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HomeMy WebLinkAbout2015-302-E DSS - Bethesda Care, LLC dba Keston Care for RN services $10,000 DocuSign Envelope ID: 10E673C3-E710-42EA-A3C9-4B338A28EADF [Departmental Use Only] TITLE Bethesda Care FY 2014-15 ORANGE COUNTY CONTRACT UNDER $15,000.00 NORTH CAROLINA THIS AGREEMENT, made and entered into this 30tb day of March, 2015, ("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 Bethesda Care, L.L.C. dba Keston Care (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: The Provider will provide a Registered Nurse to make home visits for the purpose of conducting RN assessments of beneficiaries of the Community Alternatives Program for Disabled Adults (CAP/DA) in Orange County and entering the required data in e-CAP. Assessments will be scheduled by the CAP/DA case managers in the Adult Services Unit of OCDSS. The Registered Nurse will attend OCDSS approved training prior to performing any such assessments, and attend any new training as necessary. . The term of this agreement rendered shall be from March 30, 2015 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. 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 Ten Thousand Dollars and 001100, ($10,000). The Provider will be paid at a rate of$30/per hour. Provider shall also be reimbursed at a rate of Zero Cents (¢0) per/mile for mileage costs. 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 contractor 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 Revised 7114 1 DocuSign Envelope ID: 10E673C3-E710-42EA-A3C9-4B338A28EADF 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: Provider shall obtain, at its sole expense, Commercial General Liability Insurance, Automobile Insurance, Workers' Compensation Insurance, and any additional insurance as may be required by Owner's Risk Manager as such insurance requirements are described in the Orange County Risk Transfer Policy and Orange County Minimum Insurance Coverage Requirements (each document is incorporated herein by reference and may be viewed at ht :/loran ecount c. ov/ urchasin contracts.as ). If Owner's Risk Manager determines additional insurance coverage is required such additional insurance shall consist of General Liability Professional that includes coverage for abuse or sexual misconduct and employee theft (if no additional insurance required mark NIA as being not applicable). Provider shall not commence work until such insurance is in effect and certification thereof has been received by the Owner's Risk Manager. 5. Indemnitv: 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 and Si natures: 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 I IA and Article 40 of North Carolina General Statute Chapter 66. 8. Priori : In determining the basic services to be provided, should any documents be referenced in this Agreement, the terms herein shall have priority in any conflict between the terms of referenced documents and the terms of this Agreement. 9. Governing Law: Both Both p arties 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. Provider 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 Provider's breach of this Agreement. By executing this Agreement Provider affirms Provider 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. Revised 7114 7 DocuSign Envelope ID: 10E673C3-E710-42EA-A3C9-4B338A28EADF IN WITNESS WHEREOF,Orange County and the Provider have signed this Agreement, effective as of the day first written above. Oad,NTY PRORsigned by: jOV�,Vt tf �AaM1Mt,V'S 30/2015 p �OAIn l�t, SS�t /9/2015 By.t7 4835SE4��... Dy. A419EAGAE43741A Bonnie Hammersley, County Manager 200 S. Cameron St. Roxanne Kessler P.O. Box 8181 11312 US 15-501, Chatham Crossing Suite 400 Hillsborough,NC 27278 Chapel Hill, NC 27517 Revised 7114 3 DocuSign Envelope ID: 10E673C3-E710-42EA-A3C9-4B338A28EADF First ,.Y . . . Eft klsurance Cmp(yrly I South Wacker Drive, Suite 238,0: Chicago, IL 60606 312-715-3010 MULTIPLE PERIL POLICY DECLARATIONS f7oliGy Number:,Ni'P1006082 00 Producer:Insurance,service Canter of F ayettevilla, Named Insured: Bethesda Care LLC,: Keston Care M601ing Addrm 1:1:312 Hwy 15.501 Norlb Obatham Crossing.Ste 400 Chapel.Hill NC 27514 Term of CoverW. Frarrt 10/5/2014 To 10/612015 12:01'a.m.Loral Tilte at,Your Mailin Address,Si own Above Rost Anrtu'2'd Premium: �1 Cwnragee Provided In return for your payment of the f"uir0d.Pfsmlum,we provide the covera;tge.described irr"tht PoIIGy*" Section In A. General Conditions Property lnsuranc43,yes 8.. Terms&Conditions—All Propeny`and ReWed Coverages . Option Coverages , C. General Property D, income Protection&a~)dra Expense E. Sect Pera4nal PrOp" F.. Garrtpu4ers ® :El G. Grime Prirrrary l_iaVd1ty lrlUrances H. Terms 8r<Conditions—.Primary i_iability Coverages �, t�pticu181 Ccrve�ageffi 1 $0011y fniury and Property Dacnsge 1 iability � I J1 Sexual Abuse Liat lhty K. Social Work.:FosWCare and Counseling Liability 0 13 4_ Mcaf Lability .M. Personal and Advertising Injury,Liability � N. Non-Owned and:Ffired i to Liability . C. Medical Payments P. Employee Benefits Administration Liability E3 Is Additional fonds applicable to this policy: Cate: 1 DM014 by: W - First Rona`ofit In su1 eh' GA ! ', Authorized.Rapressni�ve :-� 0412f!O PKG 1000 Page 1 bf"5 DocuSign Envelope ID: 10E673C3-E710-42EA-A3C9-4B338A28EADF PRIMARY LIABILITY DECLARATIONS LIMITS OF C VERAGE Combined Policy Year Annual Aggregate Limit—Applicable to Sections I.,J., K. and L. $ 3.00D G 0 Section L Bodily Injuryy and Property Damage Liability Each Occurrence Limit - $ $1,W0,000 Section J. Sexual Abuse Liability Each Sexual Abuse Occurrence Limit $ 1,000;000 Section K. Social Work, Foster Care and Counseling Liability Each Social Work Occurrence Limit $ 1,000,000 Section L. Medical Liability Each Medical Incident Limit $ 1,0D0,000` Section M. Personal and Advertising Injury Liability Policy Year Annual Aggregate Limit $ 1,0()0, Section N. Non-Owned and Hired Auto Liability Each.Aocident Limit $ 1.000,000 Section 0. Medical Payments $ 5,000 per Person $ 251000 per Occurrence $ 75.OW Policy Year Annual Aggregate Section P. Employee Benefit Administration Liability $ NOT PROVIDED each Clain NOTPROVIDED Policy Year Annual Aggregate Page 5 of 5 0412010 P.G 1000 DocuSign Envelope ID: 10E673C3-E710-42EA-A3C9-4B338A28EADF k?$V cr?M cmpany 1 South Wacker DriVe, Suite 2380 Chicago, IL 60606 312-715-3010 UMBRELLAUABILITYPOUCY C 5NERAl..DECLARATIONS Policy Number.: NAm sioo=3 oo Producer i f Fy ,t a ce nr. 'Renewal of Policy Nufhber.: Now 1. Named Insured: Ewthesda care LLc 1.1312 Hwy 15-501 North Main t th ix s: Cheaham Crossing Ste 400 Chapel Hilt N0,27514 2. Policy Penod: From: I(YW2o14 To: tat ols 12:01 a.m. Local Time at Mailing.Address Above 3. Annual Pren ium- 4. Limits of Insurance and Retention: a. 1.170000 Each' occurrence Limit b. 1,00o,00o General Aggregate Limit C' - � Retained Limit Underlying Policies and Limits: Coverage Limits Insurer T. �,aoo,a�o Grcc+i�eRCa B iota naxee- 1q;�r�sta General Liability t06JTfPi 5 NPP1006= 3;a00000 1Gener Ay®reyaae Employees . SQp.ifUi) .AtaefiACCidaiit. Stmsswaoq 7!i}12E7t4 , Liability W0100-009512 5£30.000 f0i®eese Po y L ! Other.Liability 500.000 Uwase Ewh EffOoyee Additional Farms Applicable To This Policy At Issuance: 8 ' Date:1"M14 Br_ Authorit0d Representative Fi t lit rofit i,rraure lr r p€tny DocuSign Envelope ID: 10E673C3-E710-42EA-A3C9-4B338A28EADF HEALTHCARE PROVIDERS SERVICE CNAORGANIZATION PURCHASING GROUP mnso (Certificate of 31110urance nurses service orpnizatimr OCCURENCE POLICY FORM Print Date: 2109!2015 Producer Branch Prefix Policy Number Policy Period 018098 970 HPG 0428064583 from 02118/15 to 02118116 at 12:01 AM Standard Time Named Insured and Address: Program Administered by: Colleen Black Semelka Nurses Service Organization 265 Severin St 159 E. County Line Road Chapel Hill, NC 27516-1511 Hatboro, PA 19040-1218 1-800-247-1500 www.nso.com Medical Specialty: Code: Insurance is provided by: Registered Nurse 80964 American Casualty Company of Reading, Pennsylvania 333 S.Wabash Avenue, Chicago, IL 60604 Professional Liability $1,000,000 each claim $3,000,000 aggregate Your professional liability limits shown above include the following: * Good Samaritan Liability * Malplacement Liability Personal Injury Liability * Sexual Misconduct Included in the PL limit shown above subject to $25,000 aggregate sublimit Coverage Extensions License Protection $25,000 per proceeding $25,000 aggregate Defendant Expense Benefit $ 1,000 per day limit $25,000 aggregate Deposition Representation $ 10,000 per deposition $10,000 aggregate Assault $ 25,000 per incident $25,000 aggregate Includes Workplace Violence Counseling Medical Payments $ 25,000 per person $ 100,000 aggregate First Aid $ 10,000 per incident $ 10,000 aggregate Damage to Property of Others $ 10,000 per incident $ 10,000 aggregate Information Privacy(HIPAA) Fines and Penalties $25,000 per incident $25,000 aggregate Workplace Liability Workplace Liability Included in Professional Liability Limit shown above Fire&Water Legal Liability Included in the PL limit shown above subject to $150,000 aggregate sublimit Personal Liability $1,000,000 aggregate Total: $ 102.00 Base Premium $102.00 Premium reflects Employed , Part Time Policy Forms& Endorsements(Please see attached list for a general description of many common policy forms and endorsements.) G-121500-D GSL10546NC G-121503-C G-121501-C G-145184-A G-147292-A GSL15563 GSL15564 GSL15565 GSL17101 GSL13424 G-123846-C32 GSL3886 GSL3908 Keep this document in a safe place.It and proof of payment are your proof of I coverage. There is no coverage in force Cf. unless the premium is paid in full.In order to activate your coverage,please remit Chairman of the Board Secretary premium in full by the effective date of this Certificate of Insurance. Master Policy# 188711433 G-141241-13(0312010) Coverage Change Date: Endorsement Change Date: