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STATE STATE OF TEXAS § CONTRACT NO .
KNOW ALL BY THESE PRESENTS:
COUNTY OF TARRANT §
CONTRACT FOR PROFESSIONAL MANAGEMENT CONSULTING SERVICES
This Contract is made by and between the City of Fort Worth, Texas, a municipal corporation
situated in Tarrant, Wise, and Denton Counties, Texas, hereinafter called"City", acting herein by
and through Richard Zavala, its duly authorized Assistant City Manager and Safety
Environmental and Engineering Solutions, acting herein by and through, Mr. Albert Mitchell, its
duly authorized Chief Operating Officer, hereinafter called "Consultant". City and Consultant
may be referred to herein individually as a"Party" and collectively as the "Parties".
1. Scope of Services
Consultant agrees to perform in accordance with the highest professional standards the
following professional management consulting services:
Develop and present the City Accident Prevention Plan (Exhibit A) utilizing the 4-phased
Implementation Plan (Exhibit B), hereinafter the"Project"
2. Compensation; Payment Schedule
2.1 The maximum amount to be paid to Consultant for all services performed
hereunder shall be $80,752.50, hereinafter"Consultant's Fee,"which shall include all expenses
incurred by consultant.
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2.2 Consultant's Fee shall be disbursed as outlined in the Schedule of Fees (Exhibit
C) and based on the completion of all services in each phase.
2.3 City and Consultant must agree in writing to any modification to the Section 1,
"Scope of Services" and/or Consultant's Fee. The City must obtain the necessary City Council
authorization before committing to an increase in Consultant's Fee.
2.4 Consultant shall submit monthly invoices to the City for payment of the sums
referenced in Section 2.2.
3. Term
Unless terminated pursuant to paragraph 4, this Contract shall be completed on or before
May 31, 2007.
4. Termination
4.1 The City may terminate this Contract for its convenience by notice in writing to
Consultant. Upon receipt of such notice, Consultant shall immediately discontinue all services
and work and the placing of all orders or the entering into contracts for all supplies, assistance,
facilities and materials in connection with the performance of this Contact and shall proceed to
cancel promptly all existing contracts insofar as they are chargeable to this Contract. If the City
terminates this Contract under this Section 4.1, the City shall pay Consultant for the total value
for services actually performed in accordance herewith prior to such termination, less such
payments as have been previously made, in accordance with a final statement submitted by
Consultant documenting the performance of such work.
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4.2 The City may terminate this agreement for cause in the event Consultant fails to
reasonably perform in accord with the requirements contained herein. In such event City shall
give Consultant written notice of Consultant's failure to perform, giving Consultant seven(7)
calendar days to come into compliance with the contract requirements. If Consultant fails to
come into compliance with this contract, City shall notify Consultant in writing and this contract
shall be terminated as of the date of such notification. In such event, Consultant shall not be
entitled to any additional compensation.
4.3 In the event no funds or insufficient funds are appropriated and budgeted by the
City in any fiscal period for any payments due hereunder, City will notify Consultant of such
occurrence and this Contact shall terminate on the last day of the fiscal period for which
appropriations were made without penalty or expense to City of any kind whatsoever, except as
to the portions of the payments herein agreed upon for which funds shall have appropriated and
budgeted. City has informed Consultant that, concurrently with approval of this Contract, City
will appropriate and budget 100% of the funds specified in this Contact, so that all funds will be
appropriated and budgeted prior to the commencement date of this Contract.
4.4 Upon termination of this Contract for any reason, Consultant shall provide the
City with copies of all completed or partially completed documents prepared under this Contract.
5. Indemnification and Release
5.1 Consultant shall indemnify and hold the City and its officers, agents and
employees harmless for any loss, damage, liability of expense for damage to property and
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injuries, including death, to any person, including but not limited to officers, agents or employees
of Consultant or subcontractors, which may arise out of any negligent act, error or omission in
the performance of Consultant's professional services. Consultant shall defend at its own
expense any suits or other proceedings brought against the City, its officers, agents and
employees, or any of them, resulting from such negligent act, error or omission; and shall pay all
expenses and satisfy all judgments which may be incurred by or rendered against them or any of
them in connection therewith resulting from such negligent act, error or omission.
5.2 In addition to the indemnification requirement above, Consultant releases Fort
Worth from any liability for injury or property damage incurred during this contract, unless such
injury or property damage was the result of intentional conduct committed by an employee of the
City. Consultant shall not permit any employee, officer, and agents of the Consultant or any
employees, officers or agents of any subcontractor to perform any activity under this contract
without first executing a release containing such provisions.
6. Insurance
Consultant shall carry insurance in the following types and amounts for the duration of
this agreement, and furnish certificates of insurance along with copies of policy declaration
pages and policy endorsements as evidence thereof:
6.1 Workers' Compensation and Employers' Liability coverage with limits consistent
with statutory benefits outlined in the Texas Workers' Compensation Act(Texas Labor Code)
and minimum policy limits for Employers Liability of$100,000 each accident/occurrence,
$500,000 bodily injury/disease policy limit and$100,000 per disease per employee.
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6.2 Commercial General Liability as follows:
$1,000,000 each occurrence
$2,000,000 aggregate limit
6.3 Business Automobile Liability Insurance for all owned, non-owned and hired
vehicles as follows:
$500,000 Bodily Injury per person/occurrence $250,000 Property Damage
$2,000,000 aggregate or
$1,000,000 each accident on a combined single limit basis
6.4 General Requirements for Insurance
6.4.1 Consultant shall be responsible for deductibles and self-insured
retentions, if any, stated in policies. All deductibles or self-insured retentions
shall be disclosed on the certificates of insurance required above.
6.4.2 All insurance, other than workers compensation, shall be written on an
occurrence basis.
6.4.3 If insurance policies are not written for amounts specified above,
Consultant shall carry Umbrella or Excess Liability Insurance for any differences
in amounts specified. If Excess Liability Insurance is provided, it shall follow the
form of primary coverage.
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6.4.4 Consultant shall not commence work under this Agreement until it has
obtained the required insurance and until the Contract Manager has reviewed such
insurance. Consultant shall not allow any subcontractor to commence work until
required insurance has been obtained and approved. Approval of insurance by the
City shall not relieve or decrease the liability of the Consultant.
6.4.5 Insurance shall be written by companies licensed to do business in the
State of Texas at the time the policy is issued and shall be written by companies
with a rating of A- or better in the current A.M. Best Key Rating Guide or have
reasonable equivalent of financial strength and solvency.
6.4.6 The City of Fort Worth shall be an additional insured as their interests
may appear on the Commercial General Liability, and Business Automobile
Liability.
6.4.7 Consultant shall produce endorsements to each affected policy to
effectuate the following:
6.4.7.1 The City of Fort Worth is named as an additional insured on all
policies (except Workers' Compensation)with a mailing address of Attn.:
Purchasing Manager, Purchasing Division, 1000 Throckmorton, Fort
Worth, Texas 76102.
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6.4.7.2 The insurance company is obligation to notify Purchasing
Manager, Purchasing Division, 1000 Throckmorton, Fort Worth, Texas
76102, of any non-renewal, cancellations or material changes on any
policy at least forty-five (45) days prior to change or cancellation.
6.4.7.3 That the "other" insurance clause shall not apply to the City where
the City of Fort Worth is an additional insured shown on the policy. It is
intended that policies required in this Agreement, covering both the City
and the Consultant shall be considered primary coverage as applicable.
6.4.7.4 The City shall be entitled, upon request and without expense, to
receive copies of policies and endorsements thereto and may make any
reasonable requests for deletion or revision or modification of particular
policy terms, conditions, limitations, or exclusions except where policy
provisions are established by law or regulations binding upon either of the
parties hereto or the underwriter on any such policies.
6.4.7.5 Consultant shall not cause any insurance to be canceled nor
permit any insurance to lapse during the term of this Agreement or as
required in this Agreement.
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6.4.7.6 The City reserves the right to review the insurance requirements
of this section during the effective period of the Agreement and to make
reasonable adjustments to insurance coverage and their limits when
deemed necessary and prudent by the City based upon changes in statutory
law, court decision or the claims history of the industry as well as of the
Consultant.
6.4.7.7 All certificates shall include a clause to the effect that the policy
shall not be reduced, restricted or limited until thirty(30) days after the
City has received written notice.
6.4.7.8 Consultant shall provide owner thirty(30) days written notice of
erosion of the aggregate limit below the per occurrence limits outlined
above.
6.4.8 Actual losses not covered by insurance as required by this Agreement
shall be paid by Consultant.
7. Independent Contractor
Consultant shall perform all work and services hereunder as an independent contractor
and not as an officer, agent or employee of the City. Consultant shall have the exclusive control
of, and the exclusive right to control, the details of the work performed hereunder and all persons
performing same and shall be solely responsible for the acts and omissions of its officers, agents,
employees and subcontractors. Nothing herein shall be construed as creating a partnership or
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joint venture between the City and the Consultant, its officers, agents, and employees and
subcontractors; and the doctrine of respondent superior shall have no application as between the
City and the Consultant.
8. Disclosure of Conflicts
Consultant warrants to the City that it has made full disclosure in writing of any existing
or potential conflicts of interest to the services to be performed hereunder. Consultant further
warrants that it will make prompt disclosure in writing of any conflicts of interest that develop
subsequent to the signing of this Contract.
9. Right to Audit
9.1 Consultant agrees that the City shall, until the expiration of three (3)(years after
final payment under this Contract, have access to and the right to examine any directly pertinent
books, documents,papers and records of the Consultant involving transactions relating to this
Contract. Consultant agrees that the City shall have access during normal working hours to all
necessary Consultant facilities and shall be provided adequate and appropriate workspace in
order to conduct audits in compliance with the provisions of this section. The City shall give
Consultant reasonable advance notice of intended audits.
9.2 Consultant further agrees to include in all its subcontractor agreements hereunder
a provision to the effect that the subcontractor agrees that the City shall, until the expiration of
three (3) years after final payment under the subcontract, have access to and the right to examine
any directly pertinent books, documents, papers and records of such subcontractor involving
transactions to the subcontract, and further that City shall have access during normal working
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hours to all subcontractor facilities and shall be provided adequate and appropriate work space in
order to conduct audits in compliance with the provisions of this paragraph. City shall give
subcontractor reasonable advance notice of intended audits.
10. Prohibition of Assignment
Neither party hereto shall assign, sublet or transfer its interest herein without the prior
written consent of the other party, and any attempted assignment, sublease or transfer of all of
any part hereof without such prior written consent shall be void.
11. M/WBE Goals; Nondiscrimination
11.1 In accordance with City of Fort Worth Ordinance No. 15530, the City has goals
for the participation of minority and women business enterprises in City contracts. Consultant
acknowledges the M/WBE goal established for this contract and its commitment to meet that
goal. Any misrepresentation of facts (other than a negligent misrepresentation) and/or the
commission of fraud by the Consultant may result in the termination of this agreement and
disbarment from participating in City contracts for a period of time of not less than three (3)
years.
11.2 As a condition of this Contract, Consultant covenants that it will take all
necessary actions to insure that, in connection with any work under this Contract, Consultant, its
associates and subcontractors,will not discriminate in the treatment or employment of any
individual or groups of individuals on the grounds of race, color, religion,national origin, age,
sex or physical handicap unrelated to job performance, either directly, indirectly or through
contractual or other arrangements.
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12. Choice of Law; Venue
12.1 This Contract shall be construed in accordance with the internal law of the State
of Texas.
12.2 Should any action,whether real or asserted, at law or in equity, arise out of the
terms of this contract, venue for said action shall be exclusively in the District Court in Tarrant
County, Texas.
EXECUTED on this, the ay of , 2006.
Albert it Ri hard Zavala
Chief Operating Officer Assistant City Manager
Safety, Environmental & Engineering City of Fort Worth
Solutions
Attest:
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Mart A. HendriContract Authorization
City Secretary s NZsb e
Date: Ul (
Approved as to form and legality:
Maleshia Fa er
Assistant City Attorney
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City of Fort Worth/
Safety Environmental and Engineering Solutions ("SEES")
Contract for Professional Management Consulting Services
EXHIBIT A
City Accident Prevention Plan
Management Policy Statement
The City Manager's Office is committed to providing a safe and healthful work
environment for all our employees and others that may work, visit, or enter our facilities.
We intend to re-emphasize safety awareness in the workplace to protect the City's most
valuable asset: the employees. Our ultimate goal is to establish and maintain the safest
and healthiest municipal work environment in the nation. To achieve that end, each of us
must assume an active and dedicated role in safety and accident prevention. This City
Safety and Accident Prevention Plan marks the beginning of our road to better safety.
To be successful, management at all levels must support a safety and accident prevention
program. It is important that each department director develop, maintain and enforce a
written safety plan for their organization, designed to minimize the risk of injury to their
employees. Continued development, maintenance and monitoring of the plan should be a
department priority in order to fulfill the mission and reduce injuries/property loss.
Department directors also should establish a safety and accident prevention committee,
consisting of appropriate members of first-line supervisors, mid- and upper management
staff, and other key personnel, who are charged with the task of developing a safety and
accident prevention program. A safety coordinator should be appointed to serve as
chairperson of the committee.
The "safe workplace" objective can only be achieved if all employees accept personal
responsibility for their own safety and well-being. Safe work habits are an essential
element of satisfactory job performance. Each employee is responsible for prompt
reporting of unsafe conditions and work practices, and taking effective temporary actions
to minimize the risk to him/her and others.
Each employee is responsible for helping us reach our accident/loss prevention goal of
preventing personal injury and loss of property due to accidents, and each employee will
be held accountable for his/her actions in safely performing his/her job.
Each supervisor, manager and director will be held accountable for the actions of their
employees. These individuals are responsible for ensuring that both he/she and their
employees follow all safety rules,regulations,policies, and procedures.
It is our intention to provide good supervision, effective training for correct and safe
performance of all job tasks and duties, and safe equipment for the job. The success of
our safety and accident prevention program depends upon the efforts of all employees to
minimize and eliminate all potential hazards.
Charles R. Boswell
City Manager
Exhibit A - 1
City-wide Safety and Accident Prevention Plan
It is the policy and desire of the City of Fort Worth to provide safe working conditions
for all employees. The City will provide the equipment and training required for
occupational safety and health in keeping with accepted safety standards. The City's
Safety Plan will encompass seven components: management responsibilities, accident
investigation, safety training, inspections, safety analysis, record keeping and safety plan
review.
I. Management Responsibilities
The City Management's office accepts the responsibility for leadership of the Safety and
Health program for its overall effectiveness and improvement, and for providing the
safeguards required to ensure a safe workplace. Each Department Director will be
responsible to prepare a Safety Plan outlining the seven components of accident and
injury prevention. The Occupational Health and Safety Division of the Human Resources
Department will be available to provide resources, guidance and consultation in preparing
the department's written safety plan. The Director is responsible and will be held
accountable for the overall implementation of this Safety Plan for their respective
department. Managers, supervisors and crew leaders will be responsible for implementing
the plan and established safety procedures.
Department Director Responsibilities
1. Ensure that a department-wide safety committee is formed and fulfilling its
responsibilities as described in this plan. This committee's composition will
vary but must include employee and management representation and the
department safety coordinator.
2. Ensure that sufficient employee time, supervisor support, and funds are
budgeted for safety equipment, training and implement the safety plan.
3. Evaluate managers each year to ensure they are fulfilling their responsibilities
as described in this plan.
4. Ensure that incidents are fully investigated and corrective actions taken to
prevent recurrence.
5. Ensure a record of injuries and illnesses (DWC-1 and DWC-6) is maintained
in this plan.
6. Set a good example by following established safety rules and attending
required training.
7. Encourage employees to communicate their safety and health concerns to
implement change and reduce injuries.
8. Ensure each supervisor/manager is trained on the safe operation of equipment
or performing tasks in a safe manner.
Manager Responsibilities
1. Provide supervisors the resources to execute this plan.
Exit A,- 2 ;,
2. Evaluate supervisors each year to ensure they are fulfilling their
responsibilities as described in this plan.
3. Ensure that incidents are fully investigated and corrective actions taken to
prevent recurrence.
4. Set a good example by following established safety rules, attending required
training, and enforcing the standards established by this plan.
5. Ensure each employee has received an initial orientation before beginning
work.
6. Ensure each supervisor is trained on the safe operation of equipment or tasks
before starting work on that equipment or project.
7. Observe the workplace and promptly correct any unsafe behavior. Provide
training and take corrective action, as necessary. Document employee
evaluations.
8. Communicate with the executive management about work practices or
equipment that will improve employee safety.
9. Ensure employees complete the required safety orientations.
Supervisor Responsibilities
1. Execute this accident prevention plan.
2. Evaluate employees each year to ensure they are fulfilling their
responsibilities as described in this plan.
3. Ensure that incidents are fully investigated and corrective actions taken to
prevent recurrence.
4. Set a good example by following established safety rules, attending required
training and enforcing the standards established by this plan.
5. Ensure each employee has received an initial safety orientation before
beginning work.
6. Ensure each employee is trained on the safe operation of equipment or tasks
before starting work on that equipment or project.
7. Ensure each employee receives required personal protective equipment (PPE)
before starting work on a project requiring PPE.
8. Conduct a daily walk-around safety check of the work area and promptly
correct hazards found.
9. Observe the employees supervised at work and promptly correct any unsafe
behavior. Provide training and take corrective action, as necessary.
Document employee evaluations.
10. Investigate all incidents and report findings to management.
11. Communicate with management about work practices or equipment that will
improve employee safety.
12. Ensure all employees complete the department safety orientation.
Exhibit A- 3
Employee Responsibilities:
1. Take responsibility for safety and be aware of their actions by displaying an
alert, coherent mental state; being physically fit for their job and its
conditions; and maintaining the proper attitude for their work/job
requirements.
2. Follow safety rules described in this program and the training provided by the
City and/or the department.
3. Report unsafe conditions or actions to the immediate supervisor, safety
committee representative or department safety coordinator.
4. Report all injuries and/or accidents to a supervisor promptly regardless of the
seriousness.
5. Always use serviceable personal protective equipment (PPE), where required.
6. Notify the supervisor if job duties, requirements, or equipment usage you are
unclear.
City Safety Coordinator Responsibilities:
1. Design and recommend effective occupational health and safety programs that
establish authority and accountability for safety citywide.
2. Lead the process of developing and recommending citywide occupational
health and safety programs and standards or change to existing programs and
their implementation.
3. Consult with department safety personnel in the implementation of safety
programs, analysis,problem solving, and corrective action plans.
4. Monitor Federal and State Occupational Health and Safety regulations and
recommend the implementation of programs to ensure the City is in
compliance.
5. Evaluate the City accident statistics and define target goals for performance,
and monitor for achievement of goals; recommend long-range accident
prevention and cost-control objectives designed to meet established goals.
6. Develop and implement processes, methods and tools designed to measure,
evaluate, and monitor departmental safety performance.
7. Oversee the design, preparation, analysis and distribution of safety data and
statistical reports concerning accidents, trends and solutions to work related
problems to all city departments and the executive management.
8. Identify and coordinates opportunities to share common resources citywide,
such as training, equipment, consultants and other resources.
9. Oversee review and approval process for department safety plans.
10. Coordinate and chair periodic citywide Safety Coordinator's meeting.
11. Suspend Activities at worksites deemed unsafe or dangerous to the health and
safety to City employees, property and/or equipment.
12. Develop and implement an electronic information/warning system to
communicate safety and health information.
13. Oversee citywide safety training.
Exhibit A- 4
Department safety coordinators are a vital part of the City's safety structure. The City
will retain a network of coordinators under the supervision of the City Safety Coordinator
to assist department management in developing and implementing its safety program.
Their responsibilities are listed below.
Department Safety Coordinator Responsibilities
1. Attend periodic City Safety Coordinators' meeting and disperse information
to his/her department.
2. Ensure department safety committee meets on a regular basis. Inform the
committee of current issues and recent injuries.
3. Update department accident prevention plan, as needed.
4. Assist supervisors in properly investigating and documenting accidents and
injuries. Review department investigations before forwarding them to the
City Safety Coordinator.
5. Conduct or coordinate periodic workplace self-inspections.
6. Act as liaison between the Occupational Health and Safety Division and other
resources for assistance with safety concerns.
7. Oversee department safety training and records maintenance.
8. Complete training listed at Appendix A.
II. Accident Investigation
The investigation is the first step toward avoiding future accidents. It should determine
what happened and why the accident occurred. The focus of the investigation should be
to determine the cause of the accident and not to assess blame.
Supervisor's Role When an Accident/Injury Occurs:
• Ensure medical attention is provided immediately.
• Report the accident to the department safety coordinator on the Initial Incident
Report Form. (Appendix B)
• Conduct the accident scene investigation as soon as possible.
• Complete Department of Insurance Form (DWC 1) as soon as possible and
forward to the department Workers' Compensation Coordinator as soon as
possible. The department WC coordinator, in turn, must forward the completed
form electronically to City Workers' Compensation Coordinator at
inluryreports@fortworthgov.org within 72 hours after the accident.
The immediate supervisor and/or department safety coordinator will be responsible for
conduct of the accident/injury investigation utilizing the Supervisor's Accident
Investigation Form (Appendix Q. Upon notification of an accident, the responsible
supervisor/safety coordinator will begin investigation to determine the following:
• How the accident or incident occurred;
• Special circumstances involved;
• Underlying, indirect or associated causes; and corrective actions or preventive
measures and controls.
Exhibit A- 5
Department Safety Coordinator's Role Upon Accident Notification:
• Report the accident to Occupational Health and Safety Division as soon as
possible on the Initial Notification Report Form.
• Assist supervisors in the investigative efforts.
• Conduct the investigation, if necessary.
• Review the completed report before forwarding it to HR-OHS.
• Provide telephonic updates to HR-OHS, as necessary.
• Request HR-OHS assistance, if necessary.
The Safety Coordinator will ensure proper records and documentation of all accident and
incident investigation activities are received and maintained. Applicable forms and
records include:
• Accident investigation forms and supporting data, including photographs,
diagrams, and witness statements.
• Records of corrective action or preventative measures implemented.
The accident investigation will be completed as soon as possible following the
accident/incident. The information collected will be utilized and reviewed by
investigation team to determine contributing factors and causes. From the investigation,
the supervisor will develop a plan of corrective action. The plan of corrective actions
and implementation will be documented and reviewed by management. The
investigation is to find the facts, not fix blame. All activities and findings of the
investigation will be documented, maintained and recorded for review by the department
safety coordinator.
Departments must notify the Occupational Health and Safety Division immediately of all
fatalities, accidents involving hospitalization, or estimated equipment damage of $5000
or greater. Notification numbers: (817) 392-8524 (work hours)/(817) 269-8635 (after
work hours).
III. Safety Training
The City of Fort Worth is committed to providing safety and health related orientation
and training to its employees. The purpose of the orientation will be to educate and
familiarize employees with safety and health procedures, rules, and work practices within
their workplace.
Safety Orientation/Reassignment
The initial safety awareness education for each employee will occur at the new employee
orientation at City and department levels. The orientations will be administered to all
new employees prior to the initial work assignment, and to employees assigned to new or
different tasks or jobs. The City's presentation will be general in content and focus on
the City's strategic safety plan and programs. The department's orientation should
consist of job assignment, work area specific safety information, a review of the general
safety rules, and required training (Appendix D). Additionally, all new employees will
Exhibit A- 6
be given a tour of the assigned work area and an opportunity to ask questions to expedite
the familiarization process. Supervisors are responsible for ensuring new employees can
perform the assigned job duties safely.
Required Programs
In addition to the required training listed at Appendix D, each department is responsible
for identifying any additional training requirements based on job hazard assessments and
job requirements. Most job tasks require written programs (example: confined space,
equipment operation, forklift, etc) that outline the safety precautions and training required
to perform a job safely. Each written program includes a description of the required
training and frequency. The Occupational Health and Safety Division will be available to
assist departments with job hazard assessments and develop training requirements. Links
to sample required programs are at Appendix E.
Ongoinz Training
Managers, supervisors, and employees are required to participate and become involved in
the ongoing health and safety training programs. Each department will need to identify
training requirements for each job classification. The frequency, repetitiveness, and
subject matter will be determined by training assignments and audits to be performed by
the managers and supervisors, and will be at intervals that ensure demonstration of
adequate training. The assessments and audits will, for the most part, be informal
questions and observation of the employees and work areas. All employees assigned
must demonstrate competency and retention of minimal acceptable information prior to
work assignment.
Documentation
All training will be documented, capturing:
• Date of training session.
• Name of trainer
• Subject
• Legibly printed name of attendees
• Signature of attendees
The department's safety coordinator or department designee will be responsible for
managing training documentation.
To identify and coordinate opportunities to share common resources citywide,
department safety coordinators are required to submit a quarterly Safety and Health
Activity Report. Electronic changes to the report will be required to the Safety Office, as
they occur. The report format is at Appendix F.
Exhibit A- 7
IV. Audit/Inspections
Each department will implement a program to identify, correct, and control hazards on an
ongoing basis. Employees will be notified of all hazards that pose an immediate threat of
physical harm or property damage and measures or steps that will be taken to eliminate,
correct, or control the hazards.
Surveys and inspections will be performed at least quarterly. Management will allocate
time and resources to perform the surveys. Checklists will be developed utilizing either
or a combination of both general or construction inspection checklists. Links to both are
below. Copies of the checklists may also be obtained from the department safety
coordinator or the City Safety Coordinator located in the Occupational Health and Safety
Division. Once developed, lists will be evaluated and updated with hazards that are
identified during the inspections.
General Inspection Checklist:
http://www.tdi.state.tx.us/wc/information/videoresources/documents/ckl eg nind.pdf
Construction Inspection Checklist:
http://www.tdi.state.tx.us/wc/information/videoresources/documents/cklgenconstru.pdf
Each department will display the required posters at Appendix G on bulletin boards
within the workplace.
The department safety coordinators will retain completed inspection reports as a
permanent record. The inspection reports will be used in trend analysis, correcting
hazards, and record keeping. Reports will also be forwarded to management for review
and corrective actions. Report files are subject to audit by the City Safety Office.
Inspections/audits completed by the City Safety Office will be forwarded to the
Department Director for corrective action within the suspense dates provided.
Safety Violation Hotline (817) 392-8414
The objective of the Safety Violations Hotline is to identify and eliminate workplace
hazards to the safety and/or health of the workers. It provides a means for workers to take
a proactive role in addressing workplace safety and health issues. A detailed description
of the program is at Appendix H.
V. Safety Analysis
The Occupational Health and Safety Division of Human Resources is responsible for the
trend analysis and documentation to be conducted at least semi-annually94., eview
.
will be based on the following records and the results utilized to modify training, as
needed:
• Workplace Inspection reports
• Accident Investigation Reports
• Insurance Reports, if applicable
• Training/safety meeting records
In addition to the documents above, the Occupational Health and Safety Division will
provide quarterly Accident and Injury Reports to each department director.
The report from the analysis will include recommendations for corrective actions. The
findings will be used to reverse trends and modify the department's safety plan.
Proposed modifications will be presented to management for feedback. The
Occupational Health and Safety Division will follow-up to ensure corrective actions have
been implemented. The report will be retained for one year.
VI. Recordkeepin2
The department's safety coordinator will assume responsibility for the record keeping
component of the department's safety plan.
The safety plan has the basic report group listed in Paragraph V above,plus:
• Equipment Inspection and Maintenance
• Accident Claim Reports
• Analysis and Review Reports
All the above records will be kept for two years or as required by City policies and
requirements of the department.
VII. Safety Plan Review
The Department's Safety Coordinator will review and revise the Accident Prevention
Plan annually during the first quarter of the calendar year. The Occupational Health and
Safety Division will be available to assist in reviewing and making recommendations.
The purpose of the review is to ascertain the effectiveness of the Plan during the previous
twelve months. The review will be documented and will identify all adjustments or
corrections made to each component of the department's safety plan. An additional
review will be conducted should new activities or operations be introduced into the
workplace.
Exhibit A- 9
Appendix A(Safety Coordinator's Required Training)
❑ Principles of Ergonomics
❑ Infectious Diseases
❑ Supervisor's Safety Certification Course(Revised)
❑ First Aid/CPR
❑ Supervisor Training For EAP/Alcohol & Substance Abuse
❑ Overview of Workers' Compensation(Supervisors)
❑ Other Health & Safety Training applicable to your department
v���
X 1 1 -
Appendix B (Initial Notification Form)
INITIAL NOTIFICATION FORM
OHS Telephone Numbers: (817)392-8524(Business hours)or(817)269-8635(Anytime)
1, OHS Case Number 2. Date&Time OHS Received Report
3.Point of Contact For Accident Information a. Name:
b. Position c.Telephone Number
4.Accident Classification 5. Time&Date of Accident 6.Period of Day
7.Type of Equipment/Material Involved 8. Department
8.Accident Location
9. PERSONNEL INVOLVED a. Total Number Personnel Involved
b. Injuries(List#of Each)
Fatalities WN q-W
Non-Fatal Injuries
c. Executives Involved:
10. Weather Conditions:
11. Accident Synopsis(What Happened)
12.Nearest Major Roadway
13.WHO WILL INVESTIGATE? _Department _City
Exhibit A- 11
Supervisor's Accident Investigation Form
(To be completed by the employee's supervisor or other responsible administrative official)
Department: Date/Time of Accident/Illness:
Name of Injured Worker:
Employee Number: Title/Occupation:
Time in Occupation (Yrs): Accident Site Supervisor:
Training Provided: Y/N Training Record Attached: Y/N
Task Being Performed at the Time of the Accident:
Accident Location:
Nature and Extent of Injury/Illness and/or Property Damage (Description):
MARK THOSE AREAS WHICH CONTRIBUTED TO THE INJURY,ILLNESS
AND/OR PROPERTY DAMAGE:
Poor Workstation _Inadequate Ventilation _Horseplay
Inadequate Training _Poor Housekeeping _Inadequate PPE
No Fall Protection _Failure to Follow Procedures _Other(Explain):
Inadequate Rest _No lockout/Tagout Program
Inadequate Guarding _Inadequate Procedures/
Instructions
Supervisor's corrective action to preclude recurrence:
Supervisor's Printed Name Supervisor's Signature Date
Safety Coordinator's Printed Name Safety Coordinator's Signature Date
Appendix C(Supervisor's Accident Investigation Form)
Exhibit A - 12
Appendix D (Required Matrix)
Training is an essential part of our plan to provide a safe work place at(Customize by
adding your department name here). To ensure that all employees are trained before
they start a task that requires training, we have a training coordinator whose name is
posted on the safety bulletin board. (Customize by inserting the name or title of the
person responsible for training in your department)That person is responsible to verify
that each employee has received an initial orientation by his/her supervisor, has received
training needed to perform the job safely and the employee's file documents the training.
Exhibit A- 13
Appendix E (Sample Required Programs)
The following are links to sample required written programs:
Emergency Plan
http://www.twcc.state.tx.us/information/videoresources/sample_emergency_action_plan.
doc
Personal Protective Equipment (PPE)
ft:Hftpl.twcc.state.tx.us/informatioLVppe.doc
Hazard Communication
ftp://ftpl.twcc.state.tx.us/information/hazcom.doc
I TY
Exhibit A- 14
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Appendix G(Required Forms)
bitp://www.tdi.state.tx.us/fonns/dwc/notice5.-Dd
hLtp://www.tdi.state.tx.us/fonns/dwc/notice5.pdf
bqp://www.tdi.state.tx.us/fonns/dwc/notice5r.pdf
Exhibit A- 16
Appendix H (Safety Violation Hotline)
The City of Fort Worth Safety Violation Hotline is (817) 392-8414.
The objective of the Safety Violations Hotline is to identify and eliminate workplace
hazards to the safety and/or health of the workers. It provides a means for workers to take
a proactive role in addressing workplace safety and health issues. A detailed description
of the program is at Appendix G.
• The Safety Violations Hotline Program is a 24-hour telephone line for workers to
report violations of health or safety law.
• Employers are required to post notices in English and Spanish informing workers
of the existence of the program. They are prohibited from taking any action
against a worker, who in good faith, reports a violation.
• The hazards reported through the Safety Violations Hotline Program are
researched, investigated, and eliminated through a cooperative effort between the
City Safety Office and the department.
• The Safety Violations Hotline Program is an on-going program, in keeping with
the City's goal of becoming the safest city possible.
To report a hazardous workplace condition, callers should provide the following
information:
• Department/Division/Section
• Specific location(s) of the safety or health hazard(s); and
• Description(s) of the safety or health hazard(s)
• Date/Time of Incident, if applicable.
Callers may remain anonymous. Information for callers who provide contact information
will be held confidential. However, under the Texas Public Information Act, parties may
request Hotline case file information, including names. The City Safety Office will not
be able to provide updates/response on complaints reported by anonymous callers.
Exhibit A- 17
City of Fort Worth /
Safety Environmental and Engineering Solutions ("SEES")
Contract for Professional Management Consulting Services
EXHIBIT B
Action Plan: Accident Prevention Plan Implementation
(Timeline Subject to Change)
EXHIBIT B
Action Plan: Accident Prevention Plan Implementation
(Timeline subject to Change)
Effective Date: June 2, 2006 Responsibility Date Status
Finalize Accident Prevention Plan W.Armstrong 2/25/2005 Completed
Meeting with Vendor W.Armstrong 3/7/2006 Completed
Brief Accident Prevention Plan to OHS Manager W.Armstrong 3/28/2006 Completed
Brief Accident Prevention Plan to HR Director J osselet/Arm strong 4/12/2006 Completed
Proposed Contract Completed Armstrong/McKinnon 4/14/2006 Completed
Authorization of Contract for Services Approved City Council 5/23/2006 Completed
Project Concept Meeting Armstrong/Vendor 5/24/2006 Completed
Draft Language of Contract with Vendor Armstrong/Josselet 6/1/2006 Completed
Project Design Begins Vendor 6/1/2006
Review of Draft Contract by Legal Dept. Josselet/M. Farmer 6/8/2006
Contract Approved and Signed by Vendor and ACM Josselet 6/15/2006
Brief Accident Prevention Plan to Executive Group Josselet/Armstrong/Vendor 7/12/2006
Letter: Leadership Forum Attendees W. Armstrong 7/14/2006
Leadership Forum Initial Rehearsal W.Armstrong 7/21/2006
Leadership Forum Preview to HR Director Armstrong/Vendor 7/28/2006
Host leadership Forumpr nd Hft, e 0/18/20()6
1- �►t1St
. = (Tenfatiue Dai)
Preview Accident Prevention Plan Workshop Armstrong/Josselet/Vendor 9/1/2006
Letter to Departments, re:Workshop W.Armstrong 9/4/2006
Host;Leadership Forum .hHRSt3 9! 5/2006
z
Rehearsal Accident Prevention Plan Workshops Armstrong/Vendor 9/15/2006
Host Accident Prevention Plan Workshop(General) Armstrong/Vendor 9/26/2006
Host Accident Prevention Plan Workshop(Construction) Armstrong/Vendor 9/28/2006
Preview Managers/Supervisors Orientation Armstrong/Vendor 10/5/2006
Managers/Supervisors Training Begins Armstrong/Vendor 10/16/2006
Phase 1 Departments' Deadline for Draft Plan to OHS Department Reps 10/31/2006
Phase 2 Departments' Deadline for Draft Plan to OHS Department Reps 11/2/2006
OHS Review Phase 1 Plans OHS Staff/Vendor 11/1-11/16/2006
OHS Review Phase 2 Plans OHS Staff/Vendor 11/17-12/1/2006
Phase 1 Department's Final Plans Due to OHS Department Reps 12/15/2006
Phase 2 Departments' Deadline for Draft Plan to OHS Department Reps 12/31/2006
Department Accident Prevention Plans Accepted Armstrong/Vendor 1/31/2007
First Supervisor Safety Course Offered OHS Staff/Vendor 2/1/2007
Managers'/Supervisors'Training Completed Armstrong/Vendor 6/30/2007
Exhibit B- 1
EXHIBIT B
Action Plan: Accident Prevention Plan Implementation
(Timeline subject to Change)
Effective Date: June 2,2006 Responsibility Date Status
Finalize Accident Prevention Plan W.Armstrong 2/25/2005 Completed
Meeting with Vendor W.Armstrong 3/7/2006 Completed
Brief Accident Prevention Plan to OHS Manager W.Armstrong 3/28/2006 Completed
Brief Accident Prevention Plan to HR Director Josselet/Armstrong 4/12/2006 Completed
Proposed Contract Completed Armstrong/McKinnon 4/14/2006 Completed
Authorization of Contract for Services Approved City Council 5/23/2006 Completed
Project Concept Meeting Armstrong/Vendor 5/24/2006 Completed
Draft Language of Contract with Vendor Armstrong/Josselet 6/1/2006 Completed
Project Design Begins Vendor 6/1/2006
Review of Draft Contract by Legal Dept. Josselet/M. Farmer 6/8/2006 Completed
Brief Accident Prevention Plan to Executive Group Josselet/Armstrong/Vendor 7/12/2006 Completed
Letter: Leadership Forum Attendees W.Armstrong 7/14/2006
Contract Approved and Signed by Vendor and ACM Josselet 7/15/2006
Leadership Forum Initial Rehearsal W.Armstrong 7/21/2006
Leadership Forum Preview to HR Director Armstrong/Vendor 7/28/2006
Preview Accident Prevention Plan Workshop Armstrong/Josselet/Vendor 9/1/2006
Letter to Departments, re:Workshop W.Armstrong 9/4/2006
Rehearsal Accident Prevention Plan Workshops Armstrong/Vendor 9/15/2006
Host Accident Prevention Plan Workshop (General) Armstrong/Vendor 9/26/2006
Host Accident Prevention Plan Workshop (Construction) Armstrong/Vendor 9/28/2006
'.Host Leadership Forum = Off'" {
4 S�ti/Vandar Qct/206
(Tentative Date)
Hast Leadership Forum 0HS1HR Staff/Vendor fj [yO�ctyJ2006
8�8 bat
Preview Managers/Supervisors Orientation Armstrong/Vendor 10/5/2006
Managers/Supervisors Training Begins Armstrong/Vendor 10/16/2006
Phase 1 Departments' Deadline for Draft Plan to OHS Department Reps 10/31/2006
Phase 2 Departments' Deadline for Draft Plan to OHS Department Reps 11/2/2006
OHS Review Phase 1 Plans OHS Staff/Vendor 11/1-11/16/2006
OHS Review Phase 2 Plans OHS Staff/Vendor 11/17-12/1/2006
Phase 1 Department's Final Plans Due to OHS Department Reps 12/15/2006
Phase 2 Departments' Deadline for Draft Plan to OHS Department Reps 12/31/2006
Department Accident Prevention Plans Accepted Armstrong/Vendor 1/31/2007
First Supervisor Safety Course Offered OHS Staff/Vendor 2/1/2007
Managers'/Supervisors'Training Completed Armstrong/Vendor 6/30/2007
Exhibit B - 1
City of Fort Worth /
Safety Environmental and Engineering Solutions ("SEES")
Contract for Professional Management Consulting Services
EXHIBIT C
Schedule of Fees
safety,
S E Environmental
&Engineering Solutions
City of Fort Worth
RFP 05-00258, Safety Training Services
This is a cost and payment schedule for the Safety Training Service contract. This is a
not-to-exceed bid based on the services described in the RFP 05-00258.
Phase 1: Curriculum Development
• Consulting/ Collaboration on Accident Prevention Plan strategy
• Leadership Conference (20 Participants)
o Planning/ Preparation Time
o Material Development Time
o Presentation Time
Phase1: Cost
Total Consulting Time $7,150.00
Material Printing Cost 450.00
Phase 1 Total Cost $7,600.00
Phase 2: Management Forum- (635 Participants)
• Planning/ Preparation Time
• Material Development Time
• Presentation Time
Phase 2: Cost
Total Consulting Time $ 9,400.00
Material Printing Cost
• Printing of the 12-page full color handout $ 3,140.50
(Includes graphic design)
• Printing the B/W Accident Prevention Plan $ 762.00
Phase 2 Total Cost$13,302.50
Phase 3: Accident Prevention Workshop- (26 Participants)
• Planning/ Preparation Time
• Material Development Time
• Presentation Time
Phase 3: Cost
Total Consulting Time $ 11,300.00
Material Printing Cost $ 480.00
Phase 3 Total Cost$ 11,780.00
Phase 4: Supervisors/ Managers Safety Orientation- (1000 Participants)
• Planning/ Preparation Time
• Material Development Time
• Presentation Time- 8 hours training sessions
(Based on 34 classes at a average class size of 30 participants)
Phase 4: Cost
Consulting Time $ 40,000.00
Material Printing Cost
• Printing of the 32-page full color handout $ 6,870.00
(Includes graphic design)
• Printing the B/W Accident Prevention Plan $ 1.200.00
Total Cost $ 48,070.00
Grand Total Cost- $ 80,752.50
Payment Schedule:
50% the cost of Phase 1 and Phase 2 is due (14) days after the effective date of the
approved contract in the amount of$10,451.25 as an initial payment. The initial
payment is used to begin the printing of the training materials and training equipment
purchases. The remaining 50% balance of Phase 1 and Phase 2 will be invoiced in
25% increments after each phase.
Phase 3 and Phase 4 payments will be invoiced and paid monthly. The invoice will be
submitted based on the monthly training and development time and the pro-rated
material cost.
Page 1 of 2
City of Fort Worth, Texas
Mayor and Council Communication
COUNCIL ACTION: Approved on 5/23/2006
DATE: Tuesday, May 23, 2006
LOG NAME: 14SEES TRAINING REFERENCE NO.: C-21468
SUBJECT:
Authorization to Enter into Agreement with Safety, Environmental & Engineering Solutions
Consultants, LLC. for Occupational Safety Training
RECOMMENDATION:
It is recommended that the City Council authorize the City Manager to enter into a one-year agreement with
one-option for renewal with Safety, Environmental & Engineering Solutions Consultants, LLC. (SEES) for
the purpose of conducting occupational safety training for the City's managers and supervisors for a cost
not to exceed $81,000.
DISCUSSION:
The City of Fort Worth currently is self-funded in the administration of its workers' compensation
program. Over the past three years, costs have increased by 15.4% from a budget of $10,323,433 in FY
2003-2004, to a proposed budget of $11,911,443 for FY 2006-2007. In order to control costs through
education and prevention, the Human Resources Department Occupational Health and Safety Division
developed a City-wide Accident Prevention Plan and sought the services of a qualified vendor through the
competitive bid process to provide management and supervisory training.
Proposals were reviewed from five companies and evaluated based on experience, staff qualifications,
quality of proposal and M/WBE committment. Based upon the results of the evaluations, staff recommends
that the City enter into an agreement with SEES based on the experience of the firm, qualifications of the
trainers and competitive pricing.
SEES will faciliate forums and workshops for over 1,000 employees over the following four phase project:
Phase 1 —Curriculum Development
SEES will assess safety needs and risks and develop curriculum and materials that reinforce the City-wide
Accident Prevention Strategy.
Phase 2 — Leadership Forum
All of the City's supervisors and managers will be introduced to the City-wide Accident Prevention Strategy.
Phase 3— Department Accident Prevention Plan Workshop
SEES will facilitate workshops and train safety representatives from each department on developing a
customized safety plan for their operations.
Phase 4—Workshop Training
Additional training will be offered in two safety tracks for construction and non-construction employees.
It is anticipated that the project will cost $40,000 for Fiscal Year 2005-2006 and $41,000 during Fiscal Year
2006-2007 for a total cost of $81,000. The City Manager's recommended buget for Fiscal Year 2006-2007
will include funding to underwrite the balance.
http://www.cfwnet.org/council_packet/Reports/mc_print.asp 11/1/2006
Page 2 of 2
M/WBE Statement: SEES is in compliance with the City's M/WBE Ordinance by committing 5% M/WBE
participation. The City's goal on this project is 5%.
FISCAL INFORMATION/CERTIFICATION:
The Finance Director certifies that funds are available in the current operating budget, as appropriated, in
the Worker's Compensation Fund. The City Manager's Fiscal Year 2006-2007 recommended budget will
include funding to underwrite the contract balance.
TO Fund/Account/Centers FROM Fund/Account/Centers
FE73 534830 0147310 $81,000.00
Submitted for City Manager's Office by: Richard Zavala (Acting) (6222)
Originating Department Head: Karen Marshall (7783)
Additional Information Contact: Ron Josselet (7766)
http://www.cfwnet.org/council_packet/Reports/mc_print.asp 11/1/2006