Free Samples Siding Contractor Bid Proposal Forms

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					    HARRIS COUNTY
 REQUEST FOR PROPOSAL                                                  Job No. 06/0407
                                                                Date Due: November 13, 2006
       Cover Sheet                                                  DUE NO LATER THAN 2:00 P.M.
                                                                   LOCAL TIME IN HOUSTON, TEXAS
                                                                Proposals received later than the date
                                                                and time above will not be considered.


 PROPOSAL FOR: Imaging Services for Patients of the Harris County Hospital District

                                           OFFERORS NOTE!!
Carefully read all instructions, requirements and          Please return proposal in an appropriately sized
specifications.  Fill out all forms properly and           envelope or box. PACKAGE MUST SHOW THE JOB
completely. Submit your proposal with all appropriate      NUMBER, DESCRIPTION AND BE MARKED
supplements and/or samples.                                "SEALED PROPOSAL".

                                     RETURN PROPOSAL TO:
                             HARRIS COUNTY PURCHASING AGENT
                               1001 PRESTON AVENUE, SUITE 670
                                     HOUSTON, TEXAS 77002

For additional information, contact: Laurie Wainwright at loretta_wainwright@hctx.net or 713-755-6597.

You must sign below in INK; failure to sign WILL disqualify the offer. All prices must be typewritten or written
in ink.
                                     Total Amount of Proposal $

Company Name:

Company Address:

City, State, Zip Code:

Taxpayer Identification Number (T.I.N.):

Telephone No.:                         FAX No.:                     E-mail:

Print Name:

Signature:



Revised 12/04




                                                                                                 Page 1 of 22
                              I
                              N
                              T

                              INTENT TO RESPOND


DATE:          _____________________________

TO:            Laurie Wainwright              (buyer‘s name) (713) 755-6597

FROM:          _____________________________ (company name)

               _____________________________ (street address)

               _____________________________ (city, state, zip)

               _____________________________ (contact name/phone#)


RE:     Vendor‘s intent to respond to Job #06/0407 Request for Proposal for Imaging Services for Patients of the
        Harris County Hospital District.


In order that Harris County may assess potential vendor‘s interest in this job, please check one of the below and
fax form to (713) 755-6695. Thank you.

Our company intends to respond to this job ______________

Our company declines to respond to this job _____________

Optional: Reason for declining ________________________

Declining to respond will not eliminate the vendor from future consideration to jobs with Harris County.
                                                     TABLE OF CONTENTS

Items checked below represent components which comprise this bid/proposal package. If the item IS NOT checked, it is NOT
APPLICABLE to this bid/proposal. Offerors are asked to review the package to be sure that all applicable parts are included. If any
portion of the package is missing, notify the Purchasing Department immediately.

It is the Offeror's responsibility to be thoroughly familiar with all Requirements and Specifications. Be sure you understand the following
before you return your bid packet.
__X__ 1.             Cover Sheet
                     Your company name, address, the total amount of the bid/proposal, and your signature (IN INK) should appear on this
                     page.

__X__ 2.          Table of Contents
                  This page is the Table of Contents.

__X__ 3.          General Requirements
                  You should be familiar with all of the General Requirements.

__X__ 4.          Special Requirements/Instructions
                  This section provides information you must know in order to make an offer properly.

__X__ 5.          Specifications
                  This section contains the detailed description of the product/service sought by the County.

__X__ 6.          Pricing/Delivery Information
                  This form is used to solicit exact pricing of goods/services and delivery costs.

__X__ 7.          Attachments
                  __X__ a.           Residence Certification/Tax Form
                                     Be sure to complete this form and return with packet.

                  _____    b.        Bid Guaranty & Performance Bond Information & Requirements
                                     This form applies only to certain bids/proposals. All public work contracts over $25,000 require a
                                     Payment Bond and over $100,000 must also have a Performance Bond, in a form approved by the
                                     County. Please read carefully and fill out completely.

                  _____    c.        Bid Check Return Authorization Form
                                     This form applies only to certain bids/proposals. Please read carefully and fill out completely.

                  _____    d.        Vehicle Delivery Instructions
                                     Included only when purchasing vehicles.

                  __X__ e.           Minimum Insurance Requirements
                                     (Included in specific requirements when applicable (does not supersede ―Hold Harmless‖ section of
                                     General Requirements).

                  _____    f.        Worker’s Compensation Insurance Coverage Rule 110.110
                                     This requirement is applicable for a building or construction contract.

                  _____    g.        Financial Statement
                                     When this information is required, you must use this form.

                  __X__ h.           Reference Sheet
                                     When this information is required, you must use this sheet.

                  __X__ i.           Other
                                     From time to time other attachments may be included.
Revised 03/04




                                                                                                                               Page 2 of 22
                                                 GENERAL REQUIREMENTS FOR PROPOSALS

READ THIS ENTIRE DOCUMENT CAREFULLY. FOLLOW ALL INSTRUCTIONS. YOU ARE RESPONSIBLE FOR FULFILLING ALL
REQUIREMENTS AND SPECIFICATIONS. BE SURE YOU UNDERSTAND THEM.

General Requirements apply to all advertised requests for proposals; however, these may be superseded, whole or in part, by the SPECIAL
REQUIREMENTS/INSTRUCTIONS OTHER DATA CONTAINED HEREIN. Review the Table of Contents. Be sure your proposal package is
complete.

ACCESS TO RECORDS
In special circumstances, vendor may be required to allow duly authorized representatives of Harris County, the Harris County Hospital District or
the state and federal government access to contracts, books, documents, and records necessary to verify the nature and extent of the cost of services
provided by vendor.

ADDENDA
When specifications are revised, the Harris County Purchasing Agent will issue an addendum addressing the nature of the change. Offerors must sign it
and include it in the returned proposal package.

ASSIGNMENT
The successful offeror may not assign, sell or otherwise transfer this contract without written permission of Harris County Commissioners Court.

AWARD
Harris County reserves the right to award this contract on the basis of LOWEST AND BEST OFFER in accordance with the laws of the State of Texas, to
waive any formality or irregularity, to make awards to more than one offeror, to reject any or all proposals. In the event the lowest dollar offeror meeting
specifications is not awarded a contract, the offeror may appear before the Commissioners Court, Hospital District Board of Managers, the Juvenile Board
or other applicable governing body and present evidence concerning his responsibility after officially notifying the Office of the Purchasing Agent of his
intent to appear.

BONDS
If this proposal requires submission of proposal guarantee and performance bond, there will be a separate page explaining those requirements. Offers
submitted without the required proposal bond or Cashier's Checks are not acceptable.

CONTRACT OBLIGATION
Harris County Commissioners Court must award the contract and the County Judge or other person authorized by the Harris County Commissioners
Court must sign the contract before it becomes binding on Harris County or the offeror. Department heads are NOT authorized to sign agreements for
Harris County. Binding agreements shall remain in effect until all products and/or services covered by this purchase have been satisfactorily delivered and
accepted.

CONTRACT RENEWALS
Renewals may be made ONLY by written agreement between Harris County and the offeror. Any price escalations are limited to those stated by the
offeror in the original proposal.

DIGITAL FORMAT
If offeror obtained the proposal specifications in digital format in order to prepare a response, the proposal must be submitted in hard copy
according to the instructions contained in this proposal package. If, in its proposal response, offeror makes any changes whatsoever to the County's
published proposal specifications, the County's proposal specifications as published shall control. Furthermore, if an alteration of any kind to the
County's published proposal specifications is only discovered after the contract is executed and is or is not being performed, the contract is subject to
immediate cancellation.

DISQUALIFICATION OF OFFEROR
Upon signing this proposal document, an offeror offering to sell supplies, materials, services, or equipment to Harris County certifies that the offeror
has not violated the antitrust laws of this state codified in §15.01, et seq., Business & Commerce Code, or the federal antitrust laws, and has not
communicated directly or indirectly the offer made to any competitor or any other person engaged in such line of business. Any or all proposals may
be rejected if the County believes that collusion exists among the offerors. Proposals in which the prices are obviously unbalanced may be rejected.
If multiple proposals are submitted by an offeror and after the proposals are opened, one of the proposals is withdrawn, the result will be that all of
the proposals submitted by that offeror will be withdrawn; however, nothing herein prohibits a vendor from submitting multiple offers for different
products or services.

E-MAIL ADDRESSES CONSENT
Vendor affirmatively consents to the disclosure of its e-mail addresses that are provided to Harris County, the Harris County Flood Control District,
the Harris County Hospital District including its HMO, the Harris County Appraisal District, or any agency of Harris County. This consent is
intended to comply with the requirements of the Texas Public Information Act, Tex. Gov‘t Code Ann. §522.137, as amended, and shall survive
termination of this agreement. This consent shall apply to e-mail addresses provided by Vendor, its employees, officers, and agents acting on
Vendor‘s behalf and shall apply to any e-mail address provided in any form for any reason whether related to this bid/proposal or otherwise.

Revised 08/06




                                                                                                                                             Page 3 of 22
EVALUATION
Evaluation shall be used as a determinant as to which proposed items or services are the most efficient and/or most economical for the County. It shall be
based on all factors which have a bearing on price and performance of the items in the user environment. All proposals are subject to negotiations by the
Purchasing Agent and other appropriate departments, with recommendation to the appropriate governing body. Compliance with all requirements,
delivery and needs of the using department are considerations in evaluating proposals. Pricing is NOT the only criteria for making a recommendation.
A preliminary evaluation by Harris County will be held and appropriate proposals will be subjected to the negotiating process. Upon completion of the
negotiations, Harris County will make an award. All proposals that have been submitted shall be available and open for public inspection after the
contract is awarded except for trade secrets or confidential information contained in the proposals and identified as such.

FISCAL FUNDING
A multi-year lease or lease/purchase arrangement (if requested by the specifications), or any contract continuing as a result of an extension option, must
include fiscal funding out. If, for any reason, funds are not appropriated to continue the lease or contract, said lease or contract shall become null and void
on the last day of the current appropriation of funds. After expiration of the lease, leased equipment shall be removed by the Contractor from the using
department without penalty of any kind or form to Harris County. All charges and physical activity related to delivery, installation, removal and
redelivery shall be the responsibility of the offeror.

GOVERNING FORMS
In the event of any conflict between the terms and provisions of these requirements and the specifications, the specifications shall govern. In the event of
any conflict of interpretation of any part of this overall document, Harris County's interpretation shall govern.

GOVERNING LAW
This request for proposals is governed by the competitive bidding requirements of the County Purchasing Act, Texas Local Government Code, §262.021
et seq., as amended. Offerors shall comply with all applicable federal, state and local laws and regulations. Offeror is further advised that these
requirements shall be fully governed by the laws of the State of Texas and that Harris County may request and rely on advice, decisions and opinions of
the Attorney General of Texas and the County Attorney concerning any portion of these requirements.

GRANT FUNDING
Any contract entered into by the County that is to be paid from grant funds shall be limited to payment from the grant funding and the
vendor/provider understands that the County has not set aside any County funds for the payment of obligations under a grant contract. If grant
funding should become unavailable at any time for the continuation of services paid for by the grant, and further funding cannot be obtained for the
contract, then the sole recourse of the provider shall be to terminate any further services under the contract and the contract shall be null and void.

HIPAA COMPLIANCE
Offeror agrees to comply with the Standards for Privacy of Individually Identifiable Health Information of the Health Insurance Portability and
Accountability Act of 1996, PL 104-191, 45 CFR Parts 160-164, as amended, and the Texas Medical Records Privacy Act, Texas Health and Safety
Code Chapter 181, as amended, collectively referred to as "HIPAA", to the extent that the Offeror uses, discloses or has access to protected health
information as defined by HIPAA. Offeror may be required to enter a Business Associate Agreement pursuant to HIPAA.

HOLD HARMLESS AGREEMENT
Contractor, the successful offeror, shall indemnify and hold Harris County harmless from all claims for personal injury, death and/or property damage
resulting directly or indirectly from Contractor's performance. Contractor shall procure and maintain, with respect to the subject matter of this proposal,
appropriate insurance coverage including, as a minimum, public liability and property damage with adequate limits to cover Contractor's liability as may
arise directly or indirectly from work performed under terms of this proposal. Certification of such coverage must be provided to the County upon request.

INSPECTIONS & TESTING
Harris County reserves the right to inspect any item(s) or service location for compliance with specifications and requirements and needs of the using
department. If an offeror cannot furnish a sample of a bid item, where applicable, for review, or fails to satisfactorily show an ability to perform, the
County can reject the bid as inadequate.

INVOICES AND PAYMENTS
Offerors shall submit an original invoice on each purchase order or purchase release after each delivery, indicating the purchase order number.
Invoices must be itemized. Any invoice which cannot be verified by the contract price and/or is otherwise incorrect will be returned to the offeror for
correction. Under term contracts, when multiple deliveries and/or services are required, the offeror may invoice following each delivery and the
County will pay on invoice. Contracts providing for a monthly charge will be billed and paid on a monthly basis only. Prior to any and all payments
made for goods and/or services provided under this contract, the offeror should provide his Taxpayer Identification Number or social security
number as applicable. This information must be on file with the Harris County Auditor‘s office. Failure to provide this information may result in a
delay in payment and/or back-up withholding as required by the Internal Revenue Service.

MAINTENANCE
Maintenance required for equipment proposed should be available in Harris County by a manufacturer-authorized maintenance facility. Costs for this
service shall be shown on the Pricing/Delivery Information. If Harris County opts to include maintenance, it shall be so stated in the purchase order and
said cost will be included. Service will commence only upon expiration of applicable warranties and should be priced accordingly.

Revised 06/05




                                                                                                                                          Page 4 of 22
MATERIAL SAFETY DATA SHEETS
Under the "Hazardous Communication Act", commonly known as the "Texas Right To Know Act", an offeror must provide to the County with each
delivery, material safety data sheets which are applicable to hazardous substances defined in the Act. Failure of the offeror to furnish this documentation
will be cause to reject any bid applying thereto.

NEW MILLENIUM COMPLIANCE
All products and/or services furnished as part of this contract must be compliant for the present year and forward. This applies to all computers
including hardware and software as well as all other commodities with date sensitive embedded chips.

POTENTIAL CONFLICTS OF INTEREST
An outside consultant or contractor is prohibited from submitting a proposal for services on a Harris County project of which the consultant or
contractor was a designer or other previous contributor, or was an affiliate, subsidiary, joint venturer or was in any other manner associated by
ownership to any party that was a designer or other previous contributor. If such a consultant or contractor submits a prohibited proposal, that
proposal shall be disqualified on the basis of conflict of interest, no matter when the conflict is discovered by Harris County.

PRICING
Prices for all goods and/or services shall be negotiated to a firm amount for the duration of this contract or as agreed to in terms of time frame. All prices
must be written in ink or typewritten. Where unit pricing and extended pricing differ, unit pricing prevails.

PROPOSAL COMPLETION
Fill out and return to Purchasing, ONE (1) complete proposal form in an appropriately sized envelope or box. PACKAGE MUST SHOW THE JOB
NUMBER, DESCRIPTION AND BE MARKED “SEALED PROPOSAL.” An authorized company representative should sign the Proposal Cover
Sheet. Completion of these forms is intended to verify that the offeror has submitted the proposal, is familiar with its contents and has submitted the
material in accordance with all requirements.

PROPOSAL RETURNS
Offerors must return all completed proposals to the office of the Harris County Purchasing Agent reception desk at 1001 Preston Avenue, Suite 670,
Houston, Texas before 2:00 P.M. LOCAL TIME IN HOUSTON, TEXAS on the date specified. Late proposals will not be accepted.

PURCHASE ORDER AND DELIVERY
The successful offeror shall not deliver products or provide services without a Harris County Purchase Order, signed by an authorized agent of the Harris
County Purchasing Agent. The fastest, most reasonable delivery time shall be indicated by the offeror in the proper place on the proposal document. Any
special information concerning delivery should also be included, on a separate sheet, if necessary. All items shall be shipped F.O.B. INSIDE
DELIVERY unless otherwise stated in the specifications. This shall be understood to include bringing merchandise to the appropriate room or place
designated by the using department. Every tender or delivery of goods must fully comply with all provisions of these requirements and the specifications
including time, delivery and quality. Nonconformance shall constitute a breach which must be rectified prior to expiration of the time for performance.
Failure to rectify within the performance period will be considered cause to reject future deliveries and cancellation of the contract by Harris County
without prejudice to other remedies provided by law. Where delivery times are critical, Harris County reserves the right to award accordingly.

RECYCLED MATERIALS
Harris County encourages the use of products made of recycled materials and shall give preference in purchasing to products made of recycled materials if
the products meet applicable specifications as to quantity and quality. Harris County will be the sole judge in determining product preference application.

SCANNED OR RE-TYPED RESPONSE
If in its response, offeror either electronically scans, re-types, or in some way reproduces the County's published proposal package, then in the event of any
conflict between the terms and provisions of the County's published proposal package, or any portion thereof, and the terms and provisions of the
response made by offeror, the County's proposal package as published shall control. Furthermore, if an alteration of any kind to the County's published
proposal package is only discovered after the contract is executed and is or is not being performed, the contract is subject to immediate cancellation.

SEVERABILITY
If any section, subsection, paragraph, sentence, clause, phrase or word of these requirements or the specifications shall be held invalid, such holding shall
not affect the remaining portions of these requirements and the specifications and it is hereby declared that such remaining portions would have been
included in these requirements and the specifications as though the invalid portion had been omitted.

SILENCE OF SPECIFICATIONS
The apparent silence of specifications as to any detail, or the apparent omission from it of a detailed description concerning any point, shall be regarded as
meaning that only the best commercial practice is to prevail and that only material and workmanship of the finest quality are to be used. All
interpretations of specifications shall be made on the basis of this statement. The items furnished under this contract shall be new, unused of the latest
product in production to commercial trade and shall be of the highest quality as to materials used and workmanship. Manufacturer furnishing these items
shall be experienced in design and construction of such items and shall be an established supplier of the item proposed.


Revised 06/05




                                                                                                                                         Page 5 of 22
SUPPLEMENTAL MATERIALS
Offerors are responsible for including all pertinent product data in the returned proposal package. Literature, brochures, data sheets, specification
information, completed forms requested as part of the proposal package and any other facts which may affect the evaluation and subsequent contract
award should be included. Materials such as legal documents and contractual agreements, which the offeror wishes to include as a condition of the
proposal, must also be in the returned proposal package. Failure to include all necessary and proper supplemental materials may be cause to reject the
entire proposal.

TAXES
Harris County is exempt from all federal excise, state and local taxes unless otherwise stated in this document. Harris County claims exemption from all
sales and/or use taxes under Texas Tax Code §151.309, as amended. Texas Limited Sales Tax Exemption Certificates will be furnished upon written
request to the Harris County Purchasing Agent.

TERM CONTRACTS
If the contract is intended to cover a specific time period, the term will be given in the specifications under SCOPE.

TERMINATION
Harris County reserves the right to terminate the contract for default if Seller breaches any of the terms therein, including warranties of offeror or if the
offeror becomes insolvent or commits acts of bankruptcy. Such right of termination is in addition to and not in lieu of any other remedies which Harris
County may have in law or equity. Default may be construed as, but not limited to, failure to deliver the proper goods and/or services within the proper
amount of time, and/or to properly perform any and all services required to Harris County's satisfaction and/or to meet all other obligations and
requirements. Harris County may terminate the contract without cause upon thirty (30) days written notice.

TESTING
Harris County reserves the right to test equipment, supplies, material and goods proposed for quality, compliance with specifications and ability to meet
the needs of the user. Demonstration units must be available for review. Should the goods or services fail to meet requirements and/or be unavailable for
evaluation, the offer is subject to rejection.

TITLE TRANSFER
Title and Risk of Loss of goods shall not pass to Harris County until Harris County actually receives and takes possession of the goods at the point or
points of delivery. Receiving times may vary with the using department. Generally, deliveries may be made between 8:30 a.m. and 4:00 p.m., Monday
through Friday. Offerors are advised to consult the using department for instructions. The place of delivery shall be shown under the "Special
Requirements/Instructions" section of this proposal and/or on the Purchase Order as a "Deliver To:" address.

WAIVER OF SUBROGATION
Offeror and offeror's insurance carrier waive any and all rights whatsoever with regard to subrogation against Harris County as an indirect party to any suit
arising out of personal or property damages resulting from offeror's performance under this agreement.

WARRANTIES
Offerors shall furnish all data pertinent to warranties or guarantees which may apply to items in the proposal. Offerors may not limit or exclude any
implied warranties. Offeror warrants that product sold to the County shall conform to the standards established by the U.S. Department of Labor under
the Occupational Safety and Health Act of 1970. In the event product does not conform to OSHA Standards, where applicable, Harris County may return
the product for correction or replacement at the offeror's expense. If offeror fails to make the appropriate correction within a reasonable time, Harris
County may correct at the offeror's expense.



                                                              VENDORS OWING TAXES
Pursuant to TX Local Government Code 262.0276, the Hospital District Board of Managers has adopted a policy which requires that vendors‘ taxes
be current as of the date bids/proposals are due. Bidders/proposers with delinquent taxes on the due date will not be eligible for award. Whether or
not a vendor‘s taxes are delinquent will be determined by an independent review of the Tax Office records. Vendors who believe a delinquency is
reflected in error must contact the Tax Office to correct any errors or discrepancies prior to submitting their bid in order to ensure that their bid will
be considered. Tax records are available online at the Tax Office website—www.hctax.net. Prior to submitting a bid, vendors are encouraged to visit
the Tax Office website, set up a portfolio of their accounts and make their own initial determination of the status of their tax accounts. This policy is
effective for all bids due on or after July 1, 2004.




Revised 06/05




                                                                                                                                         Page 6 of 22
                             SPECIAL REQUIREMENTS/INSTRUCTIONS

The following requirements and instructions supersede General Requirements where applicable. The term
“Harris County” is understood to include the Harris County Hospital District (“HCHD” or “Hospital
District”).

VENDOR INSTRUCTIONS
Responses to this Request for Proposal shall be formatted and organized in the following order for
consistency and easy screening:
    All proposals must be typed, single spaced, and printed single sided on 8 ½‖ by 11‖ paper.
    One original, clearly marked ―ORIGINAL‖, and five (5) copies, clearly marked ―COPY‖, must be
        submitted in separate three-ring, loose-leaf binders with identification of the vendor, the job number,
        and the RFP title on the front cover and binder siding.
    The complete proposal response package should be sealed in an envelope or box for delivery to the
        Office of the Harris County Purchasing Agent per instructions in the Proposal Returns paragraph of the
        General Requirements section.
    All documents included in the proposal and the outside of the package must be labeled with the
        vendor‘s name and the job number found on the RFP cover sheet.
    Each section of the vendor‘s response should start on a new page. A ‗tab page‘ marked with the section
        number and title should separate each section.
    Each page should be marked with the section title in the top heading.
    Prepare a Table of Contents for the proposal being submitted and place it before Section I.

       Section I      RFP Cover Page (completed); Residence Certificate (completed)
       Section II     Narrative of proposed program.
       Section III    Pricing - attach a price list for all available procedures and indicate your discount
                      for Hospital District patients.
       Section IV     Proposer‘s information:
                      a.    Answers to Questionnaire and any attachments.
                      b.    Certificate of Insurance using the standard industry ACORD form, showing the
                            kinds and levels of insurance, including Malpractice insurance, which will be
                            in place at the implementation of a contract. A computer printout is not
                            acceptable to meet this requirement. If the Hospital District feels the amount of
                            insurance is insufficient, it reserves the right to require the Contractor to obtain
                            additional insurance as a condition of award.
                      c.    Description of employee drug screen program.
                      d.    Copy of Contractor‘s Quality Assurance/Quality Control policies and
                            procedures.
       Section V      Details and samples of the types of reports generated including the logistics of
                      reporting each possible outcome of screening and/or diagnostic imaging services;
                      submit sample invoice.
       Section VI     Any standard agreement(s) or contract(s) associated with your response
       Section VII    Additional information as appropriate

Proposers should include ONE (1) ―ORIGINAL‖ (CLEARLY MARKED “ORIGINAL”) and FIVE (5)
COPIES (CLEARLY MARKED “COPY”) of the response sealed in an envelope or package for delivery
to the Harris County Purchasing Agent per the instructions in the General Requirements (see Proposal
Completion and Proposal Returns). All documents included in the proposal and the outside of



                                                                                                     Page 7 of 22
                     SPECIAL REQUIREMENTS/INSTRUCTIONS-(Continued)

the envelope or package must be marked with the vendor‘s name and the job number that corresponds to this
RFP.

Evaluation will consider cost productive, efficient and effective plans. Emphasis will be placed on
capability to perform within the program as well as meeting the needs of the using department. While Harris
County Hospital District appreciates a brief straightforward and concise reply, the vendor must fully
understand that evaluations are based on the information provided. Accuracy and completeness are essential.
Omissions, ambiguous or equivocal statements may be construed against the vendor. The proposal response
may be incorporated into any contract that results from this RFP, and vendors are cautioned not to make
claims or statements that they are not prepared to commit to contractually. Failure of the vendor to meet
such claims will result in a requirement that the vendor provide the resources necessary to meet submitted
claims.

Vendors are expected to examine all documents, forms, specifications and all instructions. Failure to do so
will be at the vendor‘s risk.

Under the Request for Proposal process, sealed offers will be received and opened in the Office of the Harris
County Purchasing Agent. At and after opening, proposals will not be part of the public record and subject
to disclosure, but will be kept confidential until time of award and execution of an agreement. When an
award is made and an agreement is executed, proposals are subject to review under the ―Public Information
Act‖. To the extent permitted by law, vendors may request in writing non-disclosure of confidential data.
Such information shall accompany the proposal, be readily separable from the proposal, and shall be
CLEARLY MARKED ―CONFIDENTIAL‖. For those portions identified as confidential by the vendor,
Harris County must rely on advice, decisions and opinions of the Attorney General of the State of Texas
relative to the disclosure of data or information.

Harris County Hospital District will not be liable for any costs incurred by any vendor in preparing a
response to this RFP. Vendors submit proposals at their own risk and expense. Harris County Hospital
District makes no guarantee that any equipment or services will be purchased as a result of this Request for
Proposals, and reserves the right to reject any and all proposals. All proposals and their accompanying
documentation will become the property of Harris County Hospital District.

EVALUATION PROCESS
All proposals will be examined by an evaluation committee.

Proposals that do not conform to the instructions given or which do not address all the services as specified
may be eliminated from consideration. Harris County Hospital District, however, reserves the right to accept
such proposal if it is determined to be in the Hospital District‘s best interest to do so.

Harris County Hospital District may initiate discussions with vendors. Discussions may not be initiated by
vendors. Harris County Hospital District expects to conduct discussions with vendor personnel authorized to
contractually obligate the vendor with an offer. Vendors shall not contact any Harris County Hospital
District personnel during the RFP process without the express permission from the Office of the Harris
County Purchasing Agent. Harris County Purchasing may disqualify any vendor who has made site visits,
contacted Harris County Hospital District personnel or distributed any literature without authorization from
this office.



                                                                                              Page 8 of 22
                      SPECIAL REQUIREMENTS/INSTRUCTIONS-(Continued)

All correspondence relating to this RFP, from advertisement to award, shall be sent to the Harris County
Purchasing Department. All presentations and/or meetings between the Harris County Hospital District and
the vendor relating to this RFP shall be coordinated by the Harris County Purchasing Department.

No award can be made until the Harris County Hospital District Board of Managers approves such action.

Submission of a proposal implies the vendor‘s acceptance of the evaluation criteria and vendor recognition
that subjective judgments must be made by the evaluating committee.

This Request for Proposal in no manner obligates the Hospital District to eventual rental, lease, purchase,
etc. of any equipment or service described, implied or which may be proposed, until confirmed by a written
contract. Progress toward this end is solely at the discretion of Harris County Hospital District and may be
terminated at any time prior to the signing of the contract.

Selected vendors may be expected to make a presentation to the evaluation committee. Vendor presentations
will develop into negotiating sessions with the successful vendor if selected by the evaluation committee. If
the Hospital District is unable to agree to contract terms, Harris County Hospital District reserves the right to
terminate contract negotiations with that vendor and initiate negotiations with another vendor. Vendors shall
not contact any Hospital District personnel during the RFP process without the express permission from the
Office of the Harris County Purchasing Agent.

Harris County Purchasing may disqualify any vendor who has made site visits, contacted personnel, or
distributed any literature without authorization from this office.

EVALUATION CRITERIA
The award of the contract shall be made to the responsible contractor(s) whose proposal is determined to be
the best evaluated offer taking into consideration the following:
     Proposed services and capacity                                                     20%
     Proposer‘s qualifications                                                          20%
     Proposer‘s experience                                                      20%
     Cost                                                                               20%
     Geographic location(s)                                                             15%
     Compliance with instructions and specifications                                     5%

Harris County Hospital District anticipates awarding to more than one contractor based on geographic
location, capacity and/or type of service.

INVOICING AND PAYMENT
Contractor will submit to HCHD a request for payment for each patient that has been: 1) identified and
referred by the District to Contractor for diagnostic imaging services and other services essential to the
evaluation and treatment of referred patients (diagnostic, laboratory, etc.), and 2) has no other third party
payor (the ―non-funded patient‖). The request for payment for services will be submitted for each calendar
month and/or portion thereof on a UB-92 (technical services) or HCFA form 1500 (professional services)
with the patient‘s HCHD assigned medical record number. In addition, the Contractor is to attach a copy of
the referring physician‘s documented order for the treatment. Additionally, the Contractor will provide a list
of each patient referred to the Contractor by HCHD that had a third party payor (the ―funded patient‖). For
each funded patient, the Contractor must show the service(s) that was


                                                                                                  Page 9 of 22
                      SPECIAL REQUIREMENTS/INSTRUCTIONS-(Continued)

provided, the date of the service(s), the HCHD assigned medical record number, the name of the third party
payor that was billed and the notation ―no charge to HCHD.‖ The Contractor will send the foregoing
information for funded and non-funded patients via U.S. mail on or about the last day of each calendar
month to:

                                   Harris County Hospital District
                                          P.O. BOX 66769
                                       Houston, Texas 77266
                            ATTENTION: Patient Business Services Department

The Hospital District must verify and the Contractor must provide sufficient evidence that the service(s)
charged for was provided before payment can be made by HCHD for the non-funded patient. The Contractor
will not provide any services to funded or non-funded patients without first obtaining a referral or
authorization and an additional documented order from the referring physician and/or designated third-party
payor as applicable. Furthermore, the Contractor will not bill HCHD, the patient, or a third party payor for
any procedures and reports that were repeated at the request of HCHD or the referring physician due to
image quality related issues. The Contractor shall provide copies of any documents, records, or information
that may be requested by Medicare, Medicaid or any other third party payor as required by law or authorized
by the patient. Contractor is responsible for obtaining the authorization for services that may require
preauthorization by the third party carrier. Furthermore, Contractor will grant HCHD personnel access to its
facilities and records during normal business hours, including but not limited to, patient medical records,
patient billing records, insurance billing records or claims submitted by Contractor for payment, billing
policies, procedures and practices, patient complaints and records recorded in any form or medium for the
purpose of audit or evaluation of services delivered pursuant to this Agreement.

Contractor understands that it must have a current provider agreement with federal healthcare program(s),
including, but not limited to, Medicare, Traditional Medicaid, all the Managed Medicaid Plans in the Harris
County Service area, and all of the CHIP plans in the Harris County Service area prior to commencement of
services. Contractor agrees to abide by the terms of the respective provider agreements as well as any
applicable rules and regulations concerning billing and payment for services.

HCHD assumes no responsibility for payment of any services performed but not ordered by the HCHD
referring physician. If the patient services/treatment are identified to perform, the Contractor must contact
the referring physician and obtain a documented order. HCHD will assume responsibility for reimbursing
the Contractor for third party payment denials associated with eligibility and medical necessity; however, the
Contractor will be required to submit appropriate supporting documentation with an invoice that includes:
remittance advice, explanation of benefits, and any other pertinent information requested by HCHD. HCHD
will reimburse accordingly with the associated third party rates (e.g., Medicare patients will be reimbursed
with Medicare rates. Medicaid patients will be reimbursed with Medicaid rates).

The Hospital District will pay Contractor for appropriate services provided to those patients referred to
Contractor that have no third party payor source according to the rate provider has set forth in this bid. As a
condition to payment of such services by the Hospital District, the patient must have satisfactorily completed
all Hospital District eligibility requirements and obtained a financial classification to receive Hospital
District services at no charge or at a reduced rate. HCHD will be responsible for confirming

                      SPECIAL REQUIREMENTS/INSTRUCTIONS-(Continued)


                                                                                               Page 10 of 22
eligibility requirements prior to referral, but the Contractor should ensure that this process has taken place.

Contractor agrees to notify HCHD prior to the commencement of services of each health plan and third party
payor of any kind that has approved Contractor as a provider of radiology services. In the event that HCHD
pays Contractor for services and it is subsequently determined that the patient has insurance benefits that
will cover the services, then the Hospital District shall receive a full and prompt refund from the Contractor.

Upon accepting a Medicare, Medicaid, Medicare HMO, Medicaid HMO or any other health insurance plan
referral, Contractor shall accept the assignment of benefits and the Contractor‘s reimbursement shall be
limited to the amount approved by Medicare, Medicaid, Medicare HMO, Medicaid HMO, of CHIP plan
including any applicable payment by the patient for co-insurance, deductible or non-covered charges. The
Contractor will not offer to patients/clients waiver of co-payments, deductibles, or give discounts, coupons,
rebates, or other ―special offers‖ eliminating the need for co-payments on Medicare approved items. The
Hospital District shall not be held responsible for charges and balances in excess of the amount(s) paid by
Medicare, Medicaid, a Medicare HMO, a Medicaid HMO, or any other health insurance plan, i.e., balance
billing. Additionally, the Hospital District shall not be held responsible if Medicare, Medicaid, a Medicare
HMO, Medicaid HMO, or any other third party payor is not billed for services or is not billed within the
appropriate billing timeframes.

Neither the Hospital District nor any patients referred to Contractor by the Hospital District will be
financially liable for any claims rejected by Medicare, Medicaid, a Medicare HMO or a Medicaid HMO or
any other third party payor. Additionally, the Hospital District shall not be held responsible if Medicare,
Medicaid, a Medicare HMO or a Medicaid HMO is not billed for services or is not billed within the
appropriate billing timeframes.

NONPERFORMANCE
Harris County Hospital District reserves the right to place Contractor on probation for failure to meet
minimum quality or performance standards set forth in this bid. Nonperformance shall be determined as
follows:

1.   Failure to meet and maintain all qualifications noted above;
2.   Failure to meet appropriate personnel standards and performance;
3.   Failure to maintain appropriate and necessary personnel licenses and certifications noted herein;
4.   Failure to comply with federal, state and local requirements;
5.   Failure to maintain all required insurance coverage;
6.   Failure to cure deficiencies within a reasonable amount of time as stated herein;
7.   Failure to meet the requirements for treatment, standard of care, and documentation as stated herein.

Probation may be for a period of thirty (30) days or such time as the Hospital District allows during which a
complete cure or remedy by the company is required. The Contractor‘s failure to cure any deficiency within
the allotted time frame may result in complete termination of the contract.

INSURANCE
If awarded a contract for imaging services, the Contractor agrees that during the term of the contract, it shall
maintain professional (malpractice/negligence) liability insurance and comprehensive general liability
insurance coverage in the amounts of not less than ONE HUNDRED THOUSAND AND NO/100
                      SPECIAL REQUIREMENTS/INSTRUCTIONS-(Continued)

DOLLARS ($100,000.00) per person, THREE HUNDRED THOUSAND AND NO/100 DOLLARS
($300,000.00) per occurrence and ONE HUNDRED THOUSAND AND NO/100 DOLLARS ($100,000.00)
property damage. These amounts are not intended to nor do they limit the Contractor‘s liability under this
                                                                                                 Page 11 of 22
Agreement. In addition, the Contractor shall maintain standard workers‘ compensation and employer
liability insurance coverage for all employees of Contractor involved in the performance of this Agreement.
The Contractor shall also provide any other benefits required by law for all employees of Contractor
involved in the performance of these services.

Contractor shall ensure that HCHD receives written notice sixty (60) days prior to the effective date of any
reduction in coverage or cancellation of such insurance policies.

Contractor shall provide prompt notice to the Hospital District of any claim filed or threatened against
Contractor, Contractor‘s employees, or agents of Contractor in connection with this contract.




                                                                                            Page 12 of 22
                                            SPECIFICATIONS

                 Imaging Services for Patients of the Harris County Hospital District


SCOPE
The successful contractor(s) shall provide imaging services for Harris County Hospital District patients
for a period of one year beginning on or about January 1, 2007 and continuing for twelve months or until
all services ordered prior to the expiration date have been satisfactorily provided. If you need additional
information, contact Laurie Wainwright at 713-755-6597 or email loretta_wainwright@hctx.net.

Contractors are encouraged to review this entire Request for Proposal upon receipt. Technical questions
or questions concerning data contained within the RFP and clarification or expansion of such must be
addressed to Laurie Wainwright by email at loretta_wainwright@hctx.net or faxed to (713) 755-6695.

RENEWAL
Harris County Hospital District wishes to consider a renewal option for an additional two (2) years,
renewed one year at a time, based on the same terms, conditions and pricing as the original year. Once
renewals are exhausted, the contract must be re-bid. If bidder does not wish to consider renewal, write
NA in the space provided for the year indicated on the bid sheet.

Harris County Hospital District reserves the right to re-bid at any time as is in its best interest and is not
automatically bound to renewal.

REQUIREMENTS
The Harris County Hospital District is seeking experienced imaging contractors to provide imaging
services including, but not limited to: Ultrasounds, Magnetic Resonance Imaging (MRI‘s), and
Computed Tomography (CT) Scans, for all body regions and, where applicable, with contrast, without
contrast, as well as with and without contrast studies, to Hospital District patients.

The Contractor should have the capability of capturing images via a Picture Archiving and
Communication System (PACS). Additionally, the contractor will have the capability of establishing a
high speed data connection with HCHD prior to the commencement of services.

The Hospital District, in collaboration with the patient‘s physician (―referring physician‖), will refer
patients to Contractor for performance of designated services. HCHD will make a reasonable effort to
identify any third party that may be responsible for payment of services prior to referral, but final
responsibility rests with the Contractor. HCHD reserves the right at all times to determine which
patients, if any, will be referred to Contractor for services.

The estimated annual volume of referrals is shown below; however, HCHD does not guarantee any
particular volume of work to Contractor and reserves the right to refer more or fewer patients.




                                                                                                 Page 13 of 22
                                   SPECIFICATIONS-(Continued)

                               ESTIMATED REFERRAL VOLUME
            Imaging Modality            Estimated Daily Volume        Estimated Yearly Volume
     Ultrasound                                     50                           12,600
     Computed Tomography (CT)                       26                            6,240
     Magnetic Resonance Imaging
     (MRI)                                          18                            4,320
                Total                               94                           22,560

The Hospital District shall not be responsible for payment for services rendered to patients with
Medicare or Medicare HMO, Medicaid or Medicaid HMO or any other third party payor of any source.

Services will be performed at Contractor‘s imaging center(s). The Contractor will provide appropriate
waiting rooms, changing rooms, examination rooms and rooms for interpretation that ensure adequate
space and privacy for the patient/client. The Contractor‘s facilities will have adequate heating,
illumination, and sanitation systems and comply with all applicable state and local building codes and
ordinances.

The HCHD Centralized Scheduling Center will contact the eligible patient and schedule the
procedure(s). The Contractor is expected to ensure adequate appointment availability at or above the
established standards of care; thus, patients are expected to be scheduled within 30 days of receipt of the
referral. Ideally, HCHD would like patients to be scheduled within 14 days of the referral or within a
time sufficiently above the establish standard of care. The Contractor will then perform the procedure(s)
or notify HCHD‘s Centralized Scheduling Center if a patient fails to appear for a scheduled
appointment. Contractor will provide an electronic copy of the film/image along with an electronic
report to HCHD. If in the reasonable opinion of HCHD or the referring physician, the image quality
and/or the quality and accuracy of the dictated report does not meet HCHD standards and expectations,
then Contractor will repeat the study at no cost to the Hospital District or the patient.

 The electronic imaging format, as well as the electronic report format must meet the approval of HCHD
and HCHD Information Technology. Electronic interactions between the contractor and HCHD must
conform to HL7 version 2.2 or 2.3 for transactions and DIACOM 3.0 for images. Transactions required
include: Orders inclusive of ADT, Orders Acknowledgement, and Results. Images must be transmitted
to HCHD‘s Fuji PACs system. The vendor must be able to comply with existing HCHD network
security policies.

REPORTS TO HCHD
The interpreting physician must provide all images and signed final reports to HCHD within 48 hours of
the examination in digital, electronic format. Any clinical question raised by the referring physician
should be addressed in the report.

The interpreting physician will make oral reports to the referring physician for any results when, in the
reasonable medical judgment of the interpreting physician, such oral report is necessary to met the
standard of care for the patient. Any recommended studies including additional views and adjunctive
diagnostic procedures should be communicated to the referring physician as soon as possible. The
                                  SPECIFICATIONS-(Continued)



                                                                                           Page 14 of 22
oral report shall be followed by a written report as described above. The referring physician will be
responsible for communicating and advising the patient/client of the radiology results that may change
the treatment of the patient.

QUALIFICATIONS OF PERSONNEL
The Contractor will provide a Board Certified Radiologist licensed by the State of Texas (―interpreting
physician‖) who shall be responsible, at a minimum, for supervising the performance of imaging
procedures, interpreting test results, and recording and communicating results to the referring physician
in a timely manner. He or she should possess knowledge of alternative and complementary imaging and
diagnostic examination findings as well as an understanding of imaging technology and instrumentation,
equipment calibration, and safety.

The Contractor will provide qualified Radiographers in good standing who are certified by the American
Registry of Radiologic Technologists (ARRT) and who are certified to perform radiography in the state
of Texas. (TDH certified). The Contractor will provide sonographers in good standing who are certified
by the American Registry of Diagnostic Medical Sonographers (ARDMS) or by the American Registry
of Radiologic Technologists (ARRT).

Failure to maintain current licenses and required certifications will be grounds for rejection of any bid or
subsequent termination of the contract with the Hospital District.

CONTRACTOR PERSONNEL
1.  Staff assigned to HCHD patients must meet the following testing and immunization
    requirements:

       a.      Tuberculin (PPD) Skin Test - The Contractor shall require PPD testing yearly on their
               staff who have not previously tested positive. For any staff member whose test becomes
               positive, the Contractor must present documentation of treatment status. For staff with
               previous known positive skin tests, the Contractor will present a yearly screening of
               clinical symptoms for active tuberculosis.

       b.      Hepatitis B - The Contractor shall maintain information as to whether their staff have
               received a Hepatitis B vaccination or has been offered the vaccination and declined.

       c.      Chicken Pox (Varicella) - The Contractor shall ensure that their staff know their immune
               status to Varicella by providing acceptable documentation of varicella vaccination,
               serologic testing for the presence of varicella antibodies, or a positive medical history for
               Varicella.

       d.      Rubella\Rubeola – Immunizations are strongly recommended for non-immune
               individuals who work in HCHD. Non-immune Healthcare workers who refuse
               vaccination will not be cleared to work with HCHD patients.

               The Contractor agrees to provide documentation that each staff member has met the
               above requirements prior to assignment to HCHD patients. Both parties agree that
               release of a staff member‘s health information shall be subject to proper written
               authorization from staff. The Contractor agrees to obtain any authorizations or releases




                                                                                            Page 15 of 22
                                  SPECIFICATIONS-(Continued)

              required by the Hospital District or by state or federal law. The Contractor understands
              and agrees that those failing or refusing to meet the above requirements for testing or
              immunization shall not be eligible for assignment to Hospital District patients.

2.     Contractor shall perform appropriate background checks, including a basic check for criminal
       activity, on all its employees who are assigned to this contract. If duties to be performed require
       specific qualifications, employee‘s skill must be verified and documented by the Contractor in
       advance. Contractor warrants that all employees performing services under this agreement meet
       all professional and regulatory standards appropriate to the duties performed, regardless of
       whether the Hospital District requires or receives documentation of same in every case. HCHD
       reserves the right to verify these prior to beginning service.

3.     Contractor shall have an active program in place for pre-employment and random or incident
       driven testing of their employees. Pre-employment screening must be equal to or better than
       Smith-Kline/Beecham Panel 10 Drug Screen. By assigning an individual to see Hospital District
       patients, Contractor warrants that the employee is and will continue to be drug free.

4.     All Contractor managers and staffers shall adhere to highest standards of reliability, courtesy and
       punctuality in the discharge of their responsibilities under the contract and shall dress
       professionally and appropriately in a manner that reflects positively on both the Contractor and
       HCHD.

5.     All Contractor personnel are subject to on-going review and acceptance by the Hospital District
       for compliance with these stipulations. HCHD reserves the right to reject any member of
       Contractor‘s personnel contingent, at any time, at its discretion, if retention of said person is
       determined to be at odds with the best interests of HCHD, with or without cause. Such rejection
       shall not place any kind of liability, penalty or hardship on HCHD and HCHD shall not be liable
       for payments to the Contractor for unsatisfactory service of any of their personnel.

EQUIPMENT AND QUALITY CONTROL
Instrumentation used for services covered by this proposal must be maintained in good operating
condition. Qualified equipment service personnel will conduct safety checks and preventive
maintenance according to the equipment manufacturer‘s specifications. Written, signed, and dated
documentation verifying equipment tests performed, tests results, installation of upgrades or
modifications, and any corrective measures that have been taken should be maintained on site. The
contractor should have appropriate policies in place concerning documentation and maintenance of all
applicable equipment, and equipment safety standards. Quality control tests should be conducted by a
qualified medical physicist or by the supervising radiologist at least annually and after major equipment
changes. The most recent TDH and physics report should also be included. Additionally, the contractor
shall maintain emergency medical equipment and supplies on site and personnel will possess training in
the use of such equipment.

POLICIES AND PROCEDURES
The Contractor will have documented policies concerning patient and personnel safety, control of
infectious diseases, protection of personnel and patients against infectious diseases, grievances and

                                      SPECIFICATIONS-(Continued)


                                                                                          Page 16 of 22
complaints of patients receiving services from the Contractor, storage of patient digital data and films
and confidentiality of patient health care medical information.

QUALITY ASSURANCE
The Contractor will develop and maintain a quality assurance program that evaluates the quality and
appropriateness of client care, opportunities to improve client care and promote client education, and
resolves identified problems. Prior to commencement of services, Contractor must submit a copy of its
quality control/quality assurance policy and procedures to HCHD.

CERTIFICATION AND ACCREDITATION
The contractor shall be certified and accredited and maintain such certification and accreditation by the
Joint Commission on Accreditation of Healthcare Organizations (JCAHO) if applicable and the
American Board of Radiology (ABR). Any lapse in ABR or JCAHO (if applicable) accreditation must
be reported to the Hospital District immediately. Additionally, the contractor must be a Medicare and
Medicaid certified facility.




                                                                                         Page 17 of 22
                                PRICING/DELIVERY INFORMATION

Include pricing in section III of your response.

PRICING
Pricing should include both the professional and hospital/technical fee on a per-treatment basis. In the
case of MRI and CT, Contractor must provide a flat fee to include: with contrast, without contrast, as well
as with and without contrast. No separate charges will be paid by the Hospital District.

Attach your price list and indicate the discount you will provide to the Hospital District. Prices should be
displayed separately according to modality. An example is shown below.

Ultrasounds
Pelvis
Carotid
Abdominal

Computed Tomography
Head
Body

Magnetic Resonance Imaging
Head
Body




RENEWAL
Vendor agrees to continue this contract for the period stated below under the same terms, conditions and
pricing as the original contract. (See Renewal Option, page 13.)

Renewal Year 1 (2008): ____________
Renewal Year 2 (2009): ____________




                                                                                              Page 18 of 22
                                                                                                                Attachment A
                                                                                                Job No. 06/0407
                                 RESIDENCE CERTIFICATION/TAX FORM
Pursuant to Texas Government Code §2252.001 et seq., as amended, Harris County requests Residence
Certification. §2252.001 et seq. of the Government Code provides some restrictions on the awarding of
governmental contracts; pertinent provisions of §2252.001 are stated below:

          (3)      "Nonresident bidder" refers to a person who is not a resident.

          (4)      "Resident bidder" refers to a person whose principal place of business is in this state, including a
                   contractor whose ultimate parent company or majority owner has its principal place of business in
                   this state.

          I certify that                             is a Resident Bidder of Texas as defined in
                     [Company Name]
          Government Code §2252.001.

          I certify that                             is a Nonresident Bidder as defined in
                           [Company Name]
          Government Code §2252.001 and our principal place of business is                            .
                                                                              [City and State]


Taxpayer Identification Number (T. I. N.):

Company Name submitting Bid/Proposal:

Mailing Address:

If you are an individual, list the names and addresses of any partnership of which you are a general partner:




PROPERTY: List all taxable property owned by you or above partnerships in Harris County.

Harris County Tax Acct. No.*                  Property address or location**




 * This is the property account identification number assigned by the Harris County Appraisal District.
** For real property, specify the property address or legal description. For business personal property, specify the
   address where the property is located. For example, office equipment will normally be at your office, but inventory
   may be stored at a warehouse or other location.
Do you carry Health Insurance on your employees? ___Yes ___No

If yes, what is the percentage of employees insured? _____%
Revised 12/04




                                                                                                                  Page 19 of 22
                                                                                                         Attachment e


                                  MINIMUM INSURANCE REQUIREMENTS

•        The Contractor shall, at all times during the term of this contract, maintain insurance coverage with not less
         than the type and requirements shown below. Such insurance is to be provided at the sole cost of the
         Contractor. These requirements do not establish limits of the Contractor's liability.

•        All policies of insurance shall waive all rights of subrogation against the County, its officers, employees
         and agents.

•        Upon request, certified copies of original insurance policies shall be furnished to Harris County.

•        The County reserves the right to require additional insurance should it be deemed necessary.


A.       Workers' Compensation (with Waiver of subrogation to Harris County) Employer's Liability, including all
         states, U.S. Longshoremen, Harbor Workers and other endorsements, if applicable to the Project.

         Statutory, and Bodily Injury by Accident: $100,000 each employee. Bodily Injury by Disease: $500,000
         policy limit $100,000 each employee.


B.       Commercial General Liability Occurrence Form including, but not limited to, Premises and Operations,
         Products Liability Broad Form Property Damage, Contractual Liability, Personal and Advertising Injury
         Liability and where the exposure exists, coverage for watercraft, blasting collapse, and explosions,
         blowout, cratering and underground damage.

         $300,000 each occurrence Limit Bodily Injury and Property Damage Combined $300,000 Products-
         Completed Operations Aggregate Limit $500,000 Per Job Aggregate $300,000 Personal and Advertising
         Injury Limit. Harris County shall be named as "additional insured" on commercial general liability policy.


C.       Automobile Liability Coverage:

         $300,000 Combined Liability Limits. Bodily Injury and Property Damage Combined. Harris County shall
         be named as "additional insured" on automobile policy.

Revised 12/00




                                                                                                          Page 20 of 22
                                           Attachment h
                              REFERENCES


Reference #1

Organization Name:
Contact Name/Telephone No.:
Address:

Services provided:




Reference #2

Organization Name:
Contact Name/Telephone No.:
Address:

Services provided:




Reference #3

Organization Name:
Contact Name/Telephone No.:
Address:

Services provided:




                                            Page 21 of 22
                                                                                                                 Attachment i
                                                   QUESTIONNAIRE

Provide your answers to the following questions in Section IV of your response.

Answers to the following questions should be as thorough and definitive as possible and include all pertinent data.
Offeror may also attach literature, brochures or other information that may enhance the offer.

1.      Please provide an overview of your company:
        a.      What is the official name of the company?
        b.      Does your firm use another ("trade style") name? If ―Yes‖, what is it?
        c.      How many years has your firm been in business?
        d.      How many years has the firm been under current management?
        e.      How many years has the firm been under current ownership and control?

2.      What is the address of the facility where you will be providing services to Hospital District patients? If you
        have more than one location, please provide a list and attach it to this questionnaire.

3.      Please provide a listing of your personnel including their experience and educational background. This listing
        should be identified and described as to individual capabilities including but not limited to: job descriptions,
        degrees, licenses, registrations, certificates of specialization, additional certificates, certification status, quality
        of training/information materials (include copies).

4.     What type of equipment will you use to provide these services?
       a.      Do you have open equipment?
       b.      Do you have equipment that can accommodate patients over 300 lbs?
       c.      Please provide the most recent copy of Contractor‘s TDH and physics report.

5.      What is your capacity for services that you can provide to HCHD?
        a.     What is your next available appointment?
        b.     How many HCHD Ultrasound referrals can you accommodate per day?
        c.     How many HCHD MRI referrals can you accommodate per day?
        d.     How many HCHD CT referrals can you accommodate per day?

6.      Describe or attach copies of maintenance procedures/policies for your equipment.

7.      Describe any specialized procedures you can provide or specialized equipment at your location(s).

8.      Describe the emergency medical equipment that you keep on site.

9.      Does your firm currently have in place a program that will provide for maintaining the confidentiality of
        information submitted to the Contractor by the Harris County Hospital District?

10.Has your firm ever had legal proceedings initiated against it by a client? If ―Yes‖, please explain:

11.     Are there any items/services that are not included in your proposal but for which HCHD is responsible in order
        to complete the proposed services? If ―Yes‖, please explain.




                                                                                                              Page 22 of 22

				
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