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Home My WebLink About2012-254 Aging - Vibeke Talley for Occupational Therapy Services $1,400 ago .2-1# [Departmental Use Only] TITLE Eldercare -OT Provider FY 2012-13 ORANGE COUNTY CONTRACT UNDER $10,000.00 NORTH CAROLINA THIS AGREEMENT, made and entered into this 1st day of July, 2012, ("Effective Date") by and between Orange County, North Carolina, a body politic and corporate organized under the laws of the State of North Carolina, (the "County"), party of the first part; and Vibeke Talley (the "Provider"), party of the second part; WITNESSETH: For the purpose and subject to the terms and conditions hereinafter set forth, the County hereby contracts for the services of the Provider, and the Provider agrees to provide the following services to the County in accordance with the terms of this Agreement,time being of the essence: The services and/or materials (hereinafter referred to collectively as "Services") to be furnished under this Agreement are as follows: Occupational therapy assessment, intervention, and programmatic services in the absence of UNC clinician. The term of this agreement rendered shall be from July16,2012 to June 30, 2013. Provider represents and agrees that Provider is qualified to perform and fully capable of performing and providing the services required or necessary under this Agreement in a fully competent, professional and timely manner to the satisfaction of the County. Provider shall be responsible for all errors or omissions, in the performance of the Agreement. Provider shall correct any and all errors, omissions, discrepancies, ambiguities, mistakes or conflicts at no additional cost to the County. Provider agrees that Provider shall not sub-contract any of the services to be provided in this Agreement, nor shall Provider assign any right or responsibility granted or required by this Agreement,without the prior written approval of the County. SPECIFIC TERMS 1. Payment: The County agrees to pay at the rates specified for Services satisfactorily performed in accord with this Agreement. The amount to be paid by the County shall not exceed one- thousand, four-hundred dollars, ($35.00/hr). Payment shall be made within thirty (30) days of an invoice properly submitted to County. Should Provider fail to perform its duties under the terms of this Agreement, County may, without fault or penalty, withhold any payment associated with the work to be performed until such time as said work is completed. 2. Non—waiver: Failure by County at any time to require the performance by Provider of any of the provisions hereof shall in no way waive or affect the County's right hereunder to enforce the same, nor shall any waiver by the County of any breach be held to be a waiver of any succeeding breach or a waiver of this Non-Waiver Clause. 3. Independent Contractor: The Provider shall operate as an independent Provider, and the County shall not be responsible for any of the Provider's acts or omissions. The Provider shall not be treated as an employee with respect to the Services performed hereunder for federal or state tax, unemployment or workers' compensation purposes. The Provider understands that neither federal, nor state, nor payroll tax of any kind shall be withheld or paid by the County on behalf of the Provider or the employees of the Provider. 4. Insurance: The Provider shall obtain, at its sole expense, all insurance needed to adequately insure itself during the performance of these services as required by the County's Risk Management Policy. Revised July 2010 1 a r . - 5. Indemnity: The Provider agrees to defend, indemnify, and hold harmless Orange County from all losses, liabilities, claims, demands, suits, costs, damages or expenses (including reasonable attorney's fees) arising from bodily injury, including death, to any person or persons or damage to or destruction of any property caused in whole or in part by any negligent or intentional act or omission on the part of the Provider. 6. Termination: This Agreement may be terminated at any time by mutual written agreement of the parties or by the County upon written notice to the Provider. 7. Entire Agreement: The parties have read this Agreement and agree to be bound by all of its terms, and further agree that it constitutes the complete and exclusive statement of the Agreement between the parties unless and until modified in writing and signed by the parties. Modifications may be evidenced by telefacsimile signature. 8. Governing Law: Both parties agree that this Agreement shall be governed by the laws of the State of North Carolina. Should either party initiate litigation to settle any dispute involving the terms of this Agreement such litigation shall be initiated in the General Court of Justice of North Carolina seated in Orange County,North Carolina. 9. Non Appropriation: Provider acknowledges that County is a governmental entity, and the validity of this Agreement is based upon the availability of public funding under the authority of its statutory mandate. In the event that public funds are unavailable and not appropriated for the performance of County's obligations under this Agreement, then this Agreement shall automatically expire without penalty to County immediately upon written notice to Provider of the unavailability and non-appropriation of public funds. IN WITNESS WHEREOF,Orange County and the Provider have signed this Agreement, effective as of the day first written above. ORANGE O Ti PROVI 1, R By: r � B � /� y: AlA _ L / y: _ f. a.___.� Coun7 anag;r Title: ,I , ,,i it ,,, ! L, gpi,e. 200 S. Cameron St. 134 East Try•n Street P.O. Box 8181 Hillsborough,NC 27278 Hillsborough,NC 27278 Vendor#39801 This instrument has been approved as to technical content. Janic er,Departure Director This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act. NO41-14/ ) 4 — Office of the Finance Director This in�, ent has been approved as to form and legal sufficiency. (6, i Office of the etunty Attorney Revised July 2010 2 44. dIP NORTH CAROLINA BOARD OF OCCUPATIONAL THERAPY Poet Office Rex 2280 Raleigh,North Carolina 27602 919/832-1380 Re: New Renewal Card Your renewal card for the period July 1,2012 through June 30,2013 will be printed with this letter. Pursuant to Rule 21 NCAC 38 .0301,your license and current renewal card must be available for inspection at your principal place of business as proof of current licensure in the State of North Carolina. You are now able to store your Continuing Competence Activity(CCA)online by going to "Manage Your CCA Online°and following the prompts in the continuing competence section of the Board's website. CCA points must be earned between June 1, 2012 and May 31, 2013 for your next renewal. An ethics activity will be mandatory for the 2013 renewal. You are also able to update your personal information online by going to the°Update My Personal Profile Online°at the Board's website. These include address, employment and supervision updates. In an effort to make more online services available to licensees,the Board requests that all licensees maintain a current email address at their personal profile. If you are not able to renew online, Renewal Applications will be available at the Board's website. Online renewal instructions will be posted on the website explaining the process. This letter will be the only verification provided to you confirming that you have paid the$50 fee to renew your occupational therapist or occupational therapy assistant license. The Board does not issue receipts. NORTH CAROLINA BOARD OF OCCUPATIONAL THERAPY certlfes that This is your new renewal can! b Vibelte Abselon Talley is Licensed es an Occupational Therapist out and display with your license. as defined by State Law. There is a$5 chafe for a replacement card from the Board office. ...., ._.............. ........................... ....... .......... w.,.. EXPIRATION - LICENSE* 06/30/2013 " 0176 allr.' N. 41 111 . 1 ....., . Healthcare Professional Liability . .. LIBERTY INSURANCE UNDERWRITERS INC. (..,Stock Insurance Company,hereinafter the"'Company") 55 Water Street, 18111 Floor New York,NY 10041 DECLARATIONS Policy Number: AHY-564382001 Renewal Of: SECTION 1 I rein 1. Named insured: VIBEKE TALLEY 2. Mailing Address: 134 E TRYON ST, HILLSBOROUGH,NC 27278-2550 3. Policy Period: From: 03/16/2012 To: 03/16/2013 12:01 A.M.Standard Time At Location of Designated Premises 4. Business or Profession: Affiliation: American Occupational Therapy As,sn. Occupational Therapist 5. The Named Insured is a(n): Partnership Corporation X Individual Sole Proprietor(with employees) Other: Ibis policy is made and accepted subject to the printed conditions of this policy together with the provisions, stipulations and agreements contained in the following form(s)or endorsement(s): HCPL-2037(11109),HCPL-2038(11/09) HCPL-2151(11109), HCPL-2037-9000-NC(11/09)OFAC (08/09), SECTION II Item COVERAGE Premium A. Professional Liability MI $95.00 B. General Liability I I Terrorism Risk Insurance Act ( 1 $0.00 C. Endorsements I I TOTAL: $95.00 LIMITS OF LIABILITY $2,000,000 Each Incident and Each Occurrence $4,000,000 Aggregate SECTION III SUPPLEMENTARY PAYMENTS A. First Party Assault B. I.icensing Board Reimbursement C. Wage Loss and Expense D. Deposition Expense E. First Aid Reimbursement Representative Agent: Marsh U.S.Consumer a service of Scabury&Smith,Inc. P.O.Box 14576 Des Moines,IA 50306-3576 1 111111 1-800-5(13-9230 HCPL-2037D(11/09)