001-17 - The Doctor's Clinic - Contract Amendment 1DocuSign Envelope ID: D5E3A4D1-E7FE-42B0-8982-EDE5487CB89B
Amendment No. 1 to Contract No. 001-17
CITY OF PORT ORCHARD PROFESSIONAL SERVICES AGREEMENT WITH
THE DOCTOR'S CLINIC
THIS FIRST AMENDMENT to Contract No. 001-17 ("Amendment") is entered into between the City
of Port Orchard, a Washington municipal corporation ("City") and The Doctor's Clinic, part of Franciscan
Medical Group, Occupational Medicine Clinic ("Consultant"), organized under the Laws of the State of
Washington. City and Consultant are each a "Party" and together "Parties" to this Amendment.
WHEREAS, on the 15t" of February, 2017, the City executed a Professional Services Agreement for
DOT/CDL Exam and Certification Services with the Consultant ("Underlying Agreement"); and
WHEREAS, the City desires to amend the Agreement to include Hepatitis B vaccination services; and
WHEREAS, Consultant has advised the City of a rate increase effective September 1, 2023; and
WHEREAS, the City desires to incorporate services currently provided by Consultant to the Police
Department into this Agreement; and
WHEREAS, the City desires to update the contacts for the services provided;
NOW, THEREFORE, it is agreed by and between the parties thereto as follows:
1. Amendment to Scope. Hepatitis B vaccination services are added to the professional services
authorized pursuant to the Underlying Agreement.
2. Amendment. Section 4 of the Agreement is hereby amended to read as follows:
Compensation.
Compensation for examinations scheduled by or at the request of Human Resources shall be as
follows:
DOT physical exam - $100.00; $110.00, effective September 1, 2023
General physical exam - $82.00; $85.00, effective September 1, 2023
Comprehensive physical exam - $146.00
OSHA Respirator Questionnaire only - $26.00
PFT (Spirometry) w/ questionnaire - $49.00
Respirator Physical (if needed) - $43.00
Audiogram - $35.00
Hepatitis B Vaccination - $75.00 per dose
Compensation for Examinations scheduled by or at the request of the Police Department
Exams and rates shown on Exhibit "A"
Amendment No. 1 to Agreement between City of Port Orchard and The Doctor's Clinic
Contract No. 001-17
Page 1
10712759.1- 366922 - 0001
DocuSign Envelope ID: D5E3A4D1-E7FE-42B0-8982-EDE5487CB89B
Rates may be adjusted on an as needed basis by written agreement of the parties as an
addendum to this Agreement.
3. Amendment. Section 15 of the Agreement is hereby amended to read as follows:
Notice. Any notices required to be given by the City to Consultant or by Consultant to the City shall be
in writing and delivered to the parties at the following addresses:
For contractual matters or services
scheduled by or at the request of Human
Resources:
Human Resource Director
216 Prospect Street
Port Orchard, WA 98366
Phone: 360-876-7014
Fax: 360-895-9029
For services scheduled by or at the request
of the Police Department
Police Chief
216 Prospect Street
Port Orchard, WA 98366
Phone: 360-876-1700
Fax: 360-876-5546
THE DOCTORS CLINIC
Part of Franciscan Medical Group
Attn: Marisa Clauson
9621 Ridgetop Blvd NW
Silverdale, WA 98383
Phone: 360-782-3609
Fax: 360-782-3345
4. Severability. The provisions of this Amendment are declared to be severable. If any provision
of this Amendment is, for any reason, held to be invalid or unconstitutional by a court of competent jurisdiction,
such invalidity or unconstitutionality shall not affect the validity or constitutionality of any other provision.
5. Entire Agreement. The written provisions and terms of this Amendment shall supersede all
prior verbal statements of any officer or other representative of the parties, and such statements shall not
be effective or be construed as entering into or forming a part of or altering in any manner whatsoever, this
Amendment. The entire agreement between the Parties with respect to the subject matter hereunder is
contained in the Agreement and exhibits thereto, any prior executed amendments and this Amendment.
Should any language in any of the Exhibits to the Agreement or prior amendments conflict with any
language contained in this Amendment, then this Amendment shall prevail. Except as modified by this
Amendment, all other provisions of the original Agreement and any amendments thereto not inconsistent
with this Amendment shall remain in full force and effect.
6. Effective date. This Amendment shall be effective as of August 9, 2023.
Amendment No. 1 to Agreement between City of Port Orchard and The Doctor's Clinic
Contract No. 001-17
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10712759.1- 366922 - 0001
DocuSign Envelope ID: D5E3A4D1-E7FE-42B0-8982-EDE5487CB89B
DATED this 15th day of August 12023.
CITY OF PORT ORCHARD, WASHINGTON
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Robert Putaansuu, Mayor
ATTEST/AUTHENTICATED:
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Brandy Wallace, MMC, City Clerk
APPROVED AS TO FORM:
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Charlotte A. Archer, City Attorney
THE DOCTOR'S CLINIC
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Amendment No. 1 to Agreement between City of Port Orchard and The Doctor's Clinic
Contract No. 001-17
Page 3
10712759.1- 366922 - 0001
DocuSign Envelope ID: D5E3A4D1-E7FE-42B0-8982-EDE5487CB89B
I
"NI( CHI Franciscan
Health
Our best care. Your best health."'
Exhibit A
EC
Occupational Health Service Contract
Date: April 6, 2023
Services: Price:
Pre -Employment Basic Physical (Volunteer)
$
85.00
LEFF 11 Physical Exam (Career FF)
$
146.00
6 Panel Instant Drug Screen
$
41.00
MRO Service
$
15.00
Audiogram
$
35.00
EKG
$
37.00
7 View Spine & 2 View Chest X-ray (Career FF)
$
179.00
CBC
$
27.00
CMP
$
30.00
Lipid
$
46.00
Urinalysis/micro
$
12.00
Specimen Collection (Blood Collection)
$
13.00
Hep B Series (each 3)
$
65.00
Immunization Administration
$
10.00
Hep B Titer
$
37.00
Hep C Titer
$
43.00
*Please note, appointments not cancelled 24 hours in advance of the scheduled time may incur a
no show fee.
AGREEMENT:
I have reviewed services requested and fees beginning April 6, 2023. I authorize
services being rendered to employees referred to The Doctors Clinic, A Part of
Franciscan Medical Group, Occupational Medicine Department.
COMPANY: Port Orchard Police
DocuSign Envelope ID: D5E3A4D1-E7FE-42B0-8982-EDE5487CB89B
I
"NI( CHI Franciscan
Health
Our best care. Your best health."
Authorized Signature Title Date
TERMS: Payment is due in full 30 days from billing date. Renewal contracts may
be provided yearly.
Services provided at:
The Doctors Clinic, a Part of Franciscan Medical Group
Occupational Medicine Clinic
9621 Ridgetop Blvd NW Silverdale, WA 98383
Office 360-782-3300 Fax 360-782-3345