24-15 emsCharts Agreement.pdf

b. Termination for Cause. Upon Covered Entity’s knowledge of a material breach by Business Associate of this Addendum, Covered Entity shall either: i, In its sole discretion, provide an opportunity for Business Associate to cure the breach or end the violation. If Business Associate does not cure the breach or end the violation within the time specified by Covered Entity, Covered Entity shall terminate: (A) this Addendum; (B) all of the provisions of the Services Agreement that involve the use or disclosure of Protected Health Information; and (C) such other provisions, if any, of the Services Agreement as Covered Entity designates in its sole discretion; c Effect of Termination. i Upon termination of this Addendum, for any reason, Business Associate shall retum or destroy all Protected Health Information received from Covered Entity, or created or received by Business Associate on behalf of Covered Entity. This provision shall apply to Protected Health Information that is in the possession of subcontractors or agents of Business Associate. Business Associate shall retain no copies of the Protected Health Information. ii, In the event that Business Associate determines that returning or destroying the Protected Health Information is infeasible, Business Associate shall provide to Covered Entity notification of the conditions that make retum or destruction infeasible. Upon mutual agreement of the parties that return or destruction of Protected Health Information is infeasible, Business Associate shall extend the protections of this Addendum to such Protected Health Information and limit further uses and disclosures of such Protected Health Information to those purposes that make the return or destruction infeasible, for so long as Business Associate maintains such Protected Health Information, If Covered Entity makes a reasonable determination that returning or destroying the Protected Health Information is feasible, Business Associate shall retum or destroy the Protected Health Information in the time and manner designated by Covered Entity. 6. Electronic Transaction Standards. To the extent that Business Associate or its products perform all or part of any transaction for which the Secretary has adopted a standard under HIPAA ("Covered Transactions") on the Covered Entity's behalf, the following shall apply: a Compliance with HIPAA Standards. When

any transaction for which the Secretary has adopted a standard under HIPAA ("Covered Transactions") on the Covered Entity's behalf, the following shall apply: a Compliance with HIPAA Standards. When providing its services and/or products, Business Associate shall comply with all applicable HIPAA standards and requirements (including, without limitation, those specified in 45 CFR Part 162) with respect to the transmission of health information in electronic form in connection with any Covered Transactions. Business Associate will make its services and/or products compliant with HIPAA's standards and requirements no less than thirty (30) days prior to the applicable compliance dates under HIPAA. Business Associate represents and warrants that it is aware of all current HIPAA standards and requirements regarding Covered Transactions, and Business Associate shall comply with any modifications to HIPAA standards and requirements which become effective from time to time. Business Associate agrees that such compliance shall be at its sole cost and expense, which expense shall not be passed on to Covered Entity in any form, including, but not limited to, increased fees. b. Agents and Subcontractors. Business Associate shall require all of its agents and subcontractors (if any) who assist Business Associate in providing its services and/or products to comply with all applicable requirements of HIPAA, including without limitation, compliance with 45 CFR Part 162. emsCharts Service Agreement, v12.3 Page 18 of 19

7. Miscellaneous a. Regulatory References. A reference in this Addendum to a section in HIPAA or HIPAA Regulations, or the HITECH Act, means the section as in effect or as amended or modified from time to time, including any corresponding provisions of subsequent superseding laws or regulations. b Amendment. The parties agree to take such action as is necessary to amend the Services Agreement from time to time as is necessary for Covered Entity to comply with the requirements of HIPAA, HIPAA Regulations and the HITECH Act. © Survival. The respective rights and obligations of Business Associate under Section 5,c. of this Addendum shall survive the termination of the Services Agreement. da Interpretation. Any ambiguity in this Addendum shall be resolved to permit Covered Entity to comply with HIPAA and HIPAA Regulations. e, Miscellaneous. The terms of this Addendum are hereby incorporated into the Services Agreement. Except as otherwise set forth in Section 7.d. of this Addendum, in the event of a conflict between the terms of this Addendum and the terms of the Services Agreement, the terms of this Addendum shall prevail. The terms of the Agreement which are not modified by this Addendum shall remain in full force and effect in accordance with the terms thereof. Each party to this Addendum hereby agrees and consents that any legal action or proceeding with respect to this Addendum shall only be brought in the courts of the state where the Covered Entity is located in the county where the Covered Entity is located. The Services Agreement together with this Addendum constitutes the entire agreement between the parties with respect to the subject matter contained herein. This Addendum may be executed in counterparts, each of which when taken together shall constitute one original. No amendments or modifications to this Addendum shall be effected unless executed by both parties in writing. IN WITNESS WHEREOF, the parties have executed this Addendum as of the date set forth above. TOWNSHIP OF WEST ORANGE emsCharts, Inc. By: By: (Name) (Name) (Title) (Title) Dated: Dated: emsCharts Service Agreement, v12.3 Page 19 of 19

emsCharts, Inc. 125 Warrendale Bayne Road STE100 Warrendale, PA 15086 Phone: 866-647-8282 Fax: 724-933-9333 www.emscharis.com Charts Accounts Payable Form Please fill out the form below, providing current information for invoicing and Accounts Payable for your agency, and return with your signed emsCharts Service Agreement. = Accounts Payable Contact Information: Contracted Service Name:* What is the name of the EMS Agency that is contracting with emsCharts, inc? Accounts Payable Dept: if different from Agency name. Fill out mailing information below if different from Agency mailing address. Mailing Address 1: Mailing Address 2: City, State, Zip: Invoicing Contact Information: To whom should invoices be sent? Name:* Phone:* Email:* Invoices are sent electronically to the email address provided above. Invoicing Terms: Frequency (please check one):* 0) Monthly 0 Annually Annual payments receive a 5% discount Does your agency require a Purchase Order number on invoices? O Yes O No If yes, is the Purchase Order for emsCharts attached? 0 Yes 0 No Please provide any additional information important for proper invoicing to your agency: 4836-1231-3121, v. 1 * Required information emsCharts, Inc.