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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: f lordMedicc;l S elvices S SFRVICNc,w.tnUR000Ureno.Vw.aeaWNUM MC®U NTAI N MEDICAL 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