CONTRACT 3912B Amendment CLOSEDTHIS 2ND AMENDMENT ( "Amendment ") is made and entered into this First day of October,
2010, by and between the CITY OF EL SEGUNDO, a general law city and municipal corporation
existing under the laws of California ( "CITY "), and WESTCHESTER MEDICAL
GROUP /CENTER FOR HEART AND HEALTH, a General Partnership ( "CONSULTANT ").
1. Pursuant to Agreement No. 3912 ( "Agreement "), executed by the parties on or about
February 25, 2009 and subsequently amended, the term of the agreement is extended
until September 30, 2011.
2. This Amendment may be executed in any number of counterparts, each of which will be
an original, but all of which together constitute one instrument executed on the same
date.
3. Except as modified by this Amendment, all other terms and conditions of Agreement
No. 3912 remain the same.
4. Exhibit A is incorporated by reference.
IN WITNESS WHEREOF the parties hereto have executed this contract the day and year
first hereinabove written.
ATTEST:
Cindy Morten
City Clerk
APPROVED
MARK D. H
By:
Berger, "sustant City
Robert A. Reiss, M.D., F.A.C.P.
Co- Medical Director, Partner
Taxpayer ID No.
B:Mig1-r A
CONTRACTOR RATES
3912,
EVALUATION COMPONENT
Executive, Police, Fire
Physician examination
$200.00
Vision
$15.00
Audiometry
$10.00
Chest x -ra (1 view)
$35.00
Blood panel includes:
$53.00
Chemistry panel
$40.00
Complete blood coup
$37.00
Prostate Specific Antigen
As needed/recommended
Urinalysis
$12.00
Pulmonary function (FEV, FVC)
$25.00
Resting EKG
$50.00
Stress EKG (Bruce protocol)
$150.00
Strength & flexibility
$20.00
Body composition
$10.00
Report to El Segundo
"Fit for Du !y" Report Form Only
Report to patient
No charge
Total Cost:
$580.00
Kity discount cost:
$450.00
Additional Com onents:
Resting EKG & Stress test a la carte
$200.00
Chest x-ray (2 views —PA /Lateral)
$65.00
TB Skin Test (PPD). Includes admin. fee
and supplies.
$65.00
He atitis A_(2 doses)
Negotiable
Hepatitis B (3 doses)
Negotiable
Hepatitis C Antibody
$40.00
Hepatitis B Surface Antibody
$37.00
Immunizations
Negotiable
Vaccinations
Negotiable
Pap smear
Patient expense
Colonoscopy
Referral only
,Mammogram
Referral only
ICardiology consultation
Referral only
Agreement active from October 1, 2010 through September 30, 2011.
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