COMPLETED BOARD ORDER AND AME
r�24
Before the Board of Supervisors in and for the
County of Monterey, State of California
Agreement No. A-11879
Authorize the Purchasing Manager for Natividad
Medical Center NMC) to execute Amendment
No. 4 to the Agreement No. A-11879 with Beacon
Partners for Meditech Billing and Accounts
Receivable B/AR) Module Support Services at
NMC in an amount not to exceed $513,080 in the
aggregate and $170,000 for the period July 1, 2011
to June 30, 2012
Upon motion of Supervisor Salinas, seconded by Supervisor Calcagno, and carried by those
members present, the Board hereby;
Authorized the Purchasing Manager for Natividad Medical Center NMC) to
execute Amendment No. 4 to the Agreement No. A-11879 with Beacon Partners
for Meditech Billing and Accounts Receivable B/AR) Module Support Services
at NMC in an amount not to exceed $513,080 in the aggregate and $170,000 for
the period July 1, 2011 to June 30, 2012.
PASSED AND ADOPTED on this 28th day of June, 2011, by the following vote, to wit:
AYES: Supervisors Calcagno, Salinas, and Parker
NOES: None
ABSENT: Supervisors Armenta and Potter
I, Gail T. Borkowski, Clerk of the Board of Supervisors of the County of Monterey, State of California, hereby
certify that the foregoing is a true copy of an original order of said Board of Supervisors duly made and entered in the
minutes thereof of Minute Book 75 for the meeting on June 28, 2011.
Dated: June 30, 2011 Gail T. Borkowski, Clerk of the Board of Supervisors
County of Monterey, State of California
By
Deputy
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COMPLETED BOARD ORDER AND AME
r�Original Agreement No or PO#. A-11879)
RENEWAL AMENDMENT NO.4
FOR PROFESSIONAL SERVICE AGREEMENT
BETWEEN Beacon Partners Inc AND
THE NATIVIDAD MEDICAL CENTER
FOR
Meditech Billing and Accounts Receivable B/AR Nodule Support Services
The parties to Professional Service Agreement, dated F. bru gy 1, 2010 between the County of Monterey, on
behalf of Natividad Medical Center NMC"), and Beacon Partners Inc Contractor), hereby agree to renew their
Agreement No. A-11879) on the following terms and conditions:
1. Contractor will continue to provide NMC with the same scope of service as stated in the original Agreement
No. A-11879).
2. This Amendment shall become effective on July 1, 2011 and shall continue in full force until June 30, 2012.
3. The total amount payable by County to Contractor under Agreement No. A-11879) shall not exceed the total
sum of $513,080 for the full term of the Agreement and $170,000 for fiscal year 2011-2012.
4. All other terms and conditions of the Agreement shall continue in full force and effect.
5. A copy of this Amendment shall be attached to the original Agreement No. A-11879).
IN WITNESS WHEREOF, the parties hereto are in agreement with this Amendment and Professional Service
Agreement on the basis set forth in this document and have executed this amendment on the day and year set forth
herein.
Dated 0 i
it
1
Printed Name Title c
Signature r Dated I J
Printed Name F~~r~~.1 F rtT. fill! Title irfvl(i~
***LVSTRUCTIONS: If CONTRACTOR is a corporation, including limited liability and non-profit corporations, the f rll legal name of the
corporation shall be set forth above together with the signatures of two specified officers. If CONTRACTOR is a partnership, the name of
the partnership shall be set forth above together with the signature of a partner who has authority to execute this Agreement on behalf of
the partnership. If CONTRACTOR is contracting in and individual capacity, the individual shall set forth the name of the business, if any
and shall personally sign the Agreement.
NATIVIDAD MEDICAL CENTER
Signature Dated
Pure
ing Manager
Signature Dated
NMC CEO
Approved as to Legal Form:
Charles J. McKee, County Counsel
By-
Stacy Saetta, Depdty
Attornevs for County and NMC
4(~r{rj4fAClV~u~t~ Dated: 41d Cam. 2011
4-torlo
i i3f tiusl~~Ic3V
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SIGNED BOARD REPORT AND SUPPO
{:�MONTEREY COUNTY BOARD OF SUPERVISORS
MEETING: Jun 28, 2011 AGENDA NO.: 02
SUBJECT: Auth orize the Purchasing Manager for Natividad Medical Center NMC)
to e ecute Amendment #4 to the Agreement A-11879) with Beacon
Part ers for Meditech Billing and Accounts Receivable B/AR) Module
Sup ort Services at NMC in an amount not to exceed $513,080 in the
aggr egate and $170,000 for the period July 1, 2011 to June 30, 2012.
DEPARTMENT: Nati idad Medical Center
RECOMMENDATION:
It is recommended that the Board of Supervisors Authorize the Purchasing Manager for Natividad
Medical Center NMC) to eecute Amendment #4 to the Agreement A- 11879) with Beacon
Partners for Meditech Billing and Accounts Receivable B/AR) Module Support Services at NMC in
an amount not to exceed $513,080 in the aggregate and $170,000 for the period July 1, 2011 to June
30, 2012.
SIO
SUMMARY/DISCUS
As NMC continues to optimize its clinical operations and streamline the interoperability between
key clinical applications of the Electronic Medical Record, a need has been identified to monitor,
capture and document more ccurate and complete billable service items and process from various
disparate systems within the Billing and Accounts Receivable B/AR) department. The
recommendation is to contin e obtaining subject matter expertise services in these areas from
Beacon Partners. Over the n xt year, Beacon Partners will provide a highly skilled and experienced
Meditech Billing and Accou is Receivable B/AR) module subject matter expert to ensure process
accuracy and timeliness is achieved and maintained in both the billing and claims groups within the
Billing and Accounts Receivable B/AR) department.
OTHER AGENCY INVOLVEMENT:
The Amendment has been re,
office and the Natividad Med
FINANCING:
Tiewed and approved by County Counsel, the Auditor/Controller's
ical Center Board of Trustees.
The cost for this Amendmen is $170,000 and is included in the 2011/2012 Fiscal Year
Recommended Budget. This ction will not require any additional General Fund subsidy.
Prepared by:
Jim Fenstermaker, IT Direct(
April 14, 2011
r 796-1647 Harry Weis
Chief Executive Officer
Attachments: Amendments 0, 2, 3, 4, Original Agreement, Board Order
Attachments are on file with he Clerk of the Board
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SIGNED BOARD REPORT AND SUPPO
{:�Before the Board of Supervisors in and for the
County of Monterey, State of California
Authorize the Purchasing Manager for Natividad Medical Center NMC) to execute
Amendment #4 to the Agreement A-11879) with Beacon Partners for Meditech Billing
and Accounts Receivable BJAR) Module Support Services at NMC in an amount not to
exceed $513,080 in the aggregate and $170,000 for the period July 1, 2011 to June 30,
2012
Upon motion of Supervisor seconded by Supervisor and
carried by those members present, the Board hereby;
Authorizes the Purchasing Manager for Natividad Medical Center NMC) to execute Amendment #4
to the Agreement A-11879); with Beacon Partners for Meditech Billing and Accounts Receivable
B/AR) Module Support Services at NMC in an amount not to exceed $513,080 in the aggregate and
$170,000 for the period July; 1, 2011 to June 30, 2012.
PASSED AND ADOPTED this 29th day of June 2011 by the following vote, to wit:
AYES:
NOES:
ABSENT:
I, Gail T. Borkowski, Clerk of the Board of Supervisors of the County of Monterey, State of California, hereby certify
that the foregoing is a true copy of an original order of said Board of Supervisors duly made and entered in the minutes
thereof of Minute Book for the, meeting on
Dated: Gail T. Borkowski, Clerk of the Board of Supervisors
County of Monterey, State of California
By
Deputy
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SIGNED BOARD REPORT AND SUPPO
{:�MONTEREY COUNTY BOARD OF SUPERVISORS
MEETING: February 15, 2010
AGENDA NO.:
SUBJECT: Authorize the Purchasing Manager for Natividad Medical Center NMC)
to execute Amendment #3 to the Agreement with Beacon Partners for
Meditech Billing and Accounts Receivable B/AR) Module Support
services at NMC in an amount not to exceed $343,080 an increase of
$) 50,000) for the period February 1, 2011 to June 30, 2011.
DEPARTMENT:N
tividad Medical Center
RECOMMENDATION'
It is recommended that the Board of Supervisors authorize the Purchasing Manager for Natividad
Medical Center NMC) to execute Amendment #3 to the Agreement with Beacon Partners for
Meditech Billing and Accounts Receivable B/AR) Module Support services at NMC in an amount
not to exceed $343,080 app increase of $150,000) for the period February 1, 2011 to June 30, 2011.
SUMMARY/DISCUSSI{ N:
Beacon Partners has beeniProviding Meditech Billing and Accounts Receivable B/AR) module
subject matter expertise at NMC. As NMC continues to enhance and utilize additional functionality
with B/AR, these serviceswill need to be extended. A project of this magnitude requires oversight
and management from highly skilled, back office-experienced individuals and Beacon Partners
provides these services. he recommendation is to continue obtaining subject matter expertise
services from Beacon Partners. Total spend on Beacon Partners for the period 8-12-2009 to present
is $856,609.65
OTHER AGENCY INVpLVEMENT:
The Amendment has been;reviewed and approved by County Counsel, the Auditor/Controller's
office and the Natividad Medical Center Board of Trustees.
FINANCING:
The cost for this Amendment is $150,000 and is included in the 2010/2011 FY approved budget.
This action will not require any additional General Fund subsidy.
Prepared by:
Jim Fenstermaker 796-16417 Harry Weis
Chief Information Officer Chief Executive Officer
January 18, 2011
Attachments: Amendments #1, 2, Agreement, Board Order
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SIGNED BOARD REPORT AND SUPPO
{:�29
Before the Board of Supervisors in and for the
County of Monterey, State of California
Agreement Nos. A-]i287
See Agreement No. A- 11879 for Amendment No. 2.(11/2/10)
Authorize the Purchasing Manager for
Natividad Medical center NMC) to
execute Amendment #3 to the Agreement
with Beacon Partners for Meditech Billing
and Accounts Recei able B/AR) Module
Support services at C in an amount not
to exceed $343,080 an increase of
$150,000) for the peiod February 1, 2011
to June 30, 2011.....;
Upon motion of Supjervisor Salinas, seconded by Supervisor Potter, and
carried by those members present, the Board hereby;
Authorized the Purchasing Manager for Natividad Medical Center NMC) to execute
Amendment #3 to the Agreement with Beacon Partners for Meditech Billing and
Accounts Receivabl e B/AR) Module Support services at NMC in an amount not to
exceed $343,080 an increase of $150,000) for the period February 1, 2011 to June 30,
2011.
PASSED AND ADOPTED on this 15`h day of February, 2011, by the following vote, to-
wit:
AYES: Supervisors fA.rmenta, Calcagno, Salinas, Parker, and Potter
NOES: None
ABSENT: None
I, Gail T. Borkowski, Clerk of the Board of Supervisors of the County of Monterey, State of California,
hereby certify that the f3regoing is a true copy of an original order of said Board of Supervisors duly made
and entered in the minutes thereof of Minute Book 75 for the meeting on February 15, 2011.
Dated: February 16, 20 1
Gail T. Borkowski, Clerk of the Board of Supervisors
County of Monterey, State of California
By
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SIGNED BOARD REPORT AND SUPPO
{:�Original Agreement No or PO#. A- 11879)
AMENDMENT NO. 3
FOR PROFESSIONAL SERVICE AGREEMENT
BETWEEN Beacon Partners Inc. AND
THE NATIVIDAD MEDICAL CENTER
FOR
Meditteh Billing and Accounts Receivable B/AR) Module Support Services
The parties to Professional Service Agreement, dated February 1, 2010 between the County of
Monterey, on behalf of l$latividad Medical Center NMC"), and Beacon Partners Inc. Contractor),
hereby agree to amend their Agreement No. A-11879) on the following terms and conditions:
1. Contractor will continue to provide NMC with the same scope of service as stated in the original
Agreement No. A 11879). Additionally services will include those described on Attachment A,
attached to this Amendment 40
2. This Amendment shall become effective on February 1, 2011 and shall continue in full force until
June 30, 2011.
3. The total amount payable by County to Contractor under Agreement No. A-11879) shall not
exceed the total sure of $343,080 for the full term of the Agreement and $261,350 for fiscal year
2010-2011.
4. All other terms and conditions of the Agreement shall continue in full force and effect.
5. A copy of this Amendment shall be attached to the original Agreement No. A-11879).
IN WITNESS WHjEREOF, the parties hereto are in agreement with this Amendment and
Professional Service Agreement on the basis set forth in this document and have executed this
amendment on the day and year set forth herein.
Dated dq1t /
Title &fr2$i& AA~-�
NATIVIDAD 8CENTER
Signature
Purchasing Manager
Approved as to Legal Form:
Charles J. McKee, County Counsel
Dated
Dated
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SIGNED BOARD REPORT AND SUPPO
{:�a
Beacon Partners'
Engagement Proposal
1. SCOPE of WORK
The scope of this engagement is for Beacon Partners Beacon) to provide management
consulting services to Natividad Medical Center NMC) in the form of MEDITECH Client
Server C/S) Billing and Accounts Receivable B/AR) module support and subject matter
expertise.
II. APPROACH
Beacon will provide a consultant familiar and experienced with the MEDITECH C/S 5.6 B/AR
module to provide the following services:
Work with NMC to define optimal workflow measures and opportunities for process
improvements fors utilization of the new MEDITECH functionality.
Work with department managers to discuss how the MEDITECH system will affect or
change patient services or workflows.
Provide guidance', with the design and development of dictionaries.
Assist with the needs of management and staff affected by the B/AR functionality, both
in technology transition for those utilizing the new system and changes to workflows for
those currently accustomed to other system or manual procedures.
Respond to questions regarding use of the B/AR module.
Resolve issues among the user community with regard to use of the system.
Assist in maximizing the use of the B/AR module to improve revenue cycle performance.
III. PERSONNEL, PROJECT DURATION and FEES
All personnel assigned to the engagement shall be fully qualified to perform the tasks
assigned to them and shall perform the services in a competent and professional manner.
We anticipate that the project will span 22 weeks, excluding holidays and ending July 28,
2011. Consulting fees for this project are:
PROFESSIONAL STAFF
HOURLY ESTIMATED ESTIMATED FEES
RATE HOURS
Gail Artigue, Senior Cpnsultant $170 880 $149,600
Proposal ID#: NAT011411/3573
Original Project#:0000881
Confidential
1
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SIGNED BOARD REPORT AND SUPPO
{:�All terms and conditions, as specified in our original Engagement Agreement dated January
29, 2010, will continue throughout this engagement. Fees represented above are inclusive of
travel and administrative expenses in accordance with all applicable Monterey County
policies, including without limitation the Monterey County travel policy, and are valid for 45
days from the date of this letter. Upon approval please sign where indicated and fax this entire
document 877.755.2703. Thank you for your continued use of our services.
IV. APPROVALS
R411 1)~M /Z 0
Robert Jab i Regional Director zin Signature
Beacon Partne s Natividad Medical Center
Print Name
Date
Proposal ID#: NAT011411/3573 2
Original Project#:0000881�~1
Confidential C
BEACON"
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SIGNED BOARD REPORT AND SUPPO
{:�MONTEREY COUNTY BOARD OF SUPERVISORS
MEETING: October 26, 2010 AGENDA NO.:
SUBJECT: Authorize the Purchasing Manager for Natividad Medical Center NMC)
to execute Amendment #2 to the Agreement with Beacon Partners for
Meditech Billing and Accounts Receivable B/AR) Module Support
services at NMC in an amount not to exceed $193,080 an increase of
$95,880) for the period October 1, 2010 to June 30, 2011.
I DEPARTMENT: Natividad Medical Center
RECOMMENDATIOrr:
It is recommended that the Board of Supervisors authorize the Purchasing Manager for Natividad
Medical Center NMC) to execute Amendment #2 to the Agreement with Beacon Partners for
Meditech Billing and Accounts Receivable B/AR) Module Support services at NMC in an amount
not to exceed $193,080 an increase of $95,880) for the period October 1, 2010 to June 30, 2011.
SUMMARY/DISCUSSXON:
Beacon Partners has beerx providing Meditech Billing and Accounts Receivable B/AR) module
subject matter expertise a.i NMC. As NMC continues to enhance and utilize additional functionality
with B/AR, these service$ will need to be extended. A project of this magnitude requires oversight
and management from highly skilled, back office-experienced individuals and Beacon Partners
provides these services. The recommendation is to continue obtaining subject matter expertise
services from Beacon Partners. Total spend on Beacon Partners for the period 8-12-2009 to present
is $706,609.65
OTHER AGENCY INVOLVEMENT:
The Amendment has been reviewed and approved by County Counsel, the Auditor/Controller's
office and the Natividad Medical Center Board of Trustees.
FINANCING:
The cost for this Amendment is $95,880 and is included in the 2010/2011 FY approved budget. This
action will not require any additional General Fund subsidy.
Prepared by:
Kirk Larson Harry Weis
Chief Information Officer', Chief Executive Officer
September 16, 2010
Attachments: Amendment; #1 & 2, Agreement, Board Order
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SIGNED BOARD REPORT AND SUPPO
{ :�13
Before the Board of Supervisors in and for the
County of Monterey, State of California
Agreement No: A 1t879
uthorize the Purchasing Manager for Natividad Medical Center NMC) to
execute. Amendment No. 2 to the Agreement with Beacon Partners for
Meditech Billing and. Accounts Receivable B/AR) Module Support
services at NMC in an amount not to exceed $193,080 an increase of
95,880) for the period! October 1, 2010 through June 30, 2011.
non motion of Siupdrvisor Potter, seconded by Supervisor Armenta, and carried by those
members present, the Board hereby:
Authorized the Purchasing Manager for Natividad Medical Center NMC) to execute
Amendment No. 2 to the Agreement with Beacon Partners far Meditech Billing and Accounts
Receivable B/AR) Module Support services at NMC in an amount not to exceed $193,080 an
increase of $95,880) for Inc penod October 1, 2010 through June 30, 201 l
ASSED-ANDADOP IrD.th s 2"'.day of November, 2010, by the following vote, to wit:
AYES: Supervisors Arrnenta Calcagno Salinas Parker Potter
NOES:' None
ABSENT: None
I, Gail T. Borkowski, Clerk of the Board of Supervisors of the County of Monterey, State of California, hereby
certify that the foregoing is',a true copy of an original order of said Board of Supervisors duly made and entered in
the minutes thereof of Minute Book 75 for the meeting on November 2, 2010.
Dated: November. 2, 2010 Gail T. Borkowski, Clerk of the Board of Supervisors
County of Monterey, State of California
By Z
Deputy
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SIGNED BOARD REPORT AND SUPPO
{
:�Original Agreement No or PO#. SC862)
AMENDMENT NO. 2
FOR PROFESSIONAL SERVICE AGREEMENT
BETWEEN Beacon Partners Inc. AND
THE NATIVIDAD MEDICAL CENTER
FOR
Meditech Billing and Accounts Receivable B/AR) Module Sunuort SERVICES
The parties to Professional Service Agreement, dated February 1, 2010 between the County of
Monterey, on behalf of I*latividad Medical Center NMC"), and Beacon Partners Inc. Contractor),
hereby agree to amend their Agreement No. SC862) on the following terms and conditions:
1. Contractor will continue to provide NMC with the same scope of service as stated in the original
Agreement No. SC862). Additionally, Contractor will provide the services described on
Attachment A attached to this Amendment #2.
2. This Amendment shall become effective on October 1, 2010 and shall continue in full force until
June 30, 2011.
3. The total amount payable by County to Contractor under Agreement No. SC862) shall not exceed
the total sum of $1$3,080 for the full term of the Agreement and $111,350 for fiscal year 2010-
2011.
4. All other terms and conditions of the Agreement shall continue in full force and effect.
5. A copy of this Amendment shall be attached to the original Agreement No. SC862).
IN WITNESS WIEEREOF, the parties hereto are in agreement with this Amendment and
Professional Service Agreement on the basis set forth in this document and have executed this
amendment on the day and year set forth herein.
Dated September 1, 2010
Printed Name
AL CENTER
Sign V,
Manager
Signature
Ralph P',. Fdrgnoli, Jr.
NMC CEO
Approved as to Legal Form:
Charles J. McKee, County Counsel
Stacy Saetta, Deputy
Attorneys for County and NMC
Title
President and CEO
Dated
Dated
116fl% IA 2010
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SIGNED BOARD REPORT AND SUPPO
{
:�Attachment A
1. SCOPE of WORK
The scope of this engagement is for Beacon Partners Beacon) to provide management
consulting services to Natividad Medical Center NMC) in the form of MEDITECH Client
Server C/S) Billing and Accounts Receivable B/AR) module support and subject matter
expertise.
II. APPROACH
Beacon will provide a consultant familiar and experienced with the MEDITECH C/S 5.6 B/AR
module to provide tte following services:
Work with NMC to define optimal workflow measures and opportunities for process
improvements for utilization of the new MEDITECH functionality.
Work with department managers to discuss how the MEDITECH system will affect or
change patient services or workflows.
Provide guidance with the design and development of dictionaries.
Assist with the heeds of management and staff affected by the B/AR functionality, both
in technology transition for those utilizing the new system and changes to workflows for
those currently accustomed to other system or manual procedures.
Respond to questions regarding use of the B/AR module.
Resolve issues among the user community with regard to use of the system.
Assist in maximizing the use of the B/AR module to improve revenue cycle performance,
Beacon Partners'
Engagement Proposal
III. PERSONNEL, PROJECT DURATION and FEES
All personnel assigned to the engagement shall be fully qualified to perform the tasks
assigned to them and shall perform the services in a competent and professional manner.
We anticipate that the project will span 14 weeks, excluding holidays and ending February
11, 2011. Consulting fees for this project are:
PROFESSIONAL STAFF
HOURLY ESTIMATED
RATE HOURS
ESTIMATED FEES
Gail Artigue, Senior, Consultant
Proposal ID#: NAT0 81 91 0/31 6 0
Original Project* 0000881
Confidential
$170 564
1
$95,880
Vv
BEACON'
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SIGNED BOARD REPORT AND SUPPO
{
:�I
Attachment A
All terms and conditions, as specified in our original Engagement Agreement, dated January
29, 2010, will continue throughout this engagement. Fees represented above are inclusive of
travel and administrative expenses in accordance with all applicable Monterey County
policies, including Without limitation the Monterey County travel policy, and are valid for 45
days from the date of this letter. Upon approval please sign where indicated and fax this entire
document 877.755.2703. Thank you for your continued use of our services.
IV. APPROVALS
09/01/10
Janet Warren Authorizing Signature
Client Service Manager Natividad Medical Center
Beacon Partners
Print Name
Date
Proposal ID#: NAT08191013160 2
Original Project#: 0000 881
Confidential
BEACON'
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SIGNED BOARD REPORT AND SUPPO
{
:�Original Agreement No or PO#. BPO 1971)
AMENDMENT NO. 1
FOR PROFESSIONAL SERVICE AGREEMENT
BETWEEN Beacon Partners Inc. AND
THE NATIVIDAD MEDICAL CENTER
FOR
Meditech Billing and Accounts Receivable B/AR) Module Support SERVICES
The parties to Professional Service Agreement, dated February 1, 2010 between the County of
Monterey, on behalf of Natividad Medical Center NMC"), and Beacon Partners Inc. Contractor),
hereby agree to amend their Agreement No. BPO 1971) on the following terms and conditions:
1. Contractor will continue to provide NMC with the same scope of service as stated in the original
Agreement No. BP01971). Additionally, Contractor will provide the services described on
Attachment A attached to this Amendment #1.
2. This Amendment shall become effective on May 3, 2010 and shall continue in full force until
January 31, 2011.
3. The total amount payable by County to Contractor under Agreement No. BPO1971) shall not
exceed the total sum of $97,200 for the full term of the Agreement and $97,200 for fiscal year
2009-2010.
4. All other terms and conditions of the Agreement shall continue in full force and effect.
5. A copy of this Amendment shall be attached to the original Agreement No. BPO1971).
IN WITNESS WHEREOF, the parties hereto are in agreement with this Amendment and
Professional Service Agreement on the basis set forth in this document and have executed this
amendment on the day and year set forth herein.
Dated
Title
Signature Dated
Signature
Pulrehasing Manager
NMC CEO
Dated
Approved as to Legal Form:
Charles J. IcKee, County Co
Stacy Saett a,tl pHTy
Attorneys for County and NMC
Dated: 2010
ditnr nntrnller \U
IAU
Monterey
County
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SIGNED BOARD REPORT AND SUPPO
{:�PEACO.N
PARTNERS
March 29, 2010
Mr. Kirk Larson
Chief Information Officer
Natividad Medical Center
1441 Constitution Boulevard, Building 300
Salinas, CA 93912-1611
Dear Mr. Larson:
E rrn r'lrtrCr9, Jn4.
17 UbLuy Parkwny, Sutte 310
Weymputh, MA 0216
L� 7Q1.9A2.040Q 7$1.337.5464
W tYW,~eRtot7hmpterf.rattt
BUST014 5f' HIJIN051:0T TOi1011YO
This letter will serve as on addendum to extend our consulting agreement dated January 29, 2010. It is Beacon
Partners' understanding, that the project Is going well and continues to meet Natividad Medical Center's
requirements for support of the MEDITECH B/AR upgrade and that you wish to expand our services to Include
an additional 360 hours of support for revenue cycle improvement. At your request, Beacon Partners will,
commencing May 3, 2010, provide such consulting services through July 3, 2010.
Consultants and associated fees for this engagement are as follow.
CONSULTANT / ROLE HOURS HOURLY RATE FEES
Gall Artigue, Senior Consultant 360 $170 $61,200
TOTAL $61,200
All terms and conditions, as specified In our original Engagement Agreement, will continue throughout this
extension. Fees represented above are Inclusive of professional fees, travel and administrative expenses and
valid for 45 days from the date of this letter. Thank you for your continued use of our services.
Sincerely,
Robert J. Jablonski
Regional Manager
Beacon Partners, Inc.
Addendum Approval:
Authorizing Signature
Natividad Qdlcal Center
/d sir E�S Gi? lli GJs7
Print Name
Date
*z~CoVi5x- r, A
Proposal II?#: NAT032910/2770
Original Project #: 000567
Confidential
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{:�I
Print Farm
Aft No ividadMEDICALCENTER
COUNTY OF MONTEREY AGREEMENT FOR PROFESSIONAL SERVICES
NOT TO EXCEED $100,000)
This Professional Services Agreement hereinafter Agreement") is made by and between Natividad Medical
Center NMC"), a general acute care teaching hospital wholly owned and operated by the County of
Monterey, which is a political subdivision of the State of California and Beacon Partners Inc.
hereinafter CONTRACTOR").
In consideration of the mutual covenants and conditions set forth in this Agreement, the parties agree as
follows:
SERVICES TO BE PROVIDED. NMC hereby engages CONTRACTOR to perform, and
CONTRACTOR hereby agrees to perform, the services described in Exhibit A in conformity with the
terms of the Agreement. The services are generally described as follows: Meditech Billing and
Accounts Receivable B/AR) Module support
1. PAYMENTS BY NMC. NMC shall pay the CONTRACTOR in accordance with the payment provisions
set forth in Exhibit A, subject to the limitations set forth in this Agreement. The total amount payable by
NMC to CONTRACTOR under this Agreement shall not exceed the sum of $36,000
2. TERM OF AGREEMENT. The term of this Agreement is from Feb 1, 2010 to Jars 31, 2011
unless sooner terminated pursuant to the terms of this Agreement. This
Agreement is of no force or effect until signed by both CONTRACTOR and NMC and with NMC signing
last and CONTRACTOR may not commence work before NMC signs this Agreement.
3. ADDITIONAL PROVISIONS/EXHIBITS. The following attached exhibits are incorporated herein by
reference and constitute a part of this Agreement:
Exhibit A/Schedule A: Scope of Services/Payment Provisions
4. PERFORMANCE STANDARDS.
4.1. CONTRACTOR warrants that CONTRACTOR and Contractor's agents, employees, and
subcontractors performing services under this Agreement are specially trained, experienced,
competent, and appropriately licensed to perform the work and deliver the services required under
this Agreement and are not employees of NMC, or immediate family of an employee of NMC.
4.2. CONTRACTOR, its agents, employees, and subcontractors shall perform all work in a safe and
skillful manner and in compliance with all applicable laws and regulations. All work performed under
this Agreement that is required by law to be performed or supervised by licensed personnel shall be
performed in accordance with such licensing requirements.
Revised 12/1/2008 NMC PSA Form $100,000 or Less I
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{:�I
4.3. CONTRACTOR shall furnish, at its own expense, all materials, equipment, and personnel necessary
to carry out the terms of this Agreement, except as other wise specified in this Agreement.
CONTRACTOR shall not use NMC premises, property including equipment, instruments, or
supplies) or personnel for any purpose other than in the performance of its obligations under this
Agreement.
5. PAYMENT CONDITIONS.
5.1. CONTRACTOR shad submit to the Contract Administrator an invoice on a form acceptable to NMC.
If not otherwise specified, the CONTRACTOR may submit such invoice periodically or at the
completion of services, but in any event, not later than 30 days after completion of services. The
invoice shall set forth the amounts claimed by CONTRACTOR for the previous period, together with
an itemized basis for Administrator or his or her designee shall certify the invoice, either in the
requested amount or in such other amount as NMC approves in conformity with this Agreement, and
shall promptly submit such invoice to the County Auditor-Controller for payment. The County
Auditor-Controller shall pay the amount certified within 30 days of receiving the certified invoice.
5.2. CONTRACTOR shall not receive reimbursement for travel expenses unless set forth in this
Agreement.
6. TERMINATION.
6.1. During the term of this Agreement, NMC may terminate the Agreement for any reason by giving
written notice of termination to the CONTRACTOR at least thirty 30) days prior to the effective date
of termination. Such notice shall set forth the effective date of termination. In the event of such
termination, the amount payable under this Agreement shall be reduced in proportion to the services
provided prior to the date of termination.
6.2. NMC may cancel and terminate this Agreement for good cause effective immediately upon written
notice to Contractor. Good cause" includes the failure of CONTRACTOR to perform the required
services at the time and in the manner provided under this Agreement. If NMC terminates this
Agreement for good cause, NMC may be relieved of the payment of any consideration to Contractor,
and NMC may proceed with the work in any manner, which NMC deems proper. The cost to NMC
shall be deducted from any sum due the CONTRACTOR under this Agreement.
7. INDEMNIFICATION: CONTRACTOR shall indemnify, defend and hold harmless. NMC and the
County of Monterey hereinafter County"), it officers, agents and employees from any claim, liability,
loss, injury or damage arising out of, or in connection with, performance of this Agreement by
CONTRACTOR and/or its agent, employees or sub-contractors, excepting only low, injury or damage
caused by the negligence or willful misconduct of personnel employed by NMC. It is the intent of the
parties to this Agreement to provide the broadest possible coverage for NMC. The CONTRACTOR shall
reimburse NMC for all costs, attorneys' fees, expenses and liabilities incurred with respect to any
litigation in which the CONTRACTOR is obligated to indemnify, defend and hold harmless NMC and the
County under this Agreement.
8. INSURANCE.
8.1. Evidence of Coverage:
Prior to commencement of this Agreement, the CONTRACTOR shall provide a Certificate of
Insurance" certifying that coverage as required herein has been obtained. Individual endorsements
Revised 12/1/2008 NMC PSA Form $100,000 or Less 2
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{:�executed by the insurance carrier shall accompany the certificate. In addition, the CONTRACTOR
upon request shall provide a certified copy of the policy or policies.
Executed by the insurance carrier shall accompany the certificate. In addition, the CONTRACTOR
upon request shall provide a certified copy of the policy or policies.
This verification of coverage shall be sent to NMC's Contracts/Purchasing Department, unless
otherwise directed. the CONTRACTOR shall not receive a Notice to Proceed" with the work under
this Agreement until it has obtained all insurance required and NMC has approved such insurance.
This approval of insurance shall neither relieve nor decrease the liability of the Contractor.
8.2. Qualifying Insurers: All coverage's except surety, shall be issued by companies which hold a current
policy holder's alphabetic and financial size category rating of not less that A-VII, according to the
current Best's Key Rating Guide or a company of equal financial stability that is approved by NMC's
Contracts/Purchasing Director.
8.3. Insurance Coverage Requirements: Without limiting Contractor's duty to indemnify, CONTRACTOR
shall maintain in effect throughout the term of this Agreement a policy or policies of insurance with
the following minimum limits of liability:
Commercial general liability insurance, including but not limited to premises and operations, including
coverage for Bodily Injury and Property Damage, Personal Injury, Contractual Liability, Broad form
Property Damage, Independent Contractors, Products and Completed Operations, with a combined
single limit for Bodily Injury and Property Damage of not less than $1,000,000 per occurrence.
E Exemption/Modification Justification attached; subject to approval).
Business automobile liability insurance covering all motor vehicles, including owned, leased, non-
owned, and hired vehicles, used in providing services under this Agreement, with a combined single
limit for Bodily Injury',and Property Damage of not less than $500,000 per occurrence.
Exemption/Modification Justification attached; subject to approval).
Workers' Compensation Insurance If CONTRACTOR employs other in the performance of this
Agreement, in accordance with California Labor Code section 3700 and with Employer's Liability
limits not less than $1,000,000 each person, $1,000,000 each accident and $1,000,000 each disease.
E Exemption/Modification Justification attached; subject to approval).
Professional liability insurance if required for the professional services being provided, e.g., those
persons authorized by' a license to engage in a business or profession regulated by the California
Business and Professions Code), in the amount of not less than $1,000,000 per claim and $2,000,000
in the aggregate, to cover liability for malpractice or errors or omissions made in the course of
rendering professional services. If professional liability insurance is written on a claims-made" basis
rather than an occurrence basis, the CONTRACTOR shall, upon the expiration or earlier termination
of this Agreement, obtain extended reporting coverage tail coverage") with the same liability limits.
Any such tail coverage shall continue for at least three years following the expiration or earlier
termination of this Agreement.
Exemption/Modificotion Justification attached; subject to approval).
Revised 12/1 /2008 NMC PSA Form $100,000 or Less 3
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{:�8.4. Other Insurance Requirements:
All insurance required by this Agreement shall be with a company acceptable to NMC and issued and
executed by an admitted insurer authorized to transact insurance business in the State of California.
Unless otherwise specified by this Agreement, all such insurance shall be written on an occurrence
basis, or, if the policy is not written on an occurrence basis, such policy with the coverage required
herein shall continue in effect for a period of three years following the date CONTRACTOR
completes its performance of services under this Agreement.
Each liability policy shall provide that NMC shall be given notice in writing at least thirty days in
advance of any endorsed reduction in coverage or limit, cancellation, or intended non-renewal thereof.
Each policy shall provide coverage for CONTRACTOR and additional insured with respect to claims
arising from each subcontractor, if any, performing work under this Agreement, or be accompanied by
a certificate of insurance from each subcontractor showing each subcontractor has identical insurance
coverage to the above requirements.
Commercial general liability and automobile liability policies shall provide an endorsement naming the
County of Monterey, its officers, agents, and employees as Additional insureds with respect to liability
arising out of the Cont'ractor's work including ongoing and completed operations, and shall further
provide that such insurance is primarX insurance to any insurance or self-insurance maintained by the
County and that the insurance of the Additional Insureds shall not be called upon to contribute to a loss
covered by the Contractor's insurance The required endorsement from for Commercial General
Liability Additional Inured is ISO Form CG 20 10 11-85 or CG 20 10 10 01 in tandem with CG 20 3710
01 2000). The required' endorsementrom for Automobile Additional Insured Endorsement is ISO Form
CA 20480299.
Prior to the execution of this Agreement by NMC, CONTRACTOR shall file certificates of insurance
with NMC's Contracts/Purchasing Department, showing that the CONTRACTOR has in effect the
insurance required by this Agreement. The CONTRACTOR shall file a new or amended certificate of
insurance within five calendar days after any change is made in any insurance policy, which would
alter the information on the certificate then on file. Acceptance or approval of insurance shall in no
way modify or change4he indemnification clause in this Agreement, which shall continue in full force
and effect.
CONTRACTOR shall at all times during the term of this Agreement maintain in force the insurance
coverage required under this Agreement and shall send, without demand by NMC, annual certificates
to NMC's Contracts/Purchasing Department. If the certificate is not received by the expiration date,
NMC shall notify CONTRACTOR and CONTRACTOR shall have five calendar days to send in the
certificate, evidencing no lapse in coverage during the interim. Failure by CONTRACTOR to maintain
such insurance is a default of this Agreement, which entitles NMC, at its sole discretion, to terminate
the Agreement immediately.
9. RECORDS AND CONFIDENTIALITY.
9.1. Confidentiality, CONTRACTOR and its officers, employees, agents and subcontractors shall comply
with any and all federal, state, and local laws, which provide for the confidentiality of records and
other information. CONTRACTOR shall not disclose any confidential records or other confidential
information received from NMC or prepared in connection with the performance of this Agreement,
unless NMC specifically permits CONTRACTOR to disclose such records or information.
CONTRACTOR shall promptly transmit to NMC any and all requests for disclosure of any such
Revised 12/1/2008 NMC PSA Form $100,000 or Less 4
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{:�confidential records or information. CONTRACTOR shall not use any confidential information
gained by CONTRACTOR in the performance of this Agreement except for the sole purpose of
carrying out Contractor's obligations under this Agreement.
9.2. NMC Records When this Agreement expires or terminates, CONTRACTOR shall return to NMC
and NMC records which CONTRACTOR used or received from NMC to perform services under
this Agreement.
9.3. Maintenance of Records CONTRACTOR shall prepare, maintain, and preserve all reports and
records that may be required by federal state, and County rules and regulations related to services
performed under this Agreement. CONTRACTOR shall maintain such records for a period of at
least three years after receipt of final payment under this Agreement. If any litigation, claim,
negotiation, audit exception, or other action relating to this Agreement is pending at the end of the
three year period, then CONTRACTOR shall retain said records until such action is resolved.
9.4. Access to and Audit of Records NMC shall have the right to examine, monitor and audit a] I records,
documents, conditions, and activities of the CONTRACTOR and its subcontractors related to
services provided under this Agreement. Pursuant to Government Code section 8546.7, if this
Agreement involves the expenditure of public funds in excess or $10,000, the parties to this
Agreement may be subject, at the request of NMC or as part of any audit of NMC, to the
examination and audit of the State Auditor pertaining to matters connected with the performance of
this Agreement for a period of three years after final payment under the Agreement.
9.5. Royalties and Inventions NMC shall have a royalty-free, exclusive and irrevocable license to
reproduce, publish, and use, and authorize other to do so, all original computer programs, writings,
sound recordings, pictorial reproductions, drawings, and other works of similar nature produced in the
course of or under this Agreement. CONTRACTOR shall not publish any such material without the
prior written approval ofNMC.
10. NON-DISCRIMINATION. During the performance of this Agreement, Contractor, and its
subcontractors, shall not unlawfully discriminate against any person because of race, religious creed,
color, sex, national origin, ancestry, physical disability, mental disability, medical condition, marital
status, age over 40), or sexual orientation, either in Contractor's employment practices or in the
furnishing of services to recipients. CONTRACTOR shall ensure that the evaluation and treatment of its
employees and applicants for employment and all persons receiving and requesting services are free of
such discrimination. CONTRACTOR and any subcontractor shall, in the performance of this Agreement,
full comply with all federal, sate, and local laws and regulations which prohibit discrimination. The
provision of services primarily or exclusively to such target population as may be designated in this
Agreement shall not be deemed to be prohibited discrimination.
11. COMPLIANCE WITH TERMS OF STATE OR FEDERAL GRANT. If this Agreement has been or
will be funded with monies received by NMC pursuant to a contract with the state or federal government
in which NMC is the grantee, CONTRACTOR will comply with all the provisions of said contract, and
said provisions shall be deemed a part of this Agreement, as though fully set forth herein. Upon request,
NMC will deliver a copy of said contract to Contractor, at no cost to Contractor.
12. INDEPENDENT CONTRACTOR. In the performance of work, duties, and obligations under this
Agreement, CONTRACTOR is at all times acting and performing as an independent CONTRACTOR and
not as an employee of NMC. No offer or obligation of permanent employment with NMC or particular
County department or agency is intended in any manner, and CONTRACTOR shall not become entitled
Revised 12/1/2008 NMC PSA Form $ 100,000 or Less 5
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{:�by virtue of this Agreement to receive from NMC any form of employee benefits including but not limited
to sick leave, vacation, retirement benefits, workers' compensation coverage, insurance or disability
benefits. CONTRACTOR shall be solely liable for an obligated to pay directly all applicable taxes,
including federal and state income taxes and social security, arising out of Contractor's performance of
this Agreement. In connection therewith, CONTRACTOR shall defend, indemnify, and hold NMC and
the County of Monterey harmless from any and all liability, which NMC may incur because of
Contractor's failure to pay such taxes.
13. NOTICES. Notices required under this Agreement shall be delivered personally or by first-class, postage
per-paid mail to NMC and Contractor's contract administrators at the addresses listed below.
FOR NATIVIDAD MEDICAL CENTER:
Contracts/Purchasing Manager
Name
1441 Constitution Blvd. Salinas, CA. 93906
Address
831.755.4111
Phone
FOR CONTRACTOR:
Address
7g1- z yea 7
Phone
14. MISCELLANEOUS PROVISIONS.
14.1. Conflict of Interest. CONTRACTOR represents that it presently has no interest and agrees not to
acquire any interest during the term of this Agreement, which would directly, or indirectly conflict
in any manner or to any degree with the full and complete performance of the professional services
required to be rendered under this Agreement.
14.2. Amendment. This Agreement may be amended or modified only by an instrument in writing signed
by NMC and the Contractor.
14.3. Waiver. Any waiver of any terms and conditions of this Agreement must be in writing and signed by
NMC and the Contractor. A waiver of any of the terms and conditions of this Agreement shall not be
construed as a waiver', of any other terms or conditions in this Agreement.
14.4. Contractor. The term Contractor" as used in this Agreement includes Contractor's officers, agents,
and employees acting',on Contractor's behalf in the performance of this Agreement.
14.5. Disputes. CONTRACTOR shall continue to perform under this Agreement during any dispute.
14.6. Assignment and Subcontracting. The CONTRACTOR shall not assign, sell, or otherwise transfer its
interest or obligations in this Agreement without the prior written consent of NMC. None of the
services covered by this Agreement shall be subcontracted without the prior written approval of
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RUIZ-IGNACIOM-U10
6/17/2011-U011
AGREEMENT-U012
A-11879)-U012
BEACON-U012
PARTNERS-U012
MEDITECH-U012
BILLING-U012
ACCOUNTS-U012
RECEIVABLE-U012
B/AR)-U012
MODULE-U012
SUPPORT-U012
SERVICES-U012
AT-U012
NMC-U012
IN-U012
AN-U012
AMOUNT-U012
TO-U012
EXCEED-U012
$513,080-U012
IN-U012
THE-U012
AGGREGATE-U012
$170,000-U012
THE-U012
PERIOD-U012
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2012.-U012
SIGNED BOARD REPORT AND SUPPO
{:�NMC. Notwithstanding any such subcontract, CONTRACTOR shall continue to be liable for the
performance of all requirements of this Agreement.
14.7. Successors and Assigns. This Agreement and the rights, privileges, duties, and obligations of NMC
and CONTRACTOR under this Agreement, to the extent assignable or delegable, shall be binding
upon and inure to the benefit of the parties and their respective successors, permitted assigns, and
heirs.
14.8. Compliance with Applicable Law The parties shall comply with all applicable federal, state, and
local laws and regulations in performing this Agreement.
14.9. Headings. The headings are for convenience only and shall not be used to interpret the terms of this
Agreement.
14.10. Time is of the Essence. Time is of the essence in each and all of the provisions of this Agreement
14.11. Governing Law. This Agreement shall be governed by and interpreted under the laws of the State
of California.
14.12. Non-exclusive Agreement. This Agreement is non-exclusive and both NMC and CONTRACTOR
expressly reserve the right to contract with other entities for the same or similar services.
14.13. Construction of Agreement. NMC and CONTRACTOR agree that each party has fully participated
in the review and revision of this Agreement and that any rule of construction to the effect that
ambiguities are to be resolved against the drafting party shall not apply in the interpretation of this
Agreement or any amendment to this Agreement.
14.14. Counterparts This Agreement may be executed in two or more counterparts, each of which shall
be deemed an original, but all of which together shall constitute one and the same Agreement.
14.15. Integration. This Agreement, including the exhibits, represents the entire Agreement between
NMC and the CONTRACTOR with respect to the subject matter of this Agreement and shall
supersede all prior negotiations. Representations, or agreements, either written or oral, between
NMC and CONTRACTOR as of the effective date of this Agreement, which is the date that NMC
signs the Agreement.
14.16. Interpretation of Conflicting Provisions In the event of any conflict or inconsistency between the
provisions of this Agreement and the Provisions of any exhibit or other attachment to this
Agreement, the provisions of this Agreement shall prevail and control.
Revised 12/1/2008 NMC PSA Form $100,000 or Less 7
BIB]
40740-U01
SIGNED-U02
BOARD-U02
REPORT-U02
SUPPORTING-U02
DOCS-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99940-U03
AS99966-U03
AS99967-U03
AI103204-U03
DO104218-U03
C10-U03
BOARD-U03
REPORTS-U03
7/15/2011-U04
MARCELLAC-U04
16738-U05
8-U06
AUTHORIZE-U07
THE-U07
PURCHASING-U07
MANAGER-U07
NATIVIDAD-U07
MEDICAL-U07
CENTER-U07
NMC)-U07
TO-U07
EXECUTE-U07
AMENDMENT-U07
NO.-U07
4-U07
TO-U07
THE-U07
960-NMC-U08
RUIZ-IGNACIO-U09
MAEGAN-U09
RUIZ-IGNACIOM-U10
6/17/2011-U011
AGREEMENT-U012
A-11879)-U012
BEACON-U012
PARTNERS-U012
MEDITECH-U012
BILLING-U012
ACCOUNTS-U012
RECEIVABLE-U012
B/AR)-U012
MODULE-U012
SUPPORT-U012
SERVICES-U012
AT-U012
NMC-U012
IN-U012
AN-U012
AMOUNT-U012
TO-U012
EXCEED-U012
$513,080-U012
IN-U012
THE-U012
AGGREGATE-U012
$170,000-U012
THE-U012
PERIOD-U012
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2012.-U012
SIGNED BOARD REPORT AND SUPPO
{:�NATIVIDAD MEDICAL CENTER
By:
NMC Contracts/Purchasing Agent
Date: /"_ 0
By:
Department Head if applicable)
Date:
Approved as to Legal Form
By:
Stacy Saetta
Deputy County Counsel
Date: r)4 IC, //
ontrollIr
C,
Date: 1 U
CONTRACTOR
7.de6AJ
Contractor's Business Name***
gnature of Chair, Presi ent, or Vice-President
Asst. Secretary, CFO, Treasurer
sst. Treasurer)
k, V~ P 61", L e
Na e nd Title
Date:
***INSTRUCTIONS: If CONTRACTOR is a corporation,
including limited liability and non-profit corporations,
the full legal name of the corporation shall be set forth
above together with the signatures of two specified
officers. If CONTRACTOR is a partnership, the name of
the partnership shall be set forth above together with the
signature of a partner who has authority to execute this
Agreement on behalf of the partnership. If
CONTRACTOR is contracting in and individual
capacity, the individual shall set forth the name of the
business, if any and shall personally sign the Agreement.
Revised NMC PSA Form $100,000 or Less 8
12-1-08
BIB]
40740-U01
SIGNED-U02
BOARD-U02
REPORT-U02
SUPPORTING-U02
DOCS-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99940-U03
AS99966-U03
AS99967-U03
AI103204-U03
DO104218-U03
C10-U03
BOARD-U03
REPORTS-U03
7/15/2011-U04
MARCELLAC-U04
16738-U05
8-U06
AUTHORIZE-U07
THE-U07
PURCHASING-U07
MANAGER-U07
NATIVIDAD-U07
MEDICAL-U07
CENTER-U07
NMC)-U07
TO-U07
EXECUTE-U07
AMENDMENT-U07
NO.-U07
4-U07
TO-U07
THE-U07
960-NMC-U08
RUIZ-IGNACIO-U09
MAEGAN-U09
RUIZ-IGNACIOM-U10
6/17/2011-U011
AGREEMENT-U012
A-11879)-U012
BEACON-U012
PARTNERS-U012
MEDITECH-U012
BILLING-U012
ACCOUNTS-U012
RECEIVABLE-U012
B/AR)-U012
MODULE-U012
SUPPORT-U012
SERVICES-U012
AT-U012
NMC-U012
IN-U012
AN-U012
AMOUNT-U012
TO-U012
EXCEED-U012
$513,080-U012
IN-U012
THE-U012
AGGREGATE-U012
$170,000-U012
THE-U012
PERIOD-U012
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2012.-U012
SIGNED BOARD REPORT AND SUPPO
{:�rottr'7-14
Beacon Partners
Engagement Proposal
1. SCOPE of WORK
The scope of this engagement is for Beacon Partners Beacon) to provide management
consulting services to Natividad Medical Center Natividad) in the form of MEDITECH
Client Server CIS) 5.6 Billing and Accounts Receivable B/AR) module subject matter
expertise.
II. SCOPE
Beacon understands that Natividad is in the process of implementing the MEDITECH
C/S 5.6 B/AR module and the implementation is proceeding as planned. Natividad would
like Beacon to provide a pool of consulting hours that can be drawn upon as needed to
support the analysts and implementation specialists working to implement the B/AR
module.
Ill. APPROACH
Beacon will provide a consultant familiar and experienced with MEDITECH C/S 5.6 B/AR
module to provide the following services.
Participate in the implementation project team work groups to discuss MEDITECH
experiences of best practice approaches to the implementation.
Participate in operational workflow redesign.
Work with Natividad to define optimal workflow measures and opportunities for
process improvements for utilization of the new MEDITECH functionality.
Work with department managers to discuss how the MEDITECH system will affect or
change their patient services or workflows.
Provide guidance with the design and development of dictionaries.
Provide guidance in developing and executing integration test plans.
Provide guidance in developing and executing end-user training plans.
Assist with the overall training needs of management and staff affected by the
implementation project; this task will include identifying training requirements, both in
technology transition for those utilizing the new system and changes to workflows for
those currently accustomed to other system or manual procedures.
Proposal ID#: NAT012910/2603 1 Natividad initials
Confidential
BIB]
40740-U01
SIGNED-U02
BOARD-U02
REPORT-U02
SUPPORTING-U02
DOCS-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99940-U03
AS99966-U03
AS99967-U03
AI103204-U03
DO104218-U03
C10-U03
BOARD-U03
REPORTS-U03
7/15/2011-U04
MARCELLAC-U04
16738-U05
8-U06
AUTHORIZE-U07
THE-U07
PURCHASING-U07
MANAGER-U07
NATIVIDAD-U07
MEDICAL-U07
CENTER-U07
NMC)-U07
TO-U07
EXECUTE-U07
AMENDMENT-U07
NO.-U07
4-U07
TO-U07
THE-U07
960-NMC-U08
RUIZ-IGNACIO-U09
MAEGAN-U09
RUIZ-IGNACIOM-U10
6/17/2011-U011
AGREEMENT-U012
A-11879)-U012
BEACON-U012
PARTNERS-U012
MEDITECH-U012
BILLING-U012
ACCOUNTS-U012
RECEIVABLE-U012
B/AR)-U012
MODULE-U012
SUPPORT-U012
SERVICES-U012
AT-U012
NMC-U012
IN-U012
AN-U012
AMOUNT-U012
TO-U012
EXCEED-U012
$513,080-U012
IN-U012
THE-U012
AGGREGATE-U012
$170,000-U012
THE-U012
PERIOD-U012
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2012.-U012
SIGNED BOARD REPORT AND SUPPO
{:� Provide guidance in developing end-user menus.
Provide Go-Live support.
Provide post-Live support.
IV. PERSONNEL, PROJECT DURATION and FEES
All personnel assigned to the engagement shall be fully qualified to perform the tasks
assigned to them and shall perform the services in a competent and professional
manner.
We anticipate that the project will take 200 hours over a period of four months, and
Beacon will assign consultants with MEDITECH C/S 5.6 B/AR experience. Due to the
exigencies of Natividad's situation and the part-time nature of this engagement, Beacon
may assign different consultants during different phases of the project. The consulting
fees for this project, which shall remain valid for 45 days from the date of this
Engagement Proposal, are:
PROFESSIONAL STAFF
MEDITECH C/S B/AR
Subject Matter Experts
Total
HOURLY ESTIMATED ESTIMATED FEES*
RATE HOURS
$180
200
$36,000
200
$36,000
Fees represented above are inclusive of travel and administrative expenses in
accordance with all applicable Monterey County policies, including without limitation the
Monterey County travel policy and are valid for 45 days from the date of this letter. Thank
you for your continued use of our services.
Proposal ID#: NAT012910/2603 2 Natividad initials
Confidential
BIB]
40740-U01
SIGNED-U02
BOARD-U02
REPORT-U02
SUPPORTING-U02
DOCS-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99940-U03
AS99966-U03
AS99967-U03
AI103204-U03
DO104218-U03
C10-U03
BOARD-U03
REPORTS-U03
7/15/2011-U04
MARCELLAC-U04
16738-U05
8-U06
AUTHORIZE-U07
THE-U07
PURCHASING-U07
MANAGER-U07
NATIVIDAD-U07
MEDICAL-U07
CENTER-U07
NMC)-U07
TO-U07
EXECUTE-U07
AMENDMENT-U07
NO.-U07
4-U07
TO-U07
THE-U07
960-NMC-U08
RUIZ-IGNACIO-U09
MAEGAN-U09
RUIZ-IGNACIOM-U10
6/17/2011-U011
AGREEMENT-U012
A-11879)-U012
BEACON-U012
PARTNERS-U012
MEDITECH-U012
BILLING-U012
ACCOUNTS-U012
RECEIVABLE-U012
B/AR)-U012
MODULE-U012
SUPPORT-U012
SERVICES-U012
AT-U012
NMC-U012
IN-U012
AN-U012
AMOUNT-U012
TO-U012
EXCEED-U012
$513,080-U012
IN-U012
THE-U012
AGGREGATE-U012
$170,000-U012
THE-U012
PERIOD-U012
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2012.-U012
SIGNED BOARD REPORT AND SUPPO
{:�BUSINESS ASSOCIATE AGREEMENT
This Agreement, hereinafter. r e f e r r e d to as Agreement", is made effective October 15, 2009 by and
between the County of Monterey,' a political subdivision of the State of California, on behalf. of Nativi.dad
Medical Center, hereinafter referred to as Covered Entity", and Beacon Partners Inc. hereinafter referred to
as Business Associate", individually, a Party" and collectively, the Parties"
WITNESSETH:
WHEREAS, Sections 261 through 264 of the federal Health Insurance Portability and Accountability
Act of 1996, Public Law 104-191, known as the Administrative Simplification provisions," direct the
Department of Health and Human Services to develop standards to protect the security, confidentiality and
integrity of health information; and
WHEREAS, pursuant to the Administrative Simplification provisions, the Secretary of Health-,and.
Human Services has issued regulations modifying 45 CFR Parts 160 and 164 the HIPAA'PrivacyRule");, and.
WHEREAS, the State of California has enacted statutes designed to safeguard patient privacy including,
without limitation, the Confidentiality of Medical Information Act CMIA"), California Civil Code 56 etsegi,
Senate Bill 541, enacted September 30, 2008, and Assembly Bill 211, enacted September 30, 2008; and
WHEREAS, the parties, acknowledge that California law may include provisions more stringent and
more protective of the confidentiality of health information than the provisions of HIPAA; and
WHEREAS, the Parties wish to enter into or have entered into an arrangement whereby Business
Associate will provide certain services to Covered Entity, hereby referred to as the Service Agreement" and,
pursuant to such arrangement, Business Associate may be considered a business associate" of Covered Entity as
defined in the HIPAA Privacy Rule and under California law; and
WHEREAS, Business Associate may have access to Protected Health Information as defined below) in
fulfilling its responsibilities under such arrangement;
THEREFORE, in consideration of the Parties' continuing obligations under the Service-Agreement,
compliance with the HIPAA Privacy Rule; compliance with California law, and other good and valuable--
consideration, the receipt and sufficiency of which is hereby acknowledged, the Parties agree to the provisions of
this Agreement in order to address the requirements of the HIPAA Privacy Rule and California law and to protect
the interests of both Parties.
I, DEFINITIONS
Except as otherwise defined herein, any and all capitalized terms in this Section shall have the definitions. set forth
in the HIPAA Privacy Rule. In the event of an inconsistency between the provisions of this Agreement and
mandatory provisions of the HIPAA Privacy Rule, as amended, the HIPAA Privacy Rule shall control. In the
event of an inconsistency between the provisions of this Agreement and mandatory provisions of CMIA or other.
California law, California law shall control. Where provisions of this Agreement are different than those
mandated in theHIPAA Privacy Rule and California law, but nonetheless are permitted by the HIPAA Privacy.
Rule and California law, the provisions of this Agreement shall control.
The term Protected Health Information" means individually identifiable health information including, without:
limitation, all information, data, documentation, and materials, including without.limitation, demographic,
Revised 12-26-08
BIB]
40740-U01
SIGNED-U02
BOARD-U02
REPORT-U02
SUPPORTING-U02
DOCS-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99940-U03
AS99966-U03
AS99967-U03
AI103204-U03
DO104218-U03
C10-U03
BOARD-U03
REPORTS-U03
7/15/2011-U04
MARCELLAC-U04
16738-U05
8-U06
AUTHORIZE-U07
THE-U07
PURCHASING-U07
MANAGER-U07
NATIVIDAD-U07
MEDICAL-U07
CENTER-U07
NMC)-U07
TO-U07
EXECUTE-U07
AMENDMENT-U07
NO.-U07
4-U07
TO-U07
THE-U07
960-NMC-U08
RUIZ-IGNACIO-U09
MAEGAN-U09
RUIZ-IGNACIOM-U10
6/17/2011-U011
AGREEMENT-U012
A-11879)-U012
BEACON-U012
PARTNERS-U012
MEDITECH-U012
BILLING-U012
ACCOUNTS-U012
RECEIVABLE-U012
B/AR)-U012
MODULE-U012
SUPPORT-U012
SERVICES-U012
AT-U012
NMC-U012
IN-U012
AN-U012
AMOUNT-U012
TO-U012
EXCEED-U012
$513,080-U012
IN-U012
THE-U012
AGGREGATE-U012
$170,000-U012
THE-U012
PERIOD-U012
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2012.-U012
SIGNED BOARD REPORT AND SUPPO
{:�medical and financial information, that relates to the past, present, or future physical or mental health or condition
of an individual; the provision of health care to an individual; or the past, present, or future. payment for the.
provision of health care to an individual; and that identifies the individual or with respect to which there. is a
reasonable basis to believe the information can be used to identify the individual
Business Associate acknowledges and agrees.that all Protected Health Information that is created or received by
Covered Entity and disclosed or made available in any form, including'paper record, oral. communicatigrr,, audio:
recording, and electronic display by Covered Entity or its operating units to Business Associate or is created or;.
received by Business Associate on Covered Entity's behalf shall be subject to this Agreement
II. CONFIDENTIALITY REOUM M]iNTS
a) Business Associate agrees:
i) to access, use, or disclose any Protected Health Information solely: 1) for meeting its.
obligations as set forth in any agreements between the Parties evidencing their business relationship or 2).
as required by applicable law, rule or regulation, or by accrediting or credentialing organization to whom
Covered Entity is required to disclose such information or as otherwise permitted under this Agreement,
the Service Agreement if consistent with this Agreement the HIPAA Privacy Rule, and California,law),
the HIPAA Privacy Rule, or California law and 3) as would be permitted by the HIP.AA Privacy Rule'
and California law if such use or disclosure were made by Covered Entity;
ii) 0i termination of this Agreement, the Serrioe Agreement or any similar documeilttation
of the business relationship of the Parties), or upon.request of Covered Entity, whichever occurs fiist,, if,
feasible, Business Associate will return or destroy all Protected Health Information received from' or.
created or received by Business Associate on behalf of Covered Entity that Business Associate still
maintains in any form and retain no copies of such information, or if such return or destruction is not
feasible, Business Associate will extend the protections of this Agreement to the information and limit
further access, uses, and disclosures to those purposes that make the return or destruction of the
information not feasible; and
iii) to ensure that its agents, including a subcontractor, to whom it provides Protected:Health,
Information received from or created by Business Associate on behalf of Covered Entity, agrees to the
same restrictions and conditions that apply to Business Associate with respect to such information. In
addition, Business Associate agrees to take reasonable steps to ensure that its employees' actions or
omissions do not cause Business Associate to'breach the terms of this Agreement.
b) Notwithstaiiding the prohibitions set forth in this Agreement, Business Associate may use. and
disolose Protected Health Information as follows:
i) if necessary, for the proper management and administration of Business Associate or to
carry out the legal responsibilities of Business Associate, provided that as to any such disclosure, the
following requirements are met:
A) the disclosure is required by law; oil
B) Business Associate obtains reasonable assurances from the person to whom. the
information is disclosed that it will be held confidentially and accessed, used, or further disclosed.
only as required by law or for the purpose for which it was disclosed to the person, and the person
notifies Business Associate of any instances-of which it is aware in which the confidentiality of
the information has',been breached, within five calendar days of'discoveruig said breach of
confidentiality;
ii) for data aggregation services, if to be provided by Business Associate for the health bare
operations of C'o'vered Entity pursuant to any agreements between the Parties evidencing.their business
relationship. For purposes of this Agreement, data aggregation services means the.co.mbining of
Protected Health Information by Business Associate' with the protected health information received by
Revised 12-26-08
BIB]
40740-U01
SIGNED-U02
BOARD-U02
REPORT-U02
SUPPORTING-U02
DOCS-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99940-U03
AS99966-U03
AS99967-U03
AI103204-U03
DO104218-U03
C10-U03
BOARD-U03
REPORTS-U03
7/15/2011-U04
MARCELLAC-U04
16738-U05
8-U06
AUTHORIZE-U07
THE-U07
PURCHASING-U07
MANAGER-U07
NATIVIDAD-U07
MEDICAL-U07
CENTER-U07
NMC)-U07
TO-U07
EXECUTE-U07
AMENDMENT-U07
NO.-U07
4-U07
TO-U07
THE-U07
960-NMC-U08
RUIZ-IGNACIO-U09
MAEGAN-U09
RUIZ-IGNACIOM-U10
6/17/2011-U011
AGREEMENT-U012
A-11879)-U012
BEACON-U012
PARTNERS-U012
MEDITECH-U012
BILLING-U012
ACCOUNTS-U012
RECEIVABLE-U012
B/AR)-U012
MODULE-U012
SUPPORT-U012
SERVICES-U012
AT-U012
NMC-U012
IN-U012
AN-U012
AMOUNT-U012
TO-U012
EXCEED-U012
$513,080-U012
IN-U012
THE-U012
AGGREGATE-U012
$170,000-U012
THE-U012
PERIOD-U012
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2012.-U012
SIGNED BOARD REPORT AND SUPPO
{:�Business Associate, in its capacity as a business associate of another covered entity, to permit data,
analyses that. relate to the health care operations ofthe. respective covered entities
c) Business Associate will implement appropriate safeguards to prevent access to,. use 9f,,or
disclosure of Protected Health Information other than as permitted in this Agreement, The Secretary of
Health and�Human Services shall have the right to audit.Busine$s Associate's records and practices
related. to. use and disclosure of Protected Health Information to ensure Covered Entity's compliance with
the terms. of the HIPAA Privacy Rule. Business Associate shall.reportto Covered Entity any access, use,.
or disclosure of Protected Health Information which is not in compliance with the terms. of this
Agreement of which it becomes aware within five calendar days of discovering such improper access,.
use, or disclosure. In addition, Business Associate agrees to mitigate, to the extentfpracticable, any
harmful effect that is known to Business Associate of a use, disclosure, or access of Protected. Health
Information by Business Associate in violation of the requirements of this Agreement
AVAILABILITY OF PHI'
Business Associate agrees to make available Protected Health Information to the extant and in the.manner
required by Section 164.524 of the EUPAA Privacy Rule. Business Associate agrees to make Protected Health
Information available for amendment and incorporate any amendments to Protected Health Information in
accordance with the requirements of Section 164:526 of the HIPAA Privacy Rule, In addition, $usiness
Associate agt�ees.to make Protected Health Information available for purposes of accounting.pf.disclosures, as.
required by Section 164.528 of the.HIPAA Privacy Rule.
TV. TERMINATION
Notwithstanding anything in this Agreement to the contrary, Covered Entity shall have the right to terminate this
Agreement and the Service Agreement immediately if Covered Entity determines that Business Associate has
violated any material term of this Agreement. If Covered Entity reasonably believes that Business Associate will
violate a material term of this Agreement and, where practicable, Covered Entity gives written notice to Business
Associate of such belief within areasonable time after forming.suchbelief; and Business Associate- fails to...
provide adequate written assurances to Covered Entity that it will not breach the cited term of this-Agreement
within a reasonable period of time given.the specific circumstances, but in any event,. before the threatened breach
is to occur, then Covered Entity shall have the right to terminate this Agreement and the Service Agreement
immediately, and seek injunctive and/or declaratory relief in a court of law having jurisdiction over Business
Associate.
V. MISCELLANEOUS
Except as expressly stated herein, in.:the HIPAA Privacy Rule, or under California law, the parties to this
Agreement do not intend to create any rights in any third parties. The obligations of Business Associate under this
Section shall survive the expiration, termination, or cancellation of this Agreement, the Service Agreement and/or
the business relationship of-the parties, and shall continue to bind Business Associate,.its agents, employees,,
contractors, successors, and assigns-as set forth herein.
This Agreement may be amended or modified only in a writing signed by the Parties. No Party. may assign. its
tespective rights and obligations undei this Agreement without the prior written consent of the other-Party., Norio
of the provisions of this Agreement are intended to create, nor will.,theybe� deemed�fo create any relationship
between the Parties.othet-than that. of independent parties: contracting with.each other' solely for�the.purposes of
effecting the provisions of this Agreement and aiay other agreements between the. Parties evidencing their business
relationship. This Agreement will be governed by the laws of the State of California No;change; waiver or.
Revised 12.26-08
BIB]
40740-U01
SIGNED-U02
BOARD-U02
REPORT-U02
SUPPORTING-U02
DOCS-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99940-U03
AS99966-U03
AS99967-U03
AI103204-U03
DO104218-U03
C10-U03
BOARD-U03
REPORTS-U03
7/15/2011-U04
MARCELLAC-U04
16738-U05
8-U06
AUTHORIZE-U07
THE-U07
PURCHASING-U07
MANAGER-U07
NATIVIDAD-U07
MEDICAL-U07
CENTER-U07
NMC)-U07
TO-U07
EXECUTE-U07
AMENDMENT-U07
NO.-U07
4-U07
TO-U07
THE-U07
960-NMC-U08
RUIZ-IGNACIO-U09
MAEGAN-U09
RUIZ-IGNACIOM-U10
6/17/2011-U011
AGREEMENT-U012
A-11879)-U012
BEACON-U012
PARTNERS-U012
MEDITECH-U012
BILLING-U012
ACCOUNTS-U012
RECEIVABLE-U012
B/AR)-U012
MODULE-U012
SUPPORT-U012
SERVICES-U012
AT-U012
NMC-U012
IN-U012
AN-U012
AMOUNT-U012
TO-U012
EXCEED-U012
$513,080-U012
IN-U012
THE-U012
AGGREGATE-U012
$170,000-U012
THE-U012
PERIOD-U012
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2012.-U012
SIGNED BOARD REPORT AND SUPPO
{ :�discharge of any liability or obligation hereunder on any one or more occasions shall be deemed a waiver of
performance of any continuing or other obligation; or shall prohibit enforcement of any obligation, on any other,
occasion.
The parties agree that,'in the event that any documentation of the parties, pursuant to which Business Associate
provides services to Cdvered Entity contains provisions relating to the use or disclosure. of Protected Hcaith
Information which are more restrictive thari'�tthe provisions of this:Agreement, the provisions of the more
restrictive documentation will control: The provisions of this Agreement are intended to-establish the minimum
requirements regarding Business Associate'.s use and disclosure of Protected Health Information,
In the event that any provision-of this Agreement is held by a court of competent jurisdiction to be invalid or
unenforceable, the remainder. of the provisibrig of this Agreement will remain in full force and. effect, In.addition,
in the event a party believes'in. good. faith that any provision of this Agreement fails to comply with�the.then--
current requirements of the HIPAA Privacy Rule or California law, such party shall notify the.other party in
writing. For a period of up to. thirty days, the parties shall attempt in good faith to address such concern, and.
amend the terms of this Agreement, if necessary to bring it into compliance. If at the�conclusion of such thirty-.
day period, a party believes in good faith that the Agreement still fails to comply with:the HIPAA Privacy Rule or.
California.law; then either party has the right to terminate this Agreement and the Service.Agreement upon
written notioe to the other party. Neither party may terminate this. Agreement without simultaneously terminating
the Service Agreement, unless the parties mutually agree in writing-to modify this�Agreement or immediately
replace it with a new Business Associate Agreement that. fully.cotnplies with the I{PAA Privacy Rule and
California law.
Business Associate acknowledges that Natividad Medical Center NMC) has established a Corporate Compliance
Program, and under this program NMC has developed a Code of Conduct Manual to provide guidance in the
ethical and legal performance of our professional services. Business Associate further agrees to abide by all
principles stated in the Code of Conduct while conducting business with Natividad Medical. Center, A copy of the
Code of Conduct & Principles of Compliance is available upon request.
IN WITNESS WHEREOF, the Parties have. executed-this Agreement as of the day and year written
above.
Title: n
Date:' a lb16S
Revised 12-26-08
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{ :�ACORV
CERTIFICATE OF LIABILITY INSURANCE i0/13/2o" 0`'
THIS CERTIFICATE IS 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 POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS 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 NTACT Suzette Kovacs
CO AME:
Charles River Ins. Brokerage, Inc. PHONE 508) 656-1400 AX Not 508) 656-1499
5 Whittier Street A Z IL
ESS: skovacs@crinsurance.biz
4th Floor PRODUCER 00011769
Framingham MA 01701 INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURERA:The Phoenix Insurance Cc
INSURER B: Travelers Indemnity 5658
Beacon Partners, Inc. INSURERC:Travelers Casualt and Surety
97 Libbey Parkway, Suite 310
NsuRERD:Travelers Casualty & Surety Co.
INSURERE;Travelers Property Casualty Co
Weymouth MA 02189
INSURER F
COVERAGES CERTIFICATE
NUMBER:10-11GL/CA/WC/UMB/E &O
REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT 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.
IN3R
LTR TYPE OF INSURANCE D
POLICY NUMBER POLICY EFF
MM/DD/YYYY POLICY EXP
MWOD/YYYY LIMITS
GENERAL LIABILITY EACH OCCURRENCE S 1, 000
X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 300 000
A CLAIMS-MADE OCCDR 630178M2962 10/13/2010 10/13/2011 M ED EXP Any one person) S 10,000
PERSONAL & AOV INJURY S 1,000,000
GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE UMITAPPLIES PER; PRODUCTS COMP/OP AGO $ 2,000,000
X POLICY PE Q LOC $
AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
Ea accldenl)
ANY AUTO
BODILY INJURY Per person)
$
B ALL OWNED ALTOS 164M7057 0/13/2010 10/13/2011
BODILY INJURY Per acdden0 $
SCHEDULED AUTOS
PROPERTY DAMAGE
X
HIRED AUTOS
Per acdden0 $
X NON-OWNED AUTOS $
X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 3,000,000
EXCESS LIAB CLAIMS-MADE AGGREGATE $ 3,000,000
DEDUCTIBLE S
C X RETENTION $ 10,000 UC17BM2962 10/13/2010, 10/13/2011 $
D WORKERS COMPENSATION T- OTH-
AND EMPLOYERS' LIABILITY X TOOK IMI
YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE El. EACH ACCIDENT $, 1,000,000
OFFICER/MEMBER EXCLUDED?
Mandatory in NH) N/A
NVB7658M0010
10/13/2010
10/13/2011
E.L. DISEASE- EA EMPLOYE
S 1,000,000
I( yyes describe under
DESCRIPTION OF OPERATIONS belay? E.L. DISEASE POLICY LIMIT $ 1 000 000
E Errors & Omissions E06909518 0/13/2010 0/13/2011 Each Claim $3,000,000
Aggregate $3,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES Attach ACORD 101, Additional Remarks Schedule, If more space Is required)
The County of Monterey it's officers, agents, and employees are additional insureds as respects the Commercial General
Liability and Non-Owned and Hired Auto. It is understood this insurance is primary and any other insurance
maintained by the additional insured shall be excess only, and not contributing with this insurance. 30 days
cancellation, except 10 days for non payment
CERTIFICATE HOLDER
County of Monterey
Its Officers Agents and
Sid Cato
1441 Constitution Blvd
Salinas, CA 93906
Employees
CANCELLATION
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
Ellen Bohn Gitlitz/AG
ACORD 25 2009/09) 1988-2009 ACORD CORPORATION. All rights reserved.
5 1 IN ACORD name and o re re Iste ed marks of ACORD
c`P~~ed with pdfFactory triersion www.pc~acory.orr
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SIGNED BOARD REPORT AND SUPPO
{ :�POLICY NUMBER: H-630-178M2962-PHX-10
COMMERCIAL GENERAL LIABILITY
ISSUE DATE: 11-05-10
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED
CONTRACTORS)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
NAME OF PERSON(S) OR ORGANIZATION(S):
COUNTY OF MONTEREY, ITS OFFICERS,
AGENTS AND EMPLOYEES IT IS
UNDERSTOOD THAT THIS INS IS PRIMARY,
AND ANY OTHER INS MAINTAINED BY THE
ADDL INSRD SHALL BE EXCESS ONLY, &
NOT CONTRIBUTING WITH THIS INSURANCE
1441 CONSTITUTION BLVD., SALINAS, CA 90906
PROJECT/LOCATION OF COVERED OPERATIONS:
CALIFORNIA
1. WHO IS AN INSURED Section II) is amended
to include the person or organization shown in the
Schedule above, but:
a) Only with respect to liability for bodily injury",
property damage" or personal injury"; and
b) If, and only to the extent that, the injury or
damage is caused by acts or omissions of
you or your subcontractor in the performance
of your work" on or for the project, or at the
location, shown in the Schedule. The person
or organization does' not qualify as an addi-
tional insured with respect to the independent
acts or omissions of such person or organiza-
tion.
2. The insurance provided to the additional insured
by this endorsement is limited as follows:
a) In the event that the Limits of Insurance of
this Coverage Part shown in the Declarations
exceed the limits of liability required by a
written contract requiring insurance" for that
additional insured, the insurance provided to
the additional insured shall be limited to the
limits of liability required by that written con-
tract requiring insurance". This endorsement
shall not increase the limits of insurance de-
scribed in Section III Limits Of Insurance.
b) The insurance provided to the additional in-
sured does not apply to bodily injury", prop-
erty damage" or personal injury" arising out
of the rendering of, or failure to render, any
professional architectural, engineering or sur-
veying services, including:
1. The preparing, approving, or failing to
prepare or approve, maps, shop draw-
ings, opinions, reports, surveys, field or-
ders or change orders, or the preparing,
approving, or failing to prepare or ap-
prove, drawings and specifications; and
ii. Supervisory, inspection, architectural or
engineering activities.
c) The insurance provided to the additional in-
sured does not apply to bodily injury" or
property damage" caused by your work"
and included in the products-completed op-
erations hazard" unless a written contract
requiring insurance" specifically requires you
to provide such coverage for that additional
insured, and then the insurance provided to
the additional insured applies only to such
bodily injury" or property damage" that oc-
curs before the end of the period of time for
which the written contract requiring insur-
ance" requires you to provide such coverage
CG D2 47 08 05 2005 The St. Paul Travelers Companies, Inc. Page 1 of 2
PDF created with pdfFactory trial version www.pdffactorr.com
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MARCELLAC-U04
16738-U05
8-U06
AUTHORIZE-U07
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NATIVIDAD-U07
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SIGNED BOARD REPORT AND SUPPO
{ :�COMMERCIAL GENERAL LIABILITY
or the end of the policy period, whichever is
earlier.
3. The insurance provided to the additional insured
by this endorsement is, excess over any valid and
collectible other insurance", whether primary,
excess, contingent or on any other basis, that is
available to the additional insured for a loss we
cover under this endorsement. However, if a
written contract requiring insurance" for that ad-
ditional insured specifically requires that this in-
surance apply on a primary basis or a primary
and non-contributory basis, this insurance is pri-
mary to other insurance" available to the addi-
tional insured which covers that person or organi-
zation as a named insured for such loss, and we
will not share with that other insurance". But the
insurance provided to the additional insured by
this endorsement still is excess over any valid
and collectible other insurance", whether pri-
mary, excess, contingent or on any other basis,
that is available to the additional insured when
that person or organization Is an additional In-
sured under such other insurance".
4. As a condition of coverage provided to the
additional insured by this endorsement:
a) The additional insured must give us written
notice as soon as practicable of an occur-
rence" or an offense which may result in a
claim. To the extent possible, such notice
should include:
i. How, when and where the occurrence"
or offense took place;
ii. The names and addresses of any injured
persons and witnesses; and
iii. The nature and location of any injury or
damage arising out of the occurrence" or
offense.
b) If a claim is made or suit" is brought against
the additional insured, the additional insured
must:
i. Immediately record the specifics of the
claim or suit" and the date received; and
U. Notify us as soon as practicable.
The additional insured must see to It that we
receive written notice of the claim or suit" as
soon as practicable.
c) The additional insured must immediately
send us copies of all legal papers received in
connection with the claim or suit", cooperate
with us in the investigation or settlement of
the claim or defense against the suit", and
otherwise comply with all policy conditions,
d) The additional insured must tender the de-
fense and indemnity of any claim or suit" to
any provider of other insurance" which would
cover the additional insured for a loss we
cover under this endorsement. However, this
condition does not affect whether the insur-
ance provided to the additional insured by
this endorsement is primary to other insur-
ance" available to the additional insured
which covers that person or organization as a
named insured as described in paragraph 3.
above.
5. The following definition Is added to SECTION V.
DEFINITIONS:
Written contract requiring insurance" means
that part of any written contract or agreement
under which you are required to include a
person or organization as an additional in-
sured on this Coverage Part, provided that
the bodily injury" and property damage" oc-
curs and the personal injury" is caused by an
offense committed:
a. After the signing and execution of the
contract or agreement by you;
b. While that part of the contract or
agreement Is in effect; and
c. Before the end of the policy period.
Page 2 of 2 2005 The St. Paul Travelers Companies, Inc. CG D2 47 08 05
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SIGNED BOARD REPORT AND SUPPO
{ :�NATIVIDAD MEDICAL CENTER
PURCHASE ORDER
I
ORDER DATE 11-08-2010
SC 9600 0000000862
IMPORTANT
THE ABOVE NUMBER AND SHIP TO DEPARTMENT MUST
APPEAR ON ALL SHIPPINGLABELS, PACKING SLIPS,
TRANSPORT DOCUMENTS, INVOICES AND CORRESPONDENCE.
BEACON PARTNERS INC S NATIVIDAD MEDICAL CENTER B NATIVIDAD MEDICAL CENTER
V
E
H 1441 CONSTITUTION BLVD
L P 0 BOX 81611
97 LIBBEY PARKWAY STE 310 P L
D
0 SALINAS CA 93906 SALINAS CA 93912-1611
R WEYMOUTH MA 02189 T
0 T
0
VENDOR NUMBER: V00000000267 DELIVERY DATE: F.O.B.:
ITEM QUANTITY
UNIT COMMODITY CODE
ITEM DESCRIPTION
UNIT PRICE SALES TAX
PURCH DESC: CC; 8481 PER BOARD OF SUPERVISORS 11-2-10 APPROVAL OF AMENDMENT #2 OF AGREEMENT #A-1 1879 WITH
BEACON PARTNERS INC FOR MEDITECH BILLING AND ACCOUNTS RECEIVABLE B/AR) MODULE SUPPORT SERVICES AT
NATIVIDAD MEDICAL CENTER.
ALL SERVICES SHALL BE PROVIDED IN ACCORDANCE WITH TERMS, CONDITIONS AND EXHIBITS OF THE APPROVED COUNTY OF
MONTEREY AGREEMENT.
TERM OF THE AGREEMENT OCTOBER 1, 2010 TO JUNE 30, 2011 UNLESS SOONER TERMINATED PURSUANT TO THE TERM OF THE
AGREEMENT
THIS PURCHASE ORDER IS VALID 10-1-10 THROUGH 6-30-2011. A NEW PURCHASE ORDER WILL BE ISSUED AFTER THAT TIME TO
THE CURRENT AGREEMENT.
THE TOTAL OF THIS PURCHASE ORDER IS NOT TO EXCEED $111,350
0.0 94899
COMM LINE DESC: NMC Non Physicians Services
451 9600 8142 NM0001 6613
THE SHADED ROWS ARE FOR NMC DEPARTMENT USE ONLY
EXTENDED PRICE
00 00 j 111,350.00
ORDER TOTAL
111,350.00
All Vendors are required to review the NMC general terms and conditions which apply to all contracts, purchase orders, and other electronic procurements made with NMC unless otherwise noted. Said terms
and conditions can be found on the NMC website at http://www.Natividad.com
TAX EXEMPTION INFORMATION:
FEDERAL EXCISE TAX EXEMPTION NUMBER 94-6000524
AUTHORIZED BY NMC
DEPUTIZED PURCHASING AGENT
COUNTY BUYER INFORMATION
Sidney Cato
EMAIL: catosl@natividad.com
111350.00
TELEPHONE: 831)755-4223 x71-4223
CONTRACTS/PURCHASING DIVISION
PRINT DATE: 11/08/10 1441 Constitution Blvd. P.O. Box 81611, PAGE NUMBER: I OF 1
Salinas, CA 93912-1611
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SIGNED BOARD REPORT AND SUPPO
{!:�MONTEREY COUNTY BOARD OF SUPERVISORS
MEETING: October 26, 2010
AGENDA NO.:
SUBJECT: Authorize the Purchasing Manager for Natividad Medical Center NMC)
to execute Amendment #2 to the Agreement with Beacon Partners for
Meditech Billing and Accounts Receivable B/AR) Module Support
services at NMC in an amount not to exceed $193,080 an increase of
$95,880) for the period October 1, 2010 to June 30, 2011.
DEPARTMENT: Natividad Medical Center
RECOMMENDATION:
It is recommended that the Board of Supervisors authorize the Purchasing Manager for Natividad
Medical Center NMC) to execute Amendment #2 to the Agreement with Beacon Partners for
Meditech Billing and Accounts Receivable B/AR) Module Support services at NMC in an amount
not to exceed $193,080 an increase of $95,880) for the period October 1, 2010 to June 30, 2011.
SUMMARY/DISCUSSION:
Beacon Partners has been providing Meditech Billing and Accounts Receivable B/AR) module
subject matter expertise at NMC. As NMC continues to enhance and utilize additional functionality
with B/AR, these services will need to be extended. A project of this magnitude requires oversight
and management from highly skilled, back office-experienced individuals and Beacon Partners
provides these services. The recommendation is to continue obtaining subject matter expertise
services from Beacon Partners. Total spend on Beacon Partners for the period 8-12-2009 to present
is $706,609.65
OTHER AGENCY INVOLVEMENT:
The Amendment has been reviewed and approved by County Counsel, the Auditor/Controller's
office and the Natividad Medical Center Board of Trustees.
FINANCING:
The cost for this Amendment is $95,880 and is included in the 2010/2011 FY approved budget. This
action will not require any additional General Fund subsidy.
Prepared by:
Kirk Larson Harry Weis
Chief Information Officer Chief Executive Officer
September 16, 2010
Attachments: Amendment #1 & 2, Agreement, Board Order
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SIGNED BOARD REPORT AND SUPPO
{":�I
13
Before the Board of Supervisors in and for the
County of Monterey, State of California
Agreement No: A 11879
Authorize the Purchasing Manager for Natividad Medical Center NMC) to
execute Arnendmerit No. 2 to the Agreement with Beacon Partners for
Meditech Billing and Accounts Receivable B/AR) Module Support
services at NMC in an amount not to exceed $193,080 an increase of
95,880) for the period October 1, 2010 through June 30, 2011.
pon motion of Supervisor Potter, seconded by Supervisor Armenta, and carried by those
members present, the Board hereby:
Authorized the Purchasing Manager for Natividad Medical Center NMC) to execute
endment No. 2 to the Agreement with Beacon Partners for Meditech Billing and Accounts
Receivable B/AR) Module Support services at NMC in an amount not to exceed $193,080 an
increase of $95 880) for the period October 1 2010 through June 30 2011.
PASSED_AND._AD.O,P D this 2nd. d?y of November, 2010, by the following vote, to wit:
AYES: Supervisors Armenia, Calcagno, Salinas, Parker, Potter
NOES:' None
ABSENT: None
1, Gail T. Borkowski, Clerk of the Board of Supervisors of the County of Monterey, State of California, hereby
certify that the foregoing is a true copy of an original order of said Board of Supervisors duly made and entered in
the minutes thereof of Minute Book 75 for the meeting on November 2, 2010.
ated...November,2, 2010 Gail T. Borkowski, Clerk of the Board of Supervisors
County of Monterey, State of California
By
1- Z n
eputy
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SIGNED BOARD REPORT AND SUPPO
{#:�Original Agreement No orPO#. SC862)
AMENDMENT NO.2
FOR PROFESSIONAL SERVICE AGREEMENT
BETWEEN Beacon Partners Inc. AND
THE NATIVIDAD MEDICAL CENTER
FOR
Mediteph Billing and Accounts Receivable B/AR) Module Support SERVICES
The parties to Professional Service Agreement, dated February 1, 2010 between the County of
Monterey, on behalf of Natividad Medical Center NMC"), and Beacon Partners Inc. Contractor),
hereby agree to amend their Agreement No. SC862) on the following terms and conditions:
1. Contractor will continue to provide NMC with the same scope of service as stated in the original
Agreement No. SC862). Additionally, Contractor will provide the services described on
Attachment A attached to this Amendment #2.
2. This Amendment shall become effective on October 1, 2010 and shall continue in full force until
June 30, 2011.
3. The total amount payable by County to Contractor under Agreement No. SC862) shall not exceed
the total sum of $193,080 for the full term of the Agreement and $111,350 for fiscal year 2010-
2011.
4. All other terms and conditions of the Agreement shall continue in full force and effect.
5. A copy of this Amendment shall be attached to the original Agreement No. SC862).
IN WITNESS WHEREOF, the parties hereto are in agreement with this Amendment and
Professional Service Agreement on the basis set forth in this document and have executed this
amendment on the day and year set forth herein.
Dated September 1, 2010
NATIVIDAD
AL CENTER
Title President and CEO
Signature-~~~--- Dated a 7 am'
Purchasi Manager
Signature
NMC CEO
Approved as to Legal Form:
Charles J. McKee, County Co eI
Stacy Saetta, Dept ty
Attorneys for County and NMC
Dated 1 Grt
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SIGNED BOARD REPORT AND SUPPO
{$:�Attachment A
1. SCOPE of WORK
The scope of this engagement is for Beacon Partners Beacon) to provide management
consulting services to Natividad Medical Center NMC) in the form of MEDITECH Client
Server C/S) Billing and Accounts Receivable B/AR) module support and subject matter
expertise.
II. APPROACH
Beacon will provide a consultant familiar and experienced with the MEDITECH C/S 5.6 B/AR
module to provide the following services-
Work with NMC to define optimal workflow measures and opportunities for process
improvements for utilization of the new MEDITECH functionality.
Work with department managers to discuss how the MEDITECH system will affect or
change patient services or workflows.
Provide guidance with the design and development of dictionaries.
Assist with the needs of management and staff affected by the B/AR functionality, both
in technology transition for those utilizing the new system and changes to workflows for
those currently accustomed to other system or manual procedures.
Respond to questions regarding use of the B/AR module.
Resolve issues among the user community with regard to use of the system.
Assist in maximizing the use of the B/AR module to improve revenue cycle performance.
Beacon Partners'
Engagement Proposal
Ill. PERSONNEL, PROJECT DURATION and FEES
All personnel assigned to the engagement shall be fully qualified to perform the tasks
assigned to them and shall perform the services in a competent and professional manner.
We anticipate that the project will span 14 weeks, excluding holidays and ending February
11, 2011. Consulting fees for this project are:
PROFESSIONAL STAFF
HOURLY ESTIMATED
ESTIMATED FEES
RATE
HOURS.
Gail Artigue, Senior',Consultant $170 564 $95,880
Proposal ID#. NAT08191013160
Original Project#:0000881
Confidential
1
BEACON'
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SIGNED BOARD REPORT AND SUPPO
{%:�Attachment A
All terms and conditions, as specified in our original Engagement Agreement, dated January
29, 2010, will continue throughout this engagement. Fees represented above are inclusive of
travel and administrative expenses in accordance with all applicable Monterey County
policies, including without limitation the Monterey County travel policy, and are valid for 45
days from the date of this letter. Upon approval please sign where indicated and fax this entire
document 877.755.2703. Thank you for your continued use of our services.
IV. APPROVALS
09/01/10
Janet Warren Authorizing Signature
Client Service Manager Natividad Medical Center
Beacon Partners
Print Name
Proposal ID#: NAT081910/3160
Original Project#:0000881
Confidential
Date
2
BEACON'
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SIGNED BOARD REPORT AND SUPPO
{&:�Original Agreement No or PO#. BPO1971)
AMENDMENT NO.1
FOR PROFESSIONAL SERVICE AGREEMENT
BETWEEN Beacon Partners Inc. AND
THE NATIVIDAD MEDICAL CENTER
FOR
Meditech Billing and Accounts Receivable WAR) Module Sunnort SERVICES
The parties to Professional Service Agreement, dated February 1, 2010 between the County of
Monterey, on behalf of Natividad Medical Center NMC"), and Beacon Partners Inc. Contractor),
hereby agree to amend their Agreement No. BPO1971) on the following terms and conditions;
1. Contractor will continue to provide NMC with the same scope of service as stated in the original
Agreement No. BPO1971). Additionally, Contractor will provide the services described on
Attachment A attached to this Amendment #1.
2. This Amendment shall become effective on May 3, 2010 and shall continue in full force until
January 31, 2011.
3. The total amount payable by County to Contractor under Agreement No. BPO 1971) shall not
exceed the total sum of $97,200 for the full term of the Agreement and $97,200 for fiscal year
2009-2010.
4. All other terms and conditions of the Agreement shall continue in full force and effect.
5. A copy of this Amendment shall be attached to the original Agreement No. BPO1971).
IN WITNESS WIHEREOF, the parties hereto are in agreement with this Amendment and
Professional Service Agreement on the basis set forth in this document and have executed this
amendment on the day and year set forth herein.
CON
RACTOR
T
Signature
Printed Nam a
Dated 0 0
Me
Dated Dated
NMC CEO
Approved as to Legal Form:
Charles J. p}(oKee, County Co
Stacy Saetta,
Attorneys for County and NMC
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SIGNED BOARD REPORT AND SUPPO
{':�March 29, 2010
Mr. Kirk Larson
Chief Information Officer
Natividad Medical Center
1441 Constitution Boulevard, Building 300
Salinas, CA 93912-1611
Dear Mr. Larson:
39acen Patrnvr8, Inc.
X17 UI bay PnrkwoV, Suits 91.5
t7tlI:89Z.8A5wayutnuth, MA 02189'
f, i.33jS.169
wwt>bbanson'tr rtners cmn
attsrnrt swr rprta csca, roaonrn
This letterwill serve as an addendum to extend our consulting agreement dated January 29, 2010. It Is Beacon
Partners' understanding that the project is going well and continues to meet Natlvldad Medical Center's
requirements for support of the MEDITECH 8/AR upgrade and that you wish to expand our services to Include
an additional 380 hours of support for revenue cycle improvement, At your request, Beacon Partners will,
commencing May 3, 2010, provide such consulting services through July 3, 2010.
Consultants and associated fees for this engagement are as follow.
CONSULTANT! ROLE HOURS HOURLY RATE FEB
Gall Artigue, Senior Consultant 360 $170 $61,200
TOTAL $61,200
Al] terms and conditions, as specified in our original Engagement Agreement, will continue throughout this
extension. Fees represented above are inclusive of professional fees, travel and administrative expenses and
valid for45 days from the date of this letter. Thank you for your continued use of our services,
Sincerely,
RobertJ, Jablonski
Regional Manager
Beacon Par amino.
Proposal ID#: NAT03291012770
Original Project We. 000507
Confidential
Addendum Approval:
Authorizing Signature
Natlvldad 9dical Center
Print Name
Data
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SIGNED BOARD REPORT AND SUPPO
{(:�1tt%. NatiV1d0dMEDICA,CENIER
COUNTY OF MONTEREY AGREEMENT FOR PROFESSIONAL SERVICES
NOT TO EXCEED $100.000)
This Professional Services Agreement hereinafter Agreement") is made by and between Natividad Medical
Center NMC"), a general acute care teaching hospital wholly owned and operated by the County of
Monterey, which is a political subdivision of the State of California and Beacon Partners Inc.
hereinafter CONTRACTOR").
In consideration of the mutual covenants and conditions set forth in this Agreement, the parties agree as
follows:
SERVICES TO BE PROVIDED. NMC hereby engages CONTRACTOR to perform, and
CONTRACTOR hereby agrees to perform, the services described in Exhibit A in conformity with the
terms of the Agreement, The services are generally described as follows: Meditech Billing and
Accounts Receivable B/AR) Module support
1. PAYMENTS BY NMC. NMC shall pay the CONTRACTOR in accordance with the payment provisions
set forth in Exhibit A, subject to the limitations set forth in this Agreement. The total amount payable by
NMC to CONTRACTOR under this Agreement shall not exceed the sum of $36,000
2. TERM OF AGREEMENT. The term of this Agreement is from Feb 1, 2010 to Jan 31, 2011
unless sooner terminated pursuant to the terms of this Agreement. This
Agreement is of no force or effect until signed by both CONTRACTOR and NMC and with NMC signing
last and CONTRACTOR may not commence work before NMC signs this Agreement.
3. ADDITIONAL PROVISIONS/EXHIBITS. The following attached exhibits are incorporated herein by
reference and constitute apart of this Agreement:
Exhibit A/Schedule A: Scope of Services/Payment Provisions
4. PERFORMANCE STANDARDS.
4: l,-GOialTRAC-TGR-war-rants-i hat-C-0-NTP AGT-OR-and-Gontraztar4-agants,amplo-yees'an
subcontractors perfbrming services under this Agreement are specially trained, experienced,
competent, and appropriately licensed to perform the work and deliver the services required under
this Agreement and are not employees of NMC, or immediate family of an employee of NMC,
4.2. CONTRACTOR, its agents, employees, and subcontractors shall perform all work in a safe and
skillful manner and In compliance with all applicable laws and regulations. All work performed under
this Agreement that is required by law to be performed or supervised by licensed personnel shall be
performed in accordance with such licensing requ irements.
Revised 12/1/2008 NMC PSA Form $100,000 or Lass I
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THE-U012
PERIOD-U012
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2012.-U012
SIGNED BOARD REPORT AND SUPPO
{):�4.3. CONTRACTOR shall furnish, at its own expense, all materials, equipment, and personnel necessary
to carry out the terms of this Agreement, except as other wise specified in this Agreement.
CONTRACTOR shall not use NMC premises, property including equipment, instruments, or
supplies) or personnel for any purpose other than in the performance of its obligations under this
Agreement.
5. PAYMENT CONDITIONS.
5.1. CONTRACTOR shall submit to the Contract Administrator an invoice on a form acceptable to NMC.
If not otherwise specified, the CONTRACTOR may submit such invoice periodically or at the
completion of services, but in any event, not later than 30 days after completion of services. The
invoice shall set forth the amounts claimed by CONTRACTOR for the previous period, together with
an itemized basis for Administrator or his or her designee shall certify the invoice, either in the
requested amount or in such other amount as NMC approves in conformity with this Agreement, and
shall promptly submit such invoice to the County Auditor-Controller for payment. The County
Auditor-Controller shall pay the amount certified within 30 days of receiving the certified invoice.
5.2. CONTRACTOR shall not receive reimbursement for travel expenses unless set forth in this
Agreement.
6. TERMINATION.
6.1. During the term of this Agreement, NMC may terminate the Agreement for any reason by giving
written notice of termination to the CONTRACTOR at least thirty 30) days prior to the effective date
of termination. Such notice shall set forth the effective date of termination. In the event of such
termination, the amount payable under this Agreement shall be reduced in proportion to the services
provided prior to the date of termination.
6.2. NMC may cancel and terminate this Agreement for good cause effective immediately upon written
notice to Contractor. Good cause" includes the failure of CONTRACTOR to perform the required
services at the time and in the manner provided under this Agreement. If NMC terminates this
Agreement for good cause, NMC may be relieved of the payment of any consideration to Contractor,
and NMC may proceed with the work in any manner, which NMC deems proper. The cost to NMC
shall be deducted from any sum due the CONTRACTOR under this Agreement.
7. INDEMNIFICATION: CONTRACTOR shall indemnify, defend and hold harmless. NMC and the
County of Monterey hereinafter County"), it officers, agents and employees from any claim, liability,
loss, injury or damage arising out of, or in connection with, performance of this Agreement by
CONTRACTOR and/or its agent, employees or sub-contractors, excepting only low, injury or damage
caused by the negligence or willful misconduct of personnel employed by NMC. It is the intent of the
parties-to-this-Agmerr vA-to-pre-vide-the-broadest-possib la-ego-verage-for-NMC-T-he-GONTRAGT-OR-shall
reimburse NMC for all costs, attorneys' fees, expenses and liabilities incurred with respect to any
litigation in which the CONTRACTOR is obligated to indemnify, defend and hold harmless NMC and the
County under this Agreement.
8. INSURANCE.
8.1. Evidence of Coverage:
Prior to commencement of this Agreement, the CONTRACTOR shall provide a Certificate of
Insurance" certifying, that coverage as required herein has been obtained. Individual endorsements
Revised 12/1/2008 NMC PSA Form $100,000 or Less 2
BIB]
40740-U01
SIGNED-U02
BOARD-U02
REPORT-U02
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DOCS-U02
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7/15/2011-U04
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16738-U05
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SIGNED BOARD REPORT AND SUPPO
{*:�executed by the insurance carrier shall accompany the certificate. In addition, the CONTRACTOR
upon request shall provide a certified copy of the policy or policies.
Executed by the insurance carrier shall accompany the certificate. In addition, the CONTRACTOR
upon request shall provide a certified copy of the policy or policies.
This verification of coverage shall be sent to NMC's Contracts/Purchasing Department, unless
otherwise directed. The CONTRACTOR shall not receive a Notice to Proceed" with the work under
this Agreement until it has obtained all insurance required and NMC has approved such insurance.
This approval of insurance shall neither relieve nor decrease the liability of the Contractor.
8.2. Qualifying Insurers: All coverage's except surety, shall be issued by companies which hold a current
policy holder's alphabetic and financial size category rating of not less that A-VII, according to the
current Best's Key Rating Guide or a company of equal financial stability that is approved by NMC's
Contracts/Purchasing Director.
8.3. Insurance Coverage Requirements: Without limiting Contractor's duty to indemnify, CONTRACTOR
shall maintain in effect throughout the term of this Agreement a policy or policies of insurance with
the following minimum limits of liability:
Commercial general liability insurance, including but not limited to premises and operations, including
coverage for Bodily Injury and Property Damage, Personal Injury, Contractual Liability, Broad form
Property Damage, Independent Contractors, Products and Completed Operations, with a combined
single limit for Bodily Injury and Property Damage of not less than $1,000,000 per occurrence.
r Exemption/Modification Justification attached; subject to approval).
Business automobile liability insurance covering all motor vehicles, including owned, eased, non-
owned, and hired vehicles, used in providing services under this Agreement, with a combined single
limit for Bodily Injury and Property Damage of not less than $500,000 per occurrence.
Exemption/Modification Justification attached; subject to approval).
Workers' Compensation Insurance If CONTRACTOR employs other in the performance of this
Agreement, in accordance with California Labor Code section 3700 and with Employer's Liability
limits not less than $1,000,000 each person, $1,000,000 each accident and $1,000,000 each disease.
r; Exemption/Modification Justification attached; subject to approval).
Professional liability insurance if required for the professional services being provided, e.g., those
persons authorized by a license to engage in a business or profession regulated by the California
1usiness_an.d-Px_ofessiens_Cgde~~i.n-the-ai~~aunt-of~ot_Iess-thaw in the aggregate, to cover liability for malpractice or errors or omissions made in the course of
rendering professional services. If professional liability insurance is written on a claims-made" basis
rather than an occurrence basis, the CONTRACTOR shall, upon the expiration or earlier termination
of this Agreement, obtain extended reporting coverage tail coverage") with the same liability limits.
Any such tail coverage shall continue for at least three years following the expiration or earlier
termination of this Agreement.
Jt Exemption/Modification Justification attached; subject to approval).
Revised 12/1/2008 NMC PSA Form $100,000 or Less 3
BIB]
40740-U01
SIGNED-U02
BOARD-U02
REPORT-U02
SUPPORTING-U02
DOCS-U02
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7/15/2011-U04
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16738-U05
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CENTER-U07
NMC)-U07
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AMENDMENT-U07
NO.-U07
4-U07
TO-U07
THE-U07
960-NMC-U08
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THE-U012
PERIOD-U012
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2012.-U012
SIGNED BOARD REPORT AND SUPPO
{+:�8.4. Other Insurance Requirements:
All insurance required by this Agreement shall be with a company acceptable to NMC and issued and
executed by an admitted insurer authorized to transact insurance business in the State of California.
Unless otherwise specified by this Agreement, all such insurance shall be written on an occurrence
basis, or, if the policy is not written on an occurrence basis, such policy with the coverage required
herein shall continue in effect for a period of three years following the date CONTRACTOR
completes its performance of services under this Agreement.
Each liability policy shall provide that NMC shall be given notice in writing at least thirty days in
advance of any endorsed reduction in coverage or limit, cancellation, or intended non-renewal thereof.
Each policy shall provide coverage for CONTRACTOR and additional insured with respect to claims
arising from each subcontractor, if any, performing work under this Agreement, or be accompanied by
a certificate of insurance from each subcontractor showing each subcontractor has identical insurance
coverage to the above requirements.
Commercial general liability and automobile liability policies shall provide an endorsement naming the
County of Monterey, its o fcers. agents, and employees as Additional insureds with respect to liability
arising out Qf the Contractor's work, including ongoing and completed operations and shall further
provide that such insurance is primary insurance to any insurance or self-insurance maintained by the
Coun and that the insurance of the Additional Insureds shall not be called upon to contribute to a loss
covered by the Contractor's insurance. The required endorsement from for Commercial General
LW W02 Additional Insured is.ISO Form CG 20 10 11-85 or CG 20 10 10 01 in tandem with CG 20 3710
01 2000). The reguirgd endorsement from for Automobile Additional Insured Endorsement is ISO Form
CA 20480299.
Prior to the execution of this Agreement by NMC, CONTRACTOR shall file certificates of insurance
with NMC's Contracts/Purchasing Department, showing that the CONTRACTOR has in effect the
insurance required by this Agreement. The CONTRACTOR shall file a new or amended certificate of
insurance within five calendar days after any change is made in any insurance policy, which would
alter the information on the certificate then on file. Acceptance or approval of insurance shall in no
way modify or change the indemnification clause in this Agreement, which shall continue in full force
and effect.
CONTRACTOR shall at all times during the term of this Agreement maintain in force the insurance
coverage required under this Agreement and shall send, without demand by NMC, annual certificates
to NMC's Contracts/Purchasing Department. If the certificate is not received by the expiration date,
NMC shall notify CONTRACTOR and CONTRACTOR shall have five calendar days to send in the
certificate, evidencing no lapse in coverage during the interim. Failure by CONTRACTOR to maintain
such insurance is a default of this Agreement, which entitles NMC, at its sole discretion, to terminate
the-Agreement-immecti ate-ly----
9. RECORDS AND CONFIDENTIALITY.
9.1. Confidentiality, CONTRACTOR and its officers, employees, agents and subcontractors shall comply
with any and all federal, state, and local laws, which provide for the confidentiality of records and
other information. CONTRACTOR shall not disclose any confidential records or other confidential
information received from NMC or prepared in connection with the performance of this Agreement,
unless NMC specifically permits CONTRACTOR to disclose such records or information.
CONTRACTOR shall promptly transmit to NMC any and all requests for disclosure of any such
Revised 12/1/2008 NMC PSA Form $100,000 or Less 4
BIB]
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AS99967-U03
AI103204-U03
DO104218-U03
C10-U03
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7/15/2011-U04
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16738-U05
8-U06
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PURCHASING-U07
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NO.-U07
4-U07
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960-NMC-U08
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SUPPORT-U012
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TO-U012
EXCEED-U012
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SIGNED BOARD REPORT AND SUPPO
{,:�I
confidential records or information. CONTRACTOR shall not use any confidential information
gained by CONTRACTOR in the performance of this Agreement except for the sole purpose of
carrying out Contractor's obligations under this Agreement.
9.2. NMC Records When this Agreement expires or terminates, CONTRACTOR shall return to NMC
and NMC records which CONTRACTOR used or received from NMC to perform services under
this Agreement.
9.3. Maintenance of Records CONTRACTOR shall prepare, maintain, and preserve all reports and
records that may be-required by federal state, and County rules and regulations related to services
performed under this Agreement. CONTRACTOR shall maintain such records for a period of at
least three years after receipt of final payment under this Agreement. If any litigation, claim,
negotiation, audit exception, or other action relating to this Agreement is pending at the end of the
three year period, then CONTRACTOR shall retain said records until such action is resolved.
9.4. Access to and Audit of Records. NMC shall have the right to examine, monitor and audit all records,
documents, conditions, and activities of the CONTRACTOR and its subcontractors related to
services provided under this Agreement. Pursuant to Government Code section 8546.7, if this
Agreement involves the expenditure of public funds in excess or $10,000, the parties to this
Agreement may be subject, at the request of NMC or as part of any audit of NMC, to the
examination and audit of the State Auditor pertaining to matters connected with the performance of
this Agreement for a period of three years after final payment under the Agreement.
9.5. Royalties and Inventions NMC shall have a royalty-free, exclusive and irrevocable license to
reproduce, publish, and use, and authorize other to do so, all original computer programs, writings,
sound recordings, pictorial reproductions, drawings, and other works of similar nature produced in the
course of or under this Agreement. CONTRACTOR shall not publish any such material without the
prior written approval of NMC.
10. NON-DISCRIMINATION. During the performance of this Agreement, Contractor, and its
subcontractors, shall not unlawfully discriminate against any person because of race, religious creed,
color, sex, national origin, ancestry, physical disability, mental disability, medical condition, marital
status, age over 40), or sexual orientation, either in Contractor's employment practices or in the
furnishing of services to recipients. CONTRACTOR shall ensure that the evaluation and treatment of its
employees and applicants for employment and all persons receiving and requesting services are free of
such discrimination. CONTRACTOR and any subcontractor shall, in the performance of this Agreement,
full comply with all federal, sate, and local laws and regulations which prohibit discrimination. The
provision of services primarily or exclusively to such target population as may be designated in this
Agreement shall not be deemed to be prohibited discrimination.
1l-CO fP IY4NGF WI-ITH-T.-1?RMS-0F-S-T-AT-F-4R-FEDEI' l RANlT If-th4s-Agr�ement-has-beenar
will be funded with monies received by NMC pursuant to a contract with the state or federal government
in which NMC is the grantee, CONTRACTOR will comply with all the provisions of said contract, and
said provisions shall be deemed a part of this Agreement, as though fully set forth herein. Upon request,
NMC will deliver a copy of said contract to Contractor, at no cost to Contractor.
12. INDEPENDENT CONTRACTOR. In the performance of work, duties, and obligations under this
Agreement, CONTRACTOR is at all times acting and performing as an independent CONTRACTOR and
not as an employee of NMC. No offer or obligation of permanent employment with NMC or particular
County department or agency is intended in any manner, and CONTRACTOR shall not become entitled
Revised 12/112008 NMC PSA Norm $100,000 or Less 5
BIB]
40740-U01
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{-:�by virtue of this Agreement to receive from NMC any form of employee benefits including but not limited
to sick leave, vacation, retirement benefits, workers' compensation coverage, insurance or disability
benefits. CONTRACTOR shall be solely liable for an obligated to pay directly all applicable taxes,
including federal and state income taxes and social security, arising out of Contractor's performance of
this Agreement. In connection therewith, CONTRACTOR shall defend, indemnify, and hold NMC and
the County of Monterey harmless from any and all liability, which NMC may incur because of
Contractor's failure to pay such taxes.
13. NOTICES. Notices required under this Agreement shall be delivered personally or by first-class, postage
per-paid mail to NMC and Contractor's contract administrators at the addresses listed below.
FOR NATIVIDAD MEDICAL CENTER:
Contracts/Purchasing Manager
Name
1441 Constitution Blvd. Salinas, CA. 93906
Address
FOR CONTRACTOR:
1--, j kl~6ty?oo LaM4
831.755.4111
Phone
14. MISCELLANEOUS PROVISIONS.
Phone
14.1. Conflict of Interest. CONTRACTOR represents that it presently has no interest and agrees not to
acquire any interest during the term of this Agreement, which would directly, or indirectly conflict
in any manner or to any degree with the full and complete performance of the professional services
required to be rendered under this Agreement.
14.2. Amendment. This Agreement may be amended or modified only by an instrument in writing signed
by NMC and the Contractor.
14.3. Waiver. Any waiver of any terms and conditions of this Agreement must be in writing and signed by
NMC and the Contractor. A waiver of any of the terms and conditions of this Agreement shall not be
construed as a waiver of any other terms or conditions in this Agreement.
14.4. Contractor. The term Contractor" as used in this Agreement includes Contractor's officers, agents,
and employees acting on Contractor's behalf in the performance of this Agreement.
14.5. Disputes, CONTRACTOR shall continue to perform under this Agreement during any dispute.
14.6. Assignment and Subcontracting. The CONTRACTOR shall not assign, sell, or otherwise transfer its
interest or obligations in this Agreement without the prior written consent of NMC. None of the
services covered by this Agreement shall be subcontracted without the prior written approval of
Revised 12/1!2008 NMC PSA Form $100,000 or Less 6
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40740-U01
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{.:�NMC. Notwithstanding any such subcontract, CONTRACTOR shall continue to be liable for the
performance of all requirements of this Agreement.
14.7. Successors and Assigns. This Agreement and the rights, privileges, duties, and obligations of NMC
and CONTRACTOR under this Agreement, to the extent assignable or delegable, shall be binding
upon and inure to the benefit of the parties and their respective successors, permitted assigns, and
heirs.
14.8. Compliance with Applicable Law The parties shall comply with all applicable federal, state, and
local laws and regulations in performing this Agreement.
14.9. Headings. The headings are for convenience only and shall not be used to interpret the terms of this
Agreement.
14.10. Time is of the Essence. Time is of the essence in each and all of the provisions of this Agreement
14.11. Governing Law. This Agreement shall be governed by and interpreted under the laws of the State
of California.
14.12. Non-exclusive Agreement. This Agreement is non-exclusive and both NMC and CONTRACTOR
expressly reserve the right to contract with other entities for the same or similar services.
14.13. Construction ofAgreement. NMC and CONTRACTOR agree that each party has fully participated
in the review and revision of this Agreement and that any rule of construction to the effect that
ambiguities are to be resolved against the drafting party shall not apply in the interpretation of this
Agreement or any amendment to this Agreement.
14.14. Counterparts This Agreement may be executed in two or more counterparts, each of which shall
be deemed an original, but all of which together shall constitute one and the same Agreement.
14.15. Integration. This Agreement, including the exhibits, represents the entire Agreement between
NMC and the CONTRACTOR with respect to the subject matter of this Agreement and shall
supersede all prior negotiations. Representations, or agreements, either written or oral, between
NMC and CONTRACTOR as of the effective date of this Agreement, which is the date that NMC
signs the Agreement.
14.16. Interpretation of Conflicting Provisions In the event of any conflict or inconsistency between the
provisions of this Agreement and the Provisions of any exhibit or other attachment to this
Agreement, the provisions of this Agreement shall prevail and control.
Revised 12/1/2008 NMC PSA Form $100,000 or Less 7
BIB]
40740-U01
SIGNED-U02
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REPORT-U02
SUPPORTING-U02
DOCS-U02
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7/15/2011-U04
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SIGNED BOARD REPORT AND SUPPO
{/:�NATIVIDAD MEDICAL CENTER
By:
NMC Contracts/Purchasing Agent
Date: //' 3' e
By:
Department Head if applicable)
Date: t 1610
Approved as to Legal Form
By:
Stacy Saetta
Deputy County Counsel
Date: 4 /(
Approved as to Fflcal+Provipiojqs
By:
Auditor/.ontrol l Ir
C, r
Date: 1 1~-,`~
CONTRACTOR
Contractor's Business Name***
nature of Chair, President, or Vice-President
f i cL r I d 4 Lm OL o a de*
Name and Title
Date: /r7
st, Treasurer)
Date:
***INSTRUCTIONS: If CONTRACTOR is a corporation,
including limited liability and non-profit corporations,
the full legal name of the corporation shall be set forth
above together with the signatures of two specified
officers. If CONTRACTOR is a partnership, the name of
the partnership shall he set forth above together with the
signature e� apartner-who-hes authoyty-to execute-this
Agreement on behalf of the partnership. If
CONTRACTOR is contracting In and individual
capacity, the individual shall set forth the name of the
business, if any and shall personally sign the Agreement,
Sinature of gecybtat Asst. Secretary, CFO, Treasurer
Revised NMC PSA Pain $100,000 or Less $
12-1-08
BIB]
40740-U01
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AT-U012
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SIGNED BOARD REPORT AND SUPPO
{0:�Sllffl,4
Beacon Partners
Engagement Proposal
I. SCOPE of WORK
The scope of this engagement is for Beacon Partners Beacon) to provide management
consulting services to Natividad Medical Center Natividad) in the form of MEDITECH
Client Server C/S) 5.6 Billing and Accounts Receivable B/AR) module subject matter
expertise.
11. SCOPE
Beacon understands that Natividad is in the process of implementing the MEDITECH
CIS 5.6 B/AR module and the implementation Is proceeding as planned. Natividad would
like Beacon to provide a pool of consulting hours that can be drawn upon as needed to
support the analysts and implementation specialists working to Implement the B/AR
module.
111. APPROACH
Beacon will provide a consultant familiar and experienced with MEDITECH C/S 5.6 B/AR
module to provide the following services.
Participate in the implementation project team work groups to discuss MEDITECH
experiences of best practice approaches to the implementation.
Participate in operational workflow redesign.
Work with Natividad to define optimal workflow measures and opportunities for
process improvements for utilization of the new MEDITECH functionality.
Work with department managers to discuss how the MEDITECH system will affect or
change their patient services or workflows.
Provide auidance with the Fd siga-wills P 1e1anmen of dictionar_iRS
Provide guidance in developing and executing integration test plans,
Provide guidance in developing and executing end-user training plans,
Assist with the overall training needs of management and staff affected by the
implementation project; this task will include identifying training requirements, both in
technology transition for those utilizing the new system and changes to workflows for
those currently accustomed to other system or manual procedures.
Proposal ID#: NAT01291012603 1 Natividad initials
Confidential
BIB]
40740-U01
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MEDITECH-U012
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SUPPORT-U012
SERVICES-U012
AT-U012
NMC-U012
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EXCEED-U012
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IN-U012
THE-U012
AGGREGATE-U012
$170,000-U012
THE-U012
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1,-U012
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SIGNED BOARD REPORT AND SUPPO
{1:� Provide guidance in developing end-user menus.
Provide Go-Live support.
Provide post-Live support.
IV. PERSONNEL, PROJECT DURATION and FEES
All personnel assigned to the engagement shall be fully qualified to perform the tasks
assigned to them and shall perform the services In a competent and professional
manner.
We anticipate that the project will take 200 hours over a period of four months, and
Beacon will assign consultants with MEDITECH C/S 5.6 B/AR experience. Due to the
exigencies of Natividad's situation and the part-time nature of this engagement, Beacon
may assign different consultants during different phases of the project. The consulting
fees for this project, which shall remain valid for 45 days from the date of this
Engagement Proposal, are:
PROFESSIONAL STAFF
MEDITECH C/S B/AR
Subject Matter Experts
Total
HOURLY ESTIMATED ESTIMATED FEES*
RATE HOURS
$180
200
$36,000
200
$36,000
Fees represented above are inclusive of travel and administrative expenses in
accordance with all applicable Monterey County policies, including without limitation the
Monterey County travel policy and are valid for 45 days from the date of this letter. Thank
you for your continued use of our services.
Itl C71F
Proposal ID#: NAT012910/2603 2 Natlvidad Initials
Confidential
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FO99828-U03
MG99940-U03
AS99966-U03
AS99967-U03
AI103204-U03
DO104218-U03
C10-U03
BOARD-U03
REPORTS-U03
7/15/2011-U04
MARCELLAC-U04
16738-U05
8-U06
AUTHORIZE-U07
THE-U07
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MANAGER-U07
NATIVIDAD-U07
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RUIZ-IGNACIOM-U10
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AGREEMENT-U012
A-11879)-U012
BEACON-U012
PARTNERS-U012
MEDITECH-U012
BILLING-U012
ACCOUNTS-U012
RECEIVABLE-U012
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AT-U012
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AMOUNT-U012
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$170,000-U012
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1,-U012
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SIGNED BOARD REPORT AND SUPPO
{2:�BUSINESS ASSOCIATE AGREEMENT
This Agreement, hereinafter,referred to as Agreement", is made effective October 15, 2009 by and
between the County of Monterey,' a political subdivision of the State of California, on behalf pf Natividad
Medical Center, hereinafter referred to as Covered Entity", and Beacon Partners Inc. hereinafter referred to
as Business Associate", individually, a Party" and collectively, the Parties"),
WITNE SSE, TH:
WIXEBBAS, Sections 261 through 264 of the federal Health Insurance Portability and Accountability
Act of 1996, Public Law 104-191, known as the Administrative Simplification provisions," direotthe
Department of Health and Human Services to develop standards to protect the security, confidentiality and
integrity of health information; and
WW EAS, pursuant to the Administrative Simplification provisions, the Secretary of Health,and.
Human Services has issued regulations-modifying 45 CPR Parts 160 and 164 the HlPAA'PrivacyRule" and,
WHERE AS, the State of California has enacted statutes designed to safeguard patient privacy including,
without limitation, the Confidentiality of Medical Information Act CMIA"), California Civil Code 56 et seq,,-
Senate Bill 541, enacted September 30, 2008, and Assembly Bill 211, enacted September S 0, 200$; and
PJUS, the parties aaknowlerlge that California law may include provisions more. stringent-and
more protective of the confidentiality of health information than the provisions of.HIPAA; and
WHEREAS, the Parties wish to enter into or have entered into an arrangement whereby Business
Associate will provide certain services to Covered Entity, hereby referred to as the Service Agreement" and,
pursuant to such arrangement, Business Associate may be considered a business associate" of Covered Entity as
defined in the HIPAA Privacy Rule and under California law; and
WHEREAS, Business Associate may have access to Protected Health Information as defined below) in
fulfilling its responsibilities under such arrangement;
THEREFORE, in consideration of the Parties' continuing obligations under the Secvlce-Agreement,
compliance with the IIPAA Privacy Rule; compliance with California law, and other good and valuable--
consideration, the receipt and sufficiency of which is hereby acknowledged, the Parties agree to the provisions Qf
this Agreement in order to address the requirements of the HIPAA Privacy Rule and California law and to protect
the interests of both Parties,
1. DEk'INITXONS
Except as otherwise defined herein, any and all capitalized terms in this Section shall have the definitions. set forth
in the HIPAA Privacy Rule, In the event of an inconsistency between the provisions of this Agreement and
mandatory provisions of the HTAA Privacy Rule, as amended, the HTAA Privacy Rule shall control. In-the
event of an inconsistency between the provisions of this Agreement and mandatory provisions of CM IA or other',
California law, California law shall control. Where provisions of this Agreement are different than those
mandated in the HTAA Privacy Rule and California law, but nonetheless are permitted by thQ HIPAA, Priuagy;
Rule and California lam, the provisions of this Agreement shall control.
The term Protected Health Information" means individually identifiable health information including, without�
limitation, all information, data, documentation, and materials, including without.limitation, demographic,
Revised 12.26.08
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AS99966-U03
AS99967-U03
AI103204-U03
DO104218-U03
C10-U03
BOARD-U03
REPORTS-U03
7/15/2011-U04
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8-U06
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MANAGER-U07
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960-NMC-U08
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AGREEMENT-U012
A-11879)-U012
BEACON-U012
PARTNERS-U012
MEDITECH-U012
BILLING-U012
ACCOUNTS-U012
RECEIVABLE-U012
B/AR)-U012
MODULE-U012
SUPPORT-U012
SERVICES-U012
AT-U012
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AN-U012
AMOUNT-U012
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SIGNED BOARD REPORT AND SUPPO
{3:�medical and financial information, that relates to the past, present, or future physical or mental health or condition
of an individual; the provision of health care to an individual; or the past, present,. or future. payment for the.
provision of health care to an individual; and that identifies the individual or with rgspeot to.wh.Xgh theiq is a
reasonable basis to believe the information can be used to identify the Individual.,...
Business Associate acknoWledges and agrees that all Protected Health Information.that is created or received by
Covered Entity and disclosed or made available in any form, inoludingpaper record, oral. communicatign;. audio,
recording, and electronic display by Covered Entity or its operating units to Business Asspciate pr is created r;,
received by Business Associate on Covered Entity's behalf shall be subject to this. Agreement
11 CO1 PTDENTIALITY I,4UXR1C11dENTS
a) Business Assoailite agrees:
i) to access, use, or disclose any Protected Health Information solely: 1) for;meeting its;
obligations as set forth in any agreements between the Parties evidencing their business relationship or 2)
as required by applicable law, rule or regulation, or by accrediting or credentialing organization to whom
Covered Entity is required to disclose such information or as otherwise permittdd under this�AgreemOnt,
the Service Agreement if consistent with this Agreement the HIPAA Privacy Rule, and California�law),
the HIPAq PrivaoyRule, or California law and 3) as v~oulo`. be permitted by the HIPAA Privacy Rule
and California lavr if such use or disclosure were made by *Covered Entity;
ii) it'termination of this Agreement, the Service Agreement or any similar documentation
of the business relationship of the Parties), or upon request of Covered Entity, whichever occurs first,, if;
feasible, Business Associate will return or destroy all Protected Health Information x accrued fr6ni or
created or received by Business Associate on behalf of Covered Entity that Business Associate still
maintains in any form and retain no copies of such information,, or if such return or destruction is not
feasible, Business Associate will extend the protections of this Agreement to the information and limit
further access, uses, and disclosures to those purposes that make the return or destruction of the
information not feasible; and
iii) to ensure that its agents, including a subcontractor, to whom it provides Protected. Health,
Information received #tom or created by Business Associate on behalf of Covered Entity, agrees to the,
same restrictions and conditions that apply to Business Associate with respect to such information, In
addition, Business Associate agrees to take reasonable steps to ensure that its employees' actions or
omissions do not cause Business Associate to'breach the terms of this Agreement.
b) Notwithstanding the prohibition's Set forth in this Agreement, Business Associate may use. and
disclose Protected Health Information as follows:
i) if necessary, for the proper*inanagemeht and administration of Business Associate or tq
carry out the legal responsibilities of Business Associate, provided that as to any such disolosure,�tho
following requirements are met:
A) the disclosure is required by law;' or
Bj--mousiness-Associate obtain 1easonrrble assurances-from ti e-persoirto
information is disclosed that it will be held confidentially and accessed, used, or further disclosed.
only as required by law or for the purpose for which it was disclosed to the person, and the person
notifies Business Associate of any lnstanaea'of which it is aware in which the confidentiality of
the in.forlnatlon hss been breached, withih five calendar days of'discovering said breach of
confidentiality
UV for data aggregation srvices, if to be provided by Business Associate tor the health care
operations of Covered Entity pursuant to any agreements between the Parties evidenoi�.g.their business
relationship, For purposes of this Agreement, data a~Sregation services means the. co;nbinizrg of. Protected Healtli'Informataon by Business Associate with'the protected health information received by
Revised 12-26-08
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FO99828-U03
MG99940-U03
AS99966-U03
AS99967-U03
AI103204-U03
DO104218-U03
C10-U03
BOARD-U03
REPORTS-U03
7/15/2011-U04
MARCELLAC-U04
16738-U05
8-U06
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MANAGER-U07
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960-NMC-U08
RUIZ-IGNACIO-U09
MAEGAN-U09
RUIZ-IGNACIOM-U10
6/17/2011-U011
AGREEMENT-U012
A-11879)-U012
BEACON-U012
PARTNERS-U012
MEDITECH-U012
BILLING-U012
ACCOUNTS-U012
RECEIVABLE-U012
B/AR)-U012
MODULE-U012
SUPPORT-U012
SERVICES-U012
AT-U012
NMC-U012
IN-U012
AN-U012
AMOUNT-U012
TO-U012
EXCEED-U012
$513,080-U012
IN-U012
THE-U012
AGGREGATE-U012
$170,000-U012
THE-U012
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1,-U012
2011-U012
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SIGNED BOARD REPORT AND SUPPO
{4:�Busyness Associate in its capacity as a business associate of another covered entity, to permit data.
analyses that. relate to the healthcare operations gf.the. respective covered entities.
c) Business Associate will implement appropriate safeguards to prevent access to, use of,.or
disclosure of Protected Health Information other than as permitted in this Agreement, The Secretary of
Health and,Human Services shall have the right to audik Business Assoolate's records and practices
rolated.to Use and disolosure of Protected Health; Information to ensure Covered Entity's oompiiange with
the terms. of the AA PpiyaoyRule. Business Associate shall. report'to Covered Entity any cocas, use,.,
or disclosure ofProteoted lIealth Information which is not in compliance with the terms of;this
Agreement of which it becomes aware within five calendar days of discovering such.irnproper access,.
use, or disclosure. In addition, Business Associate agrees to mitigate, to the extent'praoticeble, any
harmful effect that isknowti'to Business Associate of a use, disclosure, or access of Protected Health
Information by Business Associate in violation of the requirements of this Agreement,,
W. AVAILABILITY Oi PHI'
Business Associate agrees to make available Protected Health Information to the extent and in the.manner
required by Section 164.$24 of the I11PAA Privacy Rule. $usiness Associate agrees to snake Protected Health
Information available for amelidment and incorporate any amendments to Protected Health Information-in
accordance with the requirements of Section 164,526 of the WPAA Privacy Rule. in addition, $usiness
Associate agtees.to make Protected Health Xrrf'ortpationauailable for.purposea�of accounting.pfdisclosiues;; as.
required by Section 164.528 of the.H1I'AA Privacy Rule-;
W. TERMINATION
Notwithstanding anything in this Agreement to the contrary, Covered Entity shall have the right to terminate this
Agreement and the Service Agreement immediately if Covered Entity determines that Business Associate has
violated any material term of this Agreement. If Covered Entity reasonably believes that Business Associate will
violate a material tartan of this Agreement and, where practicable, Covered Entity gives written notice to Business
Associate of such belief within areasonable time after forming such.belief, and Business Associate-fails-to...
provide adequate written assurances to Covered Entity that it will not breach the cited term of this'Agreement
within a reasonable period of time given.the specifrc circumstanoea, blrt in airy event,. before the threatened breach
is to occur, then Covered Entity shall have the right to terminate this Agreement end. the Service Agreement.
immediately, and seek injunctive and/or declaratory relief in a court of law having jrlsdiotion aver Business
Associate.
V. NIISCELLA.NEOUS
Except as expressly stated herein, in:�the HIPAA Privacy Rule, or under California law, the parties to this
Agreement-do-notirrtt�nd-to-sr-oa3~ights-~am~d-par-ties~he-ob]igations.of.Husiness~9.ssaaiata_unrle~this
Section shall survive the expiration, teii7nination, or cancellation of this Agreement, the Service Agreement.and/or
the business relationship of the parties, and shall continue to bind J3usiness Associate,.ite agents, employees,
contractors, successors, and asaigns-as set forth herein.
This Agreement may be amended ormodified only in a writing signed by the Parties, No Party may assign its
respective rights andobligations�under this Agreement without the prior written consent of the pthgr. Party'. Norio,
of the provisions�of this Agreemant are intended to create, not willthey be� deemed�io create any relationship
between the Parties.othe'r�than than of independent parties; contracting with.eaph other; solely for��tJre purposes of
effecting the pro'vision's of this A ment and arty other egreemants between the;Parties. evideiroing their business
relationship; This Agreement will, be governed by the laws of the State of California No;change; waiver or.
Revised 12-2608
BIB]
40740-U01
SIGNED-U02
BOARD-U02
REPORT-U02
SUPPORTING-U02
DOCS-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99940-U03
AS99966-U03
AS99967-U03
AI103204-U03
DO104218-U03
C10-U03
BOARD-U03
REPORTS-U03
7/15/2011-U04
MARCELLAC-U04
16738-U05
8-U06
AUTHORIZE-U07
THE-U07
PURCHASING-U07
MANAGER-U07
NATIVIDAD-U07
MEDICAL-U07
CENTER-U07
NMC)-U07
TO-U07
EXECUTE-U07
AMENDMENT-U07
NO.-U07
4-U07
TO-U07
THE-U07
960-NMC-U08
RUIZ-IGNACIO-U09
MAEGAN-U09
RUIZ-IGNACIOM-U10
6/17/2011-U011
AGREEMENT-U012
A-11879)-U012
BEACON-U012
PARTNERS-U012
MEDITECH-U012
BILLING-U012
ACCOUNTS-U012
RECEIVABLE-U012
B/AR)-U012
MODULE-U012
SUPPORT-U012
SERVICES-U012
AT-U012
NMC-U012
IN-U012
AN-U012
AMOUNT-U012
TO-U012
EXCEED-U012
$513,080-U012
IN-U012
THE-U012
AGGREGATE-U012
$170,000-U012
THE-U012
PERIOD-U012
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2012.-U012
SIGNED BOARD REPORT AND SUPPO
{5:�discharge of any liability or obligation�hereunder on anyone or more occasions shall. bp deemed a waiver of
performance of any eontinti ng�or other obligation; or shall prohibit enforcement of any obligation, on My other;
the Service Agreement, ttnl'ess the'parties mu6ally agree in writh*.to modify this'Agreoment or inviiediateiy,
replace it with�a new Business Associate A g r e e m e n t t h a t f u l l cp#~plies w i t h the WAA Privacy Rule an t:.,
amend the terms of this Agreement, if necessary to bring it into compliance. 1'f, at the conclusion of such thirty.
day period; a party believes in good- faith that the Agreement still falls to comply with-the HIPAA Privacy Rule or...,
California-law; then either party has the, right to terminate this Agreement and the Seryloo.Agreement upon
written notice to the other party. Neither'paety may terminate this. Agreement without simultaneously terminating
current requirements of the HIPAA Privacy Rule or California law, such party shall notify tho:otber, party, an
writing. For a period of up to� thirty days, the parties shall attempt in good faith to address'auch concern, aid
in the event a party believes"ip�good. faith thatanyprovision of this Agreement fails to comply with,the then-.,4
unenforceable, theremainde r,oftheprovisions of this Agreement will remain in full fproe and,effect, Xn.addition,
restrictive documentation- will eontroi; Theliravisions'ofthis Agreement are intended.to�establash�the.migin)l}nl.....
requirements regarding Busiriess�Asaociatb's'use and disclosure of Protected Health Iztfgrmation,
in the event that any provision of this Agre9rnent is held by a court-of competent jurisdiotiQm to be invalid or
information which are more restrictive than.the provisions ofthis'Agreement, the provisions of the more
occasion.
The parties agree that,'in the event that any d'ooumentation of the parties, pursuant t4 which Business Associate
provides services to Covered Bntity contains provisions relatingtb the use or disclosure, of Protected. Health,.;
Cabior ma law.
Business Associate acknowledges that Natividad Medical Center NMC) has established a Corporate Compliance
Program, and under this program NMC has developed a Code of Conduct Manual to provide guidance in the
ethical and legal performance of our professional services, Business Associate further agrees to abide by all
principles stated in the Code of Conduct while conducting business with Natividad Medical. Center. A copy of the
Code of Conduct & Prinoiples'of Compliance is availab'Ie upon request.
xN WITNESS WHEREOF., the arties have. executed this Agreement as of the day and year written;
above.
By: By4
Title: e-ir''o Title.
Date: t, 61 a~
Date:-
BUSl1H SASSQCIA t: r
A 1
L /
/47
Vc
Revised 12��26-08
BIB]
40740-U01
SIGNED-U02
BOARD-U02
REPORT-U02
SUPPORTING-U02
DOCS-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99940-U03
AS99966-U03
AS99967-U03
AI103204-U03
DO104218-U03
C10-U03
BOARD-U03
REPORTS-U03
7/15/2011-U04
MARCELLAC-U04
16738-U05
8-U06
AUTHORIZE-U07
THE-U07
PURCHASING-U07
MANAGER-U07
NATIVIDAD-U07
MEDICAL-U07
CENTER-U07
NMC)-U07
TO-U07
EXECUTE-U07
AMENDMENT-U07
NO.-U07
4-U07
TO-U07
THE-U07
960-NMC-U08
RUIZ-IGNACIO-U09
MAEGAN-U09
RUIZ-IGNACIOM-U10
6/17/2011-U011
AGREEMENT-U012
A-11879)-U012
BEACON-U012
PARTNERS-U012
MEDITECH-U012
BILLING-U012
ACCOUNTS-U012
RECEIVABLE-U012
B/AR)-U012
MODULE-U012
SUPPORT-U012
SERVICES-U012
AT-U012
NMC-U012
IN-U012
AN-U012
AMOUNT-U012
TO-U012
EXCEED-U012
$513,080-U012
IN-U012
THE-U012
AGGREGATE-U012
$170,000-U012
THE-U012
PERIOD-U012
JULY-U012
1,-U012
2011-U012
TO-U012
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SIGNED BOARD REPORT AND SUPPO
{6:�ACORV
CERTIFICATE OF LIABILITY INSURANCE DATE MM/DD/YYYY
10/13/2010
THIS CERTIFICATE IS 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 POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS 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 CONTACT
E: Suzette! Kovacs
Charles River Ins. Brokerage, Inc. FAX
AIC L., e4
PHONE 508) 656-1400 A/C No: 508)656-1499
5 Whittier Street ADDARESS:skoyacs@crinsurance.biz
4th Floor PRODUCER] 00011769
Framingham MA 01701 INSURER(S) AFFORDING COVERAGE NAIC #
INSURED INSURERA:The Phoenix Insurance Co
INSURERB:TraVelers Indemnity 25658
Beacon Partners, Inc. INSURER C:Travelers Casualty and Surety
97 Libbey Parkway, Suite 310 INSURERD:Travelers Casualty & Surety Co.
INSURER E;Travelers Property Casualty Co
Weymouth MA 02189 INSURER F:
COVERAGES
CERTIFICATE NUMBER:10-11GL/CA/WC/tJb /E&O
REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT 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.
SR
LTR TYPE OF INSURANCE DDL BR
POLICY NUMBER POLICY EFF
MMIDDfYYYY) POLICY EXP
MM/DD LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED
PREMISES Ea occurrence) 300,000
$
A CLAIMS-MADE OCCUR 630178M2962 10/13/2010 10/13/2011 MEDEXP(Anyoneperson) $ 10,000
PERSONAL & ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS COMP/OP AGG $ 2,000,000
X POLICY PRO LOC
JECT $
AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT
$ 1,000,000
Ea accident)
ANY AUTO
164M7057
10/13/2010
10/13/2011
BODILY INJURY Per person)
$
B ALL OWNED AUTOS BODILY INJURY Per accident) $
SCHEDULED AUTOS
PROPERTY DAMAGE
X
HIRED AUTOS
Per accident) $
X NON-OWNED AUTOS $
X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 3,000,000
EXCESS LIAB CLAIMS-MADE AGGREGATE $ 3,000,000
DEDUCTIBLE $
C X RETENTION $ 10,000 PUC178M2962 10/13/2010 10/13/201 $
D WORKERS COMPENSATION
EMPLOYERS' LIABILITY X WC STATU- OTH-
CRY
ITS R_
Y/ N
ANY PROPRIETOR/PARTNER/EXECUTIVE
N/A E.L. EACH ACCIDENT $ 1,000,000
OFFICER/MEMBER EXCLUDED?
Mandatory In NH) 7658M0010 10/13/2010 10/13/2011 E.L. DISEASE EA EMPLOYE S 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE POLICY LIMIT $ 1 000 000
E Errors & Omissions E06904518 10/13/2010 10/13/2011 EachClaim $3,000,000
Aggregate $3,000,000
DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES Attach ACORD 101, Additional Remarks Schedule, if more space is required)
The County of Monterey it's officers, agents, and employees are additional insureds as respects the Commercial General
Liability and Non-Owned and Hired Auto. It is understood this insurance is primary and any other insurance
maintained by the additional insured shall be excess only, and not contributing with this insurance. 30 days
cancellation, except 10 days for non payment
CERTIFICATE HOLDER CANCELLATION
County of Monterey
Its Officers Agents and Employees
Sid Cato
1441 Constitution Blvd
Salinas, CA 93906
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
Ellen Bohn Gitlitz/AG
ACORD 25 2009/09) 1988-2009 ACORD CORPORATION. All rights reserved.
9 ACORD
T e ACORD name and o re re Istered marks of 00ACORD
with pdfFactory trig version www.c~cory.~om
BIB]
40740-U01
SIGNED-U02
BOARD-U02
REPORT-U02
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DOCS-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99940-U03
AS99966-U03
AS99967-U03
AI103204-U03
DO104218-U03
C10-U03
BOARD-U03
REPORTS-U03
7/15/2011-U04
MARCELLAC-U04
16738-U05
8-U06
AUTHORIZE-U07
THE-U07
PURCHASING-U07
MANAGER-U07
NATIVIDAD-U07
MEDICAL-U07
CENTER-U07
NMC)-U07
TO-U07
EXECUTE-U07
AMENDMENT-U07
NO.-U07
4-U07
TO-U07
THE-U07
960-NMC-U08
RUIZ-IGNACIO-U09
MAEGAN-U09
RUIZ-IGNACIOM-U10
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AGREEMENT-U012
A-11879)-U012
BEACON-U012
PARTNERS-U012
MEDITECH-U012
BILLING-U012
ACCOUNTS-U012
RECEIVABLE-U012
B/AR)-U012
MODULE-U012
SUPPORT-U012
SERVICES-U012
AT-U012
NMC-U012
IN-U012
AN-U012
AMOUNT-U012
TO-U012
EXCEED-U012
$513,080-U012
IN-U012
THE-U012
AGGREGATE-U012
$170,000-U012
THE-U012
PERIOD-U012
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2012.-U012
SIGNED BOARD REPORT AND SUPPO
{7:�POLICY NUMBER: H-630-178M2962-PHX-10
COMMERCIAL GENERAL LIABILITY
ISSUE DATE: 11-05-10
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED
CONTRACTORS)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
NAME OF PERSON(S) OR ORGANIZATION(S):
COUNTY OF MONTEREY, ITS OFFICERS,
AGENTS AND EMPLOYEES IT IS
UNDERSTOOD THAT THIS INS IS PRIMARY,
AND ANY OTHER INS MAINTAINED BY THE
ADDL INSRD SHALL BE EXCESS ONLY, &
NOT CONTRIBUTING WITH THIS INSURANCE
1441 CONSTITUTION BLVD., SALINAS, CA 90906
PROJECT/LOCATION OF COVERED OPERATIONS:
CALIFORNIA
1. WHO IS AN INSURED Section II) is amended
to include the person or organization shown in the
Schedule above, but:
a) Only with respect to liability for bodily injury",
property damage" or personal injury"; and
b) If, and only to the extent that, the injury or
damage is caused by acts or omissions of
you or your subcontractor in the performance
of your work" on or for the project, or at the
location, shown in the Schedule. The person
or organization does not qualify as an addi-
tional insured with respect to the independent
acts or omissions of such person or organiza-
tion.
2. The insurance provided to the additional insured
by this endorsement is limited as follows:
a) In the event that the Limits of Insurance of
this Coverage Part shown in the Declarations
exceed the limits of liability required by a
written contract requiring insurance" for that
additional insured, the insurance provided to
the additional insured shall be limited to the
limits of liability required by that written con-
tract requiring insurance". This endorsement
shall not increase the limits of insurance de-
scribed in Section III Limits Of Insurance.
b) The insurance provided to the additional in-
sured does not apply to bodily injury", prop-
erty damage" or personal injury" arising out
of the rendering of, or failure to render, any
professional architectural, engineering or sur-
veying services, including.
i. The preparing, approving, or failing to
prepare or approve, maps, shop draw-
ings, opinions, reports, surveys, field or-
ders or change orders, or the preparing,
approving, or failing to prepare or ap-
prove, drawings and specifications; and
ii. Supervisory, inspection, architectural or
engineering activities.
c) The insurance provided to the additional in-
sured does not apply to bodily injury" or
property damage" caused by your work"
and included in the products-completed op-
erations hazard" unless a written contract
requiring insurance" specifically requires you
to provide such coverage for that additional
insured, and then the insurance provided to
the additional insured applies only to such
bodily injury" or property damage" that oc-
curs before the end of the period of time for
which the written contract requiring insur-
ance" requires you to provide such coverage
CG D2 47 08 05 2005 The St. Paul Travelers Companies, Inc. Page 1 of 2
PDF created with pdfFactory trial version www.pdffactory.com
BIB]
40740-U01
SIGNED-U02
BOARD-U02
REPORT-U02
SUPPORTING-U02
DOCS-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99940-U03
AS99966-U03
AS99967-U03
AI103204-U03
DO104218-U03
C10-U03
BOARD-U03
REPORTS-U03
7/15/2011-U04
MARCELLAC-U04
16738-U05
8-U06
AUTHORIZE-U07
THE-U07
PURCHASING-U07
MANAGER-U07
NATIVIDAD-U07
MEDICAL-U07
CENTER-U07
NMC)-U07
TO-U07
EXECUTE-U07
AMENDMENT-U07
NO.-U07
4-U07
TO-U07
THE-U07
960-NMC-U08
RUIZ-IGNACIO-U09
MAEGAN-U09
RUIZ-IGNACIOM-U10
6/17/2011-U011
AGREEMENT-U012
A-11879)-U012
BEACON-U012
PARTNERS-U012
MEDITECH-U012
BILLING-U012
ACCOUNTS-U012
RECEIVABLE-U012
B/AR)-U012
MODULE-U012
SUPPORT-U012
SERVICES-U012
AT-U012
NMC-U012
IN-U012
AN-U012
AMOUNT-U012
TO-U012
EXCEED-U012
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IN-U012
THE-U012
AGGREGATE-U012
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THE-U012
PERIOD-U012
JULY-U012
1,-U012
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TO-U012
JUNE-U012
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SIGNED BOARD REPORT AND SUPPO
{8:�COMMERCIAL GENERAL LIABILITY
or the end of the policy period, whichever is
earlier.
3. The insurance provided to the additional insured
by this endorsement is excess over any valid and
collectible other insurance", whether primary,
excess, contingent or on any other basis, that is
available to the additional insured for a loss we
cover under this endorsement. However, if a
written contract requiring insurance" for that ad-
ditional insured specifically requires that this in-
surance apply on a primary basis or a primary
and non-contributory basis, this insurance is pri-
mary to other insurance" available to the addi-
tional insured which covers that person or organi-
zation as a named insured for such loss, and we
will not share with that other insurance". But the
insurance provided to the additional insured by
this endorsement still is excess over any valid
and collectible other insurance", whether pri-
mary, excess, contingent or on any other basis,
that is available to the additional insured when
that person or organization is an additional in-
sured under such other insurance".
4. As a condition of coverage provided to the
additional insured by this endorsement:
a) The additional insured must give us written
notice as soon as practicable of an occur-
rence" or an offense which may result in a
claim. To the extent possible, such notice
should include:
i. How, when and where the occurrence"
or offense took place;
ii. The names and addresses of any injured
persons and witnesses; and
iii. The nature and location of any injury or
damage arising out of the occurrence" or
offense.
b) If a claim is made or suit" is brought against
the additional insured, the additional insured
must:
i. Immediately record the specifics of the
claim or suit" and the date received; and
ii. Notify us as soon as practicable.
The additional insured must see to it that we
receive written notice of the claim or suit" as
soon as practicable.
c) The additional insured must immediately
send us copies of all legal papers received in
connection with the claim or suit", cooperate
with us in the investigation or settlement of
the claim or defense against the suit", and
otherwise comply with all policy conditions.
d) The additional insured must tender the de-
fense and indemnity of any claim or suit" to
any provider of other insurance" which would
cover the additional insured for a loss we
cover under this endorsement. However, this
condition does not affect whether the insur-
ance provided to the additional insured by
this endorsement is primary to other insur-
ance" available to the additional insured
which covers that person or organization as a
named insured as described in paragraph 3.
above.
5. The following definition is added to SECTION V.
DEFINITIONS:
Written contract requiring insurance" means
that part of any written contract or agreement
under which you are required to include a
person or organization as an additional in-
sured on this Coverage Part, provided that
the bodily injury" and property damage" oc-
curs and the personal injury" is caused by an
offense committed:
a. After the signing and execution of the
contract or agreement by you;
b. While that part of the contract or
agreement is in effect; and
c. Before the end of the policy period.
Page 2 of 2 2005 The St. Paul Travelers Companies, Inc. CG D2 47 08 05
PDF created with pdfFactory trial version www.pdffactory.com
BIB]
40740-U01
SIGNED-U02
BOARD-U02
REPORT-U02
SUPPORTING-U02
DOCS-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99940-U03
AS99966-U03
AS99967-U03
AI103204-U03
DO104218-U03
C10-U03
BOARD-U03
REPORTS-U03
7/15/2011-U04
MARCELLAC-U04
16738-U05
8-U06
AUTHORIZE-U07
THE-U07
PURCHASING-U07
MANAGER-U07
NATIVIDAD-U07
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CENTER-U07
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AMENDMENT-U07
NO.-U07
4-U07
TO-U07
THE-U07
960-NMC-U08
RUIZ-IGNACIO-U09
MAEGAN-U09
RUIZ-IGNACIOM-U10
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A-11879)-U012
BEACON-U012
PARTNERS-U012
MEDITECH-U012
BILLING-U012
ACCOUNTS-U012
RECEIVABLE-U012
B/AR)-U012
MODULE-U012
SUPPORT-U012
SERVICES-U012
AT-U012
NMC-U012
IN-U012
AN-U012
AMOUNT-U012
TO-U012
EXCEED-U012
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IN-U012
THE-U012
AGGREGATE-U012
$170,000-U012
THE-U012
PERIOD-U012
JULY-U012
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2011-U012
TO-U012
JUNE-U012
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SIGNED BOARD REPORT AND SUPPO
{9:�YEAR
20�
/
Withholding Exemption Certificate
This form can only be used to certify exemption from nonresident withholding under California
R&TC Section 18662. This form cannot be used for exemption from wage withholding.)
File this form with your withholding agent.
Please type or print)
Vendor/Payee's name
Beacon Partners, Inc.
Vendor/Payee's address number and street)
97 Libbey Parkway
City
Weymouth
State
MA
Withholding agent's name
Vendor/Payee's Social security number
SOS. no. California corp. no. X FEIN
0 4
APT no.
3i
59 9
ZIP Code
02189
5 0
Private Mailbox no.
Vendo
78
I certify that for the reasons checked below, the entity or individual named on this form is exempt from the California income tax
withholding requirement on payment(s) made to the entity or individual. Read the following carefully and check the box that applies
to the vendor/payee:
L Individuals Certification of Residency:
I am a resident of California and I reside at the address shown above. If I become a nonresident at any time, I will promptly
inform the withholding agent, See instructions for Form 590, General Information D, for the definition of a resident.
Vi Corporations:
The above-named corporation has a permanent place of business in California at the address shown above or is qualified
through the California Secretary of State to do business in California. The corporation will withhold on payments of Califor-
nia source income to nonresidents when required. If this corporation ceases to have a permanent place of business in
California or ceases to be qualified to do business in California, I will promptly inform the withholding agent. See instruc-
tions for Form 590, General Information E, for the definition of permanent place of business.
Partnerships:
The above-named partnership has a permanent place of business in California at the address shown above or is registered
with the California Secretary of State, and is subject to the laws of California. The partnership will file a California tax return
and will withhold on foreign and domestic nonresident partners when required. If the partnership ceases to do any of the
above, I will promptly inform the withholding agent. Note: For withholding purposes, a Limited Liability Partnership is treated
like any other partnership.
Cl Limited Liability Companies LLC):
The above-named LLC has a permanent place of business in California at the address shown above or is registered with
the California Secretary of State, and is subject to the laws of California. The LLC will file a California tax return and will
withhold on foreign and domestic nonresident members when required. If the LLC ceases to do any of the above, I will
promptly inform the withholding agent.
LI Tax-Exempt Entities:
The above-named entity is exempt from tax under California or federal law. The tax-exempt entity will withhold on payments
of California source income to nonresidents when required. If this entity ceases to be exempt from tax, I will promptly inform
the withholding agent.
LI Insurance Companies, IRAs, or Qualified Pension/Profit Sharing Plans:
The above-named entity is an insurance company, IRA, or a federally qualified pension or profit-sharing plan.
L California Irrevocable Trusts:
At least one trustee of the above-named irrevocable trust is a California resident. The trust will file a California fiduciary tax
return and will withhold on foreign and domestic nonresident beneficiaries when required. If the trustee becomes a nonresi-
dent at any time, I will promptly inform the withholding agent.
CI Estates Certification of Residency of Deceased Person:
I am the executor of the above-named person's estate. The decedent was a California resident at the time of death. The
estate will file a California fiduciary tax return and will withhold on foreign and domestic nonresident beneficiaries when
required.
CERTIFICATE: Please complete and sign below.
Under penalties of perjury, I hereby certify that the information provided herein is, to the best of my knowledge, true and correct. If
conditions change, I will promptly inform the withholding agent.
Vendor/Payee's name and title type or print) Kimberly Post, Controller
Date 8 a /
Note:
CALIFORNIA FORM
590
Failure to furnish your
identification number will
make this certificate void.
r/Payee's daytime telephone no.
1 982-8400
Form
For Privacy Act Notice, get form FTB 1131 individuals only). 59002103 590 C2 REV. 2002)
BIB]
40740-U01
SIGNED-U02
BOARD-U02
REPORT-U02
SUPPORTING-U02
DOCS-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99940-U03
AS99966-U03
AS99967-U03
AI103204-U03
DO104218-U03
C10-U03
BOARD-U03
REPORTS-U03
7/15/2011-U04
MARCELLAC-U04
16738-U05
8-U06
AUTHORIZE-U07
THE-U07
PURCHASING-U07
MANAGER-U07
NATIVIDAD-U07
MEDICAL-U07
CENTER-U07
NMC)-U07
TO-U07
EXECUTE-U07
AMENDMENT-U07
NO.-U07
4-U07
TO-U07
THE-U07
960-NMC-U08
RUIZ-IGNACIO-U09
MAEGAN-U09
RUIZ-IGNACIOM-U10
6/17/2011-U011
AGREEMENT-U012
A-11879)-U012
BEACON-U012
PARTNERS-U012
MEDITECH-U012
BILLING-U012
ACCOUNTS-U012
RECEIVABLE-U012
B/AR)-U012
MODULE-U012
SUPPORT-U012
SERVICES-U012
AT-U012
NMC-U012
IN-U012
AN-U012
AMOUNT-U012
TO-U012
EXCEED-U012
$513,080-U012
IN-U012
THE-U012
AGGREGATE-U012
$170,000-U012
THE-U012
PERIOD-U012
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2012.-U012
SIGNED BOARD REPORT AND SUPPO
{::�Beacon Partners, Inc.
wwss,6eacunpartners,com
March 21, 2011
Mr. Sid Cato
Management Analyst/Contracts
Natividad Medical Center
1441 Constitution Blvd.
Salinas, CA 93906
Dear Mr. Cato:
Enclosed please find one original signed copy of CA Form 590, 2011 Withholding Exemption
Certificate.
In addition, please find three signed original copies of Natividad Medical Center's Renewal
Amendment No. 4 for Meditech B/AR Module Support Services. Once countersigned, would you
kindly return one executed copy to my attention at the address below:
Patricia Collins
Beacon Partners
97 Libbey Parkway, Suite 310
Weymouth, MA 02189
Thank you.
Sincerely,
Patricia Collins
Executive Assistant
BIB]
40740-U01
SIGNED-U02
BOARD-U02
REPORT-U02
SUPPORTING-U02
DOCS-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99940-U03
AS99966-U03
AS99967-U03
AI103204-U03
DO104218-U03
C10-U03
BOARD-U03
REPORTS-U03
7/15/2011-U04
MARCELLAC-U04
16738-U05
8-U06
AUTHORIZE-U07
THE-U07
PURCHASING-U07
MANAGER-U07
NATIVIDAD-U07
MEDICAL-U07
CENTER-U07
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AMENDMENT-U07
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960-NMC-U08
RUIZ-IGNACIO-U09
MAEGAN-U09
RUIZ-IGNACIOM-U10
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AGREEMENT-U012
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BEACON-U012
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RECEIVABLE-U012
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MODULE-U012
SUPPORT-U012
SERVICES-U012
AT-U012
NMC-U012
IN-U012
AN-U012
AMOUNT-U012
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AGGREGATE-U012
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