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Home My WebLink About1996 10 14 Consent Item B COMMISSION AGENDA ITEM B REGULAR CONSENT X INFORMATIONAL Meeting MGR~;U/DEPT ~0 Authorization I October 14, 1996 REQUEST: Fire Department requesting authorization to enter into a service agreement for Billing Services for the Emergency Medical Transport System. PURPOSE: The purpose of this Commission item is to gain Commission authority to discontinue the Billing Services provided by EMTS Corporation, and to request authorization for the City Manager to enter into a service agreement with Medical Compliance, Inc. for Billing Services for the Emergency Medical Transport System at a cost of 5.5% of the collected amount. CONSIDERATIONS: After several months with the current Medical Transport Billing Services provider EMTS Corporation, Muncy, Pennsylvania, the following problems have occurred prompting the need for a service change. 1. The Billing Company is located in Pennsylvania, fees are charged for long distance calls to both patients and the City from their office in Pennsylvania to Winter Springs. 2. Postage is charged to the City for all claims that are mailed i.e. insurance companies, Medicare, Medicaid, patients, etc.. Also the City pays postage for the run reports we send to their office. 3. The Fire Department is responsible for receipts of payment and generating an account database for reconciliation of accounts. This causes unnecessary work that would be provided by the new Billing Service provider. October 14, 1996 Consent Agenda Item "B" Page 2 4. Payments for services are based on fees per transport, the new providers compensation is based upon collected revenue without additional fees such as postage, long distance charges, and monthly service fees. This proposed new service provider is needed to invoice the responsible party for Emergency Medical Transport of the patient to the Hospital by the Winter Springs Fire Department. The agreement will allow Medical Compliance, Inc. (Billing Center), Orlando, Florida, on behalf of the City of Winter Springs to bill the established transport fee of$184.63. The City of Winter Springs shall pay to the Billing Center for services a rate of 5.5% of the collected amount. Bids for this service were publicized and were opened on February 12, 1996 under Bid # 19~96 of the City of Altamonte Springs, Florida. The City Commission of the City of Altamonte Springs, Florida approved an award recommendation at their meeting on Tuesday, February 20, 1996. The vendor, Medical Compliance, Inc., was awarded the bid for the amount of 5.5% of the amount of the medical transport bills collected. Medical Compliance, Inc. has agreed to convey the prices, terms, and conditions of their bid with the City of Altamonte Springs, to the City of Winter Springs, as outlined in the General Specifications for Bid No. 19-96, Medical Transport Billing and Collection Services. The Cities of Altamonte Springs, Longwood, and Winter Park currently utilize Medical Compliance, Inc. for billing services. The City Attorney has approved the Service Agreement between the City of Winter Springs and Medical Compliance, Inc. as to form and legality. October 14, 1996 Consent Agenda Item "B" Page 3 The following information are items that are outlined in the service agreement including services, compensation, and term of agreement. Claims Processing Services: 1. Billing Center will pick up all claims information from the City of Winter Springs Fire Chief or his designee on a weekly basis, unless other arrangements have been made and agreed upon by both parties. 2. Billing Center will electronically process and submit the City's claims to the corresponding insurance companies and provide a computer generated report verifying their receipt by the insurance companies. City shall owe compensation to Billing Center only for primary claims, and shall not be responsible or liable for additional compensation to the Billing Center for secondary claims. 3. Billing Center shall supply the City monthly reports which shall contain Electronic Verification Reports, Patient Aging, Accounts Receivable Report, Practice Analysis Reports, Insurance Analysis Reports, Insurance documentation consisting of follow up, patient documentation on calls and collections and any other information available concerning the claims filed during the month preceding the monthly report. 4. Billing Center will deposit collected funds into the City's bank account within two days of receipt of same. Billing Center shall provide City with validated deposit slips on a weekly basis. City shall provide Billing Center with pre-printed deposit slips. Compensation: 1. City shall pay to Billing Center for the services described the per claim rate of 5.5% of the collected amount. This rate shall be in effect for twelve (12) months from the date hereof with an option for extension for up to four (4) additional years. The invoices are to be billed on a monthly basis. October 14, 1996 Consent Agenda Item "B" Page 4 Term of Agreement: 1. This agreement shall be for a term of one (1) year provided however that it may be terminated by the City upon submission of a thirty (30) days written notice to Billing Center. 2. The City shall have the option to extend this Agreement for up to four (4) additional years. 3. The City agrees to a thirty (30) day trial period during which the right to terminate this agreement shall be waived. FUNDING: This service is budgeted in the current fiscal year in the Fire Department, Medical Transport Services budget, line code (# 53410) at a projected expense of $7,410. The following Table represents a Cost and Revenue analysis comparing the existing and proposed Service Providers. BILLING COST (9 Months) EMTS MEDICAL COMPLIANCE Contract Cost $4,510.00 $3,656.00 $405.00 $0 $360.00 $0 $5,275.00 $3,656.00 Postage Long Distance Calls TOTALS REVENUE COLLECTION 1st Three Months Percentage % 65% 80% ". Dollars $ $18,001.00 $22,156.00 11 11 Based upon revenue collection experience in Altamonte Springs. October 14, 1996 Consent Agenda Item "B" Page 5 RECOMMENDATION: It is recommended that the City Manager be authorized to enter into a service agreement with Medical Compliance, Inc. for Billing Services for the Emergency Medical Transport System at a cost of 5.5% of the collected amount. IMPLEMENTATION SCHEDULE: The agreement would be executed upon approval. A TTAcBMENTS: 1. City of Altamonte Springs Bid Award Package, Bid No. 19-96 2. Electronic Claims Submission Service Agreement COMMISSION ACTION: CITY OF AL T AMONTE SPRINGS PAGE: 225 NEWBURYPORT AVENUE ALTAMONTE SPRINGS, FLORIDA 32701-3697 Telephone # 407/830-3870 Fax # 407/830-4421 PURCHASE ORDER ,I P.o: NO.: 0381 2,3 DATE: 4 /1. 9 /9 G W: MEDICAL COMPLIANCE INC '1221 LEE RD #210 ORLANDO FL 32810 SHIPW: CITY OF ALTAMONTE SPRINGS FINANCE/ACCOUNTING ,CITY HALL ' 225'NEWBURYPORT AVENUE ALTAMONTE SPRINGS FL . . 327013697 ,.:~!tVENOORNot~~1ilX ,'J:.' ~ ..', . . " . . ~ _.". 1012532, 2/28/97 NAN A . .{pj::~;, ~";:~~::';; ,\;; QUOTED :BYjYel'Jd6r)'~~~~~~~~~.f,~<<.;~tt ::~~,~~~t~~)"l~;J;;~;:~~ BUYEI3, (CitY);:::'~f~{;0;,k'~j:;,:~.:::'4~t:~J:'~:;:;:;;}REQUISIT1()NED' BY (DeptlDiv) ~,:;:; .;~':',,: " ::;::-"..~;;,{~~9:'FRE(GHJ,;)f-~~~~~;f;~~~~~~bNI~Qt:::N~:;:~~~~' !~~~tl~I~qco9N~(N.9.~(~:-;:;.,:~ ',;~.ti='ROJ~pti;~\(}: ";?t.~rf EQ:NO:~Jf~~~; '~BE<l'ifA1Er~ 1 9800.00 EA 932 060 C0424) 1 MEDICAL TRANSPORT " BILLINGAND COLLECTION SERVICES PO AMOUNT BASED ON: ' 1482 TRANSPORTS X $200 PER TRAN PORT = $296,400 X 60% COLLECTION RATE'- . ' ' $1771840 X .055 COLLECTION FEE ERCENT $978 .20 'COLLECTION FEE AMOUNT I 1. 0000 I I I 98,00 ~ 0.0 REM,ARKS : A. IN ACCORDANCE WITH ITB NO. 19- 6 B. ATTACHED TO THIS PO IS YOUR NO ICE AND AN ORIGINAL AGREEMENT I TOTAL 1 OF. CONTR CT 9800.00 L I I ______l_____ CONDlnONS - READ CAREFULLY 1 - The right is reserved to cancel this order if not filled within lhe contract time. if specified. 2 - The conditions of this order are not to be modified by any verbal understanding. 3 - Acceptance of this order includes Acceptance of all terms. prices. delivery instructions. specificalions and conditions staled. 4 - INVOICES AND PACKAGES MUST BEAR THIS ORDER NUMBER. S - THE CITY ASSUMES NO RESPONSIBILITY FOR GOODS DELIVERED WITHOUT THE AUTHORITY OF A PROPERLY EXECUTED PURCHASE ORDER. 6 - PLEASE FORWARD ALL INVOICES TO "REQUISITIONED BY" DEPARTMENT. 7 - See reverse for additional conditions. FlORIDA TAX EXEMPTION NO. 69-01-034044-54C FEDERAL 10 NO. 59-6000263 ~~ _._n,_ ____~ ORIGINAL ATTACHMENT 1 NOTICE OF CONTRACT City of Altamonte Springs, Florida Date of Contract: April 1, 1996 CC Approval Date: Februarv 20, 1996 Term of Contract: March 1, 1996 to Februarv 28, 1997 (may be renewed for four additional one year periods) Department: Finance Division: Accountinq Vendor Name: Medical Compliance, Inc. Vendor Address: 1221 Lee Road suite 210 Orlando FL 32810 Vendor Number: 1012532 .' ,.ACCOUNTn # .,PROJECT. . # . . . ... . . . . .. . . - . 'DESCRIPTION::, '" ... ,.... .I,::.::::....::....j::;, ......, .... ".. .. .. . . . . . . . . . .. :,:,::::,;: :'::;.:.:::::.::;:::::'"::;"::::::.::::::::' iii .' 16006045263031 Medical Transport Billing and Collection Services Fee Is ~ased On Amount Of Medical Transport Bills Collected 5.5% TOTAL I 5.5% I ~_(-..l \~~ ~ >-- 1-/0 /'7 ~ 9 G ~ Barbara Kiser, Purchasing Agent C-0424 Contract Number ITB NO. 19-96 Bid Number ELECTRONIC CLAIMS SUBMISSION SERVICE AGREEMENT This Electronic Claims Submission Service Agreement ("Agreement") is entered into this I~ W day of APRIL. ,1996, by and between Medical Compliance, Inc. ("Billing Centerll), a Florida corporation, and the City of Altamonte Springs, Florida CICityll) , a Florida municipal corporation. WIT N E SSE T H: WHEREAS, City is desirous of retaining Billing Center to process and submit City's claims for ambulance services to insurance companies; and WHEREAS, Billing Center for compensation and consideration set forth in this Agr~ement will process, submit and collect funds owing City for ambulance services; and WHEREAS, Billing Center agrees to abide by and comply with all covenants set forth herein and with all applicable Florida law, NOW, THEREFORE, the parties do agree as follows: 1. Claims Processinq Services. 1 .1 Billing Center will pick up all claims information from the City of Altamonte Springs Fire Chief or his designee on a weekly basis, unless other arrangements have been made and agreed upon by both parties. 1.2 Billing Center will electronically process -and submit the City's claims to the corresponding insurance companies and provide a computer-generated report verifying their receipt by the insurance companies. City shall owe compensation to Billing Center only for primary claims, and shall not be responsible or liable for additional compensation to Billing Center for secondary claims. 1.3 Billing Center shall supply the City monthly reports which shall contain Electronic Verification Reports, Patient Aging, Accounts Receivable Reports, Practice Analysis Reports, Insurance Analysis Reports, Insurance documentation consisting of follow up, patient documentation on calls and collections and any and all other information available concerning the claims filed during the month preceding the monthly report. 1.4 Billing Center will deposit collected funds into the City's bank account within two days of receipt of same. Billing Center shall provide City with validated deposit slips on a weekly basis. City shall provide Bilting Center with pre-printed deposit slips. KE: March 13. 199O C:\WPS1\D\AS\BIWNG.AGT 1 2. Compensation. 2.1 City shall pay to Billing Center for the services described in section (1) herein the per claim rate of 5.5% of the collected amount. This rate shall be in effect for twelve (12) months from the date hereof with an option for extension for up to four (4) additional years. The invoices are to be billed on a monthly basis. 3. Term of Aqreement. 3.1 This agreement shall be for a term of one (1) year provided however that it may be terminated by the City upon the submission of thirty (30) days written notice to Billing Center. 3.2 The City shall have the option to extend this Agreement for up to four (4) additional years. 3.3 The City agrees to a thirty (30) day trial period during which the right to terminate this Agreement shall be waived. 4. Code of Ethics and Debt Collection Practices. 4.1 Billing Center maintains and operates under a "Code of Ethics" to insure the integrity and confidentiality of City and patients. A copy of this code is attached hereto and incorporated herein by reference. 4.2 Billing Center covenants and agrees that it shall comply with, keep and following the guidelines, laws and regulations set forth in Chapter 559, Florida Statutes, and that it shall not violate Florida Statues 9559.72 prohibiting certain practices in collecting consumer debts nor violate any other provisions of the Florida Statutes concerning consumer or commercial collection. Billing Center warrants that it is aware of and fully knowledgeable of the laws regarding collection practices set forth in Florida Statutes Chapter 559 'and warrants that it shall at all times remain knowledgeable of the laws set forth therein and any amendments thereto. 4.3 The violation by Billing Center of either the Code of Ethics or any provision of Florida Statutes Chapter 559 shall be grounds for City's immediate, termination of this Agreement upon Billing Center's receipt of notice from City without the thirty (30) day waiting period. 5. Indemnification. 5.1 The City of Altamonte Springs, its officers and employees shall not be deemed to assume any liability for the acts, omissions, and negligence of Billir-lg Center, its officers and employees. Billing Center shall indemnify and hold the City and its officers and employees harmless from any and all liability, claims, causes of action, costs KE: March 13. 1996 C:\WP51\D\AS\BIWNG.AGT 2 or expenses either direct or indirect including attorneys fees incurred as a result of or arising under this Agreement or the provision of services hereunder. 6. Insurance. 6.1 Billing Center shall be responsible for maintaining a general liability insurance policy covering all actions taken by Billing Center in connection with either its duties under this Agreement or its relationship with the City of Altamonte Springs. The general liability policy shall have a minimum coverage of One Million Dollars ($1,000,000.00) per occurrence and One Million Dollars ($1,000,000.00) aggregate. Billing Center shall name City as an additional insured on all insurance policies obtained. Billing Center shall provide to City a Certificate of Insurance on the aforementioned policy immediately upon execution of this Agreement. . 7. Assianabilitv. This Agreement is not assignable by either party. 8. Severabilitv: Florida Law. If any part of this Agreement is adjudged invalid, all other parts herein shall remain valid and enforceable. Florida law shall govern this Lease Agreement. IN WITNESS WHEREOF, the parties hereto have signed by their duly authorized officers as of the day and year set forth above. CITY OF ALTAMONTE SPRINGS, FLORIDA uut~ KE: March 13, 19ge C:\WP51 \DIAS\BIWNGAGT 3 !;~!~!~I!:]t.JlIIl~IIJ"Afl1.,I!~!!~WJ"I~F{~2m1~N . ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICES BELOW. COMPANIES AFFORDING COVERAGE . .....~\ 1'''\,;-\.. POE AND BROWN INC 2600 LAKE LUCIEN #100 MAITLAND FL 32751 COMPANY A HARTFORD INS OF THE SOUTHEAST INSURED COMPANY _ B an1415~ COMPANY /o)"~ ~ 19&.- 1221 LEE RD STE 210 C I~ :\1110 '^ ~~\ ORLANDO FL 32810 COMPANY I'~ PURCH .~v;) ~ 1:5:::', .;:: ,.:,' ..<::::, :".' D ~ ""'",. A::'I/V", ~ :99:Y~M9,:~~:::f:"t::H~f?~:?:::tmII:~::::'?::IIIIII:i::tt'I::::~:mmmt:Iff:::::~:Hm?::f::::f:::"ttm:~:t:fff:t:':IU:::'::u::m':t:::::U::UUUI:t'IiU:::'I:t:III::::II:tt:::I::::::::j::::t::t:::::::::::::::U:::::iJw:mUUUI::!l;W.::,\f;:"M:}V'/:"::~}I%W THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED'Idi0YE FOR THE PO Y PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT W~,ec::t. - WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS S' ."U THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, MEDICAL COMPLIANCE INC co Lm TYPE OF INSURANCE POUCY NUMBER POUCY EFFECTlVI! "OUCY E:lf'mAnON DATE (MMJDDIYY) DATE (MMJDDIYYI UMrTS ~ OENERAL UABIUTY 2 1 S BAES 0 15 3 - X COMMERCIAL GENERAL UABILITY 1 CLAIMS MACE 00 OCCUR OWNER'S & CONTRACTOR'S PROT - - 2/27/96 2/27797 GENERAL AGGREGATE S PRODUCTS COMPIOP AGG .2 , 0 0 0 , 0 0 0 PERSONAL & ACV INJURY S 1 , 0 0 0 , 0 0 0 EACH OCCURRENCE S FIRE DAMAGE (Any one ftrel S 3 0 0 , 0 0 0 MED EXP (Any one person) S 1 0 , 0 0 0 1,000,000 COMBINED SINGLE LIMIT . ~ AUTOMOBlU!UABIUTY 21SBAES0153 - I- ANY AUTO I-- AU. OWNED AUTOS I- SCHEDULED AUTOS ~ HIRED AUTOS ~ NON.OWNED AUTOS 2/27/96 2/27/97 BODILY INJURY {Pe, pel30nl . BODILY INJURY (Per ecehlenl) . PROPERTY DAMAGE S ~AOE UABIUTY _ ANY AUTO - EXCESS UABIUTY I UMBRELlA FORM '\ Oll-lER ~AN UMBREUA FORM WORKERS COMPENSAnON AND EMPLOYERS'UABIUTY AUTO ONLY EA ACCIDENT S OTl-iER Tl-iAN AUTO ONLY: EACH ACCIDENT S AGGREGATE S EACH OCCURRENCE S . AGGREGATE s . THE PROPRIETOR! PARTNER~XECunvE OFFICERS ARE: OTHER RINCL EXCl I STATUTORY LIMITS EACH ACCIDENT . DISEASE POUCY UMIT S DISEASE EACH EMPlOYEE S ---.. -. -r-...n....'..,noILU~IIU"'WY~peclAL ITEMS THOSE U$UAL TO INSUREDS OPERATION, CERTIFICATE HOLDER IS ALSO ADDITIONAL INSURED. L' b~)9-c..;G SHOULD AMY OP 11tE ABOVE DESCRIBED POUCIES BE CANCEUED BEFORE THE CITY OF ALTAMONTE SPRINGS UPIlATlON DATB THEREO'. nil! ISSUINQ COMPANY Will. ENDEAVOR TO MAil l.Q.... DAYS WRrTnN NOnCI! TO na; CmT1F1CATI! HOLDER NAMED TO na; LEFT, BUT FALlIRI! TO MAL SUCH NOnCE SHAU. IMPOSE NO OBUQATlON OR UABUTY ALTAMONTE SPRINGSFL 32710 OP ANY KIND UIIQt THE COfolPANY, C'8 AOENTS Ofl REPREm,rAT1VES. AuntOR~ RUR M\~~~ \-1~~..~~~ A~6~i'#/~~1~:i?raidr:::::m::m:::t::::::::mt::::::m:m:::j:::m:ml,j::l,j:j:::j,}::::::}::m::::::::::::::::::;:;:;:;::t::::n:::n::::::::::::::j:::::::tfr":W:':':::m:::,~::,:,:m':::;'2'm:itW:fu;%=::0r::::1t:fu':~:'rmm:::~'m,t:?t:;g:A'e6nb:':':C~~OA:^flbN':'::':fiti3 225 NEWBURYPORT AVENUE INTER OFFICE MEMORANDUM City of AItamonte Springs, Florida DATE: February 14, 1996 Phillip D. Penland City Manager TO: VIA: M<;1rk B. D7Bord t~~lY) F~nance D~rector -.. FROM: Barbara Kiser ~ Purchasing Agent / ~ SUBJECT: Commission Agenda Item - February 2Q, 1996 BID AWARD BID NO: 19-96 MEDICAL TRANSPORT BILLING AND. COLLECTION SERVICES Certificate of Advertisement has been received. Bids were distributed to twenty-four (24) vendors. Bid responses were received from six (6) vendors and five (5) "No Bids" were received. Bids were opened and publicly read aloud on February 12, 1996. Bid amounts have been duly recorded on the Bid Tabulation (copy attached) . The bid called for offers to secure billing and collection services for Fire Rescue Medical Transportation Fees in conjunction with the City's needs on an as needed when needed basis. Bids were reviewed by myself for conformance to the general specifications. All bids, except Medical compliance, Inc. and CSB Audit & Billing Services, were found to be complete and responsive. These two firms failed to provide an additional copy of their bid submittal, which is a minor technicality that the City has reserved the right to waive. Bids were reviewed by Stan Human, EMS Manager, for conformance to the technical requirements of this bid. After a review of the bids, he has determined that Medical Compliance, Inc. qualifies as the lowest responsible bidder. Thus, it is recommended that an award be made to Medical Compliance, Inc. in the bid amount of 5.5% of the amount of the medical transport bills collected. I have reviewed the recommendation memo (copy attached) and am in concurrence ~with this recommendation. Recommendation: That the City Commission award Bid No: 19-96 to Medical Compliance, Inc. in the bid amount of 5.5%of the amount of the medical transport bill s collected. cc: Bid File (WP51\BIDS\96\ITB1996) ITB/RFP Tabulation File Correspondence File __u InItIIlfII, .....~~?a-q~ Jim Poulalion, Deputy Finance Director Windy Maloof, Sr Buyer BID TAB U L A.T 1,;0 N City of Altamonte Springs, Florida Bid No.: 19-96 Date: Februarv 12. 1996 Title: MEDICAL TRANSPORT BILLING AND COLLECTION SERVICES BIDDERS NAME AND ADDRESS page 1 of 2 BID/PROPOSAL INFORMATION TOTAL BASE BID OTHER BID INFORMATION MEDICAL COMPLIANCE, INC. 1221 Lee Road Ste 210 Orlando FL 32810 Contact: Julie Schuster 5.5% ADDEN #1: Yes COPY OF BID: No REFERENCES: Yes BIDDER ORGANIZATION: Yes BIDDER HISTORY: Yes ADVANCED DATA PROCESSING, INC. 520 NW 165th Street Ste 201 Miami FL 33169 Contact: Paul Franzelas 7% ADDEN #1: Yes COPY OF BID: Yes REFERENCES: Yes BIDDER ORGANIZATION: Yes BIDDER HISTORY: Yes FLORIDA REGIONAL EMERGENCY SVC US Highway 441 Eustis FL 32726 Contact: Seth Ellis 8% or 7% Plus Postage ADDEN #1: Yes COPY OF BID: Yes REFERENCES: Yes BIDDER ORGANIZATION: Yes BIDDER HISTORY: Yes ~: C'SB -AUDIT & BILLING SERVICES 202 N Federal Highway Lake Worth FL 33460 Contact: Ron Rode 8% ADDEN #1: Yes COPY OF BID: No REFERENCES: Yes BIDDER ORGANIZATION: Yes BIDDER HISTORY: Yes . -~ MEDICAL BILLING 208 W University Drive Arlington Heights IL 60004 Contact: Patrick Mannix 10% ADDEN #1: Yes COPY OF BID: Yes REFERENCES: Yes BIDDER ORGANIZATION: Yes BIDDER HISTORY: Yes _Trof'f Present: Barbara Kiser, Procurement Div Mgr Pat Wainright, City Clerk Phillip Penland, City Manager Steve Gaston, Deputy Fire Chief Stan Human, EMS Manager II Vendors Present: See Bid Sign In Sheet Attached w/ITB #17-96 ". .---- Tentative City Commission award date is 7:00 p.m., Tuesday, February 20, 1996. Call the :~~!~~~~~==~ Information Line (407/830-3878) for status of Intent To Award Recommendation. ~ '. \ . . ,',;,i ~ . BID TAB ULA TION City of Altamonte Springs, Florida .'., No.: 19-96 Date: Februarv 12. 1996 l'itle: MEDICAL TRANSPORT BILLING AND COLLECTION SERVICES page, 2 of 2 BIDDERS BID/PROPOSAL INFORMATION " NAME AND ADDRESS TOTAL BASE BID OTHER BID INFORMATION CERTIFIED AMBULANCE GROUP 11% ADDEN #1: Yes 920 Cromwell Avenue COPY OF BID: No Rocky Hill. CT 06067 REFERENCES: Yes Contact: Chris Gentile BIDDER ORGANIZATION': Yes BIDDER HISTORY: Yes "NO BID" RECEIVED FROM: 1. Liberty Collection Bureau 2. Equifax Risk Mgmt Svcs 3 . Van Ru Credit Corp 4. Ketron, Div of Bionetics 5. Municipal Services Bureau ;e:~ " INTER OFFICE MEMORANDUM City of Altamonte Springs, Florida DATE: February 14, 1996 TO: Phillip D. Penland City Manager VIA: Mark B. DeBord M8>O Finance Director --- FROM: Barbara Kiser ~~ Purchasing Agen~' SUBJECT: Commission Agenda Item - February 20, 1996 BID AWARD BID NO: 19-96 MEDICAL TRANSPORT BILLING AND COLLECTION SERVICES Certificate of Advertisement has been received. Bids were distributed to twenty-four (24) vendors. Bid responses were received from six (6) vendors and five (5) "No Bids" were received. Bids were opened and publicly read aloud on February 12, 1996. Bid amounts have been duly recorded on the Bid Tabulation (copy attached). . The bid called for offers to secure billing and collection services for Fire Rescue Medical Transportation Fees in conjunction with the City's needs on an as needed when needed basis. . Bids were reviewed by myself for conformance to the general specifications. All bids, except Medical Compliance, Inc~ and CSB Audit & Billing Services, were found to be complete and responsive. These two firms failed to provide an additional copy of their bid submittal, which is a minor technicality that the City has reserved the right to waive. Bids were reviewed by Stan Human, EMS Manager, for conformance to the technical requirements of this bid. After a review of the bids, he has determined that Medical Compliance, Inc. qualifies as the lowest responsible bidder. Thus, it is recommended that an award be made to Medical Compliance, Inc. in the bid amount of 5.5% of the amount of the medical transport bills collected. I have reviewed the recommendation memo (copy attached) and am in concurrence with this recommendation. ~ APPROVED BY, - - (~ITY' MANAGER: ')ATE: #8ft CITY OF AL T AMONTE SPRINGS 225 NEWBURYPORT AVENUE ALTAMONTE SPRINGS, FLORIDA 32701.3697 February 14, 1996 Julie Schuster Medical Compliance, Inc. 1221 Lee Road, Ste 210 Orlando, FL 32810 re: CONTRACT DOCUMENTS ITS NO: 19-96 MEDICAL ~RANSPOR~ BILLING AND COLLEC~ION SERVICES Dear Ms. Schuster, The City.of Altamonte opened and publicly read aloud the bids received for the above bid on February 12, 1996. The City Commission approved an award recommendation at their meeting on Tuesday, February 20, 1996: Vendor Name Amount Medical Compliance, Inc. 5.5% of the amount of the medical transport bills collected Jim Poulalion, Deputy Finance Director, will be contacting you within ten (10) calendar days, to negotiate the terms and conditions of the agreement. To streamline the process, it is recommended that you bring in a sample agreement that you have utilized in the past. The agreement will require approval by the City Attorney. Once the agreement has been finalized, five (5) original sets will need to be signed by both parties. Prior to any of the services commencing, a contract must be fully executed by both parties, a Certificate of Insurance received and approved and a Purchase Order issued by the Purchasing Division. All invoices, if required by the agreement, are to reflect the Purchase Order number on the invoice~ No payments may be made without a properly executed purchase order -- Sincerely, ~~, ~-"-\ ~ Barbara Kiser Procurement Division Manager cc: Bid File (WP51\BIDS\96\ITB1996) Correspondence File ~ -11Io.. ~""".an._""'1a. ......ft.-o--..~ Jim Poulalion, Deputy Finance Director Windy Maloof, Purchasing Agent · WE ARE PEOPLE WHO CARE ABOUT PEoolE .. CITY OF AL T AMONTE SPRINGS 225 NEWBURYPORT AVENUE ALTAMONTE SPRINGS. FLORIDA 32701.3697 March 29, 1996 Julie Schuster Medical Compliance, Inc. 1221 Lee Road, Ste 210 Orlando, FL 32810 re:CONTRACT DOCUMENTS ITB NO: 19-96 MEDICAL TRANSPORT BILLING AND COLLECTION SERVICES Dear Ms. Schuster, Attached are five (5) original sets of the agreement negotiated between your firm; Jim Poulalion, Deputy Finance Director and Mary L. Sneed, City Attorney/Fowler, Barice & Feeney. Please sign and return all five (5) sets. One (1) original set will be returned to you, with a Notice of Contract, and a Purchase Order issued by the Purchasing Division. All invoices are to reflect the Purchase Order number on the invoice. No payments may be made without a properly executed purchase order Sincerely, \::) ~~ Barbara Kiser Procurement Division Manager cc: Bid File (WP51\BIDS\96\ITB1996) Correspondence File Stan Human, EMS Manager . Jim Poulalion, Deputy Finance Director Windy Maloof, Purchasing Agent · WE ARE PEOPLE WHO CARE A50IJT PEOPLE . INVITATION TO BID Bid No. 19-96 City of Altamonte Springs PURCHASING DIVISION City Hall, Room 128 225 Newburyport Avenue Altamonte Springs FL 32701 -3697 Monday 02/12/96 Opening Date: 11:00 a.m. Business Phone: 407/830-3886 or 830-3870 Bid/Proposallnformation line: 407/830-3878 Fax Phone: 407/830-4421 THIS IS NOT AN ORDER FOB Point: N/A Terms of Payment: net 30 days upon deliverv and acceotance The City Shall Receive Shipment Within nla Purchase Order. From Date Vendor Receives Official Bid must be received at City Hall, Purchasing Division, Room 128 before Time: 11 :00 a.m. on 02/12/96 :- Bids will be immediately opened after the bid due date and time. You are invited to be present. Signed~n. lo.n\~ - Barbara Kiser,Purchasing Agent Stltl of Florid. Tu Exemption Number i.: 89-oI-034044-64C Date /1J,Q~o9~ SECTION Legal Advertisement Letter from Purchasing Agent Bidding Instructions, Terms & Conditions General Specifications Insurance Requirements Specifications Special Conditions Technical Specifications Attachment A - EMS Report Form Proposal Bid Form List of References Form "No Bidll Response Form PAGE LA - 1 LTR - 1 BITC - 1 GS - 1 IS - 1 SC - 1 TS - 1 A - 1 PBF - 1 R - 1 NBF - 1 ~ LEGAL ADVERTISEMENT NOTICE IS HEREBY GIVEN that the City of Altamonte Springs, Florida will receive separate sealed' bides) for the item(s) as listed below. Bid(s) must be received prior to the appointed advertised due date and time (local time), in the Purchasing Division, Room 128, City Hall, 225 Newburyport Avenue, Altamonte Springs, Florida 32701. The following bides) will be publicly opened and read aloud immediately following the below appointed due date and time in the Commission Chambers Room at City Hall. ***************************************************************** Bid No. Bid Title Ooeninq Time & Date 19-96 MEDICAL TRANSPORT BILLING AND COLLECTION SERVICES Monday 02/12/96 11:00 a.m. Purpose: The purpose of the ITB is to establish a contract for the purchase of billing and collection of Fire Rescue Medical Transportation Fees in conjunction with the City's needs on an as needed when needed basis. ***************************************************************** Bid Documents, including specifications and proper Proposal Bid forms are available, at no cost, in the Office of the Purchasing Division, 225 Newburyport Avenue, Altamonte Springs, Florida, 32701, (407) 830-3878 (Mailbox #6), unless otherwise noted. It is mandatory that interested bidders request directly from the Purchasing Division' only the bid documents prior to submission of a bid. The City of Altamonte Springs reserves the right to accept or reject any or all bids, with or without cause, to waive technicalities, or to accept the bid which, in its judgement, best serves the interest of the city. Persons are advised if they wish to appeal any meeting or decision made concerning this bid, they will need a record of the proceeding, and for such purpose, they may need to ensure that a verbatim record of the proceedings is made, which record includes the testimony and evidence upon which the appeal is to be made, per Chapter 80-150, Laws of Florida. The City does not provide this verbatim record. Persons with disabilities needing assistance to participate in any of these proceedings should contact the City Clerk Department ADA Coordinator 48 hours in advance of the meeting at 407/263-3780 (VOICE/TOO). ~ CITY OF ALTAMONTE SPRINGS /s/ Barbara Kiser Purchasing Agent Publish two (2) times -------------------- January 24 & 28, 1996 LA - 1 CITY OF AL T AMONTE SPRINGS 225 NEWBURYPORT AVENUE ALTAMONTE SPRINGS. FLORIDA 32701-3697 January 24, 1996 Dear Interested Bidder: On behalf of the City of Altamonte Springs, I would like to take this opportunity to invite your firm to submit a bid for: . ******************************************************* BID NO: 19-96 MEDICAL TRANSPORT BILLING AND COLLECTION SERVICES ******************************************************** Enclosed are the Invitation to Bid (ITB) documents for your review and consideration. To ensure that your bid is not inadvertently opened before proper time, please utilize the attached blue Bid Return Envelope. In the absence of the envelope, please indicate on the lower left hand corner of your envelope: Bid Number..... 19-96 Due............ 11:00 a.m. Monday 02/12/96 It is a pleasure to be able to send you this bid for your consideration and hope that you can offer the city a bid. Sincerely, .~~~ Barbara Kiser, PPB Purchasing Agent LTR - 1 i.;:;'\" .:..::::'.::<::::....:yBli5i3iNG .i&sij/RUell?liIN:S~'::::::.';; .. ......;;;...;..;:;:; ,:.;.:..:...:.... ;:i:;...i.:::..:.::.:.....:..i:ii:!.:.:i::j::ii;EiM1~-:Af{!)A..{4fJNttl:lL{(2;W:~.:..;...:::..:..;;::I:I!:II:i:llil:::11/::1 Iii I il::lllllilllllll::IIIIIIIIIIIIIIIII.:l1jll !II .III!:IIII MEDICAL'TKiNs~J~;i~fd~~~~Z[~3fl~~!I"~i~i;!1 1 SUBMISSION OF BIDS 1.1 Bids and modifications thereof shall be enclosed in a sealed envelope, with the Proposal Bid Form, any other required forms, and each accompanying sheet on which an entry has been made by the bidder. Sealed envelope shall be mailed or delivered to the Purchasing Division only with the name and address of the bidder, the due date and time, and the invitation number on the face of the envelope. 1.2 It is the bidders responsibility to assure that the bid is properly addressed or delivered to the purchasing Division Only. 1.2.1 Mail To: Purchasing Division CITY OF ALTAMONTE SPRINGS 225 Newburyport Avenue Altamonte Springs FL 32701-3697 1.2.2 Hand Delivery To: Purchasing Division City Hall Building, Room 128 Municipal Complex CITY OF ALTAMONTE SPRINGS 225 Newburyport Avenue 'Altamonte Springs FL 32701-3697 It is the bidders sole responsibility to allow for any delays including, but not limited to: post office delays (such as heavy mail due to holidays), weather, traffic, parking, and locating the Purchasing Division. 1.3 For purposes of this bid, the official local time that bids are due shall be the time as recorded on the clock in the Purchasing Division. Bids must be received before the official local due date and time. 1. 4 Bids will be received and officially recorded as received in the Purchasing Division ONLY. BITC - 1 1.5 To ease and facilitate handling, the attached Return Envelope has been provided for your use. this Bid Return Envelope will insure identification and handlinqof your Bid. blue Bid Usage of proper 1.6 Bids received after the due date and time shall be disqualified as late bids and will not be recorded as a responding bidder. Bids" received after the bid opening will be returned to the bidder unopened. 1.7 Telegraphic bids will not be considered. 1. 8 The bidder represents that the article (s) to be furnished under this Invitation to Bid is (are) new and unused , unless specifically so stated, and that the quality has not deteriorated so as to impair its usefulness. 1.9 The Proposal Bid Form is a mandatory form to ease bid tabulation and analysis; however, it can be accompanied by additional supportive forms. An officer or representative who has official authorization to sign bids MUST sign the Proposal Bid Form. An unsigned bid is not a valid offer (one of the essential elements of a binding contract) therefore, failure to sign in the space provided on the Proposal Bid Form will result in the bid being considered non-responsive and the bid rejected. It is not a minor technicality which the City can reserve the right to waive. 1.10 Do not return the entire bid package. Only the Proposal Bid Form, any other required forms, and each accompanying sheet on which an entry has been made by the bidder need be returned in the sealed envelope. 1.11 To facilitate the evaluation process, the bid submittal should include one complete original bid submittal set (including Proposal Bid Form and all other information submitted with the bid) plus one (1) complete duplicate. 2 "NO BIDS" 2.1 In the event you elect not to bid, respond by returning the "No Bid" Response Form. 2.2 "No Bids" must be returned by the advertised bid due date and time (see Paragraph 1.3 above) to be qualified as a responding bidder. "No Bids" received after the bid due date and time will be returned to the bidder unopened. 2.3 "No Bids" must be submitted, enclosed in a sealed envelope, with the name and address of the bidder, the BITC - 2 due date and time, the invitation number, and "No Bid" marked on the face of the envelope. To ease and facilitate handling, the attached blue Bid Return Envelope has been provid~d.'for your use. Usage of this envelope and indicating "No Bid" on the envelope will ensure proper identification of your "No Bid". 2.4 Only the "No Bid" Response Form needs to be returned in the sealed envelope. 3 PREPARATION OF BIDS 3.1 Bidders are expected to examine this bid form, attached drawings, specifications, if any, and all instructions. Failure to do so will be at the bidder's risk. 3.2 All prices and notations must be in ink or type written. No erasure permitted. Mistakes may be crossed out and corrections typed adj acent and must be initialed and dated in ink by person signing quotation. All quotations must be signed with the firm name and by a responsible officer or employee. Obligations assumed by such signature must be fulfilled. 3.3 Each bidder shall furnish the information required on the Proposal Bid Form and each accompanying sheet thereof on which he makes an entry. Bids submitted on any other format shall be disqualified. 3.4 Unit price for each unit bid shall be shown and such price shall include packing, unless otherwise specified. A total shall be entered in the amount column for each item bid. In case of discrepancy between a unit price and extended price, the unit prices will be presumed to be correct. 4 EXCEPTIONS TAKEN TO SPECIFICATIONS 4.1 In the event you elect to bid, but must take exceptions to the bid specifications, the bidder shall be required to make a notation by the particular specification he can not meet the minimum requirement. 4.2 Notation shall be in the form of marking through the particular specification taking exception to and indicated the true specification of the item either on the same page the specification is listed or on company letterhead. ~ 4.3 Only those pages that the bidder is taking exception to the specifications need be returned with the Bid Proposal Form. BITC - 3 5 WITHDRAWAL OR CORRECTION OF BIDS 5.1 Prior to bid due date and time a bid may be withdrawn or corrected only upon proper identification being presented by the person who has signed the bid. Proper identification shall be in the form of a drivers license with a picture on it and a business card that is the same as the person and company submitting a bid. 5.2 After the bid due date and time, a bidder cannot withdraw or correct a bid. 6 CONTRACT PERSON CONCERNING INQUIRIES OF THIS BID 6.1 Inquiries concerning this bid, whether technical or general in nature, must be addressed in writing on company letterhead to: Barbara Kiser, Purchasing Agent City of Altamonte Springs 225 Newburyport Avenue Altamonte Springs, FL 32701 Fax Phone #: 407/830-4421 6.2 These inquires must be received in the Purchasing Division seven (7) working days prior to the bid due date and time, in order to provide adequate response time to queries and issue an addendum, if necessary. 6.3 Questions concerning the technical specifications shall be forwarded by this office to the appropriate requesting department/division. Bidders are not to contact the requesting department/division directly unless explicitly authorized by this office. 7 ADDENDUM 7.1 All interpretations and supplemental instructions will be in the form of written addenda to the bid documents which, if issued, will be mailed to all prospective bidders (at their respective addresses furnished for such purposes) not later than five (5) calendar days or faxed no later than twenty-four (24) hours prior to the due date and time. 7.2 It is the bidders responsibility to assure that he has received any and all addendum. The bidder should call, prior to submission of the bid AND twenty-four (24) hours prior to the bid due date, the Bid/Proposal Information Line (select Mailbox #5) to that all addendum has been received. BITC - 4 7.3 In case any bidder fails to acknowledge receipts of any such addendum in the space provided on the Proposal Bid Form, his bid will nevertheless be construed as though the addendum has been received and acknowledged, and the submission of the bid will constitute acknowledgement of the receipt of the addendum. 7.4 Only the interpretation or correction given by the Purchasing Agent or authorized representative, in writing, shall be binding, and prospective bidders are warned that no other source is authorized to give information concerning, or explaining or interpreting, the contract documents. 8 BID OPENING 8.1 Immediately following the bid due date and time, a pUblic bid opening will take place. At the bid opening, when ever possible, at a minimum, the total base bid amount (as tabulated by each bidder) of each bid will read aloud. Other information, such as group bid amounts, alternate bid amounts, additive bid amounts, delivery dates, acknowledgement of receipt of required accompanying supporting bid documents, may be announced at the bid opening. (Note: Bid amounts announced at the bid opening are sUbject to change due to math err~rs made by bidders - see paragraph 3.4 of this section). 8.2 Since the published bid opening place is subj ect to change, it is recommended that bidders either call Purchasing or stop by the Purchasing Division prior to the bid due date and time. 8.3 Persons are advised that, if they decide to appeal any decision made concerning the award of this bid, they will need a record of the proceeding, and for such purpose, they may need to ensure that a verbatim record of the proceedings is made, which record includes the testimony and evidence upon which the appeal is to be made. Persons with disabilities needing assistance to participate in any of these proceedings should contact the City Clerk Department ADA Coordinator 48 hours in advance of the meeting at 407/263-3780 (VOICE/TDD). 9 BID RESULTS/TABULATION Due to limited staff, time, work load and budget restraints, city staff will not give bid results over the phone. The bid results ~ay be obtained by any of the following methods. 9.1 Public Bid Ooeninq BITC - 5 Bidders are encouraged to attend the public bid opening to obtain instantaneous bid amounts/tabulation. (Note: Bid amounts announced are subject to change due to math errors made by bidders -see paragraph 3.4 of this section) . 9.2 Bid/Proposal Information Line (407/830-3878) The next working day after the bid due date and time, bidders and any other interested party may obtain the bid results by calling the City's Bid/Proposal Information line (Phone Number: 407/830-3878, Select Mailbox #7). The information provided on the recorded message will be limited to the three (3) apparent lowest bidders only and will be available for five (5) business days following the bid due date. (Note: Bid amounts announced are subject to change due to math errors made by bidders - see paragraph 3.4 of this section). 9.3 Postinq In city Hall Lobby Upon verification of accuracy of calculated bid amounts as submitted by bidders by city staff, a typed Bid Tabulation will be printed and posted in the City Hall Lobby. Any requests, by any party that did not submit a bid, for copies will be charged at the current copy cost fee plus mailing cost (if requested) . 9.4 Mail Upon verification of accuracy of calculated bid amounts as submitted by bidders by City staff, a typed Bid Tabulation will be printed. The Bid Tabulation will be mailed, at no charge, to all bidders submitting a bid. All other interested parties may request copies of the Bid Tabulation by written request. The written request must include the bid number, self addressed stamped envelope, and a check for any copy fees as charged by the City. 10 USE OF TRADE NAMES 10.1 Specifications used are intended to be open and non- restrictive. Any reference to brand name shall not be construed as restricting to that manufacturer, but used as minimum standard of quality. When no reference or change is made on the Proposal Bid Form by the bidder, it is understood that the specific brand named in the bid shall be furnished by the bidder, If bidding on other - than the make, model, brand or number as shown and ~ offered as an equal, complete technical information, specif ications, manufacturer's name and catalog reference BITe - 6 must be clearly stated on the Proposal Bid Form or attached letter. Any deviation between brand offered and brand specified must also be clearly indicated. 10.2 certain items shall be excluded from the above paragraph. The City has found it effective to standardize on certain items. Approval has been granted by the City Commission to standardize on specific items. Proper notation shall be indicated in the bid for any such items. 11 DELIVERY 11.1 Time of delivery is of the essence in the performance of the contract, and failure to perform in accordance with the delivery deadline(s) set forth in the specifications or any other contract document shall constitute default under paragraph 13. Unless a written extension is obtained from the City prior to the delivery deadline(s), there shall be no excuse for untimely performance. The granting and duration of extensions shall be subject to the exclusive discretion of the city. 12 RESERVED RIGHTS OF THE CITY 12.1 The City may accept any item or group of items or any bid, unless the bidder qualifies his bid by specific limitations. 12.2 The right is reserved to reject any or all bids. 12.3 The right is reserved to waive technicalities. 13 TAXES The City is exempt from state and local sales tax~ The City ,of Altamonte Springs, Florida has the following tax exempt certificates assigned: 13.1 certificate of Registry No. 59-6000263 for tax free transactions under Chapter 32, Internal Revenue Codes. 13.2 Florida Sales & Use Tax Exemption certificate No. 69-01- 034044-54C (expires 06/17/97). 14 DEFAULT As a result of bids received under this Invitation, the award of the contract may be based, in whole or in part, on delivery and specification factors. Accordingly, should the bidder not meet the d~livery deadline(s) set forth in~the specifications or should the bidder fail to perform 'any of the other provisions of the specifications and/or other contract BITe - 7 documents, the City may declare the bidder in default and terminate the whole or any part of the contract. Upon declaring the bidder in default and terminating the contract in whole or in part, the city may procure and/or cause to be delivered the equipment, supplies, or materials specified, or any substitutions therefor, and the bidder shall be liable to the City for any excess costs, including but not limited to any reasonable attorney fees should any element of default be litigated in court or disputed in such a manner that requires the services of an attorney, resulting therefrom. Where the bidder fails to comply with any of the specifications, except for delivery deadline(s), the city may, in its discretion, provide the bidder with written notification of its intention to terminate for default unless prescribed deficiencies are corrected with a specific period of time. Such notification shall not constitute a waiver of any of the City's rights and remedies hereunder. 15 PATENT INDEMNITY Except as otherwise provided, the successful bidder agrees to indemnify the City and its officers, agents and employees against liability, including costs and. expenses for infringement upon letters patent of the united states arising out of the performance of this contract or out of the use or disposal by or for the account of the City of. supplies furnished or construction work performed hereunder. 16 DISCOUNTS 16.1 Trade and time payments discounts will be considered in arriving at new prices and in making awards, except that discounts for payments within less. than 30 days will not be considered in evaluation of bids. However, offered discounts will be taken less than 30 days if payment is made within discount period. 16.2 In connection with any discount offered, time will be computed from date of delivery and acceptance at destination, or from the date correct invoice is received by the Requesting Department, whichever is later. Payment is deemed to be made, for the purpose of earning the discount, on the date City check is issued. 17 CERTIFICATE OF INDEPENDENT PRICE DETERMINATION By submission of this bid, the bidder certifies, and in the case of a joint bid each party thereto certifies as its own organization, that in connection with this procurement: 17.1 The prices independently, in this bid" have without competition, been arrived at as to any matter BITC - 8 relating to such prices with any other bidder or with any competitor. 17.2 Unless otherwise required by law, the prices which have been quoted in this bid have not been knowingly disclosed by the bidder and will not knowingly be disclosed by the bidder prior to opening, directly or indirectly to any other bidder or to any competitor and 17.3 No attempt has been made or will be made by the bidder to induce any other person or firm to submit or not submit a bid for the purpose of restricting competition. 17.4 Bidder warrants the prices set forth herein do not exceed the prices charged by the bidder under a contract with the state of Florida Purchasing Division. 17.5 Bidder agrees that supplies/ services furnished under this quotation, if awarded, shall be covered by the most favorable warranties, the bidder gives to any customer for such supplies/services and that rights and remedies provided herein are in addition to and not limit any rights offered to the City by any other provision of the bid award. 18 AWARD OF BID 18.1 Once the city has completed it's evaluation and a recommendation has been made, the Purchasing Division shall attempt to notify, in writing, all bidders who submitted a bid of the City's recommendation for award prior to the City Commission meeting in which the recommendation is scheduled to be considered. 18.2 However due to time constraints and the mail service, bidder may not receive this Intent To Award Recommendation until after the City commission meeting has taken place, therefore it shall be the responsibility of the bidder to call the Bid/Proposal Information line (407/830-3878, Select Mailbox #8) to receive Intent To Award Recommendation status. 18.3 If you have and questions regarding the City's evaluation and Intent To Award Recommendation, they must be received in writing in the Purchasing Agent's Office by 4:30 p.m. of the business day prior to the City commission meeting. Questions or concerns not submitted in writing to the Purchasing Agent will not be considered at the Commission meeting. 18.4 The bid, if awarded, will be awarded to that responsible bidder whose bid will be most advantageous to the City, BITC - 9 price, compliance with specifications/bidders ability to perform, prior performance (if any) with the City, warranty offered, delivery or time of completion, bidder's financial capability and other factors considered. 19 SAMPLES Samples of items, when required, must be furnished free of expense to the City and if not called for within thirty (30) days from date of notification to retrieve, same will be disposed of to the best interest of the City. 20 PUBLIC ENTITY CRIME STATEMENT In accordance with paragraph (2) (a) of Section 287.133, Florida Statutes, "A person or affiliate who has been placed on the convicted vendor list following a conviction for a public entity crime may not submit a bid on a contract to provide any goods or services to a public entity, may not submit a bid on a contract with a public entity for the construction or repair of a public building or public work, may not submit bids on leases of real property to a public entity, may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant under a contract with any public entity, and may not transact business with any public entity in excess of the threshold amount provided in Section 287.017, for CATEGORY TWO for a period of 36 months from the date of being placed on the convicted vendor list." 21 DRUG-FREE WORKPLACE PROGRAM PREFERENCE 21.1 In Accordance with Section 287.087, Florida Statutes, preference shall be given to businesses with drug-free workplace programs. Whenever two or more bids which are equal with respect to price, quality, and service are received by the State or by any political subdivision for the procurement of commodities or contractual services, a bid received from a business that certifies that it has implemented a drug-free workplace program shall be given preference in the award process. 21.2 Established procedures for processing tie bids will be followed if none of the tied vendors have a drug-free workplace program. 21.3 In order to have a drug-free workplace program, a business shall comply with the requirements as established in the statute. If your business complies with these requirements and would like to be given preference, in case of a tie bid/proposal, then the vendors will be asked to complete a "Drug-Free Workplace BITC - 10 Program certification Form". Bidder is not required to complete the form at this time. 22 OBSERVE ABOVE INSTRUCTIONS Failure to observe any of the above instructions and conditions may constitute grounds for rejection of your bid. 23 GENERAL AND TECHNICAL SPECIFICATIONS Priority shall be given to the requirements in the Technical Specifications section then to the General Specifications of the bid. Technical Specifications over ride the General Specifications and the General Specifications shall over ride the Bidding Instructions, Terms, and Conditions. 24 TIME EXTENSION OF BID In addition, Board of City Commissioners, Altamonte Springs, Florida, reserves the option to extend the time period of the bid, including all terms and conditions of the bid documents. Such time extension shall be by mutual agreement in writing. BITC - 11 .. ... '.. ......... ........, ." . .......... -."...... ..,......'..,...,..........'.' '.....'. ,',.....,...... ...............-..,..........'..,..',............. ,i;l:..;i..:..!.i:.j.!!.;i:I';!:i:GENiJfKJfijl..isRECliJjlfg]fITI61~i:!..:.::I!.i:.:I..I!i!I:.:iiii!.!.i:I.I:I:i::::i!:!!i.!!!:.I!:!.I!:!.!i'lil.!i:i::!i'i::::!!!.:.i::i.! ......... '. '.' ','. .. . .' ....:::..~:: ;,':-:::::::;":;.;:::::::::::;::;.:.: :...,.:.;.' ":':., :.;. ';',':'Y',,;,:,:::::: ::;'::'.: ::.:::::>. :.;:;.:::'..:.:,;::;;:;.::;:::;:::::::;.-:::;.. ;':-:';.::::::::::::::::.;::::. :..':~::::: :;.:: :-::;::::,:=::::::::;.::; . ':;::::::::::::::::::::::::::;:;:;:; '-:';'::;:':'.': :.:.:::::....... ",,::::::\{::::::::- '.'.' .... . .. .. .::.:'.. .... .. .:..;... '. ....::... :.:......;F..{)~:::::.: . .-:::..:.....::..::<.:. .......::...:.:;..:....".<:.. ::;;::;::::;:;;:::::::;;::.:::: ......... .. .. .... ..... ....1JID'N(Y:1996..::...<:. .....:::.,:. ...... .......... ................... ..1,;MEJJ[ ciEkTiiANspo;H;,~ii;i~NG'!xNrid~'1il~TiaQ;;~E!f~~$ii!j';; 1 SCOPE The City of Altamonte Springs require the purchase of billing and collection of fire rescue medical transport fees. 2 EFFECTIVENESS AND DURATION 2.1 The agreement(s) resulting from this solicitation shall be a term contract for the period specified herein. 2.2 The period of agreement shall be for a period of one (1) year from effective date and may be ~xtended for four (4) additional twelve month periods provided the bidder will maintain the same prices, etc., as in the initial one (1) year contract. Continuation of the contract beyond the initial period is a City prerogative not a right of the bidder. This prerogative may be exercised only when such continuation is clearly in the best interest of the City. 2.3 Either party may cancel this agreement, in whole or in part, by giving at least 45 days prior notice in writing. However, the contractor shall not be authorized to exercise this cancellation option during the first 90 days of the agreement. 3 BID PRICE 3.1 The prices offered in this bid shall remain firm during the period of the agreement. 3.2 Unless, otherwise stated, the prices shall include all costs. Price shall be all inclusive with no additional hidden costs. 3.3 The successful bidder(s) may, at their option, convey their prices, terms, and conditions to other governmental agencies within the State of Florida. 4 AVAILABILITY OF FUNDS The contractual obligations of the City under this agreement is contingent upon the availability of appropriate funds. 5 QUANTITY ESTIMATES GS - 1 All quanti ties, if shown in the Proposal Bid Form" are approximate and no guarantee is made that any materials will be purchased. The City reserves the right to purchase any, all, or none of it's requirement~ from bidder(s) awarded the bid. 6 COMPLIANCE TO LAWS, GUIDELINES, REGULATIONS, ETC. The successful bidder must comply with all applicable federal, state and local laws guidelines, regulations, etc. This includes, but is not necessarily limited to, DOT, OSHA, EPA, and DEP. 7 ORDERING OF SUPPLIES/SERVICES Orders for items/services listed in this bid will be accomplished by an executed signed purchase order from the Purchasing Division, only. Departments/divisions are not authorized to commit the city to orders. 8 DELIVERY All materials/services requested in these specifications shall be delivered FOB destination. The merchandise/services shall be delivered to: not applicable 9 INS 'l'ALLA'l' I O!l 9.1 It ohall be the reopon8ibility of the 8ucceooful bidder(8) to in8tall the ffiuteriulo in the city de8ignated otoruge urea locuted ut the delivery uddre88 8tuted ubove. 9.2 The oucceo8ful bidder(o) ohall u80ume ull reoponoibilitie8 from the point of origin through the tranofer off the delivery trualc into the inotullution of the city'o 8torage location. 10 INVOICING AND PAYMENT 10.1 No payment will be made for materials ordered or services performed without proper purchase order authorization. 10.2 Payment will be accomplished by submission of invoice, in duplicate, with Purchase Order number referenced thereon. Invoices are to be mailed to the attention of the "Requisition BY" department/ division indicated on the Purchase Order. GS - 2 10.3 Payment terms are net 30 days upon delivery and acceptance. 11 MATERIAL SAFETY DATA SHEETS Successful bidders shall be required to submit Material Safety Data Sheets (MSDS) ,in two sets with this bid, and with each order delivered if the material ordered falls under the Right- To-Know Act. 12 REFERENCES 12.1 Bidders shall complete and return, with the Proposal Bid Form, 'a list of at least five (5) client/customer references including company name, contact person, and telephone number. 12.2 The List of References form provided in these bid documents should be used. 12.3 If the bidder already has a pre-printed list of references, then indicate on the City's List of References Form "See Attached List". Attach the pre- printed list to the City's form and submit both with the Proposal Bid Form. 13 CERTIFICATE OF INSURANCE See Insurance Requirements Specifications Section 14 TENTATIVE AWARD DATE The bids submitted will be evaluated after the bid opening and the award recommendation is tentatively scheduled for consideration by the City Commission on February 20, 1996. GS - 3 :i\". ..... '.:::' '.' . ,.:::....:::::. ":"':.: : ,,:"'" .:.:.,:.,:. " ::."':" "',;HH':::::;;"::i\{::,,:....:.::.,.::.:' ))",.:::. . ,,'," INSUHA:NGE'.RE~l.JIREl\1ENrrS'HSBE@mI<3~mI(i)~S"""" '~w~~', ,\!';;i'..'.0;\il;;:6'?i';:.rfi!;~;;lf~~,~;il:~;,~~j;.(~!!'!j!~!!!!! H'H H'H , , :::::,::,::-::::::::::.::!-l.ID.",N O,.".,.I~::,: ~6.:.-:.:,:,:,.. " HH' ':. H'HH' H'H' HH'::::::;:::::::::::::::':::::':::;:':" HH' H_ 1 Any exceptions to the insurance requirements and limits set below must be notated as instructed in Paragraph 3 of the Bidding Instructions Terms and Conditions. ' 2 All policies are to be endorsed to include the City of Altamonte Springs as Additional Insured. In the cancellation clause of the Certificate of Insurance the words "ENDEAVOR '1'0" and "BUT FAILURE '1'0 MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVE" shall be excluded and the number "30" inserted in the blank space provided before the words "days prior notice...". All policies are to be considered primary to City coverages and shall not contain co-insurance provisions. 3 The successful bidder will be required to provide within ten (10) days after Notice of Award, to the Purchasing Agent, a Certificate of Insurance demonstrating that the successful bidder is carrying sufficient insurance at the established limits below. 4 Certificate of Insurance shall be reviewed, for determination of adequate coverage, by the City's Risk Manager. S Item/Service will not be ordered until certificate has been received and approve by the Risk Manager. 6 Insurance Requirements for this bid is as follows: Yes Yes Yes Yes x No -L No No _-L No -L No -L No -L No -L No Worker's Compensation Limit$Statutorv Comprehensive General Liability Limit $ Comprehensive Auto Liability Limit $ Builder's Risk (all risk for Limit $ construction cost of the project) Owners & Contractors Protective Limit $ Professional Liability Limit $ Excess Liability Limit $ .Other:Bond in the amount of the estimated total billinq Yes Yes Yes Yes x (NOTE: All limits are per occurrence and must include Bodily Injury and Property Damage) IS - 1 . .~: ........... ....... '. .' ... ..' .... " .'.SPEfJIADC3.0NDITIONS". .... .... ...,1:;:""**,,. .....,... . EOR, ...,. ... ..... ... .. 'iiiB72rfJi'rJtA'>>spfjii~/lfLi~1il!lh}Jco~E~T:to~'rS..J!l(g~$ilI 1 PURPOSE: TO ESTABLISH A CONTRACT FOR THE CITY The purpose of this Invitation To Bid is to establish a contract for the purchase of Billing & Collecting of Fire Rescue Medical Transport Fees in conjunction with the City's needs on an as needed when needed basis. 2 TERM OF CONTRACT: TWELVE MONTHS This contract shall commence on the first calendar day of the month succeeding approval of the contract by the City Commissioners, unless otherwise stipulated in the Notice of Award Letter which is distributed by the City's Procurement Division; and contingent upon the completion and submittal of all required bid documents. The contract shall remain in effect for twelve (12) months and upon completion of the expressed and/or implied warranty period. 3 OPTION TO RENEW (4) FOUR YEARS (MAINTAIN SAME PRICES) The prices quoted shall prevail for a one year period from effective date, at which time City of Altamonte Springs shall have the option to renew for an additional four (4) years on a year to year basis provided the bidder will maintain the same prices, etc., as in the current one year contract. Continuation of the contract beyond the initial period is a City prerogative not a right of the bidder. This prerogative may be exercised only when such continuation is clearly in the best interest of the city. NOTE: SHOULD THE CITY EXERCISE THE OPTION TO RENEW, IT SHALL BE ONLY FOR THOSE ITEMS ORIGINALLY AWARDED. 4 PRICES SHALL BE FIXED AND FIRM FOR TERM OF CONTRACT If the bidder is awarded a contract under this bid solicitation, the prices proposed by the bidder shall remain fixed and firm during the term of contract; provided, however, that the bidder may offer incentive discounts from this fixed price to the City at any time during the contractual term~ 5 METHOD OF PAYMENT: MONTHLY INVOICES SC - 1 The successful bidder(s) shall submit monthly invoices by the tenth (lOth) calendar day of each month. These invoices shall be submitted to the City requesting department (s) indicated on the official purchase order issued by the Procurement Division. The invoices shall reflect the appropriate purchase order number, the service location(s) and the type of service provided to the City in the prior month. The successful Bidder must submit the format and text of all billing invoices for City approval. This includes the initial invoice and all subsequent reminder invoices. 6 CONTACT PERSONS For any additional information regarding the specifications and requirements of this contract, Contact: Procurement Division Manager, Barbara Kiser at 407/830-3886. 7 ESTIMATED QUANTITIES Estimates quantities or estimated dollars are provided for bidder's guidance only. No guarantee is expressed or implied as to quantities or dollars that will be used during the contract period. The City is not obligated to place an order for any given amount subsequent to the award of this bid. Estimates are based upon the City's actual previous needs and usage. Said estimates may be used by the City for purposes of determining the low bidder meeting specifications. The estimated annual quantity of billable transports during the initial twelve (12) month contract period and each of the four (4) one year renewal periods are provided for the Bidder's guidance only. No guarantee is expressed or implied as to quantities that will be used during the contract period(s) . 8 OMISSION FROM THE SPECIFICATIONS The apparent silence of this specification and any addendum regarding any details or the omission from the specification of a detailed description concerning any point shall be regarded as meaning that only the best commercial practices are to prevail, and that only materials and workmanship of first quality are to be used. All interpretations of this specification shall be made upon the basis of this agreement. SC - 2 .... .........'..... ...... .-'.. ...... .... .. .... ... ..... ......... , -. ... .. ....... \:::::.,j:j:TIicHNICAL.:SRECIFICATI@NS.:.'....,:..'j:..::"''':'''.'';::::;:::;''';::..:~:..'.'::,:: . . . . . ~. . ..:fll!l:.~:' "';. .. .... ......:;,:;:;",. .... .... . .:. BID "i\.TO.:"l: 9' :96.... ..... .. ..... ....... '".', .', ..,;:'J.Y.I ....... . ~ ;.:.::...... ":": .....;...;.. '.......... .. 'MEDICAB:.:::i:RANsPOR'1:Biiii&iJi,!A.NDj(COLLECJiiEl&'.$ER:lrieEB..;.::j; ...... . ..,' ...:..-......... ",'" .... .....; ...... :.;.::. .;....:.:...:...:.;.;...;.:-:.:..............,.;.:.....:..'"';':';':':'>:';';'.. 1 ALTAMONTE SPRINGS FIRE RESCUE'S TRANSPORT BUSINESS: Altamonte Springs Fire Rescue ("Fire") transports individuals from incident scenes to health care facilities in its emergency medical transport vehicles. Transported individuals are charged a transport fee, a mileage fee and an oxygen administration fee. 2 METHOD OF COLLECTING BILLING INFORMATION: To facilitate billing, Fire's emergency medical services personnel attempt to obtain all pertinent information from the transported individuals and record it on the Altamonte Springs Fire/Rescue Abbreviated EMS Report (see Attachment A). An identical or similar report form will be utilized in the future. The successful Bidder will be given a copy for each transport covered by this contract. At this time, it is not practical to download the information from the City's computers. However, this procedure may be feasible in the future. 3 BIDDER'S USE OF BILLING INFORMATION: The successful Bidder will use the collected billing information as the basis for: 3.1 Billing the transported individual, Medicare, Medicaid, insurance companies or other appropriate third party payors for services provided. 3.2 Preparing the required management and financial reports including information on delinquent accounts. 4 SERVICES TO BE PROVIDED BY SUCCESSFUL BIDDERS: 4.1 Mail in invoice to each transported individual at the current prevailing rate for transportation services. 4.2 File all insurance claim forms for all patients based upon information received from the patient or obtained from the Bidder research done at health care facilities. TS - 1 Mail (Fire provided) copies of incident reports to Medicare, Medicaid, insurance companies or third party payors, when requested, to ~btain payment. Mail copies of invoices to patients, Medicare, Medicaid, insurance companies or other third party payors, when requested. 4.5 Mail a series of fOllow-up invoices to patients, as necessary. 4.6 Re-file Medicare, Medicaid or insurance claims, as necessary to obtain payment. 4.7 Record customer payments from lock box collections. 4.8 Prepare monthly management/financial reports. 4.9 Negotiate and agree upon modified payout schedules for those individuals unable to remit the full amount when initially billed. 4.10 When a billed account has become past due (defined as: an account older than the date of transport plus seven (7) months that has a balance larger than zero), return the account to the City by providing the City with a. listing and/or computer file of these past due accounts including all pertinent facts regarding attempted collection effort. However, the City, at its option, may leave selected accounts with the successful Bidder for a longer period of time. 4.11 Any other services as agreed to be the parties, in order to effectively collect transport fees. 5 REQUIRED USE OF ELECTRONIC FILING The successful Bidder must be currently filing Medicare and Medicaid Claims electronically and must transmit Medicare claims via the required National Standard Format (NFS). 6 REQUIRED BILLING RESEARCH AT HOSPITALS Based upon past history, those billing and collection firms with the highest collection rates have send their personnel to hospitals, as necessary, to obtain billing/insurance information. Therefore, the successful Bidder will be required to either: 6.1 Send their personnel to hospitals or TS - 2 6.2 Have the ability to electronically access a hospital's database. to obtain all available information to collect an account on behalf of the city. 7 BIDDER'S REQUIRED NUMBER OF FULL-TIME EMPLOYEES city of Altamonte Springs Fire Rescue currently transports about 1,500 patients annually. This number should continue to increase'in the future. The successful Bidder is required to have an adequate number of employees necessary to perform activities related to the billing and collection of medical bills. 8 BIDDER'S REQUIRED NUMBER OF YEARS IN BUSINESS - To ensure that the successful Bidder has proven record of service and experience, the successful Bidder's company is required (a) to have been operating as the same business entity for a minimum of five (5) years and (b) been successful in the business of billing and collecting fees for medical related services actively and continuously for a minimum of five (5) years. 9 BIDDER'S REQUIRED EXPERIENCE WITH BILLING QUANTITIES Based upon Fire's current volume, the successful Bidder is required to be currently billing and collecting a minimum of 1,500 original medical related accounts per year for all its medical related accounts. 10 BIDDER'S REQUIRED MINIMUM PERCENT OF COLLECTION Each Bidder is required to provide documentation, with the Proposal Bid Form, that they currently collect a minimum of sixty percent (60%) on original billed medical related accounts. ' 11 SUCCESSFUL BIDDER'S REQUIRED COLLECTION RATES The successful Bidder must not only have a historical collection rate of at least sixty percent (60%) on original billed medical related accounts as previously described in paragraph 10 above, but will also be required to maintain minimum levels of collection rates within certain time periods. Specifically, after billing for nine (9) consecutive months and at all times thereafter, the successful Bidder must have the following levels of collection rates as described below, assuming that the initial billing month is month number one: TS - 3 11.1 As of the last day of month number two, an average of three percent (3%) or more of all dollars billed in month number one must have been collected. 11.2 As of the last day of month number three, an average of twenty-five percent (25%) or more of all dollars billed in month number one must have been collected. 11.3 As of the last day of month number four, an average of forty percent (40%) or more of all dollars billed in month number one must have been collected. 11.4 As of the last day of month number five, an average of fifty percent (50%) or more of all dollars billed in month number one must have been collected. 11.5 As of the last day of month number six, an average of fifty-five percent (55%) or more of all dollars billed in month number one must have been collected. 11.6 As of the last day of month number seven, an average of sixty percent (60%) or more of all dollars billed in month number one must have been collected. If the successful Bidder fails to maintain the levels above, they will be given three (3) months to reach the required levels. If unsuccessful, the City may cancel the contract, as its option, with sixty days (60) notice to the successful Bidder. 12 BIDDER'S ORGANIZATION Each bidder must submit with the Proposal Bid Form: 12.1 A description of their firm's organizational history and structure and indicate if contracts were previously awarded by the city. 12.2 A list of all principals, owners or directors. 12.3 The name and resume of the principal contact person for this Bid and contract. 12.4 A summary listing of all full-time employees classified by occupational titles and quanti ties. For example, Vice-Presidents - 1, Accountants - 2, Computer Operators - 2, Data Entry Clerks - 12. 13 BIDDER HISTORY OF PROVIDING SERVICES Each Bidder must submit with the Proposal Bid Form: TS - 4 13.1 A description of their firm's chronological history of providing billing and collecting services. 13.2 A listing, covering the last three (3) years, of at least two (2) major clients for whom you have provided billing and collection services. Include name, address, phone number and contact person. For each client on this listing provide: 13.2.1 Quantity and dollar amount of average monthly billing. 13.3 A description of their firm's billing cycle. Indicate the number of invoices sent to each account and the number of days between each invoice. For example, first reminder notice 30 days after initial invoice or sent for collection 90 days after initial invoice. 14 BIDDERS PERCENTAGE FEE FOR SERVICES TO BE PROVIDED The Bidder's fee for services to be provided will be a percentage of dollars they collect on accounts they bill during the contract period. Each Bidder must bid a single PERCENTAGE FEE. This same fee will be used for EACH CONTRACT YEAR, that is, the initial twelve (12) month contract period and each of the four (4) one year renewal contract periods. Therefore, each Bidder should give consideration to their possible cost increases during a potential five (5) year contract period and possible increases in transport fees, since no price adjustments will be allowed during the renewal periods. For consistency, all Bidders will base their bids on the following estimates' of annual quantities of billable transports during the initial twelve (12) month contract period' and each of the four (4) one year renewal contract periods: Initial 1st Year, 1,482; first renewal year, 1,704; second renewal ye~r, 1,960; third renewal. year, 2,254; 4th renewal year 2,592. 15 STATISTICAL DATE FOR BIDDERS 15.1 The current transport fee per City Ordinance is $182.36 for all transports, with $4.75 per mile for transports to medical facilities outside the City limits. 15.2 Currently, about 32% of patients are transported Advanced Life Support (ALS) and 66% are transported Basic Life Support (BLS). TS - 5 15.3 The city does not have any historical information regarding collections by payment source (ie: self-pay, Medicaid, Medicare and from private insurance companies) . The Bidder should note that the current date is items 15.1 through 15.3 above is for informational purposes only, and the City makes no representations as to future changes in any of these items. 16 REQUIRED MANAGEMENT REPORTS The successful Bidder must provide the City with a series of reports to show management and financial information. The following list of reports is the required minimum. 16.1 Collection Statistics: Show gross billings by date of incident (transport) month and the related collections to date. Gross billings should not be reduced for returned mail, bad debts or authorized write-offs. The required format would have a minimum of four columns as follows: 16.1.1 16.1.2 16.1.3 16.1.4 Transport month. Gross billed in transport month. Total collected in transport month. Percent collected. (16.1. 2 + 16.1.3). 16.2 Insurance Report: Shows the portion of actual collections and the accounts receivable, detailed by self, Medicaid, Medicare and private insurance. 16.3 Monthly Payment Report: Lists the payments posted to the accounts receivable in lock box batch deposit order during the month. The report must show the fOllowing information, as a minimum. 16.3.1 16.3.2 16.3.3 16.3.4 16.3.5 16.3.6 Patient number. Patient name. Patient complete address. Payment amount and type. Batch total on each lock box batch #. Grand total of all monthly payments. 16.4 Monthly Collection Summary: Lists the monthly payments in 16.3 above by original transport month. The columns will be: TS - 6 16.4.1 16.4.2 Incident Month Collected this Month 16.5 Total Billinqs by Incident Month: Lists the cumulative number of gross billings for each incident (transport) month. 16.6 Accounts Receivable: Shows the amount owed by all transported patients at the end of the month. The format will be: 16.6.1 16.6.2 16.6.3 16.6.4 Gross Billings since inception. Less: Payments since inception. Less: Fire approved adjustments and write- offs since inception. Ending balance of accounts receivable. 16.7 Adiustments and Write-Offs: Lists the detail of 16.6.3 above. The report must show: 16.7.1 16.7.2 16.7.3 16.7.4 Patient number. Patient name. Adjustment or write-off amount. The cumulative total for 16.7.3. 16.8 Billinq Report: 16.8.1 16.8.2 16.8.3 16.8.4 16.8.5 16.8.6 Patient number. Patient name. Patient Address. Incident date. Amount billed. The monthly total of 16.8.5. Additionally, this report must summarize the monthly billing activity as follows: 16.8.7 16.8.8 16.8.9 16.8.10 16.8.11 Number of ALS billings and amount billed. Number of BLS billings and amount billed. Number of mileage billing and amount billed. Number of oxygen billings and amount billed. Other categories, as necessary; number of billings and amount billed. 16.9 Payment Percentaqes: Shows what percentage of patients have made a payment. Column headings should be: TS - 7 16.9.1 16.9.2 16.9.3 16.9.4 16.9.5 Transport month and year. Total patients transported in 16.9.1. Number not making-a payment. Number making a payment. Percent making a payment (16.9.4 + 16.9.2). 16.10 Refund Listinq: Lists accounts requiring a refund due to overpayment. This report must show: 16.10.1 16.10.2 16.10.3 16.10.4 16.10.5 16.10.6 16.10.7 Patient number. Patient name. Patient Address. Incident date. Amount originally billed. Total amount(s) paid on the account detailed by date, amount and related lockbox batch number. Refund amount. 16.11 Credit Balance Report: Lists all accounts having a credit balance at the end of the month. This report would show: 16.11.1 16.11. 2 16.11.3 16.11.4 16.12 Patient number. Patient name. Incident date. Credit balance amount. Number of Davs between Incident Date and Billinq Date: Lists all incidents billed during the month (as shown on the Billing Report 16.8, above) and the number of days between the incident date and the first billing date. The report would show: 16.12.1 16.12.2 16.12.3 16.12.4 16.12.5 Patient number. Patient name. Incident date. First billing date. Number of days between (16.12.3 and 16.12.4) This report would be sorted by Rescue unit number and show subtotals and averages for 16.12.5 above. 17 LOCK BOX ACCOUNT FOR PAYMENT The City will establish a Lock Box Agreement to facilitate receipt and deposit of payments on customer's accounts. The TS - 8 successful Bidder will receive copies of all payment documents necessary to post collections to customer accounts. All costs associated with the Lock Box Account will be paid for by the City. TS - 9 . , .. ..." .. . .. ,."'" ". A:TTACHMENTH'A' '.. . . :..:.::::.::. .. ... , ...... .:.:El2~.. ....:::::;.;);}::r:;;::::y::::;.:::::::;::::::::;iiJ::;::;':::}:(::::r" ...... '..::;...:;::::::\.:;' .:.......... . .. '. ::,::':'::::::'::::;::::JJ.ID.t':i.Q.~}.l!!.7g.~:::::}::::::::::::::{:}}:::){{::::::::.:::::}t::: ..:.... :.::.::MEDIOjf!!/?IR.ANSE.ORt'BILLIN.G.)A]:{1)..;;:~()tjffJ{~/Alfjl:tiJJ'~pFB:~t~~~.:.:::::.::.:. ':':"';'.';';'>.'';. .. See Attached - Altamonte Springs Fire/Rescue Abbreviated EMS Report (Copy Of Two Part NCR Form With Printing On Front And Back) A - 1 A!tamonte Springs Fire/Rescue Abbreviated EMS Report *. Run # * Date * Unit Agency 59 EKG Only D * --Incident Location Assisting Agency # * . PM/EMT (print) # * Name * Age * 0.0.8. * Address * CiW Resident Yes No * Phone # Sex M F Race Kg * Chief Complaint/Presentation lime lime Ajrway (patent/obstructed) P 0 rale P 0 rate Circulation (carotid/radial) C R rate C R rate Blood Pressure Consciousness A V P U A V P U Pupils Skin Medications Allergies * Pertinent Hx * Treatment: ALS BLS Time Dose Route Initiated By Trauma Information Time of Injury Date of Injury Mechanism Injury site/type Alert Criteria Veh Deformity Safety Devices *Medical Facility Transported To: Social Security # o Florida Hospital Altamonte o Florida Hospital Orlando o Florida Hospital Apopka o South Seminole Community Hospital o Orlando Regional Medical Center o Other Medicare # Guardian (Patient Under 16) Pvt MD ERMD Medicaid # ] * Insurance Carrier Phone # Pa11ent Siana1ure on Reverse Side Policy # * Needed for 8illina Flre/R9!lcue . White HOlcl1al . Yellow " . ,,'r;.' Patienl Authorization / hereby guaranlee paymenl for Ambulance Transport and any supplies and/or equipment used by lite City of Allamonte Springs Fire-Rescue. / understand tltat Ambulance Transportation may t:i.flI. be covered in some i;a;.:: !:y :::y Insurance, Medicare. Medical Assistance or Medicaid and / agree (0 pay for any 110llcovereiservice, procedure and/or supplies. / autltorize any Itolder of medical or otlter informatioll about me to release to tlte Social Security Administration or its intemlediaries or carriers, or any private insurance company any informalionlleededfor litis or a related medical claim. I pennil a copy of tlris authorization to be used in place of the original and requesl paymenl of medical insurance benefits to tlte party who accepts assignment. I personally guarantee paymenl of any charges nol covered by heallll care benefits. . Prilll pati~nl name: Signa lure EKG Stripes) '" i ! I : t,;. I 1 \ i ! j ! ;:, ~ l ~-_. '. ....- ."_... . ~-"" -. -..-.- , , I \. " ...-...-.--.... .... .. ; .:~. '. (Revised //96) : " .}:)n:.;;~r~: .~ . . . ....::::::;:;:;:;:;;: .:.:j::::.,,:::':j.!!:i::'.::i.:{RRvRosjfj);:!f/Bljj:-':EfJRU;'::.i'i.! ::::::;.::'::::;:;::;:;;::';.;':::::;'.::";:;.;:;::.:.'::?::;::';' . ... . . .. '. ..... ',' ...'...'............,........ ....-.......--.............. ... ..... .. ....................................,.......... ...... ... ':..':. ..:.::: .. ... ...:.' ..:::'}f:Clfi.;;i;:..'::,,:;:;:!;.:..;:C<:.. . ':.;::::(::::;.:??/::::::: .:;::;:;::::,::::::;:'. .:.":':.:..:?;~:::::::..::::........::::..::. BliJ'iJi!!~~:!:1?;96: .:.:..;:.... ..:..::<::. ..: ....:.::::;:.;::.;:,::;:::.:::.....::::..:::::::<::::::::::!: To: Purchasing Agent City Hall, Room #128 CITY OF ALTAMONTE SPRINGS 225 Newburyport Avenue Altamonte Springs, FL 32701 The undersigned hereby declares that after carefully examining the specifications for: ******************************************************* BID NO: 19-96 MEDICAL TRANSPORT BILLING AND COLLECTION SERVICES ******************************************************* am fully aware of all conditions affecting such work/items, for which bids were advertised to be returned by 11:00 a.m., Monday, February 12, 1996, does hereby submit the following bid for completion of said work/item. Total bid price for MEDICAL TRANSPORT BILLING AND COLLECTION SERVICES per specifications is as follows: The Bidder's fee for service to be provided will be a percentage of dollars collected on accounts billed during each contract period. Percentage Fixed Fees of' Collected Amount: FOR THIS BID TO BE CONSIDERED VALID IT IS MANDATORY THAT THE BID BE SIGNED IN THE SPACE PROVIDED BELOW % The Bidder hereby acknowledges receipt of the following Addenda, if any: No. No. No. Dated Dated Dated Attached, as requested in paragraph 1 Instructions, Terms and Conditions, is one submittal (including Proposal Bid Form information submitted with the bid). (check one) of the Bidding copy of the bid and all other yes no PBF - 1 , ' Attached, as required in paragraph 12 of the General Specifications , is the List of References. yes no (check one) As required in the Technical Specifications, each bidder must submit with this Proposal Bid Form the following: 1. BIDDER'S ORGANIZATION a. A description of their firm's organizational history and structure and indicate if contracts were previously awarded by the city. b. A list of all princi~~ls, owners or directors. c. The name and resume of the principal contact person for this Bid and contract. d. A summary listing of all full-time employees classified by occupational titles and quantities. For example, Vice-Presidents - l, Accountants - 2, Computer Operators - 2, Data Entry Clerks - 12. 2. BIDDER HISTORY OF PROVIDING SERVICES a. A description of their firm's chronological history of providing billing and collecting services. b. A listing, covering the last three (3) years, of at least two (2) major clients for whom you have provided billing and collection services. Include name, address, phone number and contact person. For each client on this listing provide: Quanti ty and dollar amount of average monthly billing. d. A description of their firm's billing cycle. Indicate the number of invoices sent to each account and the number of days between each invoice. For example, first reminder notice 30 days after initial invoice or sent for collection 90 days after initial invoice. The City reserves the right to accept any or all bids, to waive informalities, and to reject all or any part of any bid as they may deem to be in the best interest of the City. PBF - 2 . .. This Proposal Bid Form is a mandatory form to ease bid tabulation and analysis; however, it can be accompanied by additional supportive forms. An of~iger or representative who has official authorization to sign bids ~ST sign this Proposal Bid Form. Failure to sign in the space provided below will result in the bid being rejected. Bids not received by advertised due date and time (see Bidding Instruction Terms and Conditions Section, Paragraph 1.3) will be returned to sender unopened. Company Name Officer's Name & Title (Print) Signature of Officer/Rep Business Address City/State/Zip Mailing Address ,City/state/Zip Business Telephone Fax Telephone PBF - 3 , , ',... '.", ........~. ...... ' . .........."......... . .................. .", ....................... '" ........-... ...... . . ..................". ... .................. ,.... ................... . tiism";"0Et..i{EEERE&<3ES:':': :':':'.::':'::.::\::"?',:,:::::.:i:':r.\:::::::::::::::'::'::;':;.,':::..:.: '.:' . . "'. ,...,....:.,..:,., .,,:..:....,......,...:..F,...,.., O............R...........,:',:,:,c.:,:.~..~. - .:,,:........',..........,...:,...:,:.,..:..,:,......:..:..:.:.. . d": .... ..,.......:..,.,.::.,':,:.:.:.'":....,:.....:..,,..,.....:..::...... .: ..:.:.::.:,:.I';:;::.::.:.....:::;... . :::: :: , ..........;::::::.:.:....-;.;.:.:-:-:.;.;-:.:.....;.;.:.;:;::::::: . .. '. '.' """'::};:BID.::NQ;';~~~96T;:'::;.:::::::,,: ., ..:..:.::::.::;........,......::....:::'::(i:::::::::::;;::;:::;:;;;:m::;:;. ,. ...............,.. ................. ....... . ........ ........ ........ ",., ... .....- ,-, -.. ........-- ...... . ... ..... ....................... "::':::::;::::::'::::>:'::::;';:::;:::;';'::':... ..................... . '. .....'........................................... . .:.:....:...:.;.;.:.:.;...:.;.;.:.:.:.;.:..:-:-....... ..........:...;....::<:..::..:.:~::::::::.:.: :>'{'::?'::':'::' : As per the General Specifications Section, below is a list of at least five (5) client/customer references including company name, contact person, and. telephone number. (Note: only list those clients/customers in which a similar type of equipment/product or scope of work/service was provided) 1. Company Name: Address: Bus Phone: Contact Person: 2. Company Name: Address: Bus Phone: Contact Person: 3. Company Name: Address: Bus Phone: Contact Person: 4. Company Name: Address: Bus Phone: Contact Person: 5. Company Name: Address: Bus Phone: Contact Person: .' . 6. Company Name: Address: Bus Phone: Contact Person: RETURN THIS FORM WITH THE PROPOSAL BID FORM R - 1 ......:::;:::.j:::.:.:::::::::::i,..tfilo)::/fjl/).W.iRF}Sil.ONSE/::j(:eiRtiJu::::,,:::;"::'::::';':::-:i:::':':::j:i::j:::'::::::';::::::/:::'::"; ..::............:.:..::::'::.::':':..'.::.....:......:.:.....:.:.;.;..:.::::;+::::::.::.::;i;::.:::.j!...:..::j'::::::~.b.:::~.::.':li.i1i..':;;:.::!li:::ii;;:;I:.::1/:i'I'::!!:!:I!.:I.I::!!:':!:::;:'::!:/:I:::"::,:':!:ilI1:11:!ll:::./::!:i!:::;:..::,:j::I,,.'::'I:.:.I..::.::I.I.':.:..II.l.I..i::ll:I:I::::'::I':::;::.:::::.:'.1::': ................... ;.;.;.;.:.:.:.;,;,;.,.;.;.;.;.;.:.;.;.;.;.". . ....:.:.:..,...:..,:::.:.:.:.......... ....\iBID::i\.TO./l.. 9:91::::. .. ........................\.:.:...:.:.:.:.:.:.;.:.:.:.:.:.... :::::::::::',:,,:,:::::::.:'...:.:.:.;.:.:...,:...::::.,::.:.:.:.:.:.::;: ". :::::/::"::::::::::::::::::::::: ,.:.;.;.:.:.;.;.:-:>: :.;.:::.:::':.:::::::::.::;:; :': .'.;.;.-.: ..:::..~.!:.I...-:.:.;.~::r:....' . .... :}~..;. ... .... .. ...'........ ... ..:...:.:.:.:.:.:::.:...:.:.:.:.:.:.:..... ":':":'~I~fff~t{t~;~;:::::::::: To: Purchasing Agent City Hall, Room #128 City of Altamonte Springs 225 Newburyport Avenue Altamonte Springs, FL 32701 The undersign hereby declares that after examining the Bid Documents for: ******************************************************* BID NO: 19-96 MEDICAL TRANSPORT BILLING AND COLLECTION SERVICES ******************************************************* for which bids were advertised to be returned by 11: 00 a.m., Monday, February 12, 1996, does hereby submit a "No Bid". Our reason(s) for not bidding are as follows: We understand that this "No Bid" must be returned by the advertised due date and time (see Bidding Instruction Terms & Conditions Sections, Paragraph 1.3) in order to be recorded as a-responding bidder and that repeated failures to bid without sufficient justification shall be cause for removal from the bid list. "NO BIDS" not received by advertised time and day will be returned to sender unopened. To ease and facilitate handling, the attached blue return label has been provided. Proper marking of sealed bid envelopes will insure proper identification of your "NO BID". In the absence of this label, please indicate on the lower left hand corner of your bid envelope the bid number, the bid due date and time, and "NO BID". Company Name Officer's Name & Title (Print) Signature of Officer Address City/State/Zip Business Telephone Fax Telephone NBF - 1 ELECTRONIC CLAIMS SUBMISSION SERVICE AGREEMENT This Electronic Claims Submission Service Agreement ("Agreement") is entered into this day of , 1996, by and between Medical Compliance, Inc. ("Billing Center"), a Florida corporation, and the City of Winter Springs, Florida ("City"), a Florida municipal corporation. WITNESSETH: WHEREAS, City is desirous of retaining Billing Center to process and submit City's claims for ambulance serVices to insurance companies; and WHEREAS, Billing Center for compensation and consideration set forth in this Agreement will process, submit and collect funds owing City for ambulance services; and WHEREAS, Billing Center agrees to abide by and comply with all covenants set forth herein and with all applicable Florida law, NOW, THEREfORE, the parties do agree as follows, 1. Claims Processing Services. 1.1 Billing Center will pick up all claims information from the City of Winter Springs fire Chief or his designee on a weekly basis, unless other arrangements have been made and agreed upon by both parties. 1.2 Billing Center will electronically process and submit the City's claims to the corresponding insurance companies and provide a computer generated report verifying their receipt by the insurance companies. City shall owe compensation to Billing Center only for primary claims, and shall not be responsible or liable for additional compensation to Billing Center for secondary claims. 1.3 Billing Center shall supply the City monthly reports which shall contain Electronic Verification Reports, Patient Aging, Accounts Receivable Report, Practice Analysis Reports, Insurance Analysis Reports, Insurance documentation consisting of follow up, patient documentation on calls and collections and any and other information available concerning the claims filed during the month preceding the monthly report. 1.4 Billing Center will deposit collected funds into the City's bank account within two days of receipt of same. Billing Center shall provide City with validated deposit slips on a weekly basis. City shall provide Billing Center with pre- printed deposit slips. ATTACHMENT 2 2. Compensation 2. I City shall pay to Billing Center for the services described in section (1) herein the per claim rate of 5.5% of the collected amount. This rate shall be in effect for twelve (12) months from the date hereof with an option for extension for up to four (4) additional years. The invoices are to be billed on a monthly basis. 3. Term of Agreement 3.1 This agreement shall be for a term of one (1) year provided however that it may be terminated by the City upon the submission of a (30) days written notice to Billing Center. 3.2 The City shall have the option to extend this Agreement for up to four (4) additional years. 3.3 The City agrees to a thirty (30) day trial period during which the right to terminate this agreement shall be waived. . i I 4. Code of Ethics and Debt Collection Practices. 4.1 Billing Center maintains and operates under a "Code of Ethics" to insure the integrity and confidentiality of City and patients. A copy of this code is attached hereto and incorporated herein by reference. 4.2 Billing Center convenants agrees that it shall comply with, keep and following the guidelines, laws and regulations set forth in Chapter 559, Florida Statutes, and that it shall not violate Florida Statues 559.72 prohibiting certain practices in collecting consumer debts nor violate any other provisions of the Florida Statutes concerning consumer or commercial collection. Billing Center warrants that it is aware of and fully knowledgeable of the laws regarding collection practices set forth in Florida Statutes Chapter 559 and warrants that it shall at all times remain knowledgeable of the laws set forth therein and any amendments thereto. 4.3 The violation by Billing Center of either the Code of Ethics or ,any provision of Florida Statues Chapter 559 shall be grounds for City's immediate termination of this Agreement upon Billing Center's receipt of notice from City without the thirty (30) day waiting period. . '. . , . 5. Indemnification 5.1 The City of Winter Springs, it's officers and employees shall not be deemed to assume any liability for the acts, omissions, and negligence of Billing Center, it's officers and employees. Billing Center shall indemnify and hold the City and it's officers and employees harmless from any and all liability, claims, cause of action, costs or expenses either direct or indirect including attorneys fees incurred as a result of or arising under this Agreement or the provision of services hereunder. 6. Insurance 6.1 Billing Center shall be responsible for maintaining a general liability insurance policy covering all actions taken by Billing Center in connection with either it's duties under this agreement or it's relationship with the City of Winter Springs. The general liability policy shall have a minimum coverage of One Million Dollars ($1,000,000.00) per occurrence and One Million Dollars ($1,000,000,00) aggregate. Billing Center shall name City as an additional insured on all insurance policies obtained. Billing Center shall provide the City a Certificate of Insurance on the aforementioned policy immediately upon execution of this Agreement. . i I 7. Assignability This agreement is not assignable by either party. 8. Severablility; Florida Law If any part of this Agreement is adjudged invalid, all other parts herein shall remain valid and enforceable. Florida law shall govern this Lease Agreement. IN WITNESS WHEREOF, the parties hereto have signed by their duly authorized pfficers as of the day and year set forth above. CITY OF WINTER SPRINGS, FLORIDA MEDICAL COMPLIANCE, lNC. ~~J.tiA LfJ~ ~ I:~~ By: Attest: ::::::......~...................:::):::/5)i;)hJfl:;:ii;:1;:~::I:!ifi;:::::::;:~;tt::::::I':i!i)~:i:"i;Wj];::^:.:~iJ$)I;::::::):)::)::::1::::::::::::):)::::')'):::),:::;)::::)::):::1::::,:':::':;:::::::.:'),)'),)::,:.)::.::).:;:,:,::::::):)::)::::::):':';::,::::::......~~;;.(;;;;;;.~;;;;...:)): ::'...~~.~.~:!.~~.~!.~...;::::;,S{:!E!)!::'::~t;,:,Yl)S!t;:)::::l::~t,:::::~,;E}:::,/ll:2:~,J;;l!nJ!~:;~:tf:tt::,ttt:tttt:::t:::::ttt:::::ttt:::,:ttttttttt: 0 9 /2 6 /9 6 ::': '~~~~~~E~ .. . ................................................................................................... THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICES BELOW. COMPANIES AFFORDING COVERAGE POE AND BROWN INC 2600 LAKE ,LUCIEN #100 MAITLAND FL 32751 COMPANY A HARTFORD INS OF THE SOUTHEAST INSURED MEDICAL COMPLIANCE INC COMPANY B 1221 LEE RD STE 210 ORLANDO FL 32810 COMPANY C COMPANY D " T'~? <::";.:"'e ',.; i :';;w ;;:;..:J THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED N~M;P ABQ:lE.,.F,q!'\.-~ POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER b.OG~~WlE'lililli~ TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIB~Q. HffiEiN--j~S~LL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID dtAt""M5. w.o: l.-U co Lm TYPE OF INSURANCE POUCY NUMBER POUCY EFFECTlVE POUCY EXPIRATION UMITS DATE (MMIDDfYY) DATE (MMIDDfYY) 2/27/96 2/27/97 GENERAL AGGREGATE $ PRODUCTS. COMP/OP AGG $ 2 , 0 0 0 , 0 0 0 PERSONAL & MJV INJURY 51,000,000 EACH OCCURRENCE $1,000,000 FIRE DAMAGE (Anyone fire) $ 300,000 MED EXP (Any one person) $ 10,000 2/27/96 2/27/97 1,000,000 COMBINED SINGLE LIMIT $ BODILY INJURY $ (Per person) BODILY INJURY $ (Per accldenl) PROPERTY DAMAGE $ AUTO ONLY. EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EACH OCCURRENCE $ AGGREGATE $ 5/24 96 5/24/97 X STATUTORY LIMITS EACH ACCIDENT $ 100,000 DISEASE. POLICY LIMIT $ 500,000 DISEASE. EACH EMPLOYEE $ 100,000 GENERAL UABILiTY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE [K] OCCUR OWNER'S & CONTRACTOR'S PROT 21SBAES0153 AUTOMOBILE UABIUTY ANY AUTO All OWNED AUTOS SCHEDULED AUTOS X HIRED AUTOS X NON.OWNED AUTOS 21SBAES0153 GARAGE UABIUTY ANY AUTO EXCESS UABIUTY UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYERS' UABIUTY 21WECDQ4353 THE PROPRIETOR! PARTNERs/EXECUTIVE OFACERS ARE: OTHER INCL EXCL DESCRIPTION OF OPERATlONSILOCATlONSNEHICLESISPECIAL ITEMS THOSE USUAL TO INSURED'S OPERATIONS. INSURED. CERTIFICATE HOLDER IS ALSO ADDITIONAL :;8mnf1;8j1!::::ff;9fB;~;~::::::::::::::::::::::::):))),::!:::t:'::::?)'):))::!:::::)m:)::::t::!,::!:)))t:::?):))::)),)::)t):):::::):))):))))))::):::r)::'):),)::::)):):):):::::):))):):'::':)GfflN$~n9;~;::)):):::m:);;::::m:f:)::;::):))t:::tt:r::::::rr:::):)::r:::::::::::(:,;;..:::':~:~:::::::::':';:::::.;.;;.;:;.,::::;::,::::::;:;::,,;;..::..::.::.::: SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBUGATlON OR UABIUTY CITY OF WINTER SPRINGS ATTN: JULIE SCHUSTER 102 N MOSS RD WINTER SPRINGS FL 32708 ::A:G.&:@:::':~~~$::::J~m.~jr;):::::::::'::r:m::;:::::::m:t):::;::):)?):::@::::::'{: .................................... .;.....;.:.......................:.:.: ......... OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. 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