Billing Services Agreement[45].docx

SERVICES AGREEMENT

THIS SERVICES AGREEMENT (“Agreement”) is made and entered into the most recent day and year set forth below by and between Gilpin Ambulance Authority, a quasi-municipal corporation and political subdivision of the State of Colorado (“GAA”), whose mailing address is 495 Apex Valley Road, Black Hawk, CO 80422, and NAME OF CONTRACTOR (“Contractor”), whose mailing address is Contractor Mailing Address. GAA and the Contractor are sometimes referred to herein individually as a “Party” and collectively as the “Parties.”

WITNESSETH:

In consideration of the mutual covenants and obligations herein expressed, it is agreed by and between the Parties as follows:

Scope of Services. The Contractor agrees to provide billing services, including obtaining reimbursement for GAA’s charges for all services rendered on or after Commencement Date, through the billing of patients and third-party payers and the management of the Authority’s accounts receivable as further described in Exhibit A, attached hereto and incorporated herein by this reference (“Scope of Services”). All provisions of Exhibit A, including without limitation any terms and conditions included therein, shall be subject to the provisions of this Agreement. In the event of a conflict or inconsistency between a provision in the body of this Agreement and a provision in Exhibit A or any other exhibit or schedule attached hereto, the provision in the body of this Agreement shall control.

Time of Commencement of Services. The services to be performed pursuant to this Agreement shall be initiated on Commencement Date.

Early Termination by GAA. Notwithstanding the time periods contained herein, GAA may terminate this Agreement at any time without cause by providing written notice of termination to the Contractor. Such notice shall be delivered at least three (3) days prior to the termination date contained in said notice unless otherwise agreed in writing by the Parties. In the event of any such early termination by GAA, the Contractor shall be paid for services rendered prior to the date of termination, subject only to the satisfactory performance of the Contractor’s obligations under this Agreement. Contractor understands and agrees that such payment shall be the Contractor’s sole right and remedy for such termination.

Suspension. Without terminating this Agreement or breaching its obligations hereunder, GAA may, at its convenience, suspend the services of the Contractor by giving the Contractor written notice one (1) day in advance of the suspension date. Upon receipt of such notice, the Contractor shall cease its work in as efficient a manner as possible so as to keep its total charges to GAA for services under this Agreement to the minimum, but in no circumstance later than three (3) business days after receipt of the notice of suspension. No work shall be performed during such suspension except with prior written authorization by GAA Representative (as defined below). If a suspension is still in effect thirty (30) calendar days after the Contractor’s receipt of the notice of suspension, the Contractor may terminate this Agreement by providing GAA with written notice of termination. Upon GAA’s receipt of such notice of termination from Contractor, this Agreement will be deemed terminated.

Compensation. In consideration of the services to be performed pursuant to this Agreement, GAA agrees to pay the Contractor the amounts set forth in Exhibit A. GAA shall provide no benefits to the Contractor other than the compensation stated above. The Contractor shall bill its charges to GAA periodically, but no more frequently than once a month.

Qualifications on Obligations to Pay. No partial payment made by GAA shall be considered final acceptance or approval of that part of the Scope of Services paid for or shall relieve the Contractor of any of its obligations under this Agreement. Notwithstanding any other terms of this Agreement, GAA may withhold any payment (whether a progress payment or final payment) to the Contractor if any one or more of the following conditions exists:

The Contractor is in default of any of its obligations under this Agreement, including without limitation the obligation to maintain insurance and provide Certificates of Insurance to GAA in accordance with Section 13 (Insurance).

Any part of such payment is attributable to services that are not performed in accordance with the terms of this Agreement and its associated exhibit(s). GAA will pay for any portion of the services performed in conformance with this Agreement and its associated exhibit(s).

The Contractor has failed to make payments promptly to any third-party used to perform any portion of the services hereunder, subject to Paragraph 9, for which GAA has made payments to the Contractor.

GAA Representative. GAA will designate, prior to commencement of work, its project representative (the “GAA Representative”) who shall make, within the scope of his or her authority, all necessary and proper decisions with reference to the Scope of Services. All requests for contract interpretations, change orders, and other clarification or instruction shall be directed to GAA Representative.

Independent Contractor. The Contractor agrees that the services to be performed by the Contractor are those of an independent contractor and not of an employee of GAA. The Contractor is obligated to pay federal and state income tax on any moneys earned pursuant to this Agreement. Neither the Contractor nor its employees, if any, are entitled to workers’ compensation benefits from GAA for the performance of the services described in this Agreement.

Assignment. The Contractor shall neither assign any responsibilities nor delegate any duties arising under this Agreement to a third party without the prior written consent of GAA, which may be granted or denied in GAA’s sole discretion.

Standard of Care. The Contractor shall perform the services hereunder at or above the standard of care of those in its profession or industry providing similar services in GAA’s local area; provided, however, that in the event the standard of care is higher in the local area where the Contractor’s office primarily responsible for providing the services is located, then the standard of care applicable to the local area where the Contractor’s office is located shall be applicable to such services.

Accuracy of Work. The Contractor represents, covenants, and agrees that its work will be accurate and free from any material errors. The Contractor shall correct any errors or deficiencies in the Contractor’s services of which it becomes aware promptly and without additional compensation unless such corrective action is directly attributable to errors or deficiencies in information furnished by GAA. GAA’s approval of the Contractor’s services shall not diminish or release the Contractor’s duties or obligations hereunder, since GAA is ultimately relying upon the Contractor’s skill and knowledge to perform the Scope of Services. The obligations contained in this Section 11 shall survive for a period of two (2) years following termination or expiration of this Agreement.

Duty to Warn. The Contractor agrees to call to GAA’s attention errors in any drawings, plans, sketches, instructions, information, requirements, procedures, and other data supplied to the Contractor by GAA or a third-party that it becomes aware of and believes may be unsuitable, improper, or inaccurate in a material way. However, the Contractor shall not independently verify the validity, completeness, or accuracy of such information unless otherwise expressly engaged to do so by GAA. Nothing shall detract from this obligation unless the Contractor advises GAA in writing that such data may be unsuitable, improper, or inaccurate and GAA nevertheless confirms in writing that it wishes the Contractor to proceed according to such data as originally given.

Insurance.

During the term of this Agreement, the Contractor shall purchase and maintain, at its own cost and expense, the following:

Workers’ compensation insurance for its employees, if any, as required by Colorado law with limits of at least $500,000 per injury or illness an employee suffers as a result of providing the services hereunder, with a $500,000 aggregate per occurrence.

Employer’s liability insurance with limits of at least $500,000 per employee/accident and $1,000,000 aggregate.

Commercial general liability insurance covering, without limitation, premises operations, products-completed operations, contractual liability insuring the obligations assumed by the Contractor under this Agreement, personal and advertising injury, and broad form property damage, with limits of at least $2,000,000 per occurrence for bodily injury, death or damage to property; $2,000,000 per occurrence for personal and advertising injury; $2,000,000 products-completed operations; and $2,000,000 general aggregate; and The insurance required herein may be satisfied through any combination of primary and excess/umbrella liability policies.

The insurance required herein shall be written by an insurance company or companies that (i) have an A.M. Best Company rating of “A-VII” or better, and (ii) are authorized to issue insurance in the State of Colorado.

GAA, GAA’s Representative, and GAA’s directors, officers, employees, and agents shall be endorsed as “Additional Insureds” under the commercial general liability insurance policy for both ongoing and completed services for a period of two (2) years.

The Contractor shall provide a waiver of subrogation endorsement, or its equivalent, under the (i) workers’ compensation and (ii) commercial general liability insurance policies in favor of GAA, its directors, officers, agents, and employees.

All liability insurance policies required herein shall provide that the coverage is primary and non-contributory to other insurance available to GAA and its directors, officers, agents, and employees. Any insurance maintained by GAA and its directors, officers, agents, and employees shall be excess of and shall not contribute with the Contractor’s insurance.

Prior to commencement of performance, the Contractor shall provide certificates of insurance satisfactory to GAA that clearly evidence all insurance coverages required herein, including but not limited to endorsements (individually and collectively, “Certificates of Insurance”). The Contractor agrees that, until GAA is supplied with Certificates of Insurance, no payment under this Agreement will be made by GAA. The Contractor will provide GAA with updated Certificates of Insurance within ten (10) calendar days of the anniversary of the effective date of coverage should that date fall during the term of this Agreement. Failure of GAA to require Certificates of Insurance or to identify a deficiency in coverage shall not relieve the Contractor of its responsibility to provide the specific insurance coverages set forth herein.

Subject to Section 9 (Assignment), the Contractor shall require each subcontractor and/or third-party performing work for the Contractor related to the Scope of Services to purchase and maintain insurance of the types and with policy limits no less than those required of Contractor under this Section 13. All general liability policies carried by a subcontractor and/or third-party shall be endorsed to include the Additional Insureds identified above. Each subcontractor and/or third-party shall be required to provide Contractor, upon request, with certificates of insurance evidencing such coverage prior to commencement of work by a subcontractor and/or third party.

The insurance policies afforded hereunder shall not be cancelled or allowed to expire unless at least thirty (30) days’ prior written notice has been delivered to GAA, except in the event of cancellation due to non-payment of a premium, in which case notice shall be given to GAA no later than ten (10) days prior to cancellation of the policy. Upon receipt of any notice of cancellation or non-renewal, the Contractor shall, within five (5) days, procure other policies of insurance as necessary to comply with this Section 13 and provide Certificates of Insurance evidencing the same to GAA. Notwithstanding the provisions contained in Section 17 (Remedies), if the Contractor fails to procure the required insurance or provide GAA with Certificates of Insurance within the timeframe provided, GAA may terminate or suspend this Agreement upon written notice to the Contractor.

Compliance with Laws. The Contractor is obligated to familiarize itself and comply with all laws applicable to the performance of the Scope of Services, including without limitation all state and local licensing and registration requirements.

Acceptance Not Waiver. GAA’s approval or acceptance of, or payment for, any of the services shall not be construed to operate as a waiver of any rights or benefits provided to GAA under this Agreement.

Default. Each and every term and condition hereof shall be deemed to be a material element of this Agreement. In the event either Party should fail or refuse to perform according to the terms of this Agreement, such Party may be declared in default.

Remedies. Except as provided in Section 13(i) (Insurance), in the event a Party declares a default by the other Party, such defaulting Party shall be allowed a period of ten (10) days within which to cure said default. In the event the default remains uncorrected, the Party declaring default may elect to (a) terminate the Agreement and seek damages; (b) treat the Agreement as continuing and require specific performance; or (c) avail itself of any other remedy at law or equity. If the non-defaulting Party commences legal or equitable actions against the defaulting Party, the defaulting Party shall be liable to the non-defaulting Party for the non-defaulting Party’s reasonable attorney fees and costs incurred because of the default.

Indemnification; No Waiver of Liability or Immunity. The Contractor agrees to indemnify, defend, and hold harmless GAA and its officers, directors, employees, agents, engineers/architects and attorneys from any and all damages and liabilities arising from the Contractor’s performance of the Scope of Services. As part of this obligation, the Contractor shall compensate GAA for the time, if any, spent by its legal counsel in connection with such claims or actions. The Contractor’s obligations under this Section 18 shall be to the fullest extent permitted by law and shall survive termination or expiration of this Agreement. Notwithstanding any other provision contained in this Agreement, including but not limited to Exhibit A, GAA does not agree to defend, indemnify, or hold harmless the Contractor or waive or limit the Contractor’s liability (either by type of liability or amount). GAA is relying on and does not waive or intend to waive by any provision of this Agreement, the monetary limitations or any other rights, immunities, defenses, and protections provided by the Colorado Governmental Immunity Act, § 24-10-101, et seq., C.R.S., as from time to time amended, or otherwise available to GAA or its officers or employees.

Binding Effect. This writing constitutes the entire agreement between the Parties and shall be binding upon the Parties, their officers, employees, agents and assigns and shall inure to the benefit of the Parties’ respective survivors, heirs, personal representatives, successors and permitted assigns.

Amendment. No amendment or modification of this Agreement shall be binding upon the Parties unless the same is in writing and approved by a duly authorized representative of each Party.

Law; Venue. The laws of the State of Colorado shall govern the construction, interpretation, execution, and enforcement of this Agreement. Venue for any dispute between the Parties arising out of or relating to this Agreement shall be in the State of Colorado District Court for Gilpin County.

Severability. In the event any term or condition of this Agreement shall be held invalid or unenforceable by any court of competent jurisdiction, such holding shall not invalidate or render unenforceable any other provision of this Agreement.

Annual Appropriation. GAA’s obligations hereunder are subject to the annual appropriation of funds necessary for the performance thereof, which appropriations shall be made in the sole discretion of GAA’s Board of Directors.

Ownership of Work Product. All documents such as reports, plans, drawings and contract specifications, information, and other materials prepared or furnished by the Contractor (or the Contractor’s independent professional associates, permitted subcontractors, and consultants) and paid for pursuant to this Agreement are instruments of public information and property of GAA. All internal documents which support the public information such as field data, field notes, laboratory test data, calculations, estimates, and other documents prepared by the Contractor as instruments of service shall be provided to GAA. GAA understands such documents are not intended or represented to be suitable for reuse by GAA or others for purposes outside the specific scope and conditions of the Scope of Services. Any reuse without written verification or adaptation by the Contractor for the specific purpose intended will be at GAA’s sole risk and without liability or legal exposure to the Contractor, or to the Contractor’s independent professional associates, permitted subcontractors, or consultants.

Taxes. GAA is a governmental entity and is therefore exempt from state and local sales and use tax. GAA will not pay for or reimburse any sales or use tax that may not directly be imposed against GAA. The Contractor shall use GAA’s sales tax exemption for the purchase of any and all products and equipment on behalf of GAA.

Time is of the Essence. All times stated in this Agreement are of the essence.

Notices. All notices which are required, or which may be given under this Agreement shall be effective when mailed via registered or certified mail, postage prepaid and sent to the address first set forth above.

Counterparts, Electronic Signatures and Electronic Records. This Agreement may be executed in multiple counterparts, each of which shall be an original, but all of which, together, shall constitute one and the same instrument. The Parties consent to the use of electronic signatures and agree that the transaction may be conducted electronically pursuant to the Uniform Electronic Transactions Act, § 24-71.3-101, et seq., C.R.S.

No Third-Party Beneficiaries. The Parties to this Agreement do not intend to benefit any person not a party to this Agreement. No person or entity, other than the Parties to this Agreement, shall have any right, legal or equitable, to enforce any provision of this Agreement.

Section Headings. The section headings in this Agreement have been inserted for convenience of reference only and shall not affect the meaning or interpretation of any part of this Agreement.

Not Construed Against Drafter. Each Party acknowledges that it has had an adequate opportunity to review each and every provision contained in this Agreement, including the opportunity to consult with legal counsel. Based on the foregoing, no provision of this Agreement shall be construed against either Party by reason of such Party being deemed to have drafted such provision.

[Signature Page Follows]

4908-9227-8645, v. 1

GAA:

Gilpin Ambulance Authority, a quasi-municipal corporation and political subdivision of the State of Colorado

By:

Name:

Title:

Date:

CONTRACTOR:

By:

Name:

Title:

Date:

exhibit a scope of services and compensation (Attach Contractor’s proposal or other documentation if available and intended for incorporation into the Agreement)[footnoteRef:2] [2: NOTE TO USER: If possible, only include the description of the services and pricing in Exhibit A. Avoid including any “Terms and Conditions” that might be in the Proposal.]