HomeMy WebLinkAbout2014-525 Health - Wake Radiology Diagnostic Imaging, Inc. to provide x-ray services to patients referred byt he OCHD $3,500 r ab14 -sas
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_ [Departmental Use Only]
TITLE Wake Radiology X-Ray Services
FY 2014-2015
ORANGE COUNTY
CONTRACT UNDER$25,000.00
NORTH CAROLINA
THIS AGREEMENT, made and entered into this first day of July, 2014, ("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"),by and through the Orange County Health Department("OCHD")party of
the first part; and Wake Radiology Diagnostic Imaging, Inc. (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 term of this agreement shall be from July 1, 2014 to June 30,2015.
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. Scope of Services. The services and/or materials (hereinafter referred to collectively as
"Services")to be furnished under this Agreement are as follows:
A. Provider. Scope of Work. Orange County Health Department will refer patients to the
Provider. Provider will provide the following x-ray services service to patients referred
by the Orange County Health Department:
1) The Provider will provide a PA chest x-ray and written interpretation for OCHD
referred patients without active TB symptoms.
2) Patients referred to Provider do not need an appointment, but must request the
service during the Provider's regular business hours.
3) All patients referred from OCHD must at the time of service present Provider with a
current completed chest x-ray voucher from OCHD.
4) Provider will provide patients with a PA chest x-ray that will be taken, developed,
and read. If ordered by OCHD,a two view chest x-ray will be taken, developed, and
read.
5) Provider will mail a written interpretation of the chest x-ray to:
Orange County Health Department
2501 Homestead Road
Chapel Hill,NC 27516
Attn: Sue Rankin,R.N.
6) Provider will maintain the x-ray and voucher in their Office.
Revised June 2012 1
B. Confidentiality. The Provider will comply with such confidentiality laws as may
be applicable in the performance of this agreement and acknowledges that in
receiving, storing, processing or otherwise dealing with any confidential
information, Provider shall safeguard and not further disclose the information
except as permitted by the Health Insurance Portability and Accountability Act of
1996, Public Law 104-191, as amended.
2. Payment: The County agrees to pay at the rates specified for Services satisfactorily
performed in accord with this Agreement. The rates specified for the services shall be $62.00
per single view x-ray(71010)and$ 80.00 for a two view x-ray(71020). The total amount to
be paid by the County shall not exceedThree Thousand Five Hundred Dollars, ($3,500).
Payment shall be within thirty (30) days of an invoice properly submitted to County and
mailed to the address provided above in Section 1. 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.
3. 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.
4. 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. The Provider
understands that no benefits, including Worker's Compensation coverage, will be provided
to him by the County.
5. Insurance.
A. General Requirements. The Provider shall purchase and maintain during the
period of performance of this Agreement Professional Liability Insurance,
covering personal injury, bodily injury and property damage and claims arising
out of or related to the performance under this Agreement by the Provider.
B. Limits of Coverage. The Provider shall maintain professional liability insurance
coverage with coverage of at least $1 million, per occurrence, $3 million
aggregate while providing services to the County.
C. Evidence of Insurance. Evidence of such insurance shall be furnished to the
County, together with evidence that each policy provides the County with not
less than thirty (30) days prior written notice of any cancellation, non-renewal or
reduction of coverage.
6. Indermi : 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.
Revised June 2012 2
7. Termination: This Agreement may be terminated at any time without cause by either Party
upon sixty (60) days written notice. This agreement may be terminated with cause at
any time by either party upon at least 30 days prior written notice to the other party
upon default of one or more of its obligations hereunder, unless such default is cured
within 30 days of the notice of termination.
8. 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.
9. Governing Law: This Agreement and the duties, responsibilities, obligations and rights of
respective parties hereunder shall be governed by the laws of the State of North Carolina.
Consultant shall at all times remain in compliance with all applicable local, state, and federal
laws, rules, and regulations including but not limited to all anti-discrimination laws.
Pursuant to the terms of North Carolina General Statute 153A-449(b) no county may enter
into a contract with a contractor unless the contractor and the contractor's subcontractors
comply with the requirements of Article 2 of Chapter 64 of the North Carolina General
Statutes. Where applicable, failure to maintain compliance with the requirements of Article
2 of Chapter 64 of the General Statutes constitutes Consultant's breach of this Agreement.
By executing this Agreement Consultant affirms Consultant is in compliance with Article 2
of Chapter 64 of the North Carolina General Statutes.
10. 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.
11. Signatures. This Agreement together with any amendments or modifications may be
executed electronically. All electronic signatures affixed hereto evidence the intent
of the Parties to comply with Article 11A and Article 40 of North Carolina General
Statute Chapter 66.
IN WITNESS WHEREOF,Orange County and the Provider have signed this Agreement, effective
as of the day first written above.
ORANGE COUNTY PROVIDER j,
BY: By: t w,r/� l `r w�- ✓�
Bonnie Hammersley, County a er , President 4�u d v a Zprol.s n IZ,
200 S. Cameron St. Wake Radiology Diagnostic Imaging, Inc.
P.O. Box 8181 3949 Browning Place
Hillsborough,NC 27278 Raleigh NC, 27609
This i trument has been approved as to technical content.
Colleen Bridger,MPH,PhD, alth Department Director
Revised June 2012 3
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal
Control Act.
(J"G' jy.
Clarence G. Grier,Asst. County Manager/CFO
This instiume t h s een proved as to form and legal sufficiency.
Annette M.Moore, $taff Attorney
Revised June 2012 4
Medical Mutual`
"0TZ=KC OV\TIOM5194
CERTIFICATE OF INSURANCE
This certificate is issued as a matter of information only and confers no rights upon the certificate holder.
This certificate does not amend,extend,or alter the coverage afforded by the policies listed below.
INSURED:
Wake Radiology Consultants PA
Attn: Accounts Payable
PO Box 19366
Raleigh,NC 27619
COMPANY AFFORDING COVERAGE:
Medical Mutual Insurance Company of North Carolina
700 Spring Forest Road 4th Floor
Raleigh,NC 27609
TYPE OF INSURANCE: Claims-Made Professional Liability
POLICY NUMBER:PG 112094 RETROACTIVE DATE: April 6, 1976
POLICY PERIOD:
FROM:October 1,2014;12:01 A.M. TO: October 1,2015;12:01 A.M.
LIMITS OF LIABILITY:
EACH CLAIM ANNUAL AGGREGATE
6,000,000 8,000,000
Date: August 07.2014
Authori '-presentative E � (�CERTIFICATE HOLDER: i5 Wake Radiology Diagnostic Imaging Inc 2 4 2014 3614 Haworth Dr
Raleigh,NC 27609
MEAICAL RfUTUAL 1TSURANCE COMPANY
PM090INC(06108) OF NORTH CAROLINA DINICINL