Contract Between Vermont and Prison Health Services Amendment2 2007
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STATE OF VERMONT CONTRACT SUi\'lMARY AND CERTIFICATION - Form I. CONTRACT INFORMATION: (3/301107) Amendment #: 2. Contractor Vendor No: 182150 Contract #: 10962 Agency/Department: Agency of Human Services/Dept of Corrections Contractor: Prison Health Services, Inc Contractor Address: 105 Westpark Drive, Suite 200, Brentwood, TN 37027 FederalLD or SS#: 23-2108853 1/31/2009 Starting Date: 1/2912007 Ending Date: Summary of contract or amendment: Change of pharmacy provider II AA~14 FINANCIAL INFORMATION $24364 376 I Prior Maximum:1 $ 24,364,376 I Prior Contract # (If Renewal): Maximum Pavable: I Cumulative amendments: I $ 0 I % Cumulative Change: Current Amendment: $0 I Prior # Units: # I # Unit ChanQe: Maximum # Units: $ Prior Rate: $ Rate: . Source of Funds ~ Busmess UIlII(S): 03520 General Fund: 100 % Federal Fund: % Other Fund: Fund Code: % Dept. ID: Dept. ID: Dept. 10: 3480004010 III. [gJ Ves D No 0% SUITABILITY OF PERSONAL SERVICES CONTRACT Does this contractor meet all 3 parts of the "ABC" definition of independent contractor? (See Bulletin 3,5) Ifnot, please indicate why this work is being arranged through a contract. D D Ves Ves [gJ [gJ No No Is agency liable for income tax withholding or FICA? Should contractor be paid on the state payroll? • IV. PUBLIC COMPETITION The agency has taken reasonable steps to control the price of the contract and to allow qualified businesses to compete for the work authorized by this contract. The agency has done this through: [8J Standard bid or RFP 0 Simplified Bid 0 Sole Sourced 0 Qualification Based Selection Other o V. [8J Personal Service 0 Construction 0 TYPE OF CONTRACT ArchitectlEngineer VI. 0 Commodity o Privatization* o Other CONFLICT OF INTEREST By signing below, I certify that no person able to control or influence award of this contract had a pecuniary interest in its award or performance, either personally or through a member of his or her household, family, or business. DYes [gJ Ves [8J No o No D Ves [8J No D Ves [8J No D Ves [8J No [gJ Ves o No Is there an "appearance" ofa conflict of interest so that a reasonable person may conclude that this contractor was selected for improper reasons: (If yes, explain) VII. PRIOR APPROVALS REQUIRED OR REQUESTED Contract must be approved by the Attorney General under 3 VSA §311 (a)(1 0) I request the Attorney General review this contract as to form No, Already performed by in-house AAG or counsel: (initial) Contract must be approved by the CIO/Commissioner of OIl; for IT hardware, software or services and Telecommunications over $150,000 Contract must be approved by the CMO; for Marketing services over $15,000 Contracl must be approved by the Secrelary of Administration VIII. AG Date Date CYIDEPARTMENT HEAD CERTIFIC TlON' APPROVAL xPP <wal by Attorney General CIO (inil) Date CMO (initial) Date *Reviewed by DHR Comm. or DHR AAG Date Secrelary of Administration . 1. CHANGE # 2 AMENDMENT It is agreed by and between the Stale of Vermont, Department of Corrections (hereafter called "State") and Prison Health Services, Inc of Brentwood, TN, Vennont (hereafter called "Contractor") that contract #10962 dated 112912007 between said Stale and Contractor is hereby amended as follows: Attachment A, Chapter II -Health Care Services, Section W - Pharmaceuticals: Delete "its direct subsidiary"; replace each usc of Secure Pharmacy Plus with Maxar National Pharmacy Services Corporation; and replace each use of SPP with Maxar. Except as modified by this above amendment, and any and all previous amendments 10 Ihis contract, all provisions of this con1ract #10962 dated 1/29/2007 shall remain unchanged and in full force and effect. The effective date of this amendment is 05/01/2007. APPROVED AS TO FORM AII~~omce Date: S/;;,,f 0) r J CONTRACTOR: Prison Health Service, Inc (Please PRINT Signature) Address: 105 Weslpark Drive, Suite 200 Brentwood, TN 37027 ::~:ed;~; ..!...... ).l., Lc. 11 (~"'\'\"'i\) ;1.007 (bvnn,.. ) (S"'.,e1 ) SI...X1.\o\. \PJC."'' '1 AI\:; Pris,oh Hc.C\/th Sc."v/'~~ Ton; Ho..tric..h F' ... n.hC., ·2 . Ipbooe) State ofVemlOnt Department of Corrections 103 South Main Street Waterbury, \'T 05671-1001 www.doc.state.\"t.us (fax) Agency ofHuman Services 802-24'-2263 802-241-2565 DEPARTMENT OF CORRECTIONS OFFICE MEMORANDUM To: Cynthia LaWare, Secretary Agency of Human Services From: Robert Hofmann, Commissioner Date: May 14, 2007 Subject: Prison Health Services, Inc - effective date of Amendment 2 I am requesting approval of a retroactive amendment for Prison Health Services, Inc. For reasons outlined below, there was not enough time to process an amendment that would not be retroactive. On April 25, 2007 we received a letter from PHS dated April 23,2007 infonning us that PHS had entered into an agreement with Maxor National Phamlacy (Maxor) which involved the sale of certain assets of their wholly-owned subsidiary, Secure Pharmacy Plus (SPP) to Maxor. In addition, PHS and Maxor signed a long-term service agreement for Maxor to serve as the PHS phannaceutical provider. The effective date of the agreement was May 1,2007. We asked the DOC legal division for an opinion as to whether this would need a fonnal amendment or just a memorandum of understanding and on April 30, 2007 received word thai an amendment should be done. This amendment does not increase the contract maximum or change the delivery of service.~~7';;1~1e;uestingyour approval of 'his request. Approved: ~.vERMONT