole expense, will obtain and maintain during the term of this Agreement, all necessary permits, licenses, and certificates that may be required in connection with the performance of Services under this Agreement. SITE INSPECTION; DISCOVERY OF HAZARDOUS MATERIALS OR LATENT CONDITIONS. The discovery, presence, handling or removal of hazardous substances is outside of CONSULTANT's expertise, unless otherwise specified in Exhibit(s) " " , and is not included in the scope of Services. Should CONSULTANT discover any hazardous material, or latent or unknown conditions that may materially affect the performance of the Services, CONSULTANT will immediately inform CITY of such fact and will not proceed except at CONSULTANT's own risk until written instructions are received from CITY. PREVAILING WAGES. CONSULTANT shall comply with the California Prevailing Wage Law to the extent it applies to work performed under this Agreement. If applicable, CONSULTANT shall pay prevailing wages to its employees and shall comply with the additional provisions set forth below: CONSULTANT shall pay prevailing wages to its employees on any agreement when required by applicable law. Copies of the general prevailing rates of per diem wages for each craft, classification, or type of worker needed to execute the Agreement, as determined by the Director of the State of California Department of Industrial Relations, are on file at the County's Capital Projects Office and may be obtained from the California Department of Industrial Relations website http://www.dir.ca.gov/OPRL/DPreWageDetennination.htm. CONSULTANT shall comply with the 8-hours per day/40 hours per week/overtime/working hours restrictions for all employees, pursuant to the California Labor Code. CONSULTANT and all subconsultants shall keep and maintain accurate employee payroll records for Work performed under the Agreement. The payroll records shall be certified and submitted as required by law, including Labor Code Sections 1771.4 (if applicable) and 1776, including to the Labor Commissioner no less frequently than monthly. CONSULTANT shall comply fully with Labor Code Section 1777.5 in the hiring of apprentices for work relating to the Agreement. CONSULTANT acknowledges and agrees that it will comply with AB 1768 (effective January 1, 2020), which amended and expanded the definition of "construction" for which prevailing wages must be paid to include "work performed during the design, site assessment, feasibility study, and other pre -construction phases of construction ... regardless of whether any further construction work is conducted... " CONSULTANT shall forfeit, as a penalty to Owner, the penalty or penalties as provided by the California Labor Code, for each laborer, workman, or mechanic employed in performing labor in and about the Work provided for in the Agreement for each day, or portion thereof, that such laborer, workman or mechanic is paid less than the said stipulated rates for any work done under the Agreement by him or her or by any Subconsultant under him or her, in violation of Articles 1 and 2 of Chapter 1 of Part 7 of Division 11 of the California Labor Code. The sums and amounts which shall be forfeited pursuant to this Paragraph and the terms of the California Labor Code shall be withheld and retained from payments due to CONSULTANT the California Labor Code, but no sum shall be so withheld, retained or forfeited except from the final payment without a full investigation by either the State Department of Industrial Relations or by Owner. The Labor Commissioner pursuant to California Labor Code § 1775 shall determine the final amount of forfeiture. CONSULTANT shall insert in every subcontract or other arrangement which CONSULTANT may make for performance of Work or labor on Work provided for in the Agreement provision that Subconsultant shall pay persons performing labor or rendering service under subcontract or other arrangement not less than the general prevailing rate of per diem wages for work of a similar character in the locality in which the Work is performed, and not less than the general prevailing rate of per diem wages for holiday and overtime work fixed in the California Labor Code. CONSULTANT and Subconsultants must keep accurate payroll records, showing the name, address, social security number, work classification, straight time and overtime hours worked each day and week, and the actual per diem wages paid to each journeyman, apprentice, worker, or other employee employed by him or her in connection with the Work of the Agreement Documents. Each payroll record shall contain or be verified by a written declaration as required by Labor Code Section 1776. The payroll records enumerated above must be certified and shall be available for inspection at all reasonable hours at the principal office of CONSULTANT as required by Labor Code Section 1776. This Project is subject to prevailing wage compliance monitoring and enforcement by the Department of Industrial Relations. WAIVER. CITY's review or acceptance of, or payment for, Services or product prepared by CONSULTANT under this Agreement will not be construed to operate as a waiver of any rights CITY may have under this Agreement or of any cause of action arising from CONSULTANT's performance. A waiver by CITY of any breach of any term, covenant, or condition contained in this Agreement will not be deemed to be a waiver of any subsequent breach of the same or any other term, covenant, or condition contained in this Agreement, whether of the same or different character. TERMINATION. Termination for Convenience. CITY may terminate this Agreement at any time with or without cause by written notice to CONSULTANT. CONSULTANT will be entitled to recover its costs expended up to the termination plus reasonable profit thereon to the termination date not to exceed the total costs under Section l(C), but may recover no other loss, cost, damage, or expense. Termination for Cause. CITY may terminate this Agreement in whole or part for default should CONSULTANT commit a material breach of this Agreement, and such breach has not been cured within fifteen (15) calendar days of the date of CITY's written notice to CONSULTANT demanding such cure. In the event CITY terminates this Agreement for default, CONSULTANT will be liable to CITY for all costs to cure the deficiencies, and all loss, cost, expense, damage, and liability resulting from such breach and termination. Upon receiving a termination notice, CONSULTANT will immediately cease performance under this Agreement unless otherwise provided in the termination notice. Except as otherwise provided in the termination notice, any Services performed by CONSULTANT after receiving a termination notice will be performed at CONSULTANT'S own cost; CITY will not be obligated to compensate CONSULTANT for such Services. Upon a termination, all finished or unfinished documents, data, studies, surveys, drawings, maps, reports and other materials prepared by CONSULTANT will become CITY's property and CONSULTANT will deliver any such items in its possession to CITY within thirty (30) days of termination. Should the Agreement be terminated pursuant to this Section, CITY may procure on its own terms Services similar to those terminated. OWNERSHIP OF DOCUMENTS. All documents, data, studies, drawings, maps, models, photographs and reports prepared by CONSULTANT under this Agreement are CITY's property. CONSULTANT may retain copies of said documents and materials as desired, but will deliver all original materials to CITY upon CITY's written notice. CITY agrees that use of CONSULTANT's Services for purposes other than identified in this Agreement is at CITY's own risk. PUBLICATION OF DOCUMENTS. Except as necessary for performance under this Agreement, CONSULTANT will not release copies, sketches, or graphs of materials, including graphic art services, prepared pursuant to this Agreement to any other person or public entity without CITY's prior written approval. All press releases, including graphic display information to be published in newspapers or magazines, will be approved and distributed solely by CITY, unless otherwise provided by written agreement between the parties. INDEMNIFICATION AND LIABILITY. To the fullest extent permitted by law, CONSULTANT shall defend (with legal counsel reasonably acceptable to CITY), indemnify and hold harmless CITY and its officers, agents, departments, officials, representatives and employees (collectively "Indemnitees") from and against any and all claims, loss, cost, damage, injury (including, without limitation, economic harm, injury to or death of an employee of CONSULTANT or its subconsultants), expense and liability of every kind, nature and description that arise from or relate to (including, without limitation, incidental and consequential damages, court costs, attorneys' fees, litigation expenses and fees of expert consultants or expert witnesses incurred in connection therewith and costs of investigation) that arise from or relate to, directly or indirectly, in whole or in part, from: (1) CONSULTANT's performance of Services under this Agreement, or any part thereof, (including any additional services authorized by CITY in writing) (2) any negligent act or omission of CONSULTANT, any subconsultant, anyone directly or indirectly employed by them, or anyone that they control; (3) any actual or alleged infringement of the patent rights, copyright, trade secret, trade name, trademark, service mark or any other intellectual or proprietary right of any person or persons in consequence of the use by CITY, or any other Indemnitee, of articles or Services to be supplied in the performance of this Agreement; or (4) any breach of this Agreement (collectively "Liabilities"). Such obligations to defend, hold harmless and indemnify any Indemnitee shall not apply to the extent such Liabilities are caused by the sole negligence or willful misconduct of such Indemnitee, but shall apply to all other Liabilities. The foregoing shall be subject to the limitations of California Civil Code section 2782.8 as to any design professional services performed by CONSULTANT and in particular the limitation on CONSULTANT's duty to defend whereby such duty only arises for claims relating to the negligence, recklessness or willful misconduct of CONSULTANT as well as the limitation on the cost to defend whereby CONSULTANT will only bear such cost in proportion to CONSULTANT's proportionate percentage of fault (except as otherwise provided in section 2782.8). The foregoing indemnification provisions will not reduce or affect other rights or obligations which would otherwise exist in favor of the CITY and other Indemnitees. CONSULTANT shall place in its subconsulting agreements and cause its subconsultants to agree to indemnities and insurance obligations in favor of CITY and other Indemnitees in the exact form and substance of those contained in this Agreement. ASSIGNABILITY. This Agreement is for CONSULTANT's professional services. CONSULTANT or any subconsultant's attempts to assign the benefits or burdens of this Agreement without CITY's written approval are prohibited and will be null and void. INDEPENDENT CONTRACTOR. CONSULTANT shall at all times be deemed an independent contractor wholly responsible for the manner in which it performs the Services, and fully liable for the acts and omissions of its employees, subconsultants and agents. Under no circumstances shall this Agreement be construed as creating an employment, agency, joint venture or partnership relationship between CITY and CONSULTANT, and no such relationship shall be implied from performance of this Agreement. Terms in this Agreement referring to direction from CITY shall be construed as providing for direction as to policy and the result of Services only, and not as to means and methods by which such a result is obtained. CONSULTANT shall pay all taxes (including California sales and use taxes) levied upon this Agreement, the transaction, or the Services and/or goods delivered pursuant hereto without additional compensation, regardless of which parry has liability for such tax under applicable law, and any deficiency, interest or penalty asserted with respect thereto. CONSULTANT shall pay all other taxes including but not limited to any applicable City business tax, not explicitly assumed in writing by CITY hereunder. CONSULTANT shall comply with all valid administrative regulations respecting the assumption of liability for the payment of payroll taxes and contributions as above described and to provide any necessary information with respect thereto to proper authorities. CONSULTANT has no authority to bind the CITY. AUDIT OF RECORDS. CONSULTANT will maintain full and accurate records with respect to all Services and matters covered under this Agreement. Those records include, without limitation, correspondence, internal memoranda, calculations, books and accounts, accounting records documenting its services under its Agreement, and invoices, payrolls, records and all other data related to matters covered by this Agreement. CITY and its designees will have free access at all reasonable times to such records, including the right to audit, examine, and make copies, excerpts, and transcripts from such records, and to inspect all program data, documents, proceedings and activities. If CITY receives funds from another governmental entity for the payment in whole or part of the Services, that governmental entity will have all rights the CITY has under this Section. CONSULTANT will retain all records subject to this Section for at least three (3) years after termination or final payment under this Agreement. INSURANCE. [All insurance terms subject to review and approval of City Risk Manager] Before commencing performance under this Agreement, and at all other times this Agreement is effective, CONSULTANT will procure and maintain the following types of insurance with coverage limits complying, at a minimum, with the limits set forth below: Type of Insurance Limits Commercial general liability: $1,000,000/$2,000,000 (aggregate) Professional liability $1,000,000 Business automobile liability $1,000,000 Workers compensation Statutory requirement Commercial general liability insurance will meet or exceed the requirements of ISO-CGL Form No. CG 00 01 11 85 or 88. The amount of insurance set forth above will be a combined single limit of $1,000,000 per occurrence, $2,000,000 general aggregate, for bodily injury, personal injury, and property damage for the policy coverage. Automobile coverage will be written on ISO Business Auto Coverage Form CA 00 0106 92, including symbol 1 (Any Auto). Liability policies will be endorsed to name CITY, its officials, and employees as "additional insureds" under said insurance coverage and to state that such insurance will be deemed "primary" such that any other insurance that may be carried by CITY will be excess thereto. Such endorsement must be reflected on ISO Form No. CG 20 10 11 85 or 88, or equivalent. Such insurance will be on an "occurrence," not a "claims made," basis and will not be cancelable or subject to reduction except upon thirty (30) days prior written notice to CITY. Professional liability coverage will be on an "occurrence basis" if such coverage is available, or on a "claims made" basis if not available. When coverage is provided on a "claims made basis," CONSULTANT will continue to renew the insurance for a period of at least three (3) years after this Agreement expires or is terminated. Such insurance will have the same coverage and limits as the policy that was in effect during the term of this Agreement, and will cover CONSULTANT for all claims made by CITY arising out of any errors or omissions of CONSULTANT, or its officers, employees or agents during the time this Agreement was in effect. CONSULTANT will furnish to CITY duly authenticated Certificates of Insurance evidencing maintenance of the insurance required under this Agreement, including endorsements, and such other evidence of insurance or copies of policies as may be reasonably required by CITY from time to time. Insurance must be placed with California -admitted insurers with (other than workers compensation) a current A.M. Best Company Rating of at least "A:VII." Waiver of Subrogation: The insurer(s) agree to waive all rights of subrogation against CITY, its elected or appointed officers, officials, agents, volunteers and employees for losses paid under the terms of the workers compensation policy which arise from work performed by CONSULTANT for CITY. Should CONSULTANT, for any reason, fail to obtain and maintain the insurance required by this Agreement, CITY may obtain such coverage at CONSULTANT's expense and deduct the cost of such insurance from payments due to CONSULTANT under this Agreement or terminate pursuant to contract language. In the alternative, should CONSULTANT fail to meet any of the insurance requirements under the Agreement, City may terminate this Agreement immediately with no penalty. Should CONSULTANT'S insurance required by this Agreement be cancelled at any point prior to expiration of the policy, CONSULTANT must notify City within 24 hours of receipt of notice of cancellation. Furthermore, CONSULTANT must obtain replacement coverage that meets all contractual requirements within 10 days of the prior insurer's issuance of notice of cancellation. CONSULTANT must ensure that there is no lapse in coverage. The CITY shall be entitled to any coverage in excess of the minimums required herein. COVID-19. CONSULTANT shall ensure its insurance coverages cover claims and/or losses related to the COVID-19 pandemic to the extent such insurance coverage is available. If such insurance is unavailable, but becomes available during the life of the contract, CONSULTANT shall procure a policy and name the City as additionally insured. Primary/noncontributing. Coverage provided by CONSULTANT shall be primary and any insurance or self-insurance procured or maintained by CITY shall not be required to contribute with it. The limits of insurance required herein may be satisfied by a combination of primary and umbrella or excess insurance. Any umbrella or excess insurance shall contain or be endorsed to contain a provision that such coverage shall also apply on a primary and non-contributory basis for the benefit of CITY before the CITY' S own insurance or self- insurance shall be called upon to protect it as a named insured. Additional insured status. General liability, automobile liability, and umbrella/excess liability insurance policies shall provide or be endorsed to provide that CITY and its officers, officials, employees, agents, and volunteers shall be additional insureds under such policies. INCIDENTAL TASKS. CONSULTANT will meet with CITY monthly to provide the status on the Services, which will include a schedule update and a short narrative description of progress during the past month for each major task, a description of the Services remaining and a description of the Services to be done before the next schedule update. DISPUTE RESOLUTION. In the event of any dispute between CONSULTANT and CITY regarding any claim, demand or request by CONSULTANT for time, money, or additional compensation for any reason whatsoever CONSULTANT shall submit to CITY, within 21 days of CONSULTANT's first knowledge of the dispute, a written description of CONSULTANT's claim, demand or request that provides a narrative of the pertinent events, the contractual basis of the CONSULTANT's position, pricing calculations (if applicable) and attaches supporting documentation. CITY will then review the issue and make a decision thereon. If CONSULTANT shall fail to provide timely notice of any such claim, demand or request, then CONSULTANT shall waive is rights to such claim, demand or request, unless CONSULTANT can demonstrate a manifest lack of prejudice to CITY resulting from such late notice. CONSULTANT shall continue its work throughout the course of any dispute, and CONSULTANT's failure to continue work during a dispute shall be a material breach of this Agreement. If the CITY denies CONSULTANT's claim, demand, or request in whole or part and CONSULTANT disagrees, and the claim, demand or request exceeds $50,000 then the parties shall, as a precondition to initiating litigation, submit the dispute claim, demand, or request to the Los Angeles JAMS office for non -binding mediation under the appropriate rules. The parties may agree to any other dispute resolution process. Nothing herein will limit CONSULTANT's obligation to timely submit to CITY a statutory Government Code Claim, in accordance with Government Code sections 910 et seq. NOTICES. All communications to either party by the other party will be deemed made when received by such party at its respective name and address as follows: If to CONSULTANT: If to CITY: ATTN: City of Santa Clarita ATTN: Kenneth W. Striplin, City Manager 23920 Valencia Boulevard, Suite 300 Santa Clarita, CA 91355 Any such written communications by mail will be conclusively deemed to have been received by the addressee three days after deposit thereof in the United States mail, postage prepaid and properly addressed as noted above. In all other instances, notices will be deemed given at the time of actual delivery. Changes may be made in the names or addresses of persons to whom notices are to be given by giving notice in the manner prescribed in this Section. CONFLICT OF INTEREST. CONSULTANT will comply with all conflict of interest laws and regulations including, without limitation, CITY's Conflict of Interest Code (on file in the City Clerk's Office). It is incumbent upon the CONSULTANT or CONSULTING FIRM to notify the CITY pursuant to Section 27 NOTICES of any staff changes relating to this Agreement. J. In accomplishing the Scope of Services of this Agreement, all officers, employees and/or agents of CONSULTANT(S), unless as indicated in Subsection (B), will be performing a very limited and closely supervised function, and, therefore, unlikely to have a conflict of interest arise. No disclosures are required for any officers, employees, and/or agents of CONSULTANT, except as indicated in Subsection (B). Initials of Consultant In accomplishing the Scope of Services of this Agreement, CONSULTANT will be performing a specialized or general service for the CITY, and there is substantial likelihood that the CONSULTANT's Services product will be presented, either written or orally, for the purpose of influencing a governmental decision. As a result, the following CONSULTANT personnel shall be subject to the Disclosure Category "1" of the CITY's Conflict of Interest Code: SOLICITATION. CONSULTANT maintains and warrants that it has not employed nor retained any company or person, other than CONSULTANT's bona fide employee, to solicit or secure this Agreement. Further, CONSULTANT warrants that it has not paid nor has it agreed to pay any company or person, other than CONSULTANT's bona fide employee, any fee, commission, percentage, brokerage fee, gift or other consideration contingent upon or resulting from the award or making of this Agreement. Should CONSULTANT breach or violate this warranty, CITY may rescind this Agreement without liability. THIRD PARTY BENEFICIARIES. CONSULTANT's subconsultants shall agree to be bound to the terms of the Agreement to the extent of their scope of services, including but not limited to, terms regarding indemnity and dispute resolution, and shall agree that CITY is deemed an express third party beneficiaries of their subconsultant agreement. Nothing in this Agreement, however, shall operate to confer such or similar rights or benefits on persons or entities not party to this Agreement. INTERPRETATION. This Agreement was drafted in, and will be construed in accordance with the laws of the State of California. The exclusive venue for any action involving this Agreement will be in Los Angeles County. ENTIRE AGREEMENT. This Agreement, and its Attachments, sets forth the entire understanding of the parties with respect to the subject matter hereof. There are no other understandings, terms or other agreements expressed or implied, oral or written. There is/are ( ) Exhibits (s) to this Agreement. To the extent of a conflict between this Agreement and one of the Exhibits, the terms of the Agreement shall take precedence. This Agreement will bind and inure to the benefit of the parties to this Agreement and any subsequent successors and assigns. RULES OF CONSTRUCTION. Each party had the opportunity to independently review this Agreement with legal counsel. Accordingly, this Agreement will be construed simply, as a whole, and in accordance with its fair meaning; it will not be interpreted strictly for or against either party. SEVERABILITY. If any portion of this Agreement is declared by a court of competent jurisdiction to be invalid or unenforceable, then such portion will be deemed modified to the extent necessary in the opinion of the court to render such portion enforceable and, as so modified, such portion and the balance of this Agreement will continue in full force and effect. AUTHORITY/MODIFICATION. The parties represent and warrant that all necessary action has been taken by the parties to authorize the undersigned to execute this Agreement and to engage in the actions described herein. To the extent of any contingency above the original Agreement amount previously approved by the CITY's City Council, additional Services may be added to this Agreement by an additional authorization executed by both parties. This Agreement may be otherwise modified by written amendment, which generally requires approval of the CITY's City Council. CITY's City Manager, or designee, may execute any such authorization or amendment on behalf of CITY. CAPTIONS. The captions of the sections and paragraphs of this Agreement are for convenience of reference only and will not affect the interpretation of this Agreement. TIME IS OF ESSENCE. Time is of the essence for each and every provision of this Agreement. DELAY. CONSULTANT shall complete all Services required by this Agreement within the times specified in the Agreement, except where (1) an event outside of CONSULTANT's reasonable control causes a delay and (2) CONSULTANT promptly advises CITY of such delay (such prompt notice to occur no more than 15 days after the first occurrence of the delay). Such events shall be limited to: acts of neglect by CITY or CITY's agents or by consultants when acting at CITY's direction; breaches of this Agreement by CITY; Acts of God such as fire and flood; explosion, acts of terrorism, war and embargo; and other similar causes beyond the Parties' reasonable control. In the event of an excusable delay the City may elect whether to terminate this Agreement or extend the time for performance. FORCE MAJEURE. Except for defaults of subcontractors at any tier, CONSULTANT shall not be liable for any excess costs if the failure to perform the Agreement arises from causes beyond the control and without the fault or negligence of CONSULTANT, including without limitation failure to reasonably mitigate any adverse impacts (Force Majeure). Force Majeure events include the following: Acts of God, fires, floods, earthquake, other natural disasters, epidemics and pandemics (other than COVID-19 or variants), abnormal weather conditions beyond the parameters otherwise set forth in this Article, nuclear accidents, strikes, lockouts, freight embargos, interruptions in service by a regulated utility, or governmental statutes or regulations enacted or imposed after the fact (together, "force maj eure events"). PROTECTION OF RESIDENT WORKERS. The CITY actively supports the Immigration and Nationality Act (INA) which includes provisions addressing employment eligibility, employment verification, and nondiscrimination. Under the INA, employers may hire only persons who may legally work in the United States (i.e., citizens and nationals of the U.S., and aliens authorized to work in the U.S.). The employer must verify the identity and employment eligibility of anyone to be hired, which includes completing the Employment Eligibility Verification Form (Form I-9), reviewing required proofs of both identify and employment authorization, and retaining the Form I-9 for the required period. Updated form I-9 information is available at www.uscis.gov. The CONSULTANT shall establish appropriate procedures and controls so no Services or products under the Agreement will be performed or manufactured by any worker who is not legally eligible to perform such Services or employment. COVID-19. Prior to execution of the Agreement, the State of California declared a state of emergency and issued a stay at home order in connection with the COVID-19 pandemic, and the County of Los Angeles ("County") issued numerous orders relating to COVID-19, including without limitation an Order to Shelter in Place, originally dated March 17, 2020 (as subsequently extended and amended, including after the date of the Agreement, the "County Order"). In no event shall CONSULTANT be entitled to any additional compensation in connection with any delay or costs associated with the COVID 19 pandemic, the County Order, or any other governmental requirements or regulations in connection therewith, whether currently existing or hereinafter enacted. In the event of any conflict between the terms of this Section and any other provision of the Agreement, in all events, the terms of this Section shall control. CONSULTANT's safety and logistics plans prepared in connection with this Contract specifically takes into account the COVID-19 Pandemic, the County Order, and all other governmental requirements or regulations regarding COVID-19 as of the date of the Contract, including without limitation all safety measures required. SAFETY OF PERSONS AND PROPERTY. CONSULTANT shall comply with, and give notices required by applicable laws, statutes, ordinances, codes, rules and regulations, and lawful orders of public authorities, bearing on safety of persons or property or their protection from damage, injury, or loss, including without limitation the County Order and all other governmental requirements or regulations regarding COVID-19, all as may be amended from time to time. FACSIMILE OR ELECTRONIC TRANSMISSION OF CONTRACT AND SIGNATURE. The parties agree that this Agreement may be transmitted and signed by facsimile or electronic mail by either/any or both/all parties, and that such signatures shall have the same force and effect as original signatures, in accordance with California Government Code section 16.5 and Civil Code section 1633.7. STANDARD SUPPLEMENTAL PROVISIONS. Notwithstanding Section 32 ENTIRE AGREEMENT above, the following Standard Supplemental Provision(s), attached to this Agreement, is(are) incorporated herein by this reference and takes precedence over any conflicting provision of this Agreement: [Insert name of any applicable SSP(s), and attach only that SSP(s)—omit remaining SSP(s). Insert "None" if applicable.) [SIGNATURES ON NEXT PAGE] IN WITNESS WHEREOF, the parties hereto have executed this contract on the date set forth below. FOR CONSULTANT: Print Name & Title IF CORPORATION: Print Name & Title Date: Date FOR CITY OF SANTA CLARITA: KENNETH W. STRIPLIN, CITY MANAGER By: City Manager Date: APPROVED AS TO FORM: JOSEPH M. MONTES, CITY ATTORNEY By: City Attorney Date: EXHIBIT A CURRENT CONTRACT RATES EXH I BIT A Component Name 2024 Price Audiogram $60.00 Breath Alcohol Test $57.00 DOT Physical $1 D7.00 Fitness for Duty Physical -Level 2 $1 D1.00 Hep B Recombivax (3 shots) #1 154_00 Hep B Recombivax (3 shots) #2 $154.00 Hep B Recombivax (3 shots) #3 $154.00 Hepatitis B Surface Antibody Quant 8475 $94_00 Physical Exam Concentra Standard $1 D2.00 Rapid eCup+15A Panel - 1200 $43.00 Rapid eCup+15 Pnl (No marijuana) $72.50 Non Reg Oral Fluid - 7 Panel $112.00 Non Reg Oral Fluid - 7 Panel (No marijuana) $1' 12.00 Non -Reg Oral Fluid - 1 Panel THC only $113.00 Regulated UDS 653D4 $B1.00 TB Skin Test $34.00 TB Symptom Screen $33-00 -Ray Chest-1 View $93.00 Physical Exam (Summer Sports Physical) $61.00 Pre -Employment Physical with 12 Panel Drug Screen $135 DOTHNon-DOT Urine Drug Screen (12 Panel) $60 PPD Chest x-Ray (Single view) $75 P P D skim test, 1-step $37 Breath Alcohol Test (Dot and Nan -Dot) $92 DOT Physicals (includes urinalysis and vision screen) $115 Fit for Duty Basic $65 Summer physicals $60 MRO Services $70 HepB Vaccine 3 Dose Adult $85 Proposal for Occupational Health Services Presented to City of Santa CI a rita Prepared by Concemrao Dominique McDermott Director of Sales Docusign Envelope ID: C60F3909-355A-4A22-BB6A-8D24BF5EA3AB Concen .ra� November 25, 2024 Jaclyn Abston, Human Resources City of Santa Clarita 23920 Valencia Blvd. Ste. 295 Santa Clarita, CA 91355-2196 RE: Occupational Health Services Dear Ms. Abston: Concentra° is pleased to present to City of Santa Clarita ("City") our proposal to provide Occupational Health Services, which adheres to all specifications and includes all relevant attachments. Our national footprint, strong infrastructure, health care expertise, and commitment to service excellence would provide tangible benefits for the City — supporting you in your efforts to meet your program objectives. Concentra draws from a pool of experienced professionals to serve our clients' needs. We assign an initial point of contact during the procurement and contracting phases and designate operational resources to provide ongoing account management and program support. The operations director would monitor contract deliverables and program expectations to help ensure we achieve successful outcomes that effectively meet the program objectives. In addition, the account management team would help ensure the services rendered under the contract remain compliant with all applicable local, state, and federal regulations. Should you have any questions or concerns regarding our response, please contact Dominique McDermott, Director of Sales, via phone: 480.338.2135 or by email: DMMcdermott@Concentra.com Concentra affirms that: • All information contained herein is current, complete, accurate, and remains valid for 120 days following the due date, November 25, 2024 • The City anticipates a contract term of one year Concentra values the City's consideration of our response. We are confident that after you review our experience, capabilities, geographic footprint, and account management strategy, Concentra will emerge as your ideal partner for the requested services. We look forward to the opportunity to serve as the preferred Occupational Health Services partner with City of Santa Clarita and its employees. Respectfully submitted, D�ocu/SCigned by: nnn 016BSD08197441 C... Kathy T. Le, MD, MPH President and Treasurer Occupational Health Centers of California, a Medical Corporation, dba Concentra Medical Centers 5080 Spectrum Drive, 1200 West Tower, Addison, Texas 75001 • 800.232.3550 Concen .ra" City of Santa Clarita ♦ HR-24-25-13 Occupational Health Services Table of Contents 1. Introduction................................................................................................................ 1 2. References................................................................................................................ 7 3. Scope of Work........................................................................................................... 8 4. Contractor Personnel............................................................................................... 20 5. Attachments.............................................................................................................22 November 25, 2024 © 2024 Concentra Operating Corporation. All rights reserved. Page 2 City of Santa Clarita ♦ HR-24-25-13 oncen .ra`� Occupational Health Services 1. Introduction 1.1.1. Introduction - A general introduction and description of the proposal shall be provided. The introduction shall include background information, including experience, qualifications, and details of any similar contracts. This section should also include business locations and hours of operation. The format of the introduction is at the discretion of the proposer. Executive Summary Concentra recognizes the City's unique service specifications. We can deliver customized clinical solutions to help you achieve your program goals. We maintain policies to ensure ongoing compliance with standard regulating bodies, including the Occupational Safety and Health Administration (OSHA), the U.S. Department of Transportation (DOT), the Americans with Disabilities Act (ADA), the Family and Medical Leave Act (FMLA), the National Fire Protection Association (NFPA), police officer standards, and many others. Concentra played a significant role in creating the workplace health industry model that exists today. We apply our proven methodologies to occupational medicine and workers' compensation to help improve treatment and overall outcomes. Our approach successfully combines evidence -based medicine with our clinical expertise and superior service discipline to deliver convenient access to quality care and measurable cost savings. Innovation Concentra HUB is a self-service, online tool that brings your employees' test results, reporting, and authorization online — making it easier and more convenient to get needed Concentra account information when it is needed. Concentra HUB includes patient -specific clinical case views for easier injury case management, online treatment authorizations, online support requests for customers to communicate with Concentra medical centers, 24/7 access to results and reports for work injury and non -jury services, and a message center for important updates. Unmatched Access With Concentra, your employees have access to our extensive network of more than 545 Concentra medical centers nationwide. Our Concentra Telemed° and Concentra Telerehab° extend access to care beyond the centers' walls and standard working hours. In addition, Concentra's Transportation Solution provides injured employees with scheduled and real-time rides to and from Concentra medical centers. Available nationwide, our transportation solution is provided free of cost after initial injury, for follow-up appointments, and for scheduled physical therapy visits. X ._ lh _ • 1 Our company mission is to improve the health of America's workforce, one patient at a time. We attribute our success to our commitment to put our customers' people first, delivering personalized attention that optimizes employee health and productivity. 1 out • of 5 � �+ +d work injuries treated in the US 3 million drug screens annually 50,000+ patients seen each day 900K+ • injured employees qP treated annually 2+ million physicals annually alts 200,000+ " employer customers nationwide, including 85% of the Fortune 500 November 25, 2024 © 2024 Concentra Operating Corporation. All rights reserved. Page 1 7 City of Santa Clarita ♦ HR-24-25-13 oncen .ra" Occupational Health Services With a clear vision and a notable record of accomplishments, we offer the best -in -class solution for occupational health care. About Concentra Concentra was founded by physicians as a medical practice in 1979 and the delivery of high -quality medical care continues to be our core competency to this day. Our footprint includes more than 545 medical centers in the United States with unmatched occupational health expertise and clinicians. We know how to deliver care that works for companies and their employees. Operating as a division of Select Medical, Concentra is a leading health care company focused on improving the health of America's workforce, one patient at a time. Through its affiliated clinicians, we provide occupational medicine, urgent care, physical therapy, and wellness services from more than 40 states nationwide. In addition to these medical center locations, Concentra currently serves employers by providing a broad range of health advisory services and operating more than 160 onsite clinics. Our People At Concentra, we believe in acknowledging and celebrating all attributes that make our team members who they are. By embracing these differences, we can more effectively and positively impact the lives of our team members and the lives of the patients we serve. We have identified Diversity, Equity, and Inclusion (DEI) as a strategic priority within our company. This emphasis has created an environment where our team members feel safe, and our DEI committee works to ensure the voices of our diverse population have developed goals, objectives, and action initiatives focused on: • Communication and marketing • Continued data and analytic review • Colleague engagement, including recognition days/events • Recruitment/talent management • Education and training This dedication to our team members is highlighted by the recognition of Concentra as one of America's Greatest Workplaces for 2024, earning 4.5 out of 5 stars. Specific categories Concentra gained recognition for include America's Greatest Workplace for Diversity (5 stars), America's Greatest Workplace for Job Starters (4.5 stars), America's Greatest Workplace for Women (5 stars), and America's Greatest Workplace for Parents & Families (5 stars). Concentra's Qualifications I prfirnl FYnPrflcr Concentra's Clinical Advisory Board (CAB) oversees company clinical operations in all Concentra medical centers and onsite clinics. The CAB's goal is to develop and disseminate guidance and policies for all Concentra clinicians. Regulatory pharmacy and Patient Care Therapy Transportation Testing and Examinations Therapeutics Concentra has developed national medical expert panels to serve as resources to clinicians, clients, and patients. The clinicians on these panels work to identify health trends, research the latest developments, and develop policies, procedures, clinical guidance documents, and processes to ensure Concentra's treatment and service philosophy November 25, 2024 © 2024 Concentra Operating Corporation. All rights reserved. Page 2 Concen .ray City of Santa Clarita ♦ HR-24-25-13 Occupational Health Services adhere to established industry best practices. These clinical experts research the latest medical literature and recommendations of national industry groups. Information is combined and integrated, then forwarded to our CAB for review and approval. Once approved, the information is disseminated via continuing medical education courses, clinical bulletins, and direct review with the clinician's supervisor depending on the topic and relevance to the practice. the City and its employees would benefit from this process which helps to ensure continual clinical program improvement. Clinical Experience Injury Experience Concentra's injury treatment experience informed our process management approach. We monitor and direct the processes that make up the structure of an individual case, all with the focus of achieving the optimal outcome. These processes include many variables, such as frequency and timing of injured employee visits, communication with the employer, and referral patterns for consultations and diagnostic testing. Our analysis of comprehensive outcomes data proves that the following factors have a considerable impact on the clinical and cost outcomes: Treating the injured employee at frequent intervals in the initial period following an injury Communicating with the employer about the activity/duty status of the injured employee Monitoring referrals to ensure that the injured employee is evaluated in a timely manner Paying attention to case closure following release to full -duty activity Non -injury Experience Concentra has been performing physical examinations, conducting drug and alcohol testing, and administering immunizations and vaccinations since our inception 45 years ago. We maintain written guidelines on all relevant regulatory standards and create client -specific service packages tailored to meet the unique needs of each client's program requirements. Furthermore, we assure that only qualified individuals perform the requested services, in accordance with all local, state, and federal guidelines. Department of Transportation Experience Annually, Concentra performs more than 800,000 DOT examinations, making us the nation's largest provider of screening services for drivers of commercial motor vehicles. We provide DOT physical examinations for employers who operate in various industries, including, but not limited to: Aviation — Federal Aviation Administration Trucking — Federal Motor Carrier Safety Administration • Railways — Federal Railroad Administration • Public Transit — Federal Transit Administration • Maritime — The United States Maritime Administration • Pipelines and Hazmat — Pipeline and hazardous Materials Safety Administration Concentra maintains current, comprehensive knowledge of DOT regulations. We require all Concentra physicians performing DOT examinations to be Federal Motor Carriers Safety Administration (FMCSA) National Registry certified. In addition, Concentra offers the FMCSA curriculum as part of our training program to educate medical examiners on multiple topics within 13 different training modules on FMCSA regulations. Concentra's participants who complete the program are prepared to: Apply knowledge of FMCSA's driver physical qualification standards and advisory criteria to findings gathered during the driver's medical examination Make sound determination of the driver's medical and physical qualifications for safely operating a commercial motor vehicle (CMV) in interstate commerce • Complete the Medical Examination Report Form November 25, 2024 © 2024 Concentra Operating Corporation. All rights reserved. Page 3 7 City of Santa Clarita ♦ HR-24-25-13 oncen .ra" Occupational Health Services As a recognized expert in DOT regulations, Concentra also provides a suite of DOT -related services to keep employers and their drivers safe and compliant, including: • DOT Drug Testing — DOT drug screenings test for the presence of illegal drugs, alcohol, and other substances • Concentra's Sleep Evaluation Program — Objective and consistent evaluation of drivers who are at a risk of collision due to excessive sleepiness • Due to our vast experience and relationship with the FMCSA, Concentra published a book, "Concentra Guide to Medical Certification of Commercial Drivers," to create consistent medical interpretations for Concentra physicians. The Concentra Guide integrates and defines the federal standards, medical guidelines, recent literature, and opinion, thereby providing a consistent framework for the medical examiner's assessment of the DOT -covered participant and determination of fitness. Concentra's vast experience in maintaining the health and safety of commercial drivers would be a benefit to the City. Services Offered Concentra offers an extensive suite of services, categorized as follows: Concentra's Suite of Services Occupational Health Care • Pre -placement services, including examinations, substance abuse testing, etc. • Regulatory and employer mandated physicals • Medical surveillance examinations • Clinical testing (X-ray, audiograms, PFT, EKG) • Work -related vaccinations and infectious disease screenings • Travel health • Functional capacity evaluations • Human performance evaluations • Office and industrial ergonomic evaluations • Occupational therapy • Medical advisory services • Utilization review services (Medical ReviewStreamT"" ) Urgent Care • Diagnosis and treatment of minor non -work -related illnesses and injuries, such as colds, flu, skin conditions, back pain, and sprains • Over 350 different types of laboratory tests • X-rays • Immunizations • Infectious disease tests and screenings Injury Care • Primary work -related injury care (workers' compensation) • Workplace injury medication dispensing" and prescribing • Physical therapy • Specialist care • Return -to -work examinations • COVID-19 evaluation for return to work *Where allowed by state law Preventive Care • Biometric screenings • Vaccinations/immunizations • Immigration examinations • School and sports physicals November 25, 2024 © 2024 Concentra Operating Corporation. All rights reserved. Page 4 Concen .ra� City of Santa Clarita ♦ HR-24-25-13 Occupational Health Services Concentra's Suite of Services Pharmacy Services* • Pre -packaged formulary • Medication dispensing for occupational medicine and travel health" • E-prescribing • Mail-order prescribing *Where allowed by state law. Service Saes Concentra Medical Centers in Your Area Training and Education • General injury prevention education • Job -specific injury prevention education • Workplace Office and Industrial stretching and exercise programs • Back care and back injury prevention • Wellness and illness prevention education • Online drug and alcohol training (CMCA) �� Santa Clarita Locations Vale 6a 2 ewhao Rat? n MagnC SFlaga Q}-' `Td Mo�mia�n 4° Valtt o- Saugus 3 w � �sci eye, Santa Clarita 14 Lyons Pave 1. Saugus 2. Valencia 22840 Soledad Canyon Rd 25733 Rye Canyon Rd Saugus, CA91350 Valencia, CA 91355 Mon -Fri. 8 am - 5 pm Mon -Fri: 8 am . 5 pm Ph: 661.799.1776 Ph. 661.295,2500 Fx: 661.7 99.177 5 Fx: 661.257.0441 November 25, 2024 © 2024 Concentra Operating Corporation. All rights reserved. Page 5 Concen .ray City of Santa Clarita ♦ HR-24-25-13 Occupational Health Services Multilingual Support Concentra offers remote translation services through our preferred provider, Voiance, to accommodate multiple language requirements. Voiance's 24/7 service supports more than 200 languages and dialects, including American Sign Language. In addition, many Concentra centers are staffed with clinician's and office staff who are bilingual, and recruiting bilingual staff is another option, where a specific engagement requires. November 25, 2024 © 2024 Concentra Operating Corporation. All rights reserved. Page 6 7 City of Santa Clarita ♦ HR-24-25-13 oncen .ra" Occupational Health Services 2. References 1.1.2. References - The respondent shall provide a contact information for a minimum of two references. References shall be similar clients. Fmnrei.iinr PinfrarariCes. Concentra offers the following other employer references for the City's review. We encourage the City to contact these entities as they can attest to our ability to perform health care services similar to those requested as part of the City's program. We perform the required services per each employer's specifications and in full compliance with all regulatory guidelines. Client Name: LA Metro City of Lynwood City of Seal Beach Address: 1 Gateway Plaza, Los 11330 Bullis Road, Lynwood, 211 Eight Street, Seal Angeles, CA CA 90262 Beach, CA 90740 Contact Name/Title: Phone Number: E-mail Address: Description of Work Performed Marisa King 213.922.2734 Kingm6@metro.net Physicals, Drug Screens, Audiogram, DOT, PFT Yolanda Delgadillo 310.603.0220 x221 ydelgadillo@lynwood.ca.gov Physicals, Drug Screens, Injury Care Lauren Barich 562.431.2527 x1336 Ibarich@sealbeachca.gov City Physicals, Audiograms, Labs, Drug Screens November 25, 2024 © 2024 Concentra Operating Corporation. All rights reserved. Page 7 Concen .ray City of Santa Clarita ♦ HR-24-25-13 Occupational Health Services I Scope of Work 1.1.3. Scope of Work Response - Narrative plans shall be prepared for each supplier responsibilities, deliverables, due dates, schedules, and timelines identified in the Scope of Work. Plans shall be clear of how expectations will be met by respondent. Concentra would successfully perform the requested scope of services proficiently and in the most cost-effective manner. We are confident our experience and expertise will make us the right company to assist the City in meeting your program objectives. We assure the City that we would: • Use company best practices that are compliant with the DOT, OSHA, and other regulated examinations • Maintain policies and procedures to ensure ongoing compliance with ADA, FMLA, NFPA, police officer standards, and many others • Conduct drug screenings in accordance with DOT standard, 49 CFR Part 40 • Utilize a SAMHSA-certified, CAP-FDT accredited, and CLIA-certified laboratory for specimen analysis • Employ only properly certified and trained staff to perform the scope of work • Assign a designated team of qualified professionals to oversee the City's program and ensure continued compliance • Document patient visits and generate meaningful reports • Maintain records securely to ensure confidentiality of personal health information in accordance with the guidelines outlined by the Health Insurance Portability and Accountability Act (HIPAA) We have the experience and resources, and qualified personnel, and are readily able to serve the City efficiently and professionally. Performing the Scope of Work Concentra medical centers offer a full complement of health care services including, but not limited to, substance abuse testing, physical examinations, clinical services, vaccinations, injury care, physical therapy, and wellness screenings. Our centers offer convenient weekday operational hours and many locations also offer evening and weekend hours. Our centers average between 3,100 and 9,000 square feet in size. The centers maintain security services, and most offer free parking on the center property or adjacent to the center. All facilities are accessible (ADA-compliant) and conform to all applicable federal, state, and local safety and disability laws. Each center's layout consists of support/common areas and clinical areas: Support/Common Areas • Waiting room — seating for • Manager office • Restroom patients with a television and • Break room • Records storage area magazine/coffee bar • Marketing office • Telephone/electrical area • Business office — work area for clerical staff Clinical Areas November 25, 2024 © 2024 Concentra Operating Corporation. All rights reserved. Page 8 7 City of Santa Clarita ♦ HR-24-25-13 oncen .ra" Occupational Health Services • Procedure rooms (for minor procedures) • Examination rooms • Lab area — separate restrooms (ADA-compliant) for drug and alcohol collections • Breath analysis/exam room — to maximize privacy for federally mandated testing • Audio testing room — a single - person booth • Physician office • Physician station — with X-ray viewing areas and privacy to enter patient data into computer system • X-ray facilities — a full -service X-ray room and digital file storage Occupational Health Services • Storage area — for patient charts • Physical therapy area with whirlpool, treatment areas, strength and flexibility equipment, hydrocollator/freezer, and a wide variety of therapy modalities We provide the following service descriptions for the City's requested scope of work. While these service descriptions highlight our standard approach, we would render all services to your specifications and in full compliance with all applicable regulatory requirements. Phv--,ir:;l FY;;min;;tinnF- Concentra has comprehensive policies and procedures outlining examination requirements in accordance with DOT, OSHA, ADA, and general occupational health. We assure the City that a trained and appropriately licensed medical professional would perform the required examinations and adhere to all applicable regulations and guidelines specific to the examination. Concentra would provide physical examinations according to the City's requirements. However, it is customary for the standard examination to include the following components: • Medical history 0 Evaluation of the respiratory system • Occupational history 0 Gastrointestinal examination • Vital signs 0 Musculoskeletal examination • Vision acuity (far distance) 0 Neurological evaluation • Examination of head, eyes, ears, nose, and throat 0 Skin and lymphatic examination • Evaluation of the cardiovascular system We would also perform other ancillary testing as requested and/or indicated, upon the City's approval and consistent with evidence -based medical standards and regulatory requirements. Medical and Work History Questionnaire Prior to any physical examination, an employee completes a thorough medical history questionnaire that includes personal, occupational, family, and medication history. Our comprehensive medical and work history questionnaires ensure your employees are compliant with all federal, state, and local mandates specific to their job category. After reviewing the questionnaire, Concentra's clinician performs a comprehensive physical examination and reviews the questionnaire in conjunction with the employee's test results to make the appropriate medical recommendations. Concentra immediately addresses any findings that pose immediate danger to the life or health of the employee. FormFox Electronic Forms Concentra uses the FormFox system to electronically capture the employee's medical history and questionnaire. The employee completes the form online before coming to the clinic/medical center, or upon arrival, thus ensuring legibility and completeness (the system prevents skipping sections). For DOT physicals, if the driver is certified, the medical examiner's certificate (MEC) is provided in the center post - visit. All determinations are reported to the National Registry of Certified Medical Examiners (NRCME) per regulations. November 25, 2024 © 2024 Concentra Operating Corporation. All rights reserved. Page 9 Concen .ray City of Santa Clarita ♦ HR-24-25-13 Occupational Health Services Custom and Spanish Forms Concentra has custom medical and work history questionnaires in both English and Spanish and can provide an array of comprehensive and mandated questionnaires necessary to maintain compliance. Pre-placement/Post-offer Physical Examination, Concentra realizes that any medical examination must be "job -related and consistent with business necessity" (29 CFR 1630.14(b)). Pre-placement/post-offer physical examinations help ensure employees or prospective employees do not have a medical condition that: • Prevents safe performance of the essential job duties • Can be exacerbated by the job duties • Affects the safety of the employee, co-workers, or others in the workplace Fitness -for -Duty Examinations Fitness -for -duty examinations help ensure that employees can safely perform their job functions. Concentra therapists and clinicians are specifically trained to assess fitness for duty for injured employees and for employees who have medical conditions that could limit their ability to perform essential job functions. A fitness -for -duty examination is performed when an employee: • Has observable difficulty performing work duties in a manner that is safe for the employee, his/her coworkers, the employer, or the public, as determined by the employee's supervisor • Poses an imminent and serious safety threat to self or others • Returns to work from a non -work -related illness or injury When an employee meeting the above conditions is referred to Concentra, our clinicians begin to implement our well -coordinated evaluation to identify issues that may be affecting performance. This begins with a comprehensive evaluation and communication with the employer to determine if the employee can return to his/her normal job or if a limited -duty arrangement is indicated. Our clinicians apply a three-phase methodology: Phase 1: Our clinicians work to understand the various jobs in the workplace and perform evaluations to ensure the employee can meet the essential job functions. We educate the employee on how to enhance function and encourage support from his/her supervisor. Phase 2: The employee undergoes a clinical examination to determine if he/she is medically able to perform his/her job; this may include a job -specific functional test. Once the medical evaluation is complete, Concentra's physical therapist conducts functional testing. In cases where the employee has other medical conditions (e.g. recent surgery or a cardiac condition), we seek clearance from the employee's primary care physician to proceed. Phase 3: Upon completion of the functional testing, our physical therapist provides the results to our physician, who combines the medical and functional test results and renders an overall "able to" or "not able to" return -to - work decision. If our clinicians believe additional testing is required to render a proper medical decision, we would seek the City's authorization to proceed. Department of Transportation (DOT) Physical Examinations Concentra has been performing Department of Transportation (DOT) physical examinations for employers for the past 40 years. Annually, we perform more than 1,000,000 DOT physicals. We maintain comprehensive policies and procedures for these examinations and thoroughly train our staff on each testing component. The Federal Motor Carrier Safety Administration (FMCSA) provides the physical requirements for commercial motor vehicle (CMV) drivers in 49 CFR 391.41. (Other DOT agencies may have prescribed different physical standards for their safety sensitive roles, such as pilots, rail conductors, etc.) The purpose of the DOT examination is to detect the presence of physical, mental, or organic conditions of such a character and extent as to affect the driver's ability to safely operate a commercial motor vehicle. The examination must be conducted carefully and include (at least) all information requested in the applicable form. A history of November 25, 2024 © 2024 Concentra Operating Corporation. All rights reserved. Page 10 7 City of Santa Clarita ♦ HR-24-25-13 oncen .ra" Occupational Health Services certain conditions may lead to a disqualification or indicate the need for further testing and/or an evaluation by a specialist. DOT Exam Details Components the ME will typically examine include the following: • General appearance and development. Note marked overweight. Note any postural defect, perceptible limp, tremor, or other conditions that might be caused by alcoholism, thyroid intoxication, or other illnesses. • Head -eyes. When charts other than the Snellen chart are used, the results must be expressed in values comparable to the standard Snellen test. If the driver wears corrective lenses for driving, these should be worn while driver's visual acuity is being tested. If contact lenses are worn, there should be sufficient evidence of good tolerance of and adaptation to their use. • Ears. Note evidence of any ear disease, symptoms of aural vertigo, or Meniere's disease. When recording hearing, record distance from patient at which a forced whispered voice can first be heard. If the individual fails the whispered voice test, the audiometric test should be administered. For the audiometric test, record decibel loss at 500 Hz, 1,000 Hz, and 2,000 Hz. Average the decibel loss at 500 Hz, 1,000 Hz, and 2,000 Hz and record as described on the form. If the individual fails the audiometric test and the whispered voice test has not been administered, the whispered voice test should be performed to determine if the standard applicable to that test can be met. • Throat. Note any permanent deformities likely to interfere with breathing or swallowing. • Heart. Note murmurs and arrhythmias, and any history of an enlarged heart, congestive heart failure, or cardiovascular disease that is accompanied by syncope, dyspnea, or collapse. Indicate onset date, diagnosis, medication, and any current limitation. An electrocardiogram is required when findings so indicate. • Blood pressure (BP). If a driver has hypertension and/or is being medicated for hypertension, he or she should be recertified more frequently. An individual diagnosed with Stage 1 hypertension (BP is 140/90-159/99) may be certified for one year. At recertification, an individual with a BP equal to or less than 140/90 may be certified for one year; however, if his or her BP is greater than 140/90 but less than 160/100, a one-time certificate for three months can be issued. An individual diagnosed with Stage 2 hypertension (BP is 160/100-179/109) should be treated and a one-time certificate for three-month certification can be issued. • Lungs. Note abnormal chest wall expansion, respiratory rate, breath sounds including wheezes or alveolar rales, impaired respiratory function, dyspnea, or cyanosis. Abnormal finds on physical examination may require further testing, such as pulmonary tests and/or chest X-rays. • Abdomen and viscera. Note enlarged liver, enlarged spleen, abnormal masses, bruits, hernia, and significant abdominal wall muscle weakness and tenderness. If the diagnosis suggests that the condition might interfere with the control and safe operation of a commercial motor vehicle, further testing and evaluation are required. • Genital -urinary and rectal examination. A urinalysis is required. Protein, blood, or sugar in the urine may be an indication for further testing to rule out any underlying medical problems. • Neurological. Note impaired equilibrium, coordination, or speech pattern; paresthesia; asymmetric deep tendon reflexes; sensory or positional abnormalities; abnormal patellar and Babinski's reflexes; ataxia. Abnormal neurological responses may be an indication for further testing to rule out an underlying medical condition. Any neurological condition should be evaluated for the nature and severity of the condition, the degree of limitation present, the likelihood of progressive limitation, and the potential for sudden incapacitation. • Spine, musculoskeletal. Previous surgery, deformities, limitation of motion, and tenderness should be noted. Findings may indicate additional testing and evaluation should be conducted. • Extremities. Carefully examine upper and lower extremities and note any loss or impairment of leg, foot, toe, arm, hand, or finger. Note any deformities, atrophy, paralysis, partial paralysis, clubbing, edema, or hypotonia. • Laboratory and other testing. Other test(s) may be indicated based upon the medical history or findings of the physical examination. • Diabetes. If insulin is necessary to control the condition of a driver who has diabetes, the driver is required to submit an Insulin -Treated Diabetes Mellitus Assessment Form MCSA-5870, obtained from their treating physician. If mild diabetes is present and it is controlled by use of an oral hypoglycemic drug and/or diet and exercise, it should not be considered disqualifying; however, the driver must remain under adequate medical supervision. November 25, 2024 © 2024 Concentra Operating Corporation. All rights reserved. Page 11 7 City of Santa Clarita ♦ HR-24-25-13 oncen .ra" Occupational Health Services Medical Examiner's Certificate The DOT physical exam is performed by a certified medical examiner listed on the National Registry of Certified Medical Examiners. The exam includes a review of the employee's medical history; a physical exam with vital signs, vision, and hearing testing; and a urine test for blood, protein, and sugar to look for conditions that may impact a driver's ability to safely operate a vehicle. Following the examination, the results are automatically reported to the National Registry and state motor vehicle agencies, as required. If the driver passes, the ME provides the required Medical Examiner's Certificate (MEC). The certificate may be issued for up to 24 months; however, the Concentra ME may limit certification based on a driver's medical history. ul n cal Screenings A range of clinical screening services are offered at Concentra centers. We perform screenings on equipment that has been thoroughly examined and calibrated so that results are as timely and accurate as possible. Some services listed below may not be available at all onsites, and can be customized as determined by the employer. The following table summarizes our clinical screening capabilities: Audiometric All audiometric screening conforms to the Occupational Safety and Health Administration (OSHA) standard Screening 29 CFR 1910.95. We have Council for Accreditation in Occupational Hearing Conservation (CAOHC)- certified technicians to perform the tests, and we would provide all certifications upon request. Concentra's services specific to audiometric screening include: ■ Audiometers that pause screening if ambient sound levels temporarily exceed OSHA levels ■ Immediate Standard Threshold Shift (STS) identification and retest capability ■ CAOHC-certified hearing specialists ■ Acoustic Systems audio booth professionally designed and installed in each clinic ■ Daily equipment calibration ■ Microprocessor audiometers Please note: Concentra cannot test hearing in people who wear hearing aids as this requires specialized equipment. People with hearing aids need to be tested by an audiologist and then submit the results. EKG (resting) Concentra performs a 12-lead EKG that measures the electrical activity of the heart, read by a center clinician. Pulmonary A technician performs all pulmonary function testing that allows real-time graphic and numeric data to verify Function the test validity. Data returns of VC, FEVI, PEFR, FEF 25 percent-75 percent, and FEVI/FVC are required. Testing Vision A trained technician performs a vision test that meets OSHA standards for visual acuity. The technician screens for visual acuity with corrective lenses, lateral and vertical phorias, stereo depth perception, and color discrimination. For visual acuity testing, we utilize the Snellen chart for distance vision, and the Ishihara book to assess color vision. Vitals A trained technician records resting pulse rates and blood pressure using a hospital grade sphygmomanometer and stethoscope. Any person who does not meet normal pulse rate or blood pressure criteria is re -tested. X-rays All posterior -anterior X-rays are performed by registered X-ray technicians and certified B-readers review selected chest X-rays in accordance with OSHA regulations. Drug and Alcohol Testing DOT -Compliant Urine Drug Screens Concentra conducts urine drug testing in full compliance with Department of Transportation (DOT) rule 49 CFR Part 40 (Procedures for Transportation Workplace Drug and Alcohol Testing) and adheres to all Substance Abuse and Mental Health Services Administration (SAMHSA) policies and procedures to ensure appropriate chain of custody. November 25, 2024 © 2024 Concentra Operating Corporation. All rights reserved. Page 12 Concen .ray City of Santa Clarita ♦ HR-24-25-13 Occupational Health Services By following these procedures in both federal and non-federal testing, Concentra simplifies the collection process, offers the most defensible procedures for our collectors and clients, and provides the optimal level of confidentiality for the donors. Our typical process includes: • Certified staff to perform collections • Use of split specimen collection method as required by DOT • Use of the proper custody and control forms (CCF) for regulated and non -regulated testing, using electronic CCFs when possible • Proper specimen containment • Shipment of specimen, within 24 hours, to a SAMHSA-certified laboratory for analysis • Involvement of a Medical Review Officer (MRO) for follow-up review, as appropriate • Utilization of Quest Diagnostics, SAMHSA, CAP-FDT, and CLIA certified, for laboratory analyses Concentra Collectors Concentra's collector certification course meets and exceeds the DOT training model. To help ensure consistency among all Concentra markets in adhering to DOT regulations, we developed a three-phase Collector Certification Program. Our policy is that all collectors (new hires and existing) successfully complete each phase of the program prior to Concentra certifying the individual to perform drug screen collections. Concentra's intention is to maintain high standards and quality throughout the collection process. To that end, although DOT regulations require refresher training to occur within five years, Concentra requires refresher training for all collectors every 2.5 years. If the collector does not complete refresher training within the designated timeframe, we do not allow him/her to perform DOT collections. We summarize each phase of our Collector Certification Program in the following table. Intranet study guide and quiz (required prior to attending Phase Two) ■ Interactive instruction Written examination (85 percent pass rate required ■ Hands-on collection training for certification) ■ Completion of Collector Acknowledgement Form ■ Five consecutive, error -free mock One "temperature out -of -range" scenario collections One scenario in which the donor refuses to sign the CCF and ■ Two uneventful collection scenarios initial the specimen bottle's tamper -evident seal ■ One "insufficient quantity of urine" scenario Collection Area Security and Measures to Ensure Valid Samples Concentra takes measures to secure the collection area, prevent unauthorized access, and ensure the collection of valid specimen samples. Examples of these measures include, but are not limited to, the following: • We confirm the donor's identity twice (by front desk personnel, then by the collector) • Once in the designated area, the collector is limited to conducting one collection at a time to avoid possible distractions that could compromise security and the integrity of the sample • As required, we perform observed collections in accordance with all state and federal regulations • Items in the collection area (i.e., trash receptacles, paper towel holders, under -sink areas, etc.) are secure to avoid the concealment of contaminants • Concentra facilities are equipped with a private, single -toilet room • Water sources are unavailable to donors to avoid specimen dilution • Water in the toilet is blue, and there is no access to soap, disinfectants, cleaning agents, or other possible adulterants November 25, 2024 © 2024 Concentra Operating Corporation. All rights reserved. Page 13 7 City of Santa Clarita ♦ HR-24-25-13 oncen .ra" Occupational Health Services • Prior to the collection, the collection site is inspected to ensure no foreign or unauthorized substances are present Collection Process Concentra uses the DOT -required split specimen collection method, when possible. DOT collection specimens are tested for substances outlined in the most recent regulations. The certified collector and appropriate laboratory adhere to the following guidelines: • Collect a minimum of 45 milliliters (mi.) of urine • Divide the specimen into two bottles, 30 mi. in one and 15 mi. into a second bottle • Seals the specimen appropriately • Transport each specimen to the laboratory within 24 hours • Once received, the lab analyzes the primary 30 mi. bottle while the second bottle is held pending a request from the employee for a second test in the event of a verified positive of the primary test result Observed Collections We acknowledge that in certain instances, direct observation may be required, and Concentra can meet this requirement. Chain of Custody When collecting urine specimens, Concentra adheres to all SAMHSA policies and procedures to ensure appropriate chain of custody to document the integrity and security of the specimen from the time of collection until receipt by the laboratory. For DOT collections, we use the federal chain of custody and control form (CCF); for non -regulated drug screens, we use the non-federal CCF. Specific to DOT testing, Concentra completes the federal CCF in accordance with SAMHSA guidelines, as we outline below: Collector check the donor's driver's license or state identification card to verify identity • Collector ensures that the name and address of the drug testing laboratory appears on the top of the CCF and that the specimen ID number on the top of the CCF matches the specimen ID number on the labels/seals • Collector provides the required information in step 1 on the CCF and provides a remark in step 2 if the donor refuses to provide his/her Social Security or employee ID number • Collector gives a collection container to the donor to provide specimen • After the donor gives the specimen to the collector, the collector checks the temperature of the specimen within four minutes, marks the appropriate temperature box in step 2 on the CCF, and provides a remark if the temperature is outside the acceptable range • Collector checks the split or single specimen collection box: ✓ If no specimen is collected, the collector checks that box, provides a remark, discards Copy 1, and distributes the remaining copies as required ✓ If it is an observed collection, the collector checks that box and provides a remark • Donor watches as the collector pours the specimen from the collection container into the specimen bottle(s), places the cap(s) on the specimen bottle(s), and affixes the label(s)/seal(s) on the specimen bottle(s) • After affixing the labels/seals, the collector dates the specimen bottle label(s) • Donor initials affixed and dated specimen bottle label(s) • Collector turns to Copy 2 (MRO Copy) and instructs the donor to (1) read the certification statement in step 5 and (2) sign, print name, date, provide phone numbers, and date of birth; if the donor refuses to sign the certification statement, the collector provides a remark in step 2 on Copy 1 • Collector completes step 4 (i.e., provides signature, printed name, date, time of collection, and name of delivery service), immediately places the sealed specimen bottle(s) and Copy 1 of the CCF in a leak -proof plastic bag, releases specimen package to the delivery service, and distributes the other copies as required November 25, 2024 © 2024 Concentra Operating Corporation. All rights reserved. Page 14 7 City of Santa Clarita ♦ HR-24-25-13 oncen .ra" Occupational Health Services Laboratory Urine Drug Screening Initial Screening Test A high -sensitivity enzyme immunoassay (EIA) screens for the presence of commonly abused drugs. At this stage, test results equal to or greater than a calibrated immunoassay cutoff concentration identify presumptively positive specimens. Each batch contains both negative and positive quality control samples along with one blind quality control sample that is inserted into the batch in a random position. Confirmation Test For specimens that do not screen negative initially, confirmatory drug testing is performed by gas chromatography/mass spectrometry (GC/MS), liquid chromatography/mass spectrometry (LC/MS), or any other technique recognized by the U.S. Department of Health and Human Services (DHHS) and Substance Abuse and Mental Health Services Administration (SAMHSA). The concentration of drug or drug metabolite in each donor specimen is determined by comparison of the response of the specimen to the response of calibrators of known concentration. As with the screening test, each batch contains both negative and positive quality control samples along with one blind quality control sample that is inserted into the batch in a random position. If required, confirmation testing for specimen validity is performed by the same or, if available, a second definitive method that can be utilized to identify specimens as adulterated, substituted, or invalid. Each confirmation test is performed on a second aliquot that is obtained from the original specimen container and all confirmation batches contain appropriate quality control samples to verify the performance of the procedure. • If a donor specimen has a concentration of drug that is less than the employer -specific cutoff, the specimen is determined to be negative for the confirmation test. • If a donor specimen has a concentration of drug that is greater than or equal to the employer -specific cutoff, the specimen is determined to be positive for the specific test. Laboratory positives are transmitted to the Medical Review Officer (MRO.) The MRO gathers all test data, interviews the donor, and confirms the result as positive or negative. The result is posted only after MRO verification. Medical Review Officer (MRO) Services When the laboratory confirms a non -negative result, Concentra enlists a Medical Review Officer (MRO) through our preferred vendor for review of the result. An MRO assistant ensures the MRO copy and the laboratory copy of the chain of custody and control form (CCF) are transmitted timely, as the MRO does not initiate a donor interview until receiving the MRO copy of the CCF and does not transmit verified results until receiving the laboratory copy. If the MRO is unable to obtain either copy, the MRO reports a "canceled" test. The MRO makes three or more attempts in a three-day period to reach the donor (barring unforeseen circumstances, such as donor's phone disconnected). The MRO interviews the donor to determine if there is a legitimate medical explanation for the non -negative result. The MRO can ask medically related questions (which the donor's employer cannot ask under the Americans with Disabilities Act) to validate or invalidate a non -negative laboratory result. The MRO's standard responsibilities include: • Conform to DOT Regulation 49 CFR Part 40 in the performance of all services and data transmissions for DOT and non -DOT drug tests • Provide an MRO assistant to review all test results and CCFs under the MRO's direct supervision • Receive appropriate copies of the CCF within 24 hours of the collection; if collection sites do not adhere to this requirement, Concentra provides appropriate follow up and training • Store MRO records within regulatory requirements and best practices to maintain confidentiality • Facilitate blind sampling for all laboratories, per DOT regulations • Adhere to federal guidelines when coordinating the collection site process • Transmit results via a secured network; SAMHSA-certified laboratories produce an export file from their information management system and send it across their internal network in an encrypted file, restricting access November 25, 2024 © 2024 Concentra Operating Corporation. All rights reserved. Page 15 7 City of Santa Clarita ♦ HR-24-25-13 oncen .ra" Occupational Health Services Tuberculosis Test [CLINICS/ONSITES] Screening for tuberculosis (TB) includes a symptom screen, as well as either a Tuberculin Skin Test (TST) or a blood test. A chest X-ray is also used as part of the screening process if the symptom screen is positive or a TST or blood test is positive. Chest X-rays alone are not used to screen for TB as they cannot diagnose latent TB infection. While an employer may choose between the TST or blood test as part of their TB screening process, Concentra clinicians will recommend the appropriate test type when specific factors or guidelines apply for a particular situation or individual. • Tuberculin Skin Test (TST): This skin test requires that the employee return in 48-72 hours after its administration to have it read. Two-step skin testing (two TSTs separated by at least one week) is recommended for the initial skin testing of adults who will be retested periodically, such as health care workers or nursing home residents. • T-Spot (Blood Test): This blood test is preferred for persons who have received the Bacille Calmette-Guerin (BCG) vaccine or employees who may have difficulty returning to have a TST read. The T-Spot requires only a single visit (no 2-step testing), even for those who will be retested periodically. The T-spot may take three to seven days to obtain results. Tecnnology Altera TouchWorks® Electronic Health Record (EMR) enables our clinicians to access patient records from any Concentra medical center, onsite clinic, Concentra Telemed, or Concentra TeleRehab site in the country. Our EMIR integrates with practice management systems and supports continuity of patient care and an exceptional customer experience. TouchWorks provides: Computerized order entry and management with electronic integration with laboratory and X-ray vendors Supports both onsite dispensing and pharmacy e-prescribing Customized clinical documentation templates to support clinical operations Best practice, evidence based, diagnosis specific care guides Integrated tasking and communication function TouchWorks supports all clinical operations, improves clinical quality, and streamlines the information exchange process to afford our clinicians the ability to quickly and accurately communicate information to the City and your employees. The system also provides data -driven insights, allowing us to apply population management principles for measurable trend management. Our ability to capture member data in real time from multiple sources helps us learn the health and social behavior patterns unique to each individual and the City's population in the aggregate. Goncentra HUB Concentra HUB is an online self-service tool for the City to conveniently access and manage account information, authorize treatment, and obtain test results and reporting. Online account management • Access to make edits to your company and location addresses and contacts • View capabilities of all service packages, components, and payors, third -party administrators, and medical review officers (MROs) • Access non -injury invoices and payment status online with option to pay online Timely delivery of your employees' non -injury and injury visit results including work restrictions • Customizable result delivery • Email notifications for visit results • Search and export functionality • Scheduled visit information for injury care cases Ability to create, manage, and review employee authorizations online • Electronic creation and transmission of authorization to medical centers (no need for employee to bring form) • Option to email authorization to employee is available but not required • Option to send online registration link using SMS text or email to employee for faster registration at center November 25, 2024 © 2024 Concentra Operating Corporation. All rights reserved. Page 16 7 City of Santa Clarita ♦ HR-24-25-13 oncen .ra" Occupational Health Services • Authorize up to 20 employees for same services at once • Search, edit, revoke, and copy authorization functions Security features to protect your information • Access control • Database monitoring • Malware and virus protection • Intrusion detection and prevention Standard Reporting With Concentra HUB, employers can designate access for different report types, as desired. Our system creates the relevant reports for each employee seen at Concentra based on the services performed and makes them available to the City via the Concentra HUB. If desired, the City could each contact to receive summary email notifications of results delivered. Sample Reports and Communications Non -Injury Status • Generated after each non -injury visit Report • Includes the employee's name and demographics, date seen, time checked in and out of the center, results, and remarks Patient Referral • Generated when a referral to a specialist takes place • Includes basic demographics, billing information, specialist information, and referrals details (i.e., type of referral, recommendations, priority, notes) Toxicology Result • Generated when a client is leveraging Concentra for specimen collection and is Certificates utilizing our selected lab and medical review officer (MRO) to process the toxicology screen. • Includes employer and donor information, specimen summary, service performed, substances tested, specimen status history, the results, and MRO remarks in accordance with DOT Rule 49 CFR Part 40 Section 40.163. Results Reporting Physical Examinations Concentra reports all medical information back to the employer's designated representative within 24 hours of receiving relevant data. These reports provide recommendations based on the results, (e.g. cleared or not cleared for job placement and/or additional testing may be required). If the exam results require supplemental testing, Concentra would notify the City's designated representative prior to performing any additional testing. Depending on the specific components tested for (i.e., blood or urine analysis), results may take up to five days to report. Drug and Alcohol Testing Concentra's average turnaround time for a negative drug screen result is 24-48 hours upon receipt at the laboratory. Turnaround time for a non -negative drug screen result, including Medical Review Office's (MRO) review, varies for non -DOT and DOT tests, and may take 48 to 72 hours depending on the MRO verifications. • For a non -DOT non -negative drug test, MRO review is at the employer's discretion and results can take 48 to 72 hours once received at the lab. • MRO review is required for all DOT non -negative drug tests. While we can report a non -negative result to the MRO within 48 hours, the average turnaround time for a non -negative DOT drug screen review by the MRO varies. Per DOT guidelines the donor has up to five days to contact the MRO before the MRO reports a result. Breath alcohol test results are reported the same day that the specimen is obtained. November 25, 2024 © 2024 Concentra Operating Corporation. All rights reserved. Page 17 7 City of Santa Clarita ♦ HR-24-25-13 oncen .ra" Occupational Health Services Administrative and Support Services Appointment Scheduling Concentra would provide the City's employees with prompt service. Although our medical centers are primarily "first come, first serve," Concentra can accommodate scheduled appointments if requested, with 24 hours' advance notice. In addition, our medical centers implement Fast Track drug/alcohol testing services where employees experience a 30-minute-or-less wait time for drug specimen collection and/or breath alcohol testing. Billing and Invoicing Concentra's Central Business Offices (CBO) maintain responsibility for all aspects of revenue billing and collection within their designated regions, including bill production, cash receipt, payment posting, and account receivable management services. We outline our standard billing process in the following table. Service Type Billing/Invoicing Details Non -Injury Care . Invoices generated weekly by market • Includes a minimum of the following for each line item: patient name, date of service, employee's department location (if provided), complete list of services performed • Term is net 30 days P.qtrant rnniFiellantialitxt Concentra takes the privacy, security, and protection of confidential and personal information very seriously and we have enterprise -wide strategies and industry leading technologies to maintain compliance with the HIPAA Privacy and Security Regulations. Concentra's Compliance Department incorporates all aspects of HIPAA, information security, privacy, and compliance into our initial colleague training upon hire and annually thereafter. New privacy and security policies including high profile topics such as phishing, social engineering, and data handling procedures are communicated through corporate communications (e.g., Concentra intranet, internal newsletters, and face-to-face educational programs) on a quarterly basis. We have HIPAA policies in place to ensure ongoing compliance with the HIPAA Privacy and Security Regulations. We also employ: • A HIPAA-compliant Business Associate Agreement (BAA) with any third -party whose services and data provided are subject to the HIPAA regulations • Concentra-owned, internal documentation systems on our servers, all of which are protected by firewalls and anti -virus technologies that are monitored daily • A secured intranet for all internal documents and a secured virtual private network (VPN) for authorized remote access • HIPAA policies and procedures that outline the required privacy and security requirements for handling, maintaining, and disposing of personal health information (PHI) • Contracted service with a bonded (HIPAA-compliant) vendor to manage the shredding and recycling of paper documents located internally in locked cabinets within our office space (as per the HIPAA guidelines). Our vendor provides an approved form of identification, picks up and removes all materials from our offices, and obtains required signatures from our bonded workers • Password protected access to all sensitive client files and access only to those staff members with a need -to - know, who require the files to support direct client services • HIPAA compliance for all employees within new -hire and annual training • HIPAA regulations regarding proper consent prior to sharing individual PHI with any party, i.e., client (employer), insurance company, or other provider(s), as required November 25, 2024 © 2024 Concentra Operating Corporation. All rights reserved. Page 18 Concen .ray City of Santa Clarita ♦ HR-24-25-13 Occupational Health Services Commitment to Service Excellenc Concentra's customer service philosophy is focused on going above and beyond to deliver a superior patient experience. This philosophy is at the root of our core values and motivates Concentra team members in their ongoing pursuit of excellence. Our medical center teams follow what we call "Orange Book" values. Concentra's Orange Book is a little book that outlines our principles to ensure a quality patient experience by performing welcoming, respectful, and skillful service every day in every location. The impact of this effort and our commitment to delivering a superior experience is evident in our patient and customer satisfaction scores even today. November 25, 2024 © 2024 Concentra Operating Corporation. All rights reserved. Page 19 7 City of Santa Clarita ♦ HR-24-25-13 oncen .ra" Occupational Health Services 4. Contractor Personnel 1.1.4. Contractor Personnel - A list of personnel who will be involved in providing services to the City. The list must include name, qualifications, and experience. Kimxf Pimrcrilinpl! Concentra carefully considers each project and its unique goals when assigning an account management team. We take a collaborative approach that combines operational and clinical support to ensure quality of service. The people we select bring valuable, relevant experience to the program and provide ongoing support. Initial Contact Dominique McDermott, Director of Sales, would ensure Concentra colleagues understand your program requirements and would be available to . 5 years with Concentra answer your questions throughout the solicitation and initial phase of . 5years of experience engagement. BA — Northern Arizona University Operational Oversight Center Operations Director (COD), Monica, Cortez, would serve as the day-to-day contact for program operations. The COD regularly monitors procedures to ensure ongoing compliance with applicable regulations and • 8 years with Concentra program specifications. The COD: • 24 years of experience ■ X-Ray Tech, Medical Assistant • Serves as the liaison between Concentra and the City • Oversees day-to-day medical center operations • Ensures ongoing compliance with operational policies, procedures, and training programs within the center • Manages patient care issues • Establishes a clear understanding of contract objectives • Collaborates with center, area, and regional leadership teams to ensure we effectively deliver the stipulated scope of work, monitors program outcomes, and maintains the City's account Medical Oversight Center Medical Director (CMD), Dr. Gregory Their,would provide primary oversight for clinical practices, ensuring continuous compliance. The CMD ensures that medical interpretations and associated clearances comply with • 1 years with Concentra current medical standards and adhere to applicable regulations. • 22 years of experience ■ MD — Uniformed Services • Reviews medical history and performs medical physical examinations University of Health Sciences • Reviews medical evaluations conducted by other center clinicians • Understands all medical surveillance requirements of the Occupational Safety and Health Administration (OSHA), the U.S. Department of Transportation (DOT), the National Fire Protection Association (NFPA), police officer standards, the Americans with Disabilities Act (ADA), the Family and Medical Leave Act (FMLA), and other regulated examinations • Reports the results of the medical evaluation to the employee • Provides the recommendation as to whether the employee is medically certified to safely perform the essential job tasks • Forwards copies of any abnormal results, along with instructions regarding primary care follow-up • Provides, or arranges for, a prescriptive rehabilitation and/or fitness program, when indicated, to aid in an employee's recovery from illness or injury • Reviews individual medical evaluations and aggregate data for evidence of occupational exposure(s) or clusters of occupational disease November 25, 2024 © 2024 Concentra Operating Corporation. All rights reserved. Page 20 7 City of Santa Clarita ♦ HR-24-25-13 oncen .ra" Occupational Health Services Physical Therapy and Functional Testing Oversight Center Therapy Director (CTD), Carla lanni, DPTwould provide oversight for the physical therapy and functional testing services rendered as part of ■ 9 years with Concentra the program. Using their expertise, the CTD delivers services that assess an ■ 10 years of experience employee's functional abilities and expedite the return -to -work process. ■ DPT —Northwestern University • Conducts an initial evaluation on clinician referrals and develops appropriate treatment plans • Communicates with all clinicians and with the employer regarding an employee's diagnoses, sets expectations for return -to -work • Utilizes knowledge of best demonstrated practices to evaluate program effectiveness, and implements methods to improve processes and outcomes • Ensures compliance with guidelines and regulations established by the Americans with Disabilities Act (ADA) and by the relevant licensing, certification, and accrediting bodies Center Staff Concentra employs experienced health care professionals to deliver services relevant to our offering. Center staff includes an appropriate combination of physicians, mid -levels, nurses, physical therapists, radiology technicians, and medical assistants. Clinical Professionals Concentra utilizes qualified and licensed clinical professionals to serve the occupational health needs of a client's workforce. Our clinical professionals undergo extensive annual training. They regularly monitor OSHA, DOT, NFPA, police officer standards, ADA, and other applicable federal and state regulations to ensure all associated services remain compliant. Support Staff Concentra employs qualified support personnel whom we train and fully certify to perform their associated tasks. Specifically, our center support staff includes drug specimen collectors certified to perform DOT collections, certified breath alcohol technicians, National Institute for Occupational Safety and Health (NIOSH)-certified pulmonary function testers, Council for Accreditation in Occupational Hearing Conservation (CAOHC)-certified personnel to perform audiometric testing, certified radiologic technologists, certified medical assistants, and certified phlebotomists. CrPHPntialinn IPrantinn, All Concentra clinicians undergo a stringent credentialing process. Once the Credentials Committee Chair/Medical Advisor clears the candidate for hire/credentialing, we follow National Committee for Quality Assurance (NCQA) guidelines for credentialing, which require primary source verification of licensure, education and training, board certifications, and any provider sanctions. In addition, we perform a System for Award Management (SAM) query to identify if a candidate is barred from contracting with the federal government and use secondary sources (copies of documentation) to verify Drug Enforcement Administration (DEA) and state-controlled substance certifications. Finally, we check the National Practitioner Databank for malpractice history and the Office of Inspector General (OIG) for Medicare/Medicaid sanctions. We re -credential our clinicians every three years and, in the interim, we monitor clinicians' licensures to ensure that they remain active. All Concentra personnel, regardless of position, are required to have a background check consisting of a felony/misdemeanor check, Social Security validation and trace, national sex offender check (for staff rendering patient care), national criminal search, drug screen, and a check against the Office of Foreign Assets Control list. November 25, 2024 © 2024 Concentra Operating Corporation. All rights reserved. Page 21 Concen .ray City of Santa Clarita ♦ HR-24-25-13 Occupational Health Services 5. Attachments In this section, Concentra includes the following information for the City's review: • Attachment A - Required Forms and Documents • Attachment B - Key Employee Qualifications • Attachment C - Legal and Risk November 25, 2024 © 2024 Concentra Operating Corporation. All rights reserved. Page 22 Concen .ray City of Santa Clarita ♦ HR-24-25-13 Occupational Health Services Attachment A Required Forms and Documents November 25, 2024 © 2024 Concentra Operating Corporation. All rights reserved. Attachment REFERENCES PROPOSAL # HR-24-25-13 Occupational Health Services City of Santa Clarita, California The following are the names, addresses, and telephone numbers of three public agencies for which proposer has performed work of a similar scope and size within the past 3 years. If the instructions on this form conflict with the references requested in the scope of work, the scope of work shall govern. Complete this form out accordingly. Fill out this form completely and upload it with your proposal. 1 LA Metro Name and Address of Owner / Agency Marisa King (213.922.2734) Name and Telephone Number of Person Familiar with Project N/A Physicals, DOT, Audiogram, PFTs N/A Contract Amount Type of Work Date Completed 2 City of Lynwood Name and Address of Owner / Agency Yolanda Delgadillo (310.603.0220 x 221) Name and Telephone Number of Person Familiar with Project N/A City Physicals, Drug Screens N/A Contract Amount Type of Work Date Completed 3 City of Seal Beach Name and Address of Owner / Agency Lauren Barich (562.431.2527 x 1336) Name and Telephone Number of Person Familiar with Project N/A City physicals, Audiograms, Labs, Drug Screens N/A Contract Amount Type of Work Date Completed Docusign Envelope ID: C60F3909-355A-4A22-BB6A-8D24BF5EA3AB ACKNOWLEDGEMENT & ACCEPTANCE OF SCOPE OF WORK PROPOSAL # HR-24-25-13 Occupational Health Services City of Santa Clarita, California By providing the three (3) required signatures below, the Contractor acknowledges full understanding, complete agreement to, and accepts in its entirety, all Scope of Work for the Occupational Health Services. The Contractor will be expected to perform maintenance practices and uphold the standards herein to the established Scope of Work throughout the length of the contract. Signed by: *Supervisor's Signat r Date:11/25/2024 Jennifer Gryn, Vice rQentpes /--Signed by: *Estimator's Signatu Dominique McDerr by: *Owner's Signatur Kathy T. Le, MD, *All three signatures required PV and I reasurer 11/25/2024 :11/22/2024 Docusign Envelope ID: C60F3909-355A-4A22-BB6A-8D24BF5EA3AB CITY OF SANTA CLARITA DISCLOSURE STATEMENT PROPOSAL # HR-24-25-13 Occupational Health Services City of Santa Clarita, California The following information must be disclosed: List the names of all persons having a financial interest in the Request for Proposals. Occupational Health Centers of California, a Medical Corporation, dba Concentra Medical Centers If any person identified pursuant to No. 1 above is a corporation or partnership, list the names of all individuals owning more than ten percent of the shares in the corporation or owning any partnership interest in the partnership. Kathy T. Le, MD at 100% If any person identified pursuant to No. 1 above is a non-profit organization or a trust, list the names of any persons serving as a director of the non-profit organization or as a trustee or beneficiary or trustor of the trust. N/A 4. Has the offeror had more than $250.00 worth of business transacted with any member of the City of Santa Clarita staff, boards, commissions, committees, and Council within the past twelve months? If yes, please indicate the person(s) with whom you have conducted business. N/A NOTE: Attach additional pages as necessary. Do�cuSigned by: �f��QBa����f Offeror Print or Type Name of Offeror KathyT. Le, MD, MPH November 25, 2024 Date Docusign Envelope ID: C60F3909-355A-4A22-BB6A-8D24BF5EA3AB NOTICE TO PROPOSERS REGARDING CONTRACTUAL REQUIREMENTS PROPOSAL # HR-24-25-13 Occupational Health Services City of Santa Clarita, California 1. SUMMARY OF CONTRACTUAL REQUIRMENTS a. A contract is required for any service performed on behalf of the City of Santa Clarita (City). b. By submitting a proposal, you have reviewed the sample contract documents contained within this request for proposals and agree to be bound by the requirements set forth. c. Questions and requests for modification of these terms must be negotiated and approved prior to proposal submission and are at the full discretion of the City. 2. SUMMARY OF INDEMNITY AND INSURANCE REQUIREMENTS a. These are the Indemnity and Insurance Requirements for Contractors providing services or supplies to City of Santa Clarita (City). By agreeing to perform the work or submitting a proposal, you verify that you comply with and agree to be bound by these requirements. If any additional Contract documents are executed, the actual Indemnity language and Insurance Requirements may include additional provisions as deemed appropriate by City's Purchasing Agent. b. You should check with your Insurance advisors to verify compliance and determine if additional coverage or limits may be needed to adequately insure your obligations under this agreement. These are the minimum required and do not in any way represent or imply that such coverage is sufficient to adequately cover the Contractor's liability under this agreement. The full coverage and limits afforded under Contractor's policies of Insurance shall be available to Buyer and these Insurance Requirements shall not in any way act to reduce coverage that is broader or includes higher limits than those required. The Insurance obligations under this agreement shall be: 1—all the Insurance coverage and limitscarried by or available to the Contractor; or 2—the minimum Insurance requirements shown in this agreement, whichever is greater. Any insurance proceeds in excess of the specified minimum limits and coverage required, which are applicable to a given loss, shall be available to City. c. Contractorshall furnish the City with original Certificates of Insurance includingall required amendatory endorsements and a copy of the Declarations and Endorsement Page of the CGL policy listing all policy endorsements to City before work begins. City reserves the right to require full -certified copies of all Insurance coverage and endorsements. 3. INDEMNIFICATION a. To the fullest extent permitted by law, CONSULTANT shall defend (with legal counsel reasonably acceptable to CITY), indemnify and hold harmless CITY and its officers, agents, departments, officials, representatives and employees (collectively "Indemnitees") from and against any and all claims, loss, cost, damage, injury (including, without limitation, economic harm, injury to or death of an employee of CONSULTANT or its subconsultants), expense and liability of every kind, nature and description thatarise Docusign Envelope ID: C60F3909-355A-4A22-BB6A-8D24BF5EA3AB from or relate to (including, without limitation, incidental and consequential damages, court costs, attorneys' fees, litigation expenses and fees of expert consultants or expert witnesses incurred in connection therewith and costs of investigation) that arise from or relate to, directly or indirectly, in whole or in part, from: (1) CONSULTANT's negligent performance of Services under this Agreement, or any part thereof; _(2) any negligent act or omission of CONSULTANT, any subconsultant, anyone directly or indirectly Formatted: Right: 0.08", Space Before: 2.85 pt employed by them, or anyone that they control; (3) any actual or alleged infringement of the patent rights, copyright, trade secret, trade name, trademark, service mark or any other intellectual or proprietary right of any person or persons in consequence of the use by CITY, or any other Indemnitee, of articles or Services to be supplied in the performance of this Agreement; or (4) any breach of this Agreement (collectively "Liabilities"). Such obligations to defend, hold harmless and indemnify any Indemnitee shall not apply to the extent such Liabilities are caused by the sole negligence or willful misconduct of such Indemnitee, but shall apply to all other Liabilities. The foregoing shall be subject to the limitations of California Civil Code section 2782.8 as to any design professional services performed by CONSULTANTand in particular the limitation on CONSULTANT's duty to defend whereby such duty only arises for claims relating to the negligence, recklessness or willful misconduct of CONSULTANT as well as the limitation on the cost to defend whereby CONSULTANT will only bear such cost in proportion to CONSULTANT's proportionate percentage of fault (except as otherwise provided in section 2782.8). b. The foregoing indemnification provisions will not reduce or affect other rights or obligations which would otherwise exist in favor of the CITY and other Indemnitees. c. CONSULTANT shall place in its subconsulting agreements and cause its subconsultants to agree to indemnities and insurance obligations in favor of CITY and other Indemnitees in the exact form and substance of those contained in this Agreement. 4. INSURANCE a. Before commencing performance under this Agreement, and at all other times this Agreement is effective, CONSULTANT will procure and maintain the following types of insurance with coverage limits complying, at a minimum, with the limits set forth below: Type of Insurance Limits Commercial general liability: $1,000,000 Professional medical malpractice liability $1,000,000 Business automobile liability $1,000,000 Workers compensation Statutory requirement b. Commercial general liability insurance will meet or exceed the requirements of ISO-CGL Form No. CG 00 011185 or 88. The amount of insurance set forth above will be a combined single limit per occurrence for bodily injury, personal injury, and property damage for the policy coverage. Automobile coverage will be written on ISO Business Auto Coverage Form CA 00 0106 92, including symbol 1 (Any Auto). Liability policies will be endorsed to name CITY, its officials, and employees as "additional insureds" under said insurance coverage, except on the Workers' Compensation and Professional Medical Malpractice Liability policies, and to state that such insurance will be deemed "primary" such that any other insurance that may be carried by CITY will be excess thereto. Such endorsement must be reflected on ISO Form No. CG 20 10 1185 or 88, or equivalent. Such insurance will be on an "occurrence," not a "claims Docusign Envelope ID: C60F3909-355A-4A22-BB6A-8D24BF5EA3AB made," basis and will not be cancelable or subject to reduction except upon thirty (30) days prior written notice to CITY. c. Professional medical malpractice liability coverage will be on an "occurrence basis" if such coverage is available, or on a "claims made" basis if not available. When coverage is provided on a "claims made basis," CONSULTANT will continue to renew the insurance for a period of at least three (3) years after this Agreement expires or is terminated. Such insurance will have the same coverage and limits as the policy that was in effect during the term of this Agreement, and will cover CONSULTANT for all claims made by CITY arising out of any t-FF;F,; ;F ;mi,;,i;P,medical malpractice of CONSULTANT, or its officers, employees or agents during the time this Agreement was in effect. d. CONSULTANT will furnish to CITY duly authenticated Certificates of Insurance evidencing maintenance of the insurance required under this Agreement, including endorsements, and such other evidence of insurance or copies of policies as may be reasonably required by CITY from time to time. Insurance must be placed with California -admitted insurers with (other than workers compensation) a current A.M. Best Company Rating of at least "A:VII." e. Waiver of Subrogation: The insurer(s) agree to waive all rights of subrogation against CITY, its elected or appointed officers, officials, agents, volunteers and employees for losses paid under the terms of the workers compensation policy which arise from work performed by CONSULTANT for CITY. f. Should CONSULTANT, for any reason, fail to obtain and maintain the insurance required by this Agreement, CITY may obtain such coverage at CONSULTANT's expense and deduct the cost of such insurance from payments due to CONSULTANT under this Agreement or terminate pursuant to TERMINATION section. In the alternative, should CONSULTANT fail to meet any of the insurance requirements under this Agreement, City may terminate this Agreement immediately with no penalty. g. Should CONSULTANT'S insurance required by this Agreement be cancelled at any point prior to expiration of the policy, CONSULTANT must notify City within 24 hours of receipt of notice of cancellation. Furthermore, CONSULTANT must obtain replacement coverage that meets all contractual requirements within 10 days of the prior insurer's issuance of notice of cancellation. CONSULTANT must ensure that there is no lapse in coverage. h. The CITY shall be entitled to any coverage in excess of the minimums required herein. I have read and understand the above requirements and agree to be bound by them for any work performed for the City. by:Authorized SignCDocuSigned Ci� Date: November 25, 2024 01665D08197441C... Printed Name: Kathy T. Le, MD, MPH, President and Treasurer Concen .ray City of Santa Clarita ♦ HR-24-25-13 Occupational Health Services Attachment B Key Employee Qualifications November 25, 2024 © 2024 Concentra Operating Corporation. All rights reserved. Attachment Monica Cortez Santa Clarita, CA • Cell: 818-400-8372 • Cortezgladiator22@gmail.com Summary of Qualifications Dedicated Operations Manager with 25+years' experience in the healthcare industry. A goal driven leader who excels at using proven methods and cutting -edge technology to successfully cut costs, streamline operations and increase productivity. Diplomatic leader and analytical thinker with an unsurpassed work ethic, who can inspire and cultivate productive working relationships with internal and external stakeholders from maximum operational efficiency. WORK EXPERIENCE Concentra Urgent Care, Valencia, CA Center Operations Director, October 2020-Present • Plan and preparing the work schedule and assigns colleagues to their specific duties • Developing and maintaining, procedures and training processes to ensure less errors • Hiring, training of system processes such as, Suspense, re -key, and Urgent Care's • Build an environment of team building, integrity, patient/colleague safety, quality care, continuous improvement, reward, and recognition at the center level • Monitor and drives key business and clinical metrics • The Forefront of providing an excellent customer experience and delivering an optimal quality of health care services for the community • Preparation and review of operational reports and schedules to ensure accuracy and efficiency • Maintains and establishes relationships with employers, payers, referral sources, networks, local communities, etc. • Complete all monthly reports; suspense, C4 call, ACC report, Pearl, missing transcripts, and clinic unbilled. • Facilitates productivity and customer service for all patients and employers via email or phone • Oversee the process of the front office, back office, checking-in/checking out patients and facilitating the board • Mentors and coaches their team regarding business metrics, patient/client happiness, process, and procedure, etc. • Ensuring staffing optimization and holds staff accountable to impact workflow and patient experience for all disciplines and sites • Works with clinicians in assessing center processes, work flows and staffing to continuously improve the patient experience • Develop colleague success through all aspects of the talent life cycle including recruiting, hiring, onboarding, orientation, mentoring / development, engagement, retention, performance management and succession planning Concentra Urgent Care, Valencia, CA Referral Supervisor - Centralized February 2017- 2020 • Oversees the processing of requests for authorization utilizing e-referral and e-task applications • Manages e-referral application to ensure status of all referrals. • Manages pending referrals to expedite approval, UR, denials in accordance with the state and company guidelines. • Supervises the scheduling for of appointments for patients upon receipt/confirmation of authorization from referral source. Ensures provider and referral entries are approved provides per state provider/facility panels. • Manages the notification for patients of all appointments, coordinates with center staff to ensure all required information is coordinated with patient, provider & clinic and resident is system whenever possible. • Interfaces with the clinic and specialists' offices as necessary to coordinate surgery appointments and the address other issues, as necessary. • Escalates pertinent issues to management to ensure timely referral approvals and scheduling of patients in accordance with the company polices. • Ensure adherence to company policies and procedures, including confidentiality, privacy and HIPPA. • Oversee that centralized referrals coordinators teams meets or exceeds timelines for work assignments and inform supervisor of work status and progress. • Maintain high level of professionalism and customer service in all interactions with all related parties. • Completes other tasks as requested & assigned by Specialty Referrals Manager. • Knowledge and use of all system(s)- Payroll, ADP, Kronos, Allscripts, Occusource, RightFax, Site Index, and Citrix. Enhanced Precision Care, Covina, CA Operations/Office Manager, November 2015- February 2017 • Oversees Billing /Collections department to ensure proper coding, completion of corrections, filing of liens timely within required deadlines effectively and efficiently. • Corresponding with insurance carriers, patient's attorney, vendors, and all third -party personnel to ensure excellent patient care and customer service. • Performs Case Management of all patients charts and Reports • HR Relations: Provide HR related duties for the Front Office, which includes, but not limited to: Recruit, Train, orienting, coaching, evaluating, counseling, supervise, and manage all Office personnel (including Assistant Manager) in their safe, effective, and efficient performance in a teamwork setting; Arrange all staff scheduling and duties, ensure on -going training for all personnel alongside the Assistant Office Manager, and perform regular performance evaluations for all the staff. • Manages internal recruitment processes from an operations perspective, to include collaboration with Human • Resources in the development of recruitment and sourcing strategies, screening of candidates. interviewing; coordinating interviews with operations managers, physicians, and other appropriate staff, confirming selections, completing pre -employment paperwork, and coordinating new hire processes with Human Resources. • Monitor Payroll / pay increases of employees. Oversees staffing operations with management team to ensure appropriate daily coverage in offices in the event of unscheduled callouts from staff. • Knowledge of SB863 and 581160 for Worker's Compensation / Implement MTUS Guides • Manage closely monitoring and maximizing doctors' schedules to ensure they are at optimal capacity. Strive to work seamlessly with doctors, practitioners effectively and efficiently to provide excellent teamwork. • Provide motivation skills to all employees of building strong team work efficiently and effectively through multitasking and excellent organizational skills. • Provide excellent patient services in all phases of clinical administrative duties, including but not limited to check -in, check-out, insurance matters, appointment setting, shipments, inquires, offsite patient services, other patient concerns, handle patients' complaints and resolve conflicts in a timely manner. Assist in maximizing and promoting products and services. • Manage all front desk procedures and operations to ensure highest level of customer service to patients. Assist with Facility Management to include, but not limited to: Ensure cleanliness and professional image in our reception area, clinical areas and rooms, quick and proper repairs and maintenance of the facility and all working counters, spaces, and IT devices. Work with the building management to ensure cleanliness and safety of bathroom, and all common areas. • Develops, reviews, and revises standard operating policies and procedures in collaboration with senior management. Advanced Care Specialist, Los Angeles, CA Traveling Office Manager August 2014-November 2015 • Development and training of staff of all operational procedures. Coordinates and/or conducts staff orientation, training, computer access, and compliance with all employment requirements. • Provides education to staff to ensure staffs awareness and compliance with applicable laws and regulations, and to improve the quality of care to patients. • Implementing of new procedures and time management for the office to be effective with all workers compensation and HIPPA laws • Examining workflow of each individual clinic and revising all job duties of employees • Redistributing responsibilities and providing guidance and opportunity for professional development • Implementing higher level of organization professionalism and efficiency to the office • Assumes administrative responsibility over individual facilities in the absence of operations managers as requested, • Manages operational and special projects within scope of responsibility. • Assists in reviewing, drafting, and negotiating various contracts. • Serves as a resource to operations managers for day-to-day personnel issues and other administrative problems requiring senior management review, input, and advice. • Consults, plans, organizes, and directs administrative (front office), clinical (back office), and health information daily operations of the medical practice(s) as required. Coordinates operations as needed between different facilities (e.g., staffing) to ensure excellent quality patient care and customer service. Delegate emails to ensure all logs have been updated and completed for annual audits as needed. Mark Greenspan M.D. Orthopedic Surgeon, Inc. Los Angeles, CA Office Manager July 2000-April 2014 • Plans, organizes, and directs administrative (front office), clinical (back office), and health information daily operations of the medical practice(s) as required. Coordinates operations as needed (e.g., staffing). • Maintained budgets, payroll, invoicing and merchandising • Oversees staffing operations with management team to ensure appropriate daily coverage in offices in the event of unscheduled callouts from staff. • Directly supervises the medical clinic. Responsible for recruiting, orienting, training, coaching, evaluating, counseling, and exiting direct reports. • Attended seminars to enhance and educate employees • Continuous training staff of new laws and procedures per Division of Workers Compensation. • Coordinates and/or conducts staff orientation, training, computer access, and compliance of all protocols and procedures with the required operations and procedures. • Develops, reviews, and revises standard operating policies and procedures in collaboration with senior management. • Coordinates all necessary paperwork and personnel actions with Human Resources. Includes processing of initial requests for recruitment, confirmation of new hire selection, and subsequent personnel action forms. • Manages internal recruitment processes from an operations perspective, to include collaboration with Human Resources in the development of recruitment and sourcing strategies, screening of candidates. interviewing; coordinating interviews with operations managers, physicians, and other appropriate staff, confirming selections, completing pre -employment paperwork, and coordinating new hire processes with Human Resources. • Provides direction and support to administrative assistant in the integration of new practices and physicians to the medical group; ensures that all aspects of practice set-up are appropriately planned for and executed. SKILLS, QUALIFICATIONS, AND CERTIFICATIONS Systems: EMR: Allscripts, BCS Occusource, Payroll, ADP, Kronos, Allscripts, RightFax, Site Index, Citrix, Epic, Prime Clinical as well as operate J-tech Medical functional testing Equipment Skills: Leadership, Managing, Operating High Volume Clinics, Workers Compensation Claims Procedure/Policies/Regulations, Occupational Health, Client/Vendor Relations, Process improvement/Procedure Development Certifications: X-Ray Technician, Medical Assistant, Breath Alcohol Technician, EMT Professional Affiliations: Member of the Board of Directors of UEI College, Member of Baldwin Park High School ROP Program, Member of C.C.W.C/ Attendee of DMW Conventions GREWRY T. THIER, MD. FAAFP 13216 Haxton PI. • San Diego, CA 92130 • 843-540-3114 • gthier@ymail.com https://www.linkedin.com/in/gregory-thier-servant-leader PROFILE Executive -level medical professional with 30+ years of applied experience in exceedingly prestigious positions including Chief Medical Officer, Chief Executive Officer, Chief Operating Officer, Policy and Practice Officer, and Family Medicine Practitioner. Recognized ability to establish and lead cohesive teams in care model innovation to achieve optimal clinical outcomes. Extensive program management skills and adept in budget management and resource allocation resulting in cost savings and increased profitability. Established and respected leader committed to providing professional development opportunities through innovative and strategic alliances and applied practice. PROFESSIONAL EXPERIENCE Concentra, Los Angeles, CA 2023 - Present Director of Medical Operations, North LA Market Functioning as Supervisor to 16 centers in busy, dynamic occupational health market overseeing the day to day medical care of America's workforce. ■ Build clinical teams focused on service delivery and driving key metrics, clinician support and growing core business. ■ Responsible for the implementation of strategy and maintaining internal and external relationships across the market. ■ Ensures superb patient care, satisfaction, and employer experience. ■ Accountable for clinical management of all centers within area of responsibility. UNITED STATES NAVY, San Diego, CA 2020 - 2023 Chief Medical Officer (Force Surgeon) - Commander, Naval Surface Forces Pacific Serve as Medical Advisor for a three -star Admiral ensuring the ability to execute mission of operating, training, maintaining, readiness, logistics, support, safety, and administration of 92 US Navy warships located throughout the waters and islands of the Pacific Ocean. ■ Develop, expand, and oversee fleet medical departments comprised of 995 medical staff in the execution of medical policy and healthcare delivery to 40K military personnel. ■ Oversee numerous programs and utilize/leverage statistical analysis to monitor overall program effectiveness, develop and execute strategy to achieve operational goals and objectives/benchmarks, direct education and team building where appropriate, and ensure overall health of the Fleet. ■ Serve as Privileging Authority; determine privileging action of Physicians, Nurses, and providers based on credentials and performance. Notable Accomplishments - Restructured Fleet Surgical Team program to reflect a more versatile/agile solution to better meet the needs of the U.S. Navy, and Marine Corps. - Aligned with UC Irvine to provide expanded professional development and training opportunities for Surgical Teams maintaining required training and certifications to ensure optimal operational readiness and trauma and casualty care of wounded service members. - Established the ability of mid -level providers to work within the UCSD Trauma Department to apply clinical knowledge and training within the field. - Focused efforts to overcome COVID-19 pandemic challenges through optimized population health management efforts while maintaining the positive health status of beneficiaries. UNITED STATES NAVY, North Chicago, IL 2018 - 2020 Chief Executive Officer (CEO) - Captain James. A. Lovell Federal Health Care Center Led, managed, and provided administrative and operational oversight to 3,200 Navy active duty, DOD, and Veteran's Affair civilian personnel at the nation's only fully integrated DOD/VA health care facility. Maintained accountability by higher authority to the highest standards of personal and professional conduct for 900 Sailors while ensuring operational medical readiness for Navy's only enlisted accessioning station. ■ Managed, allocated, and executed an annual budget of $453M ensuring appropriate utilization to enhance quality outcomes, utilization management, and cost containment. ■ Upheld responsibility in the achievement of clinical quality and patient experience goals ensuring the provision of high -quality healthcare to 165K beneficiaries. Notable Accomplishments Oversaw the final development of a Corpsman Trauma Training Program partnership between the Hospital, higher headquarters, and Stroger Cook County Hospital ensuring high quality, timely, effective, and salient combat trauma skills were taught to Navy Medics. Utilizing Process Improvement skills, restructured Board of Directors to be more efficient and cognizant of integrated facility parties to ensure equity for both organizations. Oversaw a multidisciplinary team for a $23M pilot project for logistical supply system that provided the framework for VA locations throughout the country. Pilot project reflected a 12% cost savings and 500% increase in product availability. Developed innovative ways to ensure recruit health during a global pandemic. Stood up Incident Command System to track and trend issues, increased bed capacity by 100% including additional negative pressure rooms, and created a innovative screening location outside of the clinics. UNITED STATES NAVY, Naval Air Station Lemoore, CA 2016 - 2018 Chief Operating Officer (COO) Naval Health Clinic Lemoore Led 520 military and civilian personnel across geographically diverse and remote areas, while ensuring high -quality healthcare for 32K beneficiaries. Served as CEO in their absence. ■ Oversaw patient care, drills, exercises, personnel organization, and facilities inspections. ■ Provided direct administrative oversight of organizations' Board of Directors through direction, guidance, mentoring, and team development. ■ Directed the administration of recognition programs, patient satisfaction surveys, HEDIS Metrics and Joint Commission Programs. ■ Expertly managed physician/staff relations and determined resolutions to identified challenges/conflicts. Notable Accomplishments - Reestablished a $1.8M Urgent Care Clinic four months ahead of schedule through expert efficient operations and project management. Secured funding from Headquarters funding source with an estimated government savings of $3.5M and notable increased satisfaction ratings. UNITED STATES NAVY, Falls Church, VA 2014 - 2016 Policy and Practice Officer - Navy Medical Corps Chief Office / BUMED Directed, designed, developed, and evaluated Medical Corps policy initiatives that supported continuous alignment with headquarters' strategic goals. ■ Researched and revised policies related to professional practice based upon relevant statutes and regulations on community, regional, and national levels. ■ Served on risk management Case Review Panels ensuring timely input for the Navy Surgeon General. SKILLS & EXPERTISE Healthcare Management. Patient Care. Leadership & Collaboration Hospitals. Change Management. Stakeholder Engagement Program Management. Budgeting & Cost Control. Policy & Procedures Train ing/Mentoring. Regulations & Compliance. Patient Care OTHER PREVIOUS POSITIONS Director of Medical Services — Naval Hospital Beaufort (2009-2014) Director of Public Health - NAVAL HOSPITAL ROTA (2006-2009) Senior Medical Officer / Department Head - Naval Branch Health Clinic (2003-2006) Department Head, Family Practice Clinic - Naval Hospital Guam (2002-2003) LICENSES Board Certified in Family Medicine Fellow, American Academy of Family Physicians Medical Licensure in the states of California and Louisiana EDUCATION UNIFORMED SERVICES UNIVERSITY OF THE HEALTH SCIENCES, Bethesda, MD - Medical Doctorate UNIVERSITY OF GEORGIA, Athens, GA - Bachelor of Science (Magna Cum Laude) Carla M. Ianni (Lopez) PT, DPT PROFESSIONAL EXPERIENCE Concentra Sr. Director of Clinical Services cianni@concentra.com (310) 730-9055 Phoenix, AZ January 2024-Present o Oversee Therapy Services, Pharmacy service lines, and Specialty services in Arizona and North Los Angeles markets for 26 centers and over 70+ colleagues o Work closely with Regional Vice President in delivery of best patient outcomes and region success, execution and management of projects aligning with company goals at a regional and national level, and delivery of market adherence to SOPS and new company initiatives o Analyze key performance metrics, financial budgets, and monthly financial performance to implement real time action for market success and best patient experience and outcomes o Review and synthesize reports regularly to identify opportunities for improvement in performance and patient care delivery, and develop strategic long-term planning for market growth and improvement o Partner regularly with Sales teams to create enduring and Best -In -Class client partnerships o Deliver regular mentorship on emotional intelligence, leadership, and business acumen to Directors of Clinical Services, Associate Directors of Clinical Services, and Center Therapy Directors (CTD) for market and regional success, flourishing client partnerships, and optimal patient outcomes o Collaborate daily with the Operations, Medical, and Specialist North LA and Arizona Director Leadership teams (DLT) for patient and market success o Ensure strategic center operating expenses for clinical services align with the annual budget and available resources Director of Clinical Services Los Angeles, CA January 2021— Present o Successfully managed and oversaw the North and partial South Los Angeles markets totaling 15 centers o Exceeded budgeted market KPIs including EBITDA, PTPI, and therapy efficiency o Collaborated daily with North and South LA DLTs to execute Best -in Class market strategies for high-level patient outcomes, patient experiences, and client satisfaction o Partnered with DLTs for center business and leadership development, optimal fulfillment of key center roles, and market focus on company values and mission o Developed CTD leadership and strategic impact through (1) monthly 1-on-1 calls reviewing leadership best practices and business acumen, (2) monthly CTD team call to review effective execution of thoughtful action plans, and (3) regular involvement in Center Leadership Team meetings to provide direct support across disciplines o Drove increased CTD data analysis through monthly review and guidance of evaluation of Concentra reports, business growth opportunities, and appropriate action plans o Regularly involved in, and occasionally led, client meetings for stewardship and resolution of client matters o Led the development of the national Director of Clinical Services Pharmacy guide including the initiation of a bi- weekly Pharmacy strategy calls that were replicated across the country o Held key role in the creation of the 2021 Specialist resource guidance providing vital information to the field regarding Specialist onboarding and key steps for successful CAS integration into our centers Center Therapy Director Kansas City, MO June 2015 — October 2020 o Provided specialized treatment for patients following Concentra values, mission, and our early intervention model o Oversaw and implemented solutions for high-level patient satisfaction, employer satisfaction, and optimal KPI outcomes for the Kansas City Crossroads location o Frequently participated in client tours and meetings to discuss Concentra's Best -in -Class injury management structure, client quarterly data, the benefits of our early intervention model, and identified areas of opportunity to maintain a thriving client partnership o Provided monthly reports and analysis to leadership, reviewing outcomes, opportunities, and action plans for key metrics o Participated in the Physical Therapy Student Program directly mentoring Physical Therapy students with a focus in evidence -based practice patterns, leadership development, and Concentra's values and model o Served as the ADApt program Lead for the Kansas City Market, successfully growing the program to 50+ HPEs updated, developed, and converted annually Carla M. Ianni (Lopez) PT, DPT EDUCATION cianni@concentra.com (310) 730-9055 Northwestern University Chicago, IL Doctor of Physical Therapy April 2015 Illinois College Jacksonville, IL Bachelor of Science: Major in Biology, Minor in Psychology May 2012 CERTIFICATES AND SKILLS o Proficient public speaker o Certificate in Healthcare Management, Cornell University, 2022 o Certified Orthopedic Manual Therapist, Manual Therapy Institute, 2018 o Concentra: Occupational Health University 200 Graduate, 2020 o Concentra: ADApt Certification, 2019 o Native Spanish speaker Concen .ray City of Santa Clarita ♦ HR-24-25-13 Occupational Health Services Attachment C Legal and Risk Our Legal and Risk Departments reviewed the terms, conditions, and insurance requirements and made minor modifications to the language. We include these suggested revisions on the following pages. If Concentra is the successful bidder, we desire to engage in open dialogue with the City, review the proposed modifications, and ultimately create an agreement that not only outlines the schedule of services, but also protects the business interests of both the City and Concentra. November 25, 2024 © 2024 Concentra Operating Corporation. All rights reserved. Attachment Concenaa- EXCEPTIONS TO THE CITY OF SANTA CLARITA RFP # HR-24-25-13 FOR OCCUPATIONAL HEALTH SERVICES 1) Section A(12) Renewal and Pricing Adjustment Section A(12): The Consultant requests to amend the following: Contracts entered into pursuant to this RFP may be renewed annually, up to three times, in accordance with the terms of the contract. If pet ether,.xise stated, the G RtraGt . be ro 0 o J if the Re PFiGiRg 9f the adjusted), Les ARgeles Arp-;-;-Re�.gp-.P--;e-dt---C)PaRge G96IRty area and prevailiRg wage rates, if applic--ah-le. The *hP- date, the PFeV49616 YeaF'S FateS Well apply. PF9p9SeF Shall h9R9F PF9P96al PFiGeS f9F PAP . At the beginning of each twelve (12) month period of this Agreement, following the effective date, the fees for the prior twelve (12) month period shall be automatically increased by five percent (5%). 2) Section C(3)(a) Indemnification Section C(3)(a): The Consultant requests to add the following: To the fullest extent permitted by law, CONSULTANT shall defend (with legal counsel reasonably acceptable to CITY), indemnify and hold harmless CITY and its officers, agents, departments, officials, representatives and employees (collectively "Indemnitees") from and against any and all claims, loss, cost, damage, injury (including, without limitation, economic harm, injury to or death of an employee of CONSULTANT or its subconsultants), expense and liability of every kind, nature and description that arise from or relate to (including, without limitation, incidental and consequential damages, court costs, attorneys' fees, litigation expenses and fees of expert consultants or expert witnesses incurred in connection therewith and costs of investigation) that arise from or relate to, directly or indirectly, in whole or in part, from: (1) CONSULTANT's negligent performance of Services under this Agreement, or any part thereof; (2) any negligent act or omission of CONSULTANT, any subconsultant, anyone directly or indirectly employed by them, or anyone that they control; (3) any actual or alleged infringement of the patent rights, copyright, trade secret, trade name, trademark, service mark or any other intellectual or proprietary right of any person or persons in consequence of the use by CITY, or any other Indemnitee, of articles or Services to be supplied in the performance of this Agreement; or (4) any breach of this Agreement (collectively "Liabilities"). Such obligations to defend, hold harmless and indemnify any Indemnitee shall not apply to the extent such Liabilities are caused by the sole negligence or willful misconduct of such Indemnitee, but shall apply to all other Liabilities. The foregoing shall be subject to the limitations of California Civil Code section 2782.8 as to any design professional services performed by CONSULTANT and in particular the limitation on CONSULTANT's duty to defend whereby such duty only arises for claims relating to the negligence, recklessness or willful misconduct of CONSULTANT as well as the limitation on the cost to defend whereby CONSULTANT will only bear such cost in proportion to CONSULTANT's proportionate percentage of fault (except as otherwise provided in section 2782.8). 3) Section C(4)(b) Insurance Section C(4)(b): The Consultant requests to add the following: Commercial general liability insurance will meet or exceed the requirements of ISO-CGL Form No. CG 00 0111 85 or 88. The amount of insurance set forth above will be a combined single limit per occurrence for bodily injury, personal injury, and property damage for the policy coverage. Automobile coverage will be written on ISO Business Auto Coverage Form CA 00 0106 92, including symbol 1 (Any Auto). Liability policies will be endorsed to name CITY, its officials, and employees as "additional insureds" under said insurance coverage, except on the Workers' Compensation and Professional Medical Malpractice Liability policies, and to state that such insurance will be deemed "primary" such that any other insurance that may be carried by CITY will be excess thereto. Such endorsement must be reflected on ISO Form No. CG 20 10 1185 or 88, or equivalent. Such insurance will be on an "occurrence," not a "claims made," basis and will not be cancelable or subject to reduction except upon thirty (30) days prior written notice to CITY. 4) Section D, Changes Changes: The Consultant requests to amend the following: CITY may erflep request changes in the Services within the general scope of this Agreement, consisting of additions, deletions, or other revisions, and the contract sum and the contract time will be adjusted accordingly. All such changes must be authorized in writing, executed by CONSULTANT and CITY. The cost or credit to CITY resulting from changes in the Services will be determined in accordance with written agreement between the parties. 5) Section D, Additional Services Additional Services: The Consultant requests to add the following: H. The CITY may request CONSULTANT to provide Services in addition to Scope of Services, called "Additional Services". Additional Services that incur additional costs (contingency) of up to 15% of the total contract amount must be authorized by CITY by change order or other documented means. Costs beyond this amount must first be approved by CITY in accordance with applicable thresholds and procedures. Additional Services must be authorized by CITY in writing prior to performance and any change to this Agreement may only be made by amendment executed by both parties. CONSULTANT shall be compensated for Additional Services as set forth in Exhibit(s) " as modified, or as specified in the written authorization. 6) Section D, Termination Termination: The Consultant requests to add the following: Termination for Cause. CITY may terminate this Agreement in whole or part for default should CONSULTANT commit a material breach of this Agreement, and such breach has not been cured within fifteen (15) calendar days of the date of CITY's written notice to CONSULTANT demanding such cure. In the event CITY terminates this Agreement for default, CONSULTANT will be liable to CITY for all costs to cure the deficiencies, and all loss, cost, expense, damage, and liability resulting from such breach and termination. The CONSULTANT shall have the right to terminate the Agreement for cause in the event the CITY is in default of its payment obligations under this Agreement and fails to cure the default within thirty (30) days of receiving written notice of the default from the CONSULTANT. 7) Section D, Insurance Insurance: The Consultant requests to add the following: Commercial general liability insurance will meet or exceed the requirements of ISO-CGL Form No. CG 00 0111 85 or 88. The amount of insurance set forth above will be a combined single limit of $1,000,000 per occurrence, $2,000,000 general aggregate, for bodily injury, personal injury, and property damage for the policy coverage. Automobile coverage will be written on ISO Business Auto Coverage Form CA 00 0106 92, including symbol 1 (Any Auto). Liability policies will be endorsed to name CITY, its officials, and employees as "additional insureds" under said insurance coverage, except on the Workers' Compensation and Professional Medical Malpractice Liability policies, and to state that such insurance will be deemed "primary" such that any other insurance that may be carried by CITY will be excess thereto. Such endorsement must be reflected on ISO Form No. CG 20 10 1185 or 88, or equivalent. Such insurance will be on an "occurrence," not a "claims made," basis and will not be cancelable or subject to reduction except upon thirty (30) days prior written notice to CITY. 8) Section D, Authority/Modification Authority/Modification: The Consultant requests to add the following: The parties represent and warrant that all necessary action has been taken by the parties to authorize the undersigned to execute this Agreement and to engage in the actions described herein. To the extent of any contingency above the original Agreement amount previously approved by the CITY's City Council, additional Services may be added to this Agreement by an additional authorization executed by both parties. This Agreement may be otherwise modified by written amendment, which generally requires approval of the CITY's City Council and CONSULTANT. CITY's City Manager, or designee, may execute any such authorization or amendment on behalf of CITY. 9) Section D, Medical Records Medical Records: The Consultant requests to add a new Section Medical Records as follows: MEDICAL RECORDS. CONSULTANT shall serve as the custodian of medical records created at the clinic during the term of this Agreement. CONSULTANT, as custodian of records shall abide by all local, state, and federal requirements for such record retention during and after the term of this Agreement. CONSULTANT shall also abide by all applicable laws related to CONSULTANT and the medical service record retention. CITY acknowledges that CONSULTANT will provide copies of medical records to any third -party requestor (with the appropriate executed release from the employee/patient, court order, or business affidavit, as applicable). CITY understands and acknowledges that the CITY is not entitled to access any patient medical records except to the extent allowed by law. CONSULTANT is a "covered entity" as enumerated in 45 CFR §160.103. As a covered entity, CONSULTANT may only disclose protected health information as authorized by and to the extent allowed by law. Upon the termination of this Agreement for any reason, CONSULTANT shall maintain all records created against the statutory and regulatory requirements. Should CITY request records be maintained by CONSULTANT beyond any state, local or federal rule due to an ongoing audit or legal matter, then CITY shall be invoiced for such retention for as long as such records are retained until written notice from CITY to destroy such retained records. This Section shall survive the termination of this Agreement. ACOR" CERTIFICATE OF LIABILITY INSURANCE 1*.� DATE(MM/DD/YYYY) 1 11/18/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Graham Company, a Marsh & McLennan Agency, LLC company One Penn Square West CONTACT NAME: Concentra Unit PHONE FAX A/c No Ext: 215-567-6300 A/c,Noy 215-405-2694 E-MAILADDRESS: Concentra_Unit@grahamco.com INSURER(S) AFFORDING COVERAGE NAIC# Philadelphia PA 19102 INSURERA: Columbia Casualty Company 31127 INSURED CONCGRO-01 Occupational Health Center of New York, PA dba Concentra Medical Centers INSURER B: Liberty Mutual Fire Ins. Co. 23035 INsuRERc: Allied World Assurance Company, AG INSURERD: Employers Insurance of Wausau 21458 4714 Gettysburg Rd. Mechanicsburg PA 17055 INSURERE: LM Insurance Corporation 33600 INSURER F : COVERAGES CERTIFICATE NUMBER:440193822 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICYNUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y HAZ 4032244581-8 1/1/2024 1/1/2025 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 500,000 X MED EXP (Any one person) $ Professional Lia X $1M Claim/$3M Ag PERSONAL &ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY PRO ❑ LOC JECT X PRODUCTS - COMP/OP AGG $ 3,000,000 $ OTHER: B AUTOMOBILE LIABILITY Y Y AS2-631-510199-324 4/1/2024 4/1/2025 COMBINED SINGLE LIMIT Ea accident $2,000,000 X BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY A X UMBRELLA LAB X OCCUR Y Y HMC 4032235752 1/1/2024 1/1/2025 EACH OCCURRENCE $ 9,000,000 AGGREGATE $ 10,000,000 EXCESS LAB CLAIMS -MADE DED X RETENTION $ $ B E WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N Y WA7-63D-510199-354 WA5-63D-510199-314 4/1/2024 4/1/2024 4/1/2025 4/1/2025 X PER OTH- STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ❑ N/A E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT $ 1,000,000 D Property YAC-L9L-477341-014 1/1/2024 1/1/2025 SEE BELOW C Excess Liability CO23701-009 1/1/2024 1/1/2025 $10M Each Occurrence $10M Aggregate DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) PRIMARY LIABILTY POLICY includes General Liability Coverage on an Occurrence Basis and Professional Liability Coverage on a Claims Made Basis. UMBRELLA LIABILITY COVERAGE includes Excess General Liability on an Occurrence Basis and Excess Professional Liability on a Claims Made Basis. Both Coverages are excess of a $3,000,000 Self -Insured Retention each Occurrence/Claim subject to a $18,000,000 Aggregate. INDIANA PHYSICIAN PROFESSIONAL LIABILITY COVERAGE - Continental Casualty Company - Policy #HAZ 4032244595-10; Effective 1/1/2024-1/1/2025 - $500,000 Each Medical Incident/$1,500,000 Aggregate Per Insured or Surgeon See Attached... CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CITY OF SANTA CLARITA 23920 VALENCIA BLVD., SUITE 300 SANTA CLARITA CA 91355 AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CONCGRO-01 LOC #: ACORN° AIIIIITIMIA1 RFMORK-Q -QrWl=nl11 F AGENCY NAMED INSURED Graham Company, Occupational Health Center of New York, PA dba Concentra Medical Centers POLICY NUMBER 4714 Gettysburg Rd. Mechanicsburg PA 17055 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Paae 1 of 1 KANSAS PHYSICIAN PROFESSIONAL LIABILITY COVERAGE - Continental Casualty Company - Policy #HAZ 4032244600-10; Effective 1/1/2024-1/1/2025 - $500,000 Each Medical Incident/$1,500,000 Aggregate Per Insured or Surgeon LOUISIANA PHYSICIAN PROFESSIONAL LIABILITY COVERAGE - Columbia Casualty Company - Policy #HAZ 4032244614-10; Effective 1/1/2024-1/1/2025 - $100,000 Each Medical Incident/$300,000 Aggregate Per Insured or Surgeon NEBRASKA PHYSICIAN PROFESSIONAL LIABILITY COVERAGE - Continental Casualty Company - Policy #HAZ 4032244628-10; Effective 1/1/2024-1/1/2025 - $500,000 Each Medical Incident/$1,000,000 Aggregate Per Insured or Surgeon PENNSYLVANIA PHYSICIAN PROFESSIONAL LIABILITY COVERAGE - Columbia Casualty Company - Policy #HAZ 4032244631-10; 1/1/2024-1/1/2025 - $500,000 Each Medical Incident/$1,500,000 Aggregate Per Insured or Surgeon WISCONSIN PHYSICIAN PROFESSIONAL LIABILITY COVERAGE - Continental Casualty Company - Policy #HAZ 4032244659-10; 1/1/2024-1/1/2025 - $1,000,000 Each Medical Incident/$3,000,000 Aggregate Per Insured or Surgeon PROPERTY COVERAGE: Risk of Physical Loss or Damage to Covered Property subject to policy terms and conditions KERS COMPENSATION - Occupational Health Centers of California, A Medical Corporation - Liberty Mutual Insurance Corp. - Policy i-63D-510199-314; Effective: 4/1/2024-4/1/2025 DRKERS COMPENSATION - Occupational Health Centers of Southwest, P.A. - Liberty Insurance Corp. - Policy #WA7-63D-510199-404; Effective: /2024-4/1 /2025 WORKERS COMPENSATION - Occupational Health Centers of Southwest, P.A. - Liberty Mutual Insurance Corp. - Policy #WC5-631-510199-254 (WI); Effective: 4/1 /2024-4/1 /2025 ONAL WORKERS COMPENSATION POLICIES: C of Arkansas — Liberty Insurance Corp. - Policy #WC7-631-510199-284; Effective: 4/1/2024-4/1/2025 C of Southwest (AZ/UT) — Liberty Mutual Fire Insurance Company - Policy #WC2-631-510199-244; Effective: 4/1/2024-4/1/2025 C of Delaware — Liberty Mutual Fire Insurance Company - Policy #WC2-631-510199-334; Effective: 4/1/2024-4/1/2025 C of Georgia/Hawaii — Liberty Mutual Fire Insurance Company - Policy #WC2-631-510199-384; Effective: 4/1/2024-4/1/2025 C of Illinois — Liberty Mutual Fire Insurance Company - Policy #WC2-631-510199-414; Effective: 4/1/2024-4/1 /2025 C of Louisiana — Liberty Mutual Fire Insurance Company - Policy #WC2-631-510199-294; Effective: 4/1/2024-4/1/2025 C of Michigan — Liberty Mutual Fire Insurance Company - Policy #WC2-631-510199-274; Effective: 4/1/2024-4/1/2025 C of Nebraska — Liberty Mutual Fire Insurance Company - Policy #WC2-631-510199-374; Effective: 4/1/2024-4/1/2025 C of New Jersey — Liberty Mutual Fire Insurance Company - Policy #WC2-631-510199-264; Effective: 4/1/2024-4/1/2025 C of North Carolina — Liberty Insurance Corp. - Policy #WC7-631-510199-344; Effective: 4/1/2024-4/1/2025 C of Southwest (KS) — Liberty Mutual Fire Insurance Company - Policy #WC2-631-510199-424; Effective: 4/1/2024-4/1/2025 !rapy Centers of Southwest I, PA (OR) - Liberty Mutual Fire Insurance Company - Policy #WC2-631-510199-394; Effective: 4/1 /2024-4/1 /2025 !rapy Centers of South Carolina, PA - Liberty Mutual Fire Insurance Company - Policy #WC2-631-510199-304; Effective: 4/1 /2024-4/1 /2025 C of Minnesota - Liberty Mutual Fire Insurance Company - Policy #WC2-631-510199-454; Effective: 4/1/2024-4/1/2025 C of Alaska - Liberty Mutual Fire Insurance Company - Policy #WC2-631-510199-444; Effective: 4/1/2024-4/1/2025 ER LIABILITY - AIG Specialty Insurance Company - Policy #01-476-75-23; Effective: 9/25/2023-11/25/2024 - Limit: $10,000,000 EXCESS CYBER LIABILITY - Endurance American Specialty Insurance Company - Policy #PEO-0201-0413; Effective: 9/25/2023-11/25/2024 - Limit: $10,000,000 Excess of $10,000,000 CRIME COVERAGE - National Union Fire Insurance Company of Pittsburgh, PA - Policy #01-988-32-61; Effective: 12/31/2023-12/31/2024 - Limit: $10,000,000 Coverage is provided for all medical professionals currently or previously employed or contracted by the above Named Insured, but only for professional services performed for or on behalf of the above Named Insured. RE: OHC OF CA/CMC IS BIDDING ON RFP# HR-24-25-13 TO PROVIDE OCCUPATIONAL HEALTH SERVICES TO THE EMPLOYEES OF THE NAMED CLIENT. CITY OF SANTA CLARITA, its officials, and employees are all included as additional insureds on the above General Liability, Auto Liability and Umbrella Liability Policies and coverage shall apply on a Primary and Non -Contributory basis if required by written contract. Prior to loss, and if required by written contract, Waiver of Subrogation is provided on General Liability, Auto Liability, Umbrella Liability and Workers Compensation Policies for work performed under contract if permissible by state law. Id any of the above described policies be cancelled before the expiration date thereof, Graham Company, a Marsh & McLennan Agency, LLC company will avor to mail 30 days written notice to the certificate holder, but failure to do so shall impose no obligation or liability of any kind upon Graham Company, a i & McLennan Agency, LLC company, its agents or representatives. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2% of the California workers' compensation premium otherwise due on such remuneration. Schedule Additional premium is a percent of the California Manual Workers Compensation premium. Subject to a minimum premium charge of $ 250 Person or Organization Where required by contract or written agreement prior to loss and allowed by law. Issued by Liberty Insurance Corporation 21814 Job Description For attachment to Policy No. WA7-63D-510199-354 Effective Date: 4/1/2024 Premium $ Issued to Concentra Group Holding Parent, LLC WC 04 03 06 Page 1 of 1 Ed: 04/1984 POLICY NUMBER:AS2-631-510199-324 COMMERCIAL AUTO CA20481013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. SCHEDULE Name Of Person(s) Or Organization(s): Any person or organization whom you have agreed in writing to add as an additional insured, but only to coverage and minimum limits of insurance required by the written agreement, and in no event to exceed either the scope of coverage or the limits of insurance provided in this policy. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1. of Section II - Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I - Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 48 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 282 Policy Number: AS2-631-510199-324 COMMERCIAL AUTO CA 04"1013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respectto coverage provided by this endorsement, the provisionsof the Coverage Form apply unless modified by the endorsement. SCHEDULE Name(s) Of Person(s) Or Organization(s): Any person or organization for whom you perform work under a written contract if the contract requires you to obtain this agreement from us, but only if the contract is executed prior to the injury or damage occurring. Premium: $ INCL Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident' or the 'loss" under a contract with that person or organization. CA04441013 © Insurance Services Office, Inc., 2011 Page 1 of 1 249 POLICY NUMBER: HAZ 4032244581-8 COMMERCIAL GENERAL LIABILITY CG 20 26 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): ANY PERSON OR ORGANIZATION TO WHOM OR TO WHICH YOU ARE REQUIRED TO PROVIDE ADDITIONAL INSURED STATUS IN A WRITTEN CONTRACT OR AGREEMENT EXECUTED PRIOR TO LOSS, EXCEPT WHERE SUCH CONTRACT OR AGREEMENT IS PROHIBITED BY LAW. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a c ontract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 26 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: HAZ 4032244581-8 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an add itional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. CG 20 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 CNA WAIVER OF RIGHTS OF RECOVERY APPLICABLE TO GENERAL LIABILITY COVERAGE FORM The changes set forth below are applicable only to the Commercial General Liability Coverage Form G- 145566-A, G-145567-A). The Healthcare Liability Policy Common Conditions (G-144102-A) are amended as set forth below: Condition XII., Transfer of Rights of Recovery is amended by the addition of the following: Solely within the scope of this endorsement as indicated above, we waive any right of recovery we may have against any person or organization that you have agreed with, in writing, prior to the date of loss, to waive your right to recover against because of payments we make under the Commercial General Liability Coverage Form for injury or damage arising out of your ongoing operations. This endorsement applies only to: All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. GSL6554XX (4-11) Page 1 Insured Name: Concentra Group Holdings Parent, LLC © CNA All Rights Reserved. Policy No: HAZ 4032244581-8 Endorsement No: Effective Date: 1/1/2024 Proposal For Occupational Health Services Submitted by: AFC Urgent Care of Santa Clarita Prepared by: Lupe Hafner, Director of Business Developement Lupe.hafner(g)afcuraentcaresc.com 661-714-8158 american family care URGENT CARE 19042 Soledad Canyon Road Santa Claria CA 91351 www.afcurgentcare.com/santaclarita 661-251-6300 Option 1 27550 Newhall Ranch Road Suite 203 Valencia CA 91355 www.afcurgentcare.com/valencia 661-251-6300 Option 2 Statement of Project Understanding AFC Urgent Care (American Family Care) welcomes the opportunity to present this proposal In response to the City of Santa Clarita Board RFP, Occupational Health Services Provider. AFC fully understands this proposal request is for the provision of Occupational Health Services for employees/applicants of the City of Santa Clarita. As a side note we would like to add that AFC Urgent Care has provided occupational health services to the City of Santa Clarita since 10/2021 with our contract ending 06/2025. We truly value our long-standing reltionship with the City and hope our proposal is deemed acceptable. Background of Company AFC Urgent Care (American Family Care) is a health care franchise with close to 300 clinics nationwide that specialises in urgent care, occupational medicine, and non -emergency medicine all individually owned and operated. Our location in Canyon Country opened 07/2012 with our Valencia location opening 05/2021. Former business executives Curtis and Lupe Hafner opened and operate the clinics with Dr. Gian P. Hernandez, President and Medical Director. Employer Resources: • Pre employment exams • Drug testing • DOT physical exams • Audiometric testing • Vision screening • Respirator medical clearance • Digital X-Rays • Vaccinations, TB Testing • Work place injuries • Return to work exams Hours of Operation Monday -Friday 8:00am — 8:00pm Saturday & Sunday 8:00am — 6:00 pm Contractor Responsibilities Both locations can provide all requested services listed in the RFP as demonstrated in our collaboration with the City of Santa Clarita over the last three years. Also, AFC is able to provide onsite pre -placement exams and drug testing coordinated with the City if there are substantial volumes to increase effeciancy in hiring. NOTICE TO PROPOSERS REGARDING CONTRACTUAL REQUIREMENTS PROPOSAL # HR-24-25-13 Occupational Health Services City of Santa Clarita, California 1. SUMMARY OF CONTRACTUAL REQUIRMENTS a. A contract is required for any service performed on behalf of the City of Santa Clarita (City). b. By submitting a proposal, you have reviewed the sample contract documents contained within this request for proposals and agree to be bound by the requirements set forth. c. Questions and requests for modification of these terms must be negotiated and approved prior to proposal submission and are at the full discretion of the City. 2. SUMMARY OF INDEMNITY AND INSURANCE REQUIREMENTS a. These are the Indemnity and Insurance Requirements for Contractors providing services or supplies to City of Santa Clarita (City). By agreeing to perform the work or submitting a proposal, you verify that you comply with and agree to be bound by these requirements. If any additional Contract documents are executed, the actual Indemnity language and Insurance Requirements may include additional provisions as deemed appropriate by City's Purchasing Agent. b. You should check with your Insurance advisors to verify compliance and determine if additional coverage or limits may be needed to adequately insure your obligations under this agreement. These are the minimum required and do not in any way represent or imply that such coverage is sufficient to adequately cover the Contractor's liability under this agreement. The full coverage and limits afforded under Contractor's policies of Insurance shall be available to Buyer and these Insurance Requirements shall not in any way act to reduce coverage that is broader or includes higher limits than those required. The Insurance obligations under this agreement shall be: 1—all the Insurance coverage and limits carried by or available to the Contractor; or 2—the minimum Insurance requirements shown in this agreement, whichever is greater. Any insurance proceeds in excess of the specified minimum limits and coverage required, which are applicable to a given loss, shall be available to City. c. Contractor shall furnish the City with original Certificates of Insurance including all required amendatory endorsements and a copy of the Declarations and Endorsement Page of the CGL policy listing all policy endorsements to City before work begins. City reserves the right to require full -certified copies of all Insurance coverage and endorsements. 3. INDEMNIFICATION a. To the fullest extent permitted by law, CONSULTANT shall defend (with legal counsel reasonably acceptable to CITY), indemnify and hold harmless CITY and its officers, agents, departments, officials, representatives and employees (collectively "Indemnitees") from and against any and all claims, loss, cost, damage, injury (including, without limitation, economic harm, injury to or death of an employee of CONSULTANT or its subconsultants), expense and liability of every kind, nature and description that arise from or relate to (including, without limitation, incidental and consequential damages, court costs, attorneys' fees, litigation expenses and fees of expert consultants or expert witnesses incurred in connection therewith and costs of investigation) that arise from or relate to, directly or indirectly, in whole or in part, from: (1) CONSULTANT's performance of Services under this Agreement, or any part thereof; (2) any negligent act or omission of CONSULTANT, any subconsultant, anyone directly or indirectly employed by them, or anyone that they control; (3) any actual or alleged infringement of the patent rights, copyright, trade secret, trade name, trademark, service mark or any other intellectual or proprietary right of any person or persons in consequence of the use by CITY, or any other Indemnitee, of articles or Services to be supplied in the performance of this Agreement; or (4) any breach of this Agreement (collectively "Liabilities"). Such obligations to defend, hold harmless and indemnify any Indemnitee shall not apply to the extent such Liabilities are caused by the sole negligence or willful misconduct of such Indemnitee, but shall apply to all other Liabilities. The foregoing shall be subject to the limitations of California Civil Code section 2782.8 as to any design professional services performed by CONSULTANT and in particular the limitation on CONSULTANT's duty to defend whereby such duty only arises for claims relating to the negligence, recklessness or willful misconduct of CONSULTANT as well as the limitation on the cost to defend whereby CONSULTANT will only bear such cost in proportion to CONSULTANT's proportionate percentage of fault (except as otherwise provided in section 2782.8). b. The foregoing indemnification provisions will not reduce or affect other rights or obligations which would otherwise exist in favor of the CITY and other Indemnitees. c. CONSULTANT shall place in its subconsulting agreements and cause its subconsultants to agree to indemnities and insurance obligations in favor of CITY and other Indemnitees in the exact form and substance of those contained in this Agreement. 4. INSURANCE a. Before commencing performance under this Agreement, and at all other times this Agreement is effective, CONSULTANT will procure and maintain the following types of insurance with coverage limits complying, at a minimum, with the limits set forth below: Type of Insurance Limits Commercial general liability: $1,000,000 Professional liability $1,000,000 Business automobile liability $1000 000 Workers compensation Statutory requirement b. Commercial general liability insurance will meet or exceed the requirements of ISO-CGL Form No. CG 00 011185 or 88. The amount of insurance set forth above will be a combined single limit per occurrence for bodily injury, personal injury, and property damage for the policy coverage. Automobile coverage will be written on ISO Business Auto Coverage Form CA 00 0106 92, including symbol 1 (Any Auto). Liability policies will be endorsed to name CITY, its officials, and employees as "additional insureds" under said insurance coverage and to state that such insurance will be deemed "primary" such that any other insurance that may be carried by CITY will be excess thereto. Such endorsement must be reflected on ISO Form No. CG 20 10 1185 or 88, or equivalent. Such insurance will be on an "occurrence," not a "claims made," basis and will not be cancelable or subject to reduction except upon thirty (30) days prior written notice to CITY. c. Professional liability coverage will be on an "occurrence basis" if such coverage is available, or on a "claims made" basis if not available. When coverage is provided on a "claims made basis," CONSULTANT will continue to renew the insurance for a period of at least three (3) years after this Agreement expires or is terminated. Such insurance will have the same coverage and limits as the policy that was in effect during the term of this Agreement, and will cover CONSULTANT for all claims made by CITY arising out of any errors or omissions of CONSULTANT, or its officers, employees or agents during the time this Agreement was in effect. d. CONSULTANT will furnish to CITY duly authenticated Certificates of Insurance evidencing maintenance of the insurance required under this Agreement, including endorsements, and such other evidence of Insurance or copies of policies as may be reasonably required by CITY from time to time. Insurance must be placed with California -admitted insurers with (other than workers compensation) a current A.M. Best Company Rating of at least "A:VII." e. Waiver of Subrogation: The insurer(s) agree to waive all rights of subrogation against CITY, its elected or appointed officers, officials, agents, volunteers and employees for losses paid under the terms of the workers compensation policy which arise from work performed by CONSULTANT for CITY. f. Should CONSULTANT, for any reason, fall to obtain and maintain the insurance required by this Agreement, CITY may obtain such coverage at CONSULTANT's expense and deduct the cost of such insurance from payments due to CONSULTANT under this Agreement or terminate pursuant to TERMINATION section. In the alternative, should CONSULTANT fail to meet any of the insurance requirements under this Agreement, City may terminate this Agreement immediately with no penalty. g. Should CONSULTANT'S insurance required by this Agreement be cancelled at any point prior to expiration of the policy, CONSULTANT must notify City within 24 hours of receipt of notice of cancellation. Furthermore, CONSULTANT must obtain replacement coverage that meets all contractual requirements within 10 days of the prior insurer's issuance of notice of cancellation. CONSULTANT must ensure that there Is no lapse in coverage. h. The CITY shall be entitled to any coverage in excess of the minimums required herein. I have read and understand the above requirements and agree to be bound by them for any work performed for the City. Authorized Signature: Date: a ! (YlJ Printed Name: Apryl Basaez DESIGNATION OF SUBCONTRACTORS/SUBCONSULTANTS PROPOSAL # HR-24-25-13 Occupational Health Services City of Santa Clarita, California Listed below are the names and locations of the places of business of each subcontractor, supplier, and vendor who will perform work or labor or render service in excess of % of 1 percent, or $10,000 (whichever is greater) of the prime contractor's total bid. If no Subcontractors will be used fill out the form with NA. Please add additional sheets if needed. Subcontractor DIR Registration No. Dollar Value of Work Location and Place of Business Bid Schedule Item No's: Description of Work License No. Exp. Date: / / Phone( ) Subcontractor DIR Registration No. Dollar Value of Work Location and Place of Business Bid Schedule Item No's: Description of Work License No. Exp. Date: / / Phone( ) Subcontractor DIR Registration No. Dollar Value of Work Location and Place of Business Bid Schedule Item No's: Description of Work License No. Exp. Date: / / Phone( ) NOTE: A contractor or subcontractor shall not be qualified to propose on, be listed in a proposal, subject to the requirements of Section 4104 of the Public Contract Code, or engage in the performance of any contract for public work, as defined in this chapter, unless currently registered and qualified to perform public work pursuant to Section 1725.5 of the Labor Code. It is not a violation of this section for an unregistered contractor to submit a proposal that is authorized by Section 7029.1 of the Business and Professions Code or by Section 10164 or 20103.5 of the Public Contract Code, provided the contractor is registered to perform public work pursuant to Section 1725.5 of the Labor Code at the time the contract is awarded. REFERENCES PROPOSAL# HR-24-25-13 Occupational Health Services City of Santa Clarita, California The following are the names, addresses, and telephone numbers of three public agencies for which proposer has performed work of a similar scope and size within the past 3 years. If the instructions on this form conflict with the references requested in the scope of work, the scope of work shall govern. Complete this form out accordingly. Fill out this form completely and upload it with your proposal. 1 Quantum Staffing 25020 Avenue Stafford Valencia, CA 91355 Name and Address of Owner / Agency Chaney 661-257-8740 Name and Telephone Number of Person Familiar with Project No amount set Occupational Services Open/Ongoing Contract Amount Type of Work Date Completed 2. Gothic Landscape, Inc. 27413 Tourney Road Valencia, CA 91355 Name and Address of Owner/ Agency Bladie Gutierrez 661-857-3231 Name and Telephone Number of Person Familiar with Project No amount set Occupational Medicine Open/Ongoing Contract Amount Type of Work Date Completed 3. Select Painting & Construction 33305 Barber Road Santa Clarita CA 91390 Name and Address of Owner/ Agency Lotte Frank 800-493-8724 Name and Telephone Number of Person Familiar with Project No Amount Set Occupational Medicine, Work Comp Open/Ongoing Contract Amount Type of Work Date Completed ACKNOWLEDGEMENT & ACCEPTANCE OF SCOPE OF WORK PROPOSAL# HR-24-25-13 Occupational Health Services City of Santa Clarita, Califarnla By providing the three (3) required signatures below, the Contractor acknowledges full understanding, complete agreement to, and accepts in its entirety, all Scope of Workforthe Occupational Health Services. The Contractor will be expected to perform maintenance practices and uphold the standards herein to the established Scope of Work throughout the length of the contract. *Supervisor's Signature: Date: f a j 3 y, zY Apryl Basaez, Managing Director *Estimator's Signature: Date: i °!J 1.1 j as z Apryl Basaez, Managing Director *Owners Signature: Date: Glan P. Hernandez, D.O. / *Ali three signatures required CITY OF SANTA CLARITA DISCLOSURE STATEMENT PROPOSAL# HR 24-2S-13 Occupational Health Services City of Santa Clarlta, California The following information must be disclosed: 1. List the names of all persons having a financial interest in the Request for Proposals. Gian P Hernandez, D.O. sole shareholder. SC Medical, Inc. DBA AFC Urgent Care Santa Clarita DBA AFC Urgent Care Valenica 2. If any person identified pursuant to No.1 above is a corporation or partnership, list the names of all individuals owning more than ten percent of the shares in the corporation or owning any partnership Interest in the partnership. Gian P. Hernandez, D.O. President, Medical Director 3. If any person identified pursuant to No.1 above is a non-profit organization or a trust, list the names of any persons serving as a director of the non-profit organization or as a trustee or beneficiary or trustor of the trust. For Profit 4. Has the offeror had more than $250.00 worth of business transacted with any member of the City of Santa Clarita staff, boards, commissions, committees, and Council within the past twelve months? If yes, please indicate the person(s) with whom you have conducted business. gR NOTE: Attach additional pages as necessary. Signature Af k0wr_or Apryl Basaez, Managing Director Print or Type Name of Offeror 1 D/3/Iaday Date