HomeMy WebLinkAboutContract 46006-A3 PM
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CONTRACT NO. -LIl®W-P
' CSC NO. 46006
AMENDMENT NO._V TO
WV CITY SECRETARY CONTRACT NO. 46006
MOBILE SCREENING AGREEMENT
This Amendment is entered into by and between the City of Fort Worth (hereafter
"Customer"), a home rule municipal corporation organized under the laws of the State of Texas,
with its principal place of business at 200 Texas Street, Fort Worth, Texas, and Texas Health
Harris Methodist Hospital Fort Worth (hereafter"Hospital"), a Texas non-profit corporation.
WHEREAS, the parties have previously entered into City of Fort Worth City Secretary
Contract No. 46006 (the "Contract"), which was executed on October 3, 2014; and
WHEREAS, the Contract involves Hospital's provision of health services to Customer's
employees, specifically, screening or examinations to Customer's employees during the
Wellness for Life Mobile Screening Event(the"Event"); and
WHEREAS, the City and Hospital now wish to amend the original Contract to specify
2017 Event dates, change the minimum number of participants required for a reservation, change
the number of days' notice required for cancellation by Hospital, and update contact information.
NOW, THEREFORE, City and Hospital, acting herein by the through their duly
authorized representatives, enter into the following agreement to amend the contract:
1.
Section 1 is amended to provide the following:
1. Services to be Provided. Hospital hereby agrees to provide to Customer with the
Wellness for Life Mobile Screening Event(the"Event") scheduled as follows:
1.0 Reservations. Customer engages Hospital to provide certain screening or
examinations to its employees at the Event, Event Date, Event Time, and Event
Location provided in the below table. As of the Reservation Date, the parties have
confirmed the reservation for the Events listed in the below table.
1.1 Event Date (sl:
Amendment No. I'to CSC No.46006
Page 1 of 4 OFFICIAL RECORD
CITY SECRETARY
FT.WORTH, TX
Minimum Participants
Event Event Date and Event Time Event Location Screening Provided at Event per Screening
CITY OF FORT
WORTH ZIPPER
BUILDING 275
WEST 13TH
Wellness for Life Monday,October 2,2017 STREET;FORT
Mobile Screening Screening Time:9am-3pm WORTH,TEXAS
Event 76102 Mammography Screenings 19 Participants
CITY OF FORT
WORTH ZIPPER
BUILDING 275
WEST 13TH
Wellness for Life Tuesday,October 3,2017 STREET;FORT
Mobile Screening Screening Time:9am-3pm WORTH,TEXAS
Event 76102 Mammography Screenings I9 Participants
WILL ROGERS
MEMORIAL
CENTER,3401
WEST
LANCASTER
Wellness for Life Wednesday,October 4,2017 AVENUE; FORT
Mobile Screening Screening Time:9am-3pm WORTH,TEXAS
Event 76107 Mammography Screenings 19 Participants
CITY OF FORT
WORTH ZIPPER
BUILDING 275
WEST 13TH
Wellness for Life Thursday,October 5,20I7 STREET;FORT
Mobile Screening Screening Time:9am-3pm WORTH,TEXAS
Event 76102 Mammography Screenings 19 Participants
CITY OF FORT
WORTH ZIPPER
BUILDING 275
WEST 13TH
Wellness for Life Friday,October 6, 2017 STREET;FORT
Mobile Screening Screening Time:9am-3pm WORTH,TEXAS
Event 76102 Mammography Screenings 19 Participants
FORT WORTH
POLICE
DEPARTMENT
BOB BOLEN
PUBLIC SAFETY
COMPLEX 505
Wellness for Life Friday,October 6,2017 WEST FELIX;
Mobile Screening Screening Time:9am-3pm FORT WORTH,
Event TEXAS 76115 Mammography Screenings 19 Participants
1.4 Service street addresses: October 2, 3, 5 : City of Fort Worth Zipper Building, 275 West
13`h Street,Fort Worth, Texas 76102; October 4: Will Rogers Memorial Center, 3401 West
Lancaster Avenue, Fort Worth, Texas 76107; October 6: City of Fort Worth Zipper Building,
275 West 13'b Street,Fort Worth,Texas 76102 and Fort Worth Police Department,Bob
Bolen Public Safety Complex, 505 West Felix,Fort Worth Texas 76115.
Amendment No. I to CSC No.46006
Page 2 of 4
1.5 Contact name and phone number: Vicki Tieszen, 817-392-8556.
2.
Section 2 is amended to provide the following:
2. Cancellation Policy.
2.1 Hospital Cancellation: Hospital has the right to cancel the Event due to low participation,
meaning that the minimum number of participants required for the screening (as listed in the
above table)was not scheduled at least three(3)DAYS PRIOR TO THE Event Date.
3.
Section 4 is amended to provide the following:
4. Minimum Event Requirements. The Hospital requires the following minimum number of
screening participants for each mobile screening event:
4.1 Mammography= 19
The minimum participant numbers must be scheduled at least three (3)days prior to the Event
Date or the Event will be cancelled and rescheduled.
4.
All other provisions of the Contract which are not expressly amended herein shall remain
in full force and effect.
Executed in multiples this the. day of , 2017.
TEXAS HEALTH HARRIS METHODIST 9U CITY OF FORT WORTH
SPTIAL FORT^ORTH
Name: �IE: G1�1I15. �/ Name: Susan Alanis
Title: Title: Assistant City Manager
Date: TZ Date:
Amendment No. 1 to CSC No.46006 OFFICIAL RECORD
Page 3 of 4
CITY SECRETARY
Approved As To Form Only; FT.WORTH,TX
Teri A. DeSlo
Asalatant General Counsel
Contract Compliance Manager:
By signing I acknowledge that I am the person responsible
for the monitoring and administration of this contract, including
ensuring akVerformance and reporting requirements.
w
Name of EmployEe Yl ck� or/,60.0
Title
APPR D AS TO FORM AND LEGALITY:
? 46--v
J slyn Y. Hood, Asst. City Attorney
ATTESTED Y:
ary J. • y Sec etary •��
Contract Authorization:
�XAS
M&C: None Required
Amendment No. I to CSC No.46006 OFFICIAL RECORD
Page 4 of 4
CITY SECRETARY
FT.(NORTH,TX
CITY SECRETARY
CONTRACT N0,
MOBILE SCREENING AGREEMENT
THIS MOBILE SCREENING AGREEMENT(the"Agreemenl")'Is effective on September 12, 2014(the
`Reservation bate")and-N bj.and between TEXAS HEALTH HARRIS METHODIST.HOSPITAL KORT-
WORTH("Hospital"),a Texas riorr}profit corporahorr,and City of Fort Worth("Customer).
RECITALS
WHEREAS,Hospital is in,the business of providfng health services,and
WHEREAS, Customer desires• for Hospital. to provide health services to Its employees, and
Hospital is willing to provide such-services.
NOW,THEREFORE; for and in consideration of the mutual:cgvenants herein coniaine.d and other
good and valuable consideration, •the receipt of which is hd?Oy acknowledged, the partie$agree as
follows;
1. Services to be Provided. Hospital hereby agrees to•provide to Customer with the Wellness for
Life Mobile$cre66ing Event(the"E:vent!')';cheduled'as follows:
1.1 Event Date:October 6,7,�B, 10,20.14 Time:8:00 a.m.-4;00 p.m.
1.2 Organization or business name:City of Fort Worth
1.3: Target audiedCe:�hnployees
1.4 Se.rvnce srree.t addresses: October 6, 7,8, 10 2014: City Hall, 1000'Throckmorton; Fort
Worth, Texan 76101 and Qtiober 9, 2014: Will Rogers Memorial Coliseum,Round Up fnn;-3401<W.
Lancas.ler,Fort.worth,Texas,7610.7.
1=5. Contact name and phone nurribe.r:Ellen Pearce',817.392-7753
A reseruation is nol eonfirm.ed until the Agreement is signed by both parties. .
2. Cancellation Policy.
2.1 Hospital Cancellation,- Hb5p1tal may cancel,.postpone, or reschedule the Event with.in
two (2) days of the Event. Dale-Upon written notice (via certified mail, e-mail, or facsimile) without
p2halty.
a, Force Ma'eure• 'Hospital also reserves the right to cancel the
Event due to low participation,inclement weather,or techriical difficulties. -Should
Hospital cancel Oe Event, Customer's contact person will be notified :and an
a1terriate-date Will be a'rrang'ed. Hospital will notifq aff scheduled paHricipants.
;u, -n/a-. 2.2 Customer Cancellation: Customer agrees to provide written notice(via certified mail,
M rran,or,foppaes)
m e-mail,or facsimile)to.Hospital of any intention to can4el its Eventwithln three.(3)business days of the
Event Date. If Hospital does not receive cancelfation wfrhin three-(3) business days of the Event Date,
o" Customer agrees to pay Hospital Five Huhdred Dolfars(5500.)for loss of provider revenue('Cancellation
Feel.
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8.• Compensation. Screenings will be paid for by paiticipant insurance or other funding sources,
Please check Hospital's insurance link for coverage at: http://www.texashealth.org Hospital will also
require the contact information for a representative from Customer's benefits/human resources
department to verify coverage. Customer agrees to.provide the name and telephone number of the
appropriate person at least three(3)days prior to the Event Date.,
8.1 Other Funding Sources. Funding. for screening may be available from other sources
including,federal,state, the Susan G. Komen Breast Cancer Foundation,Doris Kupferle Woman's Health
Boards, and Bernard C. Alger Fund for qualified participants without private insurance. Should a
participant not present an insurance card at the time of screening and be determined later to be
covered,the insurance company will be billed for the full amount.
9. Notices. Any notice, request or other communication required under this Agreement shall be in
writing and shall be deemed to have been given or made if delivered via certified mail,'e-mail,or facsimile
to the parties at the following addresses, or at such other addresses as shall be specified in writing by
either of the parties to the other in accordance with the-terms and conditions of this subsection:
If to Hospital: Texas Health Fort Worth
Attn: Lillie Biggins,FACHE,President
1300 Pennsylvania Avenue
Fort Worth.'Texas 76104
Copy,to: Wellness for life Mobile Screening
Attn: Rosemary Galdiano,RN,-MPH,OCN
1300 West Terrell Avenue
Fort Worth,Texas 76304
Phone Number: 817-820-4910
Facsimile Number: 817-881-5266
If to Customer.: City of Fort Worth '
Attn:Susan Alanis,Assistant City Manager
1000 Throckmorton
Fort Worth,Texas 76101
Phone Number:817-392-8180
10. Relationship of Parties. Nothing in this Agreement shall be construed to constitute either party as
a partner, employee or'agent of the other, it being intended that Customer shall be an independent
Customer of Hospital under this Agreement and solely responsible for its-own actions. No employee or
agent of one party hereto shall.be considered an employee or agent, f_th . y.Nj+t:I:TnCustomer
nor Hospital has the right-to bind the other.party hereto.
IN WITNESS WHEREOF,on the Mein belo --
AA 000000 3T`' I '►�CI'8
TEXAS HEAL HARRIS.METHOOISTp o °o ¢Y OF FORT WORTH
101L FO OR'fHuaombs a 0000000 �s r4Alanis Date
Vice President �a 11 ��4 Assistant City Manager
Approved As To Form Only:
Terri A.DoSlo APT-1A'-6VCU AS TO
Aulatant General Counsel FORM