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HomeMy WebLinkAboutPSA Between Northwest Assesment Service PLLC and the Kittitas County SOKittitas County Review Form Grants & Contract Agreement Today's Date October 23,2023 t-t-2 Agenda Date Fund/Department 30 / Sheriff Contract/Grant lnformation Financial lnformation Budget lnformation Pass Through lnformation ant Agency: Northwest Assessment service, pLLC (prof. services Agreement)Contract /Gr Period Begin Date: Upon signature Period End Date: Until either party terminates Total Grant/Contract Amount: Variable Grant/Contract Number: SH23-030 icants for ntCo ar rG a Snt mU am TSThct/IS Kibetr,veen tt tasry:Co and orthNagreement Assessment\,VCST ceServiunty ,LP forLC cond locho lc evalal uat c ond lnuctingsypons.terviews of I foob e t oructingappmploymen rese rve cSETVl e and and fot olo calprepanngconvev and antlic vale uatireportslngsychpgi onsfindingsapp Kithe tasttr Coun Sherifl fficeoty Total Amount = Variable State Funds S0 Federal Funds S0 Percen Count Funds IO0%Matchin Funds S0 CFDA# NA ln-Kind S0 EX atn ls UI ent bein urchased? NO Who owns equipment? New Personnel bei hired? NO Contact HR hiring -ortin uirementsre ity to Kittitas county: Vendor to carry full insurance per contract.Future impacts or liabil Budget Amendment Needed?Yes I attach budget form No E Why not (tn Budget) New Division Created? NO Revenue Code NA Expense Code ob ect code 001-300254101 & I 20-300254101 Agency to Pass Through NA Amount to Pass Through So Sub-Contract Approved Date: Grant/Contract Review Page 1 Prosecutor Review Has the Prosecutor reviewed this agreement?Yes No CAMAS# 10035 Count De ments lm acted Submitted s nature: Department: Sh ff Date Assi ment of Tracking lnformation Auditor Facilities Maintenance lnformation Services Human Resource Prosecutor Treasurer Auditor's Office Human Resource Prosecutor's Office 9a\ry Who Signed the grant application Reviewer Date Grant/Contract Review Page 2 PROFESSIONAL SERVICES AGREEMENT This Agreement is made by and between Kittitas County (hereinafter "the County")and Northwest Assessment Services, PLLC (hereinafter "Cohtiactor"). The County and Contractor agree as follows: General Conditions; Exhibit A (Scope of Work); Exhibit B (Compensation); Exhibit C (Proof of lnsurance). copies of which are attached hereto and incorporated herein by this reference as fully as if set forth herein. The term of this Agreement shall commence on the and continue until completion of the project Any party may terminate this Agreement by giving thirty (30) days' notice in writing either personally delivered or mailed postage-pre paid by certified mail, return receipt requested,to the party's last known address for the pu rposes ofgiving notice under this paragraph Contractor acknowledges and by signing this Agreement agrees that the lndemnification provisions set forth in Paragraphs 7 (lndependent Contracto4, g (Taxes),15 (Defense and lndemnity Agreement), 21 (Patent/Copyright lnfringement) and Z.q (Confidentiality), are totally and fully part of this Agreement and have been mutually negotiated by the parlies. of I lN WITNESS WHEREOF, the parties have executed this Agreement tri, 2 | a{"v lrlrv. , 2023. Professional Services Agreement (rev . 0g I 24 120 1 g) Page 1 of 17 APPROVED: Northwest Assessment Services, PLLC BOARD OF COUNry COMMISSIONERS KITTI UNry, WASHINGTON Signature of Signatory hairman (Date Print Name of Signatory Vice-C trman of Board Form Y VL%xx Deputy Proselutin g Attorney County's Address: PO Box 9 8 Seabeck, WA 98380 Kittitas County 205 West 5th Avenue, Suite 108 Ellensburg, WA 98926 Contractor Address: Project Contact: Monica J. Pilarc. Ph.D.. ABPP P rofessional Services Ag reement (rev . 09 I 24 I 20 1 8) Page 2 of 17 Project Contact: Kim Dawson, Sheriff's Administrative Assistant GENERAL CONDITIONS 1. Scope of Contractor's Services: Contractor agrees to provide to the County services and any materials set forth in the project narrative identified in Exhibit'A" during the Agreement period. No material, labor, orfacilities will be furnished by the County, unless otheruise provided for in the Agreement. 2. Per.formance of Work: Contractor shall perform work in accordance with, and shall comply with, allof the provisions of this Agreement. All work shall comply with applicable codes and ordinances. 3. Schedule of Performance: Unless directed othenrvise by the County, Contractor shall perform the work in accordance with any schedules made a part of this Agreement. 4. Definitions:4.1 "Additional lnsureds" means the County, its successors and assigns, and the respective directors, officers, employees, agents and representatives of the County and its successors and assigns.4.2 "Suppod" means the following: Contractor's directors, officers, employees, agents and representatives; and sub-Contractors of any tier; the respective directors, officers, employees, agents and representatives of these sub- Contractors of any tier; and any other person or entity acting under the direction or control of, or on behalf of, Contractor or any Contractor's sub- Contractors of any tier in connection with or incident to the performance of the Work or this Agreement.4.3 The "Work" means all of the duties listed in Exhibit A and the performance of all other obligations, under this Agreement by Contractor or its Support. 5. Accounting and Payment for Contractor Services: Payment to the Contractor for services rendered under this Agreement shall be as set forth in Exhibit "8". Where Exhibit "B" requires payments by the County, payment shall be based upon billings, supported unless otherwise provided in Exhibit "8", by documentation of units of work actually performed and amounts earned, including where appropriate, the actual number of days worked each month, total number of hours for the month, and the total dollar payment requested. Unless specifically stated in Exhibit "8" or approved in writing in advance by the Kittitas County Board of Commissioners, the County witt not reimbursJthe Contractor for any costs or expenses incurred by the Contractor in performance of this Agreement. Where required, the County shall, upon receipt of appropriate documentation, compensate the Contractor, no more often than monthly, through the County voucher system, for the Contractor's service pursuant to the fee schedule set forth in Exhlbit "8". Professi ona l Services Ag reement (rev . 09 1 24 120 1 8) Page 3 of 17 6. Assiqnment and Subcontractinq: No portion of this Agreement may be assigned or subcontracted to any other individual, firm or entity without the express and prior written approval of the County. 7. lndependent Contractor. The Contractor's services shall be furnished by the Contractor as an independent Contractor and nothing herein contained shall be construed to create a relationship of employer- employee or master-seryant, but all payments made hereunder and all services performed shall be made and performed pursuant to this Agreement by the Contractor as an independent Contractor. The Contractor acknowledges that the entire compensation for this Agreement is specified in Exhibit "8" and the Contractor is not entitled to any County benefits including, but not limited to: vacation pay, holiday pay, sick leave pay, medical, dental, or other insurance Ltenefits. o!'anv other" riqhts or Brivileqes aff.orded to Kittitas Countv emolorrees..J--..-...J...--.r.....-J--_..-,-...r.-, Contractor will defend, indemnify and hold harmless the County, its Additional lnsureds, officers, agents or employees from any loss or expense, including but not limited to settlements, judgments, setoffs, attorneys' fees or costs incurred by reason of claims or demands because of breach of the provisions of this paragraph. 8. No Guarantee of Employment: The performance of all or part of this Agreement by the Contractor shall not operate to vest any employment rights whatsoever and shall not be deemed to guarantee any employment of the Contractor or any employee of the Contractor or any sub-Contractor or any employee of any sub-Contractor by the County at the present time or in the future. 9. Taxes: The Contractor understands and acknowledges that the County will not withhold Federal or State income taxes. \Mere required by State or Federal law, the Contractor authorizes the County to make withholding for any taxes other than income taxes (i.e., Medicare). All compensation received by the Contractor will be repoded to the lnternal Revenue Service at the end of the calendat year in accordance with the applicable IRS regulations. lt is the responsibility of the Contractor to make the necessary estimated tax payments throughout the year, if any, and the Contractor is solely liable for any tax obligation arising from the Contractor's performance of this Agreement. The Contractor hereby agrees to indemnifu the County against any demand to pay taxes arising from the Contractor's failure to pay taxes on compensation earned pursuant to this Agreement. The County will pay sales and use taxes imposed on goods or services acquired hereunder as required by law. The Contractor must pay all other taxes including, but not limited to: Business and Occupation Tax, taxes based on the Contractor's gross or net income, or personal property to which the County does not hold title. The County is exempt from Federal Excise Tax. Professional Services Ag ree ment (rev . 09 I 24 I 20 I 8) Page 4 of 17 10. Requlations and Requirement: This Agreement shall be subject to all laws, rules and regulations of the United States of America, and State of Washington, and political subdivisions of the State of Washington, and to any other provisions set forth herein or in the attached exhibits. 11. Riqht to Review: This contract is subjectto review by any Federal or State auditor. The County or its designee shall have the right to review and monitor the financial and service components oi this program by whatever means are deemed expedient by the County. Such review may occur with or without notice, and may include, but is not limited to, on-site inspection by County agents or employees, inspection of all records or other materials which the County deems pertinent to the Agreement and its performance, and any and all communications with or evaluation by service recipients under this Agreement. The Contractor shall preserve and maintain all financial records and records relating to the performance of work under this Agreement for 6 years after contract termination, and shall make them available for such review, within Kittitas County, State of Washington, upon request. An exception is made for the specific identity of any Kittitas County Sheriff's Office employees or staff receiving confidential wellness visit services. 12. Modifications: 12.1 Either party may request changes in the Agreement. Any and all agreed modifications shall be in writing, signed by each of the parties. 12.2 The County may, at any time, by written notice thereof to Contractor ("Change Notice") makes changes in the Work within the general scope of this Agreement, including, but not limited to: (a) changes in, revisions to, substitutions for, additions to or deletions of any Work; (b) changes in schedule; and (c) acceleration, deceleration or suspension of performance of any Work. 12.3 lf any change in the Work causes an increase or decrease on Contractor's cost of, or the time required for, performance of the Work, an equitable adjustment in the compensation to Contractor and in the schedule for the performance of the Work shall be made to reflect such an increase or decrease. 12.4 Notwithstanding any dispute or delay in arriving at a mutually acceptable equitable adjustment, Contractor shall proceed in accordance with all Change Notices. Contractor must, within thirty (30) days after receipt of any Change Notice that does not set forth any acceptable adjustment, submit to the County a written statement setting forth any adjustment claimed. Professiona I Services Agree ment (rev . 0g I 24 120 1 B) Page 5 of 17 12.5 lf any change results in a decrease in the Work performed, Contractor shall be entitled to compensation associated with changing the Work, such as revising design already completed, revising calculations already performed, and revising documents. 13. fermination for Default. lf the Contractor defaults by failing to perform any of the obligations of the Agreement or becomes insolvent or is declared bankrupt or commits any act of bankruptcy or insolvency or makes an assignment for the benefit of creditors, the County may, by depositing written notice to the Contractor in the U.S. mail, postage prepaid, terminate the Agreement, and at the County's option, obtain pedormance of the work elsewhere. lf the Agreement is terminated for default, the Contractor shall not be entitled to receive any further payments under the Agreement until all work called for has been fully performed. Any extra cost or damage to the County resulting from such default(s) shall be deducted from any money due or coming due to the Contraclor. The Contraetor shall bear any extra expenses ineurred by the County in completing the work, and all damage sustained, or which may be sustained by the County by reason of such default. lf a notice of termination for default has been issued and it is later determined for any reason that the Contractor was not in default, the rights and obligations of the parties shall be the same as if the notice of termination had been issued pursuant to the Termination for Public Convenience parag raph hereof. 14. Termination for Public Convenience: The County may terminate the Agreement in whole or in part whenever the County determines, in its sole discretion that such termination is in the best interests of the County. Whenever the Agreement is terminated in accordance with this paragraph, the Contractor shall be entitled to payment for actualwork performed at unit contract prices for completed items of work. ln the event of such termination, an equitable adjustment shall be made in the compensation payable to Contractor. An equitable adjustment in the contract price for partially completed items of work will be made, but such adjustment shall not include provision for loss of anticipated profit on deleted or uncompleted work. Termination of this Agreement by the County at any time during the term, whether for default or convenience, shall not constitute a breach of contract by the County. 15. Defense & lndemnity Aqreement. The Contractor agrees to and shall defend, indemnify and hold harmless the County, its Additional lnsureds, appointed and elective officers, agents and employees, from and against all loss or expense, including but not limited to judgments, settlements, attorney's fees and costs by reason of any and all claims and demands upon the County, its Additional lnsureds, its elected or appointed officials, agents, or employees for damages because of personal or bodily injury, including death at any time resulting therefrom, sustained by any Professi onal Services Ag reement (rev . 09 124 120 1 8) Page 6 of 17 person or persons and on account of damage to property including loss of use thereof, whether such injury to persons or damage to property is due to the negligence of the Contractor, its sub-Contractors, its elected officers, employees or their agents, except only such injury or damage as shall have been occasioned by the sole negligence of the County, its Additional lnsureds, appointed or elected officials, agents, or employees. lt is further provided that no liability shall attach to the County by reason of entering into this contract, except as expressly provided herein. 16. lndustrial lnsurance Waiver: With respect to the pedormance of this Agreement and as to claims against the County, its Additional lnsureds, officers, agents and employees, the Contractor expressly waives its immunity under Title 51 of the Revised Code of Washington, the lndustrial lnsurance Act, for injuries to its employees and agrees that the obligations to indemnify, defend and hold harmless provided in this agreement extend to any claim brought by or on behalf of any employee of the Contractor. This waiver is mutuatly negotiated by the parties to thii Agreement. 17. Venue and Choice of Law: ln the event that any litigation should arise concerning the construction or interpretation of any of the terms of this Agreement, the venue of such action of litigation shall be in the Superior Court of the State of Washington in and for the County of Kittitas. This Agreement shall be governed by the law of the State of Washington. 18. Withholdin q Pavment: ln the event the Contractor has failed to perform any obligation to be per.formed by the Contractor under this Agreement within the time set forth in this Agreement, then the County may, upon written notice, withhold all monies due and payable to Contractor, without penalty, until such failure to perform is cured or othenruise adjudicated. 19. Future Non-All ocation of Funds lf sufficient funds are not appropriated or allocated for payment under this Agreement for any future fiscal period, the County will not be obligated to make payments for services or amounts incurred after the end of the current fiscal period. No penalty or expense shall accrue to the County in the event this provision applies. 20 Warra ntation The C ontractor represents and warrants to the County as follows:20.1 The Contractor is duly incorporated, validly existing and in good standing under the laws of the State of Washington, and has all requisite corporate power and authority to enter into and to perform its obligations under this Agreement. 20.2 The Contractor has the authority to execute this Agreement, to make the representations and warranties set forth in it and to perform the Professi onal Services Ag ree ment (rev . 09 124 120 1 8) Page7 ol17 20.3 20.4 20.5 20.6 obligations of the Contractor under this Agreement in accordance with its terms. This Agreement has been validly executed by an authorized representative of the Contractor and constitutes a valid and legally binding and enforceable obligation of Contractor. The Contractor has or will obtain prior to the commencement date such licenses, permits and other authorizations from federal, state and other governmental authorities, as are necessary for the performance of its obligations under this Agreement. The Contractor is not in violation of any applicable law, ordinance or regulation the consequence of which will or may materially affect Contractor's ability to perform its obligations under this Agreement. The Contractor is not subject to any order or judgment of any court, tribunal or governmental agency which materially and adversely affects its operations or assets in the State of Washington, or its ability to perform its obligations under this Agreement. None of the representations or warranties in this Agreement, and none of the documents, statements, certificates or schedules furnished or to be furnished by Contractor pursuant hereto or in connection with the performance of the obligations contemplated under this Agreement, contains or will contain any untrue statement of a material fact or omits or will omit to state a material fact necessary to make the statements of fact contained therein not misleading. 21. PatenVCopvriqht lnfrinqement: Contractor will defend and indemnify the County from any claimed action, cause or demand brought against the County; to the extent such action is based on the claim that information supplied by the Contractor infringes any patent or copyright. The Contractor will pay those costs and damages attributable to any such claims that are finally awarded against the County in any action. Such defense and payments are conditioned upon the following: 21.1 Contractor shall be notified promptly in writing by County of any notice of such claim. 21.2 Contractor shall have the right, hereunder, at its option and expense, to obtain for the County the right to continue using the information, in the event such claim of infringement is made, provided no reduction in performance or loss results to the County. 22. Disputes: 22.1 General Differences between the Contractor and the County, arising under and by virtue of the Agreement Documents shall be brought to the attention of the County at the earliest possible time in order that such matters may be settled or other appropriate action promptly taken. Except for such objections as are made of record in the manner hereinafter specified and within the time limits Professional Services Ag ree ment (rev . 09 1 24 1 201 8) Page 8 of 17 stated, the records, orders, instructions, and decisions of the Kittitas County Commissioners shall be final and conclusive. 22.2 Notice of Potential laims The Contractor shall not be entitled to additional compensation which otherwise may be payable, or to extension of time for (1) any act or failure to act by the county, or (2) the happening of any event or occurrence, unless the Contractor has given the County a written Notice of Potential Claim within ten (10) days of the commencement of the act, failure, or event giving rise to the claim, and before final payment by the county. The written Notice of Potential Claim shall set forth the reasons for which the Contractor believes additional compensation or extension of time is due, the nature of the cost involved, and insofar as possible, the amount of the potential claim. Contractor shall keep full and complete daily records of the work performed, labor and material used, and allcosts and additionaltime claimed to be additional. 22.3.Detailed CIaim The Contractor shall not be entitled to claim any such additional compensation, or extension of time, unless within thirty (30) days of the completion of the portion of the work from which the claim arose, and before final payment by the County, the Contractor has given the County a detailed written statement of each element of cost or other compensation requested and of all elements of additional time required, and copies of any supporting documents evidencing the amount or extension of time claimed to be due. 23. Ownershio of ltems Produced Any final reports or consultations prepared by the Contractor and/or its consultants or sub- Contractors, in connection with performance of this Agreement shall be the shared property of the Contractor and County. By virtue of the specific services to be rendered under thii Agreement, any other writings, programs, data, public records or other materials will remain the sole and absolute property of the Contractor. 24. Confidentialitv: The Contractor, its employees, sub-Contractors, and their employees shall maintain the confidentiality of all information provided by the County or acquired by the Contractor in performance of this Agreement, except upon the prior written consent of the Kittitas County Prosecuting Attorney or an order entered by a court after having acquired jurisdiction over the County. Contractor shall immediately give to the County notice of any judicial proceedings seeking disclosure of such information, Contractor shall indemnify and hold harmless the County, its Additional lnsureds, officials, agents or employees from all loss or expense, including, but not limited to settlements, judgments, setoffs, attorneys'fees and costs resulting from Contractor's breach of this provision. Professional Services Agree ment (rev . 0g I 24 l2O I B) Page 9 of 17 To the extent that any information obtained by the Contractor is required to be shared with or provided to others by the terms of the Statement of the Work, this provision is not breached by such acts. 25. Notice: Except as set forth elsewhere in the Agreement, for all purposes under this Agreement, except service of process, notice shall be given by the Contractor to the department head of the department for whom services are rendered, and to the Kittitas County Commissioners, 205 W sth Ave, Suite 108, Ellensburg, WA 98926. Notice to the Contractor for all purposes under this Agreement shall be given to the address reflected on the signature page. Notice may be given by delivery or by depositing in the U.S. Mail, first class, postage prepaid. 26. Severabilitv: lf anv term or condition of this Aoreement or the annlication thereof to anv nerson(s) cr.'-'''J.-_rr.Jr-. circumstances is held invalid, such invalidity shall not affect other terms, conditions or applications which can be given effect without the invalid term, condition or application. To this end, the terms and conditions of this Agreement are declared severable. 27. Miscellaneous: 27.1 The County's failure or delay to insist upon strict performance of any of the provisions of this Agreement or to exercise any rights or remedies under this Agreement shall not be construed as a waiver or relinquishment to any extent of its right to assert or rely upon any such provisions, rights or remedies in that or any other instance; rather the same shall be and remain in full force and effect. 27.2 This Agreement embodies the entire Agreement between the County and Contractor, and supersedes any and all prior agreements, regarding the Work. No change, amendment or modification of any provisions of this Agreement shall be valid unless set forth in a written instrument signed by the pafty to be bound thereby. 27.3 The rights and remedies of the County set forth in any provision of this Agreement are in addition to and do not in any way limit any other rights of remedies afforded to the County by any other provisions of this Agreement, by any of Contractor's Support or by law. 27.4 The headings of sections and paragraphs of this Agreement are for convenience of reference only and are not intended to restrict, affect or be of any weight in the interpretation or construction of the provisions of such sections or paragraphs. 28. Waiver: Waiver of any breach or condition of this Agreement shall not be deemed a waiver of any prior or subsequent breach. No terms or conditions of this Agreement shall be held to be waived, modified or deleted except by an instrument, in writing, signed by the parties hereto. Professi onal Services Agreement (rev . 09 I 24 1201 8) Page 10 of 17 29. Survival: The provisions of paragraphs 7, g, 11, 13, 14, 1s, 16, 17,1g, 19, 20,21, 22,23,24, 2g, 30, 31, and 32 shall survive, notwithstanding the termination or invalidity of this Agreement foi any reason. 30. Nondiscrimination 30.1 The County is an equal opportunity employer. 30.2 Nondiscrimination in Emplovment ln the performance of this Agreement, the contractor will not discriminate against any employee or applicant for employment on the grounds of race, creed, color, national origin, sex, sexual orientation, marital status, age or the presence of any sensory, mental or physical handicap; provided that the prohibition against discriminationin employment because of handicap shall not apply if the particular disability prevents the proper performance of the particular worker involved. The Contractor shall ensure that applicants are employed, and that employees are treated during employment without discrimination because of their race, creed, color, national origin, sex, sexual orientation, marital status, age or the presence of any sensory, mental or physical handicap. such action shall include, but not be limited to: employment, upgrading, demotion or transfers, recruitment or recruitment advertising, layoff or termination, rates of pay or other forms of compensation, and programs for training including apprenticeships. The Contractor shall take such action with respect to this Agreement as may be required to ensure full compliance with local, state and federal laws prohibiting discrimination in employment. 30.3 Nondiscriminat ion in Services The Contractor will not discriminate against any recipient of any services or benefits provided for in this Agreement on the grounds of race, creed, color, national origin, sex, sexual orientation, marital status, age or the presence of any sensory, mental or physical handicap lf any assignment and/or subcontracting has been authorized by the county, said assignment or subcontract shalr incrude appropriate safeguards against discrimination. The contractor shall take such action as may be required to ensure full compriance with the provisions in the immediately preceding paragraphs herein. 30.4 Professional Services Agreement (rev . 09 t 24 I 20 1 g) Page11of17 31. Prevailinq Waqe: Contractor shall pay the prevailing rate of wages to all workers, laborers, or mechanics employed in the performance of any part of the Work in accordance with RCW 39.12 and the rules and regulations of the Department of Labor and lndustries. The schedule of prevailing wages rates for the locality or localities of the Work is determined by the lndustrial Statistician of the Department of Labor and lndustries. lt is the Contractor's responsibility to verify the applicable prevailing wage rate. lt is understood that the Contractor is responsible for obtaining and completing all required government forms and submitting same to the proper authorities. Disputes regarding prevailing wage rates shall be referred for arbitration to the Director of the Department of Labor and lndustries. The arbitration decision shall be final and conclusive and binding on all parties involved in the dispute as provided for by RCW 39.12.060. 32. Debarment Certification: The Contractor certifies that it. 32.1 ls not presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from covered transactions by any Federal department or agency. 32.2 Has not within a three-year period preceding the execution of this contract with Kittitas County, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public or private agreement or transaction, violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, receiving stolen property, making false claims, or obstruction of justice. 32.3 ls not presently indicted for or othenvise criminally or civilly charged by a governmental entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph 32.2 of this section. 32.4 Has not within a three-year period preceding the preceding the execution of this contract with Kittitas County had one or more public transactions (Federal, State, or local) terminated for cause of default. Professional Services Ag reement (rev . 09 I 24 l2Q 1 8) Page 12 of 17 EXHIBIT ''A'' SCOPE OF WORK ln addition to providing all material and labor, the Contractor shall perform the following: . Conduct psychological evaluations including related interviews of applicants for employment or reserve service upon request by the Kittitas County Sheriffs Office. . Prepare and convey reports of those psychological findings and applicant evaluations to the Kittitas County Sheriffs Office. These evaluations shall be conducted in compliance with, and as mandated by, the provisions of RCW 43.101.095(2)(a)(iii), and wAC 139-07-030, and any provision now in existence or enacted during the period of this Professional Services Agreement, including any extension thereof. Warrant that he or she is familiar with and in compliance with the standards referenced above and incorporated herein by reference. a a a Provide confidential wellness visits and telephone follow-ups, critical incident stress or post officer involved shooting debriefings, or other appropriate employee support as requested. Provide professional consultation services upon request to the Kittitas County Sheriff's Office. The services stated above will be conducted at the Contractor's place of business, on site, or at an mutually agreeable alternative location if warranted or appropriate. (Note: I require an automobile to go to any office or location where services will be provided.) Professional Services Ag reement (rev . 0g 124 l2O 1 B) Page 13 of17 EXHIBIT "B" COMPENSATION As full compensation for satisfactory performance of the work, the County shall pay Contractor compensation not to exceed: a a As full compensation for satisfactory performance of the work, the County shall pay Contractor compensation not to exceed $450 per applicant pre-employment psycholog ical evaluation. Wellness visits, critical incident stress or post officer involved shooting debriefings, or other relevant/appropriate employee support as requested not to exceed $275 per provided service. Note that listed provided services include at least one follow-up phone call with the recipient of such services. Formal crrofessional consr:ltation services. includinq btr-rt not limited to document review and expert witness testimony, as requested not to exceed $300 per hour. a P rofessional Seruices Agreement (rev . 09 I 24 1201 8) Page 14 of 17 EXHI lT "c" PROOF OF INSURANCE The Contractor shall secure and maintain in effect at all times during performance of the Work such insurance as will protect Contractor, its Support and tne nOOitional lnsureds from all claims, losses, harm, costs, liabilities, damages and expenses arising out of personal injury (including death) or property damage that may result from performance of the work or this Agreement, whether such performance is by Contractor or any of its Support. All insurance shall be issued by companies admitted to do business in the State of Washington and have a rating of A-, Class Vll or better in the most recently published edition of Best's Reports unless otherwise approved by the County. lf an insurer is not admitted, all insurance policies and procedures for issuing the insurance policies must comply with Chapter 48.1 5 RCW and 284-15 WAC. The Contractor shall provide proof of insurance for: Commerc ial General Liabilitv lnsurance Coverage limits not less than:. $5,000,000 per occurrence. $1,000,000 per occurrence liquor liability. $1,000,000 products & completed operations aggregate. $1,000,000 personal and advertising injury, each offense. Certificate Holder - Kittitas County. The certificate must name the county as additionar insured. Sixty (60) days written notice to the County of cancellation of the insurance policy Commercial Automobile Liability lnsurance (if ANY use of vehicle in performance) Automobile Liability for owned, non-owned, hired, and leased vehicles (MCS go endorsement and a CA 9946 endorsement must be attached if 'potlutants' are to be transported). Coverage limits not less than:. $1,000,000 combined single limit. Thirty (30) days written notice to the County of cancellation of the insurance policy. ! Workers' Compensation Additional Ma Be Professional Services Agreement (rev. egl24l201g) Page 15 of17 Workers' Compensation in amounts required by law Stop Gap/Emplovers Liabilitv Coverage limits not less than:. $1,000,000 each accident. $1,000,000 disease - policy limit. $1,000,000 disease - each employee. Thirty (30) days written notice to the County of cancellation of the insurance policy. [] Professional Liability The Contractor and/or its Subcontractor and/or its consultant providing professional services shall provide evidence of Professional Liability lnsurance . covering professional errors and omissions. Such policy must provide the following minimum limits:. $1,000,000 per claim. $2,000,000 annual aggregate. lf insurance is on a claims-made form, its retroactive date, and that of all subsequent renewals, shall be no later than the effective date of this Agreement. ! eottution Liability The Contractor shall provide a Pollution Liability policy, providing coverage for claims involving bodily injury, property damage (including loss of use of tangible property that has not been physically injured), cleanup costs, remediation, disposal or other handling of pollutants, including costs and expenses incurred in the investigation, defense, or settlement of claims arising out of:. Contractor's operations related to this project; and/or. Remediation, abatement, repair, maintenance or other work with lead-based paint or materials containing asbestos; and/oro TranSportation of hazardous materials away from any site related to this project Such Pollution Liability policy shall provide the following minimum coverage.r $ Per claimr $ annual aggregate Propertv Damaqe The Contractor shall provide a policy that covers damage to Kittitas County facilities, including buildings, equipment, grounds, etc. Such policy shall provide the following minimum coverage:o $ per occurrence ! Umbrella Coveraqe Professi onal Services Ag reement (rev . 09 1 24 1201 8) Page 16 of 17 Umbrella policies shall provide coverage at least as broad as specified for underlying coverages (CGL, Auto, Employer's Liability) and cover those insured in the underlying policies, including additional insured.o Amount required for this Agreement: g Contractor shall furnish the County a Certificate of lnsurance to include the policy Endorsements/Exclusions as evidence that policies providing insurance required by thii Agreement are in full force and effect. Contractor hereby waives all rights of recourse, including any right to which another may be subrogated, against t<ittitas County for personal injury, including death, and property damage. Contractor's insurance poiicies required above shall be primary insurance and shall be non-contributing with any other insurance maintained by Kittitas County. The Contractor shall assume full responsibility for all loss or damage from any cause whatsoever to any tools, Contractor's employee-owned tools, machinery, equipment, or motor vehicles owned or rented by the Contractor, or the Contractor's agents, suppliers or contractors as well as to any temporary structures, scaffolding and protective fences. The Contractor shall have sole responsibility for ensuring the insurance coverage and limits required are obtained by subcontractors. NOTE: No contract shall form until and untess a copy of the Certificate of lnsurance with Endorsements/Exclusions, properly completed and in the amount required, is attached hereto. Failure of the Contractor to fully comply with the above insurance requirements during the term of the Agreement shall be considered a material breach of contract and cause for immediate termination of the Agreement at the County's discretion. Alternatively, the County may procure and maintain, at the Contractor's sole expense, insurance to the extent deemed proper up to the amount of the required coverage(s). The County may offset the cost of such insurance against payment due to the Contractor under this Agreement. Professional Seruices Agreement (rev . 09 124 120 1 8) Page 17 of 17 OATE (MMIDD/YYYY) t0/09/2023 THIS CERTIFICATE lS 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 POLIC]ES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: lf the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. lf SUBROGATION lS 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 certificate holder in lieu of such endorsement(s). PRODUCER Trust Risk Management Services, Inc. 1791 Paysphere Circle Chicago, [L60674 CONTACI NAME: Trust Risk Manaqement Services. lnc PHONE {A/C. No. Ext): 877.637.9700 FAX (A/c. No): 877.251.511 1 EMAIL ADDRESS: info@trustrms.com INSURER(SI AFFORDING COVERAGE NAIC # INSURER A: ACE American lnsurance Gompanv 22667 INSURED Dr. Monica Pilarc Po Box 918 Seabeck, WA 98380-0918 INSURER B: INSTIRER C: INSURER D: INSI.JRER E: INSTJRER F: .,4ACORif CERTIFICATE OF LIABILITY INSURANCE COVERAGES CERTIFICATE NUMBER REVISION NUMBER: CANC Kittitas County Sheriff's Office Ellensburg, WA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE @ 1988-2015ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSIANDING ANY REQUIREMENT, TERI\i1 OR CONDITION OF ANY CONTRACT OR OTHER DOCUNIENT 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. INSR LTR TYPE OF INSURANCE INSR SUUf wvD POLICY NUMBER tsQLICY EIT (MM/DDTYYYY} PgLIUI EAP (MM/DD/YYYN LIMITS EACH OCCURRENCE s OAMAGE TO RENTEO PRFf\4lSES (Ei occrirrencP) s MED EXP (Any one person)$ PERSONAL & ADV INJURY 5 GFNFRAI AGGIIFGATF $ PRODUCTS.COMPiOP AGG s GEN'L AGGREGAIE LIfuIIT APPLIES PER: GENERAL LIABILITY CLAIMS MADE OCCUR PRO- CONIBINED SINGLE LIMIT aEe adidentl s BODILY INJURY (Per Person)s BODILY INJURY (Per a€idenl g PROPERIY DAMAGE (Per adcidenll 5 AUTOMOBILE LIABILITY AUIO SCHEDULED AUTOS NON-OWNED AUTOS ALL OWNED AUTOS HIRED AUTOS $ EACH OCCURRENCEUMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS.MADE AGGREGATE g DED RETENTION S 5 PER STATUTE ofH- ER WORKERS COMPENSATION AND EMPLOYERS LIASILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERiMEMBER EXCLUDED? (Mandatory in NH) lf yes. descibe under DESCRIPTION OF OPERATIONS below Y/N IJ N/A E-1. DISEASE . POLICY LIMI'I $ 58G22353445 06/07/2023 06/07/2024 Each lncident Annual Aooreoate $ 1,000,000 $3,000,000A Psychologist's Professional Liability Retroactive Date 06/O7 /2002 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORO 101, Additional Remarks Schedule, may be atlached if more space is required) ACORD 25 (2016/03) B usrNpss Assocrare AonENnuu EXHIBIT "A" To rne CoNTRACT To wHrcH IT rs ATTACHED This Addendr'rm is incorporated into the contract to r,vhich this document is attached between Kittitas County Washington on behalf of the Office or Depaftment thereof ("Covered Entity,,) and the other party or parties thereto ("Business Associate"). The singLrlar shall incl'de the pliral and the plural the singular as required by the context. The Business Associate acknowledges and agrees that Protected Health information (pHI) in any format, including electronic PHI (ePHI), can be used, shared, created. retained or transferrecl only within the parameters of this document ancl the Department of Health ancl Human Services Privacy Regulations. Code of Federal Regulations, ("CFR"), Title 45, Sections 160 and 164.or as required by law. CFR Title 45, Sections 160 and 164 and any applicable Washington statutory la,uv (,.RCW,,) or Administrative Code ("WAC") provision (Federal and State statltory or regulatory standards applicable to this addendLrm are collectively referrecl to as "la\,v") are by r.vay of reference, an integral part of this Addendr-rm as if incorporatecl in lull. Business Associate is charged r,vith the knowledge of ar-rd agrees to abide by the terms and conclitions of lar,l.. To the extent that any applicable provision of RCW or WAC provicles for or mandates any standarcl differing frolr those of Federal law, the standard more restrictive of clisclosure shall control subject to fecleral preemption; this applies throughout this Addendum r.vithoLrt regard to any fgrther explicit reference to RCW or WAC provisions. This Addendttm is eft-ective Lrpon signing of this attachment or the contract to lvhich it is attached. r,vhichever is prior in time. I. PTIR E The Covered Entity needs to make available and/or disclose to the Business Associate certain PHI for nlanagement' administration, and legal responsibilities cluring the normal course of br"rsiness between the parties as referenced in the contract or other agreement to which this docttment is attached and incorporatecl by reference. This clocument is iltended to define ancl incorporate but not limit the obligations of the Business Associate r.vith regard to its use and protection of that PHI. RESPONSIBILITIES OF BUSINESS ASSOCIATE The Business Associate hereby agrees to do the fblloi,ving IT. A Use and Disclosr-rre: Use and/or disclose PHI only as permitted or reqLrirecl by this Addendum. Health Insurance Portability ancl Accolrntability Act (HIpAA). and the Health Information Technology for Economic and Clinical Health Act (Division A. Title XIII of the American Recovery and Reinvestment Act of 2009, pgb. Law l l l-5, 2009 HR l) ("FIITECH"). The Business Associate shall r,rse ancl disclose PHI only if such use or disclosr-rre, respectively, is in compliance with each applicable reqr.rirement of 45 CFR $164.504(e) or other law. The Business Associate is directly responsible for fgll B. A. A. Attachmenr Page I of 5 compliance with the privacy provisions of law'that apply to the Business Associate to the same extent as the Covered Entity. B. Security: Implement administrative, physicai, and technical safeguards that reasonably and appropriately protect the confidentiality, integrity, and availability of the PHI that it creates, receives, maintains, or transmits on behalf of the Covered Entity as reqr,rired by lar.v. The Br.rsiness Associate is directly responsible for compliance r,vith the secr-rrity provisions of HIPAA and HITECH to the same extent as the Covered Entity. C. Improper Disclosr-rres:Reporl all r-rnauthorized or otherwise improper disclosures of PHI, or security incident, to the Covered Entity r,vithin two (2) days of the Business Associate's knor,lledge of such event. D. Notice of Breach: Within trvo (2) business days of the discovery of a breacir as defined at 45 CFR ss164.402 notify the Covered Entity'of any breach of unsecured PHL Notification shali by the most rapicl means reasonably possible. such as telephonic notice made directly to an appropriate person r,vithin the covered entity and not including a voice mail or sirnilar message. Writterl notification shall follorv,,vithin that tr,vo (2) period by fax and be confirmed by direct contact r,vith the intended recipient, and include the identification of each individual r.vhose unsecured PHI has been, or is reasonably believed by the Business Associate to have been, accessed, acquired, or disclosed during sr"rch breachl a brief description of r,vhat l-rappened, including the date of the breach and tl-re date of the discovery of the breach, if knor,vn; a description of the types of unsecured PHI that i,vere involved in the breach (sr"rch as r.vhether full name. social secLrrity number, date of birth, horne address, account number, diagnosis. disability code. or other types of information w'ere involved); any steps individr.rals shor-rld take to protect themselves tiom potential harrn resulting frorn the breach; a brief description of what the Business Associate is doing to inl'estigate the breach. to mitigate harm to individtrals, and to protect against an1' ftrrther breaches; the contact procedures of the Br,rsiness Associate for individLrals to ask qr-restions or learn additional information. r,vhich shall inch-rde a toll free number. an e- mail address, Web site, or postal address; and any other information reqr"rired to be provided to the individual by the Covered Entity plrrslrant to 45 CFR $164.404, as arnended. A breach shall be treated as discovered in accordance with the terms of 45 CFR $ 164.410. The intbrmation shall be updated promptly and provided to the Covered Entitl' as requested by the Covered Entity. E. Mitigation: Mitigate. to the extent practicable, any harmful eft-ect that is known to Br"rsiness Associate of a use or disclosure of PHI by Business Associate in violation of the requirements of this Addendr,rm or the lai,v. F. Agents: E,nsure that any agent, including all of its employees, representatives, and subcontractors, to r.vhom it provides PHI received fiom, or created or received by Br-rsiness Associate on behalf of Covered Entity agrees to the same restrictions and B. A. A. Attachment Page 2 of 5 conditions that apply throtrgh this Addendum to Business Associate with respect to such information. G. Right of Access: 1. From time to time tlpon reasonable advance notice. or upon a reasonable determination by Covered Entity that Business Associate has potentially or actually breached this Addendum. make internal practices, books, and records relating to the ttse and disclosure of PHI received from, or created or received by Business Associate on behalf of Covered Entity available to the Covered Entity, or at the request of the Covered Entity to the Secretary of Department of Health and Human Services. for the pllrpose of determir-ring compliance with HIPAA. HITECH. ancl/or this Acldenclum. 2. From time to time Llpon reasonable advance notice. or Lrpon a reasonable determination by Covered Entity that Busirress Associate has potentially or actr-rally breached this Addendum, to permit Covered Entity to responcl to a request by an Individual for an accor-rnting of disclosures of PHI in accorclance w.ith 45 CFR $164.528. orto permit Covered Entity to respond to a request by ar-r Incliviclgal for access to PHI in accordance rvith 45 CFR Ss 164.524. H. Doctrmentation of Disclosures: Document such disclosures of PHI ancl information related to such disclosures as r,vould be reqr-rired for Coverecl Entity to respond to a request by an IndividLral for an accounting of disclosures of PHI in accordance with 45 CFR $ 164.528. Should an individLral make a request to Coverecl Entity for an accounting of disclosr"tres of his or her PHI pursuant to 45 CFR $ 164.528, Business Associate agrees to prornptly provide an accounting. as specified under 42 U.S.C. SS 17935(c) (1) and 45 CFR Ss164.528. of disclostrres of PHI that have been made by the Business Associate acting on behalf of the Covered Entity. The accounting shall be provided by the Business Associate to the Covered Entity'or to the individual. as clirectecl by the Coverecl Entity. I. Ametldments: Make any amendments to PHI that the Covered Entity clirects or agrees to prtrsrtant to 45 CFR Ql64.526 at the request of Covered Entity" r,r.ithin five (5) business days of written request by Covered Entity. J. Other: To the extent the Business Associate is to carry out one or more of the covered entities obiigations under Subparl E of 45 CFR 164, comply r,vith the requirements of Subpart E that apply to the covered entity in the performance of such obligations. III. PERM TED USES ANT)DISCLOSTJRES B Y BUSINESS AS CIATE A. Except as otherwise limited in this Addendum or by law, Business Associate may use Protected Health Information for the proper management and administration of the Business Associate or to carry out the legal responsibilities of the Business Associate. The BLrsiness Associate shall limit its use and disclosure of, and requests for. pHI to the minimum necessary as determined in accordance with 42 u.s.C. $ 17935(bXl ), B. A. A, Attachment Page 3 of 5 TV B. Except as otherwise limited in this Addendum or by law, Business Associate may Llse PHI to provide Data Aggregation services to Covered Entity as permitted by 45 CFR S 164.50a.@)(2XiXB). TERM AND TERMINATION A. Igru: This Addendum shall become effective on the E,ffective Date and shali continue in effect until all obligations of the parlies have been met" unless terminated as provided herein or by mutual agreernent of the parties B. Termination for Car,rse: Upon Covered Entity's knowledge of a material breach by Br,rsiness Associate, Covered Entity may provide an opportunity for Business Associate to cure tl"re breach or end the violation and terminate this Addendr"rrn if Business Associate does not cure the breach or end the violation within five (5) business days of receipt of r,vritten notice by the Covered Entity, or immediately tenninate this Addendr,utr if Br-rsir-ress Associate has breached a material term of this Addendum and cure is not possible. C. Other Terminatior-r: This AddendLrm may be terminated by' Covered Entity' r,vithout cause upon thirtl, (30) days prior u'ritten notice to the other party. r,r,hich notice shall specily the date of termination. D. Eff-ect of Termination: Except as provided ir-r paragraph B. of this Section, Lrpon termination of this Addendr"rm. for any reason. Business Associate shall return or destroy' all PHI received lrom Covered Entity, or created or received by Br"rsiness Associate on behalf of Covered Entity. This provision shall apply to PHI that is in the possession of subcontractors or agents of Br:siness Associate. Business Associate shall retain no copies of the PHL Destruction mr"rst be bv means that meet or exceed the standards of lar.v. In the event that Br.rsiness Associate determines that returning or destroying the PHI is not f-easible, Business Associate shall extend the protections of this Addendum to such PHI and limit further disclosures of such PFII to those pr"rrposes that make return or destrr-rction infeasible, for so long as Business Associate maintains such PHI. Business Associate must provide vl'ritten notice of the conditions that make return or destruction not feasible; if Covered Entity does not concllr in that assessment. Business Associate shall retLrrn or destroy the PHI within five (5) business days. MISCELLANEOUS A. Defense and Indemnification: Business Associate shall defend, indemnify and hold harmless Covered Entity from and against all claims, liabilities, judgments, fines, assessments, penalties, awards or other expenses, of any nature w'hatsoever, inclr.rding without limitation attorneys' fees, expert witness fees, and costs of investigation, litigation, or dispute resolution, relating to or arising or.rt of any breach of this Addendum by Br-rsiness Associate. its employees, officers, agents, or sub-contractors. This provision V B. A. A. Attachment Page 4 of 5 is sLrpplemental to and to be interpreted and applied in a manner consistent r.vith, any indemnification provision of the agreement to which this Addenclum is attached. B' Reimbursement for Costs Incurred Due to Breach: Business Associate shall reimbr-rrse Covered Entity, without limitation, for all costs of investigation, dispute resolution, notification of individuals. the media, and the government, and expenses incr-ured in responding to any ar,rdits or other investigation relating to or arising out of a breach of unsecured PHI by the Br"rsiness Associate, including mitigation. C' Requlatory References: A reference in this Addenclum to a Section in the Deparlment of Health and Hr-rman Services Privacy Regulations. CFR. Titie 45, Sections 160 and 164 means the Section as in effect or as amendecl, and for 1,,'hich compliance is requirecl. D. Arnendment: Changes in the law are automatically incorporatecl herein r,vithoLrt need fbr explicit amendment. The Parties agree this this Acldenclum may be amended from time to time if otherlvise necessary for Covered Entity to comply with the requirements of the Department of Health and I-luman Services Privacy Regulations, CFR, Titie 45, Sections 160 and 164 and other provisions of lar.v. E. Notices: Whenever Covered Entity or Business Associate is reqLrired to give notice to the other party, notice shall be in r.vriting. posted in the US Mail. and deemecl clelivered after three (3) business days except as described in II. D., above. F. SLrrvival: The obligatious of the BLrsiness Associate shall sr.rrvive the termi'atior-r of this Addendum. G' Interpretation: Any ambigLrity in this Aclclench-un shall be resolved in favor of a r1ea'ing that permits Covered Entity to compiy r,vith the Department of Health and Fluman Services Privacy Regr,rlations. CFR. Title 45, Sections 160 and 164 ancl other provisio's of law. An1'provision of the Unclerlying Agreement that is clirectly contradictory to one or more terms of this Addendum is supersecled by the terms of this AclclenclLrm to the extent necessary lor the parties' compliance with HIpAA. B. A. A. Attachment Page 5 of 5