PROFESSIONAL SERVICES SIGN AND RETURN THIS PAGE
AC TRANSIT DISTRICT REQUEST FOR PROPOSAL NO. 2012- Purchasing Department 1210 1600 Franklin Street, 8th Floor Oakland, CA 94612 Date: NOVMEBER 9, 2012 TITLE: REGIONAL TRANSIT PROPOSALS MUST BE RECEIVED at 1600 CONNECTION DISCOUNT CARD Franklin Street, 8th Floor, Oakland, C.A. 94612 (RTC) PROGRAM MEDICAL by 10:00 a.m., November 23, 2012 VERIFIER SERVICE
Sign the proposal, put it in an envelope, and write the Contract Proposal number and Title on the outside. Sign and return this page. Retain DO NOT INCLUDE SALES OR EXCISE TAXES in Proposer’s Duplicate copy for your files. proposal prices. ______ALL PROPOSERS COMPLETE THIS SECTION:
2012 Upon execution of a Contract Acceptance form, the undersigned agrees to furnish, subject to provisions on the reverse of this form, all articles or services within the dates specified, in the manner and at the prices stated, in accordance with the advertisement, specifications, proposal, special conditions and general conditions, all of which are made part of the contract proposal, when authorized by Purchase Order, Contract Order, or Letter of Agreement issued by the District.
Name under which business is conducted:
Business street address: Telephone:
City State Zip Code
IF SOLE OWNER, sign here: I sign as sole owner of the business named above: Signed Typed Name
IF PARTNERSHIP OR JOINT VENTURE, sign here: The undersigned certify that we are partners in the business (joint venture) named above and that we sign this contract proposal with full authority to do so (one or more partners sign):
Signed Typed Name Signed Typed Name
IF CORPORATION, sign here: The undersigned certify that they sign this contract proposal with full authority to do so: The undersigned certify that they sign this contract proposal with full authority to do so:
Corporate Name: Signed Typed Name Title Signed Typed Name Title
Incorporated under the laws of the State of Form C102 May 2007
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GENERAL CONDITIONS, INSTRUCTIONS AND INFORMATION FOR OFFERORS 1. RENDITION OF SERVICES The Contractor hereby agrees to undertake, carry out and complete all work The District may at any time by written order make changes within the established herein in a professional and efficient manner satisfactory to Scope of Services described in this Agreement. If such changes cause an District standards. increase in the budgeted cost of or the time required for performance of the agreed upon work, the Contractor shall notify the District in writing of the The professional service or the performance of work or services required by amount of time and compensation adjustments that are required. the District cannot satisfactorily be performed by the regular employees of the District. In the event the Contractor encounters any unanticipated conditions or contingencies that may affect the scope of services and would result in an 2. CONTRACTOR'S STATUS adjustment to the amount of compensation specified herein, Contractor shall Neither the Contractor nor any party contracting with the Contractor shall be so advise the District immediately upon notice of such condition or deemed to be an agent or employee of the District. The Contractor is and contingency. The written notice shall explain the circumstances giving rise shall be an independent contractor, and the legal relationship of any person to the unforeseen condition or contingency and shall set forth the proposed performing services for the Contractor shall be one solely between said adjustment in compensation resulting therefrom. parties.
Contractor shall not subcontract any services to be performed by it under Any notices shall be given to the District under the NOTICES clause of the this Agreement without the prior written approval of the District, except for Special Conditions. Any and all agreed upon pertinent changes shall be service firms engaged in drawing, production, typing and printing. expressed as a written modification to this Agreement prior to Contractor shall be solely responsible for reimbursing any subcontractors implementation of such changes. and the District shall have no obligation to them. 10. DISPUTE RESOLUTION 3. OWNERSHIP OF WORK In case any disagreement, difference or controversy shall arise between the All reports, designs, drawings, plans, specifications, schedules, and other parties, with respect to any matter in relation to or arising out of or under this materials prepared, or in the process of being prepared, for the services to Agreement or the respective rights and liabilities of the parties, and the be performed by Contractor shall be and are the property of the District and parties to the controversy cannot mutually agree thereon, then such the District shall be entitled to access thereto, and copies thereof, during the disagreement, difference, or controversy shall be determined by binding progress of the work. arbitration, according to the rules of the American Arbitration Association. Any award made by the Arbitrator(s) shall be final, binding and conclusive In the event that the work, which is the subject of this Agreement, is not upon all parties and those claiming under them. The costs and expenses of completed, for any reason whatsoever, all materials generated under this any Arbitration shall be borne and paid as the Arbitrator(s) shall, by their Agreement shall be delivered as the District may direct. award, direct. 4. RECORDS The submission to Arbitration is hereby made a condition precedent to the The Contractor shall permit the authorized representatives of the District to institution of any action at law or in equity with respect to the controversy inspect and audit all data and records relating to performance under this involved; and such action at law or in equity shall be restricted solely to the Agreement. Contractor shall maintain all such records for a period of three subject matter of the challenge of such award on the grounds and only in (3) years after the District makes final payment under this Agreement. the manner permitted by law. 5. TERMINATION FOR DEFAULT In the event the Contractor breaches the terms or violates the conditions of 11. NO ASSIGNMENT this Agreement, and does not within ten (10) days of written notice from the This Agreement is personal to each of the parties hereto, and neither party District cure such breach or violation, the District may immediately terminate may assign or delegate any of its rights or obligations hereunder without first this agreement, and shall pay the Contractor only its allowable costs to the obtaining the written consent of the other. date of termination. 12. PROHIBITED INTERESTS 6. TERMINATION FOR CONVENIENCE No member, officer, or employee of the District during his/her tenure or for The District may terminate this Agreement, in whole or in part, at any time one year thereafter, shall have any interest direct or indirect, in this for the District's convenience and without cause at any time by giving the Agreement or the proceeds thereof. Contractor written notice of termination. The Contractor will be paid for those services performed pursuant to this Agreement to the satisfaction of Contractor covenants that it presently has no interest, direct or indirect, the District up to the date of notice of termination. The Contractor shall which would conflict in any manner or degree with the performance of the promptly submit its termination claim. If the Contractor has any property in services called for under this Agreement. Contractor further covenants that its possession belonging to the District, the Contractor will account for the in the performance of this Agreement no person having any such interest same and dispose of it in the manner the District directs. shall be employed by Contractor.
7. NON-DISCRIMINATION The District may require Contractor to file an annual Statement of Economic In connection with the execution of any Contract hereunder, the Contractor Interest form pursuant to the Political Reform Act of 1974 (Government shall not discriminate against any applicant or employee on the grounds of Code Section 81000 et seq.) race, religious creed, color, national origin, ancestry, physical disability, mental disability, medical condition, genetic information, marital status, 13. WAIVER sexual orientation, sex or age as defined in Section 12926 Government Failure of any party to exercise any right or option arising out of a breach of Code. this Agreement shall not be deemed a waiver of any right or option with respect to any subsequent or different breach, or the continuance of any 8. INDEMNIFICATION existing breach. The Contractor shall indemnify, keep and save harmless the District, its 14. GOVERNING LAW Board of Directors, officers, officials, employees, agents and volunteers This Agreement, its interpretation and all work performed thereunder, shall from and against any and all liability, loss, damage, expense, costs be governed by the laws of the State of California. (including, without limitation, costs and fees of litigation) of every nature arising out of or in connection with Contractor's performance of work 15. INSURANCE hereunder or its failure to comply with any of its obligations contained in the Depending on the nature of the services being solicited, the District may Agreement, except such loss or damage which was caused by the sole have certain minimum insurance requirements. negligence or willful misconduct of the District.
9. CHANGES If any changes to the scope of services are sought by either party that would require a modification of the amount of compensation, the changes must be reviewed in advance of any action to implement the change by the Project Manager and the Purchasing Department. Page 2 of 69 AC TRANSIT REQUEST FOR PROPOSAL PURCHASING DEPARTMENT NO. 2012-1210
REGIONAL TRANSIT DISCOUNT CARD (RTC) PROGRAM MEDICAL VERIFIER SERVICE FOR THE PERIOD: DECEMBER 10, 2012 THROUGH JUNE 30, 2017 SPECIAL CONDITIONS
16. GENERAL INFORMATION
The Alameda-Contra Costa Transit District is a Special District, organized under the laws of the State of California, which provides public transit service to approximately 191,000 riders daily with a fleet of 584 buses. The District’s service area extends from western Contra Costa County to southern Alameda County. The District has approximately 1,863 employees and is financed through receipt of transit fares, property taxes, and state and federal funding.
This Request for Proposal (RFP) outlines the scope of services requested as well as information that should be included in the proposal. It is the District’s intent to award to a responsible Contractor with the lowest overall price and the most responsive proposal that conforms to this RFP.
To be considered, one (1) original version and five (5) copies of written proposals must be submitted. Subsequent to District reviews, proposals will be available for pickup at AC Transit by calling Eric L. Burks Sr., at 510-577- 8823. See Paragraph 18. PROPOSAL REQUIREMENTS, for further information. Your Offer shall be submitted no later than 10:00 a.m., local time, on November 23, 2012 to the following address:
AC Transit Purchasing Department Mr. Eric L. Burks Sr., Contract Specialist 1600 Franklin Street, 8th Floor Oakland, California 94612
All proposals must be clearly marked RFP 2012-1210 REGIONAL TRANSIT CONNECTION DISCOUNT CARD (RTC) PROGRAM MEDICAL VERIFIER SERVICE. Proposals not received at the designated place by the required date/time will not be considered for award. No facsimile or e-mail transmissions of proposals will be accepted.
Proposals will remain in effect for one hundred twenty (120) days from the designated date for receipt of proposals, unless mutually extended. No pre- award costs will be reimbursed by the District. The signature of the District General Manager will constitute a binding award.
This RFP does not commit the District to award a contract, to pay costs incurred in the preparation of Request for Proposals, or to procure or contract for services. The District reserves, at its sole discretion, the right to reject any and all Request for Proposals, cancel all or part of this RFP and waive any minor irregularities or informalities.
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REGIONAL TRANSIT DISCOUNT CARD (RTC) PROGRAM MEDICAL VERIFIER SERVICE FOR THE PERIOD: DECEMBER 10, 2012 THROUGH JUNE 30, 2017 SPECIAL CONDITIONS
17. SCOPE OF SERVICES
See Attachment A, Scope of Services.
18. PROPOSAL REQUIREMENTS
Interested parties shall submit proposals in response to this Request for Proposal (RFP), including a detailed statement of qualifications. Each proposal must be submitted in two (2) separate sealed envelopes within the proposal package. Envelope 1 will contain all responsive materials except those related to price. Envelope 2 will contain only information related to price.
Proposals shall include the following information in the scope of services, presented in a clear and comprehensive format:
A. Organization chart and staffing plan including brief job descriptions of individuals proposed for Contractor staff.
B. Name of firm, principals who will be performing services; addresses, telephone numbers and e-mail addresses for those who will be performing services.
C. Identify by name and title, the firm’s support staff who would be working on this account and describe briefly their responsibility in handling the District’s scope of work.
D. References from up to three (3) current clients/firms specifying:
• Company name
• Contact person and contact person’s title
• Contact person’s address, phone number and e-mail address
• Length of your relationship
E. The firm’s most recent annual financial statement.
F. Identify by name and title, the firm’s proposed designated account executive that would be responsible for the District’s account. Please include their respective resume.
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REGIONAL TRANSIT DISCOUNT CARD (RTC) PROGRAM MEDICAL VERIFIER SERVICE FOR THE PERIOD: DECEMBER 10, 2012 THROUGH JUNE 30, 2017 SPECIAL CONDITIONS
G. Brief description of the firm’s history, growth, and length of time in business under the same name.
H. Price proposal (which shall be submitted in a separate, sealed envelope) should be submitted on a fixed price basis.
I. Proposals may be rejected if they show such items as alteration of form, conditional or incomplete proposals, irregularities that make the proposal ambiguous or signature by other than an authorized person. Questions or further information concerning this RFP shall be directed to:
AC Transit Purchasing Department 1600 Franklin Street, 8th Floor Attn: Mr. Eric L. Burks Sr. Oakland, California 94612 Phone: (510) 577-8823 Fax: (510) 577-8839 Email: [email protected]
19. EVALUATION AND AWARD
The District will evaluate each proposal submitted, scoring the following factors listed below:
A. Evaluation Factors
1. Price (50 Points)
2. Technical
a. Project Approach (20 Points)
b. Personnel (10 Points)
c. Experience (20 Points)
B. Evaluation Process
1. All proposals are evaluated and ranked by a panel of five (5) evaluators on technical criteria specified in the solicitation.
2. Those proposals determined to be within the competitive range may be interviewed and be required to make oral presentation of their proposal.
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REGIONAL TRANSIT DISCOUNT CARD (RTC) PROGRAM MEDICAL VERIFIER SERVICE FOR THE PERIOD: DECEMBER 10, 2012 THROUGH JUNE 30, 2017 SPECIAL CONDITIONS
3. Proposals that are technically acceptable are re-evaluated with price as a consideration.
4. Using oral, technical and pricing criteria, proposals are ranked accordingly, to a competitive range.
5. District may negotiate with all responsible proposals in the competitive range.
6. The District, at its sole discretion, will determine whether to hold discussions/negotiations with Offerors who are in the competitive range or to award the contract without discussions/negotiations based on the initial priced proposal.
C. Award Process
The District reserves the right to award without negotiation/discussion. Contractors are therefore encouraged to submit their best offer, initially. The District will award to the contractor(s) whose proposal(s) is/are most advantageous to the District, price and other factors considered.
20. RIGHTS IN DATA
The term “subject data” as used herein means recorded information, whether or not copyrighted, that is delivered under this Contract. The term includes graphic or pictorial delineation in media, text in specifications or related performance or design-type documents and machine forms. Except for its own internal use, Contractor may not publish or reproduce such data in whole or in part, nor may Contractor authorize others to do so, without the written consent of the District, until such time as the District may have either released or approved release of such data.
In the event that the scope of services in this Contract is not completed for any reason whatsoever, all data generated under this Contract shall become subject data and shall be delivered as the District may direct.
21. RELEASE OF INFORMATION
Contractor must receive prior permission from the District before releasing any reports, information or promotional materials prepared in connection with this Contract. The Contractor shall provide a copy or copies to the District Project Manager for first review and comment.
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REGIONAL TRANSIT DISCOUNT CARD (RTC) PROGRAM MEDICAL VERIFIER SERVICE FOR THE PERIOD: DECEMBER 10, 2012 THROUGH JUNE 30, 2017 SPECIAL CONDITIONS
22. INSURANCE
It is strongly recommended that contractors confer with their respective insurance carriers and/or brokers to determine in advance of proposal submission the availability of insurance, Certificates and Endorsements as prescribed and provided herein. If a contractor fails to comply strictly with the insurance requirements, that contractor may be disqualified from award of the contract. Contractor shall procure and maintain for the duration of the contract insurance against claims for injuries to persons or damages for property which may arise from or in connection with the performance of the work hereunder by the contractor, contractor’s agents, representatives, employees or subcontractors. The District reserves the right to alter, amend, increase or otherwise modify the insurance requirements stated herein.
A. Minimum Scope of Insurance
Coverage shall be at least as broad as:
1. General Liability – Equal to Insurance Office Commercial General Liability Occurrence Form CG0001.
2. Automotive Liability: Coverage is to be equal to Insurance Services Office Business Auto Form CA0001 (01/87) covering Automobile Liability, code 1 (any auto).
3. Workers’ Compensation- As required by the State of California and Employer’s Liability.
4. Professional Errors and/or Omissions insurance appropriate to Contractor’s profession.
B. Minimum Limits of Insurance
Contractor shall maintain limits no less than:
1. General Liability: $1,000,000 combined single limit per occurrence for bodily injury, personal injury and property damage. If an aggregate limit is used, either separate aggregate limit shall apply to this project/location or the aggregate limit shall be twice the required occurrence limit.
2. Automobile Liability: $1,000,000 combined single limit per accident for bodily injury and property damage.
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REGIONAL TRANSIT DISCOUNT CARD (RTC) PROGRAM MEDICAL VERIFIER SERVICE FOR THE PERIOD: DECEMBER 10, 2012 THROUGH JUNE 30, 2017 SPECIAL CONDITIONS
3. Workers’ Compensation: Workers’ Compensation limits as required by State of California and Employer’s Liability limits of $1,000,000 per accident for bodily injury or disease.
4. Professional Errors/Omissions Liability: 1,000,000 per occurrence.
C. Deductible and/or Self-Insured Retentions
Any deductibles and/or self-insured retentions must be declared to and approved by the District. The District reserves the option to:
1) Require insurer to reduce or eliminate such deductible or self-insured retention as to District, and/or:
2) Require the Contractor to procure a bond guaranteeing payment of any deductible or self-insured retention of losses, related investigations, claims administration and defense expenses.
D. Other Insurance Provisions
The policies are to contain, or are to be endorsed to contain, the following provisions:
1. General Liability and Automotive Liability
a. The District, its officers, officials, employees, and volunteers are to be covered as additional insureds as respects: liability arising out of activities performed on behalf of the Contractor; products and completed operation of the Contractor; premises owned, occupied or hired by the Contractor; automobiles owned, leased; hired, or borrowed by the Contractor. The coverage shall contain no special limitation on the scope of protection afforded to the District, its directors, officers, officials, employees, or volunteers.
b. For any claims related to this Contract, the Contractor’s insurance coverage shall be primary insurance as respects the District, its officers, officials and employees, and volunteers. Any insurance or self-insurance maintained by the District, its officers, officials, employees, or volunteers shall be in excess of the Contractor’s insurance and shall not contribute with it.
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REGIONAL TRANSIT DISCOUNT CARD (RTC) PROGRAM MEDICAL VERIFIER SERVICE FOR THE PERIOD: DECEMBER 10, 2012 THROUGH JUNE 30, 2017 SPECIAL CONDITIONS
c. Any failure with reporting provisions of the policies including breaches of warranties shall not affect coverage provided to the District, its officers, officials or employees.
d. The Contractor's insurance shall apply separately to each insured against whom claim is made or suit is brought, except with respect to the limits of insurer’s liability.
2. Workers’ Compensation and Employers Liability
The insurer shall agree to waive all subrogation rights against the District, its officers, officials and employees for losses arising from work performed by the Contractor for the District.
3. All Coverages
a. Each policy required shall be endorsed to state that coverage shall not be suspended, voided or canceled by either party or reduced in coverages or limits except after 30 days prior written notice by certified mail, return receipt requested, has been given to the District.
b. Each policy is to be on an “Occurrence” form. “Claims Made” form requires prior approval by the District as well as Contractor being required to provide acceptable evidence of the policy’s retroactive date, and will also be required to maintain the coverage with same retroactive date for a period of not less than five (5) years following termination of services.
4. Acceptability of Insurers – Insurance is to be placed with insurers having a current A.M. Best & Co. Rating of no less than “A-:VII”.
5. Verification of Coverages - Consultant shall furnish the District with appropriate Certificates of Insurance and with original Endorsements effecting coverages required. The Certificates and Endorsements are to be signed by a person authorized by the insurer to bind coverage. The Certificates and Endorsements are to be on forms approved by the District. All required Certificates and Endorsements are to be received and approved by the District prior to the commencement of any work under the Contract. The District reserves the right to require complete, certified copies of all required Insurance policies at any time.
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REGIONAL TRANSIT DISCOUNT CARD (RTC) PROGRAM MEDICAL VERIFIER SERVICE FOR THE PERIOD: DECEMBER 10, 2012 THROUGH JUNE 30, 2017 SPECIAL CONDITIONS
6. Other Requirements
a. Should any work under this Contract be sublet, Contractor shall require each Sub-Contractor of any tier to comply with all of the agreement’s insurance provisions and provide the proof of such compliance to the District.
b. These insurance requirements are not intended to and shall not in any manner limit or otherwise qualify the liabilities and obligations otherwise assumed by the Consultant under this Contract, including but not limited to the provisions concerning indemnification.
c. Compliance with these insurance requirements is considered a material part of the Contract and breach of any such provision may, at the option of the District, be considered a material breach of the Contract and result in action by the District to withhold payment and/or terminate the Contract.
23. PROTEST PROCEDURES
A. Protest based upon the content of the solicitation: Any protest concerning of the solicitation must be filed prior to the bid opening or proposal submission date.
B. Protest based upon grounds other than the content of the solicitation: Protest must be filed no later than ten (10) calendar days after the District’s notice of intent to award, or notice of award, notice of non-award; whichever occurs first.
C. Copies of the District’s Procurement Protest Procedures can be obtained online at:
http://www.actransit.org/wp- content/uploads/board_policies/board_policy_46.pdf .
FAILURE TO COMPLY WITH ANY OF THE REQUIREMENTS SET FORTH IN THE DISTRICT’S WRITTEN PROPOSAL PROTEST PROCEDURES MAY RESULT IN REJECTION OF THE PROTEST.
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REGIONAL TRANSIT DISCOUNT CARD (RTC) PROGRAM MEDICAL VERIFIER SERVICE FOR THE PERIOD: DECEMBER 10, 2012 THROUGH JUNE 30, 2017 SPECIAL CONDITIONS
24. PROHIBITED INTERESTS
No member, officer, or employee of the District during his/her tenure or for one year thereafter, shall have any interest, direct or indirect, in this contract or the proceeds thereof. Contractor covenants that it presently has no interest that would conflict in any manner with performance of services under this contract. Contractor further covenants that, in the performance of this contract, no person having any such interest shall be employed by contractor. Contractor further covenants that it receives no commissions or other payments from parties other than the District as a result of services performed hereunder.
25. EQUAL OPPORTUNITY/NON DISCRIMINATION
It is the policy of the District to ensure non-discrimination in the award and administration of all contracts and to create a level playing field on which minority and small/local business can compete for all District contracts. In connection with the performance of this contract, the contractor will cooperate with the District in furthering the District’s policy.
26. SMALL LOCAL BUSINESS PROGRAM
AC Transit has established a Small Local Business Procurement Program (Board Policy 351) to ensure that small local business enterprises have a meaningful opportunity to participate in AC Transit’s procurements. AC Transit believes that a Small Local Business Procurement Policy can provide support to small local businesses and enable them to more effectively compete for AC Transit procurements, especially those businesses that have been at a disadvantage in the past. Under the current Policy, a Small Local Business is a business which meets the U.S. Government’s Small Business Administration (SBA) size standard and is located within AC Transit’s geographical service area.
Contractors doing business with AC Transit are encouraged to utilize small local businesses in their subcontracts. Contractors responding to this solicitation shall complete and submit with their response, the Small Local Business Procurement Worksheet (attached to this solicitation), which indicates whether they intend to use small local businesses in the contract to be awarded, and, if so, the percentages of contract work to be allocated to small local businesses. Contractors can contact the Contract Specialist or Buyer assigned to this procurement for information on SLBE resources.
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REGIONAL TRANSIT DISCOUNT CARD (RTC) PROGRAM MEDICAL VERIFIER SERVICE FOR THE PERIOD: DECEMBER 10, 2012 THROUGH JUNE 30, 2017 SPECIAL CONDITIONS
27. VENDOR REGISTRATION
If you are not already an AC Transit registered vendor, an online Vendor Registration is required prior to contract award. Offerors/Proposers should access www.actransit.org, select: purchasing, online purchasing, and Register as an Online Purchasing User. To complete the process, include a W-9, Request for Taxpayer Identification Number and Certification (containing original signature) in proposal/proposals. If online access is not available, contact the Purchasing Department for instructions.
28. TYPE OF CONTRACT
This is a fixed price type contract, spanning approximately 60 months (December 10, 2012 through June 30, 2017), with one (1) 3-year option, and one (1) 2-year option.
29. OPTION TO EXTEND THE CONTRACT (PRICED)
At the sole discretion of the District, the contract may be extended unilaterally by the exercise of the priced option. If exercised, the District shall notify the contractor in writing of its intent to exercise the priced option at least thirty (30) days prior to the exercise of the option. The option shall be exercised in accordance with the prices proposed in the original proposal.
30. VENUE
In the event of a dispute or breach of contract, venue shall be in Alameda County, California.
(END OF SPECIAL CONDITIONS)
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REGIONAL TRANSIT DISCOUNT CARD (RTC) PROGRAM MEDICAL VERIFIER SERVICE FOR THE PERIOD: DECEMBER 10, 2012 THROUGH JUNE 30, 2017 ATTACHMENT A – SCOPE OF SERVICES
1. BACKGROUND
The Regional Transit Connection (RTC) Discount Card ID card enables customers with qualified disabilities to travel at discount fares on fixed-route transit services throughout the Bay Area. The Medical Verifier verifies eligibility on behalf of the RTC Discount Card Program. The customer submits an application at their local transit agency office, where a picture is taken and a fee collected. The application and picture file are transmitted to the Central Processor via an Internet website. The Medical Verifier verifies the applicant’s eligibility. The Medical Verifier maintains the RTC Discount Card database and the subdirectory from which cards are issued by Clipper, the regional smart card transit payment system, under a separate agreement with the Metropolitan Transportation Commission. The RTC Discount ID Card is printed on Clipper card stock, resulting in a fully-functioning Clipper card with a photo ID. The card is mailed by Clipper to the applicant or to the local transit agency office for pickup if requested.
The Medical Verifier receives approximately 31,000 applications annually. Historically, approximately 97% of the applicants have been deemed eligible. Letters of denial are sent to the remaining 3% who fail to meet the eligibility criteria. Approximately 95% of applicants are certified as “permanent” and must renew their eligibility every 5 years. (Prior to July 1, 2012, the renewal period was 3 years.) Those who require attendant assistance, again verified by their health care provider, are eligible for an “Attendant Card” that can only be used when traveling with the RTC cardholder. Cards are issued for a shorter period of time if the cardholder’s disability is not permanent, the cardholder applies using a DMV placard registration, or a transit ID from another California transit agency.
Cardholders may renew their cards in person or by mail directly to the Medical Verifier if their eligibility status is permanent. Approximately 30% of applications are for new applications, 45% for renewals, and 20% for replacement of cards that are lost, stolen or defective. Ten to fifteen percent of cardholders take advantage of the mail-in processing option, primarily for renewal.
In addition to the Medical Verifier, the basic application process involves four other participants:
• Transit Agencies/RTC Discount Card Task Force • Applicants • Clipper Customer Service (card printing and distribution; Clipper-related card issues) Note: Cubic may assume the responsibility for the fulfillment, printing and distribution of the RTC Discount cards effective January 1, 2013.
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REGIONAL TRANSIT DISCOUNT CARD (RTC) PROGRAM MEDICAL VERIFIER SERVICE FOR THE PERIOD: DECEMBER 10, 2012 THROUGH JUNE 30, 2017 ATTACHMENT A – SCOPE OF SERVICES
• Practitioners who are qualified to certify medical applications and affected agencies (California Department of Motor Vehicles (DMV) and The Veterans Administration (VA)
2. APPLICATION VERIFICATION AND PROCESSING
The Medical Verifier will be responsible for processing applications transmitted by transit agencies and by mail, for verifying the eligibility of all applicants, and for issuing letters of denial to those who do not qualify. As part of the application process, the Medical Verifier confirms that each application is filled out completely, that the eligibility category is valid, and that no other card has been issued to the applicant. The Medical Verifier conducts all DMV, VA, and Medical Eligibility verifications. The Medical Verifier will make appropriate database entries and notations at each step of the process. For each application received, the Medical Verifier will complete the following tasks:
Task 1: Review Applications for Completeness The Medical Verifier checks that the applicant’s name, address or specified contact location, primary eligibility category, and signature are on the application, and that both the photo data file and the application scan are complete. Where the information is incomplete, the Medical Verifier will notify the transit agency or applicant, as appropriate, and make a notation in the database.
Task 2: Verification of Eligibility Data The Medical Verifier checks or reconfirms the data in the application, as appropriate, and verifies all DMV, VA, and medical certification information as required. Each specific category of application (Medicare, DMV-Disabled placard/registration, disabled veteran, medical certification, and other transit agency discount cards) must be checked according to the following procedures:
Medicare Recipients: The Medicare claim number must be written on the application with a proper alphanumeric sequence. The card will be issued with the maximum program expiration date of five years.
DMV-Disabled Placard/Vehicle Registration: The disabled placard or vehicle registration number must be written on the application. A copy of the registration document must be scanned with the application. If a registration document cannot be provided at the time of application, the Medical Verifier will contact the applicant to obtain one. The Medical Verifier confirms the placard/registration owner and expiration date and sets the card expiration data equal to the expiration date of the registration. DP license plates must be renewed every year, and disabled placards are valid for up to two years.
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REGIONAL TRANSIT DISCOUNT CARD (RTC) PROGRAM MEDICAL VERIFIER SERVICE FOR THE PERIOD: DECEMBER 10, 2012 THROUGH JUNE 30, 2017 ATTACHMENT A – SCOPE OF SERVICES
Disabled Veteran: To qualify applicants must be more than 50% disabled as the result of a service-connected injury. A copy of a VA certification letter must be scanned with the application. If the VA documentation cannot be provided at the time of application, the Medical Verifier obtains from the applicant an original letter from the Veterans Administration that indicates the disability rating (percentage) and whether the disability is service-connected. If such a letter cannot be obtained, the Medical Verifier will work with the applicant to submit a standard medical verification form. If the applicant’s information can be validated, a card will be issued reflecting data received from the Veterans Administration, but not longer than the program maximum of 5 years.
Medical Verification: The Medical Verifier confirms that the disability or DSM code is eligible, whether the disability is permanent or temporary, and that the listed practitioner is authorized to certify that particular disability. (See Attachment 1C for the Guide to Eligibility Criteria.) Practitioner information, e.g., name, license number, field of practice, address, phone number, and signature, etc., is verified directly with the Medical License Board.
The Medical Verifier will contact the practitioner if the practitioner does not return the form within 7 calendar days or if the information is incomplete or otherwise illogical. Once the application is complete and eligibility verified, a card is issued with an expiration date reflecting information provided by the practitioner, but not longer than the program maximum of five years.
If the practitioner does not respond within 7 days, the Medical Verifier will notify the applicant and mark the application as “waiting for additional information.” Any application that is open and incomplete for more than 90 days will be denied.
Other Transit Agency Discount Card: State of California Transit Agency: The Medical Verifier contacts the transit agency to confirm that the applicant’s card is valid and its expiration date. If the information is confirmed, the Medical Verifier issues a card with the expiration date of the original card or up to three years, whichever is less. If the information cannot be confirmed, the Medical Verifier will ask the applicant to complete the application process. Cards issued based on another discount card cannot be renewed. The cardholder must complete the regular application process.
Out-of-State Transit Agency: The Medical Verifier checks the transit agency name and card expiration date. If card appears to be valid, then the Medical Verifier issues a card for a 3-month period. If the card does not appear to be valid, then Medical Verifier will require
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the applicant to complete the regular application process. Individuals who visit for more than three months must follow the regular application process.
Task 3: Establish Relationships with Verification Sources The Medical Verifier will establish relationships with all appropriate individuals and agencies that verify eligibility and follow procedures to expedite turnaround time. In addition to verifying the information submitted, the Medical Verifier is responsible for educating practitioners about the RTC Discount Card Program.
The Medical Verifier will send out letters to each practitioner who completes a medical form for the first time. The letter notes the name of the person certified, describes the program and eligibility criteria, and includes an information packet. The letter asks the practitioner to contact the Medical Verifier if they have questions or if they did not fill out the application for the person named. Qualified practitioners who complete 10 or more applications within a 6-month period are considered “frequent certifiers.” The Medical Verifier will ask these practitioners to designate a contact person in their office who can confirm all applications with the signature of that practitioner.
Task 4: Prepare Data file for Card Printing If the information on the application can be verified and the applicant has been determined to be eligible, the Medical Verifier will create an “ID Print Report” data file for transmission to Clipper for card printing and distribution.
Task 5: Denials of Incomplete Records The Medical Verifier will contact the applicant and/or the transit agency that transmitted the application, as appropriate, when an incomplete application has been received. An application that requires medical verification is not considered complete until the practitioner signs and returns their copy of the application. Any incomplete application that has been pending for more than 90 days will be denied and the applicant notified. The incomplete application will be kept on file and not returned to the applicant.
Task 6: Processing of Renewal and Replacement Card Applications The Medical Verifier will notify cardholders by mail that their card is due to expire within 60 days. Cardholders may apply in-person at their local transit agency or directly by mail to the Medical Verifier. However, any cardholder who is not certified as “permanent” by the RTC Program and wishes to renew their card must reapply in-person at their local transit agency. Cardholders with outdated pictures must also apply in person at the transit agency. Applications to replace lost or stolen cards may be submitted by mail or in-person. The photo on file will be used for a replacement card unless the applicant’s appearance has changed significantly.
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The Medical Verifier verifies that the information on the application is correct and complete and that a check or money order for the correct fee accompanied the application. Changes to address, phone number, etc., must be made in the database. If the information is incomplete, the Medical Verifier will contact the cardholder or transit agency staff, as appropriate. If the cardholder fails to respond to a written request for information within 60 days, the application will be denied.
The Medical Verifier must establish a bank account to process mail-in fees and provide the Lead Agency with a full accounting and payment every six months. Payments to the Lead Agency will be net any direct mail-in expenses incurred for mail-in processing, e.g., bank charges, and check approval fees.
Task 7: Processing of Attendant Supplemental Cards Current RTC Cardholders, who are certified have an attendant symbol on their card, can apply for the attendant card by mail or at their local transit agency. New applicants may submit both applications at the same time but must apply in person. A separate fee is assessed. The Medical Verifier checks the database for eligibility or confirms the cardholder’s eligibility with the medical practitioner, as needed.
Task 8: Appeals If an application is denied, the applicant can appeal the Medical Verifier’s decision by requesting and submitting a letter of appeal. The Medical Verifier will contact the applicant and/or certifier to obtain any additional information that may be required to investigate the appeal. The Medical Verifier is required to cooperate with the Lead Agency in the investigation of any appeal and to provide the Lead Agency with all requested records and documentation in a timely manner.
Task 9: Timing The RTC Discount Card Program has a 21-day turnaround time standard; that is, applicants can expect to receive their cards or letters of denial within 21 calendar days from submittal of an application at a transit agency. Meeting this standard requires that transit agencies transmit applications to the Central Processor within 7 days of their receipt.
To meet this standard, the Medical Verifier is expected to generate an “ID Card Report” or a letter of denial by the seventh calendar day after it receives a completed application for a new, replacement, or renewal card. Daily “ID Card Reports” must be transmitted to Cubic for card printing. Reports will be segmented by type: new, renewal, replacement, and attendant.
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The Medical Verifier may incur a $100 fine for each application that is not finalized within 14 calendar days after a complete datafile is transmitted to the Medical Verifier. Finalized is defined as the date that the card or denial letter is sent to the applicant. A complete datafile is defined as a completed basic application and a photofile. For individuals filing a medical application, a complete datafile also includes a copy of the application that has been completed and signed by a qualified practitioner. For applicants using a DMV placard, a copy of the registration must also be included.
Fines will be assessed against any fees due to the Medical Verifier in the month following the infraction.
Task 10: Safekeeping of Original Applications The Medical Verifier will be required to receive original applications with copies of proof of identification from the transit agencies and to store the original in such a manner that an original application can be located, retrieved and produced upon request of a transit agency. Applications must be scanned and archived in a compact disk (cd) format annually. Paper applications may be destroyed five years after the application date.
Task 11: Establish Relationship with Medical Consultant Periodically, an applicant or qualified certifier has a question about the RTC eligibility categories that goes beyond the expertise of the RTC Task Force. Typically, these questions relate to why a particular disability does not qualify an applicant for an RTC Discount Card. To address this need, the Medical Verifier will establish a relationship with a medical consultant who is knowledgeable about the RTC Discount Card Program and how the eligibility categories mesh with the overall guidelines of the RTC program.
The Medical Verifier annual budget should include 20 hours per year of medical consultant time to handle routine inquiries.
3. RELATIONSHIP WITH CUSTOMERS AND TRANSIT OPERATORS
Task 1: Customer Relations Transit agency staff will continue to serve as the first line of customer service by answering questions about the program, issuing applications, taking ID photos, and collecting fees. The transit agency staff is also the primary point of customer contact to resolve follow-up issues such as checking the status of an application.
The Medical Verifier will also have direct contact with applicants or their representatives. Medical Verifier staff will treat all customers in a courteous and professional manner. All applications will be handled confidentially, Page 18 of 69 AC TRANSIT REQUEST FOR PROPOSAL PURCHASING DEPARTMENT NO. 2012-1210
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expeditiously, and professionally. To ensure customer confidentiality, the Medical Verifier will require that all employees who have access to applications or the database sign a confidentiality statement.
Task 2: Alternate Formats for Written Materials All program documents created for the customer must also be made available in accessible formats including but not limited to Braille, ASCII format, large print (14 pt font), electronic, and audio tape. The Medical Verifier will provide one copy of each alternate format to every transit agency.
In addition, electronic versions of the program brochure produced in Spanish and Mandarin for printing and distribution by transit agencies.
Task 3: Relationship with Transit Operators The Medical Verifier will be responsive to transit agency staff. Requests for assistance or for information will be responded to expeditiously, accurately, professionally, and courteously.
Task 4: Relationship with Cubic The Medical Verifier will work cooperatively with Cubic during the transition of card printing and distribution to Cubic. The Medical Verifier will provide technical coordination to Cubic to maintain data communications.
Task 5: Attendance at Bay Area Partnership Accessibility Committee (BAPAC) Meetings The Medical Verifier is responsible for attending meetings on a quarterly basis, or as required. All requests for information and requests to attend meetings will be directed by the Lead Agency Program Manager.
4. DATABASE OPERATION
Task 1: Receipt of Data files The Medical Verifier is responsible for receiving all data files from the transit agencies, entering all eligibility determinations into the database, and maintaining the overall integrity of the database. The Medical Verifier will maintain a subdirectory for “ID Print Reports” accessible to Clipper for card printing and a website for data exchange.
Task 2: Security and Maintenance of the Database The information contained in the database is privileged and confidential. Security of the database is of maximum priority. Therefore, the Medical Verifier must establish and implement procedures to insure that only persons who are authorized to access the database are able to do so. The Medical Verifier will
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assign system log-in names to employees and require use of a password to access the database.
The Medical Verifier must establish and implement procedures to insure that the database is up to date, accurate, and accessible to the transit operators on a continual basis. Minimally, the database should be backed up daily. A complete and up-to-date copy of the database must be posted on the website on a weekly basis.
Task 3: Reports The Medical Verifier will generate reports from the database to provide program information as requested by Lead Agency’s Program Manager.
The database generates information regarding transit operator of origin, number and type of applications received, number and type of applications processed, number and type of applications denied, duration of processing from receipt at transit agency and at Medical Verifier, applications pending by operator by date, etc. Reports will be generated on a monthly and annual basis, as well as by request from the Lead Agency’s Program Manager.
Please see Exhibit 1(a-g) for a sample of monthly and annual reports.
Task 4: Computer Hardware and Software Maintenance (See Section 15) The Discount Card Program (DCP) is a Microsoft Access 2004 database. The Medical Verifier will be responsible for all aspects of maintaining the database including routine updates and fixes to the application software and database as well as any programming needed to revise or develop reports and other management information.
The Medical Verifier is responsible for the purchase and maintenance of all computer hardware and software needed to process RTC Discount Card applications including personal computers and servers, communication devices, etc. Transit agencies are responsible for all computer hardware at their sites as well as for maintenance of the application software resident on their RTC-designated computer and connection to the Internet.
The Medical Verifier will provide technical assistance to transit agency staff for questions related to DCP database installation, updates and performance and on-site data maintenance. Transit agencies are expected to identify IT staff to work with Medical Verifier staff to resolve hardware and software issues, as appropriate. In addition to telephone assistance, the Medical Verifier will provide up to 8 hours of on-site training/technical assistance for each transit agency per year, as needed.
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Modifications to the program require prior approval from Lead Agency Program Manager.
5. TRAINING AND OUTREACH
Task 1: Outreach to Qualified Practitioners The Medical Verifier is responsible for contacting physicians or other designated persons (qualified practitioners) who certify an applicant’s disability on the medical form. The purpose of this outreach is 1) to educate certifiers who may be unfamiliar with the Program Manager or who certify individuals inappropriately and 2) to obtain clarification or additional information from the certifier.
Task 2: Training for Transit Operators The Medical Verifier is responsible for training transit agency staff to use the system. Each transit agency has a designated staff person who is the primary point of contact with the Medical Verifier. The Medical Verifier will train the agency point person directly, who is then responsible for training other staff in program procedures and use of the database program. Information regarding upgrades and changes to the system will be given to staff trainers to disseminate to their staff. In addition to ongoing telephone assistance, the Medical Verifier will be required to hold up to a total of 4 three-hour training sessions for transit agency staff at a central location. The training sessions will be scheduled as needed over the course of the agreement.
Task 3: Operations Manual The Medical Verifier is responsible for maintaining and updating the Discount Card Program Operations Manual. While it is the responsibility of the Medical Verifier to issue the changes, it is the responsibility of the transit operator to update their operations manual. Any changes to policies or procedures must be promptly transmitted to transit agency staff. The Operations Manual will be revised and updated for distribution to agency staff in the third and fifth years of the agreement.
6. APPLICATION FORMS, STANDARIZED LETTERS, AND DOCUMENTATION OF PROGRAM OPERATING PROCEEDURES
Task 1: RTC Brochure and Application Forms The Medical Verifier is responsible for designing, producing, warehousing, and distributing all forms and documentation to the transit agencies, subject to approval by the RTC Discount Card Task Force. Transit agencies distribute application forms and brochures to individual customers and social service agencies. Camera-ready graphics of the current version of the RTC brochure and application forms will be supplied to the Medical Verifier. The Medical Page 21 of 69 AC TRANSIT REQUEST FOR PROPOSAL PURCHASING DEPARTMENT NO. 2012-1210
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Verifier will be responsible for making any revisions or redesigns recommended and approved by the RTC Task force.
All documents created for customers will be in accessible formats including, but not limited to Braille, ASCII format, large print (14 pt font) and audio tape. The Medical Verifier will produce documents in accessible formats and distribute one copy of each accessible format to every transit agency.
The Medical Verifier will develop cost estimates for producing the total number of forms and brochures used annually by the transit agencies as part of the annual budget process.
Task 2: Standardized Letters All customer correspondence should be standardized to the extent possible. The Medical Verifier will be responsible for revising and/or creating customer correspondence as requested by the RTC Task Force or the LEAD AGENCY Project Manager. Current versions of form letters approved include:
• Basic application instructions and form • Medical application instructions and form • Renewal by mail instructions and form • Request for additional information • Attendant card application instructions, form, and cover letter • Application approval letter • Application denial letter • Card expiration notification • Instruction memos for Medical Certifiers • Appeal application form
Application instructions will also be made available in Spanish and Chinese for distribution by transit agencies.
7. PERFORMANCE CRITERIA
All applicants will receive either an RTC Discount Card or a letter of denial within 21 calendar days of submitting their application to a transit agency. To meet this objective, the Medical Verifier is expected to 1) to process a minimum of 40% of all applications within seven days of their receipt and 2) to maintain an average processing time of seven days. In this case, the seven day period is seven calendar days from the date the Medical Verifier receives a complete data file. Processing time starts on the date the Medical Verifier receives a data file and ends on the date that the “ID Print Report” is transmitted for card
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printing or the application denial letter is mailed. “ID Print Report” files must be transmitted daily to Clipper.
8. ANNUAL BUDGET
The Medical Verifier will submit an annual budget to Lead Agency Program Manager for review and acceptance. The budget will indicate necessary operating expenses including production and distribution of forms and brochures, website maintenance, etc., to administer the Program Manager for the following year. The purpose of the annual budget is to provide transit agencies with detailed information about how the contract dollars are being spent. The costs presented in the budget will not affect compensation to the Medical Verifier under this Agreement.
9. ANNUAL AUDIT
The Medical Verifier is subject to audit regarding fiscal activities and an annual audit for compliance with Agreement terms and conditions. The Medical Verifier is required to maintain all relevant records for the purpose of a Program Manager audit.
The Medical Verifier is also subject to an audit for compliance with RTC Discount Card Program operations and procedures.
10. TRANSIT AGENCY PROCEDURES
LEAD AGENCY is the Lead Agency on behalf of the following transit agencies that participate in the RTC Discount Card Program:
• AC Transit • BART • Contra Costa County Transit Authority • Eastern Contra Costa County Transit Authority • Golden Gate, Bridge, Highway & Transportation District • LAVTA/Wheels • Rio Vista • SF MTA • SamTrans • Santa Rosa City Bus • Sonoma County Transit • Vallejo Transit/Solano/Benicia
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• VTA
Transit agencies are the primary point of contact for customers who want a transit discount card. Transit Agency staff will explain the basic process or Program Manager benefits to customers; dispense, accept, and review applications for accuracy and completeness; take applicant photos; collect application fees; and handle follow-up issues such as application status.
It is the Transit Agency’s responsibility to transmit a complete datafile to the Medical Verifier for processing. The step-by-step application process is as follows:
A. Confirm that the application is complete. Applicant’s name, address, or specified contact location, primary eligibility category and signature must be on application. Primary eligibility categories include:
• Medicare recipient (not Medi-Cal) • DMV disabled placard registration for either a disabled license plate or parking placard • Disabled veteran • Medical verification • Other transit agency discount card
It is the transit agency’s responsibility to check the application before the Customer leaves to make sure that it is legible and complete and that the responses are logical.
B. Confirm identity of applicant. The applicant must present a current (not expired) photo ID to confirm their identity. Valid photo ID includes:
• Driver’s License or California DMV ID card • Passport • Alien Registration Card • Photo ID and birth certificate • Military Identification Card or Dependent’s Card • Mexican Consulate Card • City of San Francisco ID Card
Individuals who are unable to obtain current photo identification due to a special status, e.g., ward of the state, may be accompanied by an official to vouch for their identify when applying at a transit agency.
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Transit agency staff must verify that the photograph, name, birth date, and signature on the ID card all match the individual applying for the discount card and the information on the application.
C. Copy Identification. Transit agency staff must transmit a copy of the applicant’s photo ID and other transit agency discount card, if applicable, to the Medical Verifier along with the hard copy of the application.
D. Take applicant’s photograph.
E. Collect fee and give customer a dated receipt.
F. Enter customer information into database. The database assigns an identification number to each application when data entry is initiated.
G. Transmit applicant data files to RTC website at least once per Medical Verifier schedule. Forward original applications to Medical Verifier weekly, including a copy of proof of identification.
11. APPLICANT PROCEDURES
Applicants can acquire an application either in person or by mail from their local transit agency. The transit agency where the customer has made the application is always the primary point of contact throughout the application process, although the Medical Verifier may contact the customer directly if appropriate.
The applicant completes the appropriate application (basic or medical) and presents the application to the transit agency, along with valid photo identification and the fee. Renewal and lost card applications can be made in person at the transit agency or by mail directly to the Medical Verifier. Applicants with a physical or mental disability must take their application to an approved certifier who verifies that the individual’s impairment qualifies under the RTC Program rules.
A medical application is not considered complete until the Medical Verifier has received both the practitioner and applicant portions of the medical form. The Medical Verifier will call the certifier if the form is not returned within 14 days of the date the application was received by the Medical Verifier. If the certifier form is not returned within 90 days, the application will be rejected.
The applicant receives their card or denial letter by mail, either at their contact address or at their local transit agency office.
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12. GUIDE TO ELIGIBILITY CRITERIA
Section 1 - Non-ambulatory Disabilities. Impairments that, regardless of cause, require individuals to use a wheelchair for mobility.
Section 2 - Mobility Aids. Impairments that cause individuals to walk with significant difficulty including individuals using a leg brace, cane, walker or crutches to achieve mobility.
Section 3 - Musculo-Skeletal Impairment (Including Arthritis). Musculo- skeletal impairment such as muscular dystrophy, osteogenesis imperfecta or any type of arthritis; such as functional Class III or anatomical Stage III.
Section 4 - Amputation. Persons who suffer amputation of, or anatomical deformity of (i.e., loss of major function due to degenerative changes associated with vascular or neurological deficits, traumatic loss of muscle mass or tendons and x-ray evidence of bony or fibrous ankylosis at an unfavorable angle, joint subluxation or instability): (a) both hands; or (b) one hand and one foot; or (c) amputation of lower extremity at or above the tarsal region (one or both legs).
Section 5 - Cerebrovascular Accident (Stroke). With one of the following: (a) pseudobulbar palsy; or (b) functional motor deficit in any of two extremities; or (c) ataxia affecting two extremities substantiated by appropriate cerebellar signs or proprioceptiv e loss post 4 months.
Section 6 - Pulmonary Ills. Respiratory impairments of Class 3 and 4. Class 3: FVC between 51 percent and 59 percent of predicted; or FEV between 41 percent & 59 percent of predicted. Class 4: FVC less than or equal to 50 percent of predicted; or FEV less than or equal to 40 percent of predicted.
Section 7 - Cardiac Ills. Cardiovascular impairments of functional Class III or IV. Functional Classification: Class III: Individuals with cardiac disease resulting in marked limitation of physical activity. They are comfortable at rest. Less than ordinary physical activity causes fatigue, palpitation, dyspnea or anginal pain. For instance, inability to walk one or more level blocks or climbing a flight of ordinary stairs. Class IV: Individuals with cardiac disease resulting in inability to carry out any physical activity without discomfort. Symptoms of cardiac insufficiency or of the anginal syndrome may be present even at rest. If physical activity is undertaken, discomfort is increased.
Section 8 - Dialysis. Individuals whose disability requires the use of a kidney dialysis machine.
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Section 9 -Sight Disabilities. Those individuals whose vision in the better eye, after best correction, is 20/200 or less; or those individuals whose visual field is contracted (commonly known as tunnel vision): (a) to 10 degrees or less from a point of fixation; or (b) so the widest diameter subtends an angle no greater than 20 degrees; and (c) individuals who are unable to read information signs or symbols for other than language reasons.
Section 10-Hearing Disabilities. Deafness or hearing incapacity that makes an individual unable to communicate or hear warning signals, including those persons whose hearing loss is 70 dba or greater in the 500, 1000, 2000 Hz. ranges.
Section 11-Disabilities of Incoordination. Individuals suffering faulty coordination or palsy from brain, spinal or peripheral nerve injury and any person with a functional nerve injury and any person with a functional motor deficit in any two limbs or who suffers manifestations which significantly reduce mobility, coordination or perceptiveness not accounted for in previous categories.
Section 12-Mental Retardation. Refers to subaverage general intellectual functioning which originates during the developmental period or as the result of illness or accident later in life and is associated with impairment in adaptive behavior (a general guideline is an IQ which is more than two standard deviations below the norm).
Section 13 -Cerebral Palsy. A disorder dating from birth or early infancy or as the result of illness or accident later in life, non-progressive, although if not treated there is marked regression in functioning characterized by examples of aberrations of motor functions (paralysis, weakness, in-coordination) and often other manifestations of organic brain damage such as sensory disorders, seizures, mental retardation, learning difficulty and behavioral disorders.
Section 14 - Epilepsy (Convulsive Disorder). A clinical disorder involving impairment of consciousness, characterized by seizures (e.g., generalized, complex partial, major motor, grand mal, petit mal or psychomotor), occurring more frequently than once a month in spite of prescribed treatment, with (a) diurnal episodes (loss of consciousness and convulsive seizure); (b) nocturnal episodes which show residual interfering with activity during the day; or (c) a disorder involving absence (petit mal) or mild partial (psychomotor) seizures occurring more frequently than once per week in spite of prescribed treatment with: 1) Alteration of awareness or loss of consciousness; and 2) Transient post-ictal manifestations of conventional or antisocial behavior. Persons exhibiting seizure-free control for a continuous period of more than six (6)
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months duration are not included in the statement of Epilepsy defined in this section.
Section 15 - Infantile Autism. A syndrome described as consisting of withdrawal, very inadequate social relationships, language disturbance and monotonously repetitive motor behavior. Many children with autism will also be seriously impaired in general intellectual functioning. This syndrome usually appears before the age of 6 and is characterized by severe withdrawal and inappropriate response to external stimuli.
Section 16 - Neurological Impairment. A syndrome characterized by learning, perception and/or behavioral disorders of an individual whose IQ is not less than two standard deviations below the norm. These characteristics exist as a result of brain dysfunctions (any disorder in learning using the senses), neurologic disorder or any damage to the central nervous system, whether due to genetic, hereditary, accident or illness factors. This section includes people with severe gait problems who are restricted in mobility.
Section 17 - Mental Disorders. Individuals whose mental impairment substantially limits one or more of their major life activities. This includes inability to learn, work or care for oneself. A principal diagnosis from the DSM IV classification in one of the following areas is required for eligibility: Organic Mental Disorders, Schizophrenic Disorders, Paranoid Disorders, Psychotic Disorders not elsewhere classified, Affective Disorders, Somata Form Disorders, Dissociative Disorders, Adjustment Disorders, Psychological Factors Affecting Physical Condition, and Post Traumatic Stress Syndrome. These diagnoses must be at Class 3 to 5 levels: Class 3 - Moderate Impairment. Levels compatible with some, but not all, useful functions. Class 4 - Marked Impairment. Levels significantly impede useful functioning. Class 5 - Extreme Impairment. Levels preclude useful functioning. (NOTE: If a person's disorder is in remission or primary incapacity is acute or chronic alcoholism or drug addiction, they will be specifically excluded from discount fare eligibility.)
Section 18 - Chronic Progressive Debilitating Disorders. Individuals who experience chronic and progressive debilitating diseases that are characterized by constitutional symptoms such as fatigue, weakness, weight loss, pain and changes in mental status that, taken together, interfere in the activities of daily living and significantly impair mobility. Examples of such disorders include: (a) Progressive, uncontrollable malignancies (i.e., terminal malignancies or malignancies being treated with aggressive radiation or chemotherapy); (b) Advanced connective tissue diseases (i.e., advance stages of disseminated lupus erythematosus, scleroderma or polyarteritis nodosa); (c) Symptomatic HIV infection (i.e., AIDS or ARC) in CDC-defined clinical categories B and C.
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Section 19 - Multiple Impairments. This category may include, but not be limited to, persons disabled by the combined effects of more than one impairment, including those related to age. The individual impairments themselves may not be severe enough to qualify as a Transit Dysfunction; however, the combined effects of the disabilities may qualify the individual for the program.
Qualified practitioners may certify eligibility only in the categories related to the field of practice in which they are licensed in the state of California to diagnose:
• Licensed physicians with an M.D. or D.O. degree, licensed physician's assistants and nurse practitioners may certify in all categories in which they are licensed to diagnose; • Licensed chiropractors, categories 1, 2, 3 and 4; • Licensed podiatrists, disabilities involving the feet under categories 1, 2, 3 and 4; • Licensed optometrists, category 9; • Licensed audiologists, category 10; • Licensed clinical psychologists and licensed educational psychologists, categories 12, 15, 16 and 17; • Licensed marriage and family counselors (MFCC) and licensed clinical social workers (LCSW), category 17.
13. BROCHURE AND APPLICATION PRODUCTION GUIDELINES
Program brochures: black, white & one color, 20 pages, center\fold & staple 15,000 every two years
Medical application: black, white, 8.5”/11”, 3 part form w/double sided instruction page 40,000 per year
Basic application: black, white, 8.5”/11”, Double sided, single sheet original provided to transit agencies for copying as needed
Renewal application: black, white, 8.5”/11”, Double sided, single sheet 15,000 per year
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14. ORGANIZATIONAL STRUCTURE
• The Partnership Transit Coordinating Council (PTCC) is the policy board for the program. The Bay Area Partnership Accessibility Committee (BAPAC) is the advisory group to the PTCC. • A Lead Agency provides overall program management oversight. • A Medical Verifier contractor administers the program day-to-day, • Cubic prints and distributes cards and provides customer service to resolve Clipper issues; and • The participating Bay Area transit operators accept applications and provide front-line customer service.
A. PARTNERSHIP TRANSIT COORDINATING COUNCIL (PTCC/BAPAC) The PTCC is comprised of the General Managers of each of the participating transit agencies. The PTCC functions as the policy board for the RTC Discount Card Program. The Bay Area Partnership Accessibility Committee (BAPAC) is comprised of the Accessible Service Managers of each of the participating transit agencies and makes recommendations regarding policy and procedures to the PTCC.
B. LEAD AGENCY The Lead Agency performs overall program and financial management, and Medical Verifier contracting and management. Specific responsibilities include:
Medical Verifier Contracting: The Lead Agency issues the RFP, manages the selection process and contracts with the central processing contractor.
Medical Verifier Management: The Lead Agency manages the contractor ensuring that work is performed in accordance with the objectives of the Discount Card Program and the specific parameters of the contract. The Lead Agency reviews all management reports, annuals budgets, and work plans from the contractor and mediates any disputes between individual transit agencies and the Medical Verifier.
C. BAY AREA TRANSIT AGENCIES The participating transit agencies are responsible for front-line customer service. Transit agencies handle customer questions, receive applications, verify identification, accept fees, take pictures, and transmit application files electronically to the Medical Verifier.
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D. METROPOLITAN TRANSPORTATION COMMISSION (MTC) MTC is responsible for contracting with Cubic to provide card printing and distribution of RTC Discount Cards and customer service to cardholders to resolve all Clipper related issues. Effective January 1, 2013.
15. MINIMUM COMPUTER REQUIREMENTS FOR MEDICAL VERIFIER
Computers/PC’s:
Pentium Core Duo CPU or better 2gb RAM or more Windows 7 professional (operating system) Video Card is preferred but not required Hard drive 160GB or greater External hard drive or network server for file backup
Software:
Windows Office XP or XP professions with Access 2004 Remote control software and/or VPN connection and windows RDP (remote desktop protocol) Software
Internet connection:
1GB Ethernet Card- DSL or Better
Note: Upon request by the Lead Agency the Medical Verifier will print and distribute RTC Discount Cards. This will require additional computer/printer capabilities.
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1. INCORPORATION OF FTA TERMS
The following provisions include, in part, Standard Terms and Conditions required by the Department of Transportation (DOT), whether or not expressly set forth in the preceding contract provisions. All contractual provisions required by DOT, as set forth in FTA Circular 4220.1F, dated November 01, 2008 as may be amended are hereby incorporated by reference. Anything to the contrary herein notwithstanding, all FTA mandated terms shall be deemed to control in the event of a conflict with other provisions contained in this contract document. The Contractor shall not perform any act, fail to perform any act, or refuse to comply with any AC TRANSIT requests that would cause AC TRANSIT to be in violation of the FTA terms and conditions.
2. FLY AMERICA REQUIREMENTS
The Contractor agrees to comply with 49 U.S.C. 40118 (the “Fly America Act”) in accordance with the General Services Administration's regulations at 41 CFR Part 301 - 10, which provide that recipients and subrecipients of Federal funds and their Contractors are required to use U.S. flag air carriers for U.S. Government-financed international air travel and transportation of their personal effects or property to the extent such service is available, unless travel by foreign air carrier is a matter of necessity as defined by the Fly America Act. The Contractor shall submit, if a foreign air carrier was used, an appropriate certification or memorandum adequately explaining why service by a U.S. flag air carrier was not available or why it was necessary to use a foreign air carrier and shall, in any event, provide a certificate of compliance with the Fly America requirements, if used. The Contractor agrees to include the requirements of this Section in all subcontracts that may involve international air transportation.
3. NO FEDERAL GOVERNMENT OBLIGATION TO THIRD PARTIES
The District and Contractor acknowledge and agree that, notwithstanding any concurrence by the Federal Government in or approval of the solicitation or award of the underlying contract, absent the express written consent by the Federal Government, the Federal Government is not a party to this Contract and shall not be subject to any obligations or liabilities to the District, Contractor, or any other party (whether or not a party to that contract) pertaining to any matter resulting from the underlying contract.
The Contractor agrees to include the above clause in each subcontract financed in whole or in part with Federal assistance provided by FTA. It is further agreed that the clause shall not be modified, except to identify the subcontractor who will be subject to its provisions.
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4. PROGRAM FRAUD AND FALSE OR FRAUDULENT STATEMENTS AND RELATED ACTS
A. The Contractor acknowledges that the provisions of the Program Fraud Civil Remedies Act of 1986, as amended, 31 U.S.C. §§ 3801 et seq and U.S DOT. Regulations “Program Fraud Civil Remedies”, 49 C.F.R. Part 31, apply to its actions pertaining to this project. Upon execution of the underlying contract, the Contractor certifies or affirms the truthfulness and accuracy of any statement it has made, it makes or it may make, or causes to be made, pertaining to the underlying contract or the FTA assisted project for which this contract work is being performed. In addition to other penalties that may be applicable, the Contractor further acknowledges that if it makes, or causes to be made, a false, fictitious, or fraudulent claim, statement, submission, or certification, the Federal Government reserves the right to impose the penalties of the Program Fraud Civil Remedies Act of 1986 on the Contractor to the extent the Federal Government deems appropriate.
B. The Contractor also acknowledges that if it makes, or causes to be made, a false, fictitious, or fraudulent claim, statement, submission, or certification to the Federal Government under a contract connected with a project that is financed in whole or in part with Federal assistance originally awarded by the FTA under the authority of 49 U.S.C. § 5307, the Government reserves the right to impose the penalties of 18 U.S.C. § 5307(k)(1) on the Contractor, to the extent the Federal Government deems appropriate.
C. The Contractor agrees to include the above two clauses in each subcontract financed in whole or in part with Federal assistance provided by the FTA. It is further agreed that the clauses shall not be modified, except to identify the Sub-Contractor who will be subject to the provisions.
5. ACCESS TO THIRD PARTY CONTRACT RECORDS
The following access to records requirements apply to this Contract:
A. Contractor agrees to provide the District, the FTA Administrator or his authorized representatives, including any PMO Contractor, access to the Contractor's records and construction sites pertaining to a major capital project, defined at 49 U.S.C. 5302(a) 1, which is receiving federal financial assistance through the programs described at 49 U.S.C. 5307, 5309 or 5311. By definition, a major capital project excludes contracts of less than the simplified acquisition threshold currently set at $100,000.
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B. The Contractor agrees to permit any of the foregoing parties to reproduce by any means whatsoever or to copy excerpts and transcriptions as reasonably needed.
C. The Contractor agrees to maintain all books, records, accounts and reports required under this contract for a period of not less than three (3) years after the date of termination or expiration of this contract, except in the event of litigation or settlement of claims arising from the performance of this contract, in which case Consultant agrees to maintain same until the District, the FTA Administrator, the State Auditor, the Comptroller General, or any of their duly authorized representatives, have disposed of all such litigation, appeals, claims or exceptions related thereto. Reference 49 CFR 18.39(i)(11).
6. CHANGES TO FEDERAL REQUIREMENTS
A. Consultant shall at all times comply with all applicable FTA regulations, policies, procedures and directives, including without limitation those listed directly or by reference in the Contract (Form FTA MA (18) dated October, 2011) between the District and FTA, as they may be amended or promulgated from time to time during the term of this contract. Consultant’s failure to so comply shall constitute a material breach of this contract.
B. The Consultant also agrees to include these requirements in each subcontract exceeding $100,000 financed in whole or in part with Federal assistance provided by FTA.
7. CIVIL RIGHTS (Title VI, EEO, ADA)
A. Nondiscrimination In accordance with Title VI of the Civil Rights Act, as amended, 42 U.S.C. § 2000d, section 303 of the Age Discrimination Act of 1975, as amended, 42 U.S.C. § 6102, section 202 of the Americans with Disabilities Act of 1990, 42 U.S.C. § 12132, and Federal transit law at 49 U.S.C. § 5332, the Consultant agrees that it will not discriminate against any employee or applicant for employment because of race, color, creed, national origin, sex, age, or disability. In addition, the Consultant agrees to comply with applicable Federal implementing regulations and other implementing requirements FTA may issue.
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B. Equal Employment Opportunity The following equal employment opportunity requirements apply to this contract:
1. Race, Color, Creed, National Origin, Sex – In accordance with Title VII of the Civil Rights Act, as amended, 42 U.S.C. § 2000e, and Federal transit laws at 49 U.S.C. § 5332, the Consultant agrees to comply with all applicable equal employment opportunity requirements of U.S. Department of Labor (U.S. DOL) regulations, “Office of Federal Contract Compliance Programs, Equal Employment Opportunity, Department of Labor,” 41 C.F.R. Parts 60 et seq., (which implement Executive Order No. 11246, “Equal Employment Opportunity,” as amended by Executive Order No. 11375, “Amending Executive Order 11246 Relating to Equal Employment Opportunity,” 42 U.S.C. § 2000e note), and with any applicable Federal statutes, executive orders, regulations, and Federal policies that may in the future affect construction activities undertaken in the course of the project. The Consultant agrees to take affirmative action to ensure that applicants are employed, and that employees are treated during employment, without regard to their race, color, creed, national origin, sex, or age. Such action shall include, but not be limited to, the following: employment, upgrading, demotion or transfer, recruitment or recruitment advertising, layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. In addition, the Consultant agrees to comply with any implementing requirements FTA may issue.
2. Age – In accordance with section 4 of the Age Discrimination in Employment Act of 1967, as amended, 29 U.S.C. § 623 and Federal transit law at 49 U.S.C. § 5332, the Consultant agrees to refrain from discrimination against present and prospective employees for reason of age. In addition, the Consultant agrees to comply with any implementing requirements FTA may issue.
3. Disabilities – In accordance with section 102 of the Americans with Disabilities Act, as amended, 42 U.S.C. § 12112, the Consultant agrees that it will comply with the requirements of U.S. Equal Employment Opportunity Commission, “Regulations to Implement the Equal Employment Provisions of the Americans with Disabilities Act,” 29 C.F.R. Part 1630, pertaining to employment of persons with disabilities. In addition, the Consultant agrees to comply with any implementing requirements FTA may issue.
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4. The Consultant also agrees to include these requirements in each subcontract financed in whole or in part with Federal assistance provided by FTA, modified only if necessary, to identify the affected parties.
8. DISADVANTAGED BUSINESS ENTERPRISE (DBE)
A. It is the policy of the District (Board Policy 326) to ensure non- discrimination in the award and administration of all contracts and to create a level playing field on which Disadvantaged Business Enterprises (DBEs) can compete fairly for contracts and subcontracts relating to the District’s construction, procurement and professional services activities. To this end, the District has developed procedures to remove barriers to DBE participation in the bidding and award process and to assist DBEs to develop and compete successfully outside of the DBE Program. In connection with the performance of this contract, the Contractor will cooperate with the District in meeting these commitments and objectives.
B. The District, recipient of federal financial assistance from the Federal Transit Administration (FTA) is committed to and has adopted a DBE Program in accordance with federal regulations 49 CFR Part 26, issued by the U.S. Department of Transportation (U.S. DOT).
C. Pursuant to 49 CFR §26.13, the Contractor is required to make the following assurance in its agreement with the District and to include this assurance in any agreements it makes with Subcontractors in the performance of this contract:
“The Contractor or subcontractor shall not discriminate on the basis of race, color, national origin, or sex in the performance of this contract. The Contractor shall carry out applicable requirements of 49 CFR Part 26 in the award and administration of U.S. DOT assisted contracts. Failure by the Contractor or Subcontractor to carry out these requirements is a material breach of this contract, which may result in the termination of this contract or such other remedy, as the District deems appropriate.”
Prompt Payment to Subcontractors. The contractor shall pay any subcontractors approved by the District for work that has been satisfactorily performed no later than thirty (30) days from the date of contractor’s receipt of progress payments by the District. Within sixty (60) days of satisfactory completion of all work required of the subcontractor, contractor shall release any retained payments withheld to the subcontractor.
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Use of DBE Financial Institutions. Pursuant to 49 CFR §26.27, the District strongly encourages contractors and subcontractors to utilize the services offered by DBE financial institutions. A list of DBE financial institutions can be found online at:
http://www.fms.treas.gov/mbdp/current_list.html or provided by the District’s Contracts Compliance Administrator, Phillip McCants via email request to [email protected].
9. PATENT AND RIGHTS IN DATA
(1) The term "subject data" used in this clause means recorded information, whether or not copyrighted, that is delivered or specified to be delivered under the contract. The term includes graphic or pictorial delineation in media such as drawings or photographs; text in specifications or related performance or design- type documents; machine forms such as punched cards, magnetic tape, or computer memory printouts; and information retained in computer memory. Examples include, but are not limited to: computer software, engineering drawings and associated lists, specifications, standards, process sheets, manuals, technical reports, catalog item identifications, and related information. The term "subject data" does not include financial reports, cost analyses, and similar information incidental to contract administration.
(2) The following restrictions apply to all subject data first produced in the performance of the contract to which this Attachment has been added:
(a) Except for its own internal use, the Consultant may not publish or reproduce subject data in whole or in part, or in any manner or form, nor may the Consultant authorize others to do so, without the written consent of the Federal Government, until such time as the Federal Government may have either released or approved the release of such data to the public; this restriction on publication, however, does not apply to any contract with an academic institution.
(b) In accordance with 49 C.F.R. § 18.34 and 49 C.F.R. § 19.36, the Federal Government reserves a royalty-free, non-exclusive and irrevocable license to reproduce, publish, or otherwise use, and to authorize others to use, for "Federal Government purposes," any subject data or copyright described in subsections (2)(b)1 and (2)(b)2 of this clause below. As used in the previous sentence, "for Federal Government purposes," means use only for the direct purposes of the Federal Government. Without the copyright owner's consent, the Federal Government may not extend its Federal license to any other party.
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1. Any subject data developed under that contract, whether or not a copyright has been obtained; and
2. Any rights of copyright purchased by the Consultant using Federal assistance in whole or in part.
(c) When the federal government awards Federal assistance for experimental, developmental, or research work, it is government’s general intention to increase transportation knowledge available to the public, rather than to restrict the benefits resulting from the work to participants in that work. Therefore, unless the federal government determines otherwise, the Consultant performing experimental, developmental, or research work required by the underlying contract to which this Attachment is added agrees to permit FTA to make available to the public, either FTA’s license in the copyright to any subject data developed in the course of that contract, or a copy of the subject data first produced under the contract for which a copyright has not been obtained. If the experimental, developmental, or research work, which is the subject of the underlying contract, is not completed for any reason whatsoever, all data developed under that contract shall become subject data as defined in subsection (a) of this clause and shall be delivered as the Federal Government may direct. This subsection (c), however, does not apply to adaptations of automatic data processing equipment or programs for the Consultant's use whose costs are financed in whole or in part with Federal assistance provided by FTA for transportation capital projects.
(d) Unless prohibited by state law, upon request by the Federal Government, the Consultant agree to indemnify, save, and hold harmless the Federal Government, its officers, agents, and employees acting within the scope of their official duties against any liability, including costs and expenses, resulting from any willful or intentional violation by the Purchaser or Consultant of proprietary rights, copyrights, or right of privacy, arising out of the publication, translation, reproduction, delivery, use, or disposition of any data furnished under that contract. Neither the Purchaser nor the Consultant shall be required to indemnify the Federal Government for any such liability arising out of the wrongful act of any employee, official, or agents of the Federal Government.
(e) Nothing contained in this clause on rights in data shall imply a license to the Federal Government under any patent or be construed as affecting the scope of any license or other right otherwise granted to the Federal Government under any patent.
(f) Data developed by the Consultant and financed entirely without using Federal assistance provided by the Federal Government that has been incorporated into
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work required by the underlying contract to which this Attachment has been added is exempt from the requirements of subsections (b), (c), and (d) of this clause, provided that the Purchaser or Consultant identifies that data in writing at the time of delivery of the contract work.
(g) Unless FTA determines otherwise, the Consultant agrees to include these requirements in each subcontract for experimental, developmental, or research work financed in whole or in part with Federal assistance provided by FTA. (3) Unless the Federal Government later makes a contrary determination in writing, irrespective of the Consultant's status (i.e. , a large business, small business, state government or state instrumentality, local government, nonprofit organization, institution of higher education, individual, etc.), the Consultant agree to take the necessary actions to provide, through FTA, those rights in that invention due the Federal Government as described in U.S. Department of Commerce regulations, "Rights to Inventions Made by Nonprofit Organizations and Small Business Firms Under Government Grants, Contracts and Cooperative Agreements," 37 C.F.R. Part 401.
(4) The Consultant also agrees to include these requirements in each subcontract for experimental, developmental, or research work financed in whole or in part with Federal assistance provided by FTA.
B. Patent Rights - This following requirement apply to each contract involving experimental, developmental, or research work:
(1) General - If any invention, improvement, or discovery is conceived or first actually reduced to practice in the course of or under the contract to which this Attachment has been added, and that invention, improvement, or discovery is patentable under the laws of the United States of America or any foreign country, the Purchaser and Consultant agree to take actions necessary to provide immediate notice and a detailed report to the party at a higher tier until FTA is ultimately notified.
(2) Unless the Federal Government later makes a contrary determination in writing, irrespective of the Consultant's status (a large business, small business, state government or state instrumentality, local government, nonprofit organization, institution of higher education, individual), the Purchaser and the Consultant agree to take the necessary actions to provide, through FTA, those rights in that invention due the Federal Government as described in U.S. Department of Commerce regulations, "Rights to Inventions Made by Nonprofit Organizations and Small Business Firms Under Government Grants, Contracts and Cooperative Agreements," 37 C.F.R. Part 401. (3) The Consultant also agrees to include the requirements of this clause in each subcontract for
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experimental, developmental, or research work financed in whole or in part with Federal assistance provided by FTA.
10. GOVERNMENT-WIDE DEBARMENT AND SUSPENSION
A. The prospective lower tier participant certifies, by submission of their bid or submittal, that neither it nor its "principals" [as defined at 2 C.F.R. § 180.995] is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency.
B. When the prospective lower tier participant is unable to certify to the statements in this certification, such prospective participant shall attach an explanation to this submittal.
11. LOBBYING
The Contractor agrees to:
A. Refrain from using Federal assistance funds to support lobbying.
B. Comply, and assure the compliance of each third party Contractor at any tier and each sub-recipient at any tier, with U.S. DOT regulations, "New Restrictions on Lobbying," 49 C.F.R. Part 20, modified as necessary by 31 U.S.C. § 1352.
C. Comply with Federal statutory provisions to the extent applicable prohibiting the use of Federal assistance funds for activities designed to influence Congress or a State legislature on legislation or appropriations, except through proper, official channels.
D. Contractor must complete and execute the form entitled "Certification Regarding Lobbying" which is attached hereto and is an integral part of this Contract.
The Bidder shall complete Standard Form SF-LLL, "Disclosure of Lobbying Activities," which is included with the Bid Documents, including instructions for completion.
12. CLEAN AIR
The Consultant agrees to comply with all applicable standards, orders, or regulations issued pursuant to the Clean Air Act, as amended 42 U.S.C. § 7401
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et seq. The Consultant agrees to report each violation to the District and understands and agrees that the District will in turn, report each violation as required to assure notification to FTA and the appropriate EPA Regional Office.
13. CLEAN WATER
The Consultant agrees to comply with all applicable standards, orders, or regulations issued pursuant to the Federal Water Pollution Control Act, as amended, 33 U.S.C. 1251 et seq. The Consultant agrees to report each violation to the District and understands and agrees that the District will, in turn, report each violation as required to assure notification to FTA and the appropriate EPA regional office.
14. ENERGY CONSERVATION
Consultant shall recognize mandatory standards and policies relating to energy efficiency which are contained in the State Energy Conservation Plan issued in compliance with the Energy Policy and Conservation Act (42 U.S.C. Section 6321 et seq.)
15. NOTIFICATION OF FEDERAL PARTICIPATION
This project may be financed in part by the Federal Transit Administration (FTA). Accordingly, federal requirements apply to this contract. In the event that those requirements are revised during the performance of this contract, the Consultant shall incorporate those revised provisions mandated by the FTA.
16. TERMINATION / RESOLUTION OF DISPUTES
A. Termination for Convenience of the District
The District, by written notice, may terminate this contract, in whole or in part, whenever the District determines that such termination is in its best interests. Any termination under this provision shall be effected by delivery to the Contractor of a notice of termination specifying the extent to which performance of work under the contract is terminated, and the date upon which such termination becomes effective. After receipt of said notice, Contractor shall stop work on this contract on the date and to the extent specified in said notice, terminate all applicable orders and subcontracts, and complete all work not terminated by said notice. After receipt of said notice, Contractor shall submit to the District its termination claim setting forth Contractor’s actual, direct, and unavoidable costs incurred which cannot be canceled as a result of said termination together with such
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information as may be required by the District to evaluate the claim. The determination of the District on the claim shall be final subject only to an appeal pursuant to the dispute resolution procedures set forth herein.
B. Termination for Default
1. In the event that the Contractor breaches the terms or violates the conditions of the contract and does not within ten (10) calendar days after receipt from the District of a notice of default ( or, in the case of a default that cannot be remedies within ten (10) calendar days, to commence to cure said default within said ten (10) calendar days and thereafter to diligently pursue said cure until the default is remedied), the District may in its discretion terminate the contract, or such portion thereof, as the District determines to be most directly affected by the default.
2. The term “default” for purposes of this provision includes, but is not limited to, the performance of work in violation of the terms of this contract; abandonment, assignment, delegation or subletting of this contract without approval of the District; bankruptcy or appointment of a receiver for Contractor’s property; failure to perform services or other required acts within the time specified for the contract or any extension thereof; refusal or failure to provide proper workmanship; failure to take effective steps to end a prolonged labor dispute; and the performance of the contract in bad faith.
If, after termination for failure to fulfill contract obligations, it is determined that the Contractor was not in default, the rights and obligations of the parties shall be the same as if termination had been issued for the convenience of the District.
C. Termination for Force Majeure
The performance of work under this contract may be terminated by the District, in its discretion, upon application therefore by the Contractor and based upon unforeseen causes beyond the control and without the fault or negligence of the Contractor such as Acts of God which render impossible the Contractor’s performance under the contract. An “Act of God” shall mean an earthquake, flood, cyclone, or other cataclysmic phenomenon of nature beyond the power of the Contractor to foresee or make preparation in defense against.
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D. Disputes
Performance During Dispute - Unless otherwise directed by the District, Contractor shall continue performance under the Contract while matters in dispute are being resolved. Further, the District shall pay Contractor for any undisputed work performed by Contractor prior to or during the resolution of the matters in dispute.
E. Alternative Dispute Resolution/Mandatory Arbitration
1. In the event that any controversy, claim or dispute between the District and the Contractor arising out of or related to this Contract, or the breach hereof, that has not been resolved by informal discussions and negotiations, either party may, by written notice to the other, invoke the formal dispute resolution procedures set forth herein. The written notice invoking these procedures shall set forth in reasonable detail the nature, background and circumstances of the controversy claim or dispute. During the thirty (30) days following said written notice, the parties shall meet, confer and negotiate in good faith to resolve the dispute. Either party may, during said thirty (30) day period, request the utilization of the services of a professional mediator, and the other party or parties to this dispute shall cooperate with such request and share the reasonable costs of such mediator.
2. Mandatory and Binding Arbitration
a. In the event that any controversy, claim or dispute between the District and the Contractor arising out of or related to this contract, or the breach hereof, cannot be settled or resolved amicably by the parties during the thirty (30) day period of good faith negotiations provided for above, the either party or any party hereto may submit said controversy, claim or dispute for binding arbitration before a single neutral arbitrator in accordance with the provisions contained herein and in accordance with the Commercial Arbitration Rules of the American Arbitration Association (“Rules”); provided, however, that notwithstanding any provisions of such Rules, the parties to the arbitration shall have the right to take depositions and obtain discovery regarding the subject matter of the arbitration, as provided in Title III of Part 4 (commencing with Section 1985) of the California Code of Civil Procedure, as and to the extent that the arbitrator deems fair and reasonable. Judgment upon the award rendered by the arbitrator may be entered in any court having jurisdiction. The arbitrator shall determine all questions of fact and
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law relating to any controversy, claim or dispute hereunder, including but not limited to whether or not any such controversy, claim or dispute is subject to the arbitration provisions contained herein.
b. Any party desiring arbitration shall serve on the other party or parties and the San Francisco Office of the American Arbitration Association, in accordance with the aforesaid Rules, its Notice of Intent to Arbitrate (“Notice”). The parties shall select a single, neutral arbitrator who is generally familiar with the factual and legal issues that relate to this Contract and the dispute to be resolved by arbitration. In the event that the parties are unable to agree on a neutral arbitrator, then one shall be selected in accordance with the Rules. The arbitration proceedings provided hereunder are hereby declared to be self-executing and it shall not be necessary to petition a court to compel arbitration.
c. The parties to the arbitration shall share equally all costs of the arbitration, including the fee of the neutral arbitrator, and each party shall bear its own costs. The arbitrator shall have the authority, in accordance with the provisions of this Contract, to award to the prevailing party its costs, including its share of the arbitration costs, and reasonable attorneys’ and expert witness fees and expenses.
d. If a controversy, claim or dispute arises between the parties which is subject to the arbitration provisions hereunder, and there exists or later arises a controversy, claim or dispute between the parties, or either of them, and any third party, which controversy, claim or dispute arises out of or relates to the same transaction or series of transactions, said third party controversy, claim or dispute shall be consolidated with the arbitration proceedings hereunder; provided, however, that any such third party shall be a party to an agreement with either of the parties which provides for the arbitration of disputes thereunder in accordance with rules and procedures substantially the same in all material respects as provided for herein or, if not, shall consent to arbitration as provided for hereunder.
e. All arbitration proceedings shall be held in Oakland, California.
f. The Notice of the demand for arbitration shall be made within a reasonable time after the claim, dispute or other matter in question has arisen, and in no event shall it be made after the date when
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institution of legal or equitable proceedings based on such claim, dispute or other matter in question would be barred by the applicable statute of limitations.
g. Waiver of Remedies for any Breach
In the event that the District elects to waive its remedies for any breach by the Contractor of any covenant, term, or condition of this Contract, such waiver by the District shall not limit the district's remedies for any succeeding breach of that or any other term, covenant, or condition of this Contract.
18. PRIVACY ACT
The following requirements apply to the Contractor and its employees that administer any system of records on behalf of the Federal Government under any contract:
(1)The Contractor agrees to comply with, and assures the compliance of its employees with, the information restrictions and other applicable requirements of the Privacy Act of 1974, 5 U.S.C. § 552a. Among other things, the Contractor agrees to obtain the express consent of the Federal Government before the Contractor or its employees operate a system of records on behalf of the Federal Government. The Contractor understands that the requirements of the Privacy Act, including the civil and criminal penalties for violation of that Act, apply to those individuals involved, and that failure to comply with the terms of the Privacy Act may result in termination of the underlying contract.
(2)The Contractor also agrees to include these requirements in each subcontract to administer any system of records on behalf of the Federal Government financed in whole or in part with Federal assistance provided by FTA.
19. RECYCLED PRODUCTS
The Contractor agrees to comply with all the requirements of Section 6002 of the Resource Conservation and Recovery Act (RCRA), as amended (42 U.S.C. § 6962), including but not limited to the regulatory provisions of 40 C.F.R. Part 247, and Executive Order 13423, as they apply to the procurement of the items designated in Subpart B of 40 C.F.R. Part 247.
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FORM F: LOBBYING DISCLOSURES
INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of a covered Federal action, or a material change to a previous filing, pursuant to title 31 U.S.C. section 1352. The filing of a form is required for each payment or agreement to make payment to any lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with a covered Federal action. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information.
1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action.
2. Identify the status of the covered Federal action.
3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this covered Federal action.
4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District, if known. Check the appropriate classification of the reporting entity that designates if it is, or expects to be, a prime or sub award recipient. Identify the tier of the sub awardee, e.g., the first sub awardee of the prime is the 1st tier. Sub awards include but are not limited to subcontracts, subgrants and contract awards under grants.
5. If the organization filing the report in item 4 checks "Subawardee," then enter the full name, address, city, State and zip code of the prime Federal recipient. Include Congressional District, if known.
6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organizational level below agency name, if known. For example, Department of Transportation, United States Coast Guard.
7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans, and loan commitments. Page 46 of 69 AC TRANSIT REQUEST FOR PROPOSAL PURCHASING DEPARTMENT NO. 2012-1210
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8.Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e.g., Request for Proposal (RFP) number; Invitation for Bid (IFB) number; grant announcement number; the contract, grant, or loan award number; the application/proposal control number assigned by the Federal agency). Include prefixes, e.g., "RFP-DE-90-001."
9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitment for the prime entity identified in item 4 or 5.
10. (a) Enter the full name, address, city, State and zip code of the lobbying registrant under the Lobbying Disclosure Act of 1995 engaged by the reporting entity identified in item 4 to influence the covered Federal action.
(b) Enter the full names of the individual(s) performing services, and include full address if different from 10 (a). Enter Last Name, First Name, and Middle Initial (MI).
11. The certifying official shall sign and date the form; print his/her name, title, and telephone number.
According to the Paperwork Reduction Act, as amended, no persons are required to respond to a collection of information unless it displays a valid OMB Control Number. The valid OMB control number for this information collection is OMB No. 0348-0046. Public reporting burden for this collection of information is estimated to average 10 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, DC 20503.
(END OF INSTRUCTIONS)
(END OF FEDERAL REQUIREMENTS)
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FORMS – CONTRACTOR FILL-IN AND RETURN WITH PROPOSAL Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 1. Type of Federal 2. Status of Federal 3. Report Type: Action: Action: a. initial filing a. Contract a. bid/offer/application b. material change b. Grant b. initial award c. Cooperative Contract c. post-award For Material Change d. Loan Only: e. loan guarantee Year _____ Quarter f. loan insurance _____
Date of Last Report: ______4. Name and Address of Reporting 5. If Reporting Entity in No.4 is Entity: Sub-awardee, Enter Name and Address Prime Sub-awardee of Prime: Tier ____, if known
if known Congressional District, if known: Congressional District, :
6. Federal Department/Agency: 7. Federal Program Name/Description:
CFDA Number, If applicable: ______Federal Action Number, if known: Award Amount, if known:
$ 10a. Name and Address of Lobbying b. Individuals Performing Services Entity (last name, first name, MI): (including address if different from No. 10a)
(attach continuation sheet(s) SF-LLL- A, if necessary) (last name, first name, MI): 11. Amount of Payment (check all 13. Type of Payment (check all that apply): that apply):
$______Actual a. retainer Planned b. one-time fee c. commission
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FORMS – CONTRACTOR FILL-IN AND RETURN WITH PROPOSAL 12. Form of Payment (check all that d. contingent fee apply): e. deferred f. other, specify: Cash ______in kind, specify nature ______Value ______14. Brief description of Services Performed and Date(s) of Service, Including officer(s), employee(s), or Members(s) contacted, for Payment Indicated in Item 11:
(attach Continuation Sheet(s) SF-LLL-A, if necessary) 15. Continuation Sheet(s) SF-LLL-A attached: Yes No
16. Information requested through this form is authorized by title 31 Signature: U.S.C. section 1352. This disclosure ______of lobbying activities is a material Print Name: representation of fact upon which ______reliance was placed by the tier above Title: when this transaction was made or ______entered into. This disclosure is Telephone No.: required pursuant to 31 U.S.C. 1352. ______This information will be reported to Congress semi-annually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each failure.
Federal Use Only: Authorized for Local Reproduction Standard Form - LLL
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FORMS – CONTRACTOR FILL-IN AND RETURN WITH PROPOSAL COST/PRICE PROPOSAL FORM
Offerors are requested to insert staff person titles, hourly rates and appreciate hours in the matrix below, in accordance with your approach to provide the proposed services. The current contract is for approximately 4 FTE annually that includes a combination of professional and administrative staff.
BASE PERIOD: DECEMBER 2012 THROUGH JUNE 30, 2017 (4 YEARS; 7 MONTHS)
LABOR CATEGORY UNIT UNIT RATE QUANTITY TOTAL
Hour
Hour
Hour
Hour
Materials, supplies, Lump expenses and office Sum space {detail on separate
sheet) GRAND TOTAL
(REST OF THIS PAGE INTENTIONALLY LEFT BLANK)
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FORMS – CONTRACTOR FILL-IN AND RETURN WITH PROPOSAL COST/PRICE PROPOSAL FORM
BASE PERIOD: JULY 1, 2017 THROUGH JUNE 30, 2020 (3 YEARS)
LABOR CATEGORY UNIT UNIT RATE QUANTITY TOTAL
Hour
Hour
Hour
Hour
Materials, supplies, Lump expenses and office Sum space {detail on separate
sheet) GRAND TOTAL
(REST OF THIS PAGE INTENTIONALLY LEFT BLANK)
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FORMS – CONTRACTOR FILL-IN AND RETURN WITH PROPOSAL
COST/PRICE PROPOSAL FORM
BASE PERIOD: JULY 1, 2020 THROUGH JUNE 30, 2022 (2 YEARS)
LABOR CATEGORY UNIT UNIT RATE QUANTITY TOTAL
Hour
Hour
Hour
Hour
Materials, supplies, Lump expenses and office Sum space {detail on separate
sheet) GRAND TOTAL
(REST OF THIS PAGE INTENTIONALLY LEFT BLANK)
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FORMS – CONTRACTOR FILL-IN AND RETURN WITH PROPOSAL ATTACHMENT NO. 1: DISADVANTAGED BUSINESS ENTERPRISE (DBE) CERTIFICATION Company Name
Street /Mailing Address
City/State/Zip Code TAX I.D.
I. PRIME CONTRACTOR The Bidder/Proposer is a CalTrans, or other authorized certifying agency, certified DBE under the FTA Uniform Certification Program.
Certification No. Expiration Date
The Bidder/Proposer has applied for DBE status through CalTrans, or other authorized certifying agency, under the FTA Uniform Certification Program.
Application Date Status of application
The Bidder/Proposer is not a CalTrans, or other authorized certifying agency, certified DBE under the Uniform Certification Program.
II SUB-CONTRACTOR (if proposed in bid or proposal) Attach a separate sheet for each sub-contractor to be used in the performance of services under a proposal specifying the sub-contractor DBE status as stated under section I listed above.
If not already registered, sub-contractors should access www.actransit.org, and complete an online vendor registration form by selecting purchasing, online purchasing, and registering as an Online Purchasing User. A W-9, Request for Taxpayer Identification Number and Certification is required to complete the process.
Prime Contractor's are requested to explain the DBE program and encourage sub contractors to apply for certification.
Prime Signature Date
(Position/Title)
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FORMS – CONTRACTOR FILL-IN AND RETURN WITH PROPOSAL ATTACHMENT NO. 2: SMALL LOCAL BUSNESS PROCUREMENT WORKSHEET
Contractors doing business with the District are encouraged to utilize small local businesses in their subcontracts. Under the current Board Policy (351), a Small Local Business is a business that meets the U.S. Government’s Small Business Administration (SBA) size standard and is located within AC Transit’s geographical service area. Contractors can contact the Contract Specialist or Buyer assigned to this procurement for information on SLBE resources.
Contractors responding to this solicitation shall complete the following questions and include this Worksheet with their bid or proposal, indicating whether they intend to use Small Local Businesses in the contract to be awarded and, if so, the percentages of contract work to be allocated to Small Local Businesses. Note: If small local businesses are utilized as subcontractors in a contract awarded from this RFP, Contractor shall submit to the District, on a monthly basis, those payments made to all subcontractors. The form for reporting monthly payments to subcontractors will be supplied by the District to the successful contractor after contract award. If there is no opportunity for SLBE utilization, please indicate on this Form with “N/A”.
Subcontractor name SLBE % of project work Certification No.
Subcontractor name SLBE % of project work Certification No.
Subcontractor name SLBE % of project work Certification No.
Subcontractor name SLBE % of project work Certification No.
Subcontractor name SLBE % of project work Certification No.
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FORMS – CONTRACTOR FILL-IN AND RETURN WITH PROPOSAL ATTACHMENT NO. 3: DESIGNATION OF SUBCONTRACTORS
To comply with the requirements of the California Subletting and Subcontracting Fair Practices Act, bidder shall list the name and address of each subcontractor, including D.B.E. subcontractors to whom the bidder proposes to Subcontract more than '!h of 1 percent of the work, and description and portions of the Work or services Subcontracted. Note: If small local businesses are utilized as subcontractors in a contract awarded from this REP, Contractor shall submit to the District, on a monthly basis, those payments made to all subcontractors. The form for reporting monthly payments to subcontractors will be supplied by the District to the successful contractor after contract award. · If you do not intend to subcontract any work under the contract, please indicate on the form with "N/A".
Attach additional copies of this form if more space is required. Name:
Name:
Address:
Estimated dollar amount of subcontract & description of work:
Is the firm a DBE? (YES/NO/PENDING)
How many years has the firm been in business?
What are the firm's gross annual receipts for the most recent three years?
Name:
Address:
Estimated dollar amount of subcontract & description of work:
Is the firm a DBE? (YES/NO/PENDING)
How many years has the firm been in business?
What are the firm's gross annual receipts for the most recent three years?
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FORMS – CONTRACTOR FILL-IN AND RETURN WITH PROPOSAL ATTACHMENT NO. 4: CERTIFICATION OF PROPOSED CONTRACTOR REGARDING DEBARMENT, SUSPENSION AND OTHER INELIGIBILITY AND VOLUNTARY EXCLUSION
(Contractor) certifies to the best of its knowledge and belief, that it and its principals:
Are not presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from covered transactions by any Federal department or agency;
Have not within a three year period preceding this bid been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain or performing a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements or receiving stolen property;
Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph (2) of this certification; and
Have not within a three year period preceding this bid had one or more public transactions (Federal, State or local) terminated for cause or default.
If the Proposed Subcontractor is unable to certify to any of the statements in this certification, it shall attach an explanation to this certification.
(Subcontractor) ______, CERTIFIES OR AFFIRMS THE TRUTHFULNESS AND ACCURACY OF THE CONTENTS OF THE STATEMENTS SUBMITTED ON OR WITH THIS CERTIFICATION AND UNDERSTANDS THAT THE PROVISIONS OF 31 U.S.C. SECTIONS 3801 ET. SEQ. IS APPLICABLE THERETO.
Signature and Title of Authorized Official
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SAMPLE CONTRACT
CONTRACT is made and entered into this ____ day of _____ 2012, by and between ALAMEDA-CONTRA COSTA TRANSIT DISTRICT (hereinafter “District”), a special transit district established pursuant to California Public Utilities Code, Section 24501 et seq., and ______(hereinafter “Contractor”).
THE PARTIES AGREE AS FOLLOWS:
1. SCOPE OF WORK/SERVICES
Contractor shall provide Regional Transit Connection Discount Card (RTC) Program Medical Verifier Service in full accordance with Request for Proposal No. 2012-1210 prepared and issued by the District entitled Regional Transit Connection Discount Card (RTC) Program Medical Verifier Service as described herein.
2. COMPONENT PARTS
This Contract shall consist of the following documents, each of which is on file with the District, and is incorporated into and made a part of this Contract by reference. In the event of a conflict these documents shall control in order of precedence as set forth below:
A. This Contract.
B. Request for Proposal 2012-1210 issued _____ and any addenda.
C. Contractor Proposal submitted in response to RFP 2012-1210 dated _____.
D. In the event of a conflict between the documents, A shall control over B, and B shall control shall control over C.
3. PERIOD OF PERFORMANCE
Services under this Contract shall commence upon execution of the contract by both parties and be completed no later than June 30, 2017, with one (1) three (3) year option, and one (1) two (2) year option for services to continue until June 30, 2022, if unilaterally exercised at the sole discretion of the District. Contractor shall not be held liable for delays resulting from problems of scheduling on the part of the District.
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SAMPLE CONTRACT 4. CONTRACT PRICE
The District agrees to pay for the professional services in accordance with the submitted proposal. Award for these services will be on a fixed price basis in the amount of ______($X,XXX,XXX.XX). District and Contractor must mutually agree upon any adjustments in payment. Invoices for services performed shall be submitted monthly by Contractor to: AC Transit Accounts Payable, PO Box 28507, Oakland, CA 94604. Payment to the contractor will be made Net 30 Days after receipt of approved invoices. The Contract Number and Purchase Order Number must be referenced on all invoices. Failure to do so could delay payment.
5. NOTICES
Any notice which may be required under this Contract shall be in writing, shall be effective when received, and shall be given by personal service or by certified mail, return receipt requested, to the addresses set forth below or to such other addresses which may be specified in writing by the parties to this Contract.
AC TRANSIT DISTRICT: CONTRACTOR:
AC Transit Purchasing Manager 1600 Franklin Street, 8th Floor Oakland, California 94612
6. ATTORNEY'S FEES
In the event that it becomes necessary for either party to bring a lawsuit to enforce any of the provisions of the Contract, the parties agree that the court having jurisdiction over such dispute shall have the authority to determine and fix reasonable attorney's fees to be paid to the prevailing party.
7. SEVERABILITY
If any provision of this Contract is declared void or unenforceable, such provision shall be deemed severed from this Contract, which shall otherwise remain in full force and effect.
8. BINDING EFFECT
All of the terms, provisions, and conditions of the Contract hereunder shall be binding upon and inure the parties hereto and the respective successors, assigns and legal representatives.
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SAMPLE CONTRACT 9. CONFLICT OF INTEREST
By signing this Contract, Contractor covenants that it presently has no actual knowledge of any interest, direct or indirect, that would conflict in any manner or degree with the performance of the services called for under this contract. Contractor further covenants that in the performance of this contract, no person having any such interest shall be employed by Contractor, and that Contractor receives no commissions or other payments from parties other than the District as a result of work performed hereunder. Failure to comply with this provision serves as a basis for termination for default and the collection of any damages.
10. GOVERNING LAW
This Contract, its interpretation and all work performed hereunder, shall be governed by the laws of the State of California.
11. VENUE
In the event of a dispute or breach of contract, venue shall be in Alameda County, California.
12. ENTIRE AGREEMENT
This Contract represents the entire agreement of the parties with respect to the subject matter hereof, and all such agreements entered into prior hereto are revoked and superseded by this Contract, and no representations, warranties, inducements or oral agreements have been made by any of the parties except as expressly set forth herein, or in other contemporaneous written agreements.
This Contract may not be changed, modified or rescinded except in writing, signed by all parties hereto, and any attempt at oral modification of this agreement shall be void and of no effect.
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SAMPLE CONTRACT IN WITNESS WHEREOF, the parties have executed this Contract on the dates set forth below.
AC TRANSIT DISTRICT: CONTRACTOR:
______David J. Armijo Date Name and Title Date General Manager
Approved as to Form and Content:
______Vincent C. Ewing Date General Counsel
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EXHIBITS
EXHIBIT 1 – SAMPLE REPORTS
NUMBER TITLE
Exhibit 1 (a) Annual Application Processing by Transit Agency
Exhibit 1 (b) Annual Processing by Month/Type
Exhibit 1 (c) Summary Statistics (7 year)
Exhibit 1 (d) Card Issuance Reasons FY 11/12
Exhibit 1 (e) Card Issuance – Mail-In Applications FY 11/12
Exhibit 1 (f) Activity Status Report FY 11/12
Exhibit 1 (g) Attendant Card Verification – June 2012
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EXHIBITS EXHIBIT 1(a) - ANNUAL APPLICATION PROCESSING BY TRANSIT AGENCY
RTC Discount Card Program Central Processor Activity Report Application Processing July 2011-June 2012 Avg Mon 2011 2012 Per cent To Last July Aug Sept Oct Nov Dec Jan Feb Mar Apr May June Total Total Invoice Date Yr
AC Transit 891 1192 1022 998 834 721 848 844 992 977 967 1175 11,597 28.76% 23.35% 955 1,040
BART 366 410 349 290 290 204 487 267 297 292 278 337 3,955 9.81% 13.85% 322 228
CCCTA 130 136 112 90 95 120 103 83 69 67 41 116 1,202 2.98% 5.80% 97 95
ECCTA 21 68 59 39 71 40 57 43 35 40 33 43 552 1.37% 1.10% 46 37
GGBHTD 73 88 62 48 69 39 51 53 55 59 59 84 750 1.86% 2.00% 62 62
LAVTA 10 15 14 23 16 17 22 16 29 11 9 19 206 0.51% 1.00% 17 11
Rio Vista 1 0 3 2 6 0 1 1 5 2 6 3 31 0.08% 1.00% 3 5
SamTrans 90 128 88 112 136 129 233 126 113 120 113 142 1,547 3.84% 3.10% 128 95
Santa Rosa 33 33 42 38 62 30 23 33 30 31 34 19 415 1.03% 1.20% 34 36
SFMTA 1149 874 1084 741 823 827 692 787 887 799 753 1000 10,612 26.31% 19.60% 868 965
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EXHIBITS RTC Discount Card Program Central Processor Activity Report Application Processing July 2011-June 2012 Avg Mon 2011 2012 Per cent To Last July Aug Sept Oct Nov Dec Jan Feb Mar Apr May June Total Total Invoice Date Yr
Sonoma 1 0 0 0 0 3 1 0 0 0 0 0 7 0.02% 1.00% 0 1
Vallejo 64 89 16 64 41 28 46 34 59 40 37 37 551 1.37% 1.30% 46 34
VTA 776 726 803 740 561 640 706 680 791 888 670 844 8,905 22.08% 25.75% 735 663
Received 3,605 3,759 3,654 3,185 3,004 2,798 3,270 2,967 3,362 3,326 3,000 3,819 40,330 100% 100% 3,312 3,273
Issued 3,291 3,691 3,544 2,965 2,997 2,728 3,376 3,376 2,964 3,418 2,992 3,629 39,544 3,248 3,205
Denied/clsd 45 56 57 63 51 77 60 72 70 59 78 92 661 2% 65 68
Processed 3,336 3,747 3,601 3,028 3,048 2,805 3,436 3,448 3,034 3,477 3,070 3,721 40,205 3,313 3,273
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REGIONAL TRANSIT DISCOUNT CARD (RTC) PROGRAM MEDICAL VERIFIER SERVICE FOR THE PERIOD: DECEMBER 10, 2012 THROUGH JUNE 30, 2017
EXHIBITS EXHIBIT 1(b) - ANNUAL PROCESSING BY MONTH/TYPE
2011 2012 Avg To Month Processing Time July Aug Sept Oct Nov Dec Jan Feb Mar Apr May June Date Last Yr w/in 7 days receipt by Agency 11% 16% 25% 29% 26% 19% 23% 26% 40% 28% 23% 31% 25% 30% receipt by CP 43% 39% 49% 58% 62% 43% 45% 56% 62% 60% 60% 60% 53% 54% w/in 21 days receipt by Agency 100% 100% 99% 99% 95% 97% 99% 100% 100% 100% 99% 99% 99% 99% receipt by CP 100% 100% 100% 100% 95% 99% 99% 100% 100% 100% 99% 99% 99% 100% Avg days by Agency 11.4 11.2 11.4 9.8 11.6 12.9 10.5 11.2 10.5 9.2 11.5 11.1 11 11 by Central Processor 8.9 8.7 9.6 7.5 9.5 10.2 8.4 9.1 8.2 7.0 9.0 8.8 9 8 Processed 3,336 3,747 3,601 3,028 3,048 2,805 3,436 3,448 3,034 3,477 3,070 3,721 3,313 3,364 Issued by Reason New 22% 32% 30% 35% 33% 32% 32% 28% 33% 29% 31% 24% 30% 30% Renewal 59% 47% 48% 40% 41% 43% 43% 48% 40% 46% 42% 50% 46% 45% Lost Card 15% 17% 17% 19% 19% 18% 20% 18% 19% 17% 19% 17% 18% 19% Clipper defective 2% 2% 2% 3% 3% 3% 3% 3% 3% 5% 5% 5% 3% 2% Other 2% 2% 3% 3% 4% 3% 3% 3% 5% 3% 4% 4% 3% 3% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% By Mail 1,108 573 685 374 431 332 498 494 300 494 240 718 521 579 % of Total 33% 15% 19% 12% 14% 12% 14% 14% 10% 14% 8% 19% 15% 17% % Renewals 96% 92% 92% 86% 90% 89% 79% 87% 79% 90% 78% 92% 88% 90% % Replacements 4% 8% 8% 14% 10% 11% 21% 13% 21% 10% 22% 8% 12% 10% Attendant Cards Issued 21 35 11 22 12 13 19 -
Page 64 of 69 AC TRANSIT DISTRICT REQUEST FOR PROPOSAL PURCHASING DEPARTMENT NO. 2012-1210
REGIONAL TRANSIT DISCOUNT CARD (RTC) PROGRAM MEDICAL VERIFIER SERVICE FOR THE PERIOD: DECEMBER 10, 2012 THROUGH JUNE 30, 2017
EXHIBITS
EXHIBIT 1(c) - SUMMARY STATISTICS (7 YEAR)
RTC Discount Card Program Summary Statistics June 15, 2005-June 30, 2012 Year 7 Year 6 Year 5 Year 4 Year 3 Year 2 Year 1 FY11/12 FY10/11 FY09/10 FY/08/09 FY/07/08 FY06/07 FY05/06 Applications received 40,330 39,270 35,984 34,322 33,404 33,133 34,846
Cards issued 39,544 38,464 34,838 33,545 32,716 32,548 34,088
Applications denied 661 813 851 714 701 535 680 Percent Denied 2.1% 2.1% 1.6% 2.0% Processing time: w/in 21 days 99% 99% 100% 100% 99% 99% 1% average (days ) 99% 11 10 10 10 8.4 8.4 Type of card issued: New 29% 29% 31% 32% 31% 29% 30% Renewal 47% 46% 48% 49% 49% 52% 52% Replacement 18% 19% 17% 17% 16% 15% 15% Other 3% 4% 3% 3% 3% 4% 3% Clipper defective 3% 2% <.01% Basis of certification: Medical (includes basic) 81% 78% 77% 78% 76% 74% 75% Senior 19% 22% 23% 22% 24% 26% 25%
Page 65 of 69 AC TRANSIT DISTRICT REQUEST FOR PROPOSAL PURCHASING DEPARTMENT NO. 2012-1210
REGIONAL TRANSIT DISCOUNT CARD (RTC) PROGRAM MEDICAL VERIFIER SERVICE FOR THE PERIOD: DECEMBER 10, 2012 THROUGH JUNE 30, 2017
EXHIBITS
EXHIBIT 1(d) - CARD ISSUANCE REASONS FY 11/12
New Renewals Replacements Clipper Other Totals Defective Reasons
Alameda Contra Costa Transit 3323 5155 2559 12 548 11597 District 28.7% 44.5% 22.1% 0.1% 4.7% 100% Bay Area Rapid Transit District 1145 2015 514 211 70 3955 29.0% 50.9% 13.0% 5.3% 1.8% 100% City of Benicia Transit Service 0 6 0 0 0 6 0.00% 100.00% 0.00% 0.00% 0.00% 100% Central Contra Costa Transit 294 782 94 5 27 1202 Agency 24.5% 65.1% 7.8% 0.4% 2.2% 100% Eastern Contra Costa Transit 272 213 53 0 14 552 Agency 49.3% 38.6% 9.6% 0.0% 2.5% 100% Golden Gate Bridge and 60 54 12 1 7 134 Highway Transit District - Toll 44.80% 40.30% 9.00% 0.70% 5.20% 100% Whistlestop Wheels (GGBHTD) 175 267 137 0 37 616 28.4% 43.3% 22.2% 0.0% 6.0% 100% Livermore Amador Valley 128 54 17 0 7 206 Transit 62.1% 26.2% 8.3% 0.0% 3.4% 100% Rio Vista Transit 29 1 0 0 1 31 93.5% 3.2% 0.0% 0.0% 3.2% 100% San Mateo County Transit 673 615 191 35 33 1547 District 43.5% 39.8% 12.3% 2.3% 2.1% 100% Santa Rosa Transit District 179 197 38 0 1 415 43.1% 47.5% 9.2% 0.0% 0.2% 100% San Francisco Municipal 2678 4993 2066 603 272 10612 Railway 25.2% 47.1% 19.5% 5.7% 2.6% 100% Sonoma County Transit 0 7 0 0 0 7 0.0% 100.0% 0.0% 0.0% 0.0% 100% Vallejo Transit District 228 259 37 0 21 545 41.8% 47.5% 6.8% 0.0% 3.9% 100% Santa Clara Valley Transit 2678 4204 1333 431 259 8905 Authority 30.1% 47.2% 15.0% 4.8% 2.9% 100% Totals 11864 18822 7051 1298 1298 40333 29.4% 46.7% 17.5% 3.2% 3.2% 100%
Renewals Include Applications for Renewal to Transit Agenies and by Mail Replacements include Applications for Lost, Stolen, Defective, Changed Name and Application for Replacement by Mail.
Page 66 of 69 AC TRANSIT DISTRICT REQUEST FOR PROPOSAL PURCHASING DEPARTMENT NO. 2012-1210
REGIONAL TRANSIT DISCOUNT CARD (RTC) PROGRAM MEDICAL VERIFIER SERVICE FOR THE PERIOD: DECEMBER 10, 2012 THROUGH JUNE 30, 2017
EXHIBITS EXHIBIT 1(e) - CARD ISSUANCE – MAIL-IN APPLICATIONS FY 11/12
Alameda Contra Costa Transit Renewals Replacements Totals 1543 259 1802 District 85.6% 14.4% 100% Bay Area Rapid Transit District 822 103 925 88.9% 11.1% 100% City of Benicia Transit Service 6 0 6 100.0% 0.0% 100% Central Contra Costa Transit 550 46 596 Agency 92.3% 7.7% 100% Eastern Contra Costa Transit 84 4 88 Agency 95.5% 4.5% 100% Golden Gate Bridge and 42 6 48 Highway Transit District - Toll 87.5% 12.5% 100% Whistlestop Wheels (GGBHTD) 96 6 102 94.1% 5.9% 100% Livermore Amador Valley 24 5 29 Transit 82.8% 17.2% 100% Rio Vista Transit 1 0 1 100.0% 0.0% 100% San Mateo County Transit 245 38 283 District 86.6% 13.4% 100% Santa Rosa Transit District 62 1 63 98.4% 1.6% 100% San Francisco Municipal 1863 154 2017 Railway 92.4% 7.6% 100% Sonoma County Transit 7 0 7 100.0% 0.0% 100% Vallejo Transit District 87 3 90 96.7% 3.3% 100% Santa Clara Valley Transit 785 34 819 Authority 95.8% 4.2% 100% 659 6876 90.4% 9.6% 100%
Page 67 of 69 AC TRANSIT DISTRICT REQUEST FOR PROPOSAL PURCHASING DEPARTMENT NO. 2012-1210
REGIONAL TRANSIT DISCOUNT CARD (RTC) PROGRAM MEDICAL VERIFIER SERVICE FOR THE PERIOD: DECEMBER 10, 2012 THROUGH JUNE 30, 2017
EXHIBITS EXHIBIT 1(f) – ACTIVITY STATUS REPORT fy 11/12
Cards Issued Applications Eligibility Category Received Denied Basic Medical Senior None Total AC Transit 11597 245 1351 6948 3042 9 11350 Alameda Contra Costa Transit District 12% 61% 27% 0% BART 3955 67 1160 2201 419 6 3786 Bay Area Rapid Transit District 31% 58% 11% 0% BENICIA 6 0 3 1 2 0 6 Benicia City Transit 50% 17% 33% 0% CCCTA 1202 12 333 624 228 0 1185 Central Contra Costa Transit Agency 28% 53% 19% 0% ECCTA 552 13 163 352 25 2 542 Eastern Contra Costa Transit Agency 30% 65% 5% 0% GGBHTD1 134 4 59 52 5 0 116 Golden Gate Bridge and Highway Transit 51% 45% 4% 0% District 1 GGBHTD2 616 15 121 405 73 0 599 Whistlestop Wheels (GGBHTD) 20% 68% 12% 0% LAVTA 206 6 74 85 42 0 201 Livermore Amador Valley Transit 37% 42% 21% 0% Rio Vista 31 1 9 11 8 1 29 Rio Vista Transit 31% 38% 28% 3% SAMTRANS 1547 34 383 1073 49 4 1509 San Mateo County Transit District 25% 71% 3% 0% Santa Rosa 415 18 79 300 25 0 404 Santa Rosa Transit District 20% 74% 6% 0% SF Muni 10612 142 2053 7843 594 19 10509 San Francisco Municipal Railway 20% 75% 6% 0% Sonoma 7 0 0 7 0 0 7 Sonoma County Transit 0% 100% 0% 0% Vallejo 545 13 152 349 30 2 533 Vallejo Transit District 29% 65% 6% 0% VTA 8905 91 1094 4758 2910 6 8768 Santa Clara Valley Transit Authority 12% 54% 33% 0% Totals 40330 661 7034 25009 7452 49 39544 18% 63% 19% 0% July 6, 2012
Page 68 of 69 AC TRANSIT REQUEST FOR PROPOSAL PURCHASING DEPARTMENT NO. 2012-1210
REGIONAL TRANSIT DISCOUNT CARD (RTC) PROGRAM MEDICAL VERIFIER SERVICE FOR THE PERIOD: DECEMBER 10, 2012 THROUGH JUNE 30, 2017 SAMPLE CONTRACT
EXHIBIT 1(g) - ATTENDANT CARD VERIFICATION – JUNE 2012
Alameda Contra Costa Transit District Cardholder Current Corresponding Attendant Attendant Card Client ID Card Serial Number Issued Card Serial Number Issued Printing Date A0035658 1200949784 1200966368 6/22/2012 A0035658 1200917950 1200948723 6/15/2012 A0035660 1200948138 1200948737 6/14/2012
Total: 3 Attendant Cards for Alameda Contra Costa Transit District
Bay Area Rapid Transit District Cardholder Current Corresponding Attendant Attendant Card Client ID Card Serial Number Issued Card Serial Number Issued Printing Date B0021812 1200938986 1200939009 6/1/2012 C0004087 1201718349 1200966234 6/25/2012
Total: 2 Attendant Cards for Bay Area Rapid Transit District
San Francisco Municipal Railway Cardholder Current Corresponding Attendant Attendant Card Client ID Card Serial Number Issued Card Serial Number Issued Printing Date M0009461 1200948705 1200948724 6/15/2012 M0061647 1200948853 1200948852 6/13/2012 M0061681 1200949466 1200949465 6/20/2012
Total: 3 Attendant Cards for San Francisco Municipal Railway
Santa Clara Valley Transit Authority Cardholder Current Corresponding Attendant Attendant Card Client ID Card Serial Number Issued Card Serial Number Issued Printing Date V0021234 1200949317 1200949316 6/12/2012 V0053734 1000177762 1200948307 6/8/2012
Total: 2 Attendant Cards for Santa Clara Valley Transit Authority
Santa Rosa Transit District Cardholder Current Corresponding Attendant Attendant Card Client ID Card Serial Number Issued Card Serial Number Issued Printing Date R0002717 1200943536 1200949568 6/19/2012
Total: 1 Attendant Card for Santa Rosa Transit District
Total: 13 Attendant Cards
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