HomeMy WebLinkAboutContract 53086-A3AMENDMENT NO. 3
TO CITY OF FORT WORTH CONTRACT 53086
This Amendment is entered into by and between the City of Fort Worth (hereafter "City"),and
Occupational Health Centers of the Southwest, PA., DBA Concentra Medical Centers Vendor . City
and Vendor may be referred to individually as a Party and collectively as the Parties.
WHEREAS,on January 1, 2020, the Parties entered into City Secretary Contract 53086 for Vendor to
provide City with full range occupational health care services ;
WHEREAS, the Parties wish to amend the Agreement to incorporate the price schedule related to the
2025 flu shot clinic for employees.
NOW, THEREFORE,the Parties, acting herein by and through their duly authorized representatives,
enter into the followingagreement:
1.
AMENDMENTS
D - 2025 Flu Clinic and Billing Groups, which describes the services to be provided in relation to
the annual flu shot clinic, attached hereto, is hereby added to the Agreement.
2.
ALL OTHER TERMS SHALL REMAIN THE SAME
All other provisions of the Agreement which are not expressly amended herein shall remain in full force
and effect.
3.
ELECTRONIC SIGNATURE
This Amendment may be executed in multiple counterparts, each of which shall be an original and
all of which shall constitute one and the same instrument. A facsimile copy or computer image, such as a
PDF ortiff image, or a signature, shall be treated as and shall have the same effect as anoriginal.
ACCEPTED AND AGREED:
CITY OF FORT WORTH:
By: ___________________________
Name: Dianna Giordano
Title: Assistant City Manager
Date: ___________________________
APPROVAL RECOMMENDED:
By: ______________________________
Name: Holly Moyer
Title: Director of Human Resources
ATTEST:
By: ______________________________
Name: Jannette Goodall
Title: City Secretary
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: ______________________________
Name: Kelly Lane
Title: Benefits Manager
APPROVED AS TO FORM AND LEGALITY:
By: ______________________________
Name: Jessika Williams
Title: Assistant City Attorney
CONTRACT AUTHORIZATION:
M&C: 19-0238 (October 15, 2019)
Vendor:OCCUPATIONAL HEALTH CENTERS OF THE SOUTHWEST, P.A.
By:
Name: Robert G. Hassett, DO, MPH
Title: President, Treasurer, & Corporate
Secretary
D
2025 Flu Clinic and Billing Groups
Section 1 Service Location(s)*
Service Location(s) City, State, Zip Contact Name and Number at Service Location
505 W. Felix (Bob Bolen Auditorium) Fort Worth TX 76115 Marty Humphrey
Margaret.Humphrey@fortworthtexas.gov
1000 Calvert (Auditorium Hallway) Fort Worth TX 76115 Marty Humphrey
Margaret.Humphrey@fortworthtexas.gov
1608 11th Ave. (Water Field Ops
Large Break Room)
Fort Worth TX 76115 Pamela Jordan
Pamela.Jordan@fortworthtexas.gov
5001 James Ave. (James Avenue
Breakroom)
Fort Worth TX 76115 Cristina Macias
Cristina.Macias@fortworthtexas.gov
100 Fort Worth Trail (City Hall room
adjacent to mail room)
Fort Worth TX 76115 Ana Ayala Terrazas
ana.ayalaterrazas@fortworthtexas.gov
*Additional service locations may be added to this Section 1 by mutual agreement of the parties. City shall make
requests for additional service locations via EpisodicEvents@Concentra.com, but no service location shall be added
unless it has been confirmed by Vendor staff in Section 3 below.
Section 2 Scope of Services:
The Scope of Services performed under this Exhibit A includes those described below and any additional services
mutually agreed upon between the parties via EpisodicEvents@Concentra.com, but no additional services shall be
implemented unless it has been confirmed by Vendor staff in Section 3 below.
SCOPE:
Onsite Flu Vaccines. City will provide a sanitary and private site location with access only to City approved participants
receiving these services/components. Proposed dates and schedule are listed below.
Location Date Time* Estimated Number of Vendor
Team Members
505 W. Felix 10/6/25 9:00am 3:00pm
1000 Calvert 10/8/25 8:30am 3:30pm
505 W. Felix 10/9/25 10:00am 3:00pm
505 W. Felix 10/14/25 9:00am 3:00pm
5001 James Ave 10/21/25 6:30am 10:30am
100 Fort Worth Trail 10/22/25 10:00am 3:00pm
1608 11th Ave. 10/23/25 7:30am 10:30am
*Staff required to arrive 1 hour prior to start time for setup
Section 3 Administrative Information:
Vendor will assign a dedicated project manager to coordinate the logistics of the Service Event(s). In addition, the following
Vendor representatives shall oversee the Service Event(s):
Vendor Program Operations Oversight: Michelle Sauvigne, (267) 246-8597, MSauvigne@Concentra.com
Vendor Program Medical Oversight: Latha Brubaker, MD, (281) 725-7029, Latha_Brubaker@Concentra.com
fy its
project manager by email to EpisodicEvents@Concentra.com.
Section 4 Term:
The term of this SOW commences on September 14, 2025 and terminates on December 31, 2025. Thereafter, the Term may
be extended upon mutual written agreement of the parties.
Section 5 Payment and Invoices:
Vendor shall invoice City as the Services are performed and City shall remit payment to Vendor within thirty (30) days of
receiving an invoice. City agrees to pay any sales, use, excise or similar taxes applicable to the Services provided hereunder.
The Services of this Agreement will be performed by Vendor through its managed professional entities as identified on the
attached Exhibit B Billing Group(s)
transmitted to City by the Billing Groups.
City invoices shall be sent to:
City of Fort Worth
100 Fort Worth Trail
Fort Worth, Texas 76102
Section 6 Fees and Expenses:
Fees
project Fees for Services performed at each deployed Service location and Service Event(s) as published under this Exhibit A
and any additional services that may be mutually agreed upon and performed by Vendor.
*Services Fee Volume Location
Influenza Vaccine $40 80 505 W. Felix Event #1
Influenza Vaccine $40 80 1000 Calvert
Influenza Vaccine $40 60 505 W. Felix Event #2
Influenza Vaccine $40 70 505 W. Felix Event #3
Influenza Vaccine $40 90 5001 James Ave.
Influenza Vaccine $40 150 100 Fort Worth Trail
Influenza Vaccine $40 90 1608 11th Ave.
Staff Position* Hourly Rates:
Weekday/Night & Weekend Rate
**Physician $270.00/$330.00
Advanced Practice Clinician (PA/NP) $215.00/$270.00
Physical Therapist or APT $215.00/$270.00
Registered Nurse/LPN $160.00/$215.00
Medical Assistant/Emergency Medical Technician $85.00/$140.00
Front Office Admin $85.00/$140.00
*The Staff Position(s) set forth above are subject to availability and may be adjusted by Vendor as necessary to support the
Service Event.
**Based on the Services performed at each Service Event, should oversight of the Vendor personnel be required, such hours
will be billed back to the City as incurred.
***Should Vendor personnel work more than eight (8) hours during a single day, overtime hours (in excess of the initial eight
(8) hours) will be billed in accordance with state labor laws and regulations.
Section 7 Miscellaneous:
a. Services will be charged at the above Weekday Rate for any Services performed from 6:00 a.m. to 6:00 p.m. on Monday
through Friday.
b.Services will be charged at the above Night & Weekend Rate for any Services performed before 6:00 a.m. or after
6:00 p.m. any day of the week or for any services performed at any time of day on Saturday or Sunday.
c. Any Vendor recognized holiday that is staffed by Vendor at the request of City will be billed at 2x the applicable hourly
Fee from the table provided above.
d. If City cancels or delays a Service Event, less than 72 hours before the scheduled time, then City shall be billed at 100%
of the scheduled Service Event that has been delayed or cancelled.
e. The base estimate is the number of City employees scheduled to arrive for the Services being performed during any
Base Estimate less than the Base Estimate
provided by City, then City will be billed at 90% of the Base Estimate, (e.g., Base Estimate = 100 participants; actual
participants = 40; City will be billed for 90 participants). In the Service Event that the actual number Services performed
exceeds the Base Estimate, then City will be billed for the actual Services performed.
Section 8 Travel and Expenses:
Travel & mileage expenses will be passed through at the current applicable IRS rate.
Section 9 Additional Expenses Incurred by Vendor:
In the event Vendor incurs any additional costs associated with providing the Services listed in this Statement of Work during
any Service Event, all additional expenses will be passed through as incurred. Passed through items include, but are not limited
to: hardware, software, internet network connectivity, medical supplies, office supplies, marketing or educational materials,
personal protective equipment, printing, postage, parking fees, equipment calibration and maintenance, biohazard disposal,
freezers, document storage and removal, permitting, licensing, etc.
Section 10 Software License, Hardware and Equipment Fees:
Any software, hardware, and/or internet network connectivity costs incurred by Vendor to support this statement of work shall
be mutually agreed upon and passed through as incurred without markup. In addition, City will be billed for any furniture, fixtures,
or equipment costs incurred by Vendor to support this scope of work.
Section 11 Service Location(s) and Set-Up: City shall provide Vendor with information needed to order supplies/equipment
at each Service location with sufficient notice prior to each Service Event.
Section 12 Confidentiality: Confidentiality of Protected Health Information. Both Parties warrant that they will maintain and
protect the confidentiality of all individually identifiable health information specifically relating to Participants in accordance with
the Health Insurance Portability and Accountability Act of 1996 and all applicable federal and state laws and regulations.
However, nothing herein will limit either Party's use of any de-identified Participant information. This Section will survive the
termination of this Agreement.
Section 13 Billing Groups:
State
Abre Entity State of
Incorporation Billing Address EIN
AK Occupational Health Centers of Alaska, P.C. AK PO Box 4300, Rancho Cucamonga, California
917729-4300 83-4299793
*AL Occupational Health Centers of Alabama, P.C. AL PO Box 82730, Hapeville, Georgia 30354 87-1954410
AR Occupational Health Centers of Arkansas, P.A. TX
PO Box 75388, Oklahoma City, Oklahoma 73147-
0388 75-2688160
AZ Occupational Health Centers of the Southwest, P.A.
(AZ) AZ 1818 East Sky Harbor Circle, North Suite 150,
Phoenix, Arizona 85034 86-0750222
CA Occupational Health Centers of California, a Medical
Corporation CA PO Box 3700, Rancho Cucamonga, California
91729-3700 77-0469725
CO Occupational Health Centers of the Southwest, P.A. TX PO Box 9008, Broomfield, Colorado 80021 75-2014828
CT Occupational Health Centers of the Southwest, P.A. TX PO Box 20220, Cranston, Rhode Island 02920 75-2014828
DE Occupational Health Centers of Delaware, P.A. DE PO Box 18277, Baltimore, Maryland 21227 51-0376661
FL Occupational Health Centers of the Southwest, P.A. TX PO Box 82549, Hapeville, Georgia 30354 75-2014828
GA Occupational Health Centers of Georgia, P.C. GA PO Box 82730, Hapeville, Georgia 30354 58-2285009
HI Occupational Health Centers of Hawaii, Inc. HI PO Box 4300, Rancho Cucamonga, California
917729-4300 74-2731442
IA Occupational Health Centers of the Southwest, P.A. TX PO Box 75427, Oklahoma City, Oklahoma 73147-
5427 75-2014828
IL Occupational Health Centers of Illinois, P.C. IL PO Box 488, Lombard, Illinois 60148 46-2554525
IN Occupational Health Centers of the Southwest, P.A. TX PO Box 488, Lombard, Illinois 60148 75-2014828
KS Occupational Health Centers of Kansas, P.A. KS PO Box 369, Lombard, Illinois 60148 47-2063864
KY Occupational Health Centers of the Southwest, P.A. TX PO Box 75388, Oklahoma City, Oklahoma 73147-
0388 (Louisville) 75-2014828
KY Occupational Health Centers of the Southwest, P.A.,
P.S.C TX PO Box 5012, Southfield, Michigan 48086-5012
(Mineola) 75-2014828
LA Occupational Health Centers of Louisiana, a
Professional Corporation LA PO Box 75430, Oklahoma City, Oklahoma 73147-
0430 74-2891603
MA Occupational Health Centers of the Southwest, P.A. TX PO Box 20127, Cranston, Rhode Island 02920 75-2014828
MD Occupational Health Centers of the Southwest, P.A. TX PO Box 18277, Baltimore, Maryland 21227 75-2014828
ME Occupational Health Centers of the Southwest, P.A. TX PO Box 20127, Cranston, Rhode Island 02920 75-2014828
MI Occupational Health Centers of Michigan, P.C. TX PO Box 5106 Southfield, Michigan 48086-5106 38-2857561
MN Occupational Health Centers of Minnesota, P.C. MN PO Box 1297, Brookfield, Wisconsin 53008-1297 83-1272378
MO Occupational Health Centers of Kansas, P.A. TX PO Box 369, Lombard, Illinois 60148 47-2063864
*MS Occupational Health Centers of Mississippi, P.C. MS PO Box 75388, Oklahoma City, Oklahoma 73147-
0388 87-1979933
NC Occupational Health Centers of North Carolina, P.C. NC PO Box 82730, Hapeville, Georgia 30354 26-2484838
NE Occupational Health Centers of Nebraska, P.C. NE PO Box 75428, Oklahoma City, Oklahoma 73147 47-0827928
NH Occupational Health Centers of the Southwest, P.A. TX PO Box 20127, Cranston, Rhode Island 02920 75-2014828
NJ Occupational Health Centers of New Jersey, P.A. NJ PO Box 8750, Elkridge, Maryland 21075-8750 22-3473542
NM Occupational Health Centers of the Southwest, P.A. TX PO Box 9009, Broomfield, Colorado 80021 75-2014828
NV Occupational Health Centers of the Southwest, P.A. TX PO Box 9010, Broomfield, Colorado 80021 75-2014828
OH Occupational Health Centers of Ohio, P.A., Co. OH PO Box 5012, Southfield, Michigan 48086-5012 26-3239286
OK Occupational Health Centers of the Southwest, P.A. TX PO Box 75410, Oklahoma City, Oklahoma 73147-
0410 75-2014828
OR Occupational Health Centers of the Southwest, P.A. TX
PO Box 4300, Rancho Cucamonga, California
917729-4300 75-2014828
PA Occupational Health Centers of the Southwest, P.A. TX PO Box 8750, Elkridge, Maryland 21075 75-2014828
RI Occupational Health Centers of the Southwest, P.A. TX PO Box 20127, Cranston, Rhode Island 02920 75-2014828
SC Occupational Health Centers of the Southwest, P.A. TX PO Box 82730, Hapeville, Georgia 30354 75-2014828
TN Occupational Health Centers of the Southwest, P.A. TX PO Box 75388, Oklahoma City, Oklahoma 73147-
0388 75-2014828
TX Occupational Health Centers of the Southwest, P.A. TX PO Box 9005, Addison, Texas 75001 75-2014828
UT Occupational Health Centers of the Southwest, P.A. AZ PO Box 9008, Broomfield, Colorado 80021 86-0750222
VA Occupational Health Centers of the Southwest, P.A. TX PO Box 18277, Baltimore, Maryland 21227 75-2014828
State
Abre Entity State of
Incorporation Billing Address EIN
VT Occupational Health Centers of the Southwest, P.A. TX PO Box 20127, Cranston, Rhode Island 02920 75-2014828
WA Occupational Health Centers of Washington, P.S. WA
PO Box 4300, Rancho Cucamonga, California
917729-4300 83-1638410
WI Occupational Health Centers of the Southwest, P.A. TX PO Box 1297, Brookfield, Wisconsin 53008-1297 75-2014828
*WV Occupational Health Centers of West Virginia
Professional Corporation TX PO Box 18277, Baltimore, Maryland 21227 87-2373839
9/23/25, 11:23 AM
M&C - Council Agenda
City of Fort Worth, Texas
Mayor and Council Communication
DATE: Tuesday, October 15, 2019 REFERENCE NO.: **M&C 19-0238
LOG NAME: 13P19-0159 OCCUPATIONAL HEALTH AND SAFETY SERVICES HR JPB
SUBJECT:
Authorize Execution of Agreements with ES Squared, LLC and Occupational Health Centers of the
Southwest, P.A. d/b/a Concentra Medical Centers for Occupational Health and Safety Services in a
Combined Annual Amount Up to $461,066.00 with a Five-Year Initial Term and Authorize Two One-Year
Renewal Options for the Human Resources Department (ALL COUNCIL DISTRICTS)
RECOMMENDATION:
It is recommended that the City Council authorize the execution of agreements in a combined annual
amount up to $461,066.00 with a five-year initial term and two one-year renewal options for the Human
Resources Department with:
i) ES Squared, LLC for occupational health and safety consulting and training services; and
ii) Occupational Health Centers of the Southwest, P.A. d/b/a Concentra Medical Centers for occupational
health and safety care services.
DISCUSSION:
The Human Resources Department (HRD) approached the Purchasing Division to secure agreements for
occupational health and safety services. The services include:
• Provide consultants to City departments regarding Occupational Safety and Health Administration
(OSHA) standards;
• Develop and implement policies, programs and procedures related to OSHA;
• Provide training regarding topics and issues related to OSHA standards and/or City health, safety
and environmental policies, procedures, rules and/or workplace practices; and
• Provide physical exams: fitness for duty exams and/or other assessments, drug screening, alcohol
testing, clinical testing, exposure control program, commercial driver's license program and medical
surveillance program.
Staff issued a Request for Proposals (RFP) that consisted of detailed scope of services. The RFP was
advertised in the Fort Worth Star-Telegram every Wednesday starting on June 12, 2019 through July 10,
2019. Seventeen vendors were solicited from the purchasing database; six responses were received.
The proposals were thoroughly reviewed by an evaluation team separately for consultation, training and
care services. The evaluation team ranked the proposals based on pre-defined factors. The evaluation
team determined the following vendors provide the best overall solution to the listed services:
i) ES Squared, LLC for occupational health and safety consulting and training services; and
ii) Occupational Health Centers of the Southwest, P.A. d/b/a Concentra Medical Centers for occupational
health and safety care services.
ES Squared, LLC: Maximum Annual Not Exceed Amount
Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7
$77,500 $79,825 $82,220 $84,687 $87,228 $89,845 $92,540
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9/23/25, 11:23 AM
M&C - Council Agenda
Occupational Health Centers of the Southwest, P.A. d/b/a Concentra Medical:
Maximum Annual Not Exceed Amount
Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7
$275,000 $288,750 $303,188 $318,347 $334,264 $350,977 $368,526
An administrative change order or increase may be made by the City Manager up to the amount allowed
by relevant law and the Fort Worth City Code and does not require specific City Council approval as long
as sufficient funds have been appropriated
Upon City Council approval and execution of contracts, the initial five-year term of these contracts shall
begin. Contracts may be renewed up to two one-year terms at the City's sole discretion. This action does
not require specific City Council approval provided that sufficient funds are appropriated for the City to
meet its obligations during the renewal period. No guarantee was made that a specific amount of these
services will be purchased.
A waiver of the goal for MBE/SBE sub-contracting was requested by the Purchasing Division and
approved by the M/WBE Office, in accordance with the BDE Ordinance, because the purchase of goods
or services is from sources where sub-contracting or supplier opportunities are negligible.
FISCAL INFORMATION / CERTIFICATION:
The Director of Finance certifies that upon adoption of the Fiscal Year 2020 budget by the City Council,
that funds will be available in the Fiscal Year 2020 budget, as appropriated, of the General Fund. Prior to
expenditure being made, the Human Resources Department has the responsibility to validate the
availability of funds.
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CERTIFICATIONS:
Submitted for City Manager's Office by_
Originating Department Head:
Additional Information Contact:
Kevin Gunn (2015)
Reginald Zeno (8517)
Cynthia Garcia (8525)
John Padinjaravila Baby (2279)
ATTACHMENTS
1. 1295 Concentra.pdf (CFW Internal)
2. 1295 ES Squared LLC.pdf (CFW Internal)
3. 13P19-0159 OCCUPATIONAL HEALTH Avail Funds.docx (CFW Internal)
4. 19-0159 MWBE Waiver.pdf (CFW Internal)
5. Req with FID.pdf (CFW Internal)
6. SAMs report Concentra 8-28-19.pdf (CFW Internal)
7. SAMs report ES Squared 8-28-19.pdf (CFW Internal)
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9/23/25, 11:28 AM
M&C - Council Agenda
City of Fort Worth, Texas
Mayor and Council Communication
DATE: Tuesday, April 22, 2025 REFERENCE NO.: **M&C 25-0352
LOG NAME: 14CONCENTRA-MEDSTAR TRANSITION
SUBJECT:
(ALL) Authorize Amendment Number Two to the Agreement with Occupational Health Centers of the
Southwest, P.A. DBA Concentra Medical Centers to Increase Spending Authority for Renewal Year Six by
$173,000.00 and Renewal Year Seven by $183,000.00 for a Total Annual Spending Authority Up to
$523,977.00 and $551,526.00 Respectively, Based on Current Needs and Line-Item Pricing in the Original
Agreement for the Human Resources Department
RECOMMENDATION:
It is recommended that the City Council authorize amendment number two to the agreement with
Occupational Health Centers of the Southwest, P.A. DBA Concentra Medical Centers to increase spending
authority for renewal year six by $173,000.00 and renewal year seven by $183,000.00 for a total annual
spending authority up to $523,977.00 and $551,526.00 respectively, based on current needs and line-item
pricing in the original agreement for the Human Resources Department.
DISCUSSION:
The purpose of this Mayor and Council Communication (M&C) is to increase the annual spending
authority for Occupational Health Centers of the Southwest, P.A., DBA Concentra Medical Centers by
$173,000.00 for renewal year six and $183,000.00 for renewal year seven for a total annual spending
authority up to $523,977.00 and $ 551,526.00, respectively.
City Council approved the contract with Occupational Health Centers of the Southwest, P.A. DBA
Concentra Medical Centers on October 15, 2019 (M&C No. 19-0238; City Secretary Contract No.
53086). Approved amounts for renewal years six and seven under the initial M&C were $350,977.00 and
$368,526.00 annually. The charges for the services provided by Concentra Medical Centers are on a line -
item basis with the final calculation based on the number of City employees. The line - item cost has not
changed since the inception of the agreement. However, the number of employees since the inception of
the contract has increased.
Approval of this M&C would authorize an increase in spending authority for renewal year six and renewal
year seven for amounts up to $523,977.00 and $551,526.00, respectively.
The estimated increase factors in the current and projected number of City employees subject to change.
Funding is budgeted in the General Operating & Maintenance category in the Risk Financing Fund for the
Human Resources Department.
FISCAL INFORMATION / CERTIFICATION:
The Director of Finance certifies that funds are available in the current operating budget, as previously
appropriated, in the Risk Financing Fund to support approval of the recommendation and execution of the
amendment. Prior to any expenditure being incurred, the Human Resources Department has the
responsibility to validate the availability of funds.
FUND IDENTIFIERS (FIDs),:
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�Fund Department AccounTProjec�ProgramActivity�udge� Reference # mount
ID _ ID� � Year (Chartfield 2)
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9/23/25, 11:28 AM
FROM
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CERTIFICATIONS:
Submitted for City Manager's Office by_
Originating Department Head:
Additional Information Contact:
M&C - Council Agenda
Budget
Year
Dianna Giordano (7783)
Dianna Giordano (7783)
ATTACHMENTS
1. 14CONCENTRA-MEDSTAR TRANSITION fid table.xlsx (CFW Internal)
2. 14CONCENTRA-MEDSTAR TRANSITION funds avail.docx (CFW Internal)
Reference # �P►mou
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