HomeMy WebLinkAboutContract 57399-AD1DocuSign Envelope ID: 5F1460FB-422F-440D-9BFD-E56C098C5EED CSC No. 57399-ADl
ADDENDUM
Supplemental Agreement to the Memorandum of Agreement
By and Between
University of North Texas Health Science Center at Fort Worth
And
CITY OF FORT WORTH
University of North Texas Health Science Center at Fort Worth ("UNTHSC") and by the City of Fort Worth ("FW") shall be governed by the agreed upon terms and conditions of the Memorandum of Agreement with a last signature date of March 8, 2022 (HSC Contract #2022-0556) herein referred to as the "MOU".
NOW, THEREFORE,for and in consideration of the mutual covenants and agreements contained herein and the parties agree as follows:
Specific responsibilities of FWFD: 1.Fort Worth Fire Department (FWFD) will allow UNTHSC students to participate in observationalexperiences and clinical experiences. 2.FWFD will provide a list of experiences, expectations, locations, dates, and points of contact for thesestudent experiences. 3.FWFD will collaborate with UNTHSC on goals and objectives for these experiences.4.FWFD will provide orientation to the UNTHSC students prior to rotations.
Specific responsibilities ofUNTHSC:
1.UNTHSC students will complete blood borne pathogen training and abide by universal precautions2.UNTHSC students will abide by all HIP AA, federal, state and municipal laws as applicable toperformance with FWFD 3.UNTHSC will coordinate experiences with students that are eligible to participate in theseexperiences 4.UNTHSC students will be responsible for any injuries incurred during the clinical experience5.UNTHSC will collaborate with FWFD on goals and objectives for these experiences.
Mutual Agreements:There will be no exchange of funds as a part of this agreement.
IN WITNESS WHEREOF, the parties have made and entered into this Supplemental Agreement effective upon the date of last signature below.
UNIVERSITY OF NORTH TEXAS HEALTH
SCIENCE CENTER
DocuSigned by:
C;.,...l'l,.v/u,, v:,_'-:/ov, p"'-l'l..v,.._�1/9/2023
Char es Taylor;-PharmD Date: Provost & EVP, Academic Affairs
CITY OF FORT WORTH
\ /4t,},--Valerie W.shington (Nov 20, 2023 09:31 CST) Valerie Washington Assistant City Manager Date:
[Signature Page Follows]
1/l�,5Page 11, HSC Contract #2022-0556ac
DocuSign Envelope ID: 5F1460FB-422F-440D-9BFD-E56C098C5EED
[Signature Page Follows]
FORT WORTH: City of Fort Worth Internal Process Signatures:
City of Fort Worth
By: Valecie Washington (Nov 20, 2023 09:31 CST) Name: Valerie Washington Title: Assistant City Manager
Date: Nov 20, 202 3
Approval Recommended:
By: J
�
v 16, 2023 14:47 CST) Name: James Davis Title: Fire Chief
Attest:
� A � By: U Name: Jannette Goodall Title: City Secretary
Page 12, HSC Contract #2022-0556a
Contract Compliance Manager:By signing I acknowledge that I am the person responsible for the monitoring and administration of this contract, including ensuring all performance and reporting requirements.
By: Jaso= (W02315:42 CST) Name: Jason Cearley Title: Fire Battalion Chief
Approved as to Form and Legality:
A� /J;f,://,;,,,,_ By: ·--,-·-Name: Andrea Phillips Title: Assistant City Attorney
Contract Authorization:
M&C: Form 1295:
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX