318-22 Exhibit A-Coronis Health for Emergency Transport Third Party Billing - 2022.pdf

Exhibit “A”

TOWNSHIP OF WEST ORANGE ESSEX COUNTY, NEW JERSEY REQUEST FOR PROPOSAL THIRD PARTY BILLING FOR AMBULANCE SERVICES PROVIDED BY THE WEST ORANGE FIRE DEPARTMENT SUBMISSION DATE: November 17, 2022 At 11:00A.M TOWNSHIP OF WEST ORANGE 66 MAIN STREET RM 111 WEST ORANGE, NEW JERSEY 07052

TOWNSHIP OF WEST ORANGE WEST ORANGE FIRE DEPARTMENT THIRD PARTY BILLING FOR AMBULANCE SERVICES TABLE OF CONTENTS ________________________________________________________________________________  ADVERTISEMENT  GENERAL SUBMISSION CONDITIONS  SPECIFICATIONS  PAST QUESTIONS  PROPOSAL FORM  PROPOSAL DOCUMENT CHECKLIST  STATEMENT OF OWNERSHIP/STOCKHOLDER DISCLOSURE FORM  NON-COLLUSION AFFIDAVIT  MANDATORY AFFIRMATIVE ACTION LANGUAGE  BUSINESS REGISTRATION INFORMATION  AMERICANS WITH DISABILITIES ACT OF 1990  IRANIAN DISCLOSURE STATEMENT  TOWNSHIP POLITICAL DISCLOSURE STATEMENT  ACKNOWLEDGEMENT OF ADDENA  VENDOR INFORMATION SHEET 2

TOWNSHIP OF WEST ORANGE Invitation to Bid The Township of West Orange is seeking competitive contract bids pursuant to N.J.S.A. 40A:11-4.3, seq. from companies for the following goods and/or services: THIRD PARTY BILLING OF EMERENCY TRANSPORT SERVICES FOR THE TOWNSHIP OF WEST ORANGE Bid forms may be obtained in person at the Township of West Orange, 66 Main Street, Purchasing Room 111, County of Essex, West Orange, NJ 07052, Monday to Friday during regular business hours 8:30 a.m. to 4:30 p.m. or by emailing preynolds@westorange.org. Sealed proposals clearly marked with the title of project and name and address of party making submission, addressed to the West Orange Township Purchasing Department will be received by mail, or hand delivery, at the Municipal Building, 66 Main Street, West Orange, NJ 07052 on or before November 17, 2022 at 11:00 A.M. and will be publicly opened and read at that time in the Council Chambers on the same day. No bids received after that time will be considered. Bidders are required to comply with the Affirmative Action requirements of N.J.S.A. 10:5-31 et seq. and N.J.A.C. 17:27 and have a New Jersey Business Registration Certificate P.L. 2004, c.57 and comply with Local Unit Pay to Play Law P.L. 2004, c.19. Bid deposit will be required in the amount of $5,000.00 to be a part of the bid submission in the form of a certified or /Cashier’s check or bid bond. The Township Council reserves the right to reject any or all proposals submitted and also to increase or diminish any or all of the quantities which in their judgment be necessary. Panayiota Reynolds Purchasing Agent 3

TOWNSHIP OF WEST ORANGE I. SUBMISSION OF PROPOSALS 1. Sealed bid shall be received by the contracting unit, Township of West Orange, Essex County, New Jersey (hereinafter referred to as "TOWNSHIP") in accordance with public advertisement as required by law, with a copy of said notice being attached hereto and made a part of these specifications. 2. Sealed bid will be received by the designated representative at the time and place stated in the Notice to Bidders, and at such time and place will be publicly opened and read aloud. 3. Submit the bid in a sealed envelope addressed to the:  Township of West Orange, 66 Main St., West Orange, NJ 07052 Attn: Panayiota Reynolds, Purchasing Agent, Room 111  Bearing the name and address of the vendor written on the face of the envelope.  Clearly marked "PROPOSAL" with the contract title/’’’. 4. It is the vendor’s responsibility to see that proposals are presented to the TOWNSHIP on the time and at the place designated. Bids may be hand delivered or mailed; however, the TOWNSHIP disclaims any responsibility for a bid forwarded by regular or overnight mail. If the bid is sent by express mail service, the above address must also appear on the outside of the express mail envelope. Bids received after the designated time will be returned unopened. 5. Sealed bids forwarded to the TOWNSHIP before the time of opening may be withdrawn with a written request and evidence showing that the individual is or represents the principal or principals involved in the proposal. Once proposals are opened, they shall remain firm for a period of sixty (60) calendar days. 6. All prices and amounts must be written in ink or preferably machine-printed. a. Bids containing any conditions, omissions, unexplained erasures or alterations, items not called for in the proposal form, attachment of additive information not required by the specifications, or irregularities of any kind, may be rejected by the TOWNSHIP. Any changes, whiteouts, strikeouts, etc. in the proposal must be initialed in ink by the

ications, or irregularities of any kind, may be rejected by the TOWNSHIP. Any changes, whiteouts, strikeouts, etc. in the proposal must be initialed in ink by the person signing the proposal. 7. Each bid form must give the full business address, business phone, fax, e-mail if available, and the contact person of the bid. An authorized representative must sign your submission as follows: a. Bids by partnerships must furnish the full name of all partners and must be signed in the partnership name by one of the members of the partnership or by an authorized representative, followed by the signature and designation of the person signing. 4

TOWNSHIP OF WEST ORANGE b. Bids by corporations must be signed in the legal name of the corporation, followed by the name of the State in which incorporated and must contain the signature and designation of the president, secretary or other person authorized to bind the corporation in the matter. c. The proprietor shall sign proposals by sole-proprietorship. II. PROPOSAL SECURITY AND BONDING REQUIREMENTS The following provisions if indicated by an (X), shall be applicable to this proposal and be made a part of the proposal documents: (X) PROPOSAL GUARANTEE Vendor shall submit with the proposal a certified check, cashier's check or proposal bond in the amount of $5,000.00 payable unconditionally to the TOWNSHIP. When submitting a Proposal Bond, it shall contain Power of Attorney for full amount of Proposal Bond from a surety company authorized to do business in the State of New Jersey and acceptable to the TOWNSHIP. The check or bond of the unsuccessful vendor(s) shall be returned pursuant to N.J.S.A. 40A:11-24a. The check or bond of the vendor to whom the contract is awarded shall be retained until a contract is executed and the required performance bond or other security is submitted. The check or bond of the successful vendor shall be forfeited if the vendor fails to enter into a contract pursuant to N.J.S.A. 40A:11-21. Failure to submit this shall be cause for rejection of the proposal. III. INTERPRETATION AND ADDENDA 1. The vendor understands and agrees that its proposal is submitted based on the specifications prepared by the TOWNSHIP. The vendor accepts the obligation to become familiar with these specifications. 2. Vendors shall examine the specifications and related proposal documents with care and observe all their requirements. Ambiguities, errors, or omissions noted by vendors should be reported promptly in writing to the appropriate official. Any prospective vendor who wishes to challenge a proposal specification shall file such challenges in writing with the contracting agent no less than three business days prior to the opening of the proposals. Challenges filed after that time will not be considered and having no impact on the contracting unit or the

ontracting agent no less than three business days prior to the opening of the proposals. Challenges filed after that time will not be considered and having no impact on the contracting unit or the award of the contract pursuant to N.J.S.A. 40A:11-13. In the event the vendor fails to notify the TOWNSHIP of such ambiguities, errors, or omissions, the vendor will be bound by the requirements of the specifications and the vendor's submitted proposal. 5

TOWNSHIP OF WEST ORANGE 3. No oral interpretation and or clarification of the meaning of the specifications for any goods and services will be made. Such request shall be in writing, addressed to the TOWNSHIP'S representative stipulated in the specification. In order to be given consideration, a written request must be received at least seven (7) business days prior to the date fixed for the opening of the proposal for goods and services. a. All interpretations, clarifications and any supplemental instructions will be in the form of written addenda to the specifications, and will be distributed to all prospective vendors, in accordance with N.J.S.A. 40A:11-23. All addenda so issued shall become part of the specification and proposal documents, and shall be acknowledged by the vendor in the proposal. The TOWNSHIP'S interpretations or corrections thereof shall be final. b. When issuing addenda, the TOWNSHIP shall provide required notice prior to the official receipt of proposals to any person who has submitted a proposal or who has received a proposal package pursuant to N.J.S.A. 40A:11-23c.1. 4. Discrepancies in Proposals. If the amount shown in words and its equivalent in figures do not agree, the written words shall be binding. Ditto marks are not considered writing or printing and shall not be used. In the event that there is a discrepancy between the unit prices and the extended totals, the unit prices shall prevail. In the event that there is an error of the summation of the extended totals, the computation by the TOWNSHIP of the extended totals shall govern. IV. INSURANCE AND INDEMNIFICATION 1. Worker's Compensation and Employer's Liability Insurance. This insurance shall be maintained in full force during the life of this contract by the vendor covering all employees engaged in performance of this contract pursuant to N.J.S.A. 34:1512(a) and N.J.A.C. 12:235-1.6. Minimum Employer's Liability is $1,000,000.00 for each accident for bodily injury and $3,000,000.00 each accident for property damage, shall be maintained in force

35-1.6. Minimum Employer's Liability is $1,000,000.00 for each accident for bodily injury and $3,000,000.00 each accident for property damage, shall be maintained in force during the life of this contract by the vendor. 2. Certificates of the Required Insurance: a. Certificates as listed above shall be submitted along with the contract as evidence covering Comprehensive General Liability, Comprehensive Automobile Liability, and where applicable, necessary Worker's Compensation and Employer's Liability Insurance. b. Such coverage shall be acceptable insurance companies operating on an admitted basis in the State of New Jersey and shall name the TOWNSHIP as an additional insured. c. Self-insured contractors shall submit an affidavit attesting to their self- 6