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Home My WebLink About4146 +--------------------------------------------------------------------------+ +Browse: Next Previous First Last Update Delete Restart X - Exit + ==Retrieve the Next record ==Found: 1 Record (s) MAINTAIN Contract Number Contract Transactions 4146 +Vendor Name =+=Subject ..bDepartment ==Status Code HARRISON HOSPITAL AMBULANCE TRANSPORT FIRE SVC =+= =+= =+= =+= + =+= =+= Insurance Type Amount Amount Begin Date End Date Review Date 07/01/2000 -- 06/30/2003 -- 02/15/2005 -- -.- =+= $0.00 + =+= =+= t =+= +--------------------------------------------------------------------------+ Insurance Total Insurance Review Date Comments EXTENSION TO 6/04 W/APPROVAL (NO EXTENSION IN FILE) VAULT 01/01/2005 +--------------------------------------------------------------------------+ ~Enter Search Criteria, Press Esc Key to Transmit ' -~ress Del Key to Terminate Delete Mode - - CHANGE Contract Transactions Contract Number 4146 - -Vendor Name "Subject - -Department '-Status Code HARRISON HOSPITAL AMBULANCE TRANSPORT FIRE SVC Insurance Type Amount Amount Begin Date End Date Review Date 07/01/2000 -- 06/30/2003 -- 02/15/2005 Insurance Total Insurance Review Date $0.00 -- Comments EXTENSION TO 6/04 W/APPROVAL (NO EXTENSION IN FILE) VAULT 01/01/2005 , '" +--------------------------------------------------------------------------+ AGREEMENT BETWEEN HARRISON MEMORIAL HOSPITAL AND CITY OF BREMERTON This agreement is entered into this 1st day of July, 2000, by and between Harrison Memorial Hospital, (hereinafter referred to as "Hospital"), and the City of Bremerton, (hereinafter referred to as "the City"). I. PURPOSE AND SCOPE The purpose of the Agreement is to make available, at a reasonable charge, from a preferred provider, ambulance Advanced Life Support (ALS) and back-up Basic Life Support (BLS) patient transfers between Harrison Hospital in Bremerton and Harrison Silverdale pursuant to the terms and conditions contained in this Agreement. II. DEFINITION OF TERMS A. The term "Preferred Provider" shall mean the City is called first by the Hospital's personnel for ambulance transportation between the Emergency Room of Harrison Hospital - Silverdale and the Emergency Room of Harrison Hospital-Bremerton, as defined below. In the emergent event that the City cannot provide services in a timely manner, as defined below, another vendor shall be contacted by the Hospital. Ambulance response parameters to Harrison Silverdaie are twelve (12) minutes for BLS and six (6) minutes for ALS transports, and shall be taken as an average." B. "Patient means any patient transferred between the Bremerton Hospital campus and the Silverdale Hospital campus referred to above. IlL SERVICES The City agrees to provide ambulance services as described below to Hospital, and, will send invoices as set forth on Attachment I. A. Basic Life Support The City agrees its Basic Life Support Transports shall be staffed by two (2) members, who shall be either Emergency Medical Technicians or Paramedics, or a combination thereof, certified as such under the proper licensing authorities. Back-up ambulance services shall be rendered in a manner so as to preserve patient dignity and provide continuity of care. Ambulance services are available 24 hours a day, every day of the year. B. Advanced Life Support The City agrees its Advanced Life Support Transports shall be staffed by two (2) members, one of which shall be a Paramedic, certified as such O:\nursing\document\general\agreement\City of Bremerton.doc Page 1 of 5 under the proper licensing authorities. Ambulance services shall be rendered in a manner so as to preserve patient dignity and provide continuity of care. Ambulance services are available 24 hours a day, every day of the year. IV. RELATIONSHIP OF PARTIES The City and Hospital are independent contracting parties. The City shall not be considered an agent or employee of Hospital for any purpose. The City shall be solely and entirely responsible for its acts and the acts of its employees, officers, directors, and agents during the term of this agreement and assumes exclusive responsibility for payment of ail wages owing to its personnel for services performed by them for Hospital. Furthermore, in providing ambulance services, The city agrees to comply with all applicable federal, state, and local laws and regulations governing the delivery of such transportation services. V. LICENSURE AND CREDENTIALING The City warrants that it shall at all times maintain all necessary business and professional licenses and certificates, and that it shall, upon request, provide evidence of same to Hospital. The City also warrants that it is fully licensed, able, and certified to perform through its own staff, all aspects of ambulance transportation noted in this Agreement. VI. LIABILITY, INSURANCE, AND INDEMNITY A. Thc City shall maintain liability insurance coverage through an insurance carrier approved by the Washington State Insurance Commissioner for such coverage in the amount not less than ONE MILLION DOLLARS ($1,000,000.00) per occurrence and TWO MILLION DOLLARS ($2,000,000.00) in the aggregate at The City's expense. B. Hospital shall maintain liability insurance for its staff through an insurance carrier approved by the Washington State Insurance Commissioner for such coverage in an amount not less than the limits applicable to The City C. Mutual Indemnity. Each party to this Agreement agrees to indemnify the other party and to defend and hold the other party harmless from and against every claim, demand, liability, loss, cost, expense, and fee of any kind (including a reasonable attorney fee), and any and all liability therefore sustained or incurred by reason of each party's performance of its duties under this Agreement respectively. VII. REFERRALS AND CONTRACT MONITORING Hospital agrees to notify appropriate personnel as to The City's "Preferred Provider" status and to instruct such personnel that The City is to be utilized as the preferred or "first call" provider of ambulance transportation as provided herein, through the Cencom's 911 emergency line. OCnursing\document\general\agreement\City of Bremerton.doc Page 2 of 5 VIII. RECORD KEEPING REQUIREMENTS The City and Hospital agree to take appropriate action to maintain and protect the confidentiality of patient records and to comply with all state and federal laws and regulations pertaining to record keeping. IX. QUALITY ASSURANCE, UTILIZATION REVIEW, AND CONSUMER RELATIONS The City agrees to cooperate fully with Hospital's requirements for quality assurance, utilization review, and consumer relations programs. The City and Hospital will mutually agree to establish and provide the most efficient, medically necessary means of transportation. X. CONFIDENTIALITY Except as authorized by both The City and Hospital, as required by applicable laws and regulations, or as necessary to effectively carry out this Agreement, the information in the Attachment shall not be divulged, in whole or part, by either party, their agents, and/or employees, to any third party during the term of this Agreement. Neither party will disclose proprietary information about the other party, which is obtained in carrying out this Agreement. XI. DURATION AND TERMINATION This agreement shall commence on July 1, 2000, and shall continue for a term of three (3) years, terminating on June 30, 2003, subject to earlier termination for cause such as described in Section XII of this Agreement. The City and Hospital agree that this contract may be automatically renewed at the end of the above period for an additional one (1) year with approval of both parties in the form of an extension addendum. The City and Hospital agree that transport fees may be adjusted annually on the anniversary date of this Agreement, upon written notice. XII. TERMINATION FOR CAUSE BEFORE END OF TERM Either party shall have the right to terminate this Agreement without cause with written notice to the other party, no less than 90 days prior to termination of Agreement. XIII. BILLING AND PAYMENT TERMS The City agrees to bill Hospital quarterly for transports occurring the previous three (3) months. Hospital agrees to pay ambulance within 25 days of receipt of invoice. XIV. NOTICES All written notices, which are required or permitted under this Agreement, shall be sent by United States mail, postage prepaid, addressed to the respective parties as follows: O:\nursing\document\general\agreement\City of Bremerton.doc Page 3 of 5 Hospital The City Harrison Memorial Hospital Bremerton Fire Department 2520 Cherry Avenue 817 Pacific Avenue Bremerton, WA 98310 Bremerton, WA 98337 XV. OTItER GENERAL PROVISIONS Neither party may assign its right nor delegate its duties under this Agreement to any other person or entity for any purpose without prior notification and acceptance of effected party. This Agreement supercedes any and all other agreements, either oral or in writing, between the parties with respect to the subject matters hereof except as identified in this Agreement. This Agreement, including attachments, constitutes the entire understanding of the parties. No changes, amendments, or alterations shall be effected unless signed by both parties and attached to the original Agreement. This Agreement shall not be assigned or transferred by either party and such assignment shall be void and of no force or effect without the express written agreement of both parties. XVI. AUTHORITY OF PARTIES Each of the undersigned individuals represents and warrants that he or she is duly authorized to execute and deliver this Agreement on behalf of each corporate party indicated below and that this Agreement is binding upon said party in accordance with its terms. 1N WITNESS WHEREOF, Hospital and The City have duly executed this Agreement effective the date first above written. Hospital The City Its: ~V? [9/~ /,~ ? Attest:~ Date: cXo~/ ;~' ¢ / Date: '~- / "~ / ~ I Attest to Form/Legality O:\nursing\document\general\agreement\City of Bremerton.doc Page 4 of 5 ATTACHMENT I Financial considerations are as follows: A. Harrison Memorial Hospital agrees to pay The City according to the following schedule: 1. BLS or ALS transportation between Harrison Silverdale and Harrison Hospital, Bremerton: BLS ALS 07/01/00- 12/31/00 $234.00 $277.00 01/01/01 - 07/01/01 $253.00 $296.00 Above prices are for one-way transportation and include all ancillaries and mileage. 2. Remit payment within 25 days of receipt of qua~erly invoices for each of the above services. B. Hospital and The City agree: 1. The City will send statements on a monthly basis for each transport for services provided to: Harrison Memorial Hospital Accounts Payable 2520 Cherry Avenue Bremerton, WA 98310 2. Hospital will remit payments to: The City of Bremerton 239 4th Street Bremerton, WA 98337 C. Questions/disagreements about transports (such as number, BLS vs. ALS, appropriate type of transport, etc.) shall be discussed by Vice President, Nursing Services of Harrison Bremerton, and the Fire Chief and/or Medical Officer of the City. O:\nursing\document\general\agreement\City of Bremerton.doc Page 5 of 5