HomeMy WebLinkAbout2014-256 Contract - Emergency Reporting Contract for GOODS AND SERVICES Less than $25,000 CITY OF CONTRACTOR: Emergency Reporting -AS H LAND Fire / EMS Records Management 20 East Main Street CONTACT: Lee Kleve Ashland, Oregon 97520 Telephone: 541/488-6002 ADDRESS: 851 Coho Way Suite 301, Bellingham, WA 98225 Fax: 541/488-5311 TELEPHONE: 360-232-4891 DATE AGREEMENT PREPARED: September 8, 2014 FAX: 866-929-6157 BEGINNING DATE: September 15, 2014 COMPLETION DATE: September 14, 2018 COMPENSATION: $6,954.00 (Year 1: Initial set up $1,428.00, Annual cost $4,776.00, Year 1/Set up $750.00 GOODS AND SERVICES TO BE PROVIDED: Full ERS; CAD Link: Billing Link - Two (2) licensed stations @ $199/Month, initial set up fee $1,428.00 Export type: NEMSIS 2.2.1 Gold - Initial set up $750.00, Year 2 maintenance will be $500.00 CAD link to Jackson County CAD Center - $0.00 (No additional charge) Per Package Order Form attached as Exhibit C, CAD Order Form attached as Exhibit D and Medical Billing Form attached as Exhibit E. ADDITIONAL TERMS: In the event of conflicts or discrepancies among the contract documents, the City of Ashland Contract for Goods and Services will be primary and take precedence, and any exhibits or ancillary contracts or agreements having redundant or contrary provisions will be subordinate to and interpreted in a manner that will not conflict with the said rims City of Ashland Contract. NOW THEREFORE, pursuant to AMC 2.50.090 and after consideration of the mutual covenants contained herein the CITY AND CONTRACTOR AGREE as follows: 1. All Costs by Contractor: Contractor shall, provide all goods as specified above and shall at its own risk and expense, perform any work described above and, unless otherwise specified, furnish all labor, equipment and materials required for the proper performance of such work. 2. Qualified Work: Contractor has represented, and by entering into this contract now represents, that any personnel assigned to the work required under this contract are fully qualified to perform the work to which they will be assigned in a skilled and worker-like manner and, if required to be registered, licensed or bonded by the State of Oregon, are so registered, licensed and bonded. Contractor must also maintain a current City business license. 3. Completion Date: Contractor shall provide all goods in accordance with the standards and specifications, no later than the date indicated above and start performing the work under this contract by the beginning date indicated above and complete the work by the completion date indicated above. 4. Compensation: City shall pay Contractor for the specified goods and for any work performed, including costs and expenses, the sum specified above. Payments shall be made within 30 days of the date of the invoice. Should the contract be prematurely terminated, payments will be made for work completed and accepted to date of termination. Compensation under this contract, including all costs and expenses of Contractor, is limited to $25,000.00, unless a separate written contract is entered into by the City. 5. Ownership of Documents: All documents prepared by Contractor pursuant to this contract shall be the property of City. 6. Statutory Requirements: ORS 27913.220, 27913.225, 27913.230, 27913.235, ORS Chapter 244 and ORS 670.600 are made part of this contract. 7. Living Wage Requirements: If contractor is providing services under this contract and the amount of this contract is $20,142.20 or more, Contractor is required to comply with chapter 3.12 of the Ashland Municipal Code by paying a living wage, as defined in this chapter, to all employees performing work under this contract and to any subcontractor who performs 50% or more of the work under this contract. Contractor is also required to post the notice attached hereto as Exhibit B predominantly in areas where it will be seen by all employees. 8. Indemnification: Contractor agrees to defend, indemnify and save City, its officers, employees and agents harmless from any and all losses, claims, actions, costs, expenses, judgments, subrogations, or other damages resulting from injury to any person (including injury resulting in death), or damage (including loss or destruction) to property, of whatsoever nature arising out of or incident to the performance of this contract by Contractor (including but not limited to, Contractor's employees, agents, and others designated by Contractor to perform work or services attendant to this contract). Contractor shall not be held responsible for any losses, expenses, claims, subrogations, actions, costs, judgments, or other damages, directly, solely, and proximately caused by the negligence of City. 9. Termination: Contract for Goods and Services Less than $25,000, Revised 07/08/2014, Page 1 of 5 b. City's Convenience. This contract may be terminated at any time by City upon 30 days' notice in writing and delivered by certified mail or in person. C. For Cause. City may terminate or modify this contract, in whole or in part, effective upon delivery of written notice to Contractor, or at such later date as may be established by City under any of the following conditions: i. If City funding from federal, state, county or other sources is not obtained and continued at levels sufficient to allow for the purchase of the indicated quantity of services; ii. If federal or state regulations or guidelines are modified, changed, or interpreted in such a way that the services are no longer allowable or appropriate for purchase under this contract or are no longer eligible for the funding proposed for payments authorized by this contract; or iii. If any license or certificate required by law or regulation to be held by Contractor to provide the services required by this contract is for any reason denied, revoked, suspended, or not renewed. d. For Default or Breach. i. Either City or Contractor may terminate this contract in the event of a breach of the contract by the other. Prior to such termination the party seeking termination shall give to the other party written notice of the breach and intent to terminate. If the party committing the breach has not entirely cured the breach within 15 days of the date of the notice, or within such other period as the party giving the notice may authorize or require, then the contract may be terminated at any time thereafter by a written notice of termination by the party giving notice. ii. Time is of the essence for Contractor's performance of each and every obligation and duty under this contract. City by written notice to Contractor of default or breach, may at any time terminate the whole or any part of this contract if Contractor fails to provide services called for by this contract within the time specified herein or in any extension thereof. iii. The rights and remedies of City provided in this subsection (d) are not exclusive and are in addition to any other rights and remedies provided by law or under this contract. e. Obligation/Liability of Parties. Termination or modification of this contract pursuant to subsections a, b, or c above shall be without prejudice to any obligations or liabilities of either party already accrued prior to such termination or modification. However, upon receiving a notice of termination (regardless whether such notice is given pursuant to subsections a, b, c or d of this section, Contractor shall immediately cease all activities under this contract, unless expressly directed otherwise by City in the notice of termination. Further, upon termination, Contractor shall deliver to City all contract documents, information, works-in-progress and other property that are or would be deliverables had the contract been completed. City shall pay Contractor for work performed prior to the termination date if such work was performed in accordance with the Contract. 10. Independent Contractor Status: Contractor is an independent Contractor and not an employee of the City. Contractor shall have the complete responsibility for the performance of this contract. 11. Non-discrimination Certification: The undersigned certifies that the undersigned Contractor has not discriminated against minority, women or emerging small businesses enterprises in obtaining any required subcontracts. Contractor further certifies that it shall not discriminate in the award of such subcontracts, if any. The Contractor understands and acknowledges that it may be disqualified from bidding on this contract, including but not limited to City discovery of a misrepresentation or sham regarding a subcontract or that the Bidder has violated any requirement of ORS 279A.110 or the administrative rules implementing the Statute. 12. Asbestos Abatement License: If required under ORS 468A.710, Contractor or Subcontractor shall possess an asbestos abatement license. 13. Assignment and Subcontracts: Contractor shall not assign this contract or subcontract any portion of the work without the written consent of City. Any attempted assignment or subcontract without written consent of City shall be void. Contractor shall be fully responsible for the acts or omissions of any assigns or subcontractors and of all persons employed by them, and the approval by City of any assignment or subcontract shall not create any contractual relation between the assignee or subcontractor and City. 14. Use of Recyclable Products: Contractor shall use recyclable products to the maximum extent economically feasible in the performance of the contract work set forth in this document. 15. Default. The Contractor shall be in default of this agreement if Contractor: commits any material breach or default of any covenant, warranty, certification, or obligation it owes under the Contract; if it loses its QRF status pursuant to the QRF Rules or loses any license, certificate or certification that is required to perform the work or to qualify as a QRF if Contractor has qualified as a QRF for this agreement; institutes an action for relief in bankruptcy or has instituted against it an action for insolvency; makes a general assignment for the benefit of creditors; or ceases doing business on a regular basis of the type identified in its obligations under the Contract; or attempts to assign rights in, or delegate duties under, the Contract. 16. Insurance. Contractor shall at its own expense provide the following insurance: a. Worker's Compensation insurance in compliance with ORS 656.017, which requires subject employers to provide Oregon workers' compensation coverage for all their subject workers b. General Liability insurance with a combined single limit, or the equivalent, of not less than Enter one: $200,000, $500,000, $1,000,000, $2,000,000 or Not Applicable for each occurrence for Bodily Injury and Property for Goods and Services Less than $25,000, Revised 07/08/2014, Page 2 of 5 ,Damage. It shall include contractual liability coverage for the indemnity provided under this contract. C. Automobile Liability insurance with a combined single limit, or the equivalent, of not less than Enter one: $200,000, $500,000, $1,000,000, or Not Applicable for each accident for Bodily Injury and Property Damage, including coverage for owned, hired or non-owned vehicles, as applicable. d. Notice of cancellation or change. There shall be no cancellation, material change, reduction of limits or intent not to renew the insurance coverage(s) without 30 days' written notice from the Contractor or its insurer(s) to the City. e. Additional Insured/Certificates of Insurance. Contractor shall name The City of Ashland, Oregon, and its elected officials, officers and employees as Additional Insureds on any insurance policies required herein but only with respect to Contractor's services to be provided under this Contract. As evidence of the insurance coverages required by this Contract, the Contractor shall furnish acceptable insurance certificates prior to commencing work under this contract. The contractor's insurance is primary and non-contributory. The certificate will specify all of the parties who are Additional Insureds. Insuring companies or entities are subject to the City's acceptance. If requested, complete copies of insurance policies, trust agreements, etc. shall be provided to the City. The Contractor shall be financially responsible for all pertinent deductibles, self-insured retentions and/or self- insurance. 17. Governing Law; Jurisdiction; Venue: This contract shall be governed and construed in accordance with the laws of the State of Oregon without resort to any jurisdiction's conflict of laws, rules or doctrines. Any claim, action, suit or proceeding (collectively, "the claim") between the City (and/or any other or department of the State of Oregon) and the Contractor that arises from or relates to this contract shall be brought and conducted solely and exclusively within the Circuit Court of Jackson County for the State of Oregon. If, however, the claim must be brought in a federal forum, then it shall be brought and conducted solely and exclusively within the United States District Court for the District of Oregon filed in Jackson County, Oregon. Contractor, by the signature herein of its authorized representative, hereby consents to the in personam jurisdiction of said courts. In no event shall this section be construed as a waiver by City of any form of defense or immunity, based on the Eleventh Amendment to the United States Constitution, or otherwise, from any claim or from the jurisdiction. 18. THIS CONTRACT AND ATTACHED EXHIBITS CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE PARTIES. NO WAIVER, CONSENT, MODIFICATION OR CHANGE OF TERMS OF THIS CONTRACT SHALL BIND EITHER PARTY UNLESS IN WRITING AND SIGNED BY BOTH PARTIES. SUCH WAIVER, CONSENT, MODIFICATION OR CHANGE, IF MADE, SHALL BE EFFECTIVE ONLY IN THE SPECIFIC INSTANCE AND FOR THE SPECIFIC PURPOSE GIVEN. THERE ARE NO UNDERSTANDINGS, AGREEMENTS, OR REPRESENTATIONS, ORAL OR WRITTEN, NOT SPECIFIED HEREIN REGARDING THIS CONTRACT. CONTRACTOR, BY SIGNATURE OF ITS AUTHORIZED REPRESENTATIVE, HEREBY ACKNOWLEDGES THAT HE/SHE HAS READ THIS CONTRACT, UNDERSTANDS IT, AND AGREES TO BE BOUND BY ITS TERMS AND CONDITIONS. 19. Nona ppropriations Clause. Funds Available and Authorized: City has sufficient funds currently available and authorized for expenditure to finance the costs of this contract within the City's fiscal year budget. Contractor understands and agrees that City's payment of amounts under this contract attributable to work performed after the last day of the current fiscal year is contingent on City appropriations, or other expenditure authority sufficient to allow City in the exercise of its reasonable administrative discretion, to continue to make payments under this contract. In the event City has insufficient appropriations, limitations or other expenditure authority, City may terminate this contract without penalty or liability to City, effective upon the delivery of written notice to Contractor, with no further liability to Contractor. 20. Prior Approval Required Provision. Approval by the City of Ashland Council or the Public Contracting Officer is required before any work may begin under this contract. 21. Certification. Contractor shall sign the certification attached hereto as Exhibit A and herein incorporated by reference. Contractor:jzt City of Ashland By 41 ~i-- By J~~ Signature Department Head Print Name Pr nt Name V Title Date W-9 One copy of a W-9 is to be submitted with the signed contract. Purchase Order No. AP ED AS TO FORM Ashland M. City Ito ney Contract for Goods and Services Less than $25,000, Revised 07/08/2014, Page 3 of 5 EXHIBIT A CERTIFICATIONS/REPRESENTATIONS: Contractor, under penalty of perjury, certifies that (a) the number shown on the attached W-9 form is its correct taxpayer ID (or is waiting for the number to be issued to it and (b) Contractor is not subject to backup withholding because (i) it is exempt from backup withholding or (ii) it has not been notified by the Internal Revenue Service (IRS) that it is subject to backup withholding as a result of a failure to report all interest or dividends, or (iii) the IRS has notified it that it is no longer subject to backup withholding. Contractor further represents and warrants to City that (a) it has the power and authority to enter into and perform the work, (b) the Contract, when executed and delivered, shall be a valid and binding obligation of Contractor enforceable in accordance with its terms, (c) the work under the Contract shall be performed in accordance with the highest professional standards, and (d) Contractor is qualified, professionally competent and duly licensed to perform the work. Contractor also certifies under penalty of perjury that its business is not in violation of any Oregon tax laws, and it is a corporation authorized to act on behalf of the entity designated above and authorized to do business in Oregon or is an independent Contractor as defined in the contract documents, and has checked four or more of the following criteria: (1) 1 carry out the labor or services at a location separate from my residence or is in a specific portion of my residence, set aside as the location of the business. (2) Commercial advertising or business cards or a trade association membership are purchased for the business. (3) Telephone listing is used for the business separate from the personal residence listing. (4) Labor or services are performed only pursuant to written contracts. (5) Labor or services are performed for two or more different persons within a period of one year. (6) 1 assume financial responsibility for defective workmanship or for service not provided as evidenced by the ownership of performance bonds, warranties, errors and omission insurance or liability insurance relating to the labor or services to be provided. A0-9~y1 Contractor (Date) Contract for Goods and Services Less than $25,000, Revised 07/08/2014, Page 4 of 5 CITY OF ASHLAND, OREGON EXHIBIT B City of Ashland LIVING WAGE • per hour effective June 30, 2014 (Increases annually every June 30 by the fir` Consumer Price Index) portion of business of their 401 K and IRS eligible employer, if the employer has cafeteria plans (including ten or more employees, and childcare) benefits to the has received financial amount of wages received by assistance for the project or the employee. ➢ For all hours worked under a business from the City of service contract between their Ashland in excess of ➢ Note: "Employee" does not employer and the City of $20,142.20. include temporary or part-time Ashland if the contract employees hired for less than exceeds $20,142.20 or more. ➢ If their employer is the City of 1040 hours in any twelve- Ashland including the Parks month period. For more ➢ For all hours worked in a and Recreation Department. details on applicability of this month if the employee spends policy, please see Ashland 5m or more of the ➢ In calculating the living wage, Municipal Code Section employee's time in that month employers may add the value 3.12.020. working on a project or of health care, retirement, For additional information: Call the Ashland City Administrator's office at 541-488-6002 or write to the City Administrator, City Hall, 20 East Main Street, Ashland, OR 97520 or visit the city's website at www.ashland.or.us. Notice to Employers: This notice must be posted predominantly in areas where it can be seen by all employees. CITY OF ASHLAND Contract for Goods and Services Less than $25,000, Revised 07/08/2014, Page 5 of 5 Sales Rep: Lee Kleve EMERGENCY Order Received: REPORTING T'' Support Rep: Referral Code: Account Created: DoD 0 GSA 0 Partner: PACKAGE ORDER FORM Package offer valid from 8/6/2014 for 30 days Agency Name: Ashland Fire & Rescue Mailing Address Line 1: 455 Siskiyou Boulevard Mailing Address Line 2: Ashland, OR, 97520 County: JACKSON Phone: 541-482-2770 Fax: (541) 488-5318 Billing Address (if different): 455 SISKIYOU BOULEVARD FDID: 00012 EMS ID: 1501 Customer Type: NEW Department Type: CAREER Start Date: 9/1/2014 Package Description: Set tTp/Initial Fee: Annual Cost: Niontlih, Cost: FULL ERS; CAD LINK; BILLING $1,428.00 r $199.00 Google Maps Integration F VISION PLUS ITOTALS $1,428.00 $199.00 Training Feed' $0.00 Import Fee* $0.00 Report Fee** $0.00 FEE TOTAL $0.00 2 x $199.00 = $398.00 X12 $4,776.00 + + $1,428.00 + $0.00 = $6,204.00 # Monthly Yearly Vision Set Up Other Grand Total Licensed Cost Total Cost Yearly Fees Fees Year 1 Stations - Confidential - Scan completed form and return this portion by email to: orderskemergencyreporting.com, or fax to 1.866.929.6157 Special Contract Terms: This system is NEMSIS Gold Compliant however your state may not except this format or may require additional fields which are not supported. If you send your existing NFIRS reports and they are in NFIRS export format we will load them on your new ER account for free once we have a signed order form. Print Name: Direct Phone: Signature: Title: Date: The Information Below is Required to Process Your Order: Billing Frequency*: Yearly Monthly (Circle One) *If no billing cycle is selected the account will automatically be billed monthly. NFIRS Export Recipient (Email): lia-te NFIRS I)ata to be Imported? (Check if applicableand provide contact info) NFIRS (Free if in NFIRS Export format) Contact Name: Phone: Email: Other Imports (Check all that applN - imported for a fee-) Equipment Occupancy Hydrants Flow Test Other: *For all imports not in NFIRS Export Format there will be a $500.00 import fee. This fee applies to the first 4 hours of configuration and includes assessment, manipulation, edits and final import. If additional time is required, a quote will be provided at a rate of $125.00/hour with a 3-hour minimum. We will not import training records at this time. **Report requests will be broken into two categories; simple or custom. Simple reports will cost $250 for the first two hours and $125/hour after that. Custom reports will cost $500 for the first 4 hours and $125/hour after that. -Training fees require a custom quote from your sales rep and are based on package type, department size, and length of training requested. - Confidential - Scan completed form and return this portion by email to: orders 2emergencvreporting.com, or fax to 1.866.929.6157 Terms & Conditions Emergency Reporting, a trade name of Reporting Systems, Inc. ("RSI"), and Ashland Fire & Rescue ("AGENCY") are entering into an agreement as of the signature date. RSI shall perform the following services: 1. Collect emergency response data via a website accessible at https://secure.emergencyreporting.com. 2. Maintain collected data to standards set by FEMA's National Fire Incident Reporting System (NFIRS) and/or the National Emergency Medical Services Information System, version 2.2.1 Gold. 3. Provide EMS export services for states that are officially supported by RSI for EMS exports. Due to the number of states that have modified the NEMSIS standard, NEMSIS 2.2.1 Gold is not a supported EMS Export type in many cases. State EMS reporting is not supported unless the state is specifically listed on page 1. 4. Provide ongoing changes and bug fixes, at no additional charge, to remain in compliance with NFIRS & NEMSIS 2.2.1 Gold. 5. For supported states and exports (NFIRS, state specific EMS, or other export types) provide email or direct HTTPS download to the necessary recipients. If possible, RSI will configure direct submission to the state; if the state prohibits third party submissions, RSI will provide Agency with the applicable data for state reporting requirements. 6. Ensure appropriate security, privacy, and encryption of data transmitted to and from the website, in compliance with RSI's internal polices, federal HIPAA regulations, industry practices regarding security, and (if applicable) Department of Defense (DoD) requirements as outlined in DoD directive 8500.1, 8500.2, PIA & SORN, necessary STIGS, and others, as defined by the Secretary of Defense or his/her designee. 7. Provide access to the website by current browser technology as stated in the RSI Users Policies Manual. 8. Provide data backup to guard against data loss in the event of catastrophic system failure. 9. Guarantee uptime of 99.9%, as calculated on an annual basis. The Agency shall be responsible for the following: 1. Maintain an active user list of accounts that are authorized to access the website. 2. Pay all outstanding charges in a timely fashion. Non-timely payment may result in deactivation of service (deactivation will occur with warning to the AGENCY; AGENCY data will be accessible when charges are brought current). 3. Maintain active Internet Service Provider (ISP) services to access the website. ISP charges are not included in this agreement. ISP failures are not the responsibility of RSI. 4. Enter emergency response data and all other data into the website per system instructions, support recommendations, and in accordance to the RSI User Policy Manual available on the support page from within Emergency Reporting's website. 5. Use supported web browsers as listed in the RSI User Policy Manual. Governing Law. The AGENCY agrees that the rights of user and RSI shall be governed by the Laws of the State of Washington, without regard to any conflicts of law, rules or provisions. Sole and exclusive jurisdiction for any action or proceeding arising out of or related to this agreement shall be in an appropriate State or Federal Court located in WA State. Data Ownership. All data transmitted to the website remains the property of the AGENCY. Retransmission of this data to the necessary state reporting authorities is authorized. Modifying, deleting or other modifications of submitted incident data by RSI is prohibited. Scientific research that is based on broad data trends is authorized, but no AGENCY specific data is to be made visible to any third parties. Statute of Limitation. The AGENCY agrees that any cause of action you may have against RSI must be commenced within (6) six months after the claim arises. Termination. Either AGENCY or RSI can terminate service at any time upon 30 days written (or email) notice. Future service fees, if any, will be refunded to the Agency. Pricing. The AGENCY agrees to the prices set forth in this agreement. RSI reserves the right to modify AGENCY pricing at the billing renewal date, and will provide 30 day advance written notice of its intent to do so. Copyright. The AGENCY recognizes that the RSI website is protected under U.S. copyright and trademark law, international conventions and other applicable law. The AGENCY agrees to not license, sell, publish, decompile, reverse engineer, or otherwise deconstruct any portion of RSI's technology. RSI uses computer technology to collect data, and no such technology is 100% reliable at all times. System failures may occur without warning. Although all efforts will be made to prevent such failures, the AGENCY recognizes that these failures are outside the control of RSI, and agrees to hold RSI, its principals, employees, and agents harmless. If any court holds any portion of this Agreement to be unenforceable, then the remainder of this Agreement shall survive - Confidential - Scan completed form and return this portion by email to: ordersp_emergencyreporting.com, or fax to 1.866.929.6157 r EMERGENCY Sales Rep: Lee Kleve Order Received: REPORT1NGT Support Rep: Referral Code: Account Created: DoD 0 GSA 0 Partner: CAD ORDER FORM Package offer valid from 81612014 for 30 days Agency Name: Ashland Fire & Rescue CAD Brand/Provider: TIBURON Physical Address Line 1: 455 Siskiyou Boulevard CAD Version: Address Line 2: Ashland, OR, 97520 Provider Contact Information Contact Name: County: JACKSON Phone: Phone: 541-482-2770 Email: Fax: (541) 488-5318 Dispatch Contact Info: Billing Address Contact Name: if different from above : Phone: FDID: 00012 EMS ID: 1501 Email: Customer Type: NEW Department Type: CAREER Start Date: 9/1/2014 PackaL'e Desci-iption: C,~D Link N'ear I Initial Fee: 2 Nlaintenance Fee: CAD Interface Type: Interface Fees: $0.00 $0.00 Year One Fee: $0.00 Ongoing Yearly Maintenance Fee: $0.00 Special Contract Terms: T14E CAD LINK IS TO JACKSON COUNTY CAD CENTER. Print Name: Direct Phone: Signature: Title: Date: "Billing Frequency is Yearly - Confidential - Scan completed form and return by email to: orders(i~emergencyreporting.com, or fax to 1.866.929.6157 Terms & Conditions Emergency Reporting, a trade name of Reporting Systems, Inc. ("RSI"), and Ashland Fire & Rescue ("AGENCY") are entering into an agreement as of the signature date. RSI shall perform the following services: 1. Receive CAD interface data to the following address: https://secure.emergencyreporting.com/WS/VI.O/Dispatch/CalICenter.php. RSI reserves the right to reject or ignore invalid data. 2. Provide ongoing changes and bug fixes, at no additional charge, to keep the CAD Interface address specified above operational. 3. Supply mapping (alias) tools, submission tracking, and general processing tools to assist in the management of CAD supplied data to RSI standards. 4. For Flat File Parser (FFP) installations, RSI shall provide an installed piece of software that processes files as output from CAD and submits the data to RSI. FFP configurations shall conform to sample and specified data as output from CAD; any changes to this format may result in change order fees. 5. Ensure appropriate security, privacy, and encryption of data transmitted to and from the website, in compliance with RSI's internal polices, federal HIPPA regulations, industry practices regarding security, and (if applicable) Department of Defense (DoD) requirements as outlined in DoD directive 8500.1, 8500.2, PIA & SORN, necessary STIGS, and others, as defined by the Secretary of Defense or his/her designee. 6. Provide data backup to guard against data loss in the event of catastrophic system failure. 7. Guarantee uptime of 99.9%, as calculated on an annual basis. The Agency shall be responsible for the following: 1. Provide clean, valid data for processing, either via text file (for Flat File Parser installations) or web services (for web services direct installations) 2. For FFP Installations, the Agency shall provide a nondedicated computer to install the FFP on. The computer shall have access to CAD supplied text files, as well as outbound HTTPS access to the address specified above. The operating system shall be x86 or x64, and shall be any edition of Windows Server 2008 or 2003, and shall have the net Framework 2.0 or higher installed. 3. Agency shall provide technical staff to assist with installation, debugging, networking, and general troubleshooting of CAD link technology and infrastructure. 4. Pay all outstanding charges in a timely fashion. Non-timely payment may result in deactivation of service (deactivation will occur with warning to the AGENCY; AGENCY data will be accessible when charges are brought current). 5. Maintain active Internet Service Provider (ISP) services to access the website. ISP charges are not included in this agreement. ISP failures are not the responsibility of RSI. Governing Law. The AGENCY agrees that the rights of user and RSI shall be governed by the Laws of the State of Washington, without regard to any conflicts of law, rules or provisions. Sole and exclusive jurisdiction for any action or proceeding arising out of or related to this agreement shall be in an appropriate State or Federal Court located in WA State. Data Ownership. All data transmitted to the website remains the property of the AGENCY. Retransmission of this data to the necessary state reporting authorities is authorized. Modifying, deleting or other modifications of submitted incident data by RSI is prohibited. Scientific research that is based on broad data trends is authorized, but no AGENCY specific data is to be made visible to any third parties. Statute of Limitation. The AGENCY agrees that any cause of action you may have against RSI must be commenced within (6) six months after the claim arises. Termination. Either AGENCY or RSI can terminate service at any time upon 30 days written (or email) notice. Future service fees, if any, will be refunded to the Agency. Pricing. The AGENCY agrees to the prices set forth in this agreement. RSI reserves the right to modify AGENCY pricing at the billing renewal date, and will provide 30 day advance written notice of its intent to do so. Copyright. The AGENCY recognizes that the RSI website is protected under U.S. copyright and trademark law, international conventions and other applicable law. The AGENCY agrees to not license, sell, publish, decompile, reverse engineer, or otherwise deconstruct any portion of RSI's technology. RSI uses computer technology to collect data, and no such technology is 100% reliable at all times. System failures may occur - Confidential - Scan completed form and return by email to: ordersnemergencyreoorting.com, or fax to 1.866.929.6157 withjut warning. Although all efforts will be made to prevent such failures, the AGENCY recognizes that these failures are outside the control of RSI, and agrees to hold RSI, its principals, employees, and agents harmless. If any court holds any portion of this Agreement to be unenforceable, then the remainder of this Agreement shall survive. Full Package List: NFIRS Fire Package EMS Package Full ERS Package • NFIRS Forms • NFIRS Forms • NEMSIS Forms • NFIRS Forms • Administration Module • Fire Inspections • Pre-hospital PCR • NEMSIS Forms • Personnel Management • Administration Module • Administration Module • Administration Module • Reports Module • Apparatus Maintenance • Apparatus Maintenance • Apparatus Maintenance • Calendar Module • Calendar Module • Calendar Module NEMSIS • Daily Roster Module • Daily Roster Module • Daily Roster Module • NEMSIS Forms • Equipment Maintenance • Equipment Maintenance • Equipment Maintenance • Administration Module • Events Module • Events Module • Events Module • Personnel Management • Hydrant Maintenance • Inventory Module • Fire Inspections • Reports Module • Inventory Module • Library Module • Hydrant Maintenance • Library Module • Message Center Module • Inventory Module Emergency Reporting provides • Message Center Module • Payroll Module • Library Module the best and most accurate • Occupancy Prefire Plans • Personnel Management • Message Center Module reporting and records • Payroll Module • Reports Module • Occupancy Prefire Plans management system on the • Personnel Management • Shifts Module • Payroll Module market. Our system was the first • Reports Module • Training Module • Personnel Management cloud-based solution available - . Shifts Module • Reports Module giving our customers the freedom • Training Module • Shifts Module to access their information online from anywhere. • Training Module VISION Basic VISION Plus VISION Premier the provide interfaces for some of the country's top tier CAD firms; • Administration Module • Administration Module • Administration Module contact us for the full list. Also, • Demographics Module • Demographics Module • Demographics Module be sure to ask us about receiving • Occupancy Module • Occupancy Module • Occupancy Module a discount if you choose one of • Reports Module • Reports Module • Reports Module our preferred medical billing • Google Maps Integration • Google Maps Integration partners! • Inspections • Hydrants • Incidents Follow us on: You R• a www.emergencyreporting.com - Confidential - Scan completed form and return by email to: orders@emergencyreporting.com, or fax to 1.866.929.6157 EMERGENCY Sales Rep: Lee Kleve Order Received: REPORTING"' Support Rep: Referral Code: Account Created: DoD 0 GSA 0 Partner: MEDICAL BILLING ORDER FORM Package offer valid from 81612014 for 30 days Agency Name: Ashland Fire & Rescue Medical Billing Partner: Physical Address Line 1: 455 Siskiyou Boulevard Address Line 2: Ashland, OR, 97520 Medical Billing Contact Information: Phone: 541-482-2770 Fax: (541) 488-5318 Contact Name: Phone: Billing Address (if different from above): Email: Internal Billing Contact Information FDID: 00012 Contact Name: EMS ID: 1501 Customer Type: NEW Phone: Department Type: CAREER Email: Medical Billing Export Type: NEMSIS 2.2.1 GOLD Start Date: 9/1/2014 Export Type: NEMSIS 2.2.1 GOLD Interface Fees.. $750.00 $500.00 Year One Fee: $750.00 Ongoing Yearly Maintenance Fee: $500.00 Special Contract Terms: MEDICAL BILLING MAINTENANCE BEGINS FROM YEAR TWO ON. LINK IS TO THE SPRINGFIELD OREGON MEDICAL LINK. Print Name: Direct Phone: Signature: Title: Date: '*Billing Frequency is yearly - Confidential - Scan completed form and return by email to: ordersp_emergencyreportine.com, or fax to 1.866.929.6157 Terms & Conditions Emergency Reporting, a trade name of Reporting Systems, Inc. ("RSI"), and Ashland Fire & Rescue ("AGENCY") are entering into an agreement as of the signature date. RSI shall perform the following services: 1. Provide medical billing export services in the format specified on the front of the order form. 2. Provide ongoing changes and bug fixes, at no additional charge, to remain in compliance with specified export format. THIS DOES NOT INCLUDE CHANGES TO THE EXPORT, ONLY BUG FIXES. 3. Change orders to the format of the export is not generally possible, but if requested by the Agency, and approved by RSI, the fee shall be $200 / hour, with a $500 minimum. 4. Ensure appropriate security, privacy, and encryption of data transmitted to and from the website, in compliance with RSI's internal polices, federal HIPPA regulations, industry practices regarding security, and (if applicable) Department of Defense (DoD) requirements as outlined in DoD directive 8500.1, 8500.2, PIA & SORN, necessary STIGS, and others, as defined by the Secretary of Defense or his/her designee. 5. Provide data backup to guard against data loss in the event of catastrophic system failure. 6. Guarantee uptime of 99.9%, as calculated on an annual basis. The Agency shall be responsible for the following: 1. Accept the format of the Medical Billing format "as-is" and not demand additional changes in the future. Agency acknowledges receipt of documentation package from RSI, including sample data, documentation, and necessary code sets. 2. If billing export allows for Encrypted Email export, Agency shall provide the intended email address for delivery of encrypted EMS Export data. 3. Promptly notify RSI of any bugs, problems, configuration issues, or other issue promptly to support@emereencyreporting.com. Such problem reports shall contain the relevant information needed to resolve the problem, such as specific description of the error, incident number(s) that the error occurs on, and any other relevant information that is needed to resolve the problem. BROAD STATEMENTS, WITH LITTLE OR NO DETAILS, MAY BE IGNORED BY RSI. 4. Pay all outstanding charges in a timely fashion. Non-timely payment may result in deactivation of service (deactivation will occur with warning to the AGENCY; AGENCY data will be accessible when charges are brought current). 5. Maintain active Internet Service Provider (ISP) services to access the website. ISP charges are not included in this agreement. ISP failures are not the responsibility of RSI. Governing Law. The AGENCY agrees that the rights of user and RSI shall be governed by the Laws of the State of Washington, without regard to any conflicts of law, rules or provisions. Sole and exclusive jurisdiction for any action or proceeding arising out of or related to this agreement shall be in an appropriate State or Federal Court located in WA State. Data Ownership. All data transmitted to the website remains the property of the AGENCY. Retransmission of this data to the necessary state reporting authorities is authorized. Modifying, deleting or other modifications of submitted incident data by RSI is prohibited. Scientific research that is based on broad data trends is authorized, but no AGENCY specific data is to be made visible to any third parties. Statute of Limitation. The AGENCY agrees that any cause of action you may have against RSI must be commenced within (6) six months after the claim arises. Termination. Either AGENCY or RSI can terminate service at any time upon 30 days written (or email) notice. Future service fees, if any, will be refunded to the Agency. Pricing. The AGENCY agrees to the prices set forth in this agreement. RSI reserves the right to modify AGENCY pricing at the billing renewal date, and will provide 30 day advance written notice of its intent to do so. Copyright. The AGENCY recognizes that the RSI website is protected under U.S. copyright and trademark law, international conventions and other applicable law. The AGENCY agrees to not license, sell, publish, decompile, reverse engineer, or otherwise deconstruct any portion of RSI's technology. RSI uses computer technology to collect data, and no such technology is 100% reliable at all times. System failures may occur without warning. Although all efforts will be made to prevent such failures, the AGENCY recognizes that these failures are outside the control of RSI, and agrees to hold RSI, its principals, employees, and agents harmless. If any court holds any portion of this Agreement to be unenforceable, then the remainder of this Agreement shall survive. - Confidential - Scan completed form and return by email to: ordersnemergenc~reportin com, or fax to 1.866.929.6157 Full P2cka a List: NFIRS Fire Package EMS Package Full ERS Package • NFIRS Forms • NFIRS Forms • NEMSIS Forms • NFIRS Forms • Administration Module • Fire Inspections • Pre-hospital PCR • NEMSIS Forms • Personnel Management • Administration Module • Administration Module • Administration Module • Reports Module • Apparatus Maintenance • Apparatus Maintenance • Apparatus Maintenance • Calendar Module • Calendar Module • Calendar Module NEMSIS • Daily Roster Module • Daily Roster Module • Daily Roster Module NEMSIS Forms • Equipment Maintenance • Equipment Maintenance • Equipment Maintenance • Administration Module • Events Module • Events Module • Events Module • Personnel Management • Hydrant Maintenance • Inventory Module • Fire Inspections • Reports Module • Inventory Module • Library Module • Hydrant Maintenance • Library Module • Message Center Module • Inventory Module Emergency Reporting provides • Message Center Module • Payroll Module • Library Module the best and most accurate • Occupancy Prefire Plans • Personnel Management • Message Center Module reporting and records • Payroll Module • Reports Module • Occupancy Prefire Plans management system on the • Personnel Management • Shifts Module • Payroll Module market. Our system was the first • Reports Module • Training Module • Personnel Management cloud-based solution available - • Shifts Module • Reports Module giving our customers the freedom • Training Module • Shifts Module to access their information online from anywhere. • Training Module VISION Basic VISION Plus VISION Premier the provide interfaces for some of the country's top tier CAD firms; • Administration Module • Administration Module • Administration Module contact us for the full list. Also, • Demographics Module • Demographics Module • Demographics Module be sure to ask us about receiving • Occupancy Module • Occupancy Module • Occupancy Module a discount if you choose one of • Reports Module • Reports Module • Reports Module our preferred medical billing • Google Maps Integration • Google Maps Integration partners! • Inspections • Hydrants • Incidents Follow us on: P~2_, E UJUR a rA www.emergencyreporting.com - Confidential - Scan completed form and return by email to: ordersgemerizencyreporting.com, or fax to 1.866.929.6157 ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYW) 19/11/2014 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. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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 i certificate holder in lieu of such endorsements . PRODUCER NAME: The Unity Group PHONE FFAX 110 Unity Street E- A Lo Ex :360-647-9000 aC, No 360-734-8496 Bellingham WA 98225 ADDREss:inf h uni ro m I INSURER(S) AFFORDING COVERAGE NAIC # INSURER Alloyd's of London INSURED EMERG-1 INSURER B dba Emergency Reporting INSURER C : Reporting Systems Inc - INSURER D 851 Coho Way Ste 301 - - - Bellingham WA 98225-2021 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 370476544 REVISION NUMBER:1 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. I~TR TYPE OF INSURANCE IN R WVD POLICY NUMBER MMIDDY/YYEFF YY MM orfm LIMITS A GENERAL LIABILITY Y Y ESC01068858 /6/2014 /6/2015 EACH OCCURRENCE $2,000,000 DAMA E R N X-_ COMMERCIAL GENERAL LIABILITY PREMISES /Ea occurrence $250,000 CLAIMS-MADE -1 OCCUR MED EXP (Any one person) $5,000 PERSONAL&ADV_INJURY _ $1,000,000 _ ' GENERAL AGGREGATE $4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMPIOP AGG $4,000,000 _ Deductible $5,000 POLICY PRO- 1 1 LOC - - ~JF AUTOMOBILE LIABILITY ! Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS E] AUTOS NON OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS j Per accident., $ I $ UMBRELLA LIAR OCCUR IrEACH OCCURRENCE_ $ EXCESS LIAB~~_CLAIMS-MADE AGGREGATE DIED RETENTION $ $ A WORKERS COMPENSATION ESC01068858 /6/2014 /6/2015 WC STATU- OTH- AND EMPLOYERS' LIABILITY TORY LIMIT ER Stop Gap ~ANYPROPRIETOR/PARTNER/EXECUTIVE YIN E. L. EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? ❑ N/A _ _ j (Mandatory I. NH) E.L. DISEASE - EA EMPLOYE $1,000,000 If yes, describe under - - - - DySCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) - Per forms and conditions. Additional Insured form 873598 04; Waiver of Subrogation form 873599 04. Certificate Holder is included. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. 90 N. Mountain Ave Ashland OR 97520 AUTHORIZED REPR SENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD ((PRODUCT» INDFNINITY TO PRINCIPALS CLAUSF ATTACHING TO POLICY NUMBER: aPOLICYNUMBER)) THE INSURED: aINSURED» WITH EFFECT FROM: alnceptionDate» (NOTE: THIS CLAUSE APPLIES TO INSURING CLAUSES alCNumberss ONLY) It is hereby understood and agreed that Principals are indemnified under this Policy as an additional Insured, but only in respect of sums which they became legally obliged to pay (including liability for claimants' costs and expenses) as a result of any claim arising solely out of any wrongful act committed by you or accidental injury or damage in the course of your business activities, provided that had a claim been made against you, then you would be entitled to indemnity under this Policy. When this clause applies it shall be primary and norrcontributory to Principals' own insurance but only if you and Principals have entered into a contract that contains a provision requiring this. It is a condition precedent to indemnity under this clause that Principals shall prove to our satisfaction that the claim arose solely out of your business activities. Whilst Principals have been named under this Policy as an additional Insured, it is hereby noted and agreed that any claim made by Principals against you shall be treated as if Principals were a third party. We shall also endeavour to provide 30 days notice of cancellation to Principals; however, not doing so shall not place any additional liability upon us. It is further understood and agreed that Principals are defined as follows: aPrincipals» SUBJECT OTHERWISE TO THE TERMS AND CONDITIONS OF THE POLICY aPRODUCT» WAIVFR OF . , ATTACHING TO POLICY NUMBER: aPOLICYNUMBER» THE INSURED: alnsured» WITH EFFECT FROM: «InceptionDate» (NOTE: THIS CLAUSE APPLIES TO INSURING CLAUSE 6 ONLY) Notwithstanding our rights of recovery, we agree to waive our rights of subrogation against a responsible third party client of yours but only if you and your client have entered into a contract that contains a provision requiring us to do this. SUBJECT OTHERWISE TO THE TERMS AND CONDITIONS OF THE POLICY Page 1 / 1 CITY OF . ASHLAND DATE FPO NUMBER pirAft 20 E MAIN ST. 9/17/2014 12498 ASHLAND, OR 97520 (541) 488-5300 VENDOR: 018977 SHIP TO: Ashland Fire Department EMERGENCY REPORTING (541) 482-2770 851 COHO WAY SUITE 301 455 SISKIYOU BLVD BELLINGHAM, WA 98225 ASHLAND, OR 97520 FOB Point: Req. No.: Terms: Net Dept.: Req. Del. Date: Contact: Greq Case Special Inst: Confirming? NO Quantity Unit Description Unit Price Ext. Price Emergency Reportinq Software 6,954.00 Per attached order forms Two licensed stations $199/each per month - Annual cost $4,776.00 Year 1 initial set up: $1,428.00 NEMSIS 2.2.1 Gold - Initial set up $750.00 CAD Link to Jackson County - No additional charge Contract for Goods and Services Beqinninq date: September 15, 2014 Completion date: September 14, 2018 SUBTOTAL 6,954.00 BILL To: Account Payable TAX 0.00 20 EAST MAIN ST FREIGHT 0.00 541-552-2010 TOTAL 6,954.00 ASHLAND, OR 97520 Account Number Project Number Amount Account Number Project Number Amount E 110.07.13.00.60410 6,954.00 Autho d Signature ~7 VENDOR COPY FORTq ~LZ 1~ CITY OF f @W ASHLAND REQUISITION Date of request: Required date for delivery: Vendor Name Emergency Reporting, Reporting Systems, Inc. Address, City, State, Zip _ 851 Coho Way Suite 301, Bellingham WA. 98225 Contact Name & Telephone Number Lee Kleve 360-2324891 Fax Number 866-929-6157 SOURCING METHOD / ❑ Exempt from Competitive Bidding ❑ Reason for exemption: ❑ Invitation to Bid (Copies on file) {1 ❑ AMC 2.50 Date approved by Council: / v - ❑ Written quote or proposal attached ❑ Small Procurement Less than $5,000 ❑ Request for Proposal (Copies on file) ❑ Direct Awa Date appr ved by Council: El uo e(s) or proposal( s) Int mediate Procurement~L ZZ; ( e Source / GOODS & SERVICES-. pp ble Farm (#5,6, 7 or 8) $5.000'to $100.000 w ~ r' Written quote~or proposal attached Z'41 IT (3) Written quotes and sot e~ ❑ Form #g, Persb{ial Services $5K to $75K PERSONAL SERVICES ❑ s ecf40rocurenlent _$5,000 to $75,000 orm #9, Request for~Approval v EJ-Jm-s~~ no ❑ Written quote or proposal attached ❑ (3) Written proposals/written solicitation Date approved by Council: ❑ Form #4, Personal Services $5K to $75K Valid until: Date Description of SERVICES Emergency Reporting records management software package, CAD interface, Medical billing $ 6,954.00 ex ort and Maintenance and support services Item # Quantity Unit Description of MATERIALS Unit Price Total Cost TOTAL COST ❑ Per attached quotelproposal Project Number _ _ _ _ _ _ - _ _ _ Account Number A 0 - Pl -13 - CC- OY/ d Q Account Number___-__-__- Account Number___-__-__- - 'Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual xpend' re !0 IT Director in collaboration with department to approve all hardware and software purchases: Y IT Director Date Supp -Yes o By signing this requisition fo 1-cert' , at t e City's public contracting requirements have been satisfied. 0/117 Employee:. Department Head: / (Equal to odgreater than $5,000) Department Manager/Supervisor: City Administrator: (Equal to or greater han $25,000) Funds appropriated for current fiscal year: as / NO Finance Director- (Equal to orgreat an $5,000) Date Comments: Form #3 - Requisition