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2020 ORGANIZATIONAL MEETING\Standard Medical Division of Mountain Medical Services-Drug Testing&Physicals
RESOLUTION AUTHORIZING AGREEMENT BETWEEN TOWN OF
QUEENSBURY AND STANDARD MEDICAL TESTING SERVICES, A
DIVISION OF MOUNTAIN MEDICAL SERVICES, FOR SUBSTANCE
TESTING SERVICES & PHYSICAL EXAMS DURING 2020
RESOLUTION NO.: 92020
INTRODUCED BY:
WHO MOVED ITS ADOPTION
SECONDED BY:
WHEREAS, the Queensbury Town Board wishes to enter into an Agreement with Standard
Medical Testing Services, a division of Mountain Medical Services, (SMTS) to provide healthcare
services such as physical exams and substance testing in accordance with Federal Motor Carrier
Safety Regulations (FMCSR) for the Town during 2020, and
WHEREAS, SMTS 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 Standard Medical Testing Services, a division of 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 1st day of January, 2020,by the following vote:
AYES
NOES
ABSENT:
•••. S/�.tardMedical Services
/,• SERMING ALL POOR OCCUPATIONAL HEALTHVEEDS
MOUNTAIN 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, 2020 - Dec 31, 2020.
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 Administrative Fee: 10 or more employees $150.00
9 or less employees $ 75.00
Urine Drug Screens, 5 panel Dot $ 48.00
Urine Drug Screen, 10 panel expanded $ 50.00
Alcohol Breath Testing $ 36.00
JPA/Functional Capacity $ 70.00
DOT/CDL Physicals they do not pay for
NO Show/late Cancellation $ 30.00
Hep B Vaccine $ 95.00
Audiogram $ 35.00
Fit For Duty, PE $110.00
Respirator PE, includes PFT& Fit $130.00
Onsite Charge - Other than Randoms $100.00
NO Show Fee - $ 30.00
Observed Urine Collection $25.00
In addition, should there be after hours, post accident testing/reasonable suspicion, 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.
Shy Bladder wait time is $40.00 per hour, including after 5 pm closing time.
The fee for split specimen re-testing of positive specimens (including shipping, lab fees and
chain of custody) shall be $250.00.
The review of all Positive drug screen will be $100.00, regardless of final outcome. This
includes the MRO time for contacting physicians, donors and specialists whom the employee is
being treated by.
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.quickpayportal.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 P. M. Pond, MD
Name: r I� t L4d 1 Zit% , Name:
Title: Director of Occupational Medicine Title:
Date: '� /C/ // a Date:
Please execute this agreement, retain the original, and forward a duplicate to Standard Medical
Testing Services at 68 Quaker Road, Queensbury, NY 12804
Standard Medical Testing Services Mountain Medical Services
A division of Mountain Medical
Merrie Lynn Towle, BSN Michael Pond, MD/MRO
68 Quaker Road 1927 Saranac Avenue
Queensbury, NY 12804 Lake Placid, NY 12945
518-744-6560 518-523-7575
fax: 518-409-8441 FAX: 518-523-7577
www.standardmedicalservices.com www.mountainmedical.net
standardmedicalservices@gmail.com
354 Broadway,Saranac Lake, NY 12983
2 Hospital Drive,Massena,NY 13662
3372 St.Rte.11,Suite H,Malone,NY 12953