Loading...
HomeMy WebLinkAbout2019-582-E Aging - Linda Mansmann wellness instructor DocuSign Envelope ID:A83B22E2-5247-4331-8149-B62BAAA1856F [Departmental Use Only] TITLE Wellness Instructor FY 2019-20 NORTH CAROLINA SERVICES AGREEMENT UNDER$90,000.00 NO RFP/RFQ ORANGE COUNTY This Services Agreement (hereinafter "Agreement'), made and entered into this first day of July, 2019, ("Effective Date") by and between Orange County, North Carolina a political subdivision of the State of North Carolina (hereinafter, the "County") and Linda Mansmann, (hereinafter, the "Provider"). WITNESSETH: That the County and Provider, for the consideration herein named, do hereby agree as follows: 1. Services a. Scope of Work. i) This Agreement is for services to be rendered by Provider to County with respect to (insert type of project): Fit Feet Clinic nursing service ii) By executing this Agreement, the 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. iii) Time is of the essence with respect to this Agreement. iv) The services to be performed under this Agreement consist of Basic Services, as described and designated in Section 3 hereof. Compensation to the Provider for Basic Services under this Agreement shall be as set forth herein. 2. Responsibilities of the Provider a. Services to be provided. The Provider shall provide the County with all services required in Section 3 to satisfactorily complete the Project within the time limitations set forth herein and in accordance with the highest professional standards. b. Standard of Care. i) The Provider shall exercise reasonable care and diligence in performing services under this Agreement in accordance with the highest generally accepted standards of this type of Provider practice throughout the United States and in accordance with applicable federal, state and local laws and regulations applicable to the performance of these services. Provider is solely responsible for the professional Revised 12/18 1 DocuSign Envelope ID:A83B22E2-5247-4331-8149-B62BAAA1856F quality, accuracy and timely completion and/or submission of all work related to the Basic Services. ii) Provider shall be responsible for all errors or omissions of its agents, contractors, employees, or assigns 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. iii) The Provider shall not, except as otherwise provided for in this Agreement, subcontract the performance of any work under this Agreement without prior written permission of the County. No permission for subcontracting shall create, between the County and the subcontractor, any contract or any other relationship. iv) Provider is an independent contractor of County. Any and all employees of the Provider engaged by the Provider in the performance of any work or services required of the Provider under this Agreement, shall be considered employees or agents of the Provider only and not of the County, and any and all claims that may or might arise under any workers compensation or other law or contract on behalf of said employees while so engaged shall be the sole obligation and responsibility of the Provider. v) If activities related to the performance of this Agreement require specific licenses, certifications, or related credentials Provider represents that it and/or its employees, agents and subcontractors engaged in such activities possess such licenses, certifications, or credentials and that such licenses certifications, or credentials are current, active, and not in a state of suspension or revocation. vi) In determining the basic services to be provided, should any documents be referenced in this Agreement, the terms of this Agreement shall have priority in any conflict between the terms of referenced documents and the terms of this Agreement. Should a request for proposals and a proposal be referenced the terms of the request for proposals shall have priority over the terms of any proposal. 3. Basic Services a. Basic Services. The Services to be rendered pursuant to this Agreement are as follows (fully describe services to be provided): Fit Feet Clinic nursing service 4. Duration of Services a. Term. The term of this Agreement shall be from July 1, 2019 to June 30, 2020. b. Scheduling of Services. i) The Provider shall schedule and perform its activities in a timely manner. ii) Should the County determine that the Provider is behind schedule, it may require the Provider to expedite and accelerate its efforts, including providing additional resources and working overtime, as necessary, to perform its services in Revised 12/18 2 DocuSign Envelope ID:A83B22E2-5247-4331-8149-B62BAAA1856F accordance with the approved project schedule at no additional cost to the County. iii) The Commencement Date for the Provider's Basic Services shall be July 1, 2019. 5. Compensation a. Compensation for Basic Services. Compensation for Basic Services shall include all compensation due the Provider from the County for all services under this Agreement. The maximum amount payable for Basic Services shall not exceed six-thousand Dollars ($20.00 per hour). Payment for Basic Services shall become due and payable within thirty (30) days of Provider properly invoicing County. Payment shall be subject to provisions of Section 5(b). b. Disputes. In the event the amount stated on an invoice is disputed by the County, the County may withhold payment of all or a portion of the amount stated on an invoice until the parties resolve the dispute. 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. c. Additional Services. County shall not be responsible for costs related to any services in addition to the Basic Services performed by Provider unless County requests such additional services in writing and such additional services are evidenced by a written amendment to this Agreement. 6. Responsibilities of the County a. Cooperation and Coordination. The County has designated (Latonya Brown) to act as the County's representative with respect to the Project and shall have the authority to render decisions within guidelines established by the County Manager and/or the County Board of Commissioners and shall be available during working hours as often as may be reasonably required to render decisions and to furnish information. 7. Insurance a. General Requirements. 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 County'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://www.orangecountVnc.gov/departments/purchasing division/contracts.php). If County's Risk Manager determines additional insurance coverage is required such additional insurance shall consist of liability insurance (if no additional insurance required mark N/A as being not applicable). Provider shall not commence work until such insurance is in effect and certification thereof has been received by the County's Risk Manager. 8. Indemnity Revised 12/18 3 DocuSign Envelope ID:A83B22E2-5247-4331-8149-B62BAAA1856F a. Indemnity. The Provider agrees, without limitation, to defend, indemnify and hold harmless the County from all loss, liability, claims or expense, including attorney's fees, arising out of or related to the Project and arising from property damage or bodily injury including death to any person or persons caused in whole or in part by the negligence or misconduct of the Provider except to the extent same are caused by the negligence or willful misconduct of the County. It is the intent of this provision to require the Provider to indemnify the County to the fullest extent permitted under North Carolina law. 9. Amendments to the Agreement a. Changes in Basic Services. Changes in the Basic Services and entitlement to additional compensation or a change in duration of this Agreement shall be made by a written Amendment to this Agreement executed by the County and the Provider. The Provider shall proceed to perform the Services required by the Amendment only after receiving a fully executed Amendment from the County. 10. Termination a. Termination for Convenience of the County. This Agreement may be terminated without cause by the County and for its convenience upon seven (7) days' prior written notice to the Provider. b. Other Termination. The Provider may terminate this Agreement based upon the County's material breach of this Agreement; provided, the County has not taken all reasonable actions to remedy the breach. The Provider shall give the County seven (7) days' prior written notice of its intent to terminate this Agreement for cause. c. Compensation After Termination. i) In the event of termination, the Provider shall be paid that portion of the fees and expenses that it has earned to the date of termination, less any costs or expenses incurred or anticipated to be incurred by the County due to errors or omissions of the Provider. ii) Should this Agreement be terminated, the Provider shall deliver to the County within seven (7) days, at no additional cost, all deliverables including any electronic data or files relating to the Project. d. Waiver. The payment of any sums by the County under this Agreement or the failure of the County to require compliance by the Provider with any provisions of this Agreement or the waiver by the County of any breach of this Agreement shall not constitute a waiver of any claim for damages by the County for any breach of this Agreement or a waiver of any other required compliance with this Agreement. e. Suspension. County may suspend the Basic Services and this Agreement at any time for County's convenience and without penalty to County upon three (3) days' notice to Provider. Upon any suspension by County, Provider shall discontinue work on the Basic Services and shall not resume the Basic Services until notified to proceed by County. Revised 12/18 4 DocuSign Envelope ID:A83B22E2-5247-4331-8149-B62BAAA1856F 11. Additional Provisions a. Limitation and Assignment. The County and the Provider each bind themselves, their successors, assigns and legal representatives to the terms of this Agreement. Neither the County nor the Provider shall assign or transfer its interest in this Agreement without the written consent of the other. b. 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. By executing this Agreement Provider affirms that Provider and any subcontractors of Provider are and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147-86.58. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147-86.81. c. Non-Discrimination. 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 state and federal non-discrimination laws, policies, rules, and regulations and the Orange County Non-Discrimination Policy and Orange County Living Wage Policy(each policy is incorporated herein by reference and may be viewed at http://www.oran e�ync. o�partments/purchasing_division/contracts.php.) Any violation of the Orange County Non-Discrimination Policy is a breach of this Agreement and County may immediately terminate this Agreement without further obligation on the part of the County. This paragraph is not intended to limit and does not limit the definition of breach to discrimination. d. Dispute Resolution. Any and all suits or actions to enforce, interpret or seek damages with respect to any provision of, or the performance or non-performance of, this Agreement shall be brought in the General Court of Justice of North Carolina sitting in Orange County, North Carolina. It is agreed by the parties that no other court shall have jurisdiction or venue with respect to such suits or actions. Binding arbitration may not be initiated by either Party, however, the Parties may agree to nonbinding mediation of any dispute prior to the bringing of such suit or action. e. Entire Agreement. This Agreement represents the entire and integrated agreement between the County and the Provider and supersedes all prior negotiations, representations or agreements, either written or oral. This Agreement may be amended only by written instrument signed by both parties. Modifications may be evidenced by facsimile signatures. f. Severability. If any provision of this Agreement is held as a matter of law to be unenforceable, the remainder of this Agreement shall be valid and binding upon the Parties. Revised 12/18 5 DocuSign Envelope ID:A83B22E2-5247-4331-8149-B62BAAA1856F g. Ownership of Work Product. Should Provider's performance of this Agreement generate documents, items or things that are specific to this Project such documents, items or things shall become the property of the County and may be used on any other project without additional compensation to the Provider. The use of the documents, items or things by the County or by any person or entity for any purpose other than the Project as set forth in this Agreement shall be at the full risk of the County. h. 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. It is expressly agreed that County shall not activate this non-appropriation provision for its convenience or to circumvent the requirements of this Agreement, but only as an emergency fiscal measure during a substantial fiscal crisis. In the event of a change in the County's statutory authority, mandate and/or mandated functions, by state and/or federal legislative or regulatory action, which adversely affects County's authority to continue its obligations under this Agreement, then this Agreement shall automatically terminate without penalty to County upon written notice to Provider of such limitation or change in County's legal authority. i. Si atures. This Agreement together with any amendments or modifications may be executed electronically. All electronic signatures affixed hereto evidence the consent of the Parties to utilize electronic signatures and the intent of the Parties to comply with Article I IA and Article 40 of North Carolina General Statute Chapter 66. j. Notices. Any notice required by this Agreement shall be in writing and delivered by certified or registered mail, return receipt requested to the following: Orange County Provider's Name Attention: Latonya Brown Linda Mansmann P.O. Box 8181 8809 Farrington Mill Road Hillsborough,NC 27278 Chapel Hill,NC 27517 [SIGNATURE PAGE TO FOLLOW] Revised 12/18 6 DocuSign Envelope ID:A83B22E2-5247-4331-8149-B62BAAA1856F IN WITNESS WHEREOF, the Parties, by and through their authorized agents, have hereunder set their hands and seal, all as of the day and year first above written. ORANGE COUNTY: PROVIDER: EE0637994B755E477. Docusigned by: C�V" ocuSignedby, By . By: AUJA�aAAW County Manager 20287F604442 Linda Mansmann, Fit Feet Nurse Printed Name and Title Revised 12/18 7 DocuSign Envelope ID:A83B22E2-5247-4331-8149-B62BAAA1856F 1100 Virginia Drive, Suite 250 Fort Washington, PA 19034-3278 Phone,1-800-247-1500 Fax,1-800-758-3635 anso Website:www.nso.com 07/12/18 Linda E Mansmann 8809 Farrington Mill Rd Chapel Hill, NC 27517-9014 Dear Linda E Mansmann: Enclosed is the replacement certificate of insurance that you requested. If you have any questions or need assistance, please call us toll free at 1-800-247-1500. Our Customer Service Representatives are available weekdays from 8:00 a.m, to 6:0O p.m., EST. Sincerely, Customer Service Enclosure Q032 Dedicated 7'o,Serving The 7nmirance ;feeds oj';Vrrrces Nurses Service Organization is a registered trade name of Affinity Insurance Services,Inc.;(AR 244489);in CA&MN, AIS AMnily Insurance Agency,Inc.(CA O795465);in❑K.AIS Affinity Insurance Services Inc.;in CA,Aon Affinity Insurance Services,Inc-(OG94493),Aon Direcl insurance Administrators and Berkely Insurance Agency and in NY,AIS Affinity Insurance Agency. DocuSign Envelope ID:A83B22E2-5247-4331-8149-B62BAAA1856F HEALTHCARE PROVIDERS SERVICE CNAORGANIZATION PURCHASING GROUP (Certifitate of 311gillt'aure anso OCCURRENCE POLICY FORM Print Date: 7/12/2018 Producer Branch Prefix Policy Number Policy Period 018098 970 HPG 0651384836 from 08/15/18 to 08/15/19 at 12:01 AM Standard Time Named Insured and Address: Program Administered by: Linda E Mansmann Nurses Service Organization 8809 Farrington Mill Rd 1100 Virginia Drive, Suite 250 Chapel Hill, NC 27517-9014 Fort Washington, PA 19034 1-800-247-1500 www.nso.com Medical Specialty: Code: Insurance is provided by: Registered Nurse 80964 American Casualty Company of Reading, Pennsylvania Excludes Cosmetic Procedures 333 S. Wabash Avenue, Chicago, IL 60604 Professional Liability $1,000,000 each claim $6,000,000 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 S 25,000 per proceeding S 25,000 aggregate Defendant Expense Benefit S 1,000 per day limit S 25,000 aggregate Deposition Representation S 10,000 per deposition S 10,000 aggregate Assault S 25,000 per incident $25,000 aggregate Includes Workplace Violence Counseling Medical Payments S 25,000 per person S 100:000 aggregate First Aid S 10,000 per incident $ 10,000 aggregate Damage to Property of Others $ 10,000 per incident S 10,000 aggregate information Privacy(HIPAA) Fines and Penalties $ 25,000 per incident $25.000 aggregate Media Expense $ 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: $ 190.00 Base Premium $190,00 Premium reflects Self Employed , Part Time Policy Forms& Endorsements(Please see attached list for a general description of many common policy forms and endorsements.) G-121500-❑ GSL10546NC G-121503-C G-121501-C G-145184-A G-147292-A GSL15563 GSL15564 GSL15565 GSL17101 GSL13424 CNA80051 CNA80052 G-123846-C32 CNA81753 CNA81758 CNA82011 CNA89027 CNA79575 CNA89026 Keep this document in a safe place-It and proof of payment are your proof of coverage. There is no coverage in force . - • .� / �� unless the premium is paid in full.In order Chairman of th Board Secretary to activate your coverage, please remit 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: DocuSign Envelope ID:A83B22E2-5247-4331-8149-B62BAAA1856F POLICY FORMS & ENDORSEMENTS The following are the policy forms and endorsements that apply to your current professional liability insurance policy. COMMON POLICY FORMS& ENDORSEMENTS FORM # DESCRIPTION G-121500-D Common Policy Conditions GSL10546NC North Carolina Amendatory Endorsement G-121503-C Workplace Liability Form G-121501-C Occurrence Policy Form G-145184-A Policyholder Notice-OFAC Compliance Notice G-147292-A Policyholder Notice-Silica, Mold &Asbestos Disclosure GSL15563 Information Privacy Coverage Endorsement HIPAA Fines, Penalties & Notification Costs GSL15564 Sexual Misconduct Sublimits of Liability Professional Liability&Sexual Misconduct Exclusion GSL15565 Healthcare Providers Professional Liability Assault Coverage GSL17101 Exclusion of Specified Activities Reuse of Parenteral Devices and Supplies GSL13424 Services to Animals CNA80051 Amended Definition of Personal Injury Endorsement CNA80052 Distribution or Recording of Material or Information in Violation of Law Exclusion Endorsement G-123846-C32 North Carolina Cancellation and Non-Renewal CNA81753 Coverage &Cap on Losses from Certified Acts Terrorism CNA81758 Notice- Offer of Terrorism Coverage & Disclosure of Premium CNA82011 Related Claims Endorsement CNA89027 Entity Exclusion Endorsement CNA79575 Exclusion of Cosmetic Procedures CNA89026 Media Expense Coverage PLEASE REFER TO YOUR CERTIFICATE OF INSURANCE FOR THE POLICY FORMS & ENDORSEMENTS SPECIFIC TO YOUR STATE AND YOUR POLICY PERIOD. For NJ residents: The PLIGA surcharge shown on the Certificate of Insurance is the NJ Property& Liability Insurance Guaranty Association. For KY residents: The Surcharge shown on the Certificate of Insurance is the KY Firefighters and Law Enforcement Foundation Program Fund and the KY LGPT is the KY Local Government Premium Tax which includes charges at a municipality and/or county level. For WV residents: The surcharge shown on the Certificate of Insurance is the WV Premium Surcharge. For FL residents: The FIGA Assessment shown on the Certificate of Insurance is the FL Insurance Guaranty Association -2012 Regular Assessment. Form#:G-141241-B (03/2010) Named Insured:Linda E Mansmann Master Policy#:188711433 Policy#:0651384836