HomeMy WebLinkAboutILA - Benton Franklin Health District - Community Services ContractCOMMUNITY SERVICES CONTRACT
Between
BENTON-FRANKLIN HEALTH DISTIRCT
And
CITY OF PASCO
This Community Services Contract, hereinafter referred to as the Contract, by and between Benton -Franklin Health
District (BFHD) and the City of Pasco (Contractor), and collectively known as the "Parties" is being executed for the
purpose of providing an emergency response to the Covid-19 pandemic through community testing and related services
as a counter measure against the pandemic.
EFFECTIVE DATE: JANUARY 1, 2022 — MARCH 31, 2022
Benton -Franklin Health District Phone: (509) 460.4200
7102 W. Okanogan Place Fax: (509) 460-4590
Kennewick, WA 99336
TltlefResponsibility Contact Name
Phone
Fax
Email
Administrator/Signature Authority Jason Zaccaria
509-460.4567
509-460-4590
Jasonz Zbfhd.Wa.Qoy
Fire Chief — Primary Contact
Contracts Manager Bonnie Hall
509-460-4553
509.460-0590
BonniehOtifhd.wa.cio
EOC Incident Commander Rick Dawson
EOC Incident Commander Carla Prock
509539.1791
509-539-0874
509-460-4515
509-460-4515
Rickd &bfhd.wa.gov
Caday(a),bfhd.wa.gov
—Accounts Payable Kyle Phillips
Contractor Contacts
City of Pasco Phone: (509) 545.3426
1011 E. Ainsworth Ave. Fax: (509) 5435717
Pasco, WA 99301 Duns #:
Responsibility
Contact Name
Phone
Email
Signature Authority — City
Manager
Dave Zabell
509-545-5404
zabelld asco-wa. ov
Fire Chief — Primary Contact
Bob Gear
Gearb sco-wa. ov
Site Command
Craig Patterson
_
509-539-1976
509-5445065
Craimpatterson0charter.nat
Finance Director
Rlcha Si dg el
si eir asco-wa, ov
Finance Mane erDarc
Buckle
509-545-3432
bucklevd@casco-wa.Qov
Admin —Fire Department
Rhonda Riggle
509-5435709
d ler asco-wa. ov
Whereas, the aforementioned Parties desire to enter into this agreement in which they intend to work together
towards the goals and objectives set forth;
And Whereas, the Parties are desirous to enter an understanding, thus setting out all necessary working
arrangements that both Parties agree shall be necessary to complete this partnership;
City of Pasco- Fire Department 2022 Page 11
MISSION
The relationship under this agreement has been established with the following intended mission of
collaboration to provide testing and/or response efforts for Covid-19 to the citizens of Benton and Franklin
counties with the purpose of protecting the health of the public, to support the Governor's Safe Start
Washington Plan, and to provide Covid-19 testing as a counter measure against the pandemic.
PURPOSE AND SCOPE
The Parties intend for this Contract to provide the cornerstone and structure for the activities outlined in this
agreement and any further binding Contracts or amendments, which may be related to this partnership.
INDEPENDENT CONTRACTOR
The parties intend that an independent Contractor relationship will be created by this Contract. The Contractor
and its employees or agents performing under this Contract are not employees or agents of the District. The
Contractor, employees, or agents performing under this Contract will not hold himself/herself out as, nor claim
to be, an officer or employee of the District by reason hereof, nor will the Contractor, his or her employees, or
agent make any claim to right, privilege or benefit that would accrue to such officer or employee.
RESPONSIBILITIES OF THE PARTIES
The specific roles and responsibilities of each party are identified below as a starting point, and it is recognized
that the scope of work related to this agreement is a response effort to the Covid-19 pandemic and therefore a
fluid situation. It is anticipated that the needs for the response effort could evolve or change rapidly and
therefore each party is committed to working collaboratively to fulfill the joint mission. As the need may arise,
specific details of support to be furnished by each of the participants may be developed by amendment to this
Contract or separately from this agreement in a specific, mutually acceptable manner subject to the availability
of funds and resources. The parties will work together to Identify appropriate time and press for
decommission.
It Is the desire and wish of the Parties that this agreement allow the Parties to work together in such a manner
that would promote a genuine atmosphere of collaboration and alliance through means of the following
individual services:
SENTON-FRANKLIN HEALTH DISTRICT agrees to provide the following services:
• Test site selection and securing appropriate Contracting documentation with site owner
• Infection control protocols, initial inventory of PPE and establishment of a system for on-going
inventory management of PPE
• Long term procurement of supplies -- Ongoing Specimen Collection Kits, PPE
• Local procurement of technology/tents/tables/supplies to operate test site (as needed)
• Logistics support — as needed to support the IMT
• Patient communication design Including multi-lingual patient handouts and scripts that incorporate
language accessibility
• Provide signage
• Ordering Physician unless otherwise provided by EMS Medical Command
• Lab Courier Service as provided by agreement with University of Washington Lab
• Set up notification process / customer service for positive patients (consider Contract / partnering
with local agency)
• Provide access to Language line for on-site staff to support non-English speaking customers
CITY OF PASCO — FIRE DEPARTMENT agrees to provide the following services:
• Facilitate on-site staff access to interpreters or Language line for non-English speaking customers
• Local test site command (scheduling/daily operations)
• Sub -Contract with Columbia Safety to run daily test site operations
• Ensure Local test site is suppliedlorganized to operation requirements
• Monitor and maintain supplies to ensure adequate inventory of materials
• Create and maintain a site plan including an agreed upon traffic flow with local jurisdiction
City of Pasco — Fire Department 2022 P a g e 12
• Supervise and assure safety for all personnel while onsite
• Monthly financial activity reports detailing expenditures for which reimbursement is requested
• Monthly labor reports to BFHD for direct payment (Fire District name, employee name, date(s),
hours worked and any other documentation to assist DOH with validation of Invoices to reimburse
Fire Districts for operational labor support)
• Maintain additional financial backup documentation such as payroll and general ledger and provide
upon request
• Other reporting as requested by DOH
• A positive patient experience
TERM OF CONTRACT
The term of this Contract shall start on January 1, 2022 and be in effect until March 31, 2022 unless extended
or terminated by written mutual agreement of both Parties.
AUDIT REQUIREMENT
A non -Federal entity that expends $750,000 or more during the non -Federal entity's fiscal year in Federal
awards must have a single or program -specific audit conducted for that year In accordance with 2 CF R
200.501. If a single or program -specific audit is conducted for the funding of this agreement, Contractor shall
meet the audit requirements as described in 2 CFR Part 200 Subpart F.
FUNDING
The expected source of funding for this contract is ELC — (Epidemiology and Laboratory for Infectious Disease)
and is federally funded through the CDC and is subject to 2CRF Part 200 —Uniform Administrative
Requirements, Cost Principles, and Audit Requirements for Federal Awards.
• BARS Code 333.93.32
• CFDA# 93.323
• Federal Award ID# NU50CK000515
COMPENSATION AND METHOD OF PAYMENT
The maximum consideration for this contract is $ 790.000.00. BFHD will reimburse the City of Pasco for
satisfactory completion of the services and requirements specified in this Contract, payable upon receipt and
approval of a signed invoice of actual allowable costs based on monthly invoices submitted by City of Pasco to
the Health District. Invoices to be submitted by the 20th of the following month by email, fax or mail to the
BFHD Accountant and Contracts Manager listed on page one of this agreement.
Monthly Invoices shall include agency name, employee name, dates, hours worked and any other
documentation to assist BFHD with validation of invoices to reimburse City of Pasco - Fire District for
operational labor support. Materials and supply purchases in the amount of $1000 or greater, require copies of
the receipts included with the monthly invoice to the District. City of Pasco to retain financial backup
documentation such as payroll and general ledger records, and sub -Contractor records and provide upon
request. FEMA workbook completion may be required if FEMA funds will be accessed.
Final Invoice are due within 20 days of the end of the Contract. If final invoices and reports are not submitted
within 20 days of the close of the Contract, the Health District will be relieved of all liability for payment to the
City of Pasco of the amounts set forth in said invoices.
In-kind services are not reimbursable expenses under this agreement.
DEBARMENT AND SUSPENSION CERTIFICATON
This Contract is federally funded entities that are debarred, suspended, or proposed for debarment by the US
Government are excluded from receiving federal funds. The following acts by individuals or entities may result
City of Pasco — Fire Department 2022 P a g e 13
in permissive exclusions. This list is not all-inclusive. For a complete list refer to section 1128A Ll of the
Social Security Act:
a. License revocation or suspension
b. Fraud, kickbacks or other prohibited activities
c. Entities controlled by a sanctioned individual
Cl. Making false statements or misrepresentation of material
Background checks: Contractor will ensure that all staff working in activities funded by this Contract
have passed a Washington State Patrol background check upon hire and retain proof of such to be
made available to District upon request.
System for Award Management (SAM) site registration: Contractor shall acquire a Statewide
Payee Number by registering at www.sam.00v .
DUNS number: To comply with the Federal Funding Accountability and Transparency Act and be
eligible to perform the activities in this Statement of Work, Contractor agrees to register for and provide
the District with its DUNS number.
The Contractor, by signature of this agreement certifies that Contractor is not presently debarred,
suspended, proposed for debarment, declared ineligible, or voluntarily excluded by any Federal department
or agency from participating in transactions (debarred). The Contractor also agrees to notify the District
immediately by providing written notice if Contractor becomes debarred during the term of this agreement.
INTERNAL CONTROLS AND ACCOUNTING SYSTEM
The Contractor shall establish and maintain a system of accounting and internal controls which complies with
generally accepted accounting principles in accordance with the Financial Accounting Standards Board
(FASB), the Governmental Accounting Standards Board (GASB) or both as applicable to the Contractors form
of incorporation.
ETHICS CERTIFICAITON
Contractor certifies that they are now and shall remain, in compliance under Chapter 42.52RCW, Ethics in
Public Service, throughout the term of this Contract.
DATA USE, OWNERSHIP AND DISCLOSURE
Information provided to BFHD by Contractor will be used for all necessary public health efforts as outlined in
WAC 246-101. This will include sharing PHI as provided for by law for the purpose of protecting the health of
the public as well as congregate data for public disclosures including publishing case counts. Any data,
records or files taken off site in the course of Contractor personnel activities are to be returned to BFHD upon
completion of task or upon termination of volunteer tenure with BFHD, whichever event occurs first.
The Contractor agrees that all information, records, and data collected in connection with this Contract shall be
protected from unauthorized disclosure in accordance with applicable state and federal law.
MAINTENANCE OF RECORDS/EVALUATIONS AND INSPECTIONS
The Contractor will maintain accounts and records, including personnel, property, financial, and Contracts and
other such records as deemed necessary to ensure proper accounting for all Contract funds and compliance
with this Contract.
Medical records shall be maintained and preserved by the Contractor in accordance with state and federal
medical records statues, included but not limited to RCW 70.41.190, 70.02.160, and standard medical records
practice. If the Contractor ceases operations under this Contract, the Contractor shall be responsible for the
disposition and maintenance of such medical records.
City of Pasco— Fire Department 3022 Page 14
HIPAA AND HITECH COMPLIANCE
To the extent applicable to this Agreement, Contractor agrees to comply with the Health Information
Technology for Economic and Clinical Health Act of 2009 ("HITECH ACT'), the Administrative Simplification
provisions of the Health Insurance Portability and Accountability Act of 1996, as codified at 42 USC § 1320d
through d-8 ("HIPAA") and any current and future regulations promulgated under either the HITECH Act or
HIPAA including without limitation the federal privacy regulations contained in 45 C.F.R. Parts 160 and 164
(the "Federal Privacy Regulations"), the federal security standards contained in 45 C.F.R. Parts 160, 162 and
164 (the "Federal Security Regulations") and the federal standards for electronic transactions, all as may be
amended from time to time, and all collectively referred to herein as "HIPAA Requirements". Contractor
agrees not to use or disclose any Protected Health Information (PHI) (as defined In 45 C.F.R. § 164.501) or
Individually Identifiable Health Information (as defined in 42 USC § 1320d), other than as permitted by HIPAA
Requirements and the terms of this Agreement. Contractor will and will cause their personnel to enter into any
further agreements as necessary to facilitate compliance with HIPAA Requirements.
CORRECTIVE ACTION
If BFHD determines that a breach of Contract has occurred, that is, the Contractor has failed to comply with
any terms or conditions of this Contract, or the Contractor has failed to provide in any manner the work or
services agreed to herein, and if BFHD deems said breach to warrant corrective action, the following
sequential procedure will apply:
a. BFHD will notify the Contractor in writing of the nature of the breach;
The Contractor shall respond in writing within three (3) working days of its receipt of such
notification, which response shall indicate the steps being taken to correct the specified
deficiencies. The corrective action plan shall specify the proposed completion date for bringing
the Contract into compliance, which date shall not be more than ten (10) days from the date of
the Contractor's response, unless BFHD specifies in writing and extension of time.
b. BFHD will notify the Contractor in writing of their determination as to the sufficiency of the
Contractor's corrective action plan.
c. If the Contractor does not respond within the appropriate time with a corrective action plan, the
Contractor's corrective action plan will be determined by BFHD to be insufficient, and the Health
District may commence termination or suspension of this Contract as provided for herein.
d. In addition, BFHD may withhold any payment owed the Contractor or prohibit the Contractor from
Incurring additional obligations of funds until BFHD is satisfied that corrective action has been
taken or completed.
DISPUTE RESOLUTION
The parties shall use their best efforts to cooperatively resolve disputes and problems that arise in connection
with this Contract. Both parties will make a good faith effort to continue without delay to carry out their
respective responsibilities under this Contract while attempting to resolve the dispute.
HOLD HARMLESS AND INDEMNIFICATION
a. In providing services under this Contract, the Contractor is an Independent Contractor, and neither it nor
its officers, agents, or employees are employees of BFHD for any purpose. The Contractor shall be
responsible for all federal and/or state tax, industrial insurance, and Social Security liability that may result
from the performance of and compensation for these services and shall make no claim of career service
or civil service rights which may accrue to a BFHD employee under state or local law.
BFHD assumes no responsibility for the payment of any compensation, wages, benefits, or taxes, by, or
on behalf of the Contractor, its employees, and/or others by reason of this Contract. The Contractor shall
City of Pasco — Fire Department 2022 P a g e 15
protect, indemnify, defend and save harmless BFHD, Its officers, agents, and employees from and
against any and all claims, costs, and/or losses whatsoever occurring or resulting from (1) the
Contractor's failure to pay any such compensation, wages, benefits, or taxes, and/or (2) the supplying to
the Contractor of work, services, materials, or supplies by Contractor employees or suppliers in
connection with or support of the performance of this Contract.
b. The Contractor further agrees that it is financially responsible for and will repay BFHD all indicated
amounts following an audit exception which occurs due to the negligence, intentional act, and/or failure,
for any reason, to comply with the terms of this Contract by the Contractor, its officers, employees, agents,
and/or representatives. This duty to repay BFHD shall not be diminished or extinguished by the prior
termination of the Contract pursuant to the Terms and Termination section.
c. The Contractor shall protect, defend, indemnify and save harmless BFHD, its officers, employees, and
agents from any and all costs, claims, judgments, and/or awards of damages, arising out of, or in any
way resulting from, the negligent acts or omissions of the Contractor, its officers, employees,
subcontractors and/or agents, in its performance and/or non-performance of Its obligations under this
Contract. The Contractor agrees that its obligations under this subparagraph extend to any claim,
demand, and/or cause of action brought by, or on behalf of, and of its employees or agents. For this
purpose, the Contractor, by mutual negotiation, hereby waives, as respects BFHD only, any immunity
that would otherwise be available against such claims under the Industrial Insurance provisions of Title
51 RCW. In the event BFHD incurs any judgement, award, and/or cost arising therefrom including
attorneys' fees to enforce the provisions of this article, all such fees, expenses, and costs shall be
recoverable from the Contractor.
d. BFHD shall protect, defend, indemnify, and save harmless the Contractor, its officers, employees, and
agents from any and all costs, claims, judgements, and/or awards of damages, arising out of, or in any
way resulting from, the negligent acts or omissions of BFHD, its officers, employees, and/or agents, in its
performance and/or non-performance of its obligations under this Contract. BFHD agrees that its
obligations under this subparagraph extend to any claim, demand, and/or cause of action brought by, or
on behalf of, any of its employees or agents. For this purpose, BFHD, by mutual negotiation, hereby
waives, as respects the Contractor only, any Immunity that would otherwise be available against such
claims under the Industrial Insurance provisions of Title 51 RCW. In the event the Contractor incurs any
judgement, award, and/or cost arising therefrom including attorneys' fees to enforce the provisions of this
article, all such fees, expenses, and costs shall be recoverable from BFHD.
e. Nothing contained within this provision shall affect and/or alter the application of any other provision
contained within this Contract.
f. The Indemnification, protection, defense and save harmless obligations contained herein shall survive
the expiration, abandonment or termination of this Contract.
INSURANCE REQUIREMENTS
Contractor shall procure and maintain for the duration of this Contract the following insurance coverage:
General Liability Coverage
General Liability Insurance, or Business Liability Insurance, Including coverage for bodily injury, property
damage, and Contractual liability, with the following minimum limits: Each Occurrence- $1,000,000; General
Aggregate - $2,000,000. The policy shall include liability arising out of premises, operations, independent
Contractors, products -completed operations, personal injury, advertising injury, and liability assumed under an
insured Contract.
Business Auto Liability Insurance (BAL)
Qty of Pasco — Fire Department 2022 P a g e 16
The Contractor shall maintain a Business Automobile Policy on all vehicles used in the performance of work under
this Contract, including vehicles hired by the Contractor orowned bythe Contractor's employees, volunteers or
others,withthe following minimum limits: $1,000,000 per accident combined single limit.
Professional Liability Insurance (PL)
The Contractor shall maintain Professional Liability Insurance or Errors & Omissions insurance, including
coverage for losses caused by errors and omissions, with thefollowing minimum limits: Each Occurrence -
$1,000,000; Aggregate- $2,000,000.
Worker's Compensation
The Contractor shall comply with all applicable Worker's Compensation, occupational disease, and
occupational health and safety laws and Regulations under Title 51 RCW by the Contractor or its employees
under such laws and Regulations.
Employees and Volunteers
Insurance required of the Contractor underthe Contract shall include coverage for the acts and omissions of the
Contractor's employees and volunteers. Inaddition, the Contractor shall ensure that all employees and volunteers
who use vehicles to transport clients or deliver services have personal automobile insurance and current driver's
licenses.
Separation of Insureds
All insurance policies shall include coverageforcross liability and contain a "Separation of Insureds"provision.
Insurers
The Contractor shall obtain insurance from insurance companies identified assn admitted insurer/carrier in the
State ofWashington, with a Best's Reports'rating of B++, Class VII, orbetter. Surplus Lines insurance companies
will have a rating of A-, Class VII, or better.
The Contractor's membership in the Washington Cities Insurance Authority, a self-insured, governmental risk
pool shall satisfy all conditions set forth in the Insurance section of this Agreement.
Evidence of Coverage
The Contractor shall submit to District documentation evidencing the insurance requirements of the
Contractor before commencement of the work.
LIMITATION OF UABILITY
BFHD and its local partners, including City of Pasco — Fire Department, are working together to develop and
implement a community testing site as a counter measure against the Covid-19 pandemic and is therefore
covered under the PREP Act attached hereto as Exhibit D which provides immunity to covered person for
certain activities as defined in the PREP Act and delineated in the PREP ACT declaration issued by the
Secretary of Health and Human Services.
ASSIGNMENT/SUBCONTRACT
Contractor may not assign or transfer all or any portion of this Contract or any of its rights hereunder, or
delegate any of its duties hereunder without the prior written consent of the District. Any permitted assignment
will not operate to relieve Contractor of any of its duties and obligations hereunder, or will such assignment
affect any remedies available to the District that may arise from any breach of the provisions of this Contract.
Contractor agrees to include the following language verbatim in every subcontract for services which relate to
the scope of work in this Contract:
City of Pasco —Fire Department 2022 P a g e 17
"Subcontractor shall protect, defend, Indemnify, and hold harmless Benton -Franklin Health District
(BFHD), its officers, employees and agents from any and all costs, claims, judgements, and/or awards of
damages arising out of, or In any way resulting from the negligent act or omissions of subcontractor, Its
officers, employees, and/or agents In connection with or in support of this Contract.
Subcontractor expressly agrees and understands that BFHD is a third party beneirciary to this Contract and
shall have the right to bring an action against subcontractor to enforce the provisions of this paragraph'.
NONDISCRIMINATION
Contractor shall not discriminate against anyone in providing services under this Agreement on the grounds of
race, color, sexual orientation, gender identity, religion, national origin, creed, marital status, age, Vietnam era
or disabled veterans' status, or the present of any sensory, mental or physical disability.
GENERAL PROVISIONS
The Parties acknowledge and understand that they must be able to fulfill their responsibilities under this
Contract in accordance with the provisions of the law and regulations that govern their activities. Nothing In the
agreement is intended to negate or otherwise render ineffective any such provisions or operating procedures.
The Parties assume full responsibility for their performance under the terms of this Contract.
If at any time either party is unable to perform their duties or responsibilities under this Contract consistent with
such party's statutory and regulatory mandates, the affected party shall immediately provide written notice to
the other party to establish a date for resolution of the matter.
CHANGES OR MODIFICATIONS
The District may, at any time, by written notification to Contractor, make changes within the general scope of
the services to be performed under this Agreement. Both parties shall execute a Contract amendment
reflecting such change and an equitable adjustment of cost, period of performance or both will be made if
required by the changes.
CONTRACT SUSPENSION
• For Investigation: In the event Contractor or any of its partners, employees, officers is investigated by
a local, county, state or federal agency for a matter which the District feels may adversely affect the
delivery of services under this Contract, the District may, without notice suspend the delivery of
services or disallow the person(s) involved in the allegation from providing services pending final
resolution of the investigation.
• For Suspension of Funding and work: Because the District receives both state and federal funds
occasionally the District's funding source may enact a Contract suspension due to sequestration, loss
of budget appropriation, or other causes. When this occurs, the District may exercise Its right to
suspend this Contract until the District's funding has resumed and approval to continue work has been
received. At that time, the District will notify the Contractor that they may resume work. All notice to
suspend or reinstate work will be in writing. Any expenses incurred during the suspension of this
Contract may not be reimbursed later unless it is specifically approved at the time the Contract is
reinstated.
TERMINATION OF AGREEMENT
• For Convenience: This Contract may be terminated by either party for convenience with 14 days
written notice. If this Contract is so terminated, the parties are only liable for performance rendered or
costs incurred in accordance with this Contract prior to the effective date of termination.
qty of Pasco — Flre Department 2022 P a g e 18
By Mutual Agreement: This Contract may be terminated at any time by mutual agreement of both
parties.
Termination for Default: In the event the District determines the Contractor has failed to comply with
the terms and conditions of this Contract, the District hasthe rightto suspend orterminatethis Contract.
District shall notify the Contractor in writing of the need totake corrective action. If corrective action isnot
taken Within ten (1Q) Business Days, this Contract may beterminated. District reserves the rightto suspend
all or part of this Contract, withhold further payments, or prohibit the Contractorfrom incurring additional
obligations offunds during investigation ofthe alleged compliance breach and pending corrective action by
the Contractororadecision by the Districtto terminate this Contract.
For Non -Allocation of Funds: The District's ability to make payments is contingent on the availability
of its various funding sources. In the event funding from state, federal, or other funding sources is
withdrawn, reduced, limited or suspended during the course of this Contract, the District at its sole
discretion may elect to terminate this agreement in whole or in part or to renegotiate this Contract
subject to new funding limitations or conditions.
GOVERNING LAW
This Contract shall be governed by and construed in accordance with the laws of the State of Washington.
SEVERABILITY
If any term or condition of this Contract is held invalid by any court, the reminder of this Contract remains valid
and in full force and effect.
ENTIRE AGREEMENT
This Contract contains all the terms and conditions agreed upon by the parties. No other understandings, oral
or otherwise, regarding the subject matter of this Contract shall be deemed to exist or to bind either of the
parties.
AMENDMENTS
Either party may request changes to this Contract. Proposed changes which are mutually agreed upon shall
be incorporated by written amendments to this Contract.
NOTICE
Any notice or communication required or permitted under this Contract shall be sufficiently given if delivered in
person, by email, or certified mail, return receipt requested to Contracts Manager with a copy to the District
Administrator at the addresses set forth on page one (1) of this Contract.
AUTHORIZATION AND EXECUTION
By signature of this agreement, both parties agree to adhere to the terms and conditions set forth herein.
BENTON-FRANKLIN HEALTH DISTRICT
Jason accaria—Administrator Date
CITY OF PASCO
Dave Zabell ity Manager ate
City of Pasco— Fire Department 2022 P a 6 e 19
Remit To
Benton -Franklin Health District
Attn: Accounts Payable
7102 W Okanogan Place
Kennewick WA 99336
Phone #
Email
Invoice for services rendered under this contract for the period of:
Salaries/Wages
REG
OT
REGULAR PAY
EMPLOYEE
POSITION
HRS/WK/MO
HRS/WK/MO
RATE
OT PAY RATE
TOTAL
Incident Command
0.00
0.00
$0.00
$0.00
$0.00
Operation/Safety Chief
0.00
0.00
$0.00
$0.00
$0.00
Finance Section Chief
0.00
0.00
$0.00
$0.00
$0.00
Planning Section Chief
0.00
0.00
$0.00
$0.00
$0.00
Logistics Chief
0.00
0.00
$0.00
$0.00
$0.00
On Site Supervisor
0.00
0.00
$0.00
$0.00
$0.00
Clinician
0.00
0.00
$0.00
$0.00
$0.00
Clinician
0.00
0.00
$0.00
$0.00
$0.00
Clinician
0.00
0.00
$0.00
$0.00
$0,00
Clinician
0.00
0.00
$0.00
$0.00
$0.00
Clinician
0.00
0.00
$0.00
$0.00
$0.00
Clinician
0.00
0.00
$0.00
$0.00
$0.00
RT- Lead
0.00
0.00
$0.00
$0.00
$0.00
RT
0.00
0.00
$0.00
$0.00
$0.00
RT
0.00
0.00
$0.00
$0.00
$0.00
RT
0.00
0.00
$0.00
50.00
$0.00
RT
0.00
0.00
$0.00
$0.00
$0.00
RT
0.00
0.00
$0.00
$0.00
$0.00
RT
0.00
0.00
$0.00
$0.00
$0.00
Parking Enforcement
0.00
0.00
$0.00
$0.00
$0.00
Traffic Civilian
0.00
0.00
$0.00
$0.00
$0.00
Total Salaries/Wages
$0.00
Total Benefits -Fringe
$0.00
Supplies & Equipment
Description
Amount
Office Supplies
Medical Supplies
Minor Equipment
Other:
Total Supplies & Equipment
$0.00
TOTAL EXPENDITURES
$0.00
Vendor's Certificate: I hereby
eertity under penalty of penury that the items and totals listed herein are proper charges
for materials. merchandise
or
services furnished and that all goods famished andfor services rendered have been provided wWxmt discrimination because of age, sex, marital status,
race, creed, color, national origin, handicap, religion, or Vietnam era or disabled
veterans status.
Print Name & Tide
Signature
Date
City of Pasco - Fire Department 2022 Page 110