HomeMy WebLinkAboutContract 33068 CITY SECRETARY Q
CONTRACT NO, u
AGREEMENT FOR SERVICES
This agreement for services is by and between the City of Fort Worth,Texas(Employer), and Harris Methodist Fort
Worth(Hospital), and shall be effective as of December 1, 2005. The parties agree that Hospital shall provide certain
Executive Health services, described herein,to employees of Employer in accordance with a mutually agreed upon
schedule and location. Employer agrees to pay the first$500 of charges under this agreement,which charges shall be
due within 5 days of Employer's receipt of an appropriate invoice from Hospital. Employees shall be responsible for
all charges exceeding$500,which shall be due and payable, in full, at the time services are rendered.
Hospital will provide services as follows:
a. A customized executive health physical package for$495. This package shall include:
• Medical History/Physical Examination
• Blood Profile/Comprehensive Labs
• Resting EKG
• Stress Treadmill EKG
• Health Risk Analysis
• Chest X-ray or Pulmonary Function Test
• Auditory Test or Vision Screen with Glaucoma Test
• Prostate Specific Antigen(PSA),male
• Mammogram,female
• Pap Smear,female
b. The following preventive scans,at the prices indicated:
• Heart Scan, $495
• Lung Scan, $395
• Abdomen Scan,$395
• Pelvis Scan, $395
• Virtual Colonoscopy CT Scan, $895
• Health Scan Package(includes heart, lung, abdomen&pelvis scans), $1,260
• Discovery Package(includes all scans), $1,950
Patients contacting Hospital to schedule services hereunder shall present themselves as a City of Fort Worth
employee. Scans shall be available to employees at the time of their physical. In the event an employee chooses to
have a preventive scan without a physical exam,then a referral from the employee's physician shall be required(with
one exception-preventive heart scans).
The term of this agreement shall be one year,effective on the date indicated above. Either party may terminate this
agreement at any time without cause by providing the other party 30 days written notice. Unless earlier terminated,
this agreement shall auto-renew for additional one-year terms; however,the parties understand and agree that the
prices contained in this agreement shall be subject to re-negotiation and revision on an annual basis.
CITY OF FORT WORTH HARRIS METHODIST FORT WORTH
By(signature): By(signatu ):-'
Printed Name: R hard Zavala Printed Name. an
Position: Assistan City Manager Position: President
c. y 1 T t^i f-�
ATTESTED BY:
Marty Hendrix ZN
City Secretary
NO M&C REQUIRED
Contract Authorization
Date