County of Monterey  
Board of Supervisors Chambers  
168 W. Alisal St., 1st Floor  
Salinas, CA 93901  
Meeting Agenda  
Wednesday, November 26, 2025  
12:00 PM  
50+ page Advance Reports for the Board of Supervisors meeting on Tuesday,  
December 9, 2025.  
Advance Reports Over 50 Pages  
The following reports are scheduled for the Board of Supervisors meeting on Tuesday, December 9,  
2025. The reports are being distributed 11 + days prior to the Board of Supervisors meeting due to  
the large volume of information. These reports are not numbered at this time.  
Natividad Medical Center - Consent  
a. Authorize the Chief Executive Officer (CEO) for Natividad Medical Center (NMC) or his designee  
to execute the Third Amendment to the Professional Services Agreement (A-14537) with Marta Zulik,  
M.D. Inc. to provide pulmonology critical care services, extending the term by 24 months (January 1,  
2026 to December 31, 2027) for a revised full agreement term of November 1, 2019 to December  
31, 2027, with no change to the total contract amount of $400,000; and  
b. Authorize the CEO for NMC or his designee to sign up to three (3) future amendments to this  
Agreement where the total amendments do not significantly change the scope of work, do not exceed  
10% ($40,000) of the original contract amount and do not increase the total contract amount above  
$440,000.  
Attachments:  
Board Report  
Marta Zulik MD Third Amendment  
Marta Zulik MD Second Amendment  
Marta Zulik MD First Amendment  
Marta Zulik MD Agreement  
a. Authorize the Chief Executive Officer (CEO) for Natividad Medical Center (NMC) or his designee  
to execute the Second Amendment to the Professional and Call Coverage Services Agreement  
(A-16651) with Delphine Engel, MD Inc. to provide general and critical care surgical services,  
extending the term by 24 months (January 1, 2026 to December 31, 2027) for a revised full agreement  
term of January 1, 2024 to December 31, 2027 and adding $350,000 for a revised not to exceed  
amount of $750,000 in the aggregate; and  
b. Authorize the CEO or his designee to sign up to three (3) future amendments to this agreement  
where the total amendments do not significantly change the scope of work, do not cause an increase of  
more than 10% ($40,000) of the original contract amount and do not increase the total contract  
amount above $790,000.  
Attachments:  
Board Report  
Delphine Engel MD Amemdment No. 2  
Delphine Engel Amendment No. 1  
Delphine Engel MD Agreement  
a. Authorize the Chief Executive Officer (CEO) for Natividad Medical Center (NMC) or his designee  
to execute the Second Amendment to the Professional and Call Coverage Services Agreement  
(A-16660) with David R. Flemming, MD to provide urology services, extending the term by 24  
months (January 1, 2026 to December 31, 2027) for a revised full agreement term of November 1,  
2022 to December 31, 2027 and adding $100,000 for a revised not to exceed amount of $500,000 in  
the aggregate; and  
b. Authorize the CEO or his designee to sign up to three (3) future amendments to this agreement  
where the total amendments do not significantly change the scope of work, do not cause an increase of  
more than 10% ($10,000) of the original contract amount and do not increase the total contract  
amount above $510,000.  
Attachments:  
Board Report  
David R. Flemming MD Second Amendment  
David Flemming MD Amendment No. 1  
David Flemming MD Agreement  
Authorize the Chief Executive Officer for Natividad Medical Center (NMC) or his designee to execute  
amendment No. 4 to the agreement (A-14125) with Monarch Medical Technologies, LLC for glucose  
management system enterprise software subscription services, extending the agreement an additional  
three (3) period (February 1, 2026 through January 31, 2029) for a revised full agreement term of  
October 1, 2018 through January 31, 2029 and adding $185,736 for a revised total agreement amount  
not to exceed $645,559.  
Attachments:  
Board Report  
Monarch Medical Technologies LLC Amendment No. 4  
Monarch Medical Technologies LLC Amendment No. 3  
Monarch Medical Technologies LLC Amendment No. 2  
Monarch Medical Technologies LLC Amendment No. 1  
Monarch Medical Technologies LLC Original Agreement  
Authorize the Chief Executive Officer for Natividad Medical Center (NMC) or his designee to execute  
renewal and amendment No. 4 to the agreement (A-14305) with Stryker Sales Corporation dba  
Stryker Instruments for preventative maintenance on power tools and Neptune equipment services,  
extending the agreement an additional six (6) month period (May 15, 2025 through November 14,  
2025) for a revised full agreement term of May 1, 2018 through November 14, 2025, and adding  
$40,000 for a revised total agreement amount not to exceed $639,216.  
Attachments:  
Board Report  
Stryker Sales Corporation dba Styker Instruments Renewal &  
Amendment 4  
Stryker Sales Corporation dba Styker Instruments Renewal &  
Amendment 3  
Stryker Sales Corporation dba Styker Instruments Amendment 2  
Stryker Sales Corporation dba Styker Instruments Amendment 1  
Stryker Sales Corporation dba Styker Instruments Agreement  
a. Authorize the Chief Executive Officer (CEO) for Natividad Medical Center (NMC) or his designee  
to execute the Second Amendment to the Professional and Call Coverage Services Agreement  
(A-16661) with J. Anthony Shaheen, M.D., Inc. to provide urology services, extending the term by 24  
months (January 1, 2026 to December 31, 2027) for a revised full agreement term of October 1, 2022  
to December 31, 2027, with no change to the total contract amount of $400,000; and  
b. Authorize the CEO or his designee to sign up to three (3) future amendments to this agreement  
where the total amendments do not significantly change the scope of work, do not cause an increase of  
more than 10% ($10,000) of the original contract amount and do not increase the total contract  
amount above $410,000.  
Attachments:  
Board Report  
J. Anthony Shaheen, M.D., Inc. Amendment No. 2  
J. Anthony Shaheen MD Inc, Amendment No. 1  
J. Anthony Shaheen MD, Inc Agreement  
Authorize the Chief Executive Officer for Natividad Medical Center (NMC) or his designee to execute  
amendments No. 14 to the agreements with Medical Search, LLC dba SUMO Medical Staffing  
(A-12896) and Medical Doctor Associates, LLC dba Cross Country Locums (formerly known as  
MDA Holdings, Inc.) (A-12899), and amendment No. 15 to the agreement with AMN Healthcare  
Locum Tenens, Inc. (formerly known as Staff Care, Inc.) (A-12897) for locum tenens physician  
referral services at NMC pursuant to Request for Proposals (RFP) #9600-61, extending the  
agreements for an additional three (3) month period (January 1, 2026 through March 31, 2026) for a  
revised full agreement term of August 1, 2015 through March 31, 2026; with no change to the total  
aggregate amount for all agreements not-to-exceed $22,700,000.  
Attachments:  
Board Report  
Medical Search, LLC dba SUMO Staffing Amendment No. 14  
Medical Search, LLC dba SUMO Medical Staffing Amendment  
No. 13  
Medical Search, LLC dba SUMO Medical Staffing Amendment  
No. 11  
Medical Search, LLC d.b.a SUMO Medical Staffing Renewal and  
Amendment No. 12  
Medical Search, LLC dba SUMO Medical Staffing Amendment  
No. 10  
Medical Search, LLC dba SUMO Medical Staffing Renewal &  
Amendment No. 9  
Medical Search, LLC dba SUMO Medical Staffing Renewal &  
Amendment No. 8  
Medical Search, LLC dba SUMO Medical Staffing Amendment  
No. 7  
Medical Search, LLC dba SUMO Medical Staffing Amendment  
No. 6  
Medical Search, LLC dba SUMO Medical Staffing Amendment  
No. 5  
Medical Search, LLC dba SUMO Medical Staffing Amendment  
No. 4  
Medical Search, LLC dba SUMO Medical Staffing Amendment  
No. 3  
Medical Search, LLC dba SUMO Medical Staffing Amendment  
No. 2  
Medical Search, LLC dba SUMO Medical Staffing Amendment  
No. 1  
Medical Search, LLC dba SUMO Medical Staffing Agreement  
Medical Doctor Associates, LLC dba Cross Country Locums  
Amendment No. 14  
MDA Holdings, Inc dba Medical Doctor Associates, LLC  
Amendment No. 13  
MDA Holdings, Inc dba Medical Doctor Associates, LLC Renewal  
& Amendment No. 12  
MDA Holdings, Inc dba Medical Doctor Associates, LLC  
Amendment No.11  
MDA Holdings, Inc. dba Medical Doctor Associates, LLC  
Amendment No. 10  
MDA Holdings, Inc. dba Medical Doctor Associates, LLC Renewal  
& Amendment No. 9  
MDA Holdings, Inc. dba Medical Doctor Associates, LLC Renewal  
& Amendment No. 8  
MDA Holdings, Inc. dba Medical Doctor Associates, LLC  
Amendment No. 7  
MDA Holdings, Inc. dba Medical Doctor Associates, LLC  
Amendment No. 6  
MDA Holdings, Inc. dba Medical Doctor Associates, LLC  
Amendment No. 5  
MDA Holdings, Inc. dba Medical Doctor Associates, LLC  
Amendment No. 4  
MDA Holdings, Inc. dba Medical Doctor Associates, LLC  
Amendment No. 3  
MDA Holdings, Inc. dba Medical Doctor Associates, LLC  
Amendment No. 2  
MDA Holdings, Inc. dba Medical Doctor Associates, LLC  
Amendment No. 1  
MDA Holdings, Inc . Agreement  
AMN Healthcare Locum Tenens, Inc. (formerly known as Staff  
Care, Inc.) Amendment No. 15  
AMN Healthcare (formerly Staff Care, Inc.) Amendment No 14  
Staff Care, Inc. Renewal and Amendment No 13  
Staff Care, Inc Amendment No. 12  
Staff Care, Inc Amendment No. 11  
Staff Care, Inc. Renewal & Amendment No. 10  
Staff Care, Inc. Amendment No. 9  
Staff Care, Inc. Renewal & Amendment No. 8  
Staff Care, Inc. Amendment No. 7  
Staff Care, Inc. Amendment No. 6  
Staff Care, Inc. Amendment No. 5  
Staff Care, Inc. Amendment No. 4  
Staff Care, Inc. Amendment No. 3  
Staff Care, Inc. Amendment No. 2  
Staff Care, Inc. Amendment No. 1  
Staff Care, Inc. Agreement