HomeMy WebLinkAboutMINUTES - 12191995 - C58 TO: BOARD OF SUPERVISORS
FROM: Contra
Mark Finucane, Health Services Director
Costa
DATE: December 1, 1995 County
SUBJECT: Approval of Contract Extension Agreement #23-190-1 with
Syndicated Office Systems, Inc.
SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION
I. RECOMMENDED ACTION:
Approve and authorize the Health Services Director to execute on
behalf of the County, Contract Extension Agreement #23-190-1 with
Syndicated Office Systems, Inc. , to extend Standard Contract #23-190
from December 31, 1995 through June 30, 1996. This Contractor
provides consultation and technical assistance to the Department with
regard to Medi-Cal eligibility, collection issues, and administrative
appeals.
II. FINANCIAL IMPACT:
This Contractor is paid on a commission basis only for amounts it
collects on inpatient and outpatient Medi-Cal claims.
III. REASONS FOR RECOMMENDATIONS/BACKGROUND:
On February 28, 1995, the Board of Supervisors approved Standard
Contract #23-190 with Syndicated Office Systems, Inc. , for the period
from January 1, 1995 through December 31, 1995, to provide
consultation and technical assistance to the Department with regard to
Medi-Cal eligibility, collection issues, and administrative appeals.
Approval of Contract Extension Agreement #23-190-1 will allow the
Contractor to continue providing services through June 30, 1996.
CONTINUED ON ATTACHMENT: YES SIGNATURE: I
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
SIGNATURE(S)
ACTION OF BOARD ON _�4 9!�- APPROVED AS RECOMMENDED OTHER
VOTE OF SUPERVISORS
UNANIMOUS (ABSENT ) I HEREBY CERTIFY THAT THIS IS A TRUE
AYES,. NOES: AND CORRECT COPY OF AN ACTION TAKEN
ABSENT: ABSTAIN: AND ENTERED ON THE MINUTES OF THE BOARD
OF SUPERVISORS ON THE DATE SHOWN.
Contact: Patrick Godley (370-5007)
CC: Health Services (Contracts) ATTESTED
Risk Management Phil Batchehn,Clerk Of the Board o
Auditor-Controller r Supervisors and County Administrator
Contractor
M382/7-83 BY — DEPUTY
Contra Costa County Standard Form 1/87
CONTRACT EXTENSION AGREEMENT
(Purchase of Services) Number 23-190-1
Fund/Org #as coded
Account #2861
other #
1. Identification of Contract to be Extended.
Number: 23-190
Effective Date: January 1, 1995
Department: Health Services - Office o 'rector/Finance
Subject: Consultation and technical assist o the Department
with regard to Medi-Cal eligibility, ollection issues,
and administrative appeals
2 . Parties. The County of Contra Costa, California (County) , for its
Department named above, and the following named Contractor mutually
agree and promise as follows:
Contractor: SYNDICATED OFFICE SYSTEMS, INC.
Capacity: California Corporation Taxpayer ID#95-3154917
Address: 3 Imperial Promenade, #1100, Santa Ana, California 92707
Mailing Address: 1633 Bayshore Highway, #329
Burlingame, California 94010
3 . Extension of Term. The term of the above described contract between the
parties hereto is hereby extended from December 31, 1995 to
June 30, 1996, unless sooner terminated as provided in said contract.
4 . Payment Limit. Including the extended term of the contract, the
maximum amount payable by the County under this Contract shall not
exceed $Not Applicable.
5. Signatunas. These signatures attest the parties ' agreement hereto:
COUNTY OF CONTRA COSTA, CALIFORNIA
ATTEST: Phil Batchelor Clerk of
BOARD OF SUPERVISORS the Board of Supervisors and County
Administrator
By
Chairman/Designee Deputy
CONTRACTOR
By By
(Designate business capacity A) (Designate business capacity B)
Note to Contractor: For corporation (profit or nonprofit),the contract must be signed by two officers. Signature A must be that of the president or vice-president and
Signature B must be that of the secretary or assistant secretary (Civil Code Section 1190 and Corporations Section 313). All signatures must be acknowledged as set forth
on page two.
Contra Costa County Standard Form(Rev. 1/95)
APPROVALS/ACKNOWLEDGMENT
Number 23-190-1
APPROVALS
RECOMMENDED BY DEPARTMENT FORM APPROVED
COUNTY COUNSEL
By By
Designee Deputy
APPROVED: COUNTY ADMINISTRATOR
By:
Designee
ACKNOWLEDGMENT
STATE OF CALIFORNIA )
ss.
COUNTY OF CONTRA COSTA )
On , before me,
(insert name and title of the officer), personally appeared
personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose
name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same
in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or
the entity upon behalf of which the person(s) acted, executed the instrument.
WITNESS MY HAND AND OFFICIAL SEAL.
(Seal)
Signature
ACKNOWLEDGMENT(by Corpmticm Pamwmhip.m hdividual)
(Civil Code¢1189)