4.18 4.18
2019 ORGANIZATIONAL MEETINGMountain Medical Servides-Drug Testing&Physicals
RESOLUTION AUTHORIZING AGREEMENT BETWEEN TOWN OF
QUEENSBURY AND MOUNTAIN MEDICAL SERVICES FOR SUBSTANCE
TESTING SERVICES & PHYSICAL EXAMS DURING 2019
RESOLUTION NO.: ,2018
INTRODUCED BY:
WHO MOVED ITS ADOPTION
SECONDED BY:
WHEREAS, the Queensbury Town Board wishes to enter into an Agreement with Mountain
Medical Services to provide healthcare services such as physical exams and substance testing in
accordance with Federal Motor Carrier Safety Regulations (FMCSR)for the Town during 2019, and
WHEREAS, Mountain Medical Services has offered to perform such services in accordance
with the terms and provisions of the Contractual Agreement presented at this meeting,
NOW, THEREFORE, BE IT
RESOLVED, that the Queensbury Town Board hereby approves the Contractual Agreement
between the Town of Queensbury and Mountain Medical Services substantially in the form presented
at this meeting to provide healthcare services such as physical exams and substance testing with the
costs for such services to be paid for from the appropriate accounts, and
BE IT FURTHER,
RESOLVED, that the Town Board further authorizes and directs the Town Supervisor to
execute the Contractual Agreement and any other needed documentation and the Town Supervisor
and/or Town Budget Officer to take any other action necessary to effectuate the terms of this
Resolution.
Duly adopted this 17ffi day of December, 2018,by the following vote:
AYES
NOES
ABSENT:
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Contractual Agreement
This agreement is made between Standard Medical Testing Services, a division of Mountain
Medical Services, located at 68 Quaker Road, Queensbury, NY 12804 and with Town of
Queensbury having an address a 742 Bay Rd Queensbury, NY 12804
This agreement shall be in effect from January 1, 2019- Dec 31, 2019.
The responsibilities and obligations and liabilities shall survive the term of this agreement.
This agreement may be cancelled by either party after thirty days of written notification.
Both parties to this agreement are independent contractors, and nothing contained herein shall
be construed to place the parties in the relationship of partners,joint venture, principal-agent or
employer-employee, and neither party shall have the power to obligate or bind the other
whatsoever beyond the terms of this agreement.
Standard Medical Testing Services, a division of Mountain Medical Services, will be
compensated for its services as follows:
Yearly Consortium Fee: 10 or more employees $100.00
9 or less employees $ 50.00
Urine Drug Screens, 5 panel Dot $ 45.00
Urine Drug Screen, 10 panel expanded $ 48.00
Alcohol Breath Testing $ 35.00
JPA/Functional Capacity $ 70.00
DOT/CDL Physicals $130.00
NO Show/late Cancellation $ 25.00
Hep B Vaccine $ 95.00
Audiogram $ 25.00
Fit For Duty, PE $100.00
Respirator PE, includes PFT& Fit $125.00
lin addition, should there be after hours, post accident testing; there shall be a flat rate fee of
$120.00 per hour with a minimum two hour charge. Also there will be a mileage charge of 56.5
cents per mile applied.
r
The fee for split specimen re-testing of positive specimens (including shipping, lab fees and
chain of custody) shall be the actual cost of said testing. The MRO review and time will be
$100.00
Payment of invoices is expected within 30 days of receipt of invoice payable to Mountain
Medical Services, PO BOX 13395, Belfast Maine, 04915.. A late fee/interest fee of 1.5%
monthly will be applied to outstanding invoices over 30 days old. We accept payment
Online at www.guickpayrportal.com. Code is on Invoice.
Standard Medical Testing Services a division of Mountain Medical Services attests that it will
keep all information obtained from Town of Queensbury for the purpose of testing confidential
unless otherwise required to disclose said information by applicable law, regulation, or
subsequent agreement.
The provisions of the Agreement shall be construed, interpreted and governed by the
substantive laws of the state of New York, including all matters of construction, validity and
performance.
IN WITNESS WHEREOF, the parties hereto have caused this agreement to be executed as of
the day and year executed below:
Standard Medical Testing Services
Merrie Lynn Towle, BSN
Mountain Medical Services Town of Queensbury
Dr. Michael R M. Pond, MD
Name: Name:
Title: Director of Occupational Medicine Title:
Date: Date:
Please execute this agreement, retain the original, and forward a duplicate to Standard Medical
Testing Services at PO Box 2424 Glens Falls, NY 12801
Standard Medical Testing Services Mountain Medical Services
A division of Mountain Medical
Merrie Lynn Towle, BSN Michael Pond, MD/MRO
68 Quaker Avenue 1927 Saranac Avenue
Queensbury, NY 12804 Lake Placid, NY 12945
518-744-6560 518-523-7575
fax:518-744-1407 FAX: 518-523-7577
www.standardmedicalservices.com www.mountainmedical.net
standardmedicalservices(cDgmail.com
354 Broadway,Saranac Lake,NY 12983
2 Hospital Drive,Massena,NY 13662
3372 St.Rte.11,Suite H,Malone,NY 12953