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HomeMy WebLinkAbout2015-347-E DSS - Bethesda Care, LLC dba Keston Care for RN services $10,000 DocuSign Envelope ID: 30CC97DC-995F-48ED-9245-A640EBC3CAOC [Departmental Use Only] TITLE Bethesda Care FY 2015-16 ORANGE COUNTY CONTRACT UNDER$15,000.00 NORTH CAROLINA THIS AGREEMENT, made and entered into this 1st day of July, 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 July 1, 2015 to June 30,2016. 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. Pam: 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: 30CC97DC-995F-48ED-9245-A640EBC3CAOC 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 http;l/oranp-ecountync.gov/purcliasinWcontracts.asp). 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. 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 and Signature : 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 lA 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 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. 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 2 DocuSign Envelope ID: 30CC97DC-995F-48ED-9245-A640EBC3CAOC IN WITNESS WHEREOF, Orange County and the Provider have signed this Agreement, effective as of the day �tfirst7�written above.O 43 "'T 1 pR joV�.littU �A*�712212015 �o A�lB B y od�gFOrocav�d1B. Y' 0.633-9g4®7�5E-4?�... - 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: 30CC97DC-995F-48ED-9245-A640EBC3CAOC firS .,refit bsurance Company i South Wacker drive; Suite 2380 Chitgo, IL 80 31Z-11.5-3010 MULTIPLE PERIL POLICY DECLARATIONS Policy Number: RPM 06032 00 Producer:InWrance.service Center of Fayetteville,Inc., Rene lot,Policy Number: New Named Insured: Bethesda Care Lt_C :Keston Care lirwg Ad it ; 11312 Hit 15-501,North Chatham Crossing Ste 400 Chapr i Hill NC 27514 Coverage. From 1,3/612014 To 10/6/2015 12:Q'i e.rrt.Local 1 I �t.Your Tett�t of - .Mailing,Addrass 8hovtun Above First Annual Premium: Coverages Provided In reW rn to your poyment:Of the required prorniurn,We provide the coverage.described In this,polloy 112gigdod A- General.Conditions Property insurances B. Terms.&Condftns Alt Property and Related Coverages . Optional Coverages C. General Property D. Income Protection&.Extra Expense El E Shied>Personal.Property I F. Compoters E3 �. Go Crime. d - `Primary Liability,insurances H. Teams::&.Condifioii*-Prknary Inability Coverage a Optional Coverages: t. Bodily1rajutyar1d".P'roprty Darrage,t.iability J. Sexual Abtase-LiaibWty " K. Social Work,fosWr Care and Counseing:Liability L Medical Liability I M. Personal-and Adverftiqg Injury Liability I N, Mort4>wned and Hired Auto Lfabiflty 0. Medical:Payments P. Employes"Benefits Administration Liability Additional Corms applicable to this policy: Bate: 4:- by: L{ ' First Nonprofit Insureraee.'iCOM rvy Authorized Rapre ntalive ]kV ,0412.0110 PKG 1000 Page 1 o 5 DocuSign Envelope ID: 30CC97DC-995F-48ED-9245-A640EBC3CAOC PRIMARY LIABILITY DECLARATIONS LiiV rrS DF COVERAGE Combined Policy Year Annual Aggregate Limit-Applicable to Sections L,J., K. and L. $ ;,tx ;tx�o Section I. B"ly Injury and Property Damage Liability Each Occurrence Limit $ $11000,000 Section J. Sexual Abuse Liability Each Sexual Abuse Occurrence Limit $ 11,000,000 Section K. Social Work, Foster Care and Counseling Liability Each Social Mork Occurrence Limit $ 1,a1Q,4o0 Section L. Medical Liability Each Medical Incident Limit $: 1,000,000 Section M. Personal and Advertising Injury Liability Policy Year Annual Aggregate Limit ,opa;oi�o Section N. Non-Owned and Hired Auto Liability Each Accident Limit $ 1.000,000 Section ©. Medical Payments $ 5J000 per Person $ 25,000 per Occurrence $ 75,000 Policy Year Annual Aggregate Section P. Employee Benefit Administration Liability $ NOT PROVIDED. each Claim $ NOT PROVIDED Policy Year Annual Aggregate `;.,.• 04r2010 PKG 1000 Page 5 of 5 DocuSign Envelope ID: 30CC97DC-995F-48ED-9245-A640EBC3CAOC ..... . firstm. 1 South Wacker Drive, Suite 23:80 Chicago, IL 60668 312-715-3010 UMBRELLA LIABILITY POLICY GENERAL DECLARATIONS Policy Number.: Nmsltoew3 oo Producer, Insurance Service C.Onter'of ikyettevill®;Ind Renevral'cif Policy Number.: New 1.. Named Insured: Wtwfda care LLe Mailing-Addr 5: 1312 H"15-WI(North Cha tt m CrossIng.Ste' cna�+w�tE too�x�i a 2.. Policy Period: Fmm,:.,i0%1.2014 To: 1016 ris 12:01 a.m. Lodi Time at Mailing Address Above 3. Annual Premium: w 4: Limits cif insurance and Retention: a. 1.000:400 Each Occurrence Limit b. 1Au3tl,t'W General Aggregate Limit c: 10.000 Retained Limit 5: Underlying:Policies and Limits: Co"raae Limits Irau r Torrri General t,pF>F►,ow lEacicoemaw" FkWNanprrWrAuance: 7 ,C ca�sy Liability 1ru8isx3i5 NPPli�032 3:oDQ,� �e�m��� Emptoyer s 500AW XAch Ao6dano 5tortcwoas! 7WZ14 Liability . W 100-009502 MOW /Dbo ea Poticy LwM Other alaiiity SMOW Miaeaea Each EmpkV" Additional Forms Applicable To This Policy At Issuance: Date:1019/2014 B �1 Authorized='Representative First Nora rofiUnsurar�e Gcamvany DocuSign Envelope ID: 30CC97DC-995F-48ED-9245-A640EBC3CAOC HEALTHCARE PROVIDERS SERVICE CNAORGANIZATION PURCHASING GROUP mnso Certificate of 3 i%u aillre nurses service orpnizatinn OCCURENCE POLICY FORM Print pate: 2109/2015 Producer Branch Prefix Policy Number Policy Period 018098 970 HPG 0428064583 from 02118115to 02/18/16 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 1 9040-1 21 8 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 $1,004,000 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 S25,000 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 &End orsements(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 GSL3888 GSL3908 Keep this document in a safe place.9 p and proof of payment are your proof of i j� ,1 „f coverage. There is no coverage in force �J r u ill --- "`--- unless the premium is paid in full.In order Chairman of the Board Sec to activate your coverage, please remft premium in full by the effective date of this Certificate of Insurance. Master Policy#188711433 G-141241-B(03/2010) Coverage Change Date: Endorsement Change Date: