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Proposal should include general information on procedures followed regarding notification to <br />City for all medical services provided. Proposal should include information on Consultant's <br />recordkeeping protocols. <br />Experience of Proposer <br />Describe and provide examples of a minimum of 3 similar medical services review programs <br />you have managed for agencies similar in size to the City oflSanta Ana. Experience pertaining <br />to public agencies is preferred. <br />Staffing <br />Proposer shall identify their Project Manager assigned to thle project, who shall be committed <br />to this project for a minimum of one (1) full year. Proposer shall also identify other key <br />personnel, their qualifications, education, representative experience, and their capability to <br />explore and resolve problems. Proposer shall provide their availability for site meetings and <br />local training. Include the name of the employee/agent/associate in charge of the medical <br />services review program when project manager is unavailable. Please provide an organization <br />chart identifying those personnel who will perform services for this project. <br />Once the agreement is executed, key members of the Proposer's staff shall not be substituted <br />without the prior written approval of the City of Santa Ana. <br />Sub -consultants <br />The Consultant shall identify any sub -consultants it intends to employ in relation to this <br />agreement. The Consultant shall identify sub -consultants' qualifications and key personnel. <br />The Consultant shall be held responsible for any and all work performed by the Consultant's <br />sub-consultant(s). List the estimated percentage of work each sub -consultant will perform for <br />each of the tasks. <br />Physicians and Clinics Used by Consultant <br />Consultant shall ensure all physicians, clinics and other medical facilities used by Consultant <br />possess and maintain all appropriate licenses and insurance as specified by the City. <br />Consultant shall ensure all physicians, laboratory technicians, collectors, clinics and other <br />medical facilities and staff used in conjunction with DOT -related drug and alcohol testing follow <br />and are in compliance with DOT testing procedures as per 49 CFR, Part 40. <br />B. EXHIBIT C — PROPOSERS FEE STATEMENT AND PROPOSAL ITEM PRICING <br />The proposal shall include a fee schedule for the services to be performed, which shall be <br />based on the Consultant's best pricing. <br />C. EXHIBIT D — REFERENCES <br />The proposal shall include a list of agencies, past and present, for which you have provided <br />work similar to that identified in the Scope of Services (Exhibit A) for the last three (3) years. <br />D. EXHIBIT E — PROPOSER'S STATEMENT <br />The Proposer shall submit a signed statement that Proposer understands that a proposal is <br />required for the entire work, that the estimated quantities set forth in the RFP schedule are solely <br />for the purpose of comparing proposals, and that final compensation under the contract will be <br />based upon the actual quantities of work satisfactorily completed. Proposer shall acknowledge <br />that all terms contained in the specifications, the certification of nondiscrimination by contractors, <br />and the required insurance certificates are to be incorporated by reference into this agreement <br />and are made specifically as part of this RFP. <br />i of Santa Ana Human Resources Department <br />for Medical Services Review—August 27, 2018 <br />2-8 <br />12 <br />