EMPLOYER AGREEMENT NOT-FOR-PROFIT NON-EMERGENCY MEDICAL TRIP SHUTTLE SERVICE

Transcription

1 EMPLOYER AGREEMENT PAE Vanpool Incentive Program - (VIP) NOT-FOR-PROFIT NON-EMERGENY MEDIAL TRIP SHUTTLE SERVIE THIS AGREEMENT made this day of, 200 by and between Pace, the Suburban Bus Division of the RTA ("Pace"), and ( medical facility ) whose address is. WHEREAS: Pace administers a Vanpool Incentive Program (VIP) Not-For-Profit Non-Emergency Medical Trip Shuttle Service (hereinafter Shuttle Service ) which provides vans to medical facilities in the Pace service area for their use in transporting employees and/or non-emergency service clients; and WHEREAS: The medical facility, warrants it is a properly registered and certified not-for-profit corporation in the State of Illinois per Section 501() (3) or the Internal Revenue ode, and desires to obtain the use of one or more Pace vans to provide transportation services to its employees and/or clients since traditional modes of public transportation are unavailable; NOW, THEREFORE, the parties agree as follows: 1. Basic Rate Pace shall furnish van(s) to the medical facility for its Shuttle Service. The medical facility agrees to pay Pace $ per month/van. The monthly charge covers all regular expenses for operation of the van. The medical facility may charge riders/participants (with Pace s approval) an administrative fee(s) to cover costs associated with the operation of the Shuttle Service. The medical facilities that allow their monthly Shuttle Service fees to become two or more months in arrears will be charged a late fee of $25.00 per month until their account is brought current. 2. Security Deposit The medical facility shall select (initial) a security deposit in the manner indicated below: (a) (b) The medical facility shall pay to Pace a security deposit in the amount of $800/van prior to receipt of each van. The deposit amount (without interest) shall be returned to the medical facility upon return of the van to Pace provided the van is returned in the same condition as when it was delivered to medical facility, ordinary wear and tear excepted. Any amounts due to Pace from the medical facility may be deducted from the deposit amount. In lieu of the medical facility deposit paid to Pace in advance of the Shuttle Service, the medical facility may choose to agree to be responsible for costs chargeable in the Shuttle Service that would otherwise be deducted from the deposit. 1

2 Upon occurrence of a chargeable event, Pace will notify the medical facility and send an invoice for the amount due. If the medical facility chooses to subcontract the operation of the Shuttle Service, Options (a) and (b), above, are not applicable. The medical facility shall obtain from the Third Party ontractor and pay to Pace a $2,000 non-interest -bearing security deposit per van, prior to delivery of the vehicle. If the Agency chooses to utilize a Third Party ontractor, that party must execute this agreement and agree to its terms and conditions. 3. Mileage The basic rate covers all regular expenses for van operation and allows for up to 27,000 miles per van/year. The 27,000 miles consists of the following: A maximum of 27,000 miles per van/year (2,250 per month) for work/agency related activities. 1,200 buffer miles per van/year (100 miles per month) for van fueling, washing, maintenance activities. The 28,200 mileage allotment includes miles accrued from loaner vans used throughout the year when the regularly assigned van is out of service. With prior written approval from Pace Vanpool Services, the medical facility may accumulate in excess of 28,200 miles per van/year (including loaner van miles) at an additional charge of $0.45 per mile. 4. Three Month Minimum Participation The medical facility agrees to participate in the Pace VIP Shuttle Service for a minimum three (3) month period. This three (3) month commitment applies to each Pace provided van that the medical facility plans to operate in the Shuttle Service. Failure by the medical facility to participate for the minimum period will result in the following actions: forfeiture of any actual or assumed van deposit amount(s); The medical facility s responsibility for unpaid balance of three (3) months van fees; and legal action by Pace to collect any balances due Pace. 5. Drivers The medical facility agrees that it shall only allow those individuals whom Pace has approved to drive the Pace provided van(s). The medical facility may select its own employees to serve as drivers or may utilize third party contractor employees to serve as drivers provided the selected individuals meet Pace s driver selection criteria. Pace will enter into Driver Agreements with the individuals who are certified by Pace as trained drivers and who shall operate the vans as drivers. The medical facility agrees to indemnify Pace against any and all financial loss resulting from a violation of the driver agreement or misuse of Pace property or equipment utilized in the Pace VIP by any medical agency employee. In the event of any financial loss to Pace as a result of one or more of the above mentioned reasons, the medical facility agrees to be responsible for the full amount of the loss including but not limited to: The cost of reasonable and necessary repairs to the Pace van, or the Actual ash Value of the Pace van, whichever is less. Loss of use of the Pace van. 2

3 Loss of revenue. All unauthorized charges on the Pace-provided credit card(s) issued to the Employer. The medical facility shall ensure that Pace vans are operated only by drivers who have been trained, certified and authorized by Pace, and shall ensure that drivers follow all Shuttle Operations Manual requirements including those related to safety and accident reporting. The medical facility shall pay Pace a $100 driver approval/training fee (to cover a portion of the VIP driver approval/training costs) for each driver candidate. The medical facility shall pay Pace a $50 U.S. DOT Physical and Drug & Alcohol test renewal fee for each approved VIP driver who is administered a U.S. DOT Physical and Drug & Alcohol test by a Pace approved test facility. Each approved VIP driver is required to take a U.S. DOT Physical and Drug & Alcohol test every two years. 6. Restrictions on Use The medical facility shall not allow the Pace provided van(s) to be used in the following manner: a. For courier service, ambulance-type service, post surgical patients, emergency visits, injury visits or the transportation of goods, to pull trailers, or allow the consumption of alcoholic beverages on the van. b. Permit any driver (unless approved in advance by Pace) to drive the van for personal use. (If approved, personal use is limited to 300 miles/van/month.) c. Use or allow the van to be used illegally or improperly for hire. d. Remove the van from the State of Illinois, unless expressly authorized by Pace in writing. e. Alter, mark or install equipment in the van without Pace s written consent. f. Expose the van to seizure, confiscation, forfeiture or other involuntary transfer. The medical facility shall ensure that the van is locked at all times while parked. In addition, when the van is parked at the end of the day, it shall be parked in a secure, off-street location (preferably on the medical facility s property or at public transportation centers.) Medical facility shall take appropriate steps towards the security of Pace s van(s). 7. Records and Reports The medical facility shall designate an individual to serve as Pace s contact person on all matters relating to operation of the Pace van. This individual is required to attend and complete the administrative component of the Pace VIP Defensive Driver Training ourse. The medical facility shall ensure that drivers keep accurate and timely records as set forth in the Driver Agreements and Shuttle Operations Manual. The medical facility shall collect and forward these reports to Pace on such schedule as directed by Pace. These reports include monthly/daily ridership-trip logs for each van; Monthly VIP Shuttle Reports; accident reports; and changes in driver status (change of address, change in employment, loss of driving privileges, moving violations, etc.) Monthly VIP Shuttle Reports must be postmarked no later than the 5th of each month for the preceding month. A $7.00 late fee is charged for Monthly VIP Shuttle Reports postmarked after the 5th of the month. The medical facility understands that accurate and complete reports are necessary to meet Pace funding requirements and the medical facility shall cooperate fully in the accurate and timely completion of such reports. 3

4 The medical facility agrees to report the beginning and ending odometer readings as well as miles traveled for each van utilized during the month on the Monthly VIP Shuttle Report. Actual van odometer and mileage readings will be monitored by Pace and any discrepancies found between actual miles and reported miles will be billed to the medical facility at the Pace excess mileage rate in effect at that time. 8. Hold Harmless, Indemnification and Insurance The medical facility, its officers, employees, agents and contractors agree: (a) To waive, release and hold harmless Pace, its directors, officers, employees and agents, or any other transportation agency, from and against any claims, injuries, losses, or any causes of action whatsoever, arising out of or in any way relating to the use of Pace Vans as provided in the Agreement by the medical facility, its officers, employees, agents and contractors. (b) To indemnify Pace, its directors, officers, employees and agents, and any other transportation agency, from and against any claims, liabilities, losses, suits, judgments or settlements of any party arising out of or in any way relating to the use of Pace Vans by the medical facility, its officers, employees, agents and contractors. The medical facility and any of its officers, directors, employees, agents or contractors utilizing the Pace Vans shall each carry and keep in force commercial general and auto liability insurance covering the use of the Pace Vans in amounts not less than the following: (a) (b) (c) (d) ommercial General Liability (including Broad Form ontractual): (1) Bodily Injury Liability (2) Property Damage Liability ombined Liability Limits of $5,000, Auto Liability: (1) Bodily Injury Liability (2) Property Damage Liability ombined Liability Limits of $5,000, Auto Physical Damage: (1) ollision and omprehensive Worker s ompensation: Minimum statutory coverage. Insurance carried by the medical facility and its contractors shall be primary over any other insurance carried by Pace, including self-insurance. The Suburban Bus Division of the Regional Transportation Authority, d/b/a Pace, and the Regional Transportation Authority shall be named as additional insureds on above policies. Insurance is to be provided by an insurance company which meets or exceed Best s rating of B+. Before delivery of the equipment, the medical facility shall present certificates of insurance satisfactory to Pace, showing Pace and RTA (as described herein) as additional insureds, including certificates from any of its contractors utilizing the Pace Vans. 9. Maintenance The medical facility shall ensure that approved VIP drivers perform all maintenance, cleanings and servicing of the van as per the schedule set forth in Pace s Shuttle Operations Manual; have the van safety inspected semi-annually as required by law; obtain prior approval from the Pace Vanpool Office or its designated agent for any expenditure in excess of $50.00 per van; pay for emergency operating expenses of the van; and promptly submit all receipts for expenses paid in the previous month with the VIP Shuttle Monthly Report for submission to the Pace Vanpool Office. 4

5 Pace shall pay the costs of ordinary maintenance and repairs, provided the medical facility adheres to Pace s inspection and maintenance schedule. The medical facility shall be liable for all repair and maintenance costs resulting from its failure to adhere to the inspection and preventive maintenance schedule, or attributable to abuse of the vehicle or negligence in its maintenance. The medical facility acknowledges that a Pace designated vendor will provide fleet management services to Pace related to the vans used in the Shuttle Service. The medical facility agrees to cooperate with the Pace designated vendor at all times and to abide by any rules promulgated by the Pace designated vendor with respect to the Shuttle Service. The medical facility acknowledges that a Pace designated vendor provides accident management and subrogation services to Pace related to the vans used in the Shuttle Service. Medical facility agrees to cooperate with the Pace designated vendor at all times and to abide by any rules promulgated by the Pace designated vendor or Pace with respect to van accident/incident reporting and/or accident/incident related repairs. Medical facility acknowledges that Pace will contract for fuel credit card services for Pace VIP fleet vans utilized in Shuttle Service. Medical facility agrees to cooperate at all times with any fuel credit card company utilized by Pace and to abide by any rules promulgated by any fuel credit card company utilized by Pace or Pace with respect to fuel cards utilized in the Shuttle Service. The medical facility shall return the van to Pace in the same condition as when it was delivered, ordinary wear and tear excepted. Upon its delivery and return, the medical facility and Pace, or its agent, shall inspect the van and provide a report on its condition. The report shall be signed by both Pace and the medical facility. Damage to the van which is not attributable to a reported accident/incident and supported by a written accident/incident report or is otherwise determined by Pace to be caused by vehicle neglect will be the sole responsibility of the medical facility, and the medical facility shall compensate Pace for the cost of such repairs including those above the $ per van guarantee. 10. Pace Responsibilities 11. Term In addition to providing vans, Pace will issue Fuel and Maintenance only credit cards to the medical facility for authorized fuel, maintenance service and repairs for the Pace van(s). Pace will provide loaner vans by reservation on a first come, first serve basis for times when the assigned van is out of service. Pace will also assist the medical facility in providing alternative transportation when neither the regular van nor any loaner van is available. If requested by the medical facility, Pace will administer a Guaranteed Ride Home ( GRH ) program for its employees participating in the Shuttle Service who need alternative transportation for personal emergencies. If requested by the medical facility, Pace will assist the medical facility in selecting routes and schedules for the Shuttle Service and in encouraging participation by employees. Pace reserves the right to substitute a different van of the same size classification at any time. Upon notice to Pace and subject to availability, the medical facility may obtain additional vans upon the same terms and conditions stated herein. This agreement shall be effective as of the day of its signing and shall continue in force until one of the parties gives the other party written notice thirty (30) days in advance of the desired termination date. Pace may terminate the Agreement upon five (5) days notice in the event of failure by the medical facility to correct any safety or accident reporting violations or for failure by the medical facility to pay Pace amounts due on a timely basis. Upon termination, Pace may take any and all steps to regain possession of the van(s) including self-help. 5

6 This agreement may not be assigned by the medical facility without the approval of Pace. All successors and assigned will be bound by the terms and conditions of this Agreement and must fully comply therewith. This agreement may be modified only by a subsequent written instrument signed by each of the parties. 12. Nondiscrimination The medical facility understands and agrees that regardless of the primary purpose of the usage of the van, that all service provided must be open to the public (within the limits of schedule and space availability) and shall not be restricted to a particular group of individuals. The parties shall cooperate to ensure that no person shall be denied the opportunity to participate in nor be subjected to discrimination in the conduct of the VIP because of race, creed, color, age, sex, national origin, nor the presence of any sensory, mental or physical disability, nor in any manner contrary to applicable local ordinance, state and federal laws and regulations, specifically including Title VI of the ivil Rights Act of 1964, Title 49, ode of Federal Regulations, Part 21 - Nondiscrimination in Federally Assisted Programs of the Department of Transportation. 13. Financial Integrity As a condition of participation in the Shuttle Service, medical facility may be required to provided a financial statement for the most recent year and any other financial information requested by Pace to assist Pace in verifying medical facility s financial capability to undertake its obligations under this agreement. At any time during the term of its participation in the Shuttle Service, Agency agrees to furnish Pace within forty-eight hours of receipt of Pace s written request (which request may be forwarded by mail, telefax, or transmission), evidence satisfactory to Pace of medical facility s ability and capacity, financial or otherwise, to carry out its obligations under this Agreement and the Shuttle Service. 14. Audit and Recordkeeping Medical facility shall permit authorized representatives of Pace or its designees to inspect and audit all records and data associated with the operation of the VIP service. Medical facility shall retain all records associated with the service for a period of three (3) years following expiration or termination of the service or such longer period of time for any pending audit, litigation or other claim. 15. Not-for-Profit ertification Medical facility shall provide Pace with a copy of medical facility s certification as a Not-for Profit corporation. 6

7 IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed as of the date indicated below. (Printed Name of Medical facility) PAE By: By: Title: Title: Signed: Signed: Date: Date: Not-for-Profit orporation Act File Number (If applicable) By: (Printed Name of Third Party ontractor) Title: Signed: Date: 7

8 EXHIBIT B Intended Use of Pace Van(s) Modifications to the stated intended use, identified above, must be pre-approved by the Vanpool Office. FOR PAE VANPOOL OFFIE USE ONLY APPROVED NOT APPROVED Vanpool Department Manager Date 8