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Ordinance No. 11,336ORDINANCE NO. 11,336 AN ORDINANCE OF TI I CITY COUNCIL OF THE CITY OF BAY -TOWN, TEXAS, AUTHORIZING AN INTERLOCAL AGREEMENT WITH 'I'I IE TOWN OF FLOWER MOUND_ TEXAS, FOR AN AMBULANCE DEBT COLLECTION SERVICES CONTRACT FOR DEI_,INQUEN7" ACCOUNTS; AUTHORIZING A SUPPLEMENTAL AGREEMENT WITH EMERGICON, LLC, CONCERNING THE SAME: AUTHORIZING PAYMENT BY THE CITY OF BAYTOWN IN ACCORDANCE WITH THE INTERLOCAL AGREEMENT, THE AMBULANCE DEBT COLLECTION SERVICES CONTRACT FOR DELINQUENT ACCOUNTS. AND T171E SUPPLEMENTAL CONDITIONS: MAILING OTHER PROVISIONS 1;,'ELA "I'ED THERETO:AND PROVLDING FOR TIDE EFFECTIVE DATE THEREOF. BE IT ORDAINED BY T1 -E CITY COUNCIL OF THE CITY OF BAYTOWN. TEXAS: Section 1: That the City Council of the City of Baytown, Texas, hereby authorizes and directs the City Manager to execute and the City Clerk to attest to an interlocal agreement with the Town of Fioxver Mound, Texas, for an Ambulance Debt Collection Services Contract for delinquent accounts_ A copy of the agreement is attached hereto as Exhibit "A- and made a part hereof for all intents and purposes_ Section 2: That the City Council of the City of Baytown_ Texas_ hereby authorizes and directs the City Manager to execute and the City Clerk to attest to a Supplemental Agreement with Emergicon_ LLC_ for an Ambulance Debt Collection Services Contract for delinquent accounts. A copy of the agreement is attached hereto as Exhibit "B" and made a part hereof for al intents and purposes. Section 3: That the City Council of the City of Baytown authorizes payment to Ernergicon_ LLC_ in accordance with the Interlocal Agreement and Supplemental Agreement authorized herein_ Section 4: This ordinance shall take effect immediately from and after its passage by the City Council of the City of Baytown, INTRODUCED, READ and PASSED by the affirmative vote e City Council of the City of Bayt -this the 8" day of April, 2010. vAY;f3 , P , OONCARLOS_ Ma r L APPROVED AS TO FORM: 1 NAC[O RAMIREZ, SR_, C' Attorney RAKaren\Filcs \City COuncil\Ordinances\2 O\April 8\r-1o«- erMoundlnterlocal4Ambul anceDeblCollectionOrdinuncc,dnc Exhibit "A" INTERLOCAL AGREEMENT This agreement made and entered into this day of , 2010, by and between the CITY OF BAYTOWN (hereinafter called "BAYTOWN ") and the TOWN OF FLOWER MOUND, TEXAS (hereinafter called "FLOWER MOUND ") each acting by and through its duly authorized officials: WHEREAS, BAYTOWN and FLOWER MOUND are both governmental entities engaged in the purchase of goods and services, which is a recognized governmental function; WHEREAS, BAYTOWN and FLOWER MOUND wish to enter into an Interlocal Agreement pursuant to Chapter 791 of the Texas Government Code (hereinafter " Interlocal Cooperation Act ") to set forth the terms and conditions upon which BAYTOWN and FLOWER MOUND may purchase various goods and services commonly utilized by each entity; WHEREAS, participation in an interlocal agreement will be highly beneficial to the taxpayers of BAYTOWN and FLOWER MOUND through the anticipated savings to be realized and is of mutual concern to the contracting parties; WHEREAS, BAYTOWN and FLOWER MOUND have current funds available to satisfy any fees owed pursuant to this Agreement. NOW, THEREFORE, in consideration of the foregoing and the mutual promises, covenants and obligations as set forth herein; BAYTOWN and FLOWER MOUND agree as follows: 1. BAYTOWN and FLOWER MOUND may cooperate in the purchase of various goods and services commonly utilized by the participants, where available and applicable, and may purchase goods and services from vendors under present and future contracts; 2. BAYTOWN and FLOWER MOUND shall each be individually responsible for payments directly to the vendor and for the vendor's compliance with all conditions of delivery and quality of purchased items under such contracts. BAYTOWN and FLOWER MOUND shall each make their respective payments from current revenues available to the paying parry; 3. The Agreement shall be in full force and effect until terminated by either party; 4. Notwithstanding anything herein to the contrary, participation in this Agreement may be terminated by any party upon thirty (30) days written notice to the other participating entity(ies); 5. The undersigned officer and /or agents of the party(ies) hereto are duly authorized officials and possess the requisite authority to execute this Agreement on behalf of the parties hereto; 6. This Agreement may be executed separately by the participating entities, each of which shall be deemed an original and all of which together shall constitute one and the same instrument. EXECUTED hereto on the day and year first above written. CITY OF BAYTOWN TOWN OF FLOWER MOUND Garrison C. Brumback City Manager ATTEST: Leticia Garza City Clerk APPROVED AS TO FORM: Ignacio Ramirez, Sr., City Attorney STATE OF TEXAS § COUNTY OF HARRIS § Jody A. Smith Mayor Paula Paschal, TRMC Town Secretary Terrence S. Welch, Town Attorney This instrument was acknowledged before me on the day of , 2010, by Garrison C. Brumback, the City Manager of the CITY OF BAYTOWN, TEXAS, a home -rule municipal corporation, on behalf of such corporation. Notary Public in and for the State of Texas STATE OF TEXAS § COUNTY OF DENTON § This instrument was acknowledged before me on the day of , 2010, by of the TOWN OF FLOWER MOUND, TEXAS, a home -rule municipal corporation, on behalf of such corporation. Notary Public in and for the State of Texas SUPPLEMENTAL AGREEMENT CONCERNING THE AMBULANCE DEBT COLLECTION SERVICES CONTRACT STATE OF TEXAS KNOWN BY THESE PRESENTS: COUNTY OF HARRIS This Supplemental Agreement concerning the Ambulance Debt Collection Services Contract is made this _ day of , 2010, by and between the City of Baytown, Texas, acting by and through its City Council of the City of Baytown, Texas hereinafter referred to as the "Provider," and Emergicon, L.L.C., a Texas limited liability company, hereinafter referred to as the "Emergicon "; and the Parties do hereby make and enter into the following agreement: 1. In General 1.01 Agreement. Both the contract between Emergicon, L.L.C., and the City of Flower Mound dated August 6, 2007 (the "Flower Mound Contract"), and this Supplemental Agreement shall herein be referred to collectively as the "Agreement." Should any term or condition in this Supplemental Agreement conflict with the Flower Mound Contract, this document shall control. References to the City of Flower Mound in the Flower Mound Contract shall mean and be construed as the City of Baytown for purposes of this Agreement, except as otherwise provided herein. a. Section 1.04 "Obligations on Termination" of the Flower Mound Contract shall be amended to read as follows: 1.04 Obligations on Termination Upon termination of the Agreement, for whatever cause, Emergicon will immediately return all original medical records to Provider and shall tender to Provider a digital copy of all paper records related to the Provider in a format acceptable to the Provider. b. Section 1.05 "Mailing of Notices" of the I -lower Mound Contract shall be amended to provide the address for the Provider as follows: 1.05 Mailina of Notices. The Provider's address for purposes of this Agreement shall be as follows unless otherwise changed pursuant to the Flower Mound Contract: City of Baytown 2401 Market Street, Baytown, TX 77520 Attn: City Manager Fax: 281 -420 -6586 Supplemental Agreement, Page I The last sentence of Section 2.02 "Compensation" of the Flower Mound Contract shall be amended to read as follows: 2.02 Compensation. .... All fees shall be paid within thirty (30) days of receipt of an invoice for the services. The City reserves the right to withhold from payment any amount which it disputes. d. A new section to be numbered and entitled 2.025 "Indebtedness" shall be added to the Flower Mound Contract. which section shall read as follows: 2.0025 Indebtedness. II' Emergicon, at any time during the term of this agreement, incurs a debt. as the word is defined in section 2 -662 of the Code of Ordinances of the City of Baytown, it shall immediately notify the Provider's Director of Finance in writing. If the Provider's Director of Finance becomes aware that Emergicon has incurred a debt, the Provider's Director of Finance shall immediately notify Emergicon in writing. if Emergicon does not pay the debt within 30 days of either such notification, the Provider's Director of Finance may deduct funds in an amount equal to the debt from any payments owed to Emergicon under this Agreement, and Emergicon waives any recourse therefor. C. The last sentence of Section 2.03 "Copies of Records" of the Flower Mound Contract shall be amended to read as follows: 2.03 Copies of Records..... The Provider shall be responsible for responding to all such requests; and Emergicon shall be responsible to timely provide all requested information in order for the Provider to fully respond thereto or to request an opinion from the Texas Attorney General. The second sentence of Section 2.04 "Payment Arrangement Authority" of the Flower Mound Contract shall be amended to read as follows: 2.04 Payment Arrangement Authority. .... Provider will be given a monthly report of all payment arrangements and no payment arrangement may be made which exceeds twelve months unless prior written approval of the Provider is obtained. ... . g. The second sentence of Section 2.08 "Information Received by Provider" of the Flower Mound Contract shall be amended to read as follows: 2.08 Information Received by Provider. .... Provider shall endeavor to forward to Emergicon copies of checks, Explanations of Benefits and/or other documentation pertaining to Emergicon's services herein within five (5) days of the date of receipt. Section 3.01 "Emergicon's Indemnification" shall be amended to read as follows: Supplemental Agreement. Page 2 3.01 Emeraicon's Indemnity. EMERGICON AGREES TO AND SHALL INDEMNIFY AND HOLD HARMLESS AND DEFEND THE PROVIDER, ITS OFFICERS, AGENTS, AND EMPLOYEES (HEREINAFTER REFERRED TO AS THE "PROVIDER ") FROM AND AGAINST ANY AND ALL CLAIMS, LOSSES, DAMAGES, CAUSES OF ACTION, SUITS AND LIABILITY OF EVERY KIND, INCLUDING ALL EXPENSES OF LITIGATION, COURT COSTS, AND ATTORNEY'S FEES, FOR INJURY TO OR DEATH OF ANY PERSON, FOR DAMAGE TO ANY PROPERTY, OR FOR ANY BREACH OF CONTRACT, ARISING OUT OF, OR IN CONNECTION WITH THE WORK DONE BY EMERGICON UNDER THIS CONTRACT CAUSED BY THE SOLE OR JOINT NEGLIGENCE OF EMERGICON. IT IS THE EXPRESSED INTENTION OF THE PARTIES HERETO, BOTH EMERGICON AND THE PROVIDER, THAT THE INDEMNITY PROVIDED FOR IN THIS PARAGRAPH IS INDEMNITY BY EMERGICON TO INDEMNIFY AND PROTECT THE PROVIDER FROM THE CONSEQUENCES OF EMERGICON'S OWN NEGLIGENCE, WHETHER THAT NEGLIGENCE IS THE SOLE OR A CONCURRING CAUSE OF THE RESULTING INJURY, DEATH OR DAMAGE. SUCH INDEMNITY SHALL NOT APPLY, HOWEVER, TO LIABILITY ARISING FROM THE PERSONAL INJURY, DEATH, OR PROPERTY DAMAGE OF PERSONS THAT IS CAUSED BY OR RESULTS FROM THE NEGLIGENCE OF THE PROVIDER. IN THE EVENT THAT ANY ACTION OR PROCEEDING 1S BROUGHT AGAINST THE PROVIDER FROM WHICH THE PROVIDER IS INDEMNIFIED, EMERGICON FURTHER AGREES AND COVENANTS TO DEFEND THE ACTION OR PROCEEDING BY LEGAL COUNSEL ACCEPTABLE TO THE PROVIDER. THE INDEMNITY PROVIDED FOR IN THIS PARAGRAPH SHALL SURVIVE THE TERMINATION OR EXPIRATION OF THIS AGREEMENT. i. A new section to be numbered and entitled 3.015 "Release" shall be added to the Flower Mound Contract, which section shall read as follows: 3.015 Release. By this Agreement, the Provider does not consent to litigation or suit, and the Provider hereby expressly revokes any consent to litigation that it may have granted by the terms of this Contract or any other contract or agreement, any charter, or applicable state law. Nothing contained herein shall be construed in any way so as to waive in whole or part the Provider's sovereign immunity. Emergicon assumes full responsibility for its work performed hereunder and hereby releases, relinquishes and discharges the Supplemental Agreement, Page 3 Provider, its officers, agents, and employees from all claims, demands, and causes of action of every kind and character, including the cost of defense thereof, for any injury to or death of any person (whether they be either of the parties hereto, their employees, or other third parties) and any loss of or damage to property (whether the property be that of either of the parties hereto, their employees, or other third parties) that is caused by or alleged to be caused by, arising out of, or in connection with Emergicon's work to be performed hereunder. This release shall apply with respect to Emergicon's work regardless of whether said claims, demands, and causes of action are covered in whole or in part by insurance. j. Section 3.03 "Insurance" of the Flower Mound Contract shall be amended to read as follows: 3.03 Insurance. Throughout the term of this Agreement, Emergicon at its own expense shall purchase, maintain and keep in force and effect insurance against claims for injuries to or death of persons or damages to property which may arise out of or result from Emergicon's performance of the work under this Agreement. Emergicon's insurance coverage shall be primary insurance with respect to Provider and its officers and agents. Any insurance or self- insurance maintained by Provider, its officials, or agents shall be considered in excess of Provider's insurance and shall not contribute to it. Emergicon shall maintain the following insurance with at least the minimum coverages amounts listed below: a. Workers' Compensation Policy Statutory amounts required by Texas law Employer's Liability: $500,000 Should Emergicon be a non - subscriber, Emergicon shall provide proof thereof from the Texas Workers' Compensation Division of the Texas Department of Insurance and provide a waiver of subrogation in favor of the City. Should Emergicon's non - subscriber status change at any time during the term hereof, Emergicon shall procure a Workers' Compensation Policy that complies with the requirements herein. b. Commercial General Liability Policy General aggregate of $1,000,000 Owners' and Contractors' Protective liability of $500,000 Products and Completed Operations of $1,000,000 Personal and Advertising Injury of $1,000,000 Minimum of $500,000 per occurrence % Coverage shall be at least as broad as ISO CG 00 01 10 93. %- No coverage exclusions shall be deleted from standard policy without notification of individual exclusions being attached for review and acceptance. c. Professional Liability Policy % Limit: $500.000 for this project Claims -made form is acceptable % Coverage will be in force for one (1) years after completion of services. Supplemental Agreement. Page 4 t Provider of Baytown will be named loss - payee. All coverages afforded under the policies will not be canceled, suspended, voided, or reduced until at least thirty (30) days' prior written notice has been given to Provider via certified mail, return receipt requested. Prior to the end of each coverage period during the term of this Agreement, new certificates of insurance must be filed with Provider evidencing continuation of coverage. - Additionally, the following general requirements shall apply to all coverages, except if expressly stated otherwise: a. General Liability and Automobile Liability insurance shall be written by a carrier with an A.M. Best Rating of B+ or higher in accordance with the current Best Key Rating Guide; b. Only Insurance Carriers licensed and admitted to do business in the State of Texas will be accepted; c. Deductibles shall be listed on the Certificate of Insurance and are acceptable only on a per occurrence basis. Claims -made policies will not be accepted; d. Provider, its officials, agents, and employees are to be added as "Additional Insureds" to all liability policies. The coverage shall contain no special limitation on the scope of protection afforded to Provider, its officials, agents, or employees; e. A waiver of subrogation in favor of Provider with respect to Workers' Compensation insurance must be included; f. Upon request, certified copies of all insurance policies and /or certificates of insurance shall be furnished to Provider at no cost to Provider; g. Certificates of Insurance shall be prepared and executed by the insurance company or its authorized agent, and shall contain the following provisions and warranties: All endorsements and insurance coverages according to requirements and instructions contained herein; and k. Section 4.01 "Property of Emergicon" of the Flower Mound Contract shall be amended to read as follows: 4.01 Property of Emergicon. Provider agrees that Emergicon's equipment, computer hardware and software, billing and collections processes and other related systems and equipment are the property and trade secrets of Emergicon; provided the same are marked as "confidential "; and that, unless otherwise required by law or necessary to obtain an opinion from the Texas Attorney General pursuant to the Texas Public Information Act, Provider will not release any information regarding such trade secrets to any third party without the prior written consent of Emergicon. Should the Provider receive a public information request for such information, Provider shall notify Emergicon and send the information to the Texas Attorney General for an opinion. Thereafter, Emergicon shall be responsible to make arguments as to why the information submitted should not be subject to disclosure. The parties agree that they will Supplemental Agreement. Page 5 abide by the decision of the Texas Attorney General concerning the release of such information. Section 4.02 "Fact of Contractual Relationship May be Disclosed" of the Flower Mound Contract shall be amended to read as follows: 4.02 Fact of Contractual Relationship May be Disclosed. Notwithstanding the foregoing, either party may, without the prior written consent of the other party, disclose the existence of a contractual relationship between the parties together with the contract and other information not marked "confidential." M. Section 5.01 "Accurate Books and Records" of the Flower Mound Contract shall be amended to read as follows: 5.01 Accurate Books and Records. During the Term and for a period of three (3) years thereafter or such other period of time as required by the Provider's record retention policy. each party agrees to maintain accurate books and records associated with the billing and collections made the subject of the Agreement. n. The second sentence in Section 5.02 "Right to Audit" of the Flower Mound Contract shall be amended to read as follows: 5.02 Right to Audit .... Such audit shall be conducted at the office of the party being audited, shall be during normal business hours, and shall be at the sole cost and expense of the party conducting the audit, except as provided in Section 5.03. o. The first sentence of Section 6.01 "HIPAA Compliance" of the Flower Mound Contract shall be amended to read as follows: 6.01 HIPAA Compliance. Emergicon shall carry out obligations under this Agreement in compliance with all applicable laws, rules and regulations, including but not limited to, the privacy regulations pursuant to Public Law 104- 191 of August 21, 1996, known as the Health Insurance Portability and Accountability Act of 1996, Subtitle F — Administrative Simplification, Sections 261, el sey., as amended (HIPAA") to protect the privacy of any personally identifiable protected health information ( "PHI ") that is collected, processed or learned as a result of the services provided pursuant to this Agreement. P. Section 7.04 "Performance of Agreement; Venue; Choice of Law" of the Flower Mound Contract shall be amended to read as follows: 7.04 Performance of Agreement: Venue: Choice of Law. Provider understands and agrees that Emergicon will be performing this contract in Harris Supplemental Agreement. Page 6 County, Texas. The venue for any disputes or cases of actions that may arise out of this Agreement is the state and county courts located in Harris County, Texas. The provisions of this Agreement shall be determined in accordance with the laws of the State of Texas, excluding the choice of law provision thereof. q. Section 7.12 "Attorneys' Fees" of the Flower Mound Contract shall be deleted in its entirety. r. Section 7.13 "Appendices" of the Flower Mound Contract shall be amended to read as follows: 7.13 Appendices. Emergicon and Provider may enter into various appendices to this Agreement, which are signed by both parties, from time to time and at any time regarding additional services. Such appendices shall be considered part of this Agreement as if set forth herein at length unless such appendix provides otherwise. Provider shall not be liable for payment for any additional services unless an appendix covering such services has been properly executed by the parties. 1.02 Award of Contract. Upon the execution of this Agreement and prior to performing any work hereunder, Emergicon shall deliver to the Provider all certificates of insurance required in this Agreement. Emergicon shall be prepared to perform the work in the most expedient manner possible. ARTICLE 11. Miscellaneous Provisions 2.01 Force Majeure. Neither the Provider nor Emergicon shall be required to perform any term, condition or covenant of this Agreement while such performance is delayed or interrupted by acts of God, material or labor restrictions by any governmental authority, civil riot, flood, hurricanes or other natural disasters, any other cause not within the control of the Provider or Emergicon that by the exercise of due diligence the Provider or Emergicon is unable wholly or in part, to prevent or overcome and supersedes all prior agreements and understandings between Provider and Emergicon concerning the subject matter of this Agreement. Any such delay in performance shall be excused only for the same amount of time as the occurrence giving rise to the delay shall have lasted or such period of time as is reasonably necessary after such occurrence abates for the effects thereof to have dissipated as determined in the sole discretion of the Provider. 2.02 Construction of Agreement. The parties agree that this Agreement shall not be construed in favor of or against any party on the basis that the party did or did not author this Agreement. Supplemental Agreement, Page 7 ?.l), : \uthority. The officers executing this Agreement on hehalfofthe parties hereby confirm that such 01'hCers have full authority to execute this Ag'CCnlent and to hind the party he /she represents. IN \VITNIESS FILRI- tile parties have executed this a_U1'CC111Cnt In dUpi►Ca1C originals at Bavtown. I larris Countv. Texas. CITY OF BAYTONVN ATTEST: LETICIA G: \IZZA. City Clerk APPROVED AS TO FOR A,I: IGNACIO RAMIRLL. SR.. City Auorne\ GARRISON C. BRIJMBACK City IvIanaLer FNI RGIC'ON. L.L.C. Sisn�uul-c CI -/'7-f4 V C-r /G Printed Name nr<r,'�cf -t J CLo Title OF '1'I -X. \S a a COUNTY OF HARRIS / Belore me. G+ /���" ra''�� _. the un - rskmed nota}} puhliC. on this clay personally appeared T _ QE2 the gn�-, of 13n1ergieon. L.I_.C•.. on behalfol'such limited liability company , known to ills. proved to me on the oath of : or proved to me throu�sh his/her current ;description ol' identification card or other CIOCLI111Cnt issued by the federal Supplemental Avreetnent. Page S oovernment or any state government that contains the photograph and si`,naturc of the acknowledging person; (check one) to be the person whose namc is subscribed to the foregoing insu•ument, and acknowledged to me that lie /she executed that instrument for the purposes and consideratio)n� therein expressed. Given under my hand and seal of ofl ice this day of V ati' k —1010. U / • �- •,�,�,, Notary Public in and for the State of LINDA N. FORD Texas 01 n myc Juy� '3cpitos t�lv commission expire4kfA5,aLv R Ka rewfilrsCoutcut, Ambulance Din Callccaau. STIPPLE%11: TAI. A(; It FrM FN If)", IR?010 doc Supplemental Aurcemenl. I'age 9 EMERGICON SERVICE AGREEMENT This Service Agreement (this "Agreement ") is entered into by and between Emergicon, LLC, a Texas corporation ( "Emergicon "), and the provider of emergency medical and /or ambulance transportation services set forth on the signature page hereto (the "Provider "). RECITALS WHEREAS, Emergicon provides medical control services, billing and collections services, continuing education programs, continuous quality improvement services, and other clinical support services (the "Services ") to fire departments, ambulance providers, and other medical emergency services: WHEREAS, Provider. as part or all of its overall activities, provides emergency and/or non - emergency medical and ambulance services, including emergency medical responses, and other patient encounters and/or patient ambulance transportation (the "Ambulatory Services "): and WHEREAS. Provider is desirous of obtaining the Services of Emergicon. NOW, THEREFORE, in consideration of the mutual promises contained herein, the parties hereto agree as follows: ARTICLE ONE TERM AND TERMINATION 1.01 Term. Subject to the terms and conditions set forth herein and except as provided in Section 1.02, the initial term of this Agreement shall be for a period of two (2) years from the date of this Agreement (such initial term, together with all extensions thereof, shall be referred to herein as the "Term ") This Agreement shall automatically renew at the end of the current Term for a successive two -year Term unless either party gives written notice of its intention not to renew sixty (60) days before expiration of the current Term. 1.02 Termination. Notwithstanding any provision of this Agreement to the contrary, this Agreement may be terminated by either party, without cause and without liability (except for continuing obligations during such period). upon thirty (30) days advance written notice to the other party. 1.03 Obligations During Notice Period. During the 30 -day notice period specified in Sections 1.02, Emergicon shall be entitled to receive compensation for all Accounts (as defined in Section 2.01) billed and/or collected with respect to the Services and for all other activities performed pursuant to this Agreement, and shall be entitled, after the end of the termination period to receive compensation for all amounts billed during the termination period but not collected until after the end of the termination period. 1.04 Obligations on Termination_. Upon termination of the Agreement, for whatever cause, Emergicon will immediately return all original medical records to Provider and may. at EMERGICON SERVICE AGREEMENT Page I Emergicon's sole discretion, provide to Provider a digital copy on a CD -ROM of all paper records related to Provider. 1.05 Mailing of Notices. Any notice required or permitted pursuant to this Agreement shall be in writing and shall be deemed sufficient when delivered personally or sent by telegram or fax or forty -eight (48) hours after being deposited in the U.S. mail, as certified or registered mail, with postage prepaid, addressed as follows: (a) If to the Provider: The Town of Flower Mound 2121 Cross Timbers Flower Mound, Texas 75028 Attention: Fax: (b) If to Emergicon: Emergicon, LLC PO Box 180446 Dallas, Texas 75218 Attention:—Christopher Turner Fax: 214 328 -0749 Each party shall be entitled to specify a different address by giving live days' written notice to the other party. All such notices and communications shall be deemed to be received the same day if by fax (provided the sender has a fax machine /fax database generated proof of receipt) and in three (3) business days if by mail. ARTICLE TWO BILLING & COLLECTIONS 2.01 Billin . During the Term, Emergicon shall be responsible for the billing of charges and fees relating to the Services as directed by and provided by Provider, including, but not limited to, private insurance. Medicare. Medicaid, and other governmental programs relating to: (a) patient encounters that occur during the Term: and (b) other patient encounters forwarded to Emergicon for billing. (Note: each set of such charges and fees for the Services related to an individual patient encounter may be referred to herein as an "Account" or, collectively, the "Accounts "). 2.02 Compensation. In consideration for Emergicon providing the Provider with the agreed upon billing services described in this Article Two. the Provider will pay Emergicon EMERGICON SERVICE AGREEMENT page 2 eighteen percent (18 %) of the total amount collected on the Account if the Account is older than one hundred twenty (120) days from the date of service. If the Account is less than one hundred twenty (120) days from the date of service, the Provider will pay Emergicon six percent (6 %) of the total amount collected on the Account. All fees shall be payable monthly within fifteen (15) days of receipt of invoice. 2.03 Copies of Records. From time to time, Emergicon may receive requests from patients or the representatives of patients for copies of treatment records. Emergicon will forward all requests for medical records to Provider. The Provider shall be responsible for responding to all such requests. 2.04 Payment Arrangement Authority. Provider hereby grants Emergicon authority to enter into a payment arrangement on its behalf with patients charged for the Ambulatory Services if (a) the payment is for the full amount of a bill and (b) the length of the payments does not exceed twelve (12) months. Provider will be made aware of any payment arrangements and prior to any payment arrangement exceeding twelve (12) months. Emergicon will not waive co- payments and co- insurance payments. 2.05 Records of Patient Encounters. (a) Provider shall use its reasonable best efforts to forward all original medical records of each patient encounter to Emergicon within five (5) days of such patient encounter. Such records shall be deemed to be the property of Provider, but Emergicon shall have the right to duplicate and retain paper or electronic copies of the records. If the records exist only in electronic form, each electronic copy shall be deemed to be an original for the purposes of this Agreement. Provider shall have no obligation to forward original medical records during the 30- day notice period regarding terrnination as set forth in Paragraph 1.02. (b) Provider acknowledges that Emergicon has no responsibility for complying with all provisions of Title 42 C.F.R. Section 410.40 which states, in part, that an ambulance service bears the responsibility for obtaining Physician Certification Statements ( "PCS's "). Provider further understands and concurs that Emergicon is neither an ambulance service nor an ambulance provider within the definitions as set forth by the Centers for Medicare and Medicaid Services. 2.06 Requests for Copies. Requests for copies of medical records should be submitted directly to Emergicon. Either Emergicon or Provider may authorize release of the records such that the release is in accordance with the standards and time requirements established by State and Federal law, including but not limited to the requirements of Section 773.091 Texas Health and Safety Code. 2.07 Activity Reports. Emergicon shall provide to Provider a monthly report of all billing activities that occurred during the preceding month. 108 Information Received by Provider. To the extent that Provider receives payments or original copies of documentation directly, Provider shall forward to Emergicon copies of checks, Explanations of Benefits and/or other documentation within five (5) days of the date of receipt of payment by Provider. EMERGICON SERVICE AGREEMENT Page 3 2.09 Support Services. Emergicon will provide patients and personnel of Provider with telephone support services during normal business hours (Monday - Friday from 9:00 a.m. to 5:00 p.m.) except on public holidays or other holidays as established by Emergicon. 2.10 Obligation for Payment. Payment in accordance with this Article Two shall be due and owing to Emergicon by Provider for all Accounts collected during the Term and collected after the Term but billed during the Term by Emergicon regardless of whether payment was made to Emergicon or to Provider. Emergicon and Provider agree that the purpose of this Section 2.10 is to guarantee that Emergicon is the only provider engaging in billing services on behalf of Provider. Emergicon acknowledges that the Provider has an existing contract for Accounts that are considered delinquent or in a "collections service" status and will not bill for those Accounts; no payment shall be made to Emergicon for accounts that are collected under the Town's contract for collection services. ARTICLE THREE INDEMNIFICATION AND FIDELITY BOND 3.01 Emergicon's Indemnification. Emergicon shall indemnify and hold harmless Provider from and against claims, damages, losses and expenses, including but not limited to attorneys' fees, arising out of or resulting from Emergicon's performance of activities pursuant to this Agreement, but only to the extent caused by the willful misconduct or the negligent acts or omissions of Emergicon. The indemnification provided for herein shall not be applicable to any claim of adjustment or request for reimbursement made by an insurance company or any servicing agency for Medicare or Medicaid that may be made as the result of an audit of claims made or governmental regulations or laws, including Emergicon's fees charged, except for any adjustments or claims for reimbursement made as a direct result of Emergicon's error. 3.02 Fidelity Bond. Emergicon shall keep and maintain during the term of this Agreement a fidelity bond with a qualified insurer of no less than $10.000.00. 3.03 Insurance. Emergicon shall keep and maintain during the term of this Agreement Errors & Omissions Liability insurance with a qualified insurer of no less than $1,000,000.00. ARTICLE FOUR CONFIDENTIALITY 4.01 Property of Emergicon. Provider agrees that Emergicon's equipment, computer hardware and software, billing and collection processing, and other related systems and equipment are the property and trade secrets of Emergicon, and that Provider will not release any information regarding such trade secrets to any third party without the prior written consent of Emergicon. Notwithstanding the above. Emergicon acknowledges that the Town is subject to certain laws including the Texas Public information Act, that govern the disclosure of information maintained by the Town. The Town agrees to work with Emergicon in protecting trade secret information. EMERGICON SERVICE AGREEMENT Page 4 4.02 Fact of Contractual Relationship May Be Disclosed. Notwithstanding the foregoing, either party may.. without the prior written consent of the other party, disclose the existence of a contractual relationship between the parties. ARTICLE FIVE AUDITS 5.01 Accurate Books and Records. During the Term and for a period of three (3) years thereafter, each party agrees to maintain accurate books and records associated with the billing and collections made the subject of this Agreement. 5.02 Right to Audit. Upon reasonable written notice, either party may audit the books and records of the other party insofar and only insofar as such books and records relate or pertain directly to this Agreement. Such audit shall be conducted at the office of the party being audited, shall be during normal business hours, and shall be at the sole cost and expense of the party conducting the audit. 5.03 Penalty for Underpayment. If an audit reveals that a party has failed to pay any amount or portion of any amount due or payable under this Agreement and such amount is in excess of Twenty Thousand Dollars ($20,000.00), the party being audited shall pay to the auditing party the full cost of the audit and the full amount due or payable plus interest at the rate of ten percent (10 %u) per annum from the date(s) of non - payment. ARTICLE SIX PROTECTED HEALTH INFORMATION 6.01 HIPAA Compliance. Emergicon shall carry out obligations under this Agreement in compliance with the privacy regulations pursuant to Public Law 104 -191 of August 21, 1996, known as the Health Insurance Portability and Accountability Act of 1996, Subtitle F — Administrative Simplification, Sections 261, et seq., as amended ( "HIPAA "), to protect the privacy of any personally identifiable protected health information ("PHI ") that is collected, processed or learned as a result of the services provided pursuant to this Agreement. In conformity therewith. Emergicon agrees that it shall: a) Not use or further disclose PHI except as permitted under this Agreement or required by law; b) Use appropriate safeguards to prevent use or disclosure of PHI except as permitted by this Agreement. c) Mitigate, to the extent practicable, any harmful effect that is known to Emergicon of a use or disclosure of PHI by Emergicon in violation of this Agreement: d) Report to Provider any use or disclosure of PHI not provided for by this Agreement of which Emergicon becomes aware: EMERGICON SERVICE AGREEMENT Page 5 e) Ensure that agents or subcontractors to whom Emergicon provides PHI, or who have access to PHI, agree to the same restrictions and conditions that apply to Emergicon with respect to such PHI; f) Make PHI available to Provider and to the individual who has a right of access as required under HIPAA within ten (10) days of the request by Provider on behalf of the individual: g) Incorporate any amendments to PHI when notified to do so by Provider; h) Provide an accounting of all uses or disclosures of PHI made by Emergicon as required under the HIPAA privacy rule within sixty (60) days: and i) Make its internal practices, books and records relating to the use and disclosure of PHI available to the Secretary of the Department of Health and Human Services for purposes of determining Emergicon's and Provider's compliance with HIPAA. 6.02 HIPAA Disclosures. The specific uses and disclosures of PHI that may be made by Emergicon on behalf of Provider include: a) The preparation of invoices to patients, carriers, insurers and others responsible for payment or reimbursement of the services provided by Provider to its patients; b) Preparation of reminder notices and documents pertaining to collections of overdue Accounts; c) The submission of supporting documentation to carriers, insurers and other payers to substantiate the health care services provided by Provider to its patients or to appeal denials of payments for same; d) The preparation and release of medical records to patients or their legal representatives as permitted by HIPPA privacy rule; associate: and e) Uses required for the proper management of Emergicon as a business f) Other uses or disclosures of PHI as permitted by HIPAA privacy rule. ARTICLE SEVEN MISCELLANEOUS 7.01 No Waiver. The failure of either party to insist upon strict performance of any provision of this Agreement shall not be construed as a waiver of any subsequent breach of the same or similar nature. 7.02 Provisions Construed Separately. The parties agree that each provision of this Agreement shall he construed as separable and divisible from every other provision and that the enforceability of any one provision shall not limit the enforceability, in whole or in part, of any EMERGICON SERVICE AGREEMENT Page 6 other provision hereof. In the event that a court of competent jurisdiction determines that any tern or provision herein shall be invalid or unenforceable, the remaining terms and provisions of this Agreement shall not be affected thereby. and shall be interpreted as if the invalid term or provision were not a part hereof. 7.03 Final Agreement. This Agreement sets forth the entire, final and complete understanding between the parties hereto relevant to the subject matter of this Agreement. No waiver or modification of any of the terms or conditions of this Agreement shall be effective unless in writing and signed on behalf of both parties. 7.04 Performance of Agreement. Venue; Choice of Law. Provider understands and agrees that Emergicon will be performing this contract in Denton County, Texas. The venue for any disputes or causes of action that may arise out of this Agreement is the state and county courts located in Denton County, Texas. The provisions of this Agreement shall be determined in accordance with the laws of the State of Texas excluding the choice of law provisions thereof. 7.05 Headings. The headings of this Agreement are for ease of reference only and are not intended to limit or restrict the terms hereof. 7.06 Binding Nature of Agreement. This Agreement is binding upon the heirs, legal representatives, successors and assigns of the parties hereto. 7.07 Compliance with Laws Generally. Emergicon shall comply with all applicable laws, orders, rules, or regulations of all governmental agencies bearing on its performance hereunder. If so requested by Provider. Emergicon shall subnut appropriate evidence of such compliance. 7.08 Independent Contractor. It is understood and agreed that Emergicon is an independent contractor. Nothing herein contained shall be construed to create any partnership, joint venture. or joint enterprise between the parties. 7.09 Non - Profit Status Determination Letter. If Provider is a not - for - profit entity, Provider shall provide a duplicate of its letter determining its not - for - profit status with the Internal Revenue Service. In providing such letter, Provider further represents and warrants to Emergicon that it has done every act necessary to maintain its not -for- profit status with the Internal Revenue Service and is not aware of any pending, threatened or actual revocation of its not- for - profit status. 7.10 Appendices. Emergicon and Provider may enter into various appendices to this Agreement from time to time and at any time regarding additional services. Such appendices shall be considered part of this Agreement as if set forth herein at length unless such appendix provides otherwise. 7.11 Assignment. Neither party shall assign or otherwise transfer this Agreement. any interest in this Agreement, or any right or obligation hereunder to any other party without the written consent of the other party. EMERGICON SERVICE AGREEMENT Page 7 7.12 Attorneys' Fees. Should it become necessary for Emergicon to employ an attorney to enforce any of the terms and conditions hereof, including the collection of fees, Provider agrees to pay all expenses so incurred, including a reasonable attorneys' fee. [SIGNATURE PAGE FOLLOWS] EMERGICON SERVICE AGREEMENT Page 8 IN WITNESS on the �— day of 200�. 5-534x8 ()958/(XXx)2 WHEREOF, Emergicon and the Provider have executed this Agreement 2002, and shall be EFFECTIVE as of the Cetv-\ day of ENIERGICON, L.L.C. d,—� e'�' Name: Christopher Turner Title: President & CEO The Town of Flower M. ker, Nj&ypf Pro Tem EMERGICON SERVICE AGREEMENT Page 8 • • • INTERLOCK AGREEMENTret rY1 This agreement made and entered into this s-j day of__ / , 2010, by and between the CITY OF BAYTOWN (hereinafter called "BAY1lOWN" nd the TOWN OF FLOWER MOUND, TEXAS (hereinafter called "FLOWER MOUND") each acting by and through its duly authorized officials: WHEREAS, BAYTOWN and FLOWER MOUND are both governmental entities engaged in the purchase of goods and services, which is a recognized governmental function; WHEREAS, BAYTOWN and FLOWER MOUND wish to enter into an Interlocal Agreement pursuant to Chapter 791 of the Texas Government Code (hereinafter "Interlocal Cooperation Act") to set forth the terms and conditions upon which BAYTOWN and FLOWER MOUND may purchase various goods and services commonly utilized by each entity; WHEREAS, participation in an interlocal agreement will be highly beneficial to the taxpayers of BAYTOWN and FLOWER MOUND through the anticipated savings to be realized and is of mutual concern to the contracting parties; WHEREAS, BAYTOWN and FLOWER MOUND have current funds available to satisfy any fees owed pursuant to this Agreement. NOW, THEREFORE, in consideration of the foregoing and the mutual promises, covenants and obligations as set forth herein; BAYTOWN and FLOWER MOUND agree as follows: 1. BAYTOWN and FLOWER MOUND may cooperate in the purchase of various goods and services commonly utilized by the participants, where available and applicable, and may purchase goods and services from vendors under present and future contracts; 2. BAYTOWN and FLOWER MOUND shall each be individually responsible for payments directly to the vendor and for the vendor's compliance with all conditions of delivery and quality of purchased items under such contracts. BAYTOWN and FLOWER MOUND shall each make their respective payments from current revenues available to the paying party; 3. The Agreement shall be in full force and effect until terminated by either party; 4. Notwithstanding anything herein to the contrary, participation in this Agreement may be terminated by any party upon thirty (30) days written notice to the other participating entity(ies); 5. The undersigned officer and/or agents of the party(ies) hereto are duly authorized officials and possess the requisite authority to execute this Agreement on behalf of the parties hereto; 6. This Agreement may be executed separately by the participating entities, each of which shall be deemed an original and all of which together shall constitute one and the same instrument. • • • • EXECUTED hereto on the day and year first above written. CITY OF B TOWN OF FLOWER MOUND Garrison C. Brum J y A. ith5-, 3. lv City Mana Mayor ATT . aCiAxtet-9 ga4 CLAP eti is Garza Paula Pasch City Clerk Town Secretary APPROVED AS TO FORM: g acio Ramirez, Sr., Cit ttorney Terrence S. Welch, Town Attorney STATE OF TEXAS § COUNTY OF HARRIS § This instrument was acknowledged before me on the day of apt..Le , 2010, by Garrison C. Brumback, the City Manager of the CITY OF BAYTOWN, TEXAS, a home-rule municipal corporation, on behalf of such corporation. vVt'f'°•. AMY WHITE-TONEY *• �`'s Notary Public,State of Texas QKi' (�'T ` ,,, ,,,,T ''.;;,•••�;4' February 12,2011 Notary Pu in and for the State of Te as STATE OF TEXAS § COUNTY OF DENTON § This instrument was acknowledged before me on the 3 day of fl1CLA- , 2010, by \o(L 0-&\t&{-h l�Cc_ , A.�riof the TOWN OF FLOWER MOUND, TEXAS, a home-r� municipal corporatioh-,'on behalf of such corporation. LLL , Nota Public in an for the State of Texas 74��, TAMMY FOL! _ " Notary Pubtio.Stets :xas 1 +I My Commission _.•es ",E,''`- JULY17, 2010 • • • INTERLOCAL AGREEMENT This agreement made and entered into this / day of , 2010, by and between the CITY OF BAYTOWN (hereinafter called "BAY WN") and the TOWN OF FLOWER MOUND, TEXAS (hereinafter called "FLOWER MOUND") each acting by and through its duly authorized officials: WHEREAS, BAYTOWN and FLOWER MOUND are both governmental entities engaged in the purchase of goods and services, which is a recognized governmental function; WHEREAS, BAYTOWN and FLOWER MOUND wish to enter into an Interlocal Agreement pursuant to Chapter 791 of the Texas Government Code (hereinafter "Interlocal Cooperation Act") to set forth the terms and conditions upon which BAYTOWN and FLOWER MOUND may purchase various goods and services commonly utilized by each entity; WHEREAS, participation in an interlocal agreement will be highly beneficial to the taxpayers of BAYTOWN and FLOWER MOUND through the anticipated savings to be realized and is of mutual concern to the contracting parties; WHEREAS, BAYTOWN and FLOWER MOUND have current funds available to satisfy any fees owed pursuant to this Agreement. NOW, THEREFORE, in consideration of the foregoing and the mutual promises, covenants and obligations as set forth herein; BAYTOWN and FLOWER MOUND agree as follows: 1. BAYTOWN and FLOWER MOUND may cooperate in the purchase of various goods and services commonly utilized by the participants, where available and applicable, and may purchase goods and services from vendors under present and future contracts; 2. BAYTOWN and FLOWER MOUND shall each be individually responsible for payments directly to the vendor and for the vendor's compliance with all conditions of delivery and quality of purchased items under such contracts. BAYTOWN and FLOWER MOUND shall each make their respective payments from current revenues available to the paying party; 3. The Agreement shall be in full force and effect until terminated by either party; 4. Notwithstanding anything herein to the contrary, participation in this Agreement may be terminated by any party upon thirty (30) days written notice to the other participating entity(ies); 5. The undersigned officer and/or agents of the party(ies) hereto are duly authorized officials and possess the requisite authority to execute this Agreement on behalf of the parties hereto; 6. This Agreement may be executed separately by the participating entities, each of which shall be deemed an original and all of which together shall constitute one and the same instrument. • • S • EXECUTED hereto on the day and year first above written. CITY OF B TOWN OF FLOWER MOUND Garrison C. Brum Jody A. Smith City Mana Mayor ATT . eti is Garza i Paula Paschal, TRMC City Clerk Town Secretary APPROVED AS TO FORM: g acio Ramirez, Sr., Cit ttorney Terrence S. Welch, Town Attorney STATE OF TEXAS § COUNTY OF HARRIS § l }tti ` This instrument was acknowledged before me on the / ' day of U I tL e 2010, by Garrison C. Brumback, the City Manager of the CITY OF BAYTOWN, TEXAS, a home-rule municipal corporation, on behalf of such corporation. ;f;t. 's; AMY WHITE-TONEY'pr Fii� ^'?.,, Notary Public,State of Texas � � j . My Commission Expires arr\k/1 ( 71 L% ;;;:''; February 12,2011Notary Publf in and for the State of Te as STATE OF TEXAS § COUNTY OF DENTON § This instrument was acknowledged before me on the day of , 2010, by of the TOWN OF FLOWER MOUND, TEXAS, a home-rule municipal corporation, on behalf of such corporation. Notary Public in and for the State of Texas