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Home My WebLink AboutP-23-256 Amendment One.pdf COU�� County of Fresno INTERNAL SERVICES DEPARTMENT 1856�0 Facilities• Fleet•Graphics• Purchasing • Security•Technology �RVS AMENDMENT NUMBER ONE (1) Agreement Number: P-23-256 January 23, 2025 Occu-Med Ltd. Attn: Chris St. George 2121 W. Bullard Avenue Fresno, CA 93711 Contract Number P-23-256 covering Medical Examinations for Exposure to Hazardous Substances is amended as follows: Include services to County of Fresno Department of Behavioral Health, 3133 N. Millbrook Avenue, Fresno, CA 93703. The department contact is Sao Yang at 559-600-7983. This amendment will be effective January 23, 2025 through the expiration date of the agreement. Amendment provisions shall remain in full force and effect with any contract renewals. Maximum: The County of Fresno desires to increase this Agreement in the amount of Nine Thousand Two Hundred Dollars ($9,200.00). In no event shall services performed and/or fees paid under this Agreement be in excess of One Hundred Sixty-Three Thousand Seven Hundred Dollars ($163,700.00). Electronic Signatures. The parties agree that this Agreement may be executed by electronic signature as provided in this section. A. An "electronic signature" means any symbol or process intended by an individual signing this Agreement to represent their signature, including but not limited to (1) a digital signature; (2) a faxed version of an original handwritten signature; or(3) an electronically scanned and transmitted (for example by PDF document) of a handwritten signature. B. Each electronic signature affixed or attached to this Agreement (1) is deemed equivalent to a valid original handwritten signature of the person signing this Agreement for all purposes, including but not limited to evidentiary proof in any administrative or judicial proceeding, and (2) has the same force and effect as the valid original handwritten signature of that person. C. The provisions of this section satisfy the requirements of Civil Code section 1633.5, subdivision (b), in the Uniform Electronic Transaction Act (Civil Code, Division 3, Part 2, Title 2.5, beginning with section 1633.1). D. Each party using a digital signature represents that it has undertaken and satisfied the requirements of Government Code section 16.5, subdivision (a), paragraphs (1)through (5), and agrees that each other party may rely upon that representation. This Agreement is not conditioned upon the parties conducting the transactions under it by electronic means and either party may sign this Agreement with an original handwritten signature. Please acknowledge your acceptance by returning all pages of this letter to my office via email or USPS. 333 W. Pontiac Way, Clovis, CA 93612 / (559) 600-7110 The County of Fresno is an Equal Employment Opportunity Employer CONTRACT NO. P-23-256 Page 2 Occu-Med Ltd. January 23, 2025 If you have any questions, please contact Susan Walker, Purchasing Technician, at(559)600-7110 or email suwalker(cDfresnocountyca.aov. FOR THE COUNTY OF FRESNO Digitally signed Ryckburn Riley Blackburn Date:2025.01 24y12A1:1B1a08'00' Riley Blackburn Purchasing Manager 333 W. Pontiac Way Clovis, CA 93612 P-23-256 Amendment One.docx CONTRACT NO. P-23-256 Page 3 Occu-Med Ltd. January 23, 2025 CONTRACTOR TO COMPLETE: Company: Occu-Med, Ltd. Type of Entity: ❑ Individual ❑ Limited Liability Company ❑ Sole Proprietorship ❑ Limited Liability Partnership ■❑ Corporation ❑ General Partnership Sherri Conley Digitally signed by Sherri Conley Signature Date:2025.01.24 09:40:33-08'00' Sherri Conley, Secretary 1/24/25 Print Name and Title Date Andy Johnson Digitally signed by Andy Johnson Signature Date:2025.01.24 11:19:59-08'00' Andy Johnson, President 1/24/2025 Print Name and Title Date 2121 West Bullard Fresno CA 93711 Address City State Zip 559-435-2800 559-435-2520 ajohnson@occu-med.com TELEPHONE NUMBER FAX NUMBER E-MAIL ADDRESS ACCOUNTING USE ONLY ORG No.: 56302067 Account No.: 7295 Requisition No.: 5632510061 (7/2024) P-23-256 Amendment One.docx Procurement Agreement Number P-23-256 REVISED ATTACHMENT"A" Occu-Med Ltd. Page 1 of 4 01/23/2025 0112312025 REVISED ATTACHMENT 'A" FCCU-MED LTD GROUP Inspector Baseline Examination Physician services to include occupational and general medical history and complete physical Cost per examination. Test/Service A. Audiogram $ 66.00 B. Visual Screening (as defined) 66.00 C. Chest X-Ray(14x17) r 115.50 D. Cardiology(as defined) $ 115.50 E. Hemoccult Test 30.00 F. Complete Blood Count 25.00 G. Complete Urinalysis 17.00 H. Physical Measurements (as defined) 115.50 I. Blood Chemistry(as defined) 30.00 J.Venipuncure 33.00 K. Scheduling Fee 40.00 L. Exam Review Fee 60.00 Emergency Responder Baseline Examination Will consist of the same test listed above for Inspector Baseline Examination in addition to the following: A. Cardiology(as defined) $ 115.50 B. Spirometry(as defined) 99.00 C. Scheduling Fee 40.00 D. Exam Review Fee 60.00 SUB TOTAL $ 1,028.00 GROUP 11 The Contractor shall provide annually to all selected employees who have previously had base-line examinations,the periodic examination. The Contractor will provide more frequent examinations when conditions including previously diagnosed work-related health problems are found. Documented environmental data,which indicates occupational exposures to regulated carcinogens and other chemicals,will also establish the need for regular monitoring. Inspector's Periodic Examination Cost per Test/Service Physician services(as defined). A. Audiogram (optional/discretion) $ 66.00 B. Cardiology(as defined) 115.50 C. Blood Chemistry(as defined) 30.00 D. Complete Blood Count(as defined) 25.00 E. Urinalysis 17.00 G.Venipuncture 33.00 H. Scheduling Fee 40.00 I. Exam Review Fee 60.00 Procurement Agreement Number P-23-256 REVISED ATTACHMENT"A" Occu-Med Ltd. Page 2 of 4 01/23/2025 Emergency Responder Periodic Examination Will consist of the same test listed above for Inspector Periodic Examination in addition to the following: A. Cardiology(as defined) $ 115.50 B. Spirometry(as defined) 99.00 C. Scheduling Fee 40.00 D. Exam Review Fee 60.00 SUB TOTAL $ 701.00 GROUP III Physician services to include occupational and general medical history and complete physical examination. Lab Personnel Vaccines and Titer Cost per Test/Service A. Tetanus, diphtheria, and pertussis(Tdap)vaccine $ 93.18 B. Measles, mumps, and rubella (MMR)vaccine 165.02 C. Varicella vaccine 296.72 D. Influenza vaccine 35.99 E. SARS-CoV2 vaccine and boosters* 74.25 F. Rabies vaccine and Quantitative Titer 781.17 G. Meningococcal ACYW135 vax(Menveo)&Meningococcal B vax(Bexero) 246.63 H. Monkeypox vaccine N/A I. Hepatitis B vaccine 147.66 J. Immunization Management Fee 45.00 SUB TOTAL $ 1,885.62 *Admin Fee only GROUP IV When medical history and occupational history information indicates,the Contractor agrees to provide other tests or examinations that may be required by Title 8 of the California Administrative Code, General Industry Safety Orders, incorporated herein as follows: Cost per Test/Service A. Certification to Wear Respiratory Protective Equipment N/A B. Asbestos Exposure(as defined) 480.50 C. Carcinogens Cost per Test/Service 1. Primary target is pulmonary(as defined) N/A 2. Primary target is urinary tract(as defined) N/A 3. Primary target organ is liver(as defined) N/A 4. Primary target organ is gastrointestinal tract(as defined) N/A 5. Primary target organ is skin (as defined) N/A 6. Primary target organ system is hematopoietic(as defined) N/A D. Vinyl Chloride Cost per Test/Service 1. General Physical Examination (as defined) $ 115.50 2. Medical History(as defined) Included with Physical 3. Serum Specimen (as defined) N/A E. Dibromo 3-Chloropropane(DBCP)other known Spermatotoxic Agents(as defined) N/A F. Acrylonitrile (as defined) N/A Procurement Agreement Number P-23-256 REVISED ATTACHMENT"A" Occu-Med Ltd. Page 3 of 4 01/23/2025 G. 4 Methylenebis(2-Chloraniline) MOCA Urinary Metabolite Bioassay N/A H. Cholinesterase RBC and Plasma/Serum 60.00 I. Lateral/Oblique X-Rays $ 181.50 J. Sputum Cycology N/A K. Lung Biopsy N/A L. Laryngoscope N/A M. Proctosigmoidoscopy N/A N. Colonoscopy N/A O. Barium Contrast N/A P. Cystoscopy N/A Q. Renal Scan N/A R. Liver Biopsy N/A S. Liver Scan N/A T. Urinary Phenol N/A U. Bone Marrow N/A V. Gamma Glutamyl transpeptidase N/A W. MOCA Urinary Metabolic Assay N/A X. Physician Consultation with Examinee Scan N/A Z. Review job descriptions(physical abilities&environmental factors)as necessary, determine work N/A location and areas of work specialization. AA. OSHA Respirator Questionnaire (1910.134)Appendix C or equivalent) $ 40.00 Included with AB.Authorization for Release of Information from Medical Form Physical AC. PPD (TB)Skin Test 33.00 AD. Hepatitis Titer(anti-HB's)Testing 26.00 AE. Hepatitis B Vaccine 147.66 AF. Venipuncture 33.00 AG.Scheduling Fee 40.00 AH. Exam Review Fee 60.00 SUB TOTAL $ 480.50 GROUP V Exiting Inspectors, Emergency Responders and Lab staff will be required to participate in this medical exam. The exam content will consist of all tests as identified in the Base Line exam (for either the Inspector, Emergency Responder, or Lab staff)and/or specific tests recommended by the Physician. Exit Examinations Cost per Test/Service A. Tetanus, diphtheria, and pertussis(Tdap)vaccine $ 93.18 B. Measles, mumps, and rubella (MMR)vaccine $ 165.02 C. Varicella vaccine $ 296.72 D. Influenza vaccine $ 59.38 E. SARS-CoV2 vaccine and boosters* $ 74.25 F. Rabies vaccine and Quantitative Titer $ 781.17 G. Meningococcal ACYW135 vax(Menveo)&Meningococcal B vax(Bexero) $ 246.63 H. Monkeypox vaccine N/A I. Hepatitis B vaccine $ 147.66 J. Immunization Management Fee $ 45.00 SUB TOTAL $ 1,909.01 *Admin Fee only Procurement Agreement Number P-23-256 REVISED ATTACHMENT"A" Occu-Med Ltd. Page 4 of 4 01/23/2025 GROUP VI Other Services Fees/Rates Summary Report(Contractor's medical director shall review all medical records and test results and shall, within 30 days of the examination, submit a summary report of an employee's suitability for continued work activities and certification of ability.) Exit Examinations Cost per Test/Service A. Review and quality control of medical examinations. (defined) $ 60.00 B. Consultation Services(defined) Per Hour $ 250.00 C. Physician Review(defined) Per Hour $ 250.00 SUB TOTAL $ 560.00 GROUP VII I QUOTATION SCHEDULE-Sheriff's Office The Contractor shall provide annually to all selected Sheriff's Office employees who are in need of or have previously had base-line examinations, the annual examination. Periodic Examination Cost per Test/Service A. Audiogram $ 66.00 B. Blood Chemistry(Lead levels) $ 60.00 C. Venipuncture $ 33.00 D. Scheduling Fee $ 40.00 E. Review Fee $ 60.00 SUB TOTAL $ 259.00 GROUP VI11 Department of Behavioral Health Periodic Examination: A. PPD (TB) Skin Test B. Chest X-ray