Medical Records Scanning Services Proposal Final.pdf

Request for Proposal

PROPOSAL #18-166

Medical Records Scanning Services

For: Health and Human Services

Proposal Issued: September 6, 2018 Questions Due: September 17, 2018 3:30pm Proposals Due: September 27, 2018 1:00pm

To ensure notification of any proposal opportunities, vendor must be registered on Onvia DemandStar at www.demandstar.com. To register at NO CHARGE, visit www.onvia.com/WAPP.

Please note that all notifications, releases and amendments associated with this solicitation will be posted on DemandStar. To ensure notification of future Proposal opportunities with Walworth County, vendors must be registered on Onvia DemandStar.

BUYER: TANA VAN VEGHEL

PHONE: 262-741-7266

EMAIL: TVANVEGHEL@CO.WALWORTH.WI.US

I. INVITATION

Walworth County is accepting sealed proposals from interested firms to:

Provide Medical Records Scanning Services for the Department of Health and Human Services.

Vendors who have considerable experience in the scanning of Medical Records or other closely related projects are invited to participate.

Proposals will be received until 1pm CST on September 27, 2018 by Walworth County Purchasing Division, W4097 County Road NN, Elkhorn, WI 53121. Shortly after 1pm CST, all Proposals received will be opened and recorded in the Department of Public Works conference room.

II. POSTING OF SOLICITATIONS

All Walworth County solicitations are posted on Demandstar by Onvia. Proposal documents and specifications may be obtained from Demandstar at www.demandstar.com. Vendors may register with Demandstar, at no charge, through the Wisconsin Association for Public Procurement (WAPP) of which Walworth County is a participating member, at: http://www.onvia.com/WAPP.

NOTE: Walworth County will make no attempt to contact vendors with updated information. It is the responsibility of each vendor to periodically check the website for any and all notifications, releases and amendments associated with this solicitation.

III. STANDARD TERMS AND CONDITIONS – WALWORTH COUNTY

The Standard Terms and Conditions of Walworth County are made a part of this Proposal by reference.

Standard Terms and Conditions are available on the internet, under the Purchasing Division on the Walworth County Home Page or by clicking on the following link:

http://www.co.walworth.wi.us/Public%20Works/Purchasing/pdfs/STANDARD%20TERMS%20AND%20CON DITIONS%205-17.pdf

Documents are also available, upon request, by contacting the buyer listed in this solicitation.

IV. EXAMINATION OF SITE AND PROPOSAL DOCUMENTS

The Vendor is required to carefully examine the Proposal, the scope of work, the site of the work, and the contract contained herein. It will be assumed that the Vendor has investigated and is satisfied as to the requirements of the Proposal documents. It is mutually agreed that the submission of a Proposal shall be considered as conclusive evidence that the Vendor has made such examination and is satisfied as to all the conditions and contingencies.

Pleas of ignorance of conditions that exist or that may hereafter exist, or of conditions or difficulties that may be encountered in the execution of the work under this specification as a result of failure to make the necessary examinations and investigations will NOT be accepted as:

An excuse for any failure or omission on the part of the vendor to fulfill, in every detail, all of the requirements of the Proposal, or

As a basis for any claims whatsoever for extra compensation, or For an extension of time.

All labor, equipment, parts, items, details of services or features not specifically mentioned which are regularly furnished to complete this type of work will be furnished at Proposal pricing and shall conform in quality, workmanship and service to that usually provided by the practice as specified in this Request for Proposals.

V. VENDOR INQUIRIES / REQUESTS FOR EXCEPTIONS / CHANGES TO

PROPOSAL

Vendors should request interpretation or correction of any ambiguity, inconsistency, or error.

Unless the vendor(s) clearly indicates in their response that the product offered is an “equal” product, it will be implied that the vendor will provide the brand, name, manufacturer, stock number or product specified.

Consideration will be given to a vendor’s request for a change if any of the terms and conditions of this Proposal are not in full accord, or if changes, alterations, additions or deductions are necessary for your firm to be compliant with the specifications and submit a response. Any requests for changes, clarifications, etc., must be submitted in writing to:

Tana Van Veghel, Buyer Walworth Co. Purchasing Division W4097 County Road NN Elkhorn, WI 53121

Phone: (262) 741-7266 Fax: (262) 741-3195 Email: tvanveghel@co.walworth.wi.us

Should a vendor need to review a sample file, please contact Aaron Winden at 262-741-3716 to schedule an appointment.

Communications related to this solicitation must be received between 7:00am and 3:30pm, Monday through Friday with the exception of legal holidays.

Questions must be received no later than the close of business on September 17, 2018 at 3:30pm CST. Requests received after that time will not be considered.

Contact with any other party or attempts by Vendors to contact any other party may result in the rejection of their Proposal.

No information provided verbally, or by parties other than the Buyer, will be considered binding.

Any changes made as a result of a written request will be issued via an addendum and will be posted to www.demandstar.com. Walworth County will make no attempt to contact vendors with updated information. Vendors are responsible for periodically checking the Demandstar website for any and all notifications, releases and amendments associated with this solicitation prior to the opening date.

VI. SUBMISSION OF PROPOSAL

Proposals must be submitted using the forms provided herein. Submit only the required documents. It is not necessary to return the entire Proposal document with the Proposal. Interested firms shall submit their sealed Proposals to:

Walworth Co. Purchasing Division W4097 County Road NN

Elkhorn, WI 53121

Vendors must submit original and 4 of copies to submit copies of their Proposal enclosed in a sealed envelope. Proposals must be clearly labeled with vendor name and address, Proposal number, and Proposal title. The following documents must be included with your Proposal:

Certificate of Compliance (Attachment A) Vendor Response Document (Attachment B)

References (Attachment C) Cost Summary (Attachment D)

Proposals must be received, dated and time stamped by the Walworth County Purchasing Division on or before the date and time due. Proposals submitted or time stamped in another office will be rejected. Actual receipt in the office of the Purchasing Division is mandatory.

Late responses will not be accepted, will be returned unopened, and will not be considered.

Proposals may not be transmitted orally, by Email or Fax Machine.

All Proposals will be opened and recorded in the Walworth County Public Works Conference Room located at W4097 County Road NN, Elkhorn, WI 53121.

All Proposals shall be valid for a period of ninety (90) days after the scheduled time of closing.

All vendors, by submission of their Proposal, agree to abide by the rules, regulations, and procedures of Walworth County.

VII. COST PROPOSAL DOCUMENT

Pricing must be submitted on the cost proposal form (Attachment D) provided. Failure to do so may result in your proposal being rejected.

Cost Proposal should be delivered or mailed to arrive no later than September 27, 2018 at 1pm CST.

The Cost Proposal should be in a sealed envelope separate from the vendor response document and must be clearly labeled with vendor name, RFP number, title and opening date.

VIII. WITHDRAWAL OF PROPOSAL

Proposals may be withdrawn only in total and only by a written request to Walworth County Purchasing prior to the time and date scheduled for Proposal opening.

IX. EVALUATION CRITERIA

All proposals will be reviewed by an Evaluation Committee. The evaluation and selection of vendor shall be in accordance with the criteria stated below and shall be based on the information called for in this proposal.

The recommendation for award shall be made to the responsive, responsible vendor who complies with the requirements and scores the highest total on the evaluation criteria.

Vendor’s company and staff experience, qualifications and ability in providing services of a similar nature and compliance with provisions/requirements for Medical Records Scanning Services.

0-20 points

Completeness and content of the proposal, including clear understanding of requirements.

0-10 points

Scope of Services - Ability to meet scope of services 0-40 points

Proposed Pricing 0-30 points

X. AWARD

Award will be made in accordance with the criteria stated above.

The successful vendor(s) shall be required to enter into a contract agreement with the County. A sample copy of Walworth County’s standard Contract is included in the attachments to this RFP.

The contract shall be deemed as having been awarded when formal recommendation of award has been approved by the appropriate County Committee having the authority to make such approval.

XI. VENDOR SUPPLIED DOCUMENTATION / MATERIALS

All vendor-supplied materials, including the vendor’s Proposal, become the property of Walworth County.

Walworth County will work with vendors to meet their confidentiality requirements, provided that they are within reason. All vendor confidential material must have each page clearly marked as confidential. All materials are subject to the provisions of Wisconsin Statutes Section 19.21, et seq.

If you are claiming a statutory exception to the Wisconsin Open Records Law, you must specify which statutory exception provision applies. To review the statutory exceptions, go to:

http://folio.legis.state.wi.us/cgi-bin/om_isapi.dll?clientID=83141&infobase=stats.nfo&j1=19.36&jump=19.36&softpage=Browse_Frame_Pg

The County reserves the right to make determinations of confidentiality. If the County does not agree with the information designated under one of the disclosure exceptions, it may either reject the Proposal or discuss its interpretation of the allowable exceptions with your firm. If agreement can be reached, the Proposal will be considered. If not, the County will remove your Proposal from consideration for award and return it to your firm. In no event will price be deemed confidential.

XII. NONDISCRIMINATION / AFFIRMATIVE ACTION

In connection with the performance of any work under this request, the vendor(s) agree not to discriminate against any employee or applicant for employment because of age, race, religion, color, handicap, sex, physical condition, developmental disability as defined in s. 51.01 (5), Wis. Stats., sexual orientation as defined in s. 111.32( 13m), Wis. Stats., or national origin. This provision shall include, but not be limited to the following: employment, upgrading, demotion or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship.

Except with respect to sexual orientation, the vendor(s) further agree to take affirmative action to ensure equal employment opportunities. Failure to comply with the conditions of this clause may result in the vendor(s) becoming declared an ineligible vendor, termination of the contract, or withholding of payment.

XIII. ELIGIBILITY REQUIREMENTS

A. Proposals shall be considered only from vendors that are regularly engaged in the business of document scanning with considerable experience in Medical records or other closely related projects.

B. Vendor shall have a record of performance with reasonable financial support, personnel and organization to ensure that they can satisfactorily execute the service required and specified herein if awarded. Vendors who have failed to perform in the past may not be considered for award.

C. Vendor must possess a minimum of three (3) years of verifiable experience doing business as a medical records scanning Company at a government entity.

D. Vendor must be properly licensed to do business in the State of Wisconsin.

XIV. PROJECT SCOPE

Services listed in this proposal shall be awarded to the contractor(s) providing the most beneficial proposal and may be split amongst several contractor(s) at the discretion of Walworth County. All awards will be based on the evaluation process. Medical records scanning service will be done for a flat fee. Typical work to be performed under the resulting contract(s) will include, but not be limited to, the following:

The Walworth County Department of Health and Human Services requests proposals to establish a contract for Medical Records Scanning Services for physical documents of various sizes and condition. The successful vendor shall scan the front and back of historic Medical Records located in the Walworth County Health and Human Services office.

The successful vendor shall provide any and all necessary expertise, hardware, software and equipment necessary to perform document preparation, scanning, coding and indexing services for the Walworth County Department of Health and Human Services office.

Selected vendor will be required to work in conjunction with the County throughout the process. Vendor shall meet as requested to resolve problems. The successful vendor must meet in person with Walworth County staff to review the specifications before order placement.

XV. SPECIFICATIONS

The minimum specifications are intended to define the level of quality and performance of the services and not to be restrictive. The Walworth County Department of Health and Human Services Department requires the following services:

The immediate project is for digitizing of approximately 450,000 historical medical records (pages) to be scanned and converted to a PDF format with Optical Character Recognition (OCR) to allow for electronic searching of the entire document. These records include medical records of the clients served by the Walworth County Department of Health and Human Services Department. Documents are stored in approximately two-hundred four (204) or more banker boxes (12x10x15) containing a maximum of 2,000 pages per box, are the original documents and some are the only existing record. The documents are various sizes ranging from the size of postcards to legal sized (8-1/2” x 14”) paper. The majority of the documents are on 8-1/2” x 11” white, 20# single sided paper and of good quality. Automatic document feeding may be an option for the majority of the documents.

The majority of boxes will have file folders within that contain a single set of records. However, some older boxes may have several files that are mixed together. These files can be entered into a PDF by 100 count blocks. (See file naming below for more details).

Each image of the historic medical records will be scanned as a black and white PDF image OCR, at 240 or 300 DPI. The majority of pages are white with black lettering but there may by some that are black with white lettering that may require inverting to the white with black lettering format.

It is required that the naming convention of the files must be flexible, based on the makeup of records box, to allow for a meaningful naming scheme. For example, the letters “HS” must precede each document number.

Files shall contain no more than one-hundred (100) images, if box file has more than one-hundred (100) images a sequence number shall be added to each file, beginning with “001” at the end of the file name and continuing to increment for the number of files. The final naming scheme will be determined after the vendor selection process is completed and before the scanning of files commences.

When all documents have been scanned, the images will be loaded onto CD or DVD and delivered to the Walworth County Department of Health and Human Services office.

Each CD or DVD shall contain several files in scanned order; however the vendor shall not start one (1) box file on one (1) CD or DVD and continue onto another CD or DVD.

Walworth County Health and Human Services staff will load the scanned records into a records management system.

A sample of the Health and Human Services file is below:

File Specifications / Naming Convention

HS->BOX NAME->BOX NUMBER->SEQUENTIAL FOLDER NUMBER->001

OR

HS->BOX NAME->BOX NUMBER->FILE FOLDER NAME AND NUMBER->001

Note: If greater than 100 pages, change 001 to 002

XVI. GENERAL VENDOR REQUIREMENTS

Selected vendor will be required to work in conjunction with the County throughout the process. Successful vendor shall be required to meet the following minimum requirements:

1. The data and images must be exported in a PDF format and converted to Optical Character Recognition (OCR). Please provide references where you have performed this function.

2. Vendors must quote all setup charges for applications.

3. Walworth County may visit your facility to ensure that documents are secure while out of our care. Walworth County may occasionally need access to these documents while at the vendor’s facility, since needs arise to see archival documents before a scanning job is completed. The vendor shall be expected to digitize those documents immediately and electronically transfer them to the Walworth County Health and Human Services Department staff within one (1) business day. This is not expected to happen frequently but may arise during the term of the contract. Vendor must indicate how such access will be provided.

4. Provide a pickup date after receipts of order when submitting written quotation.

5. Have a record of performance with reasonable financial support, personnel, equipment, and organization to ensure that they can satisfactorily execute the services required and specified herein if awarded.

6. Bids shall not be considered from vendors on the State of Wisconsin Department Workforce Development list of Debarred Contractors with the effective dates during this purchase.

7. Vendor site where the scanning of medical records will take place must be located within 4 hours of W4097 County Road NN, Elkhorn, WI 53121.

XVII. DOCUMENT REQUIREMENTS

8. Once the Walworth County Department of Health and Human Services department has approved the scanned images on CD or DVD, the successful vendor shall destroy all documents by employing a third party document shredding company. A certificate of Destruction shall be provided by the shredding vendor to the County indicating the date of destruction, the type of record(s) shredded and signed by an authorized representative of the third party document shredding company.

9. Walworth County has 60 days to review the scanned documents prior to allowing the vendor to destroy the original documents.

10. Provide off-site document scanning services, as there is no space available on County premises for these services to take place on-site.

11. Vendor will sign, count and record the number of boxes taken from Walworth County facilities for control purposes.

12. During scanning the documents must be kept in the order in which they were organized when they were picked up.

13. Vendor, if necessary, must remove any staples or fasteners in order to scan the documents.

14. Vendor will sign each receipt and return the CD’s or DVD’s to the Walworth County Health and

Human Services Office.

15. Hours of pickup are 8:00 am to 5:00 pm CST Monday through Friday.

XVIII. PICK-UP/DELIVERY

16. The Successful vendor will pick up all historic medical records and deliver the scanned images on CD or DVD at a mutually agreed upon time at the Walworth County Department of Health and Human Services Office.

17. The successful vendor shall transport all documents within and enclosed vehicle. All documents may be picked up at once. Losing documents, disorganizing documents, damaging documents or destroying documents to Walworth County files due to exposure to weather will result in termination of the contract due to negligence.

18. Provide pick-up and delivery service for materials to be scanned. Documents may be released to the successful vendor in batches. Pick-up shall be made by the vendor’s own truck, with unloading to be performed by the vendor. Pricing must include all packing, transportation, insurance and other charges.

19. Banker boxes are located on shelving units in basement storage. Elevator and loading dock are available for use.

20. Due to the fact that these documents may be exclusive records and contain confidential information, documents to be scanned shall be released only to the successful vendor’s staff to transport to the vendor’s facility in vendor owned vehicles. The County shall not permit release of the documents, by County staff or the vendor, to any third party or commercial courier.

XIX. QUALITY CHECK/ASSURANCE

21. The vendor shall describe the quality controls used to ensure clarity of the images.

22. Walworth County reserves the right to check all returned work. If the work is not to Walworth

County’s satisfaction, it will be returned for re-scanning and re-delivery of a new CD or DVD of those files.

23. The vendor shall insure that the scanned image’s readability is equal to or better than that of the original document.

24. Vendors must provide quality control of the images and indexes in conformance with ANSI (American National Standards Institute) / AIIM (The Association for Information and Image Management) standards. All images must be quality checked as they are scanned, must contain all significant details from the original, and must be an adequate substitute for the original document for all purposes for which the document was created or maintained.

XX. IMAGE REQUIREMENTS

25. ALL scanned documents must be performed as Optical Character Recognition (OCR) or converted to OCR.

26. No image clean-up is required.

27. Images should be scanned at a resolution that allows for on-screen viewing and/or enlargement up to 200% and still be legible (as determined by Walworth County).

28. All images shall be in the same, vertical page orientation.

29. Image resolution may need to vary by image. Some documents with significant detail and/or color may need to be scanned at a lower resolution in order to keep the file size to a reasonable limit.

XXI. STORAGE REQUIREMENTS

30. Each box record shall be scanned into a single record. Each box of records shall be saved as a separate PDF image.

31. All data shall be the sole property of Walworth County and shall not be sold, shared or transferred to any other entity in any way.

32. The successful vendor shall retain a backup copy of all file scans and indexes until notified by email that the CD or DVD received have been tested and approve. Once the Health and Human Services staff has approved the CD’s or DVD’s vendor shall destroy the backup copy of the files approved.

XXII. CONFIDENTIALITY

33. The successful vendor shall agree to maintain the confidentiality of any information regarding client information that may be obtained from any source associated with this service, other than information necessary to the performance of the services under this contract. The successful vendor agrees not to use the names and addresses of clients for any other purpose.

34. The successful vendor and its employees agree to comply with the federal regulations implementing the Health Insurance Portability and Accountability Act of 1996 (HIPPA) to the extent those regulations apply to the services the vendor provides.

35. The restrictions herein shall survive the termination of this contract for any reason and shall continue in full force and effect and shall be binding upon the vendor or its agents, employees, successors, assigns and subcontractors which are engaged by the County of the restrictions, present and continuing, set forth herein. The successful vendor shall defend and incur all costs, if any, for actions that arise as a result of noncompliant by vendor, its agents, employees, successors, assigns and subcontractors regarding the restrictions herein.

XXIII. PILOT PROJECT DEMONSTRATION

36. To verify that the scans can be viewed on the CD’s or DVD’s, a pilot will take place at the beginning of the project. The pilot will consist of taking a sampling of documents, performing the scans, transfer images to CD’s or DVD’s and deliver to the Walworth County Health and Human Services Department. Upon the successful testing and approval of the CD’s or DVD’s the full scanning project can begin.

This pilot demonstration shall be without additional expense to the County. Failure to deliver acceptable scanning of documents in this pilot phase of the project may result in contract cancellation.

XXIV. CONFLICT OF INTEREST

All vendors must disclose with their proposal, the name of any officer, director or agent who is also an officer or employee of Walworth County. Further, all vendors must disclose the name of any Walworth County officer or employee who owns, directly or indirectly, any interest in the Contractor’s firm or any of its branches. Failure to disclose this information will result in disqualification of their proposal. The County reserves the right to seek compensation for recoupment of losses in having to re-bid or re-assign.

XXV. REJECTION

All Work done and material furnished by the Contractor are subject to acceptance by the County based on the conformity of the material and labor to these project specifications. In the event where the Contractor or its subcontractor were to provide materials, and/or labor that does not conform to these project specifications and has not gained prior approval from the County, the material and/or labor will be subject to rejection.

Rejected work or materials shall be replaced or redone at the expense of the Contractor.

XXVI. EMPLOYEES

Contractor agrees that trained, certified (where applicable) and competent employees shall perform the services required by this contract using industry-accepted standards. County shall be entitled to request the removal of individuals working on any project for any of the following grounds, provided that such request be in writing and shall specify the reasons for the County’s dissatisfaction:

Unsatisfactory performance that causes negative operational impact at the County or causes the County to commit additional resources to avoid operational impact;

Dishonesty or belligerent conduct;

Lack of compatibility with County staff; or Violation of County rules or policies.

Upon such written request, the County and Contractor shall decide on a course of action to cure any such problems, provided that there shall be no cure opportunity required for problems involving dishonesty or belligerent conduct or a violation of County rules or policies. In the event Contractor does not cure the problem within seven (7) days from the date of notice, Contractor shall remove such person and shall promptly provide a qualified replacement. The County will be liable for payment of services only up to the time of dismissal and only if services rendered meet the minimum requirements of the County. Contractor must comply with Walworth County’s work/site rules. Contractor shall comply and accept exclusive responsibility for Contractor’s employee(s) while on Walworth County property.

If for any reason the individuals identified are no longer employed by the firm, or available from the subcontracted firm, the Contractor must notify the County within a reasonable time frame. Contractor is responsible for ensuring that any substitute personnel have comparable skills and experience. The County reserves the right to interview substitute personnel prior to commencement of activity on the project to confirm to County’s satisfaction equivalency of skills and experience.

If any of the Contractor’s employee appears to be incompetent or to act in a disorderly or improper manner, such person shall be removed immediately on request of the County, and shall not again be re-employed except upon written consent of the County.

Employees shall be in a company uniform that clearly identifies the name of the company and employee name. Uniforms shall be clean and neat in appearance. Employees are required to wear a company supplied photo ID badge. Badges must be clearly visible when worn.

XXVII. TERM OF CONTRACT

A contract will be awarded to the successful Vendor. All services must be completed on or before December 28, 2018.

XXVIII. INVOICING

Contractors shall provide itemized invoices for each location showing date of service, the serviced areas, and detail of service performed.

Original Invoice must be addressed to Walworth County Finance Department-Accounts Payable Division, 100 W. Walworth Street, P.O. Box 1001, Elkhorn, WI 53121. Contractor is responsible for the completion of all recordkeeping and reporting requirements as appropriate for all items prior to payment.

The Contractor shall be required to provide an invoice detailing the service provided. Prompt payment requires that invoices be clear and complete in conformity with the instructions below. Contractor is responsible for the completion of all record keeping and reporting requirements as appropriate for all items prior to payment. Invoices must include the following:

Vendor Name Purchase Order Number Contract Number Invoice Number Description of Service Date of Service Quantity of Hours Contracted Hourly Rate Quantity of Extended Hours Contracted Extended Hourly Rate Grand Total

Walworth County’s preference is to pay with a P-Card. Indicate in the Proposal whether you will accept Visa for payment purchases. Contractor should note how many days after receipt of invoice payment must be processed to accept the credit. Please keep in mind that we will not process payment until/unless goods/services have been received (or accepted if applicable).

If unable to accept credit card, payment will be made within forty-five (45) days after acceptance of goods/services and receipt of a properly documented invoice. Invoice must be sent to the location specified on the purchase order to avoid delays in payment.

XXIX. “PIGGYBACK” CLAUSE

Common purchasing practices in government include cooperative or "piggyback" purchasing among various units of government or municipalities. This contract will be extended, with the authorization of the Contractor, to other units of government or municipalities at the same prices and/or discounts and terms and conditions. If another unit of government or municipality decides to use this contract, the Contractor must deal directly with the respective unit of government or municipality concerning the placement of orders, issuance of the purchase orders, contractual disputes, invoicing, and payment. Walworth County acts only as the "Contracting Agency" for those public agencies.

XXX. REFERENCES

Vendor shall provide three (3) references of recent clients with similar requirements as specified in this Proposal. Reference information shall include contact person, phone number, fax number and email address of a person that may be contacted. Walworth County is especially interested in receiving references from government entities that most closely match the requirements a described in this Request for Proposals. References should include accounts equal or larger in size and scope.

XXXI. CONTRACT REVIEW

Successful respondent will be required to meet with designated county personnel, on an as-needed basis, to discuss the services that are being provided. Discussions will include an overall quality review, suggestions to improve the efficiency, services to be provided, and any other matters that may affect the contract. It is also the intent of the contract review to identify and implement efficiencies that may reduce the annual cost of the services provided.

XXXII. WORK/SITE RULES

Contractor shall comply with Walworth County’s work/site rules. Contractor shall comply and accept exclusive responsibility for each individual employee while on Walworth County property.

XXXIII. BACKGROUND CHECKS

Contractor shall ensure that employee background checks, consisting of criminal record searches and employment verification, are accomplished and that current records are provided upon request of the County.

All Contractors employees seeking access to the Walworth County facilities must pass a more detailed background check performed by the Walworth County Sheriff’s Office. Costs for this background check shall be borne by the County. Contractor shall provide a photocopy of each employee’s driver’s license (or other acceptable identification) at least 72 hours prior to commencement of work.

XXXIV. COMPLIANCE WITH LAWS

Contractor is responsible to comply with all statutory rules and regulations. All applicable federal, state and local laws, rules and regulations governing this type of service will apply and will be deemed incorporated into the contract. These requirements shall be done at Contractor’s expense.

XXXV. INSURANCE REQUIREMENTS

Supplier shall furnish County with Certificate of Insurance indicating proof of the following insurance from companies licensed in the State:

Workers Compensation and Employers' Liability - Worker's Compensation statutory - in compliance with the Compensation law have the State and Employers’ Liability insurance with a limit not less than $ 100,000 each accident.

Comprehensive or Commercial General Liability with a minimum limit of $1,000,000 per occurrence, $1,000,000 if aggregate Combined Single Limit for Bodily Injury and Property Damage Liability. This insurance shall include, but is not limited to, the following coverage:

o Premises - Operations o Products and Completed Operations o Broad Form Property Damage o Contractual o Personal Injury

If excavating, underground or collapse is involved the limits of liability stated above shall be changed to $2,000,000.

If Asbestos and/or hazardous materials are involved, the limits of liability stated above shall be changed to $5,000,000.

The County reserves the right to require higher or lower limits where warranted.

Professional Liability with a minimum limit of $1,000,000 per injury/$1,000,000 aggregate.

Automobile Liability with a minimum limit of $1,000,000 per injury/$1,000,000 aggregate Combined Single

Limit for Bodily Injury and Property Damage Liability. This insurance shall include coverage for all of the following:

o Owned Automobiles o Hired Automobiles o Non-Owned Automobiles

The certificate shall list the Certificate Holder and address as follows: Walworth County, Attn: Walworth

County Purchasing, Department of Public Works, W4097 County Road NN, Elkhorn, Wisconsin 53121.

Other:

o Such insurance shall include under the General Liability and Automobile Liability Policies

Walworth County, its employees, elected officials, representatives, and members of its boards and/or commissions as "Additional Insureds."

o Such insurance shall include a thirty (30) day notice to the County prior to cancellation or material policy change. The notice shall be given to Walworth County Purchasing, Department of Public Works, W4097 County Road NN, Elkhorn, Wisconsin 53121. NOTE: Standard Cancellation Clause on a Certificate of Insurance is not acceptable.

o Supplier shall require sub supplier; if applicable, to furnish identical Certificates of Insurance to Walworth County prior to contract taking effect.

XXXVI. DEFICIENCIES

In the event that the County determines that there are deficiencies in the service work provided by the Contractor under the contract, the County shall notify the Contractor in writing as to the precise nature of any such deficiencies. Within ten (10) working days of receipt of such notice, Contractor shall take responsible steps to correct any deficiencies.

XXXVII. CANCELLATION

Walworth County reserves the right to cancel any agreement in whole or in part without penalty due to non-appropriation of funds.

ATTACHMENT A

Certificate of Compliance

GENERAL: This form must be completed in its entirety and submitted with vendor(s) response to acknowledge that vendor(s) meets or exceeds the minimum requirements.

COMPLIANCE:

Vendor shall comply with the specifications of this request for Proposal. Complies: ____ Yes ____ No

VENDOR RESPONSE DOCUMENT: Vendor(s) has completed Attachment B - Vendor Response Document.

_______ (initials)

REFERENCES: Vendor(s) has completed Attachment C - References. _______ (initials)

RECEIPT OF ADDENDUM: Vendor(s) acknowledges receipt and inclusion of Addendum number ___through_____.

FORM OF PAYMENT: Would company accept a Purchasing Card as a form of payment?

____ Yes ____ No

Without any minimums and/or additional fee(s)? ____ Yes ____ No

If credit card is used for payment, how many days after receipt of invoice (or acceptance of goods, whichever is later) payment must be processed to accept the credit card. Note: Minimum of 10 days is required. _____ Days

COST SUMMARY: Vendor has completed Attachment D, Cost Summary. ____ Yes ____ No

PIGGYBACKING: My Company agrees to furnish the item(s)/Services(s) proposed in this bid to other units of government at the same terms and conditions. ____ Yes ____ No

DEBARRED CONTRACTORS: Acknowledgement that the vendor (s) is not on any list of debarred contractors with the effective dates during the project.

EXCEPTIONS TO THE MINIMUM REQUIREMENTS:

I hereby certify that all statements herein are made on behalf of:

Name of Company:

Contact Name:

Address:

Phone Number:

Email:

Signature: Date:

Contact Person(s)

Contact person for order placement:

Name: Phone:

E-Mail: Fax:

Contact person for signature of contract:

Contact person for payment:

ATTACHMENT B

VENDOR RESPONSE DOCUMENT

RFP #18-166

MEDICAL RECORDS SCANNING SERVICES

Name of Firm Responding: _____________________________________________________

*Contact Name: ______________________________________________________________

Phone Number: _____________________________________________________________

Email Address: _____________________________________________________________

*This should be the name of the individual that can provide clarifications on technical and pricing questions, additional information, etc.

A complete narrative explanation must be provided for each question in the areas provided in this document.

This is the Vendor’s opportunity to explain their understanding of the County’s requirements as described in the RFP. Careful consideration will be given to each separate response to gauge the vendor’s grasp of the needs of the County.

Proposers should not include any pricing information in the answers provided in this document.

Pricing for services is to be included only in the Pricing Document. Failure to comply with this requirement may result in disqualification of a proposal.

XXXVIII. ELIGIBILITY REQUIREMENTS

Affirm your compliance with the following:

1. Confirm that you are regularly engaged in the business of Medical Records Scanning Services.

Complies ____ Does Not Comply____

2. Confirm that you have a record of performance with reasonable financial support, personnel, equipment and organization to ensure that they can satisfactorily execute the service required and specified herein if awarded.

3. Confirm that your firm has a minimum of three (3) years of verifiable experience doing business as a Medical Records Scanning Services company and are properly licensed and incorporated to do business in the State of Wisconsin.

Company Information

4. Briefly state your understanding of the services to be provided and a positive commitment to perform the services as defined in the request for proposal. Indicate who will be the authorized representative empowered to make binding commitments for the vendor. List name, title address, e-mail, phone and fax. The person identified shall be:

ANSWER:

5. Provide the information below regarding your firm:

Company’s full legal name:

Company Address (City, State and Zip) How long have you been in business?

6. Explain the distinctive competencies of your firm that you believe make your firm ideal to undertake this project.

7. Identify any contractual arrangements that may conflict with your role as an independent contractor for Walworth County or which may result in any monetary compensation related to county contracts.

8. Disclose the name of any officer, director or agent who is also an officer or employee of Walworth County. Further you must disclose the name of any Walworth County officer or employee who owns, directly or indirectly, any interest in the Contractor’s firm or any of its branches. Failure to disclose this information will result in disqualification of their proposal.

9. Provide a minimum of three (3) references for which you have provided similar services. Specify the specific nature of the services provided, the contact person (including telephone and email), and the duration of the contract.

10. Identify the types of information the County would be required to provide to enable your organization to complete the scope of services.

Staff Experience

11. Identify the Management representative who will act as the liaison to the County. Note: Once identified, the representative cannot be changed without the approval of Walworth County’s Contract Manager.

12. Provide the name of a backup representative in the event the dedicated account representative is unavailable.

13. Provide information on the personnel who will assigned to this contract, including the management representative(s) identified above, listing pertinent experience and professional qualifications. Include for each individual what capacity they would serve on this project.

a. Name and position title

b. Total years of experience in this type of service

c. Summary of pertinent experience and qualifications

d. Provide any other information that would assist the County in determining the qualifications of the individuals and their ability to complete the services required.

14. Provide any other information that would assist the County in determining the qualifications of the individuals and their ability to complete the services required.

ATTACHMENT C

References

Provide references for similar contracts you have, preferably one who is a public sector client, which demonstrate your firm’s relevant experience.

Reference 1:

Name of Company/Vendor:

Address:

City, State, Zip:

Contact Name:

Email Address:

Phone Number:

Fax Number:

Relevant Project Name:

Year of Service:

Reference 2:

Name of Company/Vendor:

Address:

City, State, Zip:

Contact Name:

Email Address:

Phone Number:

Fax Number:

Reference 3:

Name of Company/Vendor:

Address:

City, State, Zip:

Contact Name:

Email Address:

Phone Number:

Fax Number:

ATTACHMENT D

Cost Summary

Vendors shall provide proposed pricing to provide the services as a Medical Records Scanning Services vendor.

The proposed gee shall include all costs for providing Medical Records Scanning Services as described in this proposal.

The vendor acknowledges this proposal includes all services outlined in the Proposal. Proposed pricing shall be firm for the term of the contract. All services shall be furnished at proposed pricing and shall be without any additional charges.

Price for medical records image scans:

$______________________________ per image cost

Price for transporting medical records to vendor site:

$________________________________ per box cost

Price for shredding of medical records after scanning is complete:

$________________________________ per box cost

Exceptions

Review the Sample contract in its entirety and indicate any exceptions you are taking to the terms and conditions of the contract. If exceptions are taken, cite the paragraph involved, the exception taken, and state alternative language acceptable to your firm. Alternative language is subject to negotiation and/or approval. In the absence of such statement, the proposal shall be accepted as in strict compliance with all terms, conditions, and specifications and vendor shall be liable for injury resulting from any deviation.

Walworth County Professional Services

Sample Contract

Project Number:

Services to be provided:

Contract Period: 1/1/1_-12/31/1_ with the option to renew the Contract for

ENTER NUMBER OF YEARS IN WORDS AND

NUMBERS years OR 1/1/1_ through final project completion and acceptance.

Contract Amount: $

County:

Organization Name: Walworth County

Address: LOCATION OF PROJECT Elkhorn, WI 53121

Walworth County Point of Contact : NAME OF PERSON RESPONSIBLE FOR DAY TO

DAY ACTIVITIES OF CONTRACT

Telephone: 262-741-XXXX

Fax: 262-741-XXXX

Cell:

E-mail: XXXX@co.walworth.wi.us

Contractor:

Organization Name:

Address:

Contractor Point of Contact: NAME OF PERSON RESPONSIBLE FOR DAY TO

DAY ACTIVITIES OF CONTRACT

Telephone:

Fax:

Cell:

E-mail:

PROFESSIONAL SERVICES CONTRACT

Parties This Contract is between Walworth County whose business address is, 100 West Walworth Street, Elkhorn, WI 53121, hereinafter referred to as the County and __________________ whose business address is ________________________ hereinafter referred to as Contractor.

Article 1 – Overview

This Contract sets forth the responsibilities, time and cost of services relating to the Medical Records Scanning Services by the Contractor.

Section 1.1 Services to be Provided The COUNTY and Contractor agree that the Contractor will provide the following services:

at the following location(s):

ENTER NAME AND ADDRESS OF LOCATION(s)

Services shall be provided in accordance with Walworth County’s Request for Bid/Proposal for Description of Services and the bid/proposal submitted by the Contractor which are attached as the following exhibits and made a part of this Contract.

Exhibit A – Walworth County Request for Bid/Proposal for Medical Records Scanning Services Exhibit B – Bid/Proposal from [Enter Contractor Name]

Article 2 – Term

This Contract is to be effective for the period MM/DD/YYYY through MM\DD\YYYY with the option to renew the Contract for ENTER NUMBER OF YEARS IN WORDS AND (NUMBERS) years under the same terms and conditions upon mutual agreement. OR Upon execution of Contract through final project completion and acceptance.

Article 3 –Services to be Provided

Section 3.1 Regulations The Contractor agrees to comply with all the requirements of all applicable federal, state and local laws.

Section 3.2 Inability to Provide Quality Services The Contractor shall notify the County immediately in writing and deliver in person or by registered mail whenever it is unable to provide the quality of services agreed to in the contract. Upon such notification, the County and Contractor shall determine whether such inability will require a revision or termination of this Contract. (See Article 15 “Revision or Termination of this Contract.”)

Section 3.3 Remedies In the event the Contractor fails to provide Medical Records Scanning Services or creates errors which results in the County being obliged to perform the required services, the County will be reimbursed the total cost of the County employees’ wages including benefits and all other costs directly incurred by the County for corrective actions taken.

Section 3.4 Documentation of Quality of the Services Provided The Contractor shall retain all documentation necessary to adequately demonstrate the time, cost, duration, location, scope, quality and effectiveness of services rendered under the Contract. The County reserves the right to not pay for services reported by the Contractor that are not supported by documentation required under this Contract.

Section 3.4 Standards for Performance in Delivery of Services The County will monitor the Contractor’s performance and will use the results of this monitoring to evaluate the Contractor’s ability to provide adequate services to the County. If the Contractor fails to meet contract goals and expected results, the County may reduce or terminate the Contract immediately.

Section 3.5 Force Majeure Neither party shall be in default by reason of any failure in the performance of this Contract in accordance with reasonable control and without fault or negligence on their part. Such causes may include, but are not restricted to, acts of nature or the public enemy, acts of the government in either its sovereign or contractual capacity, fires, floods, epidemics, quarantine restrictions, strikes, freight embargoes and unusually severe weather, but in every case the failure to perform such must be beyond the reasonable control and without the fault or negligence of the party.

Article 4 – Payment and Allowable Costs

Section 4.1 Amount Paid Under Contract The maximum payment under this Contract is $______________ pursuant to Exhibit ___. Actual total payment will be based upon the services authorized by the County and the amount of services performed by the Contractor. It is understood and agreed by all parties that the County assumes no obligation to purchase from the Contractor any minimum amount of services as defined in the terms of this Contract.

Section 4.2 Reimbursement of Expenses The County is not liable to the Contractor for any expenses paid or incurred by the Contractor unless otherwise agreed in writing.

Section 4.2.1 Taxes The Contractor understands that they are responsible for all applicable taxes. Neither federal, nor state, nor local income tax nor payroll tax of any kind shall be withheld or paid by the County on behalf of the Contractor or any employees of the Contractor. The Contractor shall provide the Walworth County Department of Finance with a federal employer identification or social security number to allow for proper reporting to federal tax authorities.

Section 4.2.2 Invoicing and Payment The Contractor will invoice the County pursuant to Exhibit __. All invoices are to be mailed to Walworth County Finance Department – Accounts Payable Division, 100 West Walworth Street, Elkhorn, WI 53121. Unless otherwise agreed, Walworth County will pay properly submitted vendor invoices within forty five (45) days of receipt of services. Payment will not be made until services are accepted as specified. Invoices presented for payment must be submitted in accordance with instructions contained on the purchase order, if applicable. Walworth County’s preference is to pay for services on procurement card (P-card).