HomeMy WebLinkAbout2014-573-E HR - Job Ready Services, LLC for the WorkSTEPS Testing Program for Workplace Fitness For Duty and Functional Capacity Testing for Certain Work Groups $15,000DocuSign Envelope ID: Al E64657- B4BC- 4CBD- BBDE- 98475BE11255
LETTER AGREEMENT
THIS AGREEMENT made and entered into this the rAday of S�pt 2014 ( "Effective Date ") by and
between Job Ready Services, LLC, ( "Provider "), a North Carolina corporation located at 2300
Westinghouse Boulevard, Suite 107, Raleigh, North Carolina, 27604, WorkSTEPS°, Inc., a Texas
corporation located at University Business Park, 3019 Alvin Devaney Suite 150, Austin, Texas, 78741
( "WorkSTEPS "), and Orange County, a , a local political subdivision of the State of North Carolina,
located at 200 South Cameron Street, Post Office Box, Hillsborough, North Carolina ( "COUNTY "),
collectively ( "THE PARTIES ").
WHEREAS: COUNTY is desirous of implementing a functional employment testing program as a part of
its work injury and disability management program, to, among other reasons, effectuate a reduction of on-
the-job injuries by trying to determine if an applicant or employee can safely perform the essential
functions of the job.
WHEREAS: WorkSTEPS has developed functional employment testing protocols and procedures that
COUNTY desires to utilize for its functional employment testing program, and
WHEREAS: WorkSTEPS desires to assist COUNTY in implementing the WorkSTEPS functional
employment- testing program,
THEREFORE THE PARTIES HERETO DO HEREBY AGREE AS FOLLOWS:
Scope of Services: The services and/or materials (hereinafter referred to collectively as "Services ") to be
furnished under this Agreement are as follows: Workplace Fitness for Duty and Functional Capacity
Testing for Certain Work Groups. The scope of the project shall include testing of job positions as
identified by Orange County and as provided in the "Workplace Fitness for Duty and Functional Capacity
Testing at Risk Work Groups Proposal" (`the Proposal ") submitted by Provider and WorkSTEPS, dated
February 1, 2013 (Exhibit 1), Job Analysis Bid Proposal (Exhibit 2) and Attachments A and B, all of which
are attached and incorporated by reference into this Agreement, except as to those parts that conflict with
this Agreement. If there is any conflict between the Exhibits and the all other documents and this
Agreement, this Agreement shall take precedence over any other document.
WorkSTEPS and Provider represents and agrees that they are qualified to perform and are 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. WorkSTEPS and Provider shall be
responsible for all its' errors or omissions, in the performance of the Agreement. WorkSTEPS and
Provider shall correct any and all its' errors, omissions, discrepancies, ambiguities, mistakes or conflicts at
no additional cost to the County. WorkSTEPS and Provider agree that they will 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.
Job Analyses is the foundation of the COUNTY'S functional employment testing program. A job analyses
is a measurement of the physical demands and requirements of the essential functions of a specific job.
Accurate and current job analyses are the COUNTY'S responsibility. Job Specific Authorization Forms
that document essential function requirements must be executed by COUNTY'S representative and
provided to WorkSTEPS before testing can begin. COUNTY representatives should use professionals
experienced in assisting with job analyses or other trained and certified ergonomic assessment specialists to
assist in the preparation of job analyses and documentation of essential functions. The job analyses should
be based on a close, careful examination of the specific job by an individual trained and competent in
making the physical measurements of the essential functions of the specific job. The job analyses provides
specific job content validity to COUNTY's functional employment testing program, which seeks to
simulate the specific physical demands necessary to perform essential job functions. Accurate and up -to-
DocuSign Envelope ID: Al E64657- B4BC- 4CBD- BBDE- 98475BE11255
date job analyses help ensure that employment decisions are based on objective, sound, individual, and job
specific information. Likewise, an accurate and up -to -date job analysis helps ensure that no individual or
group of individuals is discriminated against.
County acknowledges and understands that this Agreement contemplates the functional employment testing
of prospective employees and /or actual employees of County. That County, as employer of the individuals
tested have a significant role, both before and after the test, including, but not limited to, selection of the
essential functions of the applicable job, the writing of job descriptions, if any, in communicating with the
individuals to be tested in a consistent manner, in making appropriate employment decisions based on test
results and in properly processing and advising those individuals tested. County represents and agrees that
they are qualified to perform their role in the Functional Employment Testing Program.
SPECIFIC TERMS
1. Term: The term of this agreement shall be from the effective date of this Agreement September 1,
2014 for a period of one year ending August 31, 2015.
2. Payment. The County agrees to pay at the rates specified for satisfactorily performed in accord
with this Agreement. The amount to be paid by the County shall not exceed fifteen thousand
dollars, ($15,000). Payment shall be made within thirty (30) days of an invoice properly
submitted to the County. Should Provider fail to perform the 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. Based on the functional employment
test(s) and services that have been identified the price for the test(s) and services shall be:
a. Fee Schedule:
♦
Comprehensive Post Offer Functional Employment Test
$175.00
♦
Fit For Duty, Fit For Duty RTW
$175.00
♦
Upper Quadrant / Carpal Tunnel / Post -Offer Evaluation
$240.00
♦
Job Specific Test Development per hour
$150.00
♦
Validation per hour
$150.00
♦
Sincerity of Effort Test
$300.00
♦
No Show Fee (24 hour cancellation required)
$75.00
♦
Return on Investment Study (annual)
No Charge
b. Other Services. Fees shall be as provided for services other than described in 2.a. above in the
Proposal (Exhibit 1).
3. Non — waiver: Failure by one Party at any time to require the performance by another Party of any
of the provisions hereof shall in no way waive or affect the Complaining Party's right hereunder to
enforce the same, nor shall any waiver by the Complaining Party 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 and WorkSTEPS shall operate as independent Contractors,
and the County shall not be responsible for any of their acts or omissions. The Provider nor
WorkSTEPS 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 and
WorkSTEPS understand that neither federal, state, or payroll tax of any kind shall be withheld or
paid by the County on behalf of the Provider or WorkSTEPS, or their employees.
5. Provider and WorkSTEPS Employees: COUNTY acknowledges that WorkSTEPS has invested
considerable time and financial resource in the training, education, and certification of the
professional staff necessary to deliver the services set forth on Exhibit A to this Agreement.
During the term of this Agreement, and for a period of one year after its termination, COUNTY
agrees that it shall not actively or knowingly solicit for employment any of WorkSTEPS
2
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employees or WorkSTEPS licensed Providers associated with the delivery of these services to
COUNTY.
6. Insurance: The Provider and WorkSTEPS 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.
7. Indemnity: The Provider and WorkSTEPS 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 or WorkSTEPS.
8. Compliance with Laws: The Parties agree that they will comply with all federal and state laws in
the compliance of this Agreement. County acknowledges that the County is responsible for
making employment decisions concerning any post- employment candidates' or current
employees' suitability for employment or continued employment and for making decisions
concerning reasonable accommodations.
9. Termination: This Agreement may be terminated by either Party upon written notice to the other
Parties. Receipt shall be deemed effective upon actual delivery to the noticed Party. Upon
termination, COUNTY shall be responsible to pay for any employment tests that have actually
been performed prior to the termination.
10. Confidentiality: The Provider and WorkSTEPS shall keep all information or materials received
from the COUNTY strictly confidential, and shall not divulge any such information or materials
without the express written consent of COUNTY. Notwithstanding any prohibition contained
within this Section, The PARTIES may release data or information as contemplated herein should
a state or federal court of law require it. WorkSTEPS may also release data or information
received from the testing of COUNTY's employees for any legitimate business purpose, provided
that (i) any personal information is kept confidential, and (ii) that all state and federal laws
regarding such data or information are strictly followed.
11. Trademark, Copyright and Proprietary Information: COUNTY acknowledges that is has been
advised that WorkSTEPS believes the WorkSTEPS name, and its marks and proprietary software,
protocols and testing process are federally trademarked and copyrighted. COUNTY agrees that
WorkSTEPS proprietary software, protocols, processes, procedures, including modifications
thereto, are, and shall be considered "proprietary" and "confidential information." WorkSTEPS
confidential and proprietary information will be provided to COUNTY for the sole purpose of
having the WorkSTEPS Provider provide functional employment testing services to the
COUNTY. COUNTY acknowledges, agrees and confirms that COUNTY's disclosure or
misappropriation of WorkSTEPS proprietary information could cause irreparable injury to
WorkSTEPS, and COUNTY hereby expressly agrees that it will not use the confidential and
proprietary information provided to COUNTY, except for the express purposes described in this
Agreement except as provided below.
All data and information generated by the WorkSTEPS Functional Employment Testing Program
for COUNTY shall be the property of WorkSTEPS and COUNTY. WorkSTEPS shall use best
efforts to keep such data or information in a legally compliant manner pursuant to all state or
federal laws affecting such data or information. COUNTY may keep copies of data or information
for use in its normal course of business, but COUNTY hereby agrees that should it have
possession of any WorkSTEPS materials, forms, procedures, protocols, or information, that such
shall be deemed proprietary and confidential and kept strictly confidential. COUNTY shall use
best efforts to see that such is not utilized for any purpose that would reasonably be deemed in
competition with WorkSTEPS.
DocuSign Envelope ID: Al E64657- B4BC- 4CBD- BBDE- 98475BE11255
Without limiting the generality of this Section, THE PARTIES agree that after the termination or
expiration of this Agreement, such PARTIES will not use the proprietary, confidential
information of the other PARTY to provide the same or similar services to any person (unless and
until such information ceases to be proprietary and confidential through no fault of the PARTY
seeking to use the same), however, nothing in this Section shall prohibit Provider or its affiliates,
after termination of this Agreement, from providing a service to County similar to the services
provided by in this Agreement as long as neither Provider nor its affiliates uses the proprietary,
confidential information of WorkSTEPS in so doing.
12. North Carolina Public Records Act. Provider and WorkSTEPS acknowledge that this Agreement,
the Confidential Information and any documents, memorandum, data, reports, analyses,
compilations, records, pricing and evaluation of all or any portion of the transactions contemplated
by this Agreement may be deemed public records and subject to disclosure, in whole or in part,
pursuant to the North Carolina Public Records Law. County will provide WorkSTEPS with
prompt notice of any intended disclosures or requests for disclosure pursuant to the North Carolina
Public Records Law and an appropriate opportunity to seek protection of the Confidential
Information consistent with all applicable laws and regulations. Should a public records request
be made for information WorkSTEPS claims is proprietary in nature, County will, within a
reasonable time, notify WorkSTEPS of such public records request. WorkSTEPS shall, within
five (5) business days of said notification provide notice that it does or does not object to the
County disclosing the requested information pursuant to the subject public records request. If
WorkSTEPS objects to the disclosure of the requested information, WorkSTEPS agrees that it
shall be solely responsible for the defense of and the cost of defending any claim or complaint
against the County for its refusal to disclose Confidential Information. WorkSTEPS agrees that if
any such complaint or claim is filed it will indemnify County and will reimburse County for any
and all damages awarded against County its refusal to disclose the requested information.
WorkSTEPS agrees that it releases County from all loss, liability, claims or expense, including
attorney's fees, arising out of or related to the release or disclosure or failure by the County to
release or disclose Confidential Information. WorkSTEPS further agrees that it waives the right to
file any court action for any such release, disclosure, or failure to release or disclose Confidential
Information.
13. Entire Agreement and Signatures: 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.
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.
14. Governing Law: The Parties agree that this Agreement shall be governed by the laws of the State
of North Carolina. Should any 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.
15. Non Appropriation: Provider and WorkSTEPS acknowledge 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, WorkSTEPS and the Provider have signed this Agreement,
effective as of the day first written above.
AGREED TO THIS J_ DAY OF ltav'p—� , 2014.
DocuSign Envelope ID: Al E64657- B4BC- 4CBD- BBDE- 98475BE11255
wBPOY�, Inc. / _
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President
Title
Peter Gallaher
Printed Signature
8Y L8 iii Ready Services, LLC
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By:
President
Title
Debra Lord
Printed Signature
ogGaanty, NC
66VULU't, (Mmtysb
�
y: onme ammersley, County Manager
,TII"jmffwaw,nt has been approved as to technical content. baYUhMCW
reri�a8�art�'o�omew, Human Resources Director
This instrument Qhas been pre - audited in the manner required by the Local Government Budget and Fiscal
I°liiO= ✓J A'i M
2F982EC44C2C444...
Clarence G. Grier, Asst. County Manager /CFO
4^4ut*wnt has been approved as to form and legal sufficiency.
401'
Annette M. Moore, Staff Attorney
DocuSign Envelope ID: Al E64657- B4BC- 4CBD- BBDE- 98475BE11255
Exhibit 1, Proposal
DocuSign Envelope ID: Al E64657- B4BC- 4CBD- BBDE- 98475BE11255
Job Ready Services, LLC
2300 Westinghouse Boulevard, Suite 107
Raleigh, NC 27604 e T
919256.1400 Phone:��
919 256.1403 Fax
www.lobeeadyservices.net
i
P �OpD .....
WORKPLACE FITNESS FOR DUTY AND FUNCTIONAL
CAPACITY TESTINGFOR AT RISK WORK GROUPS
PROPOSAL
February 1, 2413
PREPARED FOR; Orange County
Nicole Clark
Human Resources Director
M. Jewel Wray,
Human Resources Manager
PREPARED BY: Debra C. Lord, PT, CEAS II
President
description
Job Ready Services, LLC is a an independent provider of The WorkSTEPS® Program which was
developed by physical therapists in a clinical setting over two decades ago in response to industrys
need for reliable, medically / legally defensible employment testing program which could effectively
reduce work place injury incidence and work place injury costs. Debra Lord, PT has been a licensed
provider of the WorkSTEPS® Program since 1998 and has been awarded the ACE Award by
WorkSTEPS corporate for six of the last seven years recognizing excellence in functional testing and
product delivery. The testing program, which is based upon objective scientific data collected on new
hires and existing workers, conforms fully to EEOC guidelines for application of the Americans with
Disabilities Act (ADA) and ADA Amendment Act (ADAAA).
Visit www.worksteps.corn or contact WorkSTEPS at 512 617- 4100 or
www.iobreadyservices.net for further information.
Job Ready Services, LLC 1
919 266 -1400
www.jobreadyservices.net
DocuSign Envelope ID: Al E64657- B4BC- 4CBD- BBDE- 98475BE11255
executive summary
The Objective...
The WorkSTEPS® Program is a system of ADA compliant employment tests that are both
scientific and objective. These tests establish baseline information on employees and help insure
that they are appropriately matched to the physical demands of their jobs. Information collected
during these tests is invaluable to employers in both the hiring and post injury management of
workplace injury.
+ Need #1 : Develop a Job Analysis in a standardized format for describing each unique job
function within each designated department's job description.
a Need #2 : Implement functional capacity testing to objectively measure current and future
employees' ability to perform the required tasks outlined by the analysis.
+ Need #3: Standardize data collection and reporting pre and post injury
+ Need # 4: Prevent injuries in the workplace by appropriately matching employees' abilities to
their job responsibilities,
+ Need #5: Detect "al risk" employees who have significant pre - existing impairments,
+ Need #6 : Intervene following the inception of an injury to effectively rehab workers and
minimize lost work days,
+ Need #7. Eliminate fraud through the use of scientific consistency °checks° post injury,
The Opportunity...
Reduce costs associated with work - related injury by implementing a functional employment testing
program.
+ Goal #1 : Significantly reduce workplace injury incidence,
+ Goal #2: Reduce workplace injury costs,
+ Goal #3: Reduce last time,
+ Goal #4. Create accountability for employees & treating providers.
Job Ready Services, t_LC 2
919 256 -1400
www.jobreadyservices.net
DocuSign Envelope ID: Al E64657- B4BC- 4CBD- BBDE- 98475BE11255
`J_ q.�z
mission statement
Mission Statement
Statistics prove that the best way to treat any injury or illness is to prevent it from ever occurring.
However, there are many debates about what interventions are the most effective and which ones
achieve the highest measures of success. It is well recognized by experts in the field of
occupational and industrial medicine, that the single highest degree of injury reductions are
accomplished through functional testing. Functional testing is a bio- ergonomic intervention that
measures human strength and performance, and appropriately matches them to the physical
demands of the job. The WorkSTEPS@ Functional Test Model CModel") has proven to reduce
work - related MSD's by an average of 50% in its first year of implementation when used as a first
line of defense in the prevention of MSD's. Functional testing combined with other injury
management programming such as conditioning, ergonomics, etc., can help achieve reductions
which are even more significant.
The Model has gained wide acceptance in the business community due to the rising costs
associated with workers' compensation and increased federal regulations being imposed on
employers by the Occupational Health and Safety Administration and the Equal Employment
Opportunity Commission, The Model helps employers stay compliant with federal hiring practices
and the Americans' with Disabilities Act. The Model utilizes appropriately designed and
administered tests, historical pre- and post -injury data, and evaluations relevant to physical
performance to help mitigate the incidence and costs of injury and provide better data to its
employers to assist In resolution of claims.
The Model is currently utilized in 48 states and has proven invaluable to both large and small
employers in their ongoing efforts to reduce workplace injury incidence and their related costs.
This Model is appropriate for use in all industries as it addresses common musculoskeletal
problems that encompass heavy labor to high tech, repetitive motion injuries. Many employers
using the Model have been recognized both nationally and regionally for exemplary
accomplishments in safety and prevention programming. The employer /occupational medicine
partnership created through this Model has resulted In hundreds of safer, more productive
workplaces.
Litigation
WorkSTEPS® has never been found negligent or contributory in any settlement regarding ADA or
EEOC non - compliance.
WorkSTEPS® has a history of litigation successes. Once pre -injury status is achieved, medical
costs are justifiably stopped and maximum improvement is assigned.
WorkSTEPS® has established a significant precedent by subtracting pre - existing impairments in a
final workers' compensation award.
,lob Ready Services, LLC
919 256 -1400
DocuSign Envelope ID: Al E64657- B4BC- 4CBD- BBDE- 98475BE11255
expected
Job Ready Services as a provider of WorkSTEPSO has been successful in saving many area employers
thousands of dollars in workers` compensation insurance claims and lost time accidents. This has been
accomplished by providing a unique test that determines whether a job candidate can perform the essential
functions of their job. This testing program is a proven method of reducing costs associated with workplace
injuries. Many employers currently utilizing the testing program are reporting an average reduction of 50%
of their previous year's work injury costs, and many companies have achieved savings of as high as 80 %.
Statement of Problern /Need
+ The University of Massachusetts recently reported that 10% of existing employees are not
physically capable of performing their job tasks. This same 10% also accounts for 75% of the
costs associated with workplace injuries. information collected during WorkSTEPSO testing
identifies individuals who are at high risk for injury and prevents an employer from placing or
retaining them in job positions that they are not physically capable of performing.
+ One back injury costs over $100,000 (medical, replacement income, indemnity, etc.)
+ One carpal tunnel costs over $100,000 (medical, replacement income, indemnity, etc.)
+ One fraudulent claim costs over $70,000
Project Scope and Objectives
The Scope of the project may include testing of job positions as identified by Orange County
The following objectives shall be achieved:
+ Reduce work related injury costs by 50% over a one year period
+ identify individuals who do not meet job specific strengths or aerobic requirements
+ Appropriately match current and new employees to the physical demands of their jobs
+ Provide the company with capable/not-capable recommendations
+ Substantiate legitimate injuries and disqualify fraudulent claims
+ Reduce employee turnover
+ Expedite injured employees return to work
+ Standardize data collection and reporting pre and post injury
Jab Ready Services, LLC 4
919 256 -1400
DocuSign Envelope ID: Al E64657- B4BC- 4CBD- BBDE- 98475BE11255
services provided
The WorkSTEPSO Employment Testing Program consists of 5 parts; Information Gathering, Detection,
Intervention, Assessment, and Fraud Ellminatlon.
+ Information Gathering — The WorkSTEPS® Program starts with a thorough job analysis, which
shall be completed by trained Job Ready Services, LLC personnel certified in ergonomics. The job
analysis information forms the basis for preparation of the essential function component of the
WorkSTEPS® Employment Test per EEOC and ADA guidelines.
+ Detection — Job Ready Services, LLC will then begin testing potential employees to ensure they
are capable of performing the physical components of the identified position. This test involves a
functional evaluation involving lifting and job specific testing. Following completion of the test,
results are entered Into the WorkSTEPSO database for outcome generation. This provides a
profile of each individual employee according to the DOT physical demand of each specific job.
The capable/not- capable recommendation is received almost immediately via a computerized
network. The report generated establishes the baseline functional capabilities of the candidate for
possible comparison to future, post -injury data. The employer receives an ADA compliant report.
+ Intervention — If the candidate is hired and incurs an injury or illness, a Fit - For -Duty examination
may be required under certain circumstances before return to work to ensure this employee's
safety in performing the essential functions of the job and also for the purpose of documenting the
change in that individual's baseline due to a change in their physical status and identifying
functional deficits and establishing rehab goals.
+ Assessment — If an employee remains on 'transitional duty" for more than 2 weeks (for example)
or is taken off of work for a work- related or a non work - related injuryfillness, the employee may be
required to participate in a Fit- For -Duty testing process during the rehab process or at MML This
test allows the injured fill person to perform the essential functions of their normal job in a controlled
environment. If the person is deemed to be able to perform their job safely based upon the
essential functions, Job Ready Services, LLC will recommend that they resume their normal job. If
the person is deemed unable to perform theirjob safely or with reasonable accommodations, Job
Ready Services, LLC All notify you in writing of tasks the employee is capable of performing
safely. Orange County can then place the employee in the appropriate transitional position. The
employee may be involved in a rehab or conditioning program and then retested per Company
Policy. Policies can be developed to manage those individuals who have reached MMI and cannot
return to full duty after due process.
+ Fraud Elimination — If an applicant is hired and through the course of his/her employment suffers
any type of injury, the post -offer information Is used to compare the employee's current status with
his/her initial baseline status. This alleviates speculation regarding pre - existing conditions and
comparisons to other persons of his /her age and weight. Furthermore, since the consistency of
post -injury data and diagnostic information is easily monitored, the ability to detect faking an injury
and reduce workers' compensation liability /expense is greatly enhanced.
Job Ready Services, LLC 5
919 256 -1400
www.jobreadyservices.net
DocuSign Envelope ID: Al E64657- B4BC- 4CBD- BBDE- 98475BE11255
cast summary
Development Costs
Price
- Physical Demands Analysis (to establish essential job functions)
$20011-lour
(minimum of 2 hrs)
- Customized Job Descriptions and Essential Functions Test Development
$150 /Job Type
- Validation of Job Specific Testing
$150.00/Hour
Testing Costs
Price
- Post Offer 1 Pre Placement Comprehensive Exam
$175
- Carpal Tunnel /Comprehensive Exam
$240
- Fit -Far -Duly Testing
$175
- No Show Fee
$75
Additional Services Available
Price
Ergonomic Analysis or Causal Relations Job Analysis
$2001hour
Annual Review /Update of Job Descriptions / Job Specific Tests Review
$1251hour
Ergonomic Training
"Per Agreement
Functional Capacity Evaluation
$700.00
Sincerity of Effort Testing
$300.00
Work Conditioning
$80/hr
Medical -Legal Interventions
$1501hour
Price
Miscellaneous Costs
Travel
$501hour
Mileage
$0.55 /mile
There are.no additional start -up costs, annual administrailve costs, or hidden fees
associated with program.
"Training class pricing is dependent on number of attendees per class, number of classes
needed, scheduling
needs, class time and materials provided."
*A Job Type analysis includes job titles /positions that are similar in nature,
to: handling
of same equipmentftools, exposure to same work environment and job functions overlap
The above pricing is valid for 30 days from the date of Proposal Submission
Job Ready Services, LLC
6
919 256 -1400
www.jobreadyserAac s.net
DocuSign Envelope ID: Al E64657- B4BC- 4CBD- BBDE- 98475BE11255
project summary
Cost Estimate for Implementing Post Offer /Fit for Duty Program for 1 Job Type
Job Analysis 3 hrs per job type x $200/hr $600
Test Development 1 hr per job type x $150 /hr $150
Validation 2 hrs per job type x $150 /hr $300
Miscellaneous Travel time and Mileage $110
Estimated Cost Pull Program Implementation $1160
expected results i
Return on Investment
Estimated costs are based on review of Job Analysis, development of job specific testing criteria, content
validation of testing protocol and physical abilities testing for 5 Job Types.
Job Analysis --1 Independent Job Type
Includes time on site, Job Specific Test Design, and Content Validation $1160
Post Offer Pre Placement Testing
10 New Hires 1750
$29'10
Research indicates 101% of your employees are unable to safely perform the essential functions of their
job and have a significant risk for injury. It is also known that 800 /0 of your time and monies are spent in
managing claims for this 10 %.
The Workers Camp Research Institute recently reported the average direct cost of a workers comp claim
in NC is $42,000. DOL`s Safety Pays Program provides a conservative estimate of the indirect cost of the
claim as $46,000 for a total claim cost of $88,000. If the WorkSTEPSO model is successful in finding 1
out of the 10 employees tested who could not safely perform the essential job functions and has a
significant risk for injury, it would pay for all of the costs of testing at this level with a savings of 90% of
direct and indirect claim costs.
A Conservative ROI would be $30 for each $1 spent
Serious consideration should be given to a method that demonstrates savings with testing and not hiring
your next claim.
Job Ready References Available per Request
WorkSTEPS References Available per Request
Job Ready Services, LLC 7
919 256 -1400
www.jobreadyservices.net
DocuSign Envelope ID: Al E64657- B4BC- 4CBD- BBDE- 98475BE11255
I f recommendations
Find out what other companies already know here in North Carolina and nationwide about successful work
injury management with the WorkSTEPSO Program:
The following recommendations provided by Job Ready Services, LLC will result in a successful
work injury management experience with the WorkSTEPSO Program:
♦ Do Job Analysis
o Validate essential functions and physical demands necessary for safe job
performance
♦ Do implement post offer pre placement testing to gather baseline for pre - existing factors
• Don't pay pre - existing apportionment
• Do educate your medical providers to provide accountability for treatmentirehab
goals
♦ Do implement post employment physical agility testing
• Do single out struggling employees for individualized assessment
• Do test all employees periodically to maintain job readiness
Do implement Return to Work policies after leave
• Do create accountability post injury with Fit - For -Duty testing
• Do post injury Functional Capacity Evaluations to RTW with residual function
e Do best practice programming
e Do stop injuries and save significant dollars
Please contact Debra Lord or Michelle Morgan at Job Ready Services to discuss finalization of this
agreement: 919- 256 -1400 or email: debra .lord(o)iobreadyservices,net or
michelle.morpan aoiobreadyservices.net.
Looking Forward to a Successful Partnership
As a representative of Orange County, my signature below indicates acceptance of the proposal as offered
by Job Ready Services, LLC.
Sgnature Date
Print Name Title
Addendum., Job Analysis Contract
Addendum: Tri -Party Letter of Agreement
Job Ready Services, LLC 8
919 256 -1400
www.jobreadyservices.net
DocuSign Envelope ID: Al E64657- B4BC- 4CBD- BBDE- 98475BE11255
Exhibit "2"
Contract for Services
For
Job Analysis Bid Proposal
Orange County ( "COUNTY ") understands that a job analysis must be completed in order to meet
requirements for the Americans with Disabilities Act (ADA) so that Job Ready Services, LLC ( "Provider ")
may perform post -offer and post employment testing pursuant to WorkSTEPS employment testing
protocols. While the ADA does not require that a formal job analysis be conducted to determine the
essential functions of a specific job position, the ADA does require an employer to prove that any
exclusionary criteria obtained from a medical examination used to withdraw an offer of employment or
terminate employment are "job related and justified by business necessity." (EEOC ADA Technical
Assistance Manual H at 19 and VI at 2). Thus, the Provider must conduct a job analysis of the positions for
which employment tests are performed to ensure that the employment test is measuring the candidate's or
employee's ability to perform essential job functions. It is imperative that the COUNTY provides accurate
information to the Provider regarding the essential job functions for specific job positions. The EEOC
provides a discussion relating to the identification of essential job functions in its Technical Assistance
Manual. (EEOC ADA Technical Assistance Manual II at 13 -22). The COUNTY acknowledges that the
COUNTY is responsible for familiarizing itself with this section of the ADA Technical Assistance Manual
and providing the Provider accurate information concerning essential job functions.
A separate job analysis must be performed for each position for which the COUNTY desires to utilize
employment testing. The job analysis may include filming, weighing, and measuring tasks for the selected
major job positions for the COUNTY.
The COUNTY understands that the evaluation usually takes between one (1) and four (4) hours to
complete and is billed at $200.00 per hour. Mileage for services outside of a 20 mile radius from Job
Ready is billed at $0.55 per mile and travel time at $50.00/hour. The COUNTY hereby authorizes Provider
to provide said job analysis for each job position for which the COUNTY will be requesting employment
testing at the above referenced rate.
COUNTY Representative /Title Date
Provider Representative /Title Date
DocuSign Envelope ID: Al E64657- B4BC- 4CBD- BBDE- 98475BE11255
"Attachment A"
Description of Services
Post Offer Testing to Include:
Medical History — The job candidate is asked to complete a comprehensive medical history administered
by an occupational healthcare professional that has been trained and certified in the WorkSTEPS Program.
This history includes information gathering on previous injuries and/or surgeries, previous physical
therapy /chiropractor visits, etc. The employee also signs a statement that falsification of the information
he /she has provided could result in the withdrawal of the conditional job offer.
Musculoskeletal Examination — A WorkSTEPS certified clinician completes this portion of the exam.
The exam looks at all major joints and muscle groups. Thirty (30) baseline measurements are documented.
The muscle groups are checked for strength as well as any atrophy. The shoulders, elbows, wrists, back,
ankles, knees and hips are checked for signs of crepitus as well as ligament stability. In addition, the
lumbar and the cervical spine is also checked. Flexion, extension, side bending and twisting are all
measured. Visual inspection of the spine for signs of surgery is performed. Deep tendon reflexes of the
biceps, triceps, patellar tendon and Achilles tendon are performed to further check for spinal cord
problems. Shoulder range of motion is checked and measured as well for movement in the internal and
external rational planes. The rotator cuff is also thoroughly checked.
Static Grip - This portion of the tests measures grip strength and gathers baseline strength readings on the
employee.
Dynamic Lifting - This portion of the test gathers baseline, full motion, and strength readings. The
employee is asked to lift a NIOSH box from 4 different positions. These 4 positions are lifting the box
from floor to knuckle height, 12 inches off the floor to knuckle height, knuckle height to shoulder and
shoulder to overhead. With each of these lifts, the employee is asked to lift the box. After the lift, they are
asked if they can safely handle more weight. The employee is asked at the beginning to try and lift their
maximum safe lift. The employee is shown and instructed on the proper lifting techniques for each of these
lifting positions.
Job Specific Tasks - This portion tests assesses the job candidate's ability to perform the essential
functions of the job he /she is applying for. The essential functions for a job description are created through
job analysis that is performed by a qualified vendor of the employer's choosing (this can be the
WorkSTEPS Provider who will be providing testing service but is not required). The employer is obligated
to participate in the job analysis process by approving and verifying that the essential functions have been
properly identified and are accurate.
Upper Quadrant/Carpal Tunnel Test - A series of baseline upper extremity tests utilized to identify
carpal tunnel syndrome ( "CTS "). This test consists of a brief musculoskeletal examination focusing
primarily on the upper extremities, grip, pinch, and forearm strength and endurance tests, an optional nerve
conduction test, and essential functions tests if applicable. The results are compared to recognized norms
and an employment recommendation is given to the employer. The Upper Quadrant/Carpal Tunnel Test is
NOT used to diagnose CTS. It is performed only as a baseline test to identify abnormalities that have
resulted in strength, motion, or sensory loss that correlates to pain or other symptoms consistent with
common upper extremity problems and cumulative traumas like CTS. When symptoms or loss of function
are identified during the testing process, a "Refer for "Additional Medical Clearance"
DocuSign Envelope ID: Al E64657- B4BC- 4CBD- BBDE- 98475BE11255
Fit For Duty Testing As Part Of A Return To Work ( "RTW ") Program To Include:
WorkSTEPS will be conducting Fit - for -Duty (Post -Injury RTW) Tests on existing employees to include the
following:
• Any reported injury, illness, or condition that gives the employer reasonable belief that the
employee's ability to perform essential job functions will be impaired or create a direct threat to
health and safety.
• This category may also include testing at the request of the employer because, although there has
been no formal injury or medical condition reported, the employer has observed current
performance problems or has received reliable reports of performance problems indicating that the
employee may not be able to perform essential job functions, or may pose a direct threat to the
health and safety of the employee or others.
• Even if the employee has fully "recovered" from injury or illness and no longer considers him or
herself "injured", for documentation purposes the test should be identified as a "post- injury" fit for
duty, or an injured worker, because that was the trigger for the test.
• When testing an employee post -injury or illness the provider will:
• Use the WorkSTEPS Fit for Duty Physical Capacity Consent Form
• Use the WorkSTEPS Post Injury Fit for Duty Medical History Interview
• Not perform "routine" medical measures, including heart rate and blood pressure, that are
not related to the injury or condition for which the employee is being seen, or that are not
contributing to a job related functional deficit.
• Not perform the standard "baseline" tests such as step test, Sorenson's or grip if they are
not related to the injured area.
• Perform only the dynamic lift postures that are considered qualifying criteria.
• Perform any and all standard job specific tasks for the position, and expand to include
any additional essential function tasks that could be impacted by their injury or condition.
Representative /Title
Date
WorkSTEPS Representative /Title Date
0
DocuSign Envelope ID: Al E64657- B4BC- 4CBD- BBDE- 98475BE11255
---"—a%
JOBRE -1 OP ID: SI
�1 CERTIFICATE OF LIABILITY INSURANCE
° 1
101131!231/20114 4
THI3 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 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
Dupree & Webb, Inc.
PO Box 6522
Raleigh, NC 27628 -6522
Adrian B. Band
CONTACT DUPREE S WEBB INC
PHONE FAX
919 -828 -3241 Noll: 919- 821 -3911
ADDRESS:
INSU S AFFORDING COVERAGE
NAIC II
INSURERA:Hartford Casualty Insurance Co
29424
$ 1,000,00
INSURED JOB READY SERVICES, LLC
INSURER B: Hartford Ins. Co. of Midwest
37478
2300 WESTINGHOUSE BLVD # 107
RALEIGH, INC 27604
INSURER C: Evanston Insurance Company
S 1,000,00
GENERAL AGGREGATE
INSURER D:
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO LOC
INSURER E:
$ 2,000,00
INSU F :
A
AUTOMOBILE LIABILITY
ANYAUTD
ALL OWNED SCHEDULED
AUTOS X
NON-OWNED
HIRED gUTO$ AUTO $
CAVEF AGEA CFRTIFICATF NUMRFR-- REVISION NUMBER: 002
THIS 18 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.
LS
TYPE OF INSURANCE
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
POLICY NUMBER
MMloD11YYW
M DIYYYY
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE a OCCUR
HILLSBOROUGH, NC 27278
225BAIF7783
03/0112014
0310112015
EACH OCCURRENCE
$ 1,000,00
TO RENTEff__
PREMISES Ea occurrence
s 300,00
MED EXP (Any one person)
$ 10,00
PERSONAL &ADV INJURY
S 1,000,00
GENERAL AGGREGATE
$ 2,000,00
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO LOC
PRODUCTS - COMPIOP AGG
$ 2,000,00
$
A
AUTOMOBILE LIABILITY
ANYAUTD
ALL OWNED SCHEDULED
AUTOS X
NON-OWNED
HIRED gUTO$ AUTO $
22SBAIFT783
03/01/2014
03/01/2015
Es axid.r") SINGLE LIMIT
$ 1,000,00
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
ACCIDENT)
PER�X
$
S
A
X
UMBRELLA LIAB
EXCESS LLA13
X
OCCUR
CLAJMS_MADE
22SBAIF7783
0310112014
03!0112015
EACH OCCURRENCE
3 2,000,00
AGGREGATE
$ 2,000,00
X
DED RETENTION $ 10,000
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETORMARTNERIEXECUTIVE Yl�N
OFFICERIMEMBEREXCLUDED? N
(Mandatory In NH)
Ha dearsibe under
DESCRIPTION OF OPERATION$ below
NIA
22WBCE03770
03101120114
0310112015
X WC STATU- I OTH-
TORY LI MITS
E.L. EACH ACCIDENT
$ 500,00
E.L. DISEASE - EA EMPLOYEE
$ 500,00
E.L. DISEASE -POLICY LIMIT
S 500100
C
PROFESSIONAL LIAR
SM899038
03/0112014
03101!2015
PER CLAIM 1,000,00
AGGREGATE 3,000,00
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more apace Is required)
SEE FORM SS 08 04 45, PAGES 11 -14, ITEM 6. FOR GENERAL LIABILITY ADDITIONAL
INSURED PROVISIONS.
I%mn -ri •rHATC Lr/11 rICD CAhICRI I ATin NI
ORANG -1
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
ORANGE COUNTY
POST OFFICE BOX 8181
E
AUTHORIZED dria IiEP Bond
Adrian B. Bond
HILLSBOROUGH, NC 27278
ACORD 26 (2010106)
01888 -2010 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
DocuSign Envelope ID: Al E64657- B4BC- 4CBD- BBDE- 98475BE11255
(b) Rented to, in the care, custody or
control of, or over which physical
control is being exercised for any
purpose by you, any of your
"employees", "volunteer workers ",
any partner or member (if you are
a partnership or joint venture), or
any member (if you are a limited
liability company).
b. Real Estate Manager
Any person (other than your "employee" or
"volunteer worker"), or any organization
while acting as your real estate manager.
c. Temporary Custodians Of Your
Property
Any person or organization having proper
temporary custody of your property if you
die, but only:
(1) With respect to liability arising out of the
maintenance or use of that property; and
(2) Until your legal representative has
been appointed.
d. Legal Representative If You Die
Your legal representative if you die, but
only with respect to duties as such. That
representative wiii have all your rights and
duties under this insurance.
e. Unnamed Subsidiary
Any subsidiary and subsidiary thereof, of
yours which is a legally incorporated entity
of which you own a financial interest of
more than 50% of the voting stock on the
effective date of this Coverage Part.
The insurance afforded herein for any
subsidiary not shown in the Declarations
as a named insured does not apply to
injury or damage with respect to which an
insured under this insurance is also an
insured under another policy or would be
an insured under such policy but for its
termination or upon the exhaustion of its
limits of insurance.
3. Newly Acquired Or Formed Organization
Any organization you newly acquire or form,
other than a partnership, joint venture or
limited liability company, and over which you
maintain financial interest of more than 50% of
the voting stock, will qualify as a famed
Insured if there is no other similar insurance
availabie,to that organization. However:
a. Coverage under this provision is afforded
only until the 180th day after you acquire
or form the organization or the end of the
policy period, whichever is earlier; and
BUSINESS LIABILITY COVERAGE FORM
b. Coverage under this provision does not
apply to:
(1) "Bodily injury" or "property damage"
that occurred; or
(2) "Personal and advertising injury"
arising out of an offense committed
before you acquired or formed the
organization.
4. Operator Of Mobile Equipment
With respect to "mobile equipment" registered in
your name under any motor vehicle registration
law, any person is an insured while driving such
equipment along a public highway with your
permission. Any other person or organization
responsible for the conduct of such person is
also an insured, but only with respect to liability
arising out of the operation of the equipment, and
only if no other insurance of any kind is available
to that person or organization for this liability.
However, no person or organization is an insured
with respect to:
a. "Bodily injury" to a co- "employee" of the
person driving the equipment; or
b. "Property damage" to property owned by,
rented to, in the charge of or occupied by
you or the employer of any person who is
an insured under this provision.
S. Operator of Nonowned Watercraft
With respect to watercraft you do not own that
is less than 51 feet long and is not being used
to cant' persons for a charge, any person is an
insured while operating such watercraft with
your permission. Any other person or
organization responsible for the conduct of
such person is also an insured, but only with
respect to liability arising out of the operation
of the watercraft, and only if no other
insurance of any kind is available to that
person or organization for this liability.
However, no person or organization is an
insured with respect to:
a. "Bodily injury" to a co "employee" of the
person operating the watercraft; or
b. "Property damage" to property owned by,
rented to, in the charge of or occupied by
you or the employer of any person who is
an insured under this provision.
B. Additional Insureds When Required By
Written Contract, Written Agreement Or
Permit
The person(s) or organization(s) identified in
Paragraphs a. through f. below are additional
insureds when you have agreed, in a written
Form SS 00 08 04 05 Page 11 of 24
DocuSign Envelope ID: Al E64657- B4BC- 4CBD- BBDE- 98475BE11255
BUSINESS LIABILITY COVERAGE FORM
contract, written agreement or because of a
(e) Any failure to make such
permit issued by a state or political
inspections, adjustments, tests or
subdivision, that such person or organization
servicing as the vendor has
be added as an additional insured on your
agreed to make or normally
policy, provided the injury or damage occurs
undertakes to make in the usual
subsequent to the execution of the contract or
course of business, in connection
agreement, or the issuance of the permit.
with the distribution or sale of the
A person or organization is an additional
products;
insured under this provision only for that
(f) Demonstration, installation,
period of time required by the contract,
servicing or repair operations,
agreement or permit.
except such operations performed
However, no such person or organization is an
at the vendor's premises in
connection with the sale of the
additional insured under this provision if such
product;
person or organization is included as an
additional insured by an endorsement issued
(g) Products which, after distribution
by us and made a part of this Coverage Part,
or sale by you, have been labeled
including all persons or organizations added
or relabeled or used as a
as additional insureds under the specific
container, part or ingredient of any
additional insured coverage grants in Section
other thing or substance by or for
F. — Optional Additional Insured Coverages.
the vendor; or
a. Vendors
(h) "Bodily injury" or "property
damage" arising out of the sole
Any person(s) or organization(s) (referred to
negligence of the vendor for its
below as vendor), but only with respect to
own acts or omissions or those of
"bodily injury" or "property damage" arising
its employees or anyone else
out of "your products" which are distributed
acting on its behalf. However, this
or sold in the regular course of the vendor's
exclusion does not apply to:
business and only if this Coverage Part
provides coverage for "bodily injury" or
(i) The exceptions contained in
"property damage" included within the
Subparagraphs (d) or (f); or
"products-completed operations hazard ".
(ii) Such inspections, adjustments,
(1) The insurance afforded to the vendor
tests or servicing as the vendor
is subject to the following additional
has agreed to make or normally
exclusions:
undertakes to make in the usual
course of business, in
This insurance does not apply to:
connection with the distribution
(a) "Bodily injury" or "property
or sale of the products.
damage" for which the vendor is
(2) This insurance does not apply to any
obligated to pay damages by
insured person or organization from
reason of the assumption of
whom you have acquired such products,
liability in a contract or agreement.
or any ingredient, part or container,
This exclusion does not apply to
entering into, accompanying or
liability for damages that the
containing such products.
vendor would have in the absence
of the contract or agreement;
b. Lessors Of Equipment
(b) Any express warranty
(1) Any person or organization from
unauthorized by you;
whom you lease equipment; but only
with respect to their liability for "bodily
(c) Any physical or chemical change
injury", "property damage" or
in the product made intentionally
"personal and advertising injury"
by the vendor;
caused, in whole or in part, by your
(d) Repackaging, except when
maintenance, operation or use of
unpacked solely for the purpose of
equipment leased to you by such
inspection, demonstration, testing,
person or organization.
or the substitution of parts under
instructions from the manufacturer,
and then repackaged in the
original container;
Page 12 of 24 Form SS 00 08 04 05
DocuSign Envelope ID: Al E64657- B4BC- 4CBD- BBDE- 98475BE11255
BUSINESS LIABILITY COVERAGE FORM
(2)
With respect to the insurance afforded
e. Permits Issued By State Or Political
to these additional insureds, this
Subdivisions
insurance does not apply to any
(1) Any state or political subdivision, but
"occurrence" which takes place after
only with respect to operations
you cease to lease that equipment.
performed by you or on your behalf for
c. Lessors Of Land Or Premises
which the state or political subdivision
(1)
Any person or organization from
has issued a permit.
whom you lease land or premises, but
(2) With respect to the insurance afforded
only with respect to liability arising out
to these additional insureds, this
of the ownership, maintenance or use
insurance does not apply to:
of that part of the land or premises
(a) "Bodily injury", "property damage"
leased to you.
or "personal and advertising
(2)
With respect to the insurance afforded
injury" arising out of operations
to these additional insureds, this
performed for the state or
insurance does not apply to:
municipality; or
(a) Any "occurrence" which takes
(b) "Bodily injury" or "property damage"
place after you cease to lease that
included within the "products -
land or be a tenant in that
completed operations hazard ".
premises; or
f. Any Other Party
(b) Structural alterations, new
(1) Any other person or organization who
construction or demolition
is not an insured under Paragraphs a.
operations performed by or on
through e. above, but only with
behalf of such person or
respect to liability for "bodily injury",
organization.
"property damage" or "personal and
d. Architects, Engineers Or Surveyors
advertising injury" caused, in whole or
(1)
Any architect, engineer, or surveyor, but
in part, by your acts or omissions or
only with respect to liability for "bodily
the acts or omissions of those acting
injury", "property damage" or "personal
on your behalf:
and advertising injury" caused, in whole
(a) In the performance of your
or in part, by your acts or omissions or
ongoing operations;
the acts or omissions of those acting on
(b) In connection with your premises
your behalf:
owned by or rented to you; or
(a) In connection with your premises;
(c) In connection with "your work" and
or
included within the "products -
(b) In the performance of your
completed operations hazard ", but
ongoing operations performed by
only if
you or on your behalf.
(t) The written contract or written
(2)
With respect to the insurance afforded
agreement requires you to
to these additional insureds, the
provide such coverage to
following additional exclusion applies:
such additional insured; and
This insurance does not apply to
(11) This Coverage Part provides
"bodily injury", "property damage" or
coverage for "bodily injury" or
"personal and advertising injury"
"property damage" included
arising out of the rendering of or the
within the "products -
failure to render any professional
completed operations hazard".
services by or for you, including:
(2) With respect to the insurance afforded
(a) The preparing, approving, or
to these additional insureds, this
failure to prepare or approve,
insurance does not apply to:
maps, shop drawings, opinions,
"Bodily injury", "property damage" or
reports, surveys, field orders,
"personal and advertising injury"
change orders, designs or
arising out of the rendering of, or the
drawings and specifications; or
failure to render, any professional
(b) Supervisory, inspection,
architectural, engineering or surveying
architectural or engineering
services, including:
activities.
Form SS 00 08 04 05 Page 13 of 24
DocuSign Envelope ID: Al E64657- B4BC- 4CBD- BBDE- 98475BE11255
BUSINESS LIABILITY COVERAGE FORM
(a) The preparing, approving, or
failure to prepare or approve,
maps, shop drawings, opinions,
reports, surveys, field orders,
change orders, designs or
drawings and specifications; or
(b) Supervisory, inspection,
architectural or engineering
activities.
The limits of insurance that apply to additional
insureds are described in Section D. — Limits
Of Insurance.
How this insurance applies when other
insurance is available to an additional insured
is described in the Other Insurance Condition
in Section E. — Liability And Medical Expenses
General Conditions.
No person or organization is an insured with
respect to the conduct of any current or past
partnership, joint venture or limited liability
company that is not shown as a Named Insured in
the Declarations.
D. LIABILITY AND MEDICAL EXPENSES
LIMITS OF INSURANCE
1. The Most We Will Pay
The Limits of Insurance shown in the
Declarations and the rules below fix the most
we will pay regardless of the number of:
a. Insureds;
b. Claims made or "suits" brought; or
c. Persons or organizations making claims or
bringing "suits
2. Aggregate Limits
The most we will pay for:
a. Damages because of "bodily injury" and
"property damage" included in the
"products- oompleted operations hazard' is
the Products - Completed Operations
Aggregate Limit shown in the
Declarations.
b. Damages because of all other "bodily
injury", "property damage" or "personal
and advertising injury", including medical
expenses, is the General Aggregate Limit
shown in the Declarations.
This General Aggregate Limit applies
separately to each of your 'locations"
owned by or rented to you.
"Location" means premises involving the
same or connecting lots, or premises
whose connection is interrupted only by a
street, roadway or right -of -way of a
railroad.
This General Aggregate limit does not
apply to "property damage" to premises
while rented to you or temporarily
occupied by you with permission of the
owner, arising out of fire, lightning or
explosion.
3. Each Occurrence Limit
Subject to 2.a. or 2.b above, whichever
applies, the most we will pay for the sum of all
damages because of all "bodily injury",
"property damage" and medical expenses
arising out of any one 'occurrence" is the
Liability and Medical Expenses Limit shown in
the Declarations.
The most we will pay for all medical expenses
because of "bodily injury" sustained by any
one person is the Medical Expenses Limit
shown in the Declarations.
4. Personal And Advertising Injury Limit
Subject to 2.b. above, the most we will pay for
the sum of all damages because of all
"personal and advertising injury" sustained by
any one person or organization is the Personal
and Advertising Injury Limit shown in the
Declarations.
5. Damage To Premises Rented To You Limit
The Damage To Premises Rented To You
Limit is the most we will pay under Business
Liability Coverage for damages because of
"property damage" to any one premises, while
rented to you, or in the case of damage by fire,
lightning or explosion, while rented to you or
temporarily occupied by you with permission of
the owner.
In the case of damage by fire, lightning or
explosion, the Damage to Premises Rented To
You Limit applies to all damage proximately
caused by the same event, whether such
damage results from fire, lightning or explosion
or any combination of these.
6. How Limits Apply To Additional Insureds
The most we will pay on behalf of a person or
organization who is an additional insured
under this Coverage Part is the lesser of
a. The limits of insurance specified in a
written contract, written agreement or
permit issued by a state or political
subdivision; or
b. The Limits of Insurance shown in the
Declarations.
Such amount shall be a part of and not in
addition to the Limits of Insurance shown in
the Declarations and described in this Section.
Page 14 of 24 Form SS 00 08 04 05