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HomeMy WebLinkAboutItem 06 Approval of Clinic Operations to Crowne Consulting Group, Inc. i ocoee florida AGENDA ITEM COVER SHEET Meeting Date: December 3, 2019 Item #: Reviewed By.: Contact Name: Gene Williford Department Directo / 4/. Contact Number: 407-905-3154 City Manager: Robert Fra �/f '' Subject: Assignment of Clinic Operations to Crowne Consulting Group, Inc. Background Summary: In 2007, the City executed a contract with the Crowne Consulting Group to operate the City's newly constructed employee clinic (revised/re-executed in 2010). In subsequent years, the Crowne Group merged with CareHere and the contracts were assigned as required to continue with their clinic operations. The City's contract continues on a year to year basis. In 2018, CareHere and the Crowne Consulting Group separated into distinct entities, and their clinic operations were divided between the two companies. The City requested our clinic operations be assigned back to our original contractor (Crowne) however CareHere did not honor our wishes and continued to serve as our clinic operator. Due to the expiration of a non-compete clause, the Crowne Consulting Group is now able to serve as our clinic operator once again. Since the bulk of the City's experience in clinic operations has been handled in an exemplary manner by Crowne, staff is of the opinion that clinic operations should be moved to Crowne once again. In addition, Crowne has a contractual provision with Carehere whereby they can maintain the existing medical staff at the clinic. Issue: Whether or not to change clinic providers. Recommendations: Staff recommends staff to be authorized to execute any needed agreements and/or termination notification to the Crowne Group or CareHere to assign clinic operations to the Crowne Group effective on or around March 1, 2020. Attachments: CareHere Agreement Financial Impact: Crowne has agreed to honor all costs at or below those currently charged by CareHere. Adequate funding is in the FY 19/20 budget. Type of Item: (please mark with an "x") ❑ Public Hearing For Clerk's Dept Use: ❑ Ordinance First Reading I l Consent Agenda ❑ Ordinance Second Reading Public Hearing 1 ❑ Resolution 0 Regular Agenda 14 Commission Approval ❑ Discussion&Direction ❑ Original Document/Contract Attached for Execution by City Clerk ❑ Original Document/Contract Held by Department for Execution Reviewed by City Attorney Reviewed by Finance Dept. Reviewed by 2 CareHere,LLC Medical Services Agreement This Medical Services Agreement is made and entered into this 20th day of November 2007, and revised on May 2010, by and between the City of Ocoee, a Florida municipal corporation ("Employer"), and CareHere, LLC, a Tennessee limited liability corporation("CareHere"). Recitals: A. CareHere contracts with employers to provide physicians or physician extenders (nurse practitioners or physician assistants) and/or medical assistants at the employer's place of business to perform certain medical services to the employees of such employers, their eligible dependents and/or retirees. The Employer shall determine the eligibility for all potential patients. B. The Employer desires to contract with CareHere and CareHere desires to contract with the Employer for CareHere to furnish a physician and/or physician extender and medical assistant and/or nurse to provide certain onsite medical services to the employees of the Employer and/or their dependents on the terms and subject to the conditions contained herein. NOW, THEREFORE, for good and valuable consideration, the receipt and the sufficiency of which are hereby acknowledged, the Employer and CareHere hereby agree as follows: ARTICLE I PROVISION OF PHYSICIAN OR PHYSICIAN EXTENDERS 1.01 Provision of Medical Professional. CareHere shall furnish a Physician(s) or Physician Extenders (Nurse Practitioner(s) or Physician Assistant(s)) (hereafter collectively referred as "Medical Professional"), and/or medical assistants ("Medical Assistant")to provide the Medical Services (as defined herein) at the offices of Employer to the employees of the Employer and/or the dependents thereof, in accordance with the Employer's choice(s). CareHere is not committing to furnish a particular person as the Medical Professional/Medical Assistant and,at any time and from time to time, CareHere may change the Medical Professional/Medical Assistant. Employer shall have the opportunity to interview all final physician candidates identified by CareHere. Employer shall also have the right to have CareHere remove a physician or other medical professional upon written notice, which notice shall specify the time by which the physician shall be removed. The initial phase of this Agreement requires (i) a Physician for 16 hours each week and either a Licensed Practical Nurse or a Medical Assistant for 20 hours each week, and (ii) that the office provided by the Employer be staffed with a Medical ORLA 609378.3 Professional and/or Medical Assistant up to 4- 2 days per week (which days shall be weekdays and not weekends). .• - - - - - • u -•_' i • •. •• •ro '•e• • . • , . •- ober • hours as funding through the budget allows. The foregoing staffing, weekly hours and days of operation shall not be materially increased or materially decreased without the prior written approval of the City Commission. As used herein, the term "Medical Services"means, with respect to the Employer, the medical services with respect to which CareHere has agreed to furnish a physician/nurse pursuant to this Agreement. The Medical Services with respect to which CareHere has agreed to furnish a physician/nurse are listed on Exhibit A. The Employer City Manager and CareHere may, at any time and from time to time, amend or supplement Exhibit A by written agreement, as funding through the budget allows, 1.02 Standards of Medical Professional Performance. CareHere shall contract with the Medical Professional such that the Medical Professional is obligated to perform or deliver the following, supported by a Medical Assistant under the Medical Professional's direction and control: (a) The Medical Professional shall determine his or her own means and methods of providing Medical Services in connection with this Agreement. (b) The Medical Professional shall comply with all applicable laws and regulations with respect to the licensing and the regulation of physicians, and shall ensure that the Medical Assistant does the same with respect to the licensing and regulation of nurses. (c) The Medical Professional and Medical Assistant shall provide the Medical Services in a manner consistent with all applicable laws and regulations and in a professional manner consistent with Medical Services provided in the community. (d) The Medical Professional shall maintain, during the term of this Agreement,Appropriate Credentials including: (1) A duly issued and active license to practice medicine and prescribe medication in the State of Florida. (2) A good standing with his or her profession and state professional association, (3) The absence of any license restriction, revocation, or suspension, ORLA_609378.3 (4) The absence of any involuntary restriction placed on his or her federal DEA registration, and (5) The absence of any conviction of a felony. (e) In the event that any Medical Professional (1) has his or her license to practice medicine or prescribe medication restricted, revoked or suspended, (2) has an involuntary restriction placed on his or her federal DEA registration, (3) is convicted of a felony, or (4) is no longer in good standing with his or her professional or state licensing authority, CareHere shall promptly remove that Medical Professional and replace such Medical Professional with another Medical Professional that meets the requirements of Section 1.02 (d). CareHere shall require any Medical Professional to remove and promptly replace any Medical Assistant or other Health Professional (as defined in Section 1.08) who has his or her professional license restricted, revoked or suspended, is convicted of a felony, or is no longer in good standing with his or her professional or state licensing authority. (f) CareHere shall require the Medical Professional to ensure that any Medical Assistant or other Health Professional complies with the requirements of this Section 1.02 with respect to performance, licensing, certification, and good standing, as applicable, except as otherwise provided in Section 1.06 with respect to medical doctor interns and residents. CareHere shall require the Medical Professional to notify CareHere immediately in the event the Medical Professional learns of the possibility that any of the events specified in Section 1.03(e) may occur with respect to the Medical Professional, any Medical Assistant or any other Health Professional, and CareHere shall immediately notify the Employer of such notification, so that the Employer can determine whether or not to exercise its right to remove the Medical Professional pursuant to Section 1.01. (g) CareHere will indemnify and hold the Employer harmless from and against all claims, demands, costs, expenses, liabilities and losses (including reasonable attorneys' fees and costs), that may result against the Employer as a consequence of any alleged medical malpractice, malfeasance or neglect caused or alleged to be caused by the Medical Professional or Medical Assistant in connection with the performance of services pursuant to this Agreement. (h) The Medical Professional will be required to use it best efforts to have a wait time which does not exceed thirty (30) minutes from the scheduled appointment time and the time that the patient is seen by the Medical Professional or Medical Assistant. 1.03 Scheduling of Services. CareHere shall contract with the Medical Professional/Medical Assistant for the Medical Professional to provide the Medical Services at a location(s) and schedule agreeable with Employer; provided, however, that CareHere shall requires that the Medical Professional ensure that Medical Services are ORLA_609376.3 provided at the office provided by the Employer in accordance with the schedule set forth in Section 1.01 above. 1.04 Place of Services. The Employer shall provide the Medical Professional an examination room(s) that is located at such office of the Employer, which examination room shall be reasonably satisfactory, in the judgment of the Medical Professional, for the provision of the Medical Services. In addition, the Employer shall provide to the Medical Professional a private office, which private office may be used by the Medical Professional to maintain a desk and a small refrigerator for the storage of prescription drugs, and to store drug samples, medical records, and prescription drugs; the private office shall be reasonably satisfactory to the Medical Professional, in the judgment of the Medical Professional, and the private office shall have a lock which permits the Medical Professional to limit access to the private office. The Employer has advised CareHere that the office to be used by the Medical Professional will be located at 17 E. Oakland Street, Ocoee, Florida in a residential house which has been renovated for use under this Agreement. CareHere agrees to provide a Medical Professional willing to work at such location. The Medical Professional shall not use the office and supplies provided by the Employer for any purpose other than the provision of Medical Services under this Agreement. 1.05 Equipment and Supplies. The Employer shall also provide the Medical Professional the equipment and the supplies, which are listed on Exhibit B (in addition to a chair, a desk, a file cabinet and office supplies, all of which shall also be supplied by the Employer). The Medical Professional shall notify, at any time and from time to time, the Employer of the quantity of such equipment and such supplies which the Medical Professional reasonably requires in connection with the provision of the Medical Services and the date by which such equipment and such supplies are required and the Employer shall provide such equipment and such supplies by such date. 1.06 Professional Liability Insurance. CareHere shall ensure that the Medical Professional maintains, throughout the term of this Agreement, professional liability insurance covering the acts and omissions of the Medical Professional, in the minimum annual coverage amounts of $500,000 per occurrence and $1,000,000 in the aggregate with an insurance company reasonably satisfactory to CareHere. CareHere will require the Medical Professional to notify CareHere immediately in the event he or she does not have the required coverage and will promptly remove and replace such Medical Professional with another qualified Medical Professional. CareHere shall provide Employer proof of such professional liability insurance maintained by the Medical Professional. 1.07 Responsibilities of Parties. The Employer and CareHere are independent contractors. The Medical Professional shall be solely responsible for his or her actions and /or omissions and the actions and/or the omissions of any agent or any employee used by him or her (including without limitation any Medical Assistant or other Health Professional) in connection with providing the Medical Services contemplated by this Agreement. Neither the Employer nor CareHere shall have any control or involvement in ORLA_609378.3 the independent exercise of medical judgment by the Medical Professional and/or any Medical Assistant or other Health Professional, and neither the Employer nor CareHere shall incur any liability for the actions or the omissions of the Medical Professional and/or any agent or any employee used by the Medical Professional (including without limitation any Medical Assistant or other Health Professional) in connection with this Agreement. CareHere agrees to indemnify and hold harmless Employer from and against any cost, damage, expense, loss, liability or obligation of any kind, including, without limitation, reasonable attorneys' fees and costs, including paralegal fees, which Employer may incur in connection with CareHere's furnishing of Medical Professionals, Medical Assistants or other Health Professionals, or with the Medical Services provided by them. under this Agreement. However, such indemnification by CareHere shall not be construed to mean malpractice insurance in any manner. 1.08 Other Licensed Health Professionals. The Employer agrees and acknowledges that Medical Professional may from time to time have other Health Professionals, as defined the next sentence, assist the Medical Professional and/or replace the Medical Professional during his or her regularly scheduled time at the Employer's place of business in the event of an emergency at the hospital or at the Medical Professional's office (provided, however, that CareHere will require the Medical Professional to ensure that the services provided by replacement individuals do not exceed the scope of their professional training and licensure). "Health Professional" shall mean a duly licensed nurse, medical doctor and licensed physician's assistant. Section 1.07 shall apply in the same manner to the Health Professional as such section applies to the Medical Professional. CareHere shall also ensure, or require the Medical Professional to ensure, that all Health Professionals who provide services hereunder have insurance coverage consistent with the requirements of Section 1.06. From time to time the Medical Professional,•upon consent of an employee of the Employer and/or spouse or dependent of the employee, may have medical doctors that are interns or residents associated with one of the medical schools in the state observe and assist the Medical Professional for educational and teaching purposes under the Medical Professional's direct supervision. The same level of professional standards as set forth in Section 1.02 shall apply as well to Health Professionals, other than medical doctor interns and residents working under the direct supervision of the Medical Professional. 1.09 Billing. CareHere shall contract with the Medical Professional that the Medical Professional shall not bill or otherwise solicit or accept payment from employees of the Employer and/or their dependents, or Employer, or from the Employee Benefit Plan Trust for the Medical Services provided by the Medical Professional. 1.10 Medical Records. CareHere shall contract with the Medical Professional for the Medical Professional to maintain medical records with respect to all of the patients, all of which medical records shall be maintained in a professional manner consistent with the accepted practice of the community in which the Medical Professional provides the Medical Services in connection with this Agreement. CareHere shall also require the Medical Professional comply with the HIPAA privacy standards. All patient ORLA_609378.3 records maintained by the Medical Professional in connection with this Agreement shall be the sole property of the Medical Professional and CareHere. The Employer understands and agrees that all of the medical records and other protected health information maintained by the Medical Professional will be held by the Medical Professional in strictest confidence, and that the Employer will not be entitled to have access to the medical records maintained by the Medical Professional, in the absence of an appropriate written authorization from the patient/employee. 1.11 Quarterly Reports. CareHere shall provide to the Employer, no later than the last day of the month immediately following the end of each quarter of the calendar year, a written report with respect to the provision by the Medical Professional of the Medical Services during the immediately preceding quarter. The written report shall be in form reasonably satisfactory to each of the Employer and CareHere and it is contemplated that the written report will report (a) the number of employees and dependents treated by the Medical Professional during such immediately preceding quarter, (b) the number of employees for whom work-related treatments were provided and (c) the number of employees for whom primary care services were provided. 1.12 Noncompliance by the Medical Professional. In the event that the Employer becomes aware of any failure by the Medical Professional to comply with the obligations of the Medical Professional which are contemplated by this Agreement, the Employer shall immediately provide written notice to CareHere of such failure, which written notice shall describe the failure in reasonable detail, and CareHere shall use its best efforts to address such failure. In the alternative, CareHere may arrange for the substitution of another person as the Medical Professional. As provided in Section 1.01, Employer shall have the right to require the immediate removal of the Medical Professional by CareHere. 1.13 Commencement of Medical Services. It is anticipated by the parties hereto that the Medical Professional will commence the provision of Medical Services under this Agreement on February 1 ,2008 (the"Services Commencement Date"). 1.14 Independent Contractor. The Medical Professional and Medical Assistants shall be independent contractors and the Employer shall not withhold or in any way be responsible for the payment of any federal, state or local income or occupational taxes, F.I.C.A. taxes, unemployment compensation or workers' compensation contributions, vacation pay, sick leave, retirement benefits or any other payments of or on behalf of CareHere. All such payments, withholdings and benefits are the responsibility of CareHere, and CareHere shall indemnify and hold Employer harmless from any and all loss or liability arising with respect to such payments, withholdings and benefits. The Medical Professional and Medical Assistant are not entitled to workers' compensation benefits from the Employer. The Medical Professional and Medical Assistant shall not be considered an employee, statutory employee, borrowed employee, joint venturer or partner of Employer when performing their duties hereunder. ORLA 609378.3 ARTICLE II COMPENSATION 2.02 2.41 Monthly Fee. • . . • • - • . . . . . - - . - . . immediately Within thirty (30) days following the receipt of the CareHere invoice, the Employer shall pay to CareHere the amount of$23.00 per employee the number of all .u- ._,a .._i 'u. -II . . - c•_--- . . - , - . , • - . • I per month for furnishing the Medical Professionals and the other services provided under this Agreement during the immediately preceding calendar month. Notwithstanding any provision contained herein to the contrary, the forgoing monthly fee shall commence on the Services Commencement Date and shall be prorated if such date is not the first day of the month. 2.03 2,02 Additional Fees. In advance of the first day of each month. CareHere shall submit an amount equal to the sum of the estimate of that month's medical expenditures and an adjustment from prior months' actual expenditures for Medical Professional and Medical Assistant fees, reimbursement to Medical Professional for medical malpractice insurance, medical supplies, equipment and other items that may be required by CareHere or the Medical Professional to provide adequate Medical Services under this Agreement. The Employer shall be responsible to pay CareHere such amount invoiced 'ate_ than lie '`t -• - - - • • - -• - - •'. • ••• - within thirty(30)days following the receipt of the CareHere invoice. 2.04 2.03 Not to Exceed. For the - - -- • - - _ term of this Agreement, • - - ••- - -- -- - -- - • `: ., CareHere shall guarantee that Employer's hourly fee rate paid to the following Medical Professionals and Medical Assistants shall not exceed the amount associated with each. Medical Professional—Physician $120 hourly fee rate maximum Medical Professional—Nurse Practitioner or PA $ 70 80 hourly fee rate maximum Medical Professional—Registered Nurse $ 40 hourly fee rate maximum Medical Professional —Licensed Practical Nurse $39 35 hourly fee rate maximum Medical Assistant—Certified Medical Assistant $20 25 hourly fee rate maximum CareHere shall give the Employer at least ninety (90) thirty (30) days notice of any increase in the hourly rates set forth above. ORIA_609378.3 ff than-10%. ARTICLE III TERM AND TERMINATION 3.01 Term. This Agreement shall be for a term of five years commencing on the date of this Agreement, subject to earlier termination in accordance with this Agreement. Unless either the Employer or CareHere gives written notice of nonrenewal to the other party at least ninety (90) calendar days prior to the end of the initial term or of any renewal term, this Agreement shall be automatically renewed for additional periods of one year each. 3.02 Termination With or Without Cause. This Agreement may be terminated by either the Employer or CareHere, with or without cause, by providing the other party at least ninety (90)calendar days' prior written notice. 3.03 Effect of Expiration or Termination. The expiration or the termination of this Agreement shall not affect the obligation of the Employer to pay compensation to CareHere or pay for any outstanding invoice for the period prior to such expiration or termination and shall not affect the obligation of CareHere to provide monthly reports for the period prior to the effective date of such expiration or such termination. 3.04 Non-Compete. In the event of Termination, for a period of one (1) year, Employer shall not use the onsite professional healthcare services of the Medical Professional furnished by CareHere. ARTICLE IV MISCELLANEOUS 4.01 Notice. All notices and other communications permitted or required pursuant to this Agreement shall be in writing, addressed to the party at the address set forth at the end of this Agreement or to such other address as the party may designate from time to time in accordance with this Section 4.01. All notices and other communications shall be (a) mailed by certified or registered mail, return receipt requested, postage pre-paid, (b) personally delivered, (c) sent by telecopy with a receipt confirmation, or (d) by overnight next day delivery service. Notices mailed pursuant to this Section 4.01 shall be deemed given as of three days after the date of mailing, notices personally delivered or sent by telecopy shall be deemed given at time of receipt, and notices sent by overnight next day delivery service shall be deemed given on the next business day. ORLA 609378.3 . 4.02 Transferability. Except as provided in Section 4.07, neither the Employer nor CareHere may assign or otherwise transfer this Agreement to a third party without the prior written consent of the other party, which may be given or withheld by the other party in its sole discretion. 4.03 Entire Agreement; Amendment. This Agreement constitutes the entire agreement between the Employer and CareHere with respect to the subject matter hereof and supersedes all prior agreements. This Agreement shall not be amended or waived, in whole or in part,except in writing signed by both of the Employer and CareHere. 4.04 Governing Law. This Agreement shall be governed by, and interpreted in accordance with, the internal laws of the State of Florida, without giving effect to its conflict of laws provisions. 4.05 Non-Disclosure. The Employer and CareHere shall take all reasonable steps to insure that information with respect to the terms of this Agreement or with respect to the business of the Employer and CareHere acquired by virtue of the position of the other party under this Agreement shall not be disclosed or used outside of the business of either party; provided, however, the foregoing restriction shall not apply to information (a) provided to government authorities as required by applicable law or applicable regulation or consented to by the patient; (b) furnished to healthcare providers involved in a particular patient's case; (c) which is or becomes public knowledge through no fault of either party; or (d) which is otherwise required to be disclosed by applicable law or applicable regulation or pursuant to a court order. Notwithstanding the foregoing. Employer and CareHere acknowledge that this Agreement is subject to the Florida Public Records Law. 4.06 Access to Books and Records. Both of CareHere and the Employer agree to provide access to their books and records to the other party. 4.07 Successors. This Agreement is binding upon the parties, their successors and assigns. Thirty (30) days notice of any change in ownership, management. etc. shall be given the other party by the party experiencing the change. In such event, this Agreement shall be assumed upon a change of ownership, change of control, change in management, reorganization, etc. of, or at. Employer. i ORLA_609378.3 IN WITNESS WHEREOF, the Employer and CareHere have executed and delivered this Agreement as of the date first above written. CareHere,LLC Crowne Consulting Group, Inc. By: By: ' Name: Ben Baker Name: Ray Tomlinson Title: Vice President Title: President Executed on: Executed on: Address for Purposes of Notice: 215 Jamestown Park Drive, Ste 204 1552 Boren Drive, Ste 100 Brentwood, TN 37027 Ocoee, FL 34761 Fax Number: Fax Number: ATTEST: CITY OF OCOEE, FLORIDA i ;sots . ? .. . i . . By: Beth Eikenberry, City Irk S. Scott Vandergrift, Mayor tV (SEAL) Executed on: Mal tal f S t 241 0 FOR.USE AND RELIANCE ONLY BY APPROVED BY THE OCOEE CITY THE CITY OF OCOEE,FLORIDA; COMMISSION AT A EETING APPROVED AS TO FORM AND HELD ON ,2007 2010 LE ALITY this It day of UNDER AGENDA TEM NO. 4..7 20. .FOLEipt LARDNER LLP Address for Purposes of Notice: Attn: City Manager By: 150 North Lakeshore Drive City Attorney Ocoee, Florida 34761 Fax Number 407-905-3110 1 ORLA_609378.3 EXHIBIT A "SCOPE OF SERVICES" Medical Services include but are not limited to the following: • Chronic illness evaluation, treatment and management o Diabetes o High Cholesterol o Etc. • Acute Conditions o Sore throats/ears/headache o Cough, Sinus o Strains/sprains/musculoskeletal problems o Acute urinary complaints • Lab testing • Medication dispensements • Occupational Conditions o OJI/Work-related injuries o Minor surgical procedures,such as sutures for laceration treatment • Employment Related Activities o Pre-employment and routine physicals o Pre-employment drug testing • Personal hygiene related problems • Ordinary and routine care of the nature of a visit to the doctor's office Long Term Prevention Programs Included • Labinsight Health Risk Assessment with comprehensive blood draw analysis • Aggregate data analysis from your employee population that allows us to develop just the right programs for you Pharmaceutical Program Management • tailored to your specific population • Physician/Nurse "Reach Out" Program to touch the people with the highest health risks • Population Health Management programs targeted for the greatest impact (obesity, diabetes, high blood pressure, etc.) • Disease/Case Management—we proactively assign a"coach" to help those employees with the greatest need • Self Care Education Tools and Manual online and in print form • Comprehensive Health Education Training • Physician Health Seminars • Quarterly Population Promotions Program Enablers and Infrastructure Included ORLA_609378.3 • 800 Customer Support • 24x7 Online Scheduling System • Online Medical Management& Tracking System • Clinic Best Practices Sharing • Clinic Inventory Management(supplies, medications, etc.) • Physician Recruiting • Medical Assistant Recruiting • Physician Management • Medical Assistant Management • Quarterly Analysis,Trends, Reporting& Survey Results • Quarterly Program Scorecards ORLA_609378.3 EXHIBIT B EXAM ROOM SET UP MEDICAL SUPPLIES AND EQUIPMENT Other items may be required by the Medical Professional to deliver Medical Services in accordance with the Agreement. Exam table/stool Disinfectant Small refrigerator Waste cans Lockable cabinet Waste can liners Gooseneck light Gloves Diag Set 3.5V Halogen/disposable covers Suture supplies Sundry jars Glucose test supplies Pillow/pillow covers(cloth and Urinalysis supplies disposable) Table paper Strep testing supplies Thermometer/disposable covers Mono testing supplies 4 X 4's Disposable gowns Tongue depressors Disposable drapes Cotton balls • Thermometer(freezer) Alcohol 3"Elastic bandage Alcohol dispenser Cold pack Blood pressure cuffs Emesis basins Stethoscope Medications/Injectables (by physician order) Surgical tape Lab supplies (Tubes, requisitions, tourniquets) Biohazard bags and Removal Service Wall Posters, Charts Biohazard stickers Small desk and chair(if not provided by Employer) `'Allergic To" stickers Needles Sharps containers Syringes Computer, Fast Internet Connection. •'4 in Trash removal, Clean-up. and General 1"Printer/Fax/Copier/Scanner Maintenance ORLA_609378.3 . EXHIBIT C ! : _. • ! - - $59.00 PEPM $223,020 Annual Initi _ I . . - . -•- - •- - . . •..• . -- .••. •; •. . . - . . . . i •- .. . on a 30% utilization. Costs may vary based on actual utilization and ORLA 609378.3