Loading...
HomeMy WebLinkAbout23I037 - NFPA-COMPLIANT HEALTH, WELLNESS & BEHAVIORKEMPER Auto COMMERCIAL Customer Service. (800) 722-3391 Kemper Auto Commercial 11700 Great Oaks Way, Suite 450 Alpharetta, GA 30022 Underwritten by: Infinity Select Insurance Company Claims Service: (800) 353-6737 PRIMARY AND NONCONTRIBUTORY ENDORSEMENT 50004878601 1 03/10/2025 12:01 a.m. City of Palm Springs 3200 E Tahquitz Canyon Way Palm Springs, CA 92262 ON DUTY HEALTH PC This endorsement is attached to and forms a part of the listed policy. The following endorsement applies only If Form Number 500PNCV01 appears on your Declarations Page. This endorsement modifies the insurance provided under your COMMERCIAL AUTO POLICY. PART A — LIABILITY COVERAGE OTHER INSURANCE — PART A ONLY TT e-fo ing is added to this section: The coverage afforded under your Commercial Auto Policy is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: a. You have agreed in writing in a contractor agreement that the coverage afforded under your Commercial Auto Policy would be primary and would not seek contribution from any other insurance available to such additional insured; and b. Such additional insured is a named insured under such other insurance. ALL OTHER TERMS, LIMITS, CONDITIONS, AND PROVISIONS OF THE POLICY REMAIN UNCHANGED. RECEIVED sp 3 U 2024 OFFICE OF THE CITY CLERK ADDL INSURED COPY AMEND DATE : 09/26/2024 500PNCV01 ENDORSEMENT : 4-10 KEMPER Au#o Kemper Auto Commercial 11700 Great Oaks Way, Suite 450 COMMERCIAL Alpharetta, GA 30022 Underwritten by: Infinity Select Insurance Company Customer Service: (800) 722-3391 Claims Service: (800) 353-6737 ADDITIONAL NAMED INSURED ENDORSEMENT City of Palm Springs 3200 E Tahquitz Canyon Way Palm Springs, CA 92262 50004878601 1 03/10/202512:01 a.m. ON DUTY HEALTH PC This endorsement is attached to and forms a part of the listed policy. No changes will be effective prior to the time changes are requested. Additionallinsured City of Palm Springs a Part A - Liability Coverage, is changed as follows: a The definition of insured is changed to include the additional insured named above. Adding an insured will not increase the limit of our liability. The insurance provided by this endorsement will be excess over any other valid and collectible Insurance. All other parts of this Policy remain unchanged. ADDL INSURED COPY AMEND DATE: 09/26/2024 50461AIRn1 FNnORSFMFNT * 4-1n CONTRACT ABSTRACT Contract/Amendment Name of Contract: Company Name: Company Contact: Email: Summary of Services: Contract Price: Contract Term: Public Integrity/ Business Disclosure Forms: Contract Administration Lead Department: Contract Administrator/ Ext: Contract Approvals Council/City Manager Approval Date: Agreement Number: Amendment Number: Contract Compliance Exhibits: Insurance: Routed By: Bonds: Business License: Sole Source Co-Op CoOp Agmt #: Sole Source Documents: CoOp Name: CoOp Pricing: By: Submitted on: Contract Abstract Form Rev 8.16.23 Authorized Signers: Name, Email (Corporations require 2 signatures) NFPA_Compliant Health, Wellness & Behavioral Assessments On Duty Health, PC Kristin Batla, PA-C info@onduty.health Health & Fitness Assessments for Annual Fire Fighter Screenings $58,925 + $79,490 = $138,415 April 1, 2023 through March 31, 2024 Yes Greg Batla, greg@onduty.health Fire Department Jason Loya 6/29/2023 23I037 1 Yes Yes Yes Procurement - No N/A N/A N/A October 12, 2023 Brian Sotak-Rossman DocuSign Envelope ID: 723F0F74-9AF3-4A73-9D4F-7FB21BB5BC5F AMENDMENT NO. 1 TO THE CONTRACT SERVICES AGREEMENT BETWEEN THE CITY OF PALM SPRINGS AND ON DUTY HEALTH FOR FIRE DEPARTMENT HEALTH AND FITNESS SERVICES 1. Parties and Date. This Amendment No. 1 to the CONTRACT SERVICES AGREEMENT is made and entered into as of this 5th day of June 2023, by and between the City of Palm Springs (“City”) and On Duty Health, with its principal place of business at 1752 E. Lugonia Ave, Suite 117-4949, Redlands, CA 92374 (“Contractor”). City and Contractor are sometimes individually referred to as “Party” and collectively as “Parties.” 2. Recitals. 2.1 Agreement. The City and Contractor have entered into an agreement entitled “CONTRACT SERVICES AGREEMENT” dated March 27, 2023 (“Agreement” or “Contract”) for the purpose of retaining the services of Contractor to provide health and fitness assessments. 2.2 Amendment. The City and Contractor desire to amend the Agreement dated March 27, 2023, to revise the scope of services and extend services to include up to 95 staff for these services. The additional compensation for this Amendment will be $79,504.00. The total contracted amount with Amendment will be $138,415.00. 2.3 Amendment Authority. This Amendment No. 1 is authorized pursuant to Section 3 of the Agreement. 3. Terms. 3.1 Proposal – Annual Firefighter Health & Fitness Assessment of the Agreement is hereby amended in its entirety to read as follows: "Health & Fitness Assessment Crew 89 (Line Item #1) for the compensation amount of $63,902.00 to be replaced by “Health & Fitness Assessment Crew 95 (Line Item #1) for the compensation amount of $68,210.00”. Under Additional Services Available – Cancer Labs - "Galleri Multi-Cancer Early Detection Blood Test (50+ cancers) was offered for an additional cost of $719.00 per staff member to be replaced by “Galleri 50+ Multicancer Detection Test Crew 95 (Line Item #8) for the compensation amount of $70,205.00”. Page 1 of 3 Revised: 5.9.23 DocuSign Envelope ID: 723F0F74-9AF3-4A73-9D4F-7FB21BB5BC5F "Labs to be drawn at Quest Crew 11 (Line Item #10) for the compensation amount of $0 to be replaced by “Labs to be drawn at Quest Crew 95 (Line Item #9) for the compensation amount of $0”. "Total compensation amount of $58,911.00 (as approved in Purchase Order No.: 23001137) to be replaced by “Total (Line Item #10) for the compensation amount of $138,415.00”. “Exhibit “A” – Contract dated March 27, 2023, is hereby deleted in its entirety, and replaced with Exhibit “B” – Revised Contract dated May 5, 2023, attached hereto, and incorporated herein by reference. 3.2 Continuing Effect of Agreement. Except as amended by this Amendment No. 1, all other provisions of the Agreement remain in full force and effect and shall govern the actions of the parties under this Amendment No. 1. From and after the date of this Amendment No. 1, whenever the term “Agreement” or “Contract” appears in the Agreement, it shall mean the Agreement as amended by this Amendment No. 1. 3.3 Adequate Consideration. The Parties hereto irrevocably stipulate and agree that they have each received adequate and independent consideration for the performance of the obligations they have undertaken pursuant to this Amendment No. 1. 3.4 Severability. If any portion of this Amendment No. 1 is declared invalid, illegal, or otherwise unenforceable by a court of competent jurisdiction, the remaining provisions shall continue in full force and effect. 3.5 Counterparts. This Amendment No. 1 may be executed in duplicate originals, each of which is deemed to be an original, but when taken together shall constitute but one and the same instrument. [SIGNATURES ON FOLLOWING PAGE] Page 2 of 3 Revised: 5.9.23 DocuSign Envelope ID: 723F0F74-9AF3-4A73-9D4F-7FB21BB5BC5F SIGNATURE PAGE TO AGREEMENT BY AND BETWEEN THE CITY OF PALM SPRINGS AND ON DUTY HEALTH IN WITNESS WHEREOF, the Parties have executed this Agreement as of the dates stated below. CONTRACTOR: By: _ By: _ Signature Signature (2nd signature required for Corporations) Date: CITY OF PALM SPRINGS: APPROVED BY CITY COUNCIL: Date: 06/29/2023 Item No. 1H APPROVED AS TO FORM: By: Date: ATTEST: By: City Attorney City Clerk APPROVED: By: City Manager – over $50,000 Date: Deputy/Assistant City Manager – up to $50,000 Director – up to $25,000 Manager – up to $5,000 Page 3 of 3 Revised: 5.9.23 DocuSign Envelope ID: 723F0F74-9AF3-4A73-9D4F-7FB21BB5BC5F 10/12/2023 10/12/2023 EXHIBIT "B" DocuSign Envelope ID: 723F0F74-9AF3-4A73-9D4F-7FB21BB5BC5F Firefighter & Physician Owned Keeping Firefighters Healthy & Fit For Service Item 1H - Page 7 DocuSign Envelope ID: 723F0F74-9AF3-4A73-9D4F-7FB21BB5BC5F Proposal for Palm Springs, CA Fire Department NFPA-1582 Firefighter Health and Fitness Assessments On-site Occupational Health Providers Specialized in Firefighter Health Prepared For Wayne Seacrist, Captain Amendment for a Revised Scope of Service to include up to 95 staff for these services. (Services listed in proposal below, which include Comprehensive Physical Assessment, Lab panel and urinalysis, and Galleri Multicancer test) Contract date: 3-27-2023 Revision date: 5-9-2023 Keeping Firefighters Healthy & Fit For Service On Duty Health First Responder Health 1752 E Lugonia Ave, STE 117-4949 Redlands, CA 92374 512.655.3578 info@onduty.health DocuSign Envelope ID: 723F0F74-9AF3-4A73-9D4F-7FB21BB5BC5F Dear Captain Seacrist: Thank you for your proposal request from On Duty Health regarding your upcoming annual firefighter health & fitness assessments. We take very seriously the high calling that it is to serve this critical population. And we’re confident that we’ll provide you with expert health assessments as well as excellent customer service. Included in this proposal, you’ll find the outline of services we offer, including a full NFPA 1582, 1583 and WFI compliant annual assessment at your department. This includes a full body ultrasound screening, comprehensive labs, a maximal 12-lead EKG treadmill stress test (WFI protocol), TRUE VO2 Max testing, vision and audiometry testing, muscular strength and endurance testing, in-depth behavioral health assessment, and more. Our medical record system is fully electronic, meaning that each of your members will always have a secure online portal through which they can track their health results year to year. And, we provide administration with a department-wide analytics dashboard to help inform your decisions on where to implement health improvement plans, with our guidance. We also hope to partner with you to offer continuing services such as return-to-duty assessments, new hire assessments, health education seminars, behavioral health support, nutrition counseling and fitness training. Consider us your one-stop-shop for all your fire health needs. Our Co-owner and Chief Operating Officer is a Fire Chief with 28 years in the industry, bringing a firefighter-tailored experience and perspective to everything we do. We practice evidence-based medicine, following current peer-reviewed research, offering novel cancer screening tools such as the Galleri Multi-Cancer Detection Blood Test and Low Dose CT. Our physicians are board certified in cardiology, radiology, dermatology, general and preventative medicine. And our team of Physician Assistants, Nurse Practitioners, Ultrasound Technicians, Exercise Physiologists, Counselors, Nutritionists, Personal Trainers and Phlebotomists are all specifically trained in firefighter occupational health. Again, thank you for your request. I’m hopeful that we’ll be working together soon to help keep your firefighters healthy and fit for service. And please don’t hesitate to call or email us if you have any questions. Warm regards, Kristin Batla, PA-C Chief Medical Officer, Co-owner On Duty Health Highlights • Full NFPA 1582, 1583, and WFI compliant annual assessment at your department. • Full body ultrasound screening, including Radiology followup for abnormal findings • Cardiopulmonary Exercise Testing (CPET) • TRUE VO2 Max testing • Comprehensive labs and urinalysis • Vision and audiometry testing • Muscular strength and endurance testing • In-depth behavioral health assessments • Department-wide Health Dashboards • Return-to-duty assessments • New hire assessments • Health education seminars • Behavioral health support • Nutrition counseling • Fitness training • Conducting, participating in, and incorporating the latest research in firefighter health DocuSign Envelope ID: 723F0F74-9AF3-4A73-9D4F-7FB21BB5BC5F Company Profile On Duty Health is a female and firefighter owned, physician-led, customer-service-centered healthcare company specifically specialized in mobile firefighter health. We serve over 4,000 first responders in 82 cities across California, Texas & Missouri with our comprehensive annual health and fitness assessments. This company was founded specifically to improve health outcomes for firefighters; a highly at-risk population. These risks include: Cancers (NIOSH) • 9% higher risk of being diagnosed with cancer • 14% higher risk of dying from cancer • Significantly higher risk for specific types of cancer Cardiac Deaths (NFPA) 40-50% of annual duty-related fatalities Behavioral Health Issues (IAFF) 19% experienced suicidal thoughts 27% struggled with substance abuse 65% suffer from PTSD 80% said asking for help would make them seem “weak” With the above statistics in mind, our system has been designed to identify life threatening issues early so a firefighter may have the best chance at not only surviving, but thriving well into retirement. We are fully NFPA-compliant, but go well beyond the NFPA standards by incorporating recommendations from IAFF & IAFC, US Preventative Services Task Force, CDC, National Institute for Occupational Safety and Health, American College of Cardiology, American Heart Association, American College of Sports Medicine, OSHA, and the research and experience of our own health team. DocuSign Envelope ID: 723F0F74-9AF3-4A73-9D4F-7FB21BB5BC5F Proposal Annual Firefighter Health & Fitness Assessments Description Crew Unit Price Pricing HEALTH & FITNESS ASSESSMENT 95 $718 $68,210 Full Physical Included • Comprehensive Physical with Health History & Vitals • Titmus V2 Advanced Vision Testing • Audiometry Testing • Skin Cancer Assessment • Behavioral Health Assessment • Review of Results w/ Personalized Health Plan Cardiopulmonary Screening & Fitness Assessment Included • Cardiopulmonary Exercise Testing (CPET) consisting of 12- lead EKG treadmill/stepmill stress test run to maximal volition utilizing WFI protocol, Blood Pressure readings, and TRUE VO2 Max Testing) • Pulmonary Function Testing (Spirometry) • Metabolic Analysis w/ Body Composition • Muscular Endurance, Strength and Flexibility Evaluation • Cardiology followup interpretation for irregular results Ultrasound Enhanced Cancer Screening Included • Ultrasound imaging of the heart with function, aorta & aortic valves, carotid arteries, thyroid, liver, pancreas, gall bladder, spleen, kidneys, bladder, pelvic (women), testicular and prostate (men) • Radiology followup interpretation for irregular results Galleri 50+ Multicancer Detection Test 95 $739 $70205 Labs to be drawn at Quest 95 $0 $0 Total $138,415.00 DocuSign Envelope ID: 723F0F74-9AF3-4A73-9D4F-7FB21BB5BC5F Additional Services Available Item Description Pricing Cancer Labs Galleri Multi-Cancer Early Detection Blood Test (50+ cancers) $739 CA-125 (ovarian cancer screening - women) $49 Cancer antigen 15-3 (CA 15-3) [breast cancer] $99 Other Labs Hepatitis A, B and C Test (Acute Hepatitis Panel) $69 QuantiFERON Gold TB (Blood test) $89 Medical Professionals Urine Drug Screen (12 drug panel) $99 Nicotine Screening (Urine) $49 HIV testing $49 Heavy Metals Profile I, Blood (arsenic, lead, mercury) $129 Heavy Metals Profile II, Blood (arsenic, cadmium, lead, mercury) $159 Cholinesterase (HazMat) testing $69 Testosterone levels $49 New Hire & Return to Available on an ongoing basis with regional scheduling (Send member to us at Standard Duty a nearby agency). Same pricing as full assessment. Mental Health Support Each health assessment comes standard with a written and oral behavioral Variable health assessment, designed for firefighters. For continued support, we use Pricing counselors & therapists that are specifically trained to meet the needs of your firefighter with PTSD support and more. Can be offered on-site or through tele- medicine. Personal Training Our certified personal trainer can build individual or group packages to improve Variable health outcomes through customized workout routines and demonstrations Pricing Nutrition Counseling Each health assessment comes standard with nutrition recommendations. However, our licensed nutritionist can build individual or group packages to Variable Pricing work with your members for guidance in meal planning, shopping, cooking, and more for enhanced health outcomes. DocuSign Envelope ID: 723F0F74-9AF3-4A73-9D4F-7FB21BB5BC5F Health Dashboards Awareness of your department’s overall health is extremely important. We assist you by providing a de-identified Health Dashboard which shares various key health metrics, guiding you for improving the health and longevity of your crew. Galleri 50+ Multicancer Test We have partnered with Grail to offer the Galleri test, which is a revolutionary new blood test that can detect over 50 different types of active cancers. Incredibly, this test has a false positivity rate of 0.5% and a specificity of 99.5%. Our rate is drastically reduced from the standard price of $949/pp (plus provider fees) due to an agreement with the IAFF. Click the picture to the right to learn more. Fiscal Responsibility We offer the most competitive pricing, while also offering the most advanced, comprehensive exam available. Our COO, as a Fire Chief, has made it a priority for us to offer this high-level of service, while keeping costs down to fit the budgets of smaller, rural departments. This means that departments of all sizes benefit from our pricing structure, which ensures taxpayers that their dollars are being spent wisely. From our lower pricing, you can see one simple, but important reality: On Duty Health is focused on First Responder Health, not maximizing profits. An important principle in our pricing structure, is that no member should be left behind. That means, for most of our packages, every member is receiving the Ultrasound Screening and Stress Testing every year. While there is some research to support age stratification, where members under 40 receive these tests over longer intervals, we have found cancer and life threatening heart conditions in this younger population. Our system provides the most comprehensive option by including these important testing elements for each member every year. DocuSign Envelope ID: 723F0F74-9AF3-4A73-9D4F-7FB21BB5BC5F California Based We are based in Southern California. We currently serve 33 Fire Departments across California, from the San Diego area all the way up to Eureka. CA References: Jay Wojnowski, Heartland Fire jwojnowski@heartlandfire.org Alex Kargbo, Santa Barbara Fire akargbo@SantaBarbaraCA.gov Jay Enns, Paso Robles Fire JEnns@prcity.com Reviews: ✪✪✪✪✪ On Duty Health has set a very high bar for Health and Wellness screenings, and consulting. The team at On Duty Health took great care of our Firefighters, spent ample time explaining the findings of our assessments, and set us up for success to better serve our community. We look forward to working with them annually. -Sid Jamotte, Health & Wellness Coordinator, Ross Valley, CA FD. ✪✪✪✪✪ On Duty Health has been great for all our members at Santa Barbara City Fire and would recommend ODHs services to any and everybody. Amazing staff and end product. -Alex Kargbo, Health & Wellness Coordinator, Santa Barbara, CA FD. ✪✪✪✪✪ This is our second year using this service. We are very pleased. Thank you for keeping our people healthy. Amazing staff and end product. -Brian Hayward, Division Chief, Heartland Fire & Rescue, CA. ✪✪✪✪✪ On Duty Health has been a fantastic company to work with. After transitioning to them for our annual department physicals, our personnel have had nothing but positive things to say about the experience. The consensus, which is hard to get with 180 personnel, is that the thoroughness and quality of their services is far superior to our previous provider. In my position I interact with numerous vendors and On Duty is at the top of my list for the best to work with. From the ownership to the practitioners on site, everyone is professional and responsive to our needs. Communications are clear and timely, with a truly collaborative effort existing between our department and On Duty. I highly recommend On Duty Health to anyone looking into providers for their department’s physicals. -Captain Kyle Williford, Richardson, TX FD DocuSign Envelope ID: 723F0F74-9AF3-4A73-9D4F-7FB21BB5BC5F Intent to Enlist Services If you agree with the above proposal and base pricing, please sign and date below indicating your intent to enlist our services. Signatures: “Customer”: Palm Springs, CA Fire Department Customer Signature Print Name Print Title Date Kristin Batla, PA-C Chief Medical Officer “Company": On Duty Health 5-9-2023 Date DocuSign Envelope ID: 723F0F74-9AF3-4A73-9D4F-7FB21BB5BC5F Master Terms & Conditions These Master Terms and Conditions (“MTC”) govern all use of the Services from On Duty Health (“Company”) by the “Customer”, as defined in the Proposal/Purchase Order (collectively the “Parties” and individually a “Party”). 1. Services. The Company shall provide the Customer’s employees with certain services (“Services”). Services consist of an annual Firefighter Physical/Fitness Assessment based on each member’s essential job functions as set forth in their applicable job description. “Fitness Assessment,” as defined by the National Fire Protection Association, includes a medical history evaluation, hands- on physical exam, blood analysis, urinalysis, vision testing, audiometry testing, pulmonary function testing, treadmill stress test with 12 lead EKG, cancer screening elements, in substantial compliance with NFPA 1582, NFPA 1583, and WFI (Wellness Fitness Initiative) standards. 2. Fee. The Customer shall pay the Company the fee set forth in the Proposal/Purchase Order for each Fitness Assessment. The Customer shall remit payment to the Company for all Services within thirty (30) days of receipt of the invoice. A 2% late fee charge will be assessed after 30 days, and for each month thereafter that the payment is delayed. 3. Modification and Cancellation of Purchase Order. The Customer may cancel or modify the Purchase Order, in whole or in part, without penalty prior to six (6) weeks out from the date set for receiving the Services. After this point, the Customer may not modify or cancel the Purchase Order and shall be responsible for the fees for all Services described in the Purchase Order. If Customer has an Employee(s) who will miss the assessments due to sickness or other reasons, the Customer will hold a “credit” for that Employee, and may work with Company to schedule them for their assessments at another time and place. This credit will remain valid for two hundred (200) days from the start date of the current series of assessments. 4. Employee List & Schedule. At least four (4) weeks before the Company performs the Services, the Customer shall provide the Company with a list of all employees that will receive the Services (based off of the “Roster Template” provided by the Company). At least two (2) weeks before the Company performs the Services, the Customer shall provide the Company with a Schedule of which Employees will be seen at what date and time (based off of the “Schedule Template” provided by the Company). 5. Equipment. The Company agrees to provide all equipment and supplies necessary for the assessments, EXCEPT for a treadmill. The Customer agrees to provide a properly functioning treadmill (with variable speed and variable incline) and adequate space for the assessments to be conducted. 3 separate, private rooms is preferred. A reliable WiFi connection and log-on information is required. 6. Location Reciprocity. The Customer agrees to allow a small number of members from other departments, if any, to be seen on their premises. This allows for make-up physicals if a member missed at a nearby department, return to duty or new hire physicals. As such, other nearby departments will be granting such reciprocity to The Customer. Other departments shall agree to hold harmless the hosting department (The Customer) should any issue occur, such as an injury incurred by the visiting member. Likewise, The Customer shall agree to hold harmless a hosting department if a member visits another department for a similar reason. Furthermore, On Duty Health agrees to hold harmless the hosting department for any issue that may occur from the visiting member. 7. Expected Price Increases. The pricing listed in the proposal is valid for thirty (30) days from the date listed on the cover sheet. Due to inflation, please expect a ~5% price increase each year (as per the Medical Price Index average), unless signing a multiyear contract. DocuSign Envelope ID: 723F0F74-9AF3-4A73-9D4F-7FB21BB5BC5F 8. Limitation of Liability. EXCEPT AS PROHIBITED BY LAW, IN NO EVENT SHALL COMPANY BE LIABLE TO CUSTOMER FOR ANY INDIRECT, SPECIAL, INCIDENTAL, EXEMPLARY, MULTIPLE, PUNITIVE OR CONSEQUENTIAL DAMAGES OF ANY KIND, WHETHER BASED ON CONTRACT, TORT (UNLESS WITHOUT LIMITATION NEGLIGENCE), WARRANTY, GUARANTEE OR ANY OTHER LEGAL OR EQUITABLE GROUNDS, EVEN IF COMPANY HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. FURTHER, EXCEPT AS PROHIBITED BY LAW, THE CUMULATIVE, AGGREGATE LIABILITY OF COMPANY (INCLUDING ATTORNEYS’ FEES AWARDED UNDER THIS AGREEMENT) TO THE CUSTOMER AND ANY OTHER THIRD PARTIES FOR ALL CLAIMS, LIABILITIES AND DAMAGES ARISING OUT OF OR RELATING TO THIS MTC, WHETHER IN CONTRACT OR TORT OR BY WAY OF INDEMNITY OR OTHERWISE, SHALL NOT EXCEED: THE FEES PAID BY THE CUSTOMER TO THE COMPANY FOR THE TWELVE (12) MONTHS IMMEDIATELY PRECEDING THE BREACH FOR WHICH THE DAMAGES ARE CLAIMED. 9. Notice. All notices hereunder must be in writing to the other Party. If to the Company, the notice shall be sent to: Greg Batla Chief Executive Officer 1752 E Lugonia Ave, STE 117-4949 Redlands, CA 92374 greg@onduty.health 10. Amendments. No amendment to, modification of, or termination of this MTC will be effective unless it is in writing and signed by the Parties. 11. Force Majeure. The Company shall not be liable or responsible to the Customer, nor be deemed to have defaulted or breached this MTC, for any failure or delay in fulfilling or performing any term of this MTC when and to the extent such failure or delay is caused by or results from acts or circumstances beyond the reasonable control of the Company including, without limitation, acts of God, flood, fire, earthquake, explosion, governmental actions, war, invasion or hostilities (whether war is declared or not), terrorist threats or acts, riot, or other civil unrest, national emergency, revolution, insurrection, epidemic, pandemic, lock-outs, strikes or other labor disputes (whether or not relating to either party’s workforce), or restraints or delays affecting carriers or inability or delay in obtaining supplies of adequate or suitable materials, or telecommunication breakdown or power outage. 12. Agreement. In signing the Proposal/Purchase Order above, you agree to the entirety of terms and conditions set forth in this Master Terms And Conditions agreement. DocuSign Envelope ID: 723F0F74-9AF3-4A73-9D4F-7FB21BB5BC5F Contact 512.655.3578 info@onduty.health 1752 E Lugonia Ave STE 117-4949 Redlands, CA 92374 www.onduty.health Follow Us @ondutyhealth DocuSign Envelope ID: 723F0F74-9AF3-4A73-9D4F-7FB21BB5BC5F SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 2/14/2023 Arthur J.Gallagher Risk Management Services,LLC 2850 Golf Rd Rolling Meadows IL 60008 Gallagher Client Service Team 833-391-6524 Select_Certificates@ajg.com Ohio Security Insurance Company 24082 ONDUTYH-01 Employers Preferred Insurance Company 10346ONDUTYHEALTH–TEXAS,PLLC On Duty Health,LLC;On Duty Health,PC 2028 East Ben White Boulevard Ste 240A Austin TX 78704 Ohio Casualty Insurance Company 24074 276329906 A X 1,000,000 X 1,000,000 15,000 1,000,000 2,000,000 X X BKS64292113 1/11/2023 1/11/2024 2,000,000 C X X 2,000,000USO642921131/11/2023 1/11/2024 2,000,000 X 10,000 B XEIG4929978012/10/2023 2/10/2024 1,000,000 1,000,000 1,000,000 A Employment Practices Liability TX Data Compromise BKS64292113 1/11/2023 1/11/2024 Agg Limit/Deductible Agg Limit/Deductible $25,000 /$5,000 $100,000 /$2,500 CG 88 10 04 13 -Commercial General Liability Extension CG 20 37 04 13 -Additional Insured -Owners,Lessees or Contractors -Completed Operations CG 24 04 05 09 -Waiver of Transfer of Rights of Recovery Against Others to Us WC040306 (4/84)-CA WAIVER OUR RIGHT TO RECOVER WC420304B (6/14)-TX WAIVER OF SUBROGATION City of Palm Springs,CA 3200 E Tahquitz Canyon Way Palm Springs CA 92262 DocuSign Envelope ID: 723F0F74-9AF3-4A73-9D4F-7FB21BB5BC5F