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TVF&R - Intent to renew contract services low TVF#R6 www.tvfr.com Tualatin Valley Fire & Rescue RECEIVED August 24, 2011 AUG 2 9 2011 RISK MANAGEMENT Loreen Mills City of Tigard 13125 SW Hall Blvd Tigard, Oregon 97223 RE: Renewal of Services Thank you for choosing Tualatin Valley Fire & Rescue to provide occupational health services to your agency. Please find enclosed your copy of the fully executed Letter of Intent to Renew Services. We appreciate the opportunity to serve your organization. Mileage will be invoiced at current government rate. Mileage will be calculated (round trip)from our Training Center at 12400 SW Tonquin Road, Sherwood to your site. We have received our first shipment of flu vaccine! If we are providing your organization with flu vaccinations, please contact us to schedule your flu clinics. There appears to be no shortage of vaccine this year. If you have questions, please feel free to contact me at (503)259-1687. Sincerely, in a Wert Program Assistant Occupational Health Services Tualatin Valley Fire& Rescue Command&Business Operations Center Training Center Occupational Health Services and Central Operating Center 12400 SW Tonquin Road 12400 SW Tonquin Road 11945 SW 70th Avenue Sherwood,Oregon 97140-9734 Sherwood,Oregon 97140-9734 Tigard,Oregon 97223-9196 503-259-1600 503-259-1687 503-649-8577 503-259-1688 confidential fax Letter of Intent to Renew Contract Services City of Tigard The purpose of this document is to renew services with Tualatin Valley Fire&Rescue Occupational Health Services(OHS). The current contract to provide occupational health services expires June 30, 2011. Your agency's authorized signature will provide an extension of services until June 30,2012 by mutual consent. Should either party wish to suspend services,30 days written notice is required. Your agency's current contract for fiscal year 2010-2011 was for the Comprehensive package based on 7 Police personnel at$25.00 per employee; 58 Public Works personnel at$20.00 per employee. The contract amount of$2,760.00 was billed in quarterly installments of$690.00. Vaccine and laboratory charges billed separately. Please specify below if your agency wants to continue with the comprehensive package or opt for the complete package. The following services are provided by OHS. Current prices are listed. Hepatitis A Vaccine $42.00 per dose(Series of 2) Hepatitis B Vaccine $37.50 per dose(Series of 3) Tuberculosis Testing $15.00 Influenza Vaccination $20.00 Diphtheria/Tetanus/Pertussis(Adult) $43.00 Hepatitis B Antibody(titer) $26.00 Post-exposure Hepatitis C Test $31.50 Post-exposure HIV Antibody Test $26.00 Respiratory Questionnaire Review $10.00 Injection Fee/Phlebotomy* $10.00 Blood and Airborne Pathogen Training/Session* $150.00 Vaccination and Testing Clinic/Per Hour* $55.00 Mileage(If Applicable) Government rate RN Service/Per Hour* $55.00 *If applicable,depending upon service package chosen. X Comprehensive Package: $25.00 per person for police and fire; $20.00 per person for all other departments. Your fiscal year 2011-2012 contract is based on 79 Police personnel at $25.00 per employee;46 Public Works personnel at$20.00 per employee. The contract amount of$2,895.00 will be billed in quarterly installments of$723.75. Complete Package: $15.00 per person. Your fiscal year 2011-2012 contract is based on 125 personnel at $15.00 per person. The contract amount of$1,875.00 will be billed in quarterly installments of$468.75. Basic Exposure Access: $10.00 per person. Your fiscal year 2011-2012 contract is based on 125 personnel at $10.00 per person. The contract amount of$1,225.00 will be billed in quarterly installments of$312.50. Authorized Signature Debra Guzman,Chief Fi an i Officer City of Tigard Tualatin Valley Fire&Rescue 69-;;?-/ I -7 - 6 - / l Date Date