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HomeMy WebLinkAboutR-2001-161 Access Paratransit, Inc. Agreement for Dial-a-Ride M1 RESOLUTION R 2001- 161 A RESOLUTION authorizing and directing the City Manager to execute an agreement with Access Paratransit, Inc., for Dial -A -Ride transportation services. WHEREAS, the City of Yakima currently provides and intends to continue to provide complementary paratransit transportation services in Yakima to persons with disabilities through a contracted program known as Dial -A -Ride, as required by the Americans with Disabilities Act (ADA); and WHEREAS, Access Paratransit, Inc., currently provides Dial -A -Ride transportation services in the City of Yakima and its proposal submitted in response to Request for Proposals Number 10112 will satisfy the City of Yakima's requirements; and WHEREAS, it is in the best interest of the City of Yakima to award the Dial -A- Ride Transportation Service Broker and/or Provider Agreement to Access Paratransit, Inc., according to the terms of its response to Request for Proposals Number 10112; now, therefore: BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF YAKIMA: The City Manager is authorized and directed to execute the attached Dial -A- Ride Transportation Service Broker and/or Provider Agreement with Access Paratransit, Inc. for ADA complementary paratransit transportation service in the City of Yakima. ADOPTED BY THE CITY COUNCIL this 4 day of December, 2001. 2Z6 arY Place, Mayor Al TEST: Karen S. Roberts, City Clerk Macintosh HD:System Folder.Exchange Temporary Items:auth k res.doc I ast printed 11/28/01 11:27 AM RFP 10012 - DIAL -A -RIDE TRANSPORTATION SERVICE BROKER AND /OR PROVIDER AGREEMENT • THIS AGREEMENT is entered into this day of , 2001, by and between the City of Yakima, Washington, hereinafter called "the City," through the Department of Public Works, Transit Division, 2301 Fruitvale Blvd., Yakima, Washington 98901, and Access Paratransit, Inc., hereinafter called the "Contractor." 1. Purpose of Agreement. The purpose of this Agreement is to provide complementary paratransit transportation services, also known as 'Dial -A- Ride" services, within the City of Yakima to persons who, under the Americans with Disabilities Act, are considered disabled. 2. Scope of Services. Contractor shall, on behalf of the City, provide reservation, dispatch, and transportation services, and may broker service to other subcontractors to provide such transportation services to eligible persons, all as more particularly stated under Section III "Scope of Service" of the Request for Proposals upon which this contract is based. Section III "Scope of Service" of the Request for Proposals in incorporated herien by this reference. A copy of Section III "Scope of Service" is attached to this contract. 3. Price. Trip Rates to be as Follows: Ambulatory $10.10 per boarding for one (1) ambulatory passenger not requiring a wheelchair lift - equipped vehicle. Annual Base Trip Projection is 38,700 Wheelchair $13.96 per boarding for one (1) passenger requiring a wheelchair lift- equipped vehicle. Annual Base Trip Projection is 17,000. 4. Term. This Agreement shall become effective on its execution by both the successful proposer and the City Manager as authorized by resolution of the Yakima City Council, and shall terminate on three years after execution. The City may, at its sole option, extend this contract for one year periods, not to exceed (5) five years total. 5. Service Area. The Contractor agrees to provide services under this Agreement to eligible riders, namely those who have been pre - qualified under procedures established and conducted by the City for transportation within the corporate limits of the City of Yakima. 6. Insurance. • 6.1 Coverages. Contractor shall maintain, throughout the term of this Contract, liability insurance insuring Contractor, its officers, employees and agents, with regard to 1 RFP 10012 all claims and damages specified in Section 6 herein, in the minimum amounts as follows: 6.1.1 Commercial Liability Insurance. On or before the date this Contract is fully executed by the parties, Contractor shall provide the City with a certificate of insurance as proof of commercial liability insurance with a minimum liability limit of One Million Dollars ($1,000,000) combined single limit bodily injury and property damage. This coverage will have a per job aggregate endorsement and Washington stop gap coverage. Said certificate of insurance shall clearly identify the provider, the amount of coverage, the policy number, and when the policy and its provisions are in effect. Said policy shall be in effect for the duration of this Contract. The policy shall name the City, its elected and appointed officials, officers, agents and employees as additional insureds, and shall contain a clause that the insurer will not cancel or change the insurance without first giving the City thirty (30) calendar days prior written notice (any language in the clause to the effect of "but failure to mail such notice shall impose no obligation or liability of any kind upon the company" shall be crossed out and initialed by the insurance agent). The insurance shall be with an insurance company or companies rated A -VII or higher in Best's Guide and admitted in the State of Washington. If Contractor uses any other contractors and/or subcontractors to perform any of the work referenced in this Contract, such other contractors and/or subcontractors shall maintain the same minimum limits of liability and comply with all other provisions discussed above in this subsection entitled "Commercial Liability Insurance." 6.1.2 Commercial Automobile Liability Insurance. On or before the date this Contract is fully executed by the parties, Contractor shall provide the City with a certificate of insurance as proof of commercial automobile liability insurance with a minimum liability limit of One Million Dollars ($1,000,000) combined single limit bodily injury and property damage. Said certificate of insurance shall clearly identify the provider, the amount of coverage, the policy number, and when the policy and provisions provided are in effect. Said policy shall be in effect for the duration of this Contract. The policy shall name the City, its elected and appointed officials, officers, agents and employees as additional insureds, and shall contain a clause that the insurer will not cancel or change the insurance without first giving the City thirty (30) calendar days prior written notice (any language in the clause to the effect of "but failure to mail such notice shall impose no obligation or liability of any kind upon the company" shall be crossed out and initialed by the insurance agent). The insurance shall be with an insurance company or companies rated A -VII or higher in Best's Guide and, admitted in the State of Washington. If Contractor uses any other contractors and/or subcontractors to perform any of the work referenced in this Contract, such other contractors and/or subcontractors shall maintain the same minimum limits of liability and comply with all other provisions discussed above in this subsection entitled "Commercial Automobile Liability Insurance." 6.1.3 Umbrella Liability Insurance. Contractor and its contractors and/or subcontractors shall maintain umbrella liability insurance coverage, in an occurrence form, over underlying commercial liability and automobile liability. On or before the date this Contract is fully executed by the parties, Contractor shall provide the City with a 2 RFP 10012 certificate of insurance as proof of umbrella coverage with a minimum liability limit of Three Million Dollars ($3,000,000). The insurance shall be with an insurance company or companies rated A -VII or higher in Best's Guide and admitted in the State of Washington. Providing coverage in the amounts as set forth above shall not be construed to relieve Contractor from liability in excess of those limits. 6.2 Proof of Insurance. Contractor shall file with the City copies of all certificates of insurance showing up -to -date coverages, additional insured coverages and evidence of payment of premiums as set forth above. Contractor shall file and maintain a certificate of insurance along with written evidence of payment of the required premiums with the manager of the City Transit Division, or his /her designee. 6.3 Alteration of Insurance. Insurance coverages, as required by this Contract, shall not be changed, cancelled or otherwise altered without prior written approval of the City. Contractor shall provide the City no less than thirty (30) days prior written notice of any such proposed change, cancellation or other alteration. The City may, at its option, review all insurance coverages. If it is determined by the City that circumstances require and that it is reasonable and necessary to increase insurance coverage and liability limits above such coverage and limits as are set forth in this Contract, in order to adequately cover the risks of the City, Contractor and Contractor's officers, agents and employees, the City may require additional insurance to be acquired by Contractor. Should the City exercise its right to require additional insurance, the City will provide Contractor with written notice. 6.4 Failure to Procure. Contractor acknowledges and agrees, by acceptance of this Contract, that failure to procure and maintain the insurance coverages as detailed in Section 6.1 of this Contract shall constitute a material breach of this Contract. In the event of such failure to procure and maintain the referenced insurance coverages, the City may immediately suspend Contractor's operations under this Contract, terminate or otherwise revoke this Contract and/or, at its discretion, procure or renew such insurance in order to protect the City's interests, in which event the City shall be entitled to be reimbursed by Contractor for all premiums and other reasonable expensed incurred in connection therewith. 7. Performance Bond. Prior to the effective date of this Contract, Contractor shall furnish to the City proof of the posting of a performance bond running to the City, with good and sufficient surety approved by the City, in the penal sum of One Hundred Thousand Dollars ($100,000), conditioned that Contractor shall well and truly observe, fulfill and perform each term and condition of this Contract. Contractor shall pay all premiums charged for said bond. Said bond shall be effective to continue obligation for the term of this Contract, including any extensions, and thereafter until Contractor or any successor or assign of Contractor has satisfied all of its obligations with. the City that may have arisen from the acceptance of this Contract by Contractor or from its exercise of any privilege herein granted. Said bond shall contain a provision stating that said bond shall not be terminated or otherwise allowed to expire without thirty (30) days prior written 3 I RFP 10012 notice having been provided to the City. The form and content of said bond and any associated documents shall be approved in advance by the City Attorney, or his or her designee. Contractor shall provide a duplicate copy of said bond to the City and said duplicate copy shall be kept on file at the City Transit Division office or its successor(s). Neither the provisions of this Section nor any performance bond accepted by the City pursuant thereto, nor any damages or other amounts recovered by the City thereunder, shall be construed to excuse faithful performance by Contractor or to limit liability of Contractor under this Contract either to the full amount of the performance bond or otherwise, except as otherwise provided herein. 8. Indemnity, No Estoppel, No Duty. 8.1 Contractor shall, at its sole expense, protect, defend, indemnify and hold harmless the City, its elected officials, and in their capacity as such, the officials, agents, officers and employees of the City from any and all accidents, damages, losses, liens, liabilities, fines, penalties, claims, lawsuits, demands, actions, judgments, awards, costs and expenses arising directly or indirectly from or out of, relating to or in any way connected with the performance or non - performance, by reason of any intentional or negligent act, occurrence or omission of Contractor, whether singularly or jointly with others, its representatives, permittees, employees, contractors or subcontractors, whether or not such acts or omissions were contemplated or authorized by this Contract or applicable law; arising from actual or alleged injury to persons or property, including the loss of use of property due to an occurrence, whether or not such property is physically damaged or destroyed; arising out of or alleged to arise out of any claim for damages for Contractor's invasion of privacy, defamation of any person, firm or corporation, or of any other right of any person, firm or corporation; arising out of or alleged to arise out of Contractor's failure to comply with any and all provisions of any statute, regulation or resolution of the United States, State of Washington or any local agency applicable to Contractor and its business. Nothing herein shall be deemed to prevent the parties indemnified and held harmless herein from participating in the defense of any litigation by their own counsel at such parties' expense. Such participation shall not under any circumstances relieve Contractor from its duty of defense against liability or of paying any judgment entered against such party. Notwithstanding any provision of this Section to the contrary, Contractor shall not be obligated to indemnify, defend or hold the City harmless to the extent any claim, demand, lien, damage or liability arises out of or in connection with negligent acts or.omissions of the City. 8.2 Contractor hereby affirms that the City and Contractor have specifically negotiated these provisions, as required by RCW 4.24.115, to the extent that it may apply. 8.3 Whenever any judgment for any such liability, costs, or expenses, is recovered against the City or any other indemnitee, such judgment shall be conclusive against Contractor, not only as to the amount of such damage, but as to its liability, provided Contractor has reasonable notice or actually knew, or should have known, of the pendency of such suit. Under such circumstances, Contractor may also request the 4 RFP 10012 opportunity to defend or participate in the suit with legal counsel of its choice, at its - expense, said request not to be unreasonably denied. 8.4 No action, error or omission, or failure to act by the City, its agents, officers, officials or employees, in connection with administering its rights, duties or regulatory functions related to this Contract shall be asserted by Contractor, directly, indirectly or by way of seeking indemnification or as an assertion that the City has waived or is estopped to assert any municipal right hereunder, against the City, its boards, departments, divisions, officers, officials or employees. 8.5 It is not the intent of this Contract to acknowledge, create, imply or expand any duty or liability of the City in the exercise of its police powers or for any other purpose. Any City duty nonetheless deemed created shall be a duty to the general public and not to any specific party, group or entity. 9. Safeguarding of Information. The use or disclosure by the Contractor, or any persons employed by the Contractor, of any confidential information concerning a participant, recipient, or client for any purpose, with respect to contracted activities provided under this Agreement, is prohibited except on written consent of the participant, recipient, or client, his /her attorney or his /her responsible parent or guardian, or as otherwise provided by law. 10. Relationship of the Parties. The parties agree that an independent contractor relationship is created by this Agreement. The performance of contracted activities and the results to be achieved are solely the responsibility of the Contractor and those subcontractors it chooses to hire. No agent, employee, servant, or representative of the Contractor shall be deemed to be an employee, agent, servant, or representative of the City for any purpose under this Agreement and the employees of the Contractor are not entitled to any of the benefits which the City provides for City employees. The Contractor will be solely and entirely responsible for its acts and for the acts of its agents, - employees, servants, subcontractors, or otherwise, during the performance of this Agreement. The parties intend that an independent contractor /city relationship will be created by this Contract. The City is interested only in the results to be achieved, the implementation of services will lie solely with Contractor. No agent, employee, or representatives of Contractor shall be deemed to be an employee, agent, servant or representative of the City for any purpose, and the employees of Contractor are not entitled to any of the benefits the City provides for its employees. Contractor will be solely and entirely responsible for its acts and for the acts of its agents, employees, servants, subcontractors, or otherwise during the performance of this Contract. In the performance of the contracted activities herein contemplated, the Contractor is an independent contractor with the responsibility and authority to control and direct the performance of the details of the work, in accordance with the terms and conditions of this Agreement. However, the results of the work contemplated herein must meet the 5 RFP 10012 approval of the City and shall be subject to the City's general rights of inspection and review to secure the satisfactory completion thereof. In the event that any of the Contractor's employees, agents, servants, or otherwise, carry on activities or conduct themselves in any manner which may jeopardize the funding of this Agreement, the Contractor shall be responsible for taking adequate measures to prevent said employee, agent or servant from performing or providing any of the contracted activities described within the terms of this Agreement. Communications between the Contractor and the City shall be addressed to the Transit Manager of the City and the executive director of the Contractor at their respective addresses stated herein or at new addresses designated by either party by written notice. Communications for day -to -day operational or client issues shall be addressed to the designated City representatives. 11. Venue Stipulation. This Agreement has been and shall be construed as having been made and delivered within the State of Washington, and it is understood and agreed that this Agreement shall be governed by laws of the State of Washington both as to interpretation and performance. Any action at law, suit in equity, or other judicial proceeding from the enforcement or breach of this Agreement or any provision hereof, shall be instituted and maintained only in any of the courts of competent jurisdiction in Yakima County, Yakima, Washington. 12. Service Delivery. The Contractor shall provide reservation, dispatch, and transportation services under this Agreement in accordance with the policies and specifications more particularly stated under Section III "Scope of Service" of the Request for Proposals upon which this contract is based. Section III "Scope of Service" of the Request for Proposals in incorporated herien by this reference. A copy of Section III "Scope of Service" is attached to this contract. The City specifically reserves the right to set a limit on the amount of services to be provided by the Contractor based upon the City's budget. 13. Entire Agreement. This Agreement, along with the Request for Proposal, Scope of Services, Addenda, Acknowledgements, Technical Proposal, Technical Plan, FTA Required Clauses, Firms response, and any and all Exhibits and Attachments constitute the entire agreement between the parties, and supersede any prior negotiation, agreement or understandings. 14. Modification. No change or addition to this Agreement shall be valid or binding upon either party unless such change or addition is in writing and executed by both parties. 6 • RFP 10012 IN WITNESS WHEREOF the parties have executed this Agreement the day and year first above written. • CITY OF YAKIMA CONTRACTOR __ By: ,��� By: 1C-v.---z•A- J. 1 -- Richard A. Zais, Jr., City Manager C_E� Its: ATTEST: ' City Clerk /= [ —v. >.; s' Contract No. 2001 -126 Resolution No. R- 2001 -161 • BUSINESS OF THE CITY COUNCIL YAKIMA, WASHINGTON AGENDA STATEMENT Item No. For Meeting of December 4, 2001 ITEM TITLE: A Resolution Authorizing Execution of an Agreement with Access Paratransit, Inc., for ADA Complementary Paratransit Transportation Service (Dial -A -Ride) SUBMITTED BY: Chris Waarvick, Director of Public Works CONTACT PERSON/TELEPHONE: John Haddix, 575 -6005 SUMMARY EXPLANATION: On Thursday, November 1, 2001, bids were opened on the Dial -A -Ride contract with two bids received. The bid opening was later followed by a period of analysis conducted by a review panel consisting of Council and Staff representatives. After review and discussion, it is the recommendation of the review panel that the contract be awarded to Access Paratransit, Inc., as the lowest, most responsive bidder. Adoption of the attached Resolution authorizes execution of a contract that is for three years with options for an additional two years by executing two single, one -year extensions. This service contract is budgeted at $645,000 in the Transit Operating Fund for 2002. Resolution X Ordinance Contract X Paratransit Service Agreement (Dial -A -Ride) Mail to: Access Paratransit, Inc., 612 N 16th Avenue, Yakima, WA 98902 Funding Source 462 - Transit Division Operating Budget APPROVED FOR SUBMITTAL: 1,treg 4c City Manage STAFF RECOMMENDATION: Approve an agreement with Access Paratransit, Inc., to provide ADA Complementary Paratransit Transportation service. BOARD /COMMISSION RECOMMENDATION: Adoption of a resolution authorizing execution of an agreement with Access Paratransit, Inc. to provide ADA Complementary Paratransit Transportation service. COUNCIL ACTION: Resolution adopted. RESOLUTION NO. R -2001 -161 • CONTRACT N0. Wj—!a6 RESOLUTION NO. ,Q a?OD/-/&/ CONTRACT/LEASE/AGREEMENT ROUTE SLIP & CHECK LIST DATE SENT COMPLETE Two copies for original signatures City Manager signature City Clerk signature City Attorney signature Make copy of above signatures Notification letter/obtain sign. Notification - 7 --- 7—% A,i 1, (:�6 ", Individual/Organization COMMENTS: m PURCHASING DIVISION 129 North Second Street Yakima, Washington 98901 Phone (509) 575-6093 . Fax: (509) 576-6394 August 4, 2006 Steve Jones, President and William R. Kelley, Vice President, C.O.O. Access Transportation 612 N. 16" Ave. Yakima, WA 98902 Re: Termination of Citv Contract No. 2001-126 Dear Mr. Jones and Mr. Kelley: I am in receipt of your letter dated July 21, 2006. 1 did not respond sooner since you advised you would be on vacation until August 1, 2006. Your letter contains a number of factual inaccuracies regarding discussions between the City and your company over the last year. However, your desire to terminate this contractual relationship is matched by our own. Therefore, the City accepts your offer to terminate City Contract No. 2001-126 effective 12:01 a.m. on August 23, 2006. The new provider of paratransit services for the City of Yakima is A-1 Tri -City Taxi, Inc. A-1 will assume provision of those services effective 12:01 a.m. on August 23, 2006. You indicated in your letter to me that you would honor your obligations under the Agreement through the termination date. This is a statement you have made before, including in an e-mail to me dated February 22, 2006, in which you wrote, "We want to assure you and the city that we will, to the best of our ability, work for a smooth transition should we not be awarded the new contract. Our goal is to assure the community and our ridership of the highest quality service possible." As you know, paratransit clients are some of the most vulnerable members of our society, including the elderly and disabled, and a smooth transition from Access Paratransit, Inc. to A-1 Tri -City Taxi, Inc. is vital to the health and safety of those individuals. Such a transition requires that you continue to process reservations through August 22, 2006, and that you forward any and all information regarding rides reserved to take place after August 22, 2006 to the City at the close of business every day beginning on Wednesday, August 9, 2006. That information will be forwarded to the new provider so that it can begin providing rides immediately on August 23, 2006. The City will expect and require that you perform the actions stated above for the following reasons (1) to aid in a smooth transition as you have promised to do (2) because failure to do so will leave your vulnerable clients without scheduled rides to medical and other appointments on August 23, 2006 and (3) because they are contractually required. (See section A(12) of the Scope of Services, which provides, "It is the intent of the City to maximize its computer access yakhm-,? Am aAncaary 10 1991, to client and service data. The Contractor must cooperate, facilitate, and participate fully in this effort.") If you refuse to honor your legal and moral obligations as stated above, please be advised that the City will pursue legal action to protect those vulnerable members of society from the harm caused thereby. Finally, I would like to remind you that when you began providing paratransit services to the City of Yakima in 1996, the phone numbers that had been used to schedule paratransit rides by the public (248-1119 and 248-2229) were transferred to you by People for People so that vulnerable paratransit clients would not be penalized by the transition from one provider to another. It has always been the City's belief that you would transfer those numbers on to the next provider to continue that goodwill. To date, the City has asked you for the phone numbers and then (in response to Mr. Jones' reauest of "how much they are worth to t1s" ) offered to hi v them Yni l rejected both thin ramp i-,zt an�I the monetary offor sero, lid IiL to + thi n rtu it. t� d that +h,- s 3 vi I vvvuiu 11% w La e u If 1-; 1 Lunity tv r el i II you ll IQl ll ICJC numbers I IberJ were transferred to you when you started and that your refusal to sell them back demonstrates indifference to the needs of your vulnerable clients. Since it will take approximately 2 weeks for A-1 to obtain new phone numbers and there are thousands of vulnerable paratransit clients to inform, I urge you to re -consider your position in light of the harm to the public that will result thereby. Thank you for your attention to this matter. Very truly yours, Sue Ownby ' Purchasing Manager cc: Dick Zais, City Manager Dave Zabell, Assistant City Manager Sofia Mabee, Assistant City Attorney Chris Waarvick, Public Works Director Ken Mehin, Transit Karen Allen, Transit Neil McClure, Council Member Ron Bonlender, Council Member Micah Cawley, Council Member AGREEMENT MODIFICATION NO. I PROJECT: City of Yakima Bid No. 10112 DESCRIPTION: Complementary Paratransit Transportation Services "Dial -A -Ride" VENDOR: Access Paratransit, Inc. This agreement modification shall amend and be incorporated into the contract dated December 10, 2001 between the City of Yakima and Access Paratransit, Inc. The parties agree that Section 3 of the Contract shall be amended to read as follows: Description Old Price Ambulatory $ Non -Ambulatory $13.96 Percent New Price Increase $10.91 7.98% $15.08 7.98% Except as expressly modified herein, all other terms and conditions of the contract dated December 10, 2001 shall remain in full force and effect. CITY OF YAKIMA AUTHORIZATION: City Manager, R. A. Zai s, Jr. Date CONTRACTOR ACCEPTANCE: Access Paratransit, Inc. Date ATTEST: City Clerk Date City Contract No. 2003-18 City Resolution No. R-2003-23 Client • 75 ACCEPARl ��s��4�-.,•�� � �:,� -�- ��.;� ACOR CERTIFICATE OF LIABILITY INSURANCE 04/11/02 PRODUCER Bell -Anderson Insurance P . 0 . BOX 887 724 West Smith St. Kent, WA 98035-0887 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURED Access Paratransit Inc/Steve Jones 612 N 16th Ave Yakima, WA 98902 INSURERA: Empire Fire and Marine INSURERB: Discover Property & Casualty Co INSURERc: Burlington Insurance INSURERD: United Ins Co INSURER E. COVERAGES THE POLICIESOFINSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, IN RI LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MWDDIYY POLICY EXPIRATION DATE MMMD LIMITS C I GENERAL LIABILITY BO 10 9 Q510 0 6 11/06/01 11/06/02 EACH OCCURRENCE 1$2, 000, 000 FIRE DAMAGE (Any one fire) $50,000 X COMMERCIAL GENERAL LIABILITY MED EXP (Any one person) s5, 000 CLAIMS MADE OCCUR PERSONAL &ADV INJURY $1 000,000 GENERAL AGGREGATE s2, 000,000 GEN'L AGGREGATE L IM IT APPLIES PER: I PRODUCTS -COMPIOPAGG $1, 000,000 PPRO LOC POLICY JECT A B AUTOMOBILE LIABILITY ANY AUTO CAO 016 0 9 5 0 D156A00044 11/06/01 04/13/02 11/06/02 04/13/03 COMBINED SINGLE LIMIT (Ea accident) i$1, 000, 000 BODILY INJURY $ (Per person) X ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY $ (Per accident) HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE S (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT I $ OTHER THAN EA ACC $ AUTO ONLY, AGG $ ANY AUTO D EXCESS LIABILITY ' XTP 6 8 7 6 3 101/01/02 i 01/01/03 EACH OCCURRENCE s3,000,000 AGGREGATE s3,000,000 X OCCUR CLAIMS MADE $ S DEDUCTIBLE I $ RETENTION $ WORKERS COMPENSATION AND 1 I TH- iTORY ILM TS C STTU-CER E.L EACH ACCIDENT $ EMPLOYERS' LIABILITY E.L. DISEASE -EA EMPLOYEE $ i E.L DISEASE -POLICY LIMIT $ A OTHER UM CA00160950 11/06/01 11/06/02 $1,000,000 B DI56AO0044 1$100,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS The City, its Officers, Agents and Employees are named as additional insured as to work performed by the Named Insured. CERTIFICATE City of Yakima 129 N 2nd St Yakima, WA 98901 ACORD 25-S (7(97)1 o f 2 #39550 SHOULD ANYOF TH E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL MAIL 3_Q_DAYSWRTTEN NOTICETOTHE CERTIFICATE HOLDER NAMED TOTH E LEFT, L ANY KIND-UPOWTW E INSUREFNTS-AGE4I-TS-6R- AUTHORIZED REPRESENTATIVE KLP,y © ACORD CORPORATION 1988 1920r�z��r►� DIAL -A -RIDE TRANSPORTATION SERVICE BROKER AND/OR PROVIDER AGREEMENT THIS AGREEMENT is entered into this day of �c �� —�, 2001, by and between the City of Yakima, Washington, hereinafter called "the City," through the Department of Public Works, Transit Division, 2301 Fruitvale Blvd., Yakima, Washington 98901, and Access Paratransit, Inc., hereinafter called the "Contractor." 1. Purpose of Agreement. The purpose of this Agreement is to provide complementary paratransit transportation services, also known as 'Dial -A -Ride" services, within the City of Yakima to persons who, under the Americans with Disabilities Act, are considered disabled. 2. Scope of Services. Contractor shall, on behalf of the City, provide reservation, dispatch, and transportation services, and may broker service to other subcontractors to provide such transportation services to eligible persons, all as more particularly stated under Section III "Scope of Service" of the Request for Proposals upon which this contract is based. Section III "Scope of Service" of the Request for Proposals in incorporated herien by this reference. A copy of Section III "Scope of Service" is attached to this contract. 3. Price. Trip Rates to be as Follows: Ambulatory $10.10 per boarding for one (1) ambulatory passenger not requiring a wheelchair lift -equipped vehicle. Annual Base Trip Projection is 38,700 Wheelchair $13.96 per boarding for one (1) passenger requiring a wheelchair lift -equipped vehicle. Annual Base Trip Projection is 17,000. 4. Term. This Agreement shall become effective on its execution by both the successful proposer and the City Manager as authorized by resolution of the Yakima City Council, and shall terminate on three years after execution. The City may, at its sole option, extend this contract for one year periods, not to exceed (5) five years total. 5. Service Area. The Contractor agrees to provide services under this Agreement to eligible riders, namely those who have been pre -qualified under procedures established and conducted by the City for transportation within the corporate limits of the City of Yakima. 6. Insurance. 6.1 Coverages. Contractor shall maintain, throughout the term of this Contract, liability insurance insuring Contractor, its officers, employees and agents, with regard to 1 RFP 10012 all claims and damages specified in Section 6 herein, in the minimum amounts as follows: 6.1.1 Commercial Liability Insurance. On or before the date this Contract is fully executed by the parties, Contractor shall provide the City with a certificate of insurance as proof of commercial liability insurance with a minimum liability limit of One Million Dollars ($1,000,000) combined single limit bodily injury and property damage. This coverage will have a per job aggregate endorsement and Washington stop gap coverage. Said certificate of insurance shall clearly identify the provider, the amount of coverage, the policy number, and when the policy and its provisions are in effect. Said policy shall be in effect for the duration of this Contract. The policy shall name the City, its elected and appointed officials, officers, agents and employees as additional insureds, and shall contain a clause that the insurer will not cancel or change the insurance without first giving the City thirty (30) calendar days prior written notice (any language in the clause to the effect of "but failure to mail such notice shall impose no obligation or liability of any kind upon the company" shall be crossed out and initialed by the insurance agent). The insurance shall be with an insurance company or companies rated A -VII or higher in Best's Guide and admitted in the State of Washington. If Contractor uses any other contractors and/or subcontractors to perform any of the work referenced in this Contract, such other contractors and/or subcontractors shall maintain the same minimum limits of liability and comply with all other provisions discussed above in this subsection entitled "Commercial Liability Insurance." 6.1.2 Commercial Automobile Liability Insurance. On or before the date this Contract is fully executed by the parties, Contractor shall provide the City with a certificate of insurance as proof of commercial automobile liability insurance with a minimum liability limit of One Million Dollars ($1,000,000) combined single limit bodily injury and property damage. Said certificate of insurance shall clearly identify the provider, the amount of coverage, the policy number, and when the policy and provisions provided are in effect. Said policy shall be in effect for the duration of this Contract. The policy shall name the City, its elected and appointed officials, officers, agents and employees as additional insureds, and shall contain a clause that the insurer will not cancel or change the insurance without first giving the City thirty (30) calendar days prior written notice (any language in the clause to the effect of "but failure to mail such notice shall impose no obligation or liability of any kind upon the company" shall be crossed out and initialed by the insurance agent). The insurance shall be with an insurance company or companies rated A -VII or higher in Best's Guide and admitted in the State of Washington. If Contractor uses any other contractors and/or subcontractors to perform any of the work referenced in this Contract, such other contractors and/or subcontractors shall maintain the same minimum limits of liability and comply with all other provisions discussed above in this subsection entitled "Commercial Automobile Liability Insurance." 6.1.3 Umbrella Liability Insurance. Contractor and its contractors and/or subcontractors shall maintain umbrella liability insurance coverage, in an occurrence form, over underlying commercial liability and automobile liability. On or before the date this Contract is fully executed by the parties, Contractor shall provide the City with a 2 nolvarl1 certificate of insurance as proof of umbrella coverage with a minimum liability limit of Three Million Dollars ($3,000,000). The insurance shall be with an insurance company or companies rated A -VII or higher in Best's Guide and admitted in the State of Washington. Providing coverage in the amounts as set forth above shall not be construed to relieve Contractor from liability in excess of those limits. 6.2 Proof of Insurance. Contractor shall file with the City copies of all certificates of insurance showing up-to-date coverages, additional insured coverages and evidence of payment of premiums as set forth above. Contractor shall file and maintain a certificate of insurance along with written evidence of payment of the required premiums with the manager of the City Transit Division, or his/her designee. 6.3 Alteration of Insurance. Insurance coverages, as required by this Contract, shall not be changed, cancelled or otherwise altered without prior written approval of the City. Contractor shall provide the City no less than thirty (30) days prior written notice of any such proposed change, cancellation or other alteration. The City may, at its option, review all insurance coverages. If it is determined by the City that circumstances require and that it is reasonable and necessary to increase insurance coverage and liability limits above such coverage and limits as are set forth in this Contract, in order to adequately cover the risks of the City, Contractor and Contractor's officers, agents and employees, the City may require additional insurance to be acquired by Contractor. Should the City exercise its right to require additional insurance, the City will provide Contractor with written notice. 6.4 Failure to Procure. Contractor acknowledges and agrees, by acceptance of this Contract, that failure to procure and maintain the insurance coverages as detailed in Section 6.1 of this Contract shall constitute a material breach of this Contract. In the event of such failure to procure and maintain the referenced insurance coverages, the City may immediately suspend Contractor's operations under this Contract, terminate or otherwise revoke this Contract and/or, at its discretion, procure or renew such insurance in order to protect the City's interests, in which event the City shall be entitled to be reimbursed by Contractor for all premiums and other reasonable expensed incurred in connection therewith. 7. Performance Bond. Prior to the effective date of this Contract, Contractor shall furnish to the City proof of the posting of a performance bond running to the City, with good and sufficient surety approved by the City, in the penal sum of One Hundred Thousand Dollars ($100,000), conditioned that Contractor shall well and truly observe, fulfill and perform each term and condition of this Contract. Contractor shall pay all premiums charged for said bond. Said bond shall be effective to continue obligation for the term of this Contract, including any extensions, and thereafter until Contractor or any successor or assign of Contractor has satisfied all of its obligations with the City that may have arisen from the acceptance of this Contract by Contractor or from its exercise of any privilege herein granted. Said bond shall contain a provision stating that said bond shall not be terminated or otherwise allowed to expire without thirty (30) days prior written 3 RFP 10012 notice having been provided to the City. The form and content of said bond and any associated documents shall be approved in advance by the City Attorney, or his or her designee. Contractor shall provide a duplicate copy of said bond to the City and said duplicate copy shall be kept on file at the City Transit Division office or its successor(s). Neither the provisions of this Section nor any performance bond accepted by the City pursuant thereto, nor any damages or other amounts recovered by the City thereunder, shall be construed to excuse faithful performance by Contractor or to limit liability of Contractor under this Contract either to the full amount of the performance bond or otherwise, except as otherwise provided herein. 8. Indemnity, No Estoppel, No Duty. 8.1 Contractor shall, at its sole expense, protect, defend, indemnify and hold harmless the City, its elected officials, and in their capacity as such, the officials, agents, officers and employees of the City from any and all accidents, damages, losses, liens, liabilities, fines, penalties, claims, lawsuits, demands, actions, judgments, awards, costs and expenses arising directly or indirectly from or out of, relating to or in any way connected with the performance or non-performance, by reason of any intentional or negligent act, occurrence or omission of Contractor, whether singularly or jointly with others, its representatives, permittees, employees, contractors or subcontractors, whether or not such acts or omissions were contemplated or authorized by this Contract or applicable law; arising from actual or alleged injury to persons or property, including the loss of use of property due to an occurrence, whether or not such property is physically damaged or destroyed; arising out of or alleged to arise out of any claim for damages for Contractor's invasion of privacy, defamation of any person, firm or corporation, or of any other right of any person, firm or corporation; arising out of or alleged to arise out of Contractor's failure to comply with any and all provisions of any statute, regulation or resolution of the United States, State of Washington or any local agency applicable to Contractor and its business. Nothing herein shall be deemed to prevent the parties indemnified and held harmless herein from participating in the defense of any litigation by their own counsel at such parties' expense. Such participation shall not under any circumstances relieve Contractor from its duty of defense against liability or of paying any judgment entered against such party. Notwithstanding any provision of this Section to the contrary, Contractor shall not be obligated to indemnify, defend or hold the City harmless to the extent any claim, demand, lien, damage or liability arises out of or in connection with negligent acts or omissions of the City. 8.2 Contractor hereby affirms that the City and Contractor have specifically negotiated these provisions, as required by RCW 4.24.115, to the extent that it may apply. 8.3 Whenever any judgment for any such liability, costs, or expenses, is recovered against the City or any other indemnitee, such judgment shall be conclusive against Contractor, not only as to the amount of such damage, but as to its liability, provided Contractor has reasonable notice or actually knew, or should have known, of the pendency of such suit. Under such circumstances, Contractor may also request the 11 RFP 10012 opportunity to defend or participate in the suit with legal counsel of its choice, at its expense, said request not to be unreasonably denied. 8.4 No action, error or omission, or failure to act by the City, its agents, officers, officials or employees, in connection with administering its rights, duties or regulatory functions related to this Contract shall be asserted by Contractor, directly, indirectly or by way of seeking indemnification or as an assertion that the City has waived or is estopped to assert any municipal right hereunder, against the City, its boards, departments, divisions, officers, officials or employees. 8.5 It is not the intent of this Contract to acknowledge, create, imply or expand any duty or liability of the City in the exercise of its police powers or for any other purpose. Any City duty nonetheless deemed created shall be a duty to the general public and not to any specific party, group or entity. 9. Safeguarding of Information. The use or disclosure by the Contractor, or any persons employed by the Contractor, of any confidential information concerning a participant, recipient, or client for any purpose, with respect to contracted activities provided under this Agreement, is prohibited except on written consent of the participant, recipient, or client, his/her attorney or his/her responsible parent or guardian, or as otherwise provided by law. 10. Relationship of the Parties. The parties agree that an independent contractor relationship is created by this Agreement. The performance of contracted activities and the results to be achieved are solely the responsibility of the Contractor and those subcontractors it chooses to hire. No agent, employee, servant, or representative of the Contractor shall be deemed to be an employee, agent, servant, or representative of the City for any purpose under this Agreement and the employees of the Contractor are not entitled to any of the benefits which the City provides for City employees. The Contractor will be solely and entirely responsible for its acts and for the acts of its agents, employees, servants, subcontractors, or otherwise, during the performance of this Agreement. The parties intend that an independent contractor/city relationship will be created by this Contract. The City is interested only in the results to be achieved, the implementation of services will lie solely with Contractor. No agent, employee, or representatives of Contractor shall be deemed to be an employee, agent, servant or representative of the City for any purpose, and the employees of Contractor are not entitled to any of the benefits the City provides for its employees. Contractor will be solely and entirely responsible for its acts and for the acts of its agents, employees, servants, subcontractors, or otherwise during the performance of this Contract. In the performance of the contracted activities herein contemplated, the Contractor is an independent contractor with the responsibility and authority to control and direct the performance of the details of the work, in accordance with the terms and conditions of this Agreement. However, the results of the work contemplated herein must meet the 5 RFP 10012 approval of the City and shall be subject to the City's general rights of inspection and review to secure the satisfactory completion thereof. In the event that any of the Contractor's employees, agents, servants, or otherwise, carry on activities or conduct themselves in any manner which may jeopardize the funding of this Agreement, the Contractor shall be responsible for taking adequate measures to prevent said employee, agent or servant from performing or providing any of the contracted activities described within the terms of this Agreement. Communications between the Contractor and the City shall be addressed to the Transit Manager of the City and the executive director of the Contractor at their respective addresses stated herein or at new addresses designated by either party by written notice. Communications for day-to-day operational or client issues shall be addressed to the designated City representatives. 11. Venue Stipulation. This Agreement has been and shall be construed as having been made and delivered within the State of Washington, and it is understood and agreed that this Agreement shall be governed by laws of the State of Washington both as to interpretation and performance. Any action at law, suit in equity, or other judicial proceeding from the enforcement or breach of this Agreement or any provision hereof, shall be instituted and maintained only in any of the courts of competent jurisdiction in Yakima County, Yakima, Washington. 12. Service Delivery. The Contractor shall provide reservation, dispatch, and transportation services under this Agreement in accordance with the policies and specifications more particularly stated under Section HI "Scope of Service" of the Request for Proposals upon which this contract is based. Section III "Scope of Service" of the Request for Proposals in incorporated herien by this reference. A copy of Section III "Scope of Service" is attached to this contract. The City specifically reserves the right to set a limit on the amount of services to be provided by the Contractor based upon the City's budget. 13. Entire Agreement. This Agreement, along with the Request for Proposal, Scope of Services, Addenda, Acknowledgements, Technical Proposal, Technical Plan, FTA Required Clauses, Firms response, and any and all Exhibits and Attachments constitute the entire agreement between the parties, and supersede any prior negotiation, agreement or understandings. 14. Modification. No change or addition to this Agreement shall be valid or binding upon either party unless such change or addition is in writing and executed by both parties. 9 RFP 10012 IN WITNESS WHEREOF the parties have executed this Agreement the day and year first above written. CITY OF YAKIMA By: _` Richard A. Zais, Jr., City Manager ATTEST: City Clerk j Contract No. 2001-126 Resolution No. R-2001-161 7 •00 C: w By: -s,. )6" Its: CECD BUSINESS OF THE CITY COUNCIL YAKIMA, WASHINGTON AGENDA STATEMENT Item No. For Meeting of December 4 2001 ITEM TITLE: A Resolution Authorizing Execution of an Agreement with Access Paratransit, Inc., for ADA Complementary Paratransit Transportation Service (Dial -A -Ride) SUBMITTED BY: Chris Waarvick, Director of Public Works CONTACT PERSON/TELEPHONE: John Haddix, 575-6005 SUMMARY EXPLANATION: On Thursday, November 1, 2001, bids were opened on the Dial -A -Ride contract with two bids received. The bid opening was later followed by a period of analysis conducted by a review panel consisting of Council and Staff representatives. After review and discussion, it is the recommendation of the review panel that the contract be awarded to Access Paratransit, Inc., as the lowest, most responsive bidder. Adoption of the attached Resolution authorizes execution of a contract that is for three years with options for an additional two years by executing two single, one-year extensions. This service contract is budgeted at $645,000 in the Transit Operating Fund for 2002. Resolution X Ordinance Contract X Paratransit Service Agreement (Dial -A -Ride) Mail to: Access Paratransit Inc 612 N 16th Avenue, Yakima WA 98902 Funding Source 462 - Transit Divisi APPROVED FOR SUBMITTAL: Citv M 144 STAFF RECOMMENDATION: Approve an agreement with Access Paratransit, Inc., to provide ADA Complementary Paratransit Transportation service. BOARD/COMMISSION RECOMMENDATION: Adoption of a resolution authorizing execution of an agreement with Access Paratransit, Inc. to provide ADA Complementary Paratransit Transportation service. COUNCIL ACTION: RESOLUTION R 2001-161 A RESOLUTION authorizing and directing the City Manager to execute an agreement with Access Paratransit, Inc., for Dial -A -Ride transportation services. WHEREAS, the City of Yakima currently provides and intends to continue to provide complementary paratransit transportation services in Yakima to persons with disabilities through a contracted program known as Dial -A -Ride, as required by the Americans with Disabilities Act (ADA); and WHEREAS, Access Paratransit, Inc., currently provides Dial -A -Ride transportation services in the City of Yakima and its proposal submitted in response to Request for Proposals Number 10112 will satisfy the City of Yakima's requirements; and WHEREAS, it is in the best interest of the City of Yakima to award the Dial -A - Ride Transportation Service Broker and/or Provider Agreement to Access Paratransit, Inc., according to the terms of its response to Request for Proposals Number 10112; now, therefore: BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF YAKIMA: The City Manager is authorized and directed to execute the attached Dial -A - Ride Transportation Service Broker and/or Provider Agreement with Access Paratransit, Inc. for ADA complementary paratransit transportation service in the City of Yakima. ADOPTED BY THE CITY COUNCIL this 4t11 day of December, 2001. ATTEST: Karen S. Roberts, City Clerk i,k •-x. A IN Macintosh HD:System Folder:Exchange Temporary Items:auth k res:l�3i Mary Place, Mayor c- s� -n Ilii CITY D- _.puty Last printed 11/28/0111:27 AM OFFICE OF THE CITY CLERK 129 North Second Street Yakima, Washington 98901 Phone: (509) 575-6037 : Fax. (509) 575-6107 December 7, 2001 Access Paratransit, Inc. 612 N. 16th Avenue Yakima, WA 98902 REFERENCE: Dial -A -Ride Transportation Agreement Enclosed are two originals of the referenced agreement signed by the City Manager and requiring your signature. Please sign both originals and return one to my attention. I have also enclosed a certified copy of Resolution R-2001-161 covering this agreement for your records. Sincerely, 4 uzc' � j L4nda Watkins Records Clerk Enclosure Yakima bmftd 1994 ACCESS PABA TRAINSIT 6 1 2 N 18TH AVENUE YAKIMA WASHINGTON 98902 (509) 246-2220 FAx (509) 248-9350 Mrs. Sue Ownby, CPPB Puchasmig Manager 129 North 21d Street Yakima, Wash. 98901 Mrs. Sue Ownby, Access Paratransit, Inc. has looked forward to submiitting a proposal to Yakima Transit for the Dial -A -Ride Specialized Transportion Service (Proposal No. 10112). Access Paratransit, Inc. is a Specialized Transportation Service that is dedicated to the Yakima City limits, Enclosed, please find a complete proposal that responds to all the criteria of thl- C Russ Keen CEO M A 0 tV%--.CESS PARATRANSIT INC. ADA COMPLIANT AND SPECIALIZE1 TRANSPORTATION SERVICE MISSION STATEMEN'T To consistently deliver quality transportation 'W service to each dent in a timely and efficient - K! manner, to beknown for excellence andvalue in the community and ADA transportation industry. VALUES -Placing safety of clients and employeels first ®great each client with respect and dignity P,,Place client care and welfare only second to safety �Continue to improve our skills through -n- A. education and training -i:-- lei! a to-Tocontinue toimprove service to our clients P -Wise stewardshipof resources lo- Seek new and innovative ways to enhance and improve client care and delivery A�: A Access Paratransit, Inc., hereafter AP1, has been providing specialized transportation service to the elderly and disabled community for the past five years. Access Paratransit, Inc. Specialized Transportation Service was provided through contract with Yakima Transit. During this time, API, has been in the process of developing better methods t provide safer transportation for persons with special needs. Plans toincorpora more comprehensive training has been implemented. Access Paratransit, Inc., pl to work more closely with contracting staff to obtain a better understanding passenger needs. This desire to understand passenger need will launch the pursul of creating a training resource designed to completely understand industri, standards, challenges, and methods in which to train drivers appropriately. In the last five years API has provided Specialized Transportation with sedans with an passenger vans and within •the past two years, cutaway buses. API has be successful *in acquiring some newer accessible vehicles to accommodate passenge and to meet the ever-changing demanof ds the 'industry. The process of upgradi ji and acquiring newer and better accessible vehicles has provided API with a betu margin of competition. Equally, the acquisition of an improved staff has helpel create a transportation group that is knowledgeable and that can assure a hig standard of service quality. API, has been successful in providing a high level of service while operating und fairly stringent contract requirements. API takes pride in building excellel working relationships with contracting agencies and continues to make a positi mark in the transportation industry. API now possesses a complete training , human resources, quality assurance, dispatch, reservations, maintenance, and accounting departments. These departments can now better function individually and as a team by identifying tasks and responsibilities. Tasks are streamlined, productivity increased, and meeting goals and deadlines has improved remarkably. Philosophy: Access Paratransit, Inc. "s, hereafter known as APL philosophy on customer service and quality assurance is very simple. API believes that every customer who experiences service through API, should have an experience that reflects a positive, safe, and enjoyable ride. Whether such rides are based on a "one on one" or "grouped" scenario, each individual deserves service that is accommodating, sincere, prompt in pick up and delivery, and that provides dignity while serving the customer's needs. Providing quality service successfully is dependant on safe, clean, and reliable vehicles, as well as the ability of staff to recognize each customers, disability and transportation need. The transition from recognizing customer need should filter down to accurate dispatching the most appropriate mode of transportation. Transportation, however, is only a fraction of the service expected. Without quality drivers, transportation would seem sterile and without complete purpose. True customer service involves friendly, courteous, and professional drivers. Ensuring quality service through drivers *involves an extensive tra *in mig program to ensure that drivers are trained properly and are knowledgeable regarding customer it eeds, and overall proper operation of vehicles and company procedures. API uses this philosophy and incorporates a stringent training program to ensur;� quality drivers, thus providing a well rounded and complete quality service program. API promotes its mission and a team concept throughout the organization. Driver mechanics, and office staff are recognized as "team members". Each departme il not only recognizes their part in contributing, but also is aware of accountabili and how a positive approach to team goals creates a unified and more comple product. Yakima Transit 2301 Fruitva|e Blvd. Yakima, WA 98902 Attention: Dial A Ride Coordinator Dear Dial A Ride Coordinator, It has C0[ne to our attention that the contract Y@kxrn@ Tr8DSb has with ACCeSS Paratn3Os|twxU soon be up for renegotiation. The staff at Sun Tower and Sun Tower Assisted Living would like you to know how much we appreciate the services Access P2n8tr8DSitoffers our facility, The staff 8tAccess has always been polite, helpful and willing to help us learn the ropes. We have 8 new Assisted Living facility in the Sun Tower building, and the ACCe8S Staff have been enormously helpful iDestablishing our Dial A Ride Facility Program. We have 3vvOOdGrful working relationship, and vvOu|d like to see it COndnU8. The population that resides in this building is elderly. They know and like the drivers and the 82Se[v8tiOniStS. They are familiar with the program rules and the routines. They are very grateful for the stellar customer service. There have been many occasions that Access has gone above and beyond their 'normal' duties for our residents. The staff at Sun Tower and Sun Tower Assisted Living vvOu\d like to see Access P9r8t[@n5it continue to serve our community. We feel that they have established @ wonderful pr0grQrn, and that change in this service would be detrimental for all they serve. Thank you for this opportunity tDshare how m*e atSun Tower feel about Access Par@traDSb a �r/m`y' /H /a /v n e/R N Health Care Coordinator, Sun Tower Assisted Living RESIDENCE FOR SENIOR CITIZENS SUN TOWER ° monrx s/xrx srRcsT ,^n'm^.w^s*/marow eoso` PHONE 248-3191 Yakima Transit 2301 Fruitva|e Blvd. Yakima, WA 98902 Attention: Dial A Ride Coordinator Dear Dial A Ride Coordinator, It has C0[ne to our attention that the contract Y@kxrn@ Tr8DSb has with ACCeSS Paratn3Os|twxU soon be up for renegotiation. The staff at Sun Tower and Sun Tower Assisted Living would like you to know how much we appreciate the services Access P2n8tr8DSitoffers our facility, The staff 8tAccess has always been polite, helpful and willing to help us learn the ropes. We have 8 new Assisted Living facility in the Sun Tower building, and the ACCe8S Staff have been enormously helpful iDestablishing our Dial A Ride Facility Program. We have 3vvOOdGrful working relationship, and vvOu|d like to see it COndnU8. The population that resides in this building is elderly. They know and like the drivers and the 82Se[v8tiOniStS. They are familiar with the program rules and the routines. They are very grateful for the stellar customer service. There have been many occasions that Access has gone above and beyond their 'normal' duties for our residents. The staff at Sun Tower and Sun Tower Assisted Living vvOu\d like to see Access P9r8t[@n5it continue to serve our community. We feel that they have established @ wonderful pr0grQrn, and that change in this service would be detrimental for all they serve. Thank you for this opportunity tDshare how m*e atSun Tower feel about Access Par@traDSb a �r/m`y' /H /a /v n e/R N Health Care Coordinator, Sun Tower Assisted Living RESIDENCE FOR SENIOR CITIZENS Z, , WOMB,:, REQUEST FOR PROPOSAL to Provide ADA COMPLEMENTARY PARATRANSIT TRANSPORTATION SERVICE for ADA QUALIFIED INDIVIDUALS Section A Acknowledgment I Russell Keen hereby acknowledge total familiarity with the entire Request for Proposal No. 10112 package, and, I hold the title of Chief Executive Officer, for Access Paratransit and, I am legally authorized to sign, execute and complete this and the attached forms on behalf of Access Paratransit, and this proposal shall remain valid for at least ninety (90) from the latest published IFP closing date. I Russell Keen also acknowledge receipt off' Addedda(unig) # 1 Signature: "''o Date Signed:4 / No V Z00 PURCHASING DIVISION 129 North Second Street Yakima, Washington 98901 Phone (509) 575-6093 • Fax: (509) 576-6394 October 23, 2001 ATTENTION: All Proposers SUBJECT: Request for Bid No. 10112 — ADA Complementary Paratransit Transportation Service for ADA Qualified Individuals Addendum No. I The following paragraphs will be added to the final contract. Price Increases: Any price increase requests must be in writing and approved by the City. Vendors shall be allowed to adjust prices, provided proof of price increase can be furnished to the City. If approved, the price increase shall take effect thirty (30) days after acceptance by the City. Vendor shall not be allowed to alter the basic profit margin. No general and administrative expense, overhead, or profit shall be allowed for any adjustment. Price Decreases: During the contract period and any renewals thereof, any price declines shall be reflected in a reduction of the contract price to the City, retroactive to the date they were effective to the vendor. The following paragraph will be incorporated into the Regicest Lor Proposal: Insurance Option -Vendor shall quote prices in conjunction with limits of liability coverage as set forth in Attachment B. Vendors may also submit options for different ranges of liability coverage along with separate cost proposals. The City retains the right to accept whichever option is in the best interest of the City. Yakima µtiwr,ad 1994 Page 17, Item # 13, Insert after Paragraph 1, "Vehicle Whenever a vehicle is used in Dial -A -Ride service that exceeds eight (8) years of age, it will be regularly inspected on a more frequent basis, once it is first inspected and approved for service. These inspections shall be conducted on a quarterly basis, four (4) times per year, as long as the vehicle condition remains satisfactory. If, in the opinion of the City of Yakima staff or designated representative conducting the inspections, the vehicle is beginning to deteriorate due to age and/or maintenance issues, inspections may be conducted more frequently, and will be at the Contractor's expense. These vehicles will also remain in the random inspection pool and subject to random inspections also. Page 19, Item # 18, acid: "Blood Born Pathogens certification" to the first sentence. Please acknowledge receipt of this Addendum No. I on page 23 of your proposal. NO OTHER CHANGES. Sincerely, Sue Ownby, CPPB Purchasing Manager cc: All vendors receiving proposal package file B. TECHNICAL PROPOSAL RFP 10112 Firm Name: ACCESS PARATRANSIT, INC. Address: 612 N. 16THAVE YAKIMA, WASHINGTON, 98902 Contact Name: RUSSELL KEEN Telephone: 509-248-2229 Fax: 509-248-9350 Federal ID: 91-17411363 If a Corporation, list all officers: Title Name Address PRESIDENT STEVE JONES 716 E. WRIGHT AVE. TACOMA, WASHINGTON CEO RUSSELL KEEN 9701 AHTANUM RD. YAKIMA, WASHINGTON Date Incorporated: 9-1-96 State/County: WASHINGTON PIERCE Indicate: PRIVATE FOR-PROFIT Yes If sole proprietor or partnership, list all principles . NOT APPLICABLE 2. Name of your Bank: BANK OF AMERICA 4002 TACOMA MALL BLVD SUITE 101, TACOMA WA Contact Name: Manager Telephone: 1-800-461-0810 3. If you are a Certified Disadvantaged Business Enterprise, attach Proof of Certification. NOT APPLICABLE 4. Attach a compiled Financial Statement for the two most current fiscal years. Include a cash flow statement showing bank account balance and banks who maintain the accounts. A minimum of 45 days of operating reserves must be demonstrated. A letter of Credit or other certification from a bank will be sufficient. SEE EXHIBIT: FS -COMPILED FS -CASH FLOW FS -LOC 5. List the name of your insurance agent and all companies who insure you. Attach copies of Insurance Certificates. If current insurance does not meet requirement under Contract Specifications, attach evidence from your insurance agent of compliance by start up date. Auto Insurance: BELL ANDERSON General Liability: BELL ANDERSON Workman's Comp: Department of Labor SEE EXHIBIT A PAGES 1-2 6. Provide a listing of any Pending Lawsuits. THERE ARE NO LAWSUITS PENDING Telephone: 800-442-1281 Telephone: 800-442-1281 Telephone: 509-454-3078 7. Attach a copy of Insurance Loss Runs for the last three years SEE EXHIBIT B PAGES 1-16 S. Qualifications of the firm a. Number of years in the passenger transport business: 5 b. Number of years operating in the Yakima area: 5 C. Describe type of transportation your company provides: ACCESS PARATRANSIT, INC. HAS PROVIDED TRANSPORTATION FOR THE DIAL -A -RIDE CONTRACT SINCE NOVEMBER 16, 1996. WE HAVE SUCCESSFULLY PERFORMED SPECIALIZED TRANSPORTATION SERVICE FOR WHEELCHAIR CLIENTS. THIS HAS REQUIRED VANS OR BUSES THAT ARE LIFT -EQUIPPED VEHICLE AND THAT ARE ADA COMPLIANT WITH FEDERAL AND STATE LAWS. WE ALSO TRANSPORT AMBULATORY CLIENTS, USING SEDANS THAT HAVE THE CAPACITY TO TRANSPORT (5) PASSENGERS, INCLUDING THE DRIVER. d. Describe the number and types of vehicles you currently operate: CURRENTLY ACCESS PARATRANSIT, INC. HAS (6) CHEVROLET CAPRICES WITH SEATING CAPACITY OF (6) PASSENGERS, INCLUDING THE DRIVER. WE ALSO HAVE (2) FORD BUSES EQUIPPED TO ACCOMMODATE (3) WHEELCHAIRS AND (9) AMBLE PASSENGERS. (1)FORD BUS THAT WILL ACCOMMODATE (5)WHEELCHAIRS AND (2) AMBLE PASSENGERS. (1) SMALL FORD VAN THAT ACCOMMODATES (2) WHEELCHAIRS. e. Provide a description of the Key Staff including dispatcher, schedulers, and other office personnel. Attach a resume of the Project Manager Who will have primary responsibility for the contract. Explain Manager's Paratransit experience, contract management experience and percent of time that will be dedicated to the project. DISPATCHER: CLINT VAN HORN SEE EXHIBIT -C JAMIE COLBY PAGES 1-3 OFFICE STAFF SCHEDULERS: SHARON BUCKLEY SEE EXHIBIT -D VIRGINIA KREISEL PAGES 1-4 S. Qualifications of the Firm (cont) e. Continued CEO PROJECT MANAGER: RUSSELL KEEN SEE EXHIBIT -E OPERATIONS KIMBERLY COLBY COORDINATOR: SEE EXHIBIT -F f. List subcontractors, if any, by company name, address, contact person, telephone number and proposed function within the scope of the Contract ( Attach a certification signed by all sub -contractors verifying they meet the same requirements as the General Contractor). WE DO NOT INTEND TO USE SUB -CONTRACTORS FOR THIS CONTRACT. APPROPRIATE CERTIFICATION DOCUMENTS WILL BE PROVIDED SHOULD THIS CHANGE. 9. Related Experience and references of the Firm a. Does your company have related experience in specialized transportation for persons with disabilities. YES If yes, explain. Include experience with wheelchair transport service if applicable. ACCESS PARATRANSIT, INC. (API) CURRENTLY OPERATES AS THE DIAL -A -RIDE PROVIDER FOR THE CITY OF YAKIMA, SERVICES INCLUDES AMBULATORY AND PERSONS UTILIZING A WHEELCHAIR. OUR EXPERIENCE INCLUDES AN ANNUAL COUNT OF 50,000 AMBULATORY, 17,000 WHEELCHAIR TRIPS. API HAS BEEN PROVIDING THIS SPECIALIZED CONTRACT SERVICE FOR 5 YEARS. ALL ELEMENTS OF OPERATION INCLUDE SPECIALIZED TRAINING IN THE SPECIAL NEEDS OF THIS COMMUNITY. 9. Related Experience and References of the Firm (continued) b. Provide examples of similar service or other related contract work you have provided in the last year. Attach letters of reference or furnish the name, title, address and telephone number of the person(s) who is most knowledgeable about the work performed. ACCESS PARATRANSIT OPERATIONS HAVE BEEN DEDICATED WITH NEAR EXCLUSIVITY TO THE DIAL -A -RIDE CONTRACT WITH THE CITY OF YAKIMA. ACCESS PARATRANSIT, INC ALSO PROVIDED A SHUTTLE SERVICE FOR GOODWILL INDUSTRIES. THIS SERVICE WAS PROVIDED FROM 1 JUNE 1999 TO 20 JULY 2001 WHEN GOODWILL OBTAINED THERE OWN BUS. REFERENCE AS FOLLOWS. DENNIS MARTIN, MANAGER GOODWILL INDUSTRIES 503S. IST STREET SELAH, WASHINGTON. PHONE: 509-698-3560 C. Provide copies of current City and, if applicable, current County Occupational licence(s) in the same name and permanent business address as the proposer. If the local government with jurisdiction indicates no license is necessary, a letter from the license official explaining the exemption must accompany the proposal. City License No: 8433 SEE EXHIBIT- G d. Have you ever had your License terminated or suspended? NO C. TECHNICAL PLAN 1. Days and Hours of Operation a. List days and hours service will be provided under the contract. (Indicate closed on Holidays) Days: 7 Hours of Operations: MONDAY THRU FRIDAY 6:00 AM TO 7:00 PM SATURDAY 8:00 AM TO 7:00 PM SUNDAY 8:30-1:30 Exceptions: SERVICE WILL BE PROVIDED ON HOLIDAYS WITH EXCEPTION OF MEMORIAL DAY AND LABOR DAY. 2. Drug and Alcohol Policy a. Explain how you plan to meet the Federal Transit Administration (FTA) requirements for driver testing and safety sensitive employees. Include plan for the pre-employment, probable cause Post accident, and random testing. CURRENT DRUG AND ALCOHOL POLICIES MEET OR EXCEED FEDERAL TRANSIT ADMINISTRATION REQUIREMENTS FOR DRIVER TESTING AND SAFETY. ACCESS PARATRANSIT IS COMMITTED TO UPHOLDING OUR DRUG AND ALCOHOL ABUSE POLICY. IT IS OUR POLICY TO MAINTAIN A SAFE AND DRUG/ALCOHOL FREE WORKPLACE ENVIRONMENT. SEE EXHIBIT- H PAGES 1-7 2. Drug and Alcohol Policy (cont) a. List name of certified laboratory used for testing and chain of custody procedures. PROVIDENCE BUSINESS HEALTH SERVICES 206 SOUTH 11THAVENUE SUITE 48 YAKIMA, WASHINGTON 98902 C. Attach a copy of your company's drug free work Place Policy. SEE EXHIBIT- I PAGES 1-3 3. Driver Qualification a. Describe your formal driver selection process and attach samples of forms used for permanent personnel records. ACCESS PARATRANSIT IS AN EQUAL OPPORTUNITY EMPLOYER. OUR SELECTION PROCESS REQUIRES APPLICANT TO MEET STRINGENT QUALIFICATIONS. ALL POTENTIAL EMPLOYEES MUST PRODUCE A DRIVING RECORD THAT IS ACCEPTABLE: PASS A PRE-EMPLOYMENT DRUG SCREEN: MUST BE ABLE TO PASS A CRIMINAL BACK GROUND CHECK WITH NO FELONY CONVICTIONS. EACH APPLICANT IS INTERVIEWED AND AN EXPLANATION OF OPERATIONAL REQUIREMENTS ARE PROVIDED. EACH ELEMENT OF THE HIRING PROCESS BECOMES A PERMANENT PART OF THE NEW HIRES EMPLOYMENT FILE. ACCESS PARATRANSIT SEEKS POTENTIAL EMPLOYEES WHO ARE WILLING TO BE PROFESSIONAL, AND HAVE A DESIRE TO WORK WITH AN ARRAY OF PEOPLE AS A TEAM PLAYER. SEE EXHIBIT- J PAGES 1-12 3. Driver Qualifications (cant) b. Explain your driver training program and attach a written plan for, training of new drivers and on-going training and re-training. Describe method of documentation verifying the training has been received. ACCESS PARATRANSIT, INC. DRIVER TRAINING IS AN EXTENSIVE 40 HOUR CLASSROOM PROGRAM. DRIVER TRAINING INCLUDES ,BUT IS NOT LIMITED TO, THE FOLLOWING: BASIC FIRST AID & CPR BLOOD-BORNE PATHOGENS ADA PASSENGER TECHNIQUES AND SAFETY DEFENSIVE DRIVING FIRE SUPPRESSION CHILD RESTRAINT OPERATION COMPANY POLICIES AND PROCEDURES SAFETY ORIENTATION ALL CLASSROOM TESTING AND DOCUMENTATION IS MAINTAINED IN A PERMANENT EMPLOYEE TRAINING FILE. STUDENTS RECEIVE CERTIFICATION FOR CLASSES SUCCESSFULLY COMPLETED. FOLLOWING CLASSROOM INSTRUCTION, RIDE -A -LONG INSTRUCTION IS PROVIDED TO OBSERVE PERFORMANCE. ON- GOING EVALUATION IS CONDUCTED QUARTERLY AND RANDOMLY. SEE EXHIBIT- K PAGES 1-13 C. Describe your plans for monitoring driver performance, including procedures for documenting occurrences, complaints, accidents, etc. AFTER HIRE, AN EMPLOYEE IS PLACED ON A 90 DAY PROBATION AT THE END OF THE 90 DAYS EMPLOYEE PERFORMANCE IS EVALUATED. ANNUAL AND RANDOM EVALUATIONS ARE CONDUCTED ON ALL EMPLOYEES WHICH COULD INCLUDE EMPLOYEE WARNINGS AND REPRIMANDS AS CIRCUMSTANCES WARRANT. ALL EVALUATIONS ARE KEPT IN EMPLOYEE'S FILE. ALL COMPLAINTS, OCCURRENCES, AND ACCIDENTS ARE RECEIVED EITHER THROUGH DISPATCH OR DIRECTLY TO MANAGEMENT. 3. Driver Qualification (cont) EACH CONCERN IS CAREFULLY DOCUMENTED AND INVESTIGATED FOR ACCURACY. A COPY OF THE COMPLETED REPORT IS THEN FILED IN THE APPROPRIATE AREA. SEE EXHIBIT -L PAGES 1-7 4. Safety Plan a. If you have a written Safety Program, provide a copy with the response. SEE EXHIBIT- M PAGES 1-28 b. Describe your procedures for handling accidents/incidents. Provide copies of forms used to document occurrences. FOR PURPOSES OF THIS ANSWER, "ACCIDENTS" ARE DEFINED AS AS ANY OCCURRENCE RESULTING IN BODILY INJURY OR PROPERTY DAMAGE. AFTER AN ACCIDENT HAS OCCURRED, DRIVER NOTIFIES THE DISPATCHER TO INFORM HIM OF VITAL INFORMATION. DISPATCHER IS INSTRUCTED TO GET THE FOLLOWING INFORMATION: INJURIES (IF ANY); LOCATION OF ACCIDENT; NUMBER OF VEHICLES INVOLVED. IF INJURIES REQUIRE MEDICAL ATTENTION, 911 IS CALLED AND MEDICAL TRANSPORT IS ARRANGED. LAW ENFORCEMENT IS INFORMED IF NOT ALREADY ON THE SCENE. MANAGEMENT IS NOTIFIED IMMEDIATELY AND DISPATCHED TO THE SCENE TO INVESTIGATE AND GATHER PERTINENT INFORMATION. AT THE SCENE, PHOTOS ARE TAKEN, WITNESSES INTERVIEWED, AND STATEMENTS GATHERED. IF ON BOARD PASSENGER(S) ARE UNINJURED, DISPATCHER ARRANGES FOR IMMEDIATE TRANSPORTATION. SEE EXHIBIT- N PAGES 1-2 "INCIDENTS" ARE DEFINED AS ANY OCCURRENCE INVOLVING BEHAVIORAL ISSUES, EQUIPMENT FAILURE, OR COMPLAINTS WITH POTENTIAL FOR SERIOUS RAMIFICATIONS. 4. Safety Plan (cant) b. Describe you procedures for handling accidents/incidents. Provide copies of forms used to document occurrences. INCIDENT REPORTS CAN BE DOCUMENTED BY DRIVER, DISPATCH, RESERVATIONIST, MANAGEMENT, CLIENTS, CLIENT FACILITIES. AFTER DATA IS COLLECTED AND DOCUMENTED ON AN INCIDENT REPORT FORM. INFORMATION IS THEN FORWARDED TO MANAGEMENT. THE INFORMATION IS REVIEWED AND INVESTIGATED. APPROPRIATE ACTION IS TAKEN AND DOCUMENTED. ALL INCIDENT REPORTS ARE MAINTAINED ON FILE. AS REQUIRED BY THE GUIDELINES OF OF OUR CONTRACT, INFORMATION IS THEN FORWARDED TO YAKIMA TRANSIT WITH DISPOSITION. SEE EXHIBIT -O PAGES 1-3 C. List any other methods for promoting safety awareness. ACCESS PARATRANSIT, INC HAS AN ACTIVE SAFETY PROGRAM. THIS INCLUDES AN ACCIDENT REVIEW BOARD CONSISTING OF A DESIGNATE FROM THE DRIVERS, MAINTENANCE, OFFICE STAFF AND MANAGEMENT. EACH ACCIDENT IIS REVIEWED FOR PREVENTION TACTICS THAT WOULD HAVE APPLIED ALONG WITH OTHER CONTRIBUTING FACTORS. RESULTS ARE POSTED IN A COMMON WORK AREA FOR REVIEW BY OTHER EMPLOYEES SAFETY BROCHURES ARE POSTED AND ALTERNATED ROUTINELY. DISPATCH AND DRIVERS INFORM EACH OTHER, AS WELL AS MANAGEMENT, OF POTENTIAL SAFETY HAZARDS DURING THE OPERATIONAL WORK DAY. MANAGEMENT CONDUCTS QUARTERLY SAFETY MEETINGS IN CONJUNCTION WITH COMPANY MEETINGS. MANDATORY, PAID ATTENDANCE, IS REQUIRED. AN HOURLY DISPATCH TEN SECOND BROADCAST ALERTS THE ENTIRE FLEET OF SAFETY ISSUES. 5. Communication a. Describe your two way communication system. Include range, capability and indicate location of base and if all vehicles proposed to be used in contract service will be equipped with mobile units. ALL VEHICLES ARE EQUIPPED WITH UHF 2 -WAY RADIOS. THEY HAVE 2 DEDICATED FREQUENCIES MATCHED TO A BASE STATION LOCATED AT 612 N. 16THAVE. YAKIMA WASHINGTON. BROADCAST RANGE EXCEEDS 10 MILES. b. Provide a copy of written dispatch procedures. SEE EXHIBIT- P PAGES 1-4 C. Attach a copy of your FCC Radio License. SEE EXHIBIT -Q PAGE 1 6. Performance Log a. Explain method of maintaining a daily operations log. Indicate activity to be included, staff to be assigned, and attach a sample copy. PERFORMANCE LOGS ARE KEPT AND UTILIZED IN THE FOLLOWING MANNER. RESERVATIONIST ENTERS INFORMATION FOR PRE -SCHEDULED TRIPS INTO A SOFTWARE PROGRAM CALLED RAPID -RIDE THIS SOFTWARE COMPILES PERTINENT INFORMATION IN A TRACKING FORMAT WHICH IS UTILIZED BY DISPATCH FOR DAILY TRANSPORTATION NEEDS. THIS INFORMATION INCLUDES DATE, DRIVER NUMBER, VEHICLE NUMBER ASSIGNED, CLIENT NAME AND ADDRESS, RIDE STATUS, DESTINATION ADDRESS, AND TIMES. PERSONNEL RETRIEVES COMPILED INFORMATION FROM COMPUTER DATABASE ON THE APPROPRIATE RIDE DAY AND USES FOR DISPATCH PURPOSE. AS RIDES PROGRESS FROM START TO COMPLETION, DISPATCHER LOGS APPROPRIATE NOTES AND TIMES THROUGHOUT THE DURATION OF THE RIDE. THIS IS STORED AND SAVE IN THE RAPID -RIDE PROGRAM. 6. Performance Log (cont) a. Explain method of maintaining a daily operations log. Indicate activity to be included, staff to be assigned, and attach a sample copy. THIS INFORMATION PROVIDES THE BASIS AND EVIDENCE FOR BILLING AND WORK PERFORMED BY MANAGEMENT. THIS SYSTEM WILL ALSO PRODUCE A CLIENT DATABASE OF ALL CLIENTS QUALIFIED TO BE ON DIAL -A -RIDE. 7. Proposed Facility/Facilities a. Describe your proposed facility including location, administrative, operating, and vehicle parking/storage area capacity. Include maintenance area, if applicable. FACILITY IS LOCATED AT 612 N. 16TH AVE., YAKIMA, WA. STRUCTURE IS TWO-STORY MASONRY BUILDING EXCEEDING 6,000 SQUARE FEET. SHOP AREA IS HEATED, ENCLOSED AND HAS ROOM FOR FOUR WORK BAYS. PARKING AREA IS FENCED, LIGHTED, AND SECURE WITH THE CAPABILITY OF HOLDING THE ENTIRE OPERATIONAL FLEET. ADDITIONAL PAVED PARK- ING ACCOMMODATES ALL EMPLOYEE PARKING. CLEANING AND VAC BAYS ARE LOCATED IMMEDIATELY ADJACENT TO FACILITY. OUR FACILITY IS DIVIDED INTO SIX SEPARATE ADMINISTRATIVE OFFICE STATIONS. 1. DISPATCH OFFICE 2. RESERVATION OFFICE 3. MECHANIC OFFICE 4. MECHANIC PARTS AND OPERATION 5. TRAINING ROOM 6. MANAGEMENT OFFICE 8. Is Facility Leased or rented? CURRENTLY RENTING WITH A FIVE YEAR LEASE OFFER FROM EILERS INC, LOCATED AT 1003 W. YAKIMA AVE SELAH, WASHINGTON 98942 SEE EXHIBIT -S PAGE 1-2 9. Vehicle Maintenance a. Attach a copy of your vehicle maintenance plan which includes: preventative maintenance, schedule, safety inspection, vehicle history, life maintenance and/or other requirements. ATTACHED DOCUMENTS ARE KEPT IN EACH VEHICLE'S SEPARATE HISTORY FILE. THIS INFORMATION IS USED TO DOCUMENT WORK PER -FORMED, INCLUDING PARS AND LABOR. SEE EXHIBIT -T PAGES 1-9 Milillill[�$ = = 11,12 3711 1211 ff!'1700B��� DRIVERS ARE RESPONSIBLE TO INSURE THAT THEIR VEHICLE IS CLEAN AND PRESENTABLE ON A DAILY BASIS. THIS INCLUDES, BUT IS NOT LIMITED TO REMOVAL OF ANY DISCARDABLE ITEMS LEFT IN THE VEHICLE. DETAILING OF VEHICLES IS PERFORMED ON A WEEKLY BASIS OR AS NEEDED, BY MAINTENANCE STAFF. MAINTENANCE STAFF IS RESPONSIBLE TO PERFORM ALL SCHEDULED DETAILING ITEMS AS OUT LINED IN THE ATTACHMENT. SEE EXHIBIT -U C. If routine maintenance of vehicles is contracted to another company, does the maintenance company have a Drug and Alcohol Policy and testing program for safety sensitive positions. a. Attach a vehicle inventory to include only those vehicles proposed to be Used in the service. Accessible vehicles must meet ADA requirements. If vehicles proposed have not been purchased, provide notarized proof of availability from dealer or manufacture that vehicles will be available by the starting date of this contract. Provide certification that financing is available to purchase the vehicles if awarded the contract. SEE EXHIBIT -V PAGES 1-2 10. Vehicles (cont) b. Inventory Format for each vehicle SEE EXHIBIT -V PAGES 1-2 CONTINUED 11. 'Trip Rates AMBULATORY $ 10.10 PER BOARDING FOR ONE (1) AMBULATORY PASSENGER NOT REQUIRING A WHEELCHAIR LIFT - EQUIPPED VEHICLE. WHEELCHAIR S 13.96 PER BOARDING FOR ONE (1) PASSENGER REQUIRING A WHEELCHAIR LIFT -EQUIPPED VEHICLE. The City of Yakima is now in the process of annexing a large new area. Best estimates project a growth of Dial -A -Ride clients of approximately 230 people and 8,300 trips annually, once the annexation is complete. Patterns show that 35% of those trips would be non-ambulatory persons requiring wheelchair lift equipped vehicles. Trip projections are based on projections and do not constitute a guarantee of service levels. They should only be used as a guide for determining capacity and proposed rates. Five (5) year ridership history is included in this packet. 12. Invoicing On or before the 10" day of the month, the Contractor shall invoice the City's Transit Manager for the service of the previous month as calculated above. The City shall pay within thirty (30 ) days. Any charge disputed by the City shall be separated from the invoice and the undisputed portion shall be paid. Both parties shall meet and resolve disputed charges within thirty (3) days aft after the invoice. Date. f' � /" V 209 i By: el� �`? 10. Vehicles (cont) b. Inventory Format for each vehicle SEE EXHIBIT -V PAGES 1-2 CONTINUED 11. Trip Rates Provide a fully allocated cost for Ambulatory and Wheelchair trips TRIP RATES PROPOSED AS FOLLOWS: AMBULATORY $10.10 PER BOARDING FOR ONE (1) AMBULATORY PASSENGER NOT REQUIRING A WHEELCHAIR LIFT - EQUIPPED VEHICLE. WHEELCHAIR $ 13.96 PER BOARDING FOR ONE (1) PASSENGER REQUIRING A WHEELCHAIR LIFT -EQUIPPED VEHICLE. The City of Yakima is now in the process of annexing a large new area. Best estimates project a growth of Dial -A -Ride clients of approximately 230 people and 8,300 trips annually, once the annexation is complete. Patterns show that 35% of those trips would be non-ambulatory persons requiring wheelchair lift equipped vehicles. Trip projections are based on projections and do not constitute a guarantee of service levels. They should only be used as a guide for determining capacity and proposed rates. Five (5) year ridership history is included in this packet. 12. Invoicing On or before the 1Wh day of the month, the Contractor shall invoice the City's Transit Manager for the service of the previous month as calculated above. The City shall pay within thirty (30 ) days. Any charge disputed by the City shall be separated from the invoice and the undisputed portion shall be paid. Both parties shall meet and resolve disputed charges within thirty (3) days aft after the invoice. Date: C'l I" V ZOO i RFP 1001? State of f_� ��_ , County of being first duly sworn, deposes and says that: (Owner, Partner, Officer,Representativl- or g,x_ o: a Ti' Respondent s' has subnu*tted attached Response; (2) (S)He is fully informed respecting the preparation and contents of the attached Response and of all pertinent circumstances respecting such Response; (3) Such Response is genuine and is not a collusive or sham; (4) Neither the said Respondent nor any of its officers, partners, owners, agents, representative, employees or parties in interest, including this affidavit, has in any way colluded, conspired, connived, or agreed, directly or indirectly, with any other Respondent; firm, or person to submit a collusive or sham respondent in connection with such Contract, or has in any manner, directly or indirectly, sought by agreement or collusion or communication or conference with any other Respondent, firm, or person, or to secure through any collusion, conspiracy, connivance, or unlawful agreement any advantage against any person interested in the proposed Contract. (Signed) Z",'11– -S . Titled Subscribed and sworn to before me ��1 ®���¢ ��+� �dar of Q�Oe--r— this f 2001 P e ® NOTARy 15� o _day , Title My commission expires 7/a-2/0!5 MUST BE SUBMITTED WITH BID PROPOSAL 30 RFP 10012 2. BUS' AMERICA REQUIIEIMENTS 49 U.S.C. 5323(j) �® 49 CFR Part 661 Applicability to Contracts The Buy America requirements apply to the following types of contracts: Construction Contracts and Acquisition of Goods or Dolling Stock (valued at more than $100.000). Flow Down The Buy America requirements flow down from FTA recipients and subrecipients to first tier contractors. who are responsible for ensuring that lower tier contractors and subcontractors are in compliance. Clause/Lanzua,ze Buv America - The contractor agrees to comply with 49 U S.C. 53230) and 49 CFR Part 661, which provide that Federal funds may not be obligated unless steel, iron_ and manufactured products used in FTA -funded projects are produced in the United States, unless a waiver has been granted by FTA or the product is subject to a general waiver General waivers are listed in 49 CFR 6617. and include final assembly in the United States for 15 passenger vans and 15 passenger wagons produced by Chrysler Corporation_ microcomputer equipment, software, and small purchases (currently less than $100,000) made with capital, operating or planning funds. Separate requirements for rolling stock are set out at 53230)(2)(C) and 49 CFR 661 11 Rolling stock not subject to a general waiver must be manufactured in the Umted States and have a 60 percent domestic content. A bidder or offeror must submit to the FTA recipient the appropriate Buy America certification (below) with all bids on FTA -funded contracts, except those subject to a general waiver. Bids or offers that are not accompanied by a completed Buy America certification must be rejected as non-responsive. This requirement does not apply to lower tier subcontractors. Certification requirement for procurement of steel, iron, or manufactured products Certificate of Compliance with 49 CS -C. 5323(j)(1) The bidder or offeror herebv certifies that it will meet the requirements of 49 U S.0 53230)(1) and the applicable regulations in 49 CFR Part 661 Date Signature . ....... Company Name, ...... ................. .... -- -- ---- -- ---- Title Certificate of.Non-Compliance with 49 CSC 5323(j)(1) The bidder or offeror hereby certifies that it cannot comply with the requirements of 49 U S C 53230)(1). but it may qualify for an exception pursuant to 49 U.S C. 53230)(2)(B) or 0)(2)(D) and the regulations in 49 CFR 661 7 Date Signature ... Company Name ..... _ . 32 RFP 10012 Title .. ..................... Certification requirement for procurement of buses, other rolling stock and associated equipment Certificate of Compliance with 49 U S. C. 5323 0) (2) (C) The bidder or offeror hereby certifies that it will comply with the requirements of 49 U.S.C. 53 23 0)(2)(C) and the regulations at 49 CFR Part 661. Date / ....N.oQ........-....M.......?.3...c......5.2.......Z .................... ............................... ............................................................. ..... ...................................................... ... Signature ..................... ................... . Company Name....Ac-c-Es'�, . ................ . ................ .............. ...... ............. ..................... .. ................. .......... ....... ... - TitleC��o ............................. — ......... . ......... I ........ .. ................ ............ ..... ................ ....... .... .... .. ............ Certificate of.Von-Compliance with 49 U.S.C. 53236)(2)(C) The bidder or offeror hereby certifies that it cannot comply with the requirements of 49 U.S C 53230)(2)(C), but may qualify for an exception pursuant to 49 U S.0 53230)(2)(B) or 0)(2)(D) and the regulations in 49 CFR 661.7 Date....... ................. ...... ............. .... .. ........................... ...................................................... ............... ..... ........ Signature.. — ........... . ..... . .. .. .... ........ . .... ....... . . .... ..... ...... I ..... . . . .... ..... ... .. . I .... .... . ... ..... . ..... CompanyName ... . ..... ........ .... .... .......................... ........ ... .......... ... .... ...... . — - ..... . ........ ...... .......... Title................................... . ..... ................... ..................................... ........................... ......................... ............ MUST BE SUBNHTTED WITH BID PROPOSAL 33 RFP 1001? 10. LOBBYING 31 U.S.C. 1352 49 CFR Part 19 49 CFR Part 20 Applicability to Contracts The Lobbying requirements apply to Construction/Architectural and Engmeering/Acgwsition of Rolling Stock/Professional Service Contract/Operational Service Contract/Turnkey contracts. Flow Down The Lobbying requirements mandate the maximum flow down, pursuant to Byrd Anti-Lobbving Amendment, 31 U S C § 1352(b)(5) and 49 C.F.R. Part 19, Appendix A_ Section 7 Clause/Lantsuage Byrd Anti -Lobbying Amendment, 31 U.S.C. 1352, as amended by the Lobbying Disclosure Act of 1995, P.L. 104- 65 [to be codified at 2 U.S.C. § 1601, et seq.] - Contractors who apply or bid for an award of $100.000 or more shall file the certification required by 49 CFR part 20, "New Restrictions on Lobbying." Each tier certifies to the tier above that it wrill not and has not used Federal appropriated funds to pay any person or organization for influencing or attempting to influence an officer or employee of any agency, a member of Congress. officer or employee of Congress. or an employee of a member of Congress in connection with obtaining any Federal contract_ grant or any other award covered by 31 U S.0 1352 Each tier shall also disclose the name of any registrant under the Lobbying Disclosure Act of 1995 who has made lobbying contacts on its behalf with non -Federal funds with respect to that Federal contract,grant or award covered by 31 U S.0 1352. Such disclosures are forwarded from tier to tier up to the recipient. APPENDIX A. 49 CFR PART 20 --CERTIFICATION REGARDING LOBBYING Certification for Contracts, Grants, Loans. and Cooperative Agreements (To be submitted with each bid or offer exceeding 5'100, 000) The undersigned [Contractor] certifies, to the best of his or her knowledge and belief. that. (1) No Federal appropriated funds have been paid or will be paid. by or on behalf of the undersigned. to any person for influencing or attempting to influence an officer or employee of an agency. a Member of Congress. an officer or employee of Congress, or an employee of a Member of Congress in connection with the awardmg of any Federal contract the making of any Federal grant, the making of any Federal loan. the entering into of any cooperative agreement, and the extension, continuation. renewal, amendment, or modification of any Federal contract, grant loan, or cooperative agreement. (2) If any fiends other than Federal appropriated funds have been paid or will be pard to any person for making lobbying contacts to an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract. grant_ loan, or cooperative agreement, the undersigned shall complete and submit Standard Form --LLL. "Disclosure Form to Report Lobbying." in accordance with its instructions [as amended by "Government wide Guidance for New Restrictions on Lobbying," 61 Fed. Reg. 1413 (1/19/96) Note Language in paragraph (2) herein has been modified in accordance with Section 10 of the Lobbying Disclosure Act of 1995 (P.L. 104-65. to be codified at 2 U S C 1601, et sect )] of ATTACHMENT J Firm Name: p-sS �4 Z Tke5nSi� � l,�.ftL.Contact: -, t.t,ss S E EKI Address: n i �, }� . 111`x- Phone Number: o`Z - Z z 9 City: {fi t f State: Zip: ® D Type of Service Provided: Are you a certified DBE or WMBE?: YES— number? NO. If yes, what is your certification Contractor's Entirei' 1 1► need additional space,photo f J i section d attach it to this form. Occupation Total Employed Total Minorities Black Asian Native American Hispanic Apprentice Trainee M F M F M F MF M F M F M F Officers Foremen i Clerical 3 L4 7 3 I Totals: i & Goals for minorities and women employees in the contractor's and subcontractor's workforce are 10% combined. Contractors and subcontractors do not have to fire or lay off employees to meet these goals, however, if new employees are hired, it shall be an obligation to make a good faith effort to hire qualified minorities and women. CERTIFIED PUBLIC To the Board of Directors Access Paratransit, Inc. 716 East Wright Tacoma, WA 98404 ACCOUNTANTS 5800 Soundview Drive #E104 Gig Harbor, WA 98335 253-851-1794 253-474-9438 Fax -253-851-3997 Email- doug@gigharborcpa.com We have compiled the accompanying Balance Sheets of Access Paratransit, Inc. (a corporation) as of December 31, 2000 and 1999, and the related Income Statements and Statements of Cash Flows for the years then ended, in accordance with Statements on Standards for Accounting and Review Services issued by the American Institute of Certified Public Accountants. A compilation is limited to presenting, in the form of financial statements, information that is the representation of the management. We have not audited or reviewed the accompanying financial statements and, accordingly, do not express an opinion or any other form of assurance on them. Management has elected to omit substantially all of the disclosures and the Statement of Retained Earnings required by generally accepted accounting principles. If the omitted financial statement and disclosures were included in the financial statements, they might influence the user's conclusions about the owner's financial position, results of operations, and changes in cash flows. Accordingly, these financial statements are not designed for those who are not informed about such matters. The Company, with the consent of its shareholders, has elected under the Internal Revenue Code to be an S -Corporation. In lieu of corporation income taxes, shareholders of an S -Corporation are taxed on their proportionate share of the Company's taxable income. Therefore, no provision or liability for Federal income taxes has been included in these financial statements. Sincerely, R. D s Collier Ce fie ublic Accountant Oct r 26, 2001 Access Paratransat, Inc. Balance Sheets December- 31, 2000 and 1999 LIABILITIES & EQUITY 2000 1999 ASSETS Current Assets $ 26,968 $ 42,161 Cash in Bank $ 6,124 $ 5,899 Receivables 64,826 51,814 Total Current Assets 70,950 57,713 Fixed Assets 27,824 60 Vehicles & Equipment 45,661 20,575 Less Depreciation (40,861) (20,575) Total Fixed Assets 4,800 - TOTAL ASSETS $ 75,750 $ 57,713 LIABILITIES & EQUITY Current Liabilities Accounts Payable $ 26,968 $ 42,161 Taxes Payable 8,728 8,586 Total Current Liabilities 35,696 50,747 Long Term Liabilities Line of Credit 27,824 60 Loan from Shareholder 55,909 80,644 Total Long Term Liabilities 83,733 80,704 Equity Capital 3,439 3,439 Retained Earnings (77,178) (103,162) Current Net Income 30,060 25,985 Total Equity (43,679) (73,738) TOTAL LIABILITIES & EQUITY $ 75,750 $ 57,713 Page -2- See Accountant's Compilation Report Access Paratransit, Inc. Income Statements For the Years Ended December 31, 2000 and 1999 INCOME D.A.R. Revenues Shuttle & Private Pay Miscellaneous Income TOTAL INCOME EXPENSE Advertising Bank Charges Contract Labor Depreciation Expense Employee Benefits Equipment Leases Insurance Interest Expense License & Fees Maintenance -General Meals Miscellaneous Office Expense Penalties Postage Professional Fees Rent Expense Salaries & Wages Supplies Taxes -Business Taxes -Payroll Telephone Travel Utilities Vehicle Fuel Vehicle Maintenance TOTALEXPENSE E-5 2000 600,129 61,188 13,443 674,760 1,295 717 885 20,286 8,469 4,408 21,894 4,590 3,374 5,900 92 5,311 7,822 3,543 1,095 8,732 19,160 315,168 1,666 4,246 53,094 9,365 229 5,074 54,618 83,665 $ 645,223 21,646 5.878 672,747 1,401 769 3,014 2,271 10,934 12,881 15,350 13,514 3,817 1,997 120 3,403 8,672 8,711 1,558 8,850 17,629 344,529 1,828 4.332 45,624 10,453 815 5,898 44,016 74,377 646,762 NET INCOME $ 30,061 $ 25,985 Page -3- See Accountant's Compilation Report Access Paratransit, Inc. Statements of Cash Flows For the Years Ended December 31, 2000 and 1999 Cash Flows from Operating Activities Net Income Adjustments to reconcile net income to cash from operating activities: Depreciation Changes in assets and liabilities Decrease/(Increase) in Accounts Receivable (Decrease)/Increase in Accrued Liabilities Net Cash from Operating Activities Cash Flows From Investing Activities Investment in Equipment Net Cash used by Investing Activities Cash Flows from Financing Activities Increase to Line of Credit Repayment of Shareholder Loan Net Cash used by Financing Activities Net increase/ (Decrease) in Cash Cash, Beginning of Year Cash, End of Year Page -4- See Accountant's Compilation Report 2000 1999 $ 30,060 $ 25,985 20,286 2,271 (13,012) 4,940 (15,052) (1,820) 22,282 31,376 (25,086) (160) (25,086) (160) 27,764 60 (24,735) (22,770) 3,029 (22,710) 225 $ 8,506 5,899 (2.607) $ 6,124 $ 5,899 10/22/01 14:20 FAX 208 852 7572 HELL ANVhXNUn Washington Mutual OCTOBER 22, 2001 TO WHOM IT MAY CONCERN: STEVE R JONES, PRESIDENT OF ACCESS PARATRANSIT, INC. HAS NO BUSINESS RELATIONSHIPS WITH WASHINGTON MUTUAL, BUT HAS BEEN A CUSTOMER OF OUR BANK SINCE 1993 STEVE JONES HAS SEVERAL PERSONAL ACCOUNTS WITH US AND SEVERAL LINES OF CREDIT WHICH EXCEED $150,000. THE AVAILABLE BALANCE ON THE LINES OF CREDITS AS OF TODAY'S DATE IS $80,000. IF YOU NEED ANY FURTHER INFORMATION, PLEASE FEEL FREE TO CONTACT MYSELF, OR THE BRANCH MANAGER, RICK RIEBLI AT (253) 852-5000 SINCERELY, REBECCA NAHAKU ASSISTANT MANAGER KENT FINANCIAL CENTER Kent Financial Center 512 W Smith St, Kent, WA 98032-4468 phone 253.852.5000 fax 253 859 1965 W -- INSURANCE CERTIFICATE 10/26/01 15.10 FAX 206 852 7572 BELL ANDERSON Lt%Bell-Anderson oGrae 1989 Insurance October 25, 2001 ACCESS PARATRANSIT 6I2 N. 16TH AVE. YAKIMA, WASHINGTON 98902 Re: Insurance Renewal Dear Ms. Colby, I wanted to commit to writing our understanding about your renewing insurance coverage's for your business operations at Access Paratransit. As I indicated to you on the phone, we will be able to provide you with auto liability, -_ general liability and excess liability as follows: Auto Liability: 1,000,000 Combined Single Limits Underinsured Motorist: 1,000,000 Combined Single Limits Physical Damage: Per schedule General Liability: 1,000,000 Combined Single Limits Excess Liability: 3,000,000 Combined Single Limits These coverage's can be placed with admitted, A-7, or better markets. These coverage's have been quoted and available for binding at this time, upon receipt of your written request. Hopefully, this answers questions about the availability of coverage's for your operation. Sincerely. /00 Molly Mor ,CSR 10001 BELL -ANDERSON AGENCY, INC. 724 WEST SMITH STREET. P.O. BOX 887. KENT, WA 98035.0887 / (253) 952-1680 / SEA. (208) 682-7402 / FAX (253) 859-2051 330 -112TH AVE. N.E., SURE $301, P.D. BOX 40509. BELLEVUE, WA 98015-4509i(425) 482.7x43 OR SEA. (206)222-"a7/ FAX (425) 453-0763 402 - 16TH ST. N.E., SUITE *101 AUBURN. WA 98002 / (253) 633-1550 - 136 W. 2na, PO. BOX 1411, NORTH BEND, WA 980451(425)988-0827 415 E. MT VIEW AVE. SUITE B, ELLENSBURG, WA 98926 / (509) 962-9825 - PO. BOX 1116. EASTBOUND. WA 98245 / (380) 376-2157 2993 GRIFFIN AVENUE, ENUMCLAW, WA 98022 / (360) 825-6567 - 5319 S.W WESTGATE DR.. SUITE 8272. PORTLAND, OR 97221-2411 / (503) 292-1687 ,9 COMMERCIAL AVE., SUITE D, ANACOF(TES, WA 96221-41301(360) 299.2087 - 707 PACIFIC AVENUE. P.O. BOX 419, BREMERTON, WA 98337 / (380) 377-8547 17921 BOTHELL-EVERETT HWY SUITE 107 BOTHELL. WA 98012 / (425) 488.0451 - 4001 SUMMITVIEW AVE.. SUITE 2H. YAKIMA WA 98908 / (509) 972.8259 113.2NO STREET, SUITE 5, WENATCHEE, WA 98801 / (509) 885.5994 www.ball-arodorwn.com CERTIFICATE OF LIABILITY INSURANCE 11/05/9 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Bell -Anderson Insurance, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE OR P. 0. BOX 887 ALTER�THE COVERAGE�AFFORDGED BY THE POLICIES NOT AMEND. OW 724 West Smith St. i 'ent, WA 98035-0887 INSURERS AFFORDINGCOAIERAGE .NSURED INSURERA:American Casualty Co. Access Paratransit Inc INSURER B: 612 N 16th Ave INsuRER C: Yakima, WA 98902 1 NSUREA D: EXHIBIT "A" PGS 1-2 INSURER e .AGES THE POLICES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERGA OR CONDMON OF ANY CONTRACT OR CTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICES DESCRKNM HEREIN IS SUBJECT TO ALL THE TUMS, EXCLUSIONS AND CONDMONS OF SUCH PCUC:IES. AGGREGATE LAURTS SHOWN MAY HAVE BEEN REDUCED BY PMD CLAIMS. LTR TYPEOF!NSURANCE I POLI&NUMSER PEFFECT POLICY EXPIRATION: MDQNSR! OATYDAEIMM DDM I LIMITS A �F GENERAL LIABILITY IER3110723 15 11/06/00 ;11/06/01 i EAC` OCCURR ENCE iS1,000,000 •COMMERCIAL GENERALLIABILTY i II I FIR E DAMAGE ;Any one tire) s50, 000 rSrj• I�-j CLAIMS MADE X � OCCUR UR; I ; MEDEXP,Anyoneoerson; 000 - j � - - ! PERSONABADY'N-URY Sl, 000, 000 GENERA,AGGREGA-E '52,000,000 GEN'LAGGREGATEL!MIT APPL!ESPER: (PRODUC'S-COMPfOPAGG' s2,000,000 r 1 -0 L:CY 77 Pc�- ! !LOC I 1 A I AUTOMOSiLEL;ABIL;TY iER3110723 111/06/00 ,11/06/01 COMB^DSINGLELtW7 S1,000,000 ANY AUTO 1 ! j A!-OWNEDAI:TOS I I BOD'LY'V.:UQY S X S0.H EDULEDAUTOS i ,Per go -son; I HIRED AUTOS I �-' B07'_Y'X.,;;RY :S j ;Pe-acc:deal; NON -OWNED A; `OS i PROPER -Y OA MAGE I S ! GARAGE LABILITY i I ! Ai<-OONLY- EA ACC!.DENT' S ANY AU -0 i j 0'1ER-HAN EA ACC S • AU OONLY AGG S EXCESS UABIL;TY i EACr OCCURRENCE I S I" OCCUR i LAI MS MADE% !AGG?EGA'E I S DEDI CTIBLE I S I I RE ENTION S ! I ! S TORY'o; j WORKERS COMPENSATION AND :R ! !TORY i .R �M�vlTS ; EMPLOYERS' LABILITY ! E_ EACF AC IDEN- ;S I I I ! E_.OISEASE EAEMP_OYEEi 5 ! ( . DISEASE-POL.CY_IM:T,S A OTHER um ER3110723 11/06/00 I 111/06/01 !$1,000,000 ! DESCRIPTION OFOPERAT!ONS/LOCAT!ONS(YEHICLES(EXCLUSIONS ADDED BYENDORSEMENT/SPEC'AL PROY!S'ONS The City, its Officers, Agents and Employees are named as additional insured as to work performed by the Named Insured. TE HOLD City of Yakima attn: 129 N 2nd St Yakima, WA 98901 SHOULDANYOFTHEABOVEDESCRBED POCC;ESBECANCELLEDBEFORETHEEXP'RATON tlm jenson OATETHEREOF. THE ISSUING iNSURERW'LLENDEAVOR TOMkL3-D___DAYS WRITTEN NOTICETOTHE CERTIF°GATE HOLDER NAMED 70 THE LEFT, BUTF&LURE TO DOSOSHALL IMPOSE NOOBUGATONOR L,ABtLTYOF ANY NO UPON THE'NSURER.JSAGENTS OR R EPR ES ENTAIM ES AUTHORIZED REPRESENTAT'YE ACORD25-S(7,97)1 of 2 #2379 KKH o ACORD CORPORATION 19M awu.�ne� ACORD, CERTIFICATE OF LIABILITY INSURANCE zoii9� 0 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Bell -Anderson Insurance, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P . O . BOX 887 HOLDER. THIS CERTIFICATE DOES NOT AMEND, SIMM OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 724 West Smith St. Kent, WA 98035-0887 WSURERSAFFORDING COVERAGE INSURED lNSL;RFRA:American Casualty Co Access Paratransit Inc :NSURERB: 612 N 16th Ave I'NSUREAC: Yakima, WA 98902 I INSURER D: j INSURER E-- THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REAUIRE3ME7dT, TERMI OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HERM IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LhWTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAXS. INSR; POLICYEFFECTIVE !POLICYIXPIRAT:ON LTR TYPEOF'NSURANCE POLI&NUMBER IDATEIMMIDDftn, DATE MM DD OMITS EAC=0CC:.'RRFN0E I S iiGENERALLIABILITY I i j iF:RE 7AMAGE,Any rneCreJ S jC0MMERC;ALGEN9QALLIA81Li1`Y� CLAIMS MAOI 7 I i 1 J OCCUR! i MED=XR;Any one oe•son; S PE?SONA_SAOV 1. jF;Y S 'u^tiERA, AG =3A-= S !GEN'LAGGREGATEL MiTAPP! iESPER: j PROD -,; -_-S -COMP(OP AGG b ?Ji'CY r� 'O- LOC A �AOMDBILELABILITY 'ER3110723 111/06/00 11/06/01 COYBN=DS:NG_E_M- $1,00 000 r-UTANYAU'O ,Ea rcc: dem; _ AL_OWNEDAU'OS S ;X SC. EDU,EDA_, DS ;Percers •-1REDAU-OS j : BOD:_Y N—py b (.Peracc.dem . NON-OWNEDAUTOS PROPER YDAMAGE S (Peracc:dem; GARAGE LIABILITY AG -O ONLY -=A ACC.DEN' S ANY AU'OI iO-i cq _„AN EA ACC S i i AUTO ON Y AGG ' $ CESS LiABi L'TYI EA C"OCC::RRENCS S OCCUR i CLAIMS MADE: AGGREGA = S - - r•� DEDUCIS!E ' S RE EN -ION S s OER WORKERS COMPENSATION AND I I O"Y_MVS EMPLOYERS' LiABILTY . EAC^ ACCJENT : $ j I DiS=ASC EA EMPLOYE -j S DiS=aSc-�OL CY _ Mi_ S A OTHER UM i IER3110723 I 111/06/00'11/06/01': 1,000,000 DESCR'PTON OF OPERA T.ONS/LOCATIONS/VEHICLES/ECCLUS IONS ADDED BY ENDORSEMENT/SPEC AL PROWS;ONS CERTIFICATE HOLDE WTUTC PO BOX 47250 OLYMPIA WA 98504 7250 ACORD 25-S (7/97) 1 of 2 #7276 GANGtLLA I ILM SHOULDANYOFTHEABOVE DESCRBED POLC:ES8ECAN CELLEDBEFORE THEEXP'RATON DATETHEREOF, THE SSUING'NSURER W'LL ENDEAVOR TO MA:L3.0_ DAYS WRITTEN NOTCETOTHE CERT:FCATE HOLDER NAMED TO THE LEFT, BUTFA.LURE TO DOSOSHALL IMPOSENOOBL.GAT'ON OR L,ABtL,TYOFANYK NO UPON THE:NSURER,.TSAGENTS OR R EPR ES ENTATi V ES hGna Eon Iile. KKH 0 ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the poiicy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does a affirmatively or negatively amend, e>aend or after the coverage afforded by the policies listed thereon. ACORD25-S(7;57)2 of 2 #2379 AUG 17 2001 9:55 AM FR INSURANCE PROFESIONRL91 2690 TU tit --LL HNVtX2DUN r.ec�e4 EXHIBIT "B" PGS 1-16 TI M INSURANCE PROFESSIONALS, INC. o8/I7/01 To: Bell -Anderson Agency Re: Access Paratransit Inc. Policy Effective Date: 11/6/00 Policy Expiration Date: 11/6/01 Policy 226758162 (GL)/r226758176 (Prop) Company: American Casualty Co.of Reading, PA For current loss runs on the above mentioned account, please be advised that no losses were found on this risk as of 7/26/01. This is not to be construed as an absolute statement of no claims, only that no loss history has been located at this time. Sincerely, �ae- L From: Fran Watkins, CISR Assistant Underwriter 8140 NORTH HAVOEN ROAD BUILDING Hi 10 SCOTTSDALE, AZ 85258.2468 PH (460) 991 3600 FX (480) 9910990 WWW.THEINSPROS.COM Ju(v 2g ^ , 20PMurdock Claim Man, ent Corp. (CT) 5:58 PM Loss Run by Party,, . ieserve Type Financials As Of July 26, 2001 Paid This Period With Recovery Using - July 2001 GROUP 8Y: ller2 company name, policy_number, primary holder name REPORT RESTRICTIONS: BRANCH: M 1, CLIENT, CNA E S, AS OF DATE: 0712012001 FILTER: Iisr2_company_name = CNA ES (TIP Commercial Auto Program) and policy_number = 226750159 and primaryholder name = Access Paratransil Inc iF iter; CNA E&S (TIP Commercial Auto Program) 226758159 Access Paratransil Inc 1102 Fh CJgL Numbor 29"(L -Oft Tier Claim Number Contac) Name Party Name P.�( Soc Sec Number Loss Cauaalion Tvae of Iniury Typ Party Status Body Part 11pe of Sickness M i-CNAEO-0072800 Dec -21-200012:00 AM EO -72800 Steven J. Ford Duane Cherry IV turned Into by OV Claimant Closed Reserve Tvae Paid In Period Paid to Dale Recovery to Dale Outstanding Incurred ALAE Expense $0.00 $70.00 $0.00 $0.00 $70.00 Property Damage $0.00 $4,019.40 $0.00 $0.00 $4.01940 Duane Cherry Totals: $0.00 $4,089.40 $0.00 $0.00 $4,009.40 M 1-CNAEO-0072800 Dec -21-200012:00 AM EO -72000 Aooess Paratran Access Paratran,. IV turned into by OV Steven J. Ford Insured Closed Reserve Type Pa)d in Period Paid to Date Recovery to Date Outs4anding Incurred ALAE Expense $0.00 $70.00 $0.00 $0.00 $70.00 Collision $0.00 $0.00 $0.00 $0.00 $000 Access Paralran Access Paralranslt, Totals: $0.00 $70.00 $0.00 $0.00 $70.00 M 1-CNAEO-0072800 Totals: $0.00 $4,159.40 $0.00 $0.00 $4,159.40 M 1-CNAEO.0074577 May -0-2001 12:00 AM EO -74577 Steven J. Ford Lynne Kliseimer Other - All other codes Strain Claimant Closed Cervical Vertabrae Reserve Tvae Paid in Period Paid to Dale Recovery to Date Oulstanding rd I Curr gr Injury $0.00 $0.00 $0.00 w1 nn $000 Property Damage $0.00 $0.00 $0.00 $0.00 $0.00 Lynne Ktiselmer Totals: $000 $0.00 $0.00 $0.00 $0.00 M 1-CNAEO-0074577 May -4-2001 12:00 AM EO -74577 Elizabeth Anson Other - All other vodes Steven J. Ford Claimant Closed Reserve Type Paid In Period Paid to Dale Recovery to Date Outstanding In t rred Property Damage $0.00 $0.00 $0,00 $0 00 $0.00 Elizabeth Anson Totals: $0.00 $0.00 $0.00 $0,00 $0.00 M :-CNAEO-0074577 May -42001 12:00 AM EO -74577 Marilyn Matthew Other - All other oodes Steven J. Ford Claimant Closed Reserve Type pald in Period Paid to Date Recovery to Date Outstanding ln&ljtre4 Property Damage $0.00 $0.00 $0.00 $0.00 $0.00 Marilyn Matthew Totals: $0.00 $0.00 $0.00 $0.00 $0.00 Jvlr 20, 200' Murdock Claim Marra ml Corp. (CT) S:Sd PM Loss Run by Party b„ -eserve Type Financials As Of July 26, 2001 Paid This Period With Recovery Using - July 2001 GROUP BY: tier2_company_nama, pollcy_number, primary_holder name REPORT RESTRICTIONS: BRANCH: M 1, CLIENT: CNA E _S, A8 OF DATE: 0712612001 FILTER: Iler2_company_name = CNA ES (TIP Commercial Auto Program) and policy_number = 226750159 and primary_holder name = Access Paralransit Inc E -or CNA E&S (TIP Commercial Auto Program) 226758159 Access Paratransit Inc 2of2 Ph Claim Number bate of Loss Tier Claim Number Contact Name Party Name Soc Sec Number Loss Causation Tvpe of Iniury Pa Type Party Status Bod Pa _fC� Type of Sickness M 1-CNAEO-0074577 May -4-2001 12:00 AM EO -74577 Slephanie M. Christensen Other - All other codes Strain Steven J. Ford Claimant Closed Cervical Verlabrae Reserve Type Paid in Period Paid to Date Recovery to Date Ouistandlna Incurred Bodily Injury $0.00 $0.00 $0.00 80.00 $0.00 Stephanie M. Christensen Totals: $0.00 $0.00 $0.00 $0.00 $0.00 M 1-CNAEO.0074577 May -4-2001 12:00 AM EO -74577 Steven J. Ford Doris B. Gray Other - All other oodes Strain Claimant Closed Cervical Vertabrae Reserve TyDe Paid In Period Paid to Date Recovery to Dale t)u41a,..Qdlna Incurred Bodily Injury $0.00 $0.00 $0.00 $0.00 $0.00 Doris B. Gray Totals: $0.00 $000 $DAO $0.00 $0.00 M 1-CNAE040074577 May -4-2001 12:00 AM EO -74677 Steven J. Ford Access Paratransit Other - All other codes Insured Closed Reserve Type Paid In Period Paid to Date Recovery Io Date Outstanding Incurred Collision $0.00 _ $0.00 $0,00 $0.00 $000 Access Paratransit Totals: $0.00 $0.00 $0.00 $0.00 $0.00 M 1-CNAEO-0074577 Totals: $0.00 $0.00 $0.00 $0.00 $0.00 Access Paratransilt It1C Totais: SOVU $4,159.40 $0.00 $0.00 $4,159.40 226758159 Totals: $000 $4,159.40 $0.00 $0.00 $4,159.40 S (TIP Commercial Auto Pro qram) Totals: $0.00 $4,15940 SO.00 $000 $4,159.40 Grand Totals: $0.00 $4,159.40 $0.00 $0.00 $4,159.40 Policy Loss Evaluatio Insured Name: ACCESS PARATRANSIT o Icy I erm 1,99 Claim # Loss Date: 11/9/97 254 - 39607 Report Date: 11110197 Receipt Date: 11122197 Claimant Status 1 GALLAWAY SAMUEL Closed 2 ACCESS PARATRANSIT Closed 'aim # Loss Date: 2118/98 254 - 42343 Report Date: 2/24/98 Receipt Date: 2/24/98 Claimant Status 1 ACCESS PARATRANSIT IN Closed Claim # Loss Date: 6124198 254 - 45905 Report Date: 6/25/98 Receipt Date: 6126198 Claimant Status 1 DELANEY ELECTRIC Closed 2 ACCESS PARATRANSIT IN Notice Only Policy: E. A1.07-23 Valuation Date: 616101 Policy Term: 1997 Adjuster: 7927 Handling Office: Portland P&G Loss Desc: INSURED ALLEGEDLY STRUCK THE. CLAIMANT'SVEHICLE AFTER PULLING OUT FROM A STOP SIGN Loss Type Date Closed Paid Total Reserves Total Subrogation Incurred Total ALIAS -PD 01/20/1998 $2,033.84 $0.00 $0.00 $2,033.84 AUTOCOLL 12/02/1997 $0.00 $0.00 $0.00 $0.00 Policy Term: 1997 Adjuster: 7503 Handling Office: Portland P&C Loss Desc: INSURED ALLEGEDLY BACKED UP INTO ANOTHEROF TEH INSUREDS VEHICLES Loss Type Date Closed Paid Total Reserves Total Subrogation Incurred Total AUTOCOLL 03103/1998 $744.81 $0.00 $0.00 $744.81 Policy Term: 1997 Adjuster: 307 Handling Office: Portland P&G Loss Desc: CLAIMANT MADE RIGHT TURN & COLLIDEDWITH INSURED VEHICLE HEADING STRAIGHT Loss Type Date Closed Paid Total Reserves Total Subrogation Incurred Total ALIAB-PD 10/14/1999 $0.00 $0.00 $0.00 $0.00 AUTOCOLL Not Appli. $0.00 $0.00 $0.00 $0.00 Claim # Loss Date: 8120198 Policy Term: 1997 Adjuster: 4434 254 - 47575 Report Date: 8/21/98 Handling Office: Portland P&C Receipt Date: 8/21/98 Loss Desc: INSURED'S DRIVER ALLEGEDLY COLLIDED WITHCLAIMANT'S VEHICLE IN INTERSECTION Claimant Status Loss Type Date Closed Paid Total Reserves Total Subrogation Incurred Total 1 AMERIGAS Closed ALIAS -PD 06/18/1999 $5,120.80 $0.00 $0.00 $5,120.80 2 ACCESS PARATRANSIT Closed AUTOCOLL 09/29/1998 $0.00 $0.00 $0.00 $0.00 3 LATOUR DOROTHY Closed ALIAB-BI 12/09/1999 $14,000.00 $0.00 $0.00 $14,000.00 4 FULKERSON BETH Notice Only ALIAB-BI Not Appii. $0.00 $0.00 $0.013 $0.00 WOU $0.00 $19.12[1711u - Printed: August 28, 2001 Page 1 R ,cy Loss Evaluatio Iftured Name: ACCESS PARATRANSIT Policy: E 11-07-23 Valuation ...Ate: 616101 armLoss ate: 10/19/98 PolicyTerm: 1997 Jus er: 4434 254 - 49366 Report Date: 10/21/98 Handling Office: Portland P&C Receipt Date: 10/21/98 Loss Desc: CLAIMANT WAS KNOCKED DOWN AND DRAGGED BY INSUREDS VEHICLE WHEN HER COAT GOT CAUGHT IN THE DOOR Claimant Status 1 FOUNTAINE MARGARET Closed Claim # Loss Date: 8120198 254 - 52915 Report Date: 8121198 Receipt Date: 8121198 Claimant Status 1 ACCESS PARATRANSIT Closed Claim N Loss Date: 11/9/97 254 - 52991 Report Date: 11/10/97 Receipt Date: 11/22/97 Claimant Status 1 ACCESS PARATRANSIT IN Closed Policy erm 1,993 "lalm # Loss Date: 12/4198 254 - 50861 Report Date: 12!7198 Receipt Date: 12/8/98 Claimant 1 EMERICK MATILDA 2 ACCESS PARATRANSIT Claim >IR Loss Date: 254 - 54121 Report Date: Receipt Date: Claimant Status Closed Notice Only Loss Type Dale Closed Paid Total Reserves Total Subrogation Incurred Total ALIAB-BI 10/17/2000 $85,000.00 $0.00 $0.00 $85,000.00 , UUMUu— Policy Term: 1997 Adjuster: 3175 Handling Office: Portland P&G Loss Desc: INSURED'S DRIVER ALLEGEDLY COLLIDED WITHCLAIMANT'S VEHICLE IN INTERSECTION Loss Type Date Closed Paid Total Reserves Total Subrogation Incurred Total AUTOCOLL 04/08/1999 $1,621.20 $0.00 $0.00 $1,621.20 Policy Term: 1997 Adjuster: 7927 Handling Office: Portland P&C Loss Desc: INSURED ALLEGEDLY STRUCK CLAIMANT'SVEHICLE AFTER PULLING OUT FROM A STOP SIGN Loss Type Date Closed Paid Total Reserves Total Subrogation Incurred Total AUTOCOLL 04/16/1999 $2,806.90 $0.00 ($641.38) $2,165.52 5.J 111,327.55 —0.00 ($641.38)- $1110,686.7 Policy Term: 1998 Adjuster: 563 Handling Office: Portland P&G Loss Desc: INSURED AND CLAIMANT BACKED INTO EACH OTHER Loss Type Date Closed Paid Total Reserves Total Subrogation Incurred Total ALIAB-PD 01/27/1999 $0.00 $0.00 $0.00 $0.00 AUTOCOLL Not Appli. $000 $0.00 $0.00 $0.00 5111/99 Policy Term: 1998 Adjuster: 768 5/11/99 Handling Office: Portland P&C 5/11199 Loss Desc: INSURED'S VEHICLE BACKED OUT OF PARKINGSPOT & STRUCK CLAIMANT'S ILLEGALLY PARKED VEHICLE Status Loss Type Date Closed Paid Total Reserves Total Subrogation Incurred Total Printed: Augusl 28, 2001 Page 2 P` xy Loss Evaluatio Insured Name: ACCESS PARATRANSIT Policy: E' 1-07-23 Valuation Date: 616/01 ose 2 ACCESS PARATRANSIT Notice Only AUTOCOLL Not Appli. $0.00 $0.00 $0.00 $0.00 Claim 9 Loss Date: 7118199 254 - 55441 Report Date: 7119199 Receipt Date: 7119/99 Claimant Status 1 CHELLY DEBRA Closed Walm # Loss Date: 7130/99 254 - 55750 Report Date: 814199 Receipt Date: 815/99 Claimant Status 1 UNKNOWN Closed Claim as Loss Date: 10/18/99 254 - 57254 Report Date: 10/22199 Receipt Date: 10/22/99 Clalmant Status 1 ROY DOROTHY Closed 2 LOVESTRAND ASTRID Closed Claim # Loss Date: 10130/99 2�4 - 60594 Report Date: 3000 Receipt Date: 312100 Claimant Status 1 BRUMMETT EVELYN Closed Policy lerm 1,999 Policy Term: 1998 Adjuster: 4433 Handling Office: Portland P&C Loss Desc: STRAP ON WHEEL CHAIR IN INSURED'S VAN CAME LOOSE CAUSING CLAIMANT'S CHAIR SWIVEL INJURING CLAIMANT Loss Type Date Closed Paid Total Reserves Total Subrogation Incurred Total ALIAB-BI 0713011999 $500.00 $0.00 $0.00 $500.00 Policy Term: 1998 Adjuster: 4433 Handling Office: Portland P&C Loss Desc: ENGINE WIRING CAUSED FIRE IN INSURED'S VEHICLE Loss Type Date Closed Paid Total Reserves Total Subrogation Incurred Total AUTOCOMP 08/30/1999 $3,881.32 $0.00 $0.00 $3,881.32 Policy Term: 1998 Adjuster: 3489 Handling Office: Portland P&C Loss Desc: INSURED'S VEHICLE BACKED FROM A PARKINGSPACE INTO RIGHT FRONT FENDER OF CLAIMANT'S PASSING VEHICLE Loss Type Date Closed Paid Total Reserves Total Subrogation Incurred Total ALIAS -PD 11/22/1999 $1,040.64 $0.00 $0.00 $1,040.64 ALIAS -131 03/06/2000 $2,037.43 $0.00 $0.00 $2,037.43 Policy Term: 1998 Adjuster: 72 Handling Office: Portland P&C Loss Desc: CLAIMANT ALLEGES INSUREDS VEHICLE SIDESWIPED HER PARKED VEHICLE Loss Type Date Closed Paid Total Reserves Total Subrogalion Incurred Total ALIAS -PD 05/2412000 $0.00 $0.00 $0.00 $0.00 8,738.38 0.00 0.00 $8,738.3F Printed: Auoust 28, 2001 Pactc 3 P icy Loss Evaluatio .4 Insured Name: ACCESS PARATRANSIT Policy: F 11-07-23 Valuation 'nate: 616101 Claim W Loss ate: 1127100 o icyTerm: 1999 Adjuster: 5318 254 - 60551 Report Date: 1/27/00 Handling Office: Portland P&C Receipt Date: 1127/00 Loss Desc: RAMP LEFT DOWN ON INSUREDS VEHICLE ALLEGEDLY STRUCK CLAIMANTS PARKED VEHICLE Claimant Status 1 JEFFREY AND CINDY HOU Closed Claim 0 Loss Date: 2123/00 254 - 61570 Report Date: 4112100 Receipt Date: 4/12/00 Claimant Status 1 ROBERTS WILLIAM A Closed 2 ROBERTS WILLIAM (BI) Closed Claim # Loss Date: 5/22/00 254 - 62990 Report Date: 6/9100 Receipt Dale: 6/9/00 Claimant Status 1 GARTON DEBRA Open 2 GARTON DEBRA Open Loss Type Date Closed Paid Total Reserves Total Subrogation Incurred Total ALIAS -PD 03/03/2000 $1,832.71 $0.00 $0.00 $1,832.71 Policy Term: 1999 Adjuster: 4513 Handling Offlce: Portland P&C Loss Desc: OTHER PARTY REARENDED INSURED'S VEHICLECAUSING INJURY TO PASSENGER Loss Type Date Closed Paid Total Reserves Total Subrogation Incurred Total ALIAB-BI 05/04/2000 $0.00 $0.00 $0.00 $0.00 AUTO -BI 05/12/2000 $1,094.89 $0.00 $0.00 $1.094.89 31,1394799– Policy Policy Term: 1999 Adjuster: 1817 Handling Office: Portland PRC Loss Desc: INSURED ALLEDGEDLY REARENDED CLAIMANT Loss Type Date Closed Paid Total Reserves Total Subrogation Incurred Total ALIAB-BI Not Appii. $0.00 $1,000.00 $0.00 $1,00000 ALIAB-PD Not Appii. $0.00 $1,000.00 $0.00 $1,000.00 2,927.60 —'$2,000.00 0.00 4,927.60 "'otal forACCESS PARATRANSIT $122,993.53 $2,000.00 ($641.38) $124,352.15 Printed: August 20, 2001 Paue 4 AUG.28.2001 2:23PM Amans Fund& American Business Coverage To: From: Re: Western ASC Center 2M Prospect Pack Drive, suite Zoo Rancho Cordova, CA VA70 FAX: - (800) 594-3659 �Ck- \r\5; 4 - Fax: Date: Pages: NU.Jbb r..1/y 0 (incl. Cover Page) AUG.20.2001 2:26PM _ AUTO CLAIM DETAIL FOR POLICY DATE: 08/28101 860 A 634987 11-06-96 TO 11-06-97 CLOSED CLAIM DTE -DF -LOSS 12-05-96 CAT- DTE-RPTD 12-11-96 ACC LOC- YAKIMA WR ACTION - TURNING CAUSE - OTHER VEHICLE DRIVER - RAMOS, SANDRA AGE- 00 SEX- F M/S- U 91 CHEV CORSICA SM 01 CASTILLO, VICE RPD CLOSED CEDED DED- 0 SX 02 ACCESS PARATRA COL CLOSED CEDED DED- 500 N0.300 P.. 91y 9 MLU ouuulLul GROSS- 399 NET LOSS- 399 CLAIM PO TO DTE- 399 DESC- IU PULLED BUT OF DRIVE, OV SUE RUED TO AVOID. SLID ON ICE INT 0 INSD. DESCRIBED AUTO PD TO DTE LOSS INC RECOVERY ALLOC EXP 0 0 0 0 0 0 0 0 399 399 0 0 0 0 0 0 MESSAGE: HIT ENTER KEY TO RETURN TO CLAIM SUMMARY SCREEN F1=SELECT POLICY F2=RISK LEVEL F3=SUMMARY MORE= NO AUG.28.2001 2:25PM AUTO CLAIM DETAIL FOR POLICY DATE: 08/28/01 860 A 637511 11-06-96 TO 11-06-97 CLOSED CLAIM DTE -OF -LOSS 03-30-97 CAT- DTE-RPTD 04-08-97 RCC LOC- YAKIMA WA ACTION - CAUSE - DRIVER - REGAN, TED AGE- 90 SEX- M M/3- M 83 FORD SX 01 HARRIS, FANNIE CLOSED DED - SX F1140 NO. 300 P.. 8/9 GROSS- 651 NET LOSS- 651 CLAIM PD TO DTE- 651 DESC- INSURED DRIVER STRUCK CLAIMANT PARKED UEHICLEIN PARKING LOT DAMAGING BUMPER OF CLMT VEH. DESCRIBED AUTO PD TO DTE LOSS INC RECOVERY ALLOC EXP APD 651 651 0 0 CEDED 0 0 0 0 0 CEDED MESSAGE: HIT ENTER KEY TO RETURN TO CLAIM SUMMARY SCREEN F1=SELECT POLICY F2=RISK LEVEL F3=SUMMARY MORE= NO HUB . e -b . CfQ101 G • G:)r'1'1 I1V.--- . .1• J ACTION - CAUSE - DRIVER - DANIEL, KERRY AGE- 39 SES{- M M/S- M 91 CHEV CAPRICE SX 01 PONCE, GABRIEL APD CLOSED CEDED DED- 0 SX 02 ACCESS PARATRA COL CLOSED CEDED DED- 0 DESC- INSD VEHICLE ENTERED ROADWAY, AND STRUCK CLAIMANT PASSIM G BY. DESCRIBED ALTO PD TO DTE LOSS INC RECOVERY ALLOC EXP 684 684 0 0 0 0 0 0 593 593 0 0 0 0 0 0 MESSAGE: HIT ENTER KEY TO RETURN TO CLAIM SUMMARY SCREEN F1=SELECT POLICY F2=RISK LEVEL F3=SUMMARY MORE= NO �t Tr�irrsr' . ,i��t�q� ....���ar�d::.,, � �,� • AUTO CLAIM DETAIL FOR POLICY M7G 8066.261 QF 5 42 _ DATE: OS�2$�01 860 A 638401 11-06-96 TO 11-06-97 GROSS- 1,277 CLOSED CLAIM DTE -OF -LOSS 05-02-97 NET LOSS- 1,277 CAT- DTE-RPTD 05-07-97 CLAIM PD TO DTE- 1,277 ACG LOC- YAKIMA UA i ACTION - CAUSE - DRIVER - DANIEL, KERRY AGE- 39 SES{- M M/S- M 91 CHEV CAPRICE SX 01 PONCE, GABRIEL APD CLOSED CEDED DED- 0 SX 02 ACCESS PARATRA COL CLOSED CEDED DED- 0 DESC- INSD VEHICLE ENTERED ROADWAY, AND STRUCK CLAIMANT PASSIM G BY. DESCRIBED ALTO PD TO DTE LOSS INC RECOVERY ALLOC EXP 684 684 0 0 0 0 0 0 593 593 0 0 0 0 0 0 MESSAGE: HIT ENTER KEY TO RETURN TO CLAIM SUMMARY SCREEN F1=SELECT POLICY F2=RISK LEVEL F3=SUMMARY MORE= NO HUG. CLQ .: bwu I e_; GVlrrl ..xjej . w, r un 1 G- uvf tvr va. 860 L 640124 CLOSED CLAIM CAT - ACG LOC- YAKIMA ACTION - CAUSE - AGG TYPE- GENERAL AGG TYPE - GEN ID - 11-06-96 TO 11-06-97 GROSS- 0 DTE -OF -LOSS 06-29-97 NET LOSS- 0 DTE-RPTD 07-23-97 CLAIM PD TO DTE- 0 DT-CLM-MDE - - un DESC- CLAIMANT ALLEGES THAT IVSD EMP LOYEE SCRATCHEDCLMT CAH WITH W GEN AGG RMT - 1,000,000 HEELCHAIR PRD AGG AMT - BRAND - PD TO DTE Ski 01 GETSINGER, JAC UPD 0 CLOSED CEDED 0 SX CEDED LOSS INC RECOVERS' ALLOC EXP El 6 0 0 0 0 MESSAGE: HIT ENTER KEY TO RETURN TO CLAIM SUMMARY SCREEN F1=SELECT POLICE' F2=RISK LEVEE. F3=SUMMARY MORE= NO AUG.28.2001 2:24PM ` ";�^,a,,.;c r � a�,,p�,���,v� � ..�__ �„3. i:..-:•9 t m�n� �•�n" .�''��!� '...... .�'�i.r'L.�y.�':",•,;'�I'�,, _ AUTO CLAIM DETAIL FAR POLICY MZG 80661261 DATE: 08/23/01 N0.300 P..5i9 O )T� 4,F �rlfif 860 A 641092 11-06-96 TO i1-%-97 GROSS- 1,004 CLOSED CLAIM DTE -DF -LOSS 07-29-97 NET LOSS- 1,004 CAT- DTE-RPTD 03-29-97 CLAIM PD TO DTE- 1,004 ACC LOC- YAKIMA WA ACTION - DESC- IVSD BUMPED REAR OF CLMT VEN, CAUSE - DAMAGED CLMT VAN. DRIVER - RAMOS, SANDY AGE- 58 SEX- F M/S- M 91 CHEVROLET CAPRICE DESCRIBED AUTO PCS TO DTE LOSS INC RECOVERY ALLOC EMP SX 81 BATES, JOHN ARD 1,004 1,004 0 0 CLOSED CEDED 0 0 0 0 DED- 0 SX CEDED DED - MESSAGE: HIT ENTER KEY TO RETURN TO CLAIM SUMMARY SCREEN F1=SELECT POLICY F2=RISK LEVEL F3=SUMMARY MORE= NO AUG.20.2001 2:24PM NO. 300 P. 4/y 6) DATE: 08/28/01 REX LOSS HISTORY STATEMENT - CLAIM SUMMARY R938 POLICY MZG 80661261 POLICY PERIOD 11-06-96 TO 11-06-97 CLAIM 0005 OF 0005 CLAIM NUMBER STATUS CLAIMANT DOL GROSS NET LOSS PD TO DATE j SELECT ALL CLAIMS LOCATE CLAIM NUMBER: i 860 A 641092 CLOSED BATES, JOHN 07-29-97 1,004 1,604 1,004 860 l- L 640124 CLOSED GETSINGER, JAC 06-29-97 0 0 Oi 860 A 638401 CLOSED PONCE, GABRIEL 05-02-97 1,277 1,277 1,277 ''- 860 A 637811 CLOSED HARRIS, FANNIE 03-30-97 651 651 651 �- 860 A 634987 CLOSED CASTILLO, MICE 12-05-96 399 399 399 MESSAGE: ALL CLAIMS DISPLAYED - MAKE SELECTION OR ENTER TO RE -DISPLAY CLAIMS F1=SELECT POLICY FZ=RISK LEVEL MORE= NO AUG.28.2001 2:24PM DATE: 08/28/01 N0.300 P..3/9 c/aD REX LOSS HISTORY STATEMENT - RISK LEVEL RX20 M7G 80661261 REQUESTED POLICY NUMBER '3 MM 80661261 POLICY PERIOD 11-06-96 TO 11-06-97 INSURED ACCESS PARATRAN PRODUCER BELL ANDERSON AGENCY, INC. 46490156 KENT WA 980350887 OPEN CLAIMS 0 TOTAL INCURRED 3,331 CLOSED CLAIMS 5 PAID TO DATE 3,331 TOTAL NUMBER OF CLAIMS 0095 GROSS 3,331 i, �.� NO PRIOR POLICY PERIOD INSURED PRODUCER - - TO - - OPEN CLAIMS 0 TOTAL INCURRED 0 CLOSED CLAIMS 0 PAID TO DATE 0 TOTAL NUMBER OF CLAIMS BOO@ GROSS 0 MESSAGE: PLEASE SELECT POLICY PERIOD TO VIED THE CLAIM SUMMARY SCREEN F1=SELECT POLICY F2=RISK INDEX AUG.29.2001 2:23PM DATE: 08-28-01 Was REX LOSS HISTORY STATEMENT - RISK INDEX R960 MZG 80661261 REQUESTED POLICY NUMBER INSURED ACCESS PARATRAN POLICY LINKAGE M7G 80661261 POLICY PERIOD 11-06-96 TO 11-06-97 RHS/LSE STANDING ORDER INFO RHS STD ORDER N RHS STD ORDER FREQ LSE STD ORDER N LSE YRS OF DETAIL LSE NO OF COPIES LSE STD ORDER FRED LSE REQUESTED LOB REOUESTOR MESSAGE: F1=SELECT POLICY F2=RISK REUEL MORE= NO MAINTENANCE SUPERVISOR MARK WALLACE ACCESS PARATRANSIT, INC. MANAGEMENT STRUCTURE TASK RESPONSIBILITY PRESIDENT STEVE JONES CEO RUSS KEEN MANAGER KIM COLBY EMPLOYEE DEVELOPMENT WETYlTRAINING RESERVATIOWOFFICE ACCOUNTING DISPATCHERS SHARON BUCKLEY KIM COLBY CUNT VAN HORN OINl,1GR KRIE8EL I I JAMIE COLEY MANAGEMENT STRUCTURE: Possessing the skills and philosophy is only achieving a small part of success. API has built a management team that can respond quickly to growing service demands, and respond quickly to issues that require resolution. The management structure has provided better focus on tasks, responsibilities, and accountability by identifying key managers withe the responsibility of oversight and compliance with targeted production goals. The experience of the management structure is comprised of years of transportation experience including vehicle maintenance, safety and training, operations, administration, and dispatching. Collectively, this management group brings forth a positive and professional approach to providing quality service, responding to customer needs, and resolving issues. The management structure involves a "team" concept and is supported through regular scheduled meetings designed to monitor progress on individual and group tasks. The management team reviews contract performance and works closely with each department to ensure that plans for service improvement are devised, implemented, and completed. The key components of this structure are: ► President ► Safety and Training , Employee Development (performed by management) ► CEO (Chief Executive Officer) Manager ► Accounting ► Maintenance ► Reservations / Office ► Dispatch ► Drivers The President deals specifically with issues involving the direction of the company. This includes contract relations, business development and complete oversight of all departments and company activities. The President is instrumental in providing support to the departments by acquiring and securing funds in which to create addition resources for service (i.e. vehicles, staffing, equipment, etc.) The CEO has the responsibility of overseeing all aspects of contracts are in compliance. The CEO also delegates certain tasks to key personnel to ensure that operations and accountability is placed. The Manager focuses primarily on issues that involve customer service. This includes the oversight of operations and performing as a liaison between contracting agencies and API. This involves responding to service issues and developing plans for resolution to key service concerns. The Manager works closely with the CEO to resolve issues that deal with driver conduct, safety and operational issues. Also included in the oversight, is dispatch, office, and maintenance operations. Safety/Training and Employee Development has the responsibility of functioning as a safety and training officer thus ensuring that training programs are developed, maintained and revised as training procedures change. The responsibilities also include providing direction and support to the training staff as well as coordinating training. Safety/Training and Employee Development also functions as a "human resources" group with the responsibilities of employee recruitment and development. This involves a wide range of tasks that are relative to hiring, training, termination, and the management of personnel files. The Maintenance Supervisor has the responsibility of ensuring that the fleet is maintained to a high standard of safety, and that vehicles are regularly inspected and serviced. The responsibilities of the Maintenance Supervisor also include parts inventory, providing roadside emergency service, and complete oversight of overall service and procedures, including complete vehicle and engine repairs. The Maintenance Supervisor is instrumental in ensuring that work is performed to factory specifications. The Maintenance Supervisor provides assistance to drivers, and is visible in the field and is responsible for conducting driver safety assessments, investigating vehicle accidents and access issues. The Maintenance Supervisor works closely with the Management Team to assist in process of complaint investigation. Accounting has the complete responsibility of ensuring the timely submittal of invoices, billing, and payroll. Accounting also has the responsibility of reviewing all driver logs and associated trip information to ensure that all billing criteria has been met and recorded. Accounting works with contracting agencies to ensure that invoices are complete and as required and acts as a liaison to communicate and resolve billing issues. The complete oversight of managing financial files, tax information and other "business" expense information is within the realm of Accounting. ACCESS PARATRANSIT EXHIBIT `C' PAGE 1 - 3 CLINT VAN HORN JAMIE COLBY POSITION: DISPATCHER REPORTS TO: OFFICE MANAGER POSITION PURPOSE: Dispatches on -duty drivers to clients with time or will call returns in a timely manner, so clients can reach their destinations safely and dependably. PRINCIPAL ACCOUNTABILITIES: - Be aware at all times the locations and status of all drivers. - Notify appropriate personnel of any and all mechanical problems that occur during their shift. - Notify appropriate personnel up to and including emergency services if needed. - Relay to drivers all pertinent information regarding a client, i.e., status change, location if other than is shown on the screen. - Notify office staff of any client status changes, whether permanent or temporary, complaints, transport problems. - Research and provide directions to the drivers if needed. - Use proper radio etiquette, including the memorization of all radio codes and their proper use. - Maintain vehicle fluid records, key and fuel card records. - Notify management of any and all accidents, no matter how mirror, JOB DESCRIPTION Page 2 QUALIFICATIONS: Must be twenty-one (2 1) years of age or older. Good working knowledge of multi -line phones, computers and basic office operations. Good cornmunication skills, both written and oral. Require a strong sense of teamwork, and ability to work cooperatively with others. Good working knowledge of city limits and locations of streets and avenues. Must have, within 34 days, a current ADAPTS certificate. Must have a valid Washington State driver's license. Ability to work with the physically and mentally challenged. Good working knowledge of the safe operations of vehicles and the State of Washington Motor vehicles Laws. I I-LgVE READ AND UNDERSTAND THE ABOVE JOB DESCRIPTION. NAME DATE ACCESS PARATRANSIT 612 N. 16' Avenue Yakima, Washington. 98902 (509) 248-1119 IN SERVICE DISPATCHER INSTRUCTION AND EVALUATION DAY I * Introduction to job duties 8 HOURS * Dial -A -Ride rules * Policy and procedures * Radio procedures and hands on training Day 2 DISPATCH (Cont) 8 HOURS * Introduction to Rapid Ride computer dispatch program * Customer service (to include phone mannerisms) * Reservations * Map orientation to include city boundaries * Handling emergency situations Day 3 ADA Passenger Techniques &Safety ( modified) 8 HOURS * Communication Skills * Passenger problems * Passenger assistance techniques * Customer Service (Cont) * Passenger sensitivity DAY 4 CPR & BASIC FIRST AID & Blood borne pathogens 8 HOURS DAY 5 Drug and Alcohol Awareness program & Training 8 HOURS DAY 6-10 ON THE JOB TRAINING (Supervised) 40 HOURS ACCESS PARATRANSIT EXHIBIT `D' PAGE I - 4 SHARON BUCKLEY GINGER KREISEL POSITION: OFFICE STAFF/SCHEDULERS REPORTS TO: PROGRAM DIRECTOR/OPERATIONS MANAGER POSITION PURPOSE: Processes requests for ride reservations and return trips with accuracy, and keeping the client data bases updated. PRINCIPAL ACCOUNTABILITIES: - Using proper telephone etiquette, answer incorning phone lines to process requests for ride reservations and return trips. - Input ride requests into the appropriate computer programs with accuracy. - Update client data bases as changes occur, maintaining a log of such changes. - Maintain logs of Dial -A -Ride tickets signed out and sold. - Insure that an adequate supply of driver and office paperwork / forms is available. - Maintain filing systems as needed. - Maintain appropriate office attire and good clean appearance. - Communicate client and / or facility problems to supervisors. - Responsible for keeping updated of all Access Paratransit, Inc. policies and procedures. - Maintain vehicle condition reports under the direction of the Operations Manager. JOB DESCRIPTION Pa e 2 - Relate to and handle various personalities and possess an awareness of human needs. - Perform other duties as required. QUALIFICATIONS: Must be eighteen (18) years of age or older. Physically able to perform duties listed above. Good working knowledge of phones, computers and basic office operations. Good cormnunication skills, both written and oral. Ability to work with the physically and mentally challenged. Require strong sense of teamwork, and ability to work cooperatively with others. I HAVE READ AND UNTDERSTAND THE ABOVE JOB DESCRIPTION. NAME DATE ACCESS PARATRANSIT 612 N. 16TH Avenue Yakima, Washington. 98902 (509) 248-1119 IN SERVICE RESERVATIONIST INSTRUCTION AND EVALUATION DAY -1 8 HOURS * Introduction to Job duties * Office Procedures * DAR rules * Policy and procedures * Office machine knowledge * Customer Service Skills DAY -2 RESERVATIONS (CONT) 8 HOURS * Phone procedures * Fax procedures verifying and recording * Filing * Communications * Customer Service Skills ( Cont) DAY -3 8 HOURS COMPUTER TRAINING * Introduction to Rapid Ride reservation * Use of inquiry * Introduction to data base * Standing Rides * Hands on experience DAY -4 COMPUTER TRAINING 8 HOURS * Hands on experience DAY -5 8 HOURS ADA Passenger Techniques & Safety DAY- b * Drug and Alcohol Awareness Program Training S HOURS DAY- 7-10 32 HOURS * On the job Training (Supervised) RUSSELL KEEN CHIEF EXECUTIVE OFFICER OPERATIONS MANAGERS ACCESS PARATRANSIT, INC. 612 N 16TH AVENUE YAKIMA, WASH. 98902 PHONE NUMBER: 248-2229 EXHIBIT "E" WORK EXPERIENCE: JANUARY 2000 - PRESENT ACCESS PARATRANSIT, INC. - Yakima, Washington CHIEF EXECUTIVE OFFICER Oversees all aspects of paratransit operations through delegation of certain tasks to key personnel. Insure contract compliance with the City of Yakima and other Agencies. OCTOBER 1996 - JANUARY 2000 GENERAL MANAGER/TRAINOR Duties and responsibilities include, deveoped and maintained personnel files. Provide an evaluation procedure for all employees. Develope policies and procedures. Implemented safty programs, established a training program, for operators and other staff. Instructor Certified in: Basic First Aid, CPR, Defensive Driving, ADAPTS, oversee maintenance department. Provide support in other areas, re: dispatch, reservations, etc. Supervisor Driver/ Driver Operate company vehicles to transport Dial -A -Ride clients in a safe manner. As Supervisor of drivers my duties include driver scheduling , Human Relations, scheduled training, complaint resolution. KIMBERLY COLBY MANAGER/ OPERATIONS COORDINATOR ACCESS PARATRANSIT, INC. 612 N 16TH AVENUE YAKIMA, WA. 98902 PHONE NUMBER - (509) 248-7953 EXHIBIT "F" WORK EXPERIENCE: JANUARY 1997 - JANUARY 1998 ACCESS PARATRANSIT, INC. - 612 N 16 AVE - YAKIMA,WASH. 98902 Reservationist/Sched uler. Primary duty was to answer incoming phone calls from DAR clients that were seeking Specialized Transportation. This position included; confirming the information provided by Yakima Transit ( clients home address, phone number, ride status); reservation data entry; ride verification of date, time and desired destination. Other job duties included filing, inputting data into client data base, setting up and maintaining standing rides, and entering addresses into a Common Address book that was in the Rapid Ride program used for scheduling. JANUARY 1998 - JANUARY 2000 ACCESS PARATRANSIT, INC. Contract Specialist Responsible for program complicance; payroll; and employee file management. Additional tasks included driver and office scheduling. Developed statistical spreadsheets in Lotus and Excel for various data reports required by transportation contracts. JANUARY 2000 - TO PRESENT ACCESS PARATRANSIT, INC. Operations Coordinator This management position includes oversight of all billing and statistical reports and operations required by government entities. Position includes oversight of reservationist, dispatch personnel, drivers and vehicle maintenance staff All communication with clients, staff, and Yakima Transit Dial -A -Ride Coordinator is a vital part of this position. Responsibilities extend to and include operational policies, procedures, and training. SUMMARY I am available during all operating hours. Further, staff and employees are able to reach me 24/7 when circumstances require management imput. I am dedicated to the current Dial -A -Ride contract and am constantly striving to improve policies and procedures along with staying in compliance with applicable contract and government policy changes. This full-time position is dedicated exclusively to the Dial -A -Ride contract. Due to the amount of experience this position has required, I have developed skills that are an asset to this company as a contract provider to theYakima community. CrrY OF YAMMA LICENSE LICENSE # U.B.I. # 8433 6017359 0 FOR: GENERAL BUSINESS LICENSE I S ST UO E D LOCATION: 612 N 16TH AVE The issuance of this license is a tax on your business activity and does not entitle you to conduct business in violation of any other federal, state or local laws applicable to that business operation. CTTY OF YAKIMA LICENSE NAME: FOR: FEE: EXPIRES. NOT TRANSFERABLE # PERSONS 2 EXHIBIT "G" LICENSE FEE 4 .90j VALID FROM: JANUARY 1, 2001 VALID TO: DECEMBER 31, 2001 CITY OF YAKIMA RECEIPT Date: 01/24/01 Issued b Y ; ,C; For: GENERAL BUSINESS LICENSE DBA Name: TRANSMED j Location: 612 N 16TH AVE Amount: `T��.4�� Check _Cash License #: 8433 ACCESS PARATRANSIT, INC. TECHNICAL PLAN QUESTION # 2 DRUG AND ALCOHOL POLICY ACCESS PARATRANSIT, INC. 612 N 16 AVE YAKIMA, WA. 98902 (509) 248-2229 EXHIBIT "H" PGS 1-7 DRUG AND ALCOHOL ABUSE POLICY I. INTRODUCTION: Access Paratransit,Inc. provides vital public services to our community. To ensure that this service is delivered safely, we are dedicated to providing and maintaining a drug and alcohol free working environment. It is the policy of Access Paratransit,Inc., hereafter referred to as API, to do the following: a) Assure that employees and independent contractors have the ability to perform assigned duties in a safe , healthy, and productive manner. b) Create a workplace free from the adverse effects of drug and alcohol abuse or misuse. c) Prohibit the unlawful distribution, possession, or use of controlled substances. API cares about the health and well-being of its employees/ independent contractors. Those who are involved in the use of or the trafficking of drugs on or off the job have an adverse impact on the workplace and impair the company's ability to maintain a safe work environment. We urge anyone who believes that they are having an alcohol or chemical dependency problem to seek treatment before their job performance and employment are endangered. ZERO TOLERANCE DRUG POLICY Employees must not report for duty -perform service -enter company property under the influence of controlled substances. Any employee who test positive for a controlled substance (or its metabolite) in their urine is conclusively presumed to be under the influence of drugs. The use -possession- sale of controlled substances by employees while on company property us strictly prohibited. Employees must not report for duty or perform sevice under the influence or be impaired by prescription drugs -medication -other substances that may in any way adverselv affect their alertness -coordination -reaction -response -or safetv. ZERO TOLERANCE ALCOHOL POLICY Employees must not report for duty -perform service - enter company property with an alcohol content greater than 0.00 and are prohibited from the use -possession - sale of alcoholic beverages while on duty or on company property. Any employee whose off-duty use or abuse of alcohol effects their work will be subject to disciplinary action up to and including termination. A) PURPOSE The purpose of this policy is to assure employee/ independent contractor fitness for duty and to protect our employees/independent contractors, passengers, and the public from risks posed by worker's use of alcohol and drugs. This policy is intended to comply with all the applicable Federal regulations governing workplace alcohol and / or drug misuse in the transit industry. Regulations issued by the U.S. Department of Transportation and the Federal Administration mandate urine drug testing and evidential breath alcohol testing for safety -sensitive positions. This policy sets forth the API alcohol and drug abuse program and the testing and reporting guidelines for safety -sensitive employees/independent contractors as required by those regulations. B) APPLICABILITY This policy applies in general to all transit system employees and/or independent contractors: full-time, part-time, and all other independent contractors when they are performing transit related business off property. Employees/independent contractors who perform safety -sensitive functions for API will be subject to specific alcohol and drug testing as required by federal regulation. A safety - sensitive function is any duty related to the safe operation, dispatch, and maintenance of a revenue service vehicle (in or out of service). A list of safety - sensitive positions is attached. C) PROHIBITED SUBSTANCES Prohibited drugs are any illegal controlled substance including, but not limited to, marijuana, amphetamines, opiates, phencyclidine (PCP), and cocaine as well as any drug not approved for medical use by the USDA or the USFDA. Illegal use includes use or impairment by any illegal drug, misuse of legally prescribed or over the counter drugs, or illegally obtained prescription drugs. The use of any beverage or mixture, including any medication, containing alcohol during or prior to performing a safety -sensitive function is also prohibited. The appropriate use of legally prescribed drugs and non-prescription is not prohibited. However, the use of any substance which carries a warning label indicating that mental functioning, motor skills, or judgement will be adversely affected MUST be reported to supervisory personnel prior to performing safety - sensitive duties. It is the responsibility of employees/independent contractors to remove themselves from service if they are experiencing any adverse effects form medication. Legally prescibed drugs must include documentation of the patient's name, the substance name, the quantity to be taken and the period of authorization. D) PROHIBITED CONDUCT Employees/independent contractors who are using, manufacturing, dispensing, distributing drugs or who are in possession of or impaired by alcohol or drugs when reporting for duty, while on duty, or when on API premises constitute a threat to the health, safety, and security of themselves, their fellow employees/independent contractors, passengers, and other members of the public. Therefore, employees/independent contractors must not report for work or continue working under these circumstances. Such behavior is absolutely prohibited. ALCOHOL USE: No safety -sensitive employee/independent contractor shall report for duty withing four hours of using alcohol, or use alcohol while subject to being on call. A positive alcohol test is defined under this policy as a blood alcohol concentration of 0.00 or greater on an evidentiary breath testing device. E) COMPLIANCE WITH TESTING All potential employees will be required to submit to a pre-employment urine or hair drug screen. All API employees are required to take part in the consortium (random test pool). Any individual who refuses the testing requrement or who tampers with the drug screen will not be considered for hire. Additionally, any potential employee whose drug screen is positive - adulterated - or unsuitable for analysis will not be consider for hire. Any API employee whose drug screen is positive - adulterated - or unsuitable for analysis will be terminated from employment with API immediately. API has arranged with Providence Business Health Services to collect urine or hair specimens for the purpose of performing drug screens. All collections will be nerformed following strict collection, and!testing protocol. All snecimens will be forwarded to a certified toxicology lab. The employee or prospective employee is required to provide photo identification (or managerial verbal identification) and sign the drug screen chain of custody which includes a consent form. Drug screen results will be provided --in strict confidence-- both verbally and in writing to a designated company representative. Negative and negative dilute drug screen results are generally reported the next working day after collection. Positive - adulterated - unsuitable for analysis results are generally reported the second working day after collection. F) CHECK IN AND COLLECTION PROCEDURES * Check in at front counter including signing in on a clip board.. * At this time donor will be asked to present picture ID that will be kept until the collection is completed. * Donor will be asked to have a seat in the waiting room until it is their turn, drug screen collection is done on a "walk-in" basis, with a first come first collected procedure. * Collector verifies donor by picture identification. * Collector explains the basic collection process, including showing the donor the instructions on the back of the Custody and Control form, hereafter refered to as (COC). * Collector will direct the employee to remove any unneccessary outer clothing (coat, jacket, hat, etc.) and to leave carried items ( breifcase, pocketbook, etc.) outside the enclosure. (Secure these items and provide a receipt if requested by donor). Donor will also be asked to empty pockets and display the items to ensure that no items are present which could be used to adulterate the specimen. If okay items may be returned to pockets and proceed to step 4. If material is found that could be used to tamper with the specimen determine if it appears to have been brought with intent to alter, if it is , conduct a directly observed collection. If it was inadvertently brought (eg: eye drops) secure and maintain until after collection complete and continue with step 1. * Collector will complete step 1 of COC (Chain of Custody). * Collector will instruct employee to wash and dry hands. Inform donor they are not permitted to wash again until collection is complete. * Collector provides an individually wrapped/ sealed collection container. With donor present open kit. * Direct donor to take the collection cup and provide a specimen of at least 45m1, not to flush the toilet or run water, and to return the specimen to you as s000n as the donor haq comnleted the -hid With the excention of an nh.gerved collection no one is permitted into the restroom with the donor. * Donor will hand the full container to the collector. (Both the donor and the collector will remain in visual contact with the specimen until labels/seals are placed on containers and initialed.) * Collector checks the specimen, reading temperature within 4 minutes. Mark the appropriate box on the COC. (Step 2) Check the volume, ensuring there is at least 45ml. Check the specimen for unusual color, odor, or other qualities that may indicate an attempt to adulterate the specimen. * Collector checks the appropriate box indicating this is or is not a split specimen. (Step 2) (DOT is always split). * Collector will pour at least 30ml of specimen into a specimen bottle (if a split specimen collection, designate as bottle A). The remainder of the specimen (at least 15ml) will be poured into a second bottle. (Bottle B) If it is a single specimen collection, follow steps for bottle A. * Collector immediately closes containers and places labels/seals over the lids and down the sides. (Step3) * Collector, not donor, writes dates on the labels/seals.(Step3) * Donor initials both labels/seals. * Donor may now wash hands , empty container and flush toilet. * Donor will be instructed to fill out step 5 on copy 2 of the COC. * Collector will complete the collection by filling out step 4 of the COC. It must include the name of the courier service specimen released to as well as the date and time of collection. * Record any remarks concerning collection in the "remarks" section of the COC. (Step 2) * Collector will give donor his/her copy of the COC (copy 5). The donor may now leave the site. * Collector will package bottles with the top copy of the COC for shipment to the appropriate lab. II. TESTING FOR PROHIBITED SUBSTANCES All employees/independent contractors will be subjected to testing prior to employment, for reasonable suspicion, and prior to returning to duty following a failed test or upon completion of substance abuse treatment. Those who perform safety -sensitive functions as defined in the attachment to this policy shall also be subject of testing on a random, unannounced basis and following an accident. A) CONFIDENTIALITY Confidentiality is maintained thoughout the drug/alcohol testing process. All nnsitive - aclulterfited `-.=lin.crnitahle for testing reqults are first forwarded to a contracted Medical Review Officer (MRO) for review. The MRO reviews the individual medical history and affords the employee an opportunity to offer any clarifying information that would explain the positive test. The General Manager will maintain results in the strictest of confidence in a medical file separate from the official personnel file. In cases where disciplinary action results from a positive test, such information is shared only with those in supervisory capacity involved in that action. API will carry out this policy in a manner which respects the dignity and confidentiality of those involved. B) TYPES OF TESTING 1. Pre -Employment Testing : Applicants for all positions shall undergo urine drug testing prior to employment or transfer into a safety- sensitive position. Receipt of a negative drug test is required prior to employment and failure to pass will disqualify an applicant for employment.. 2. Reasonable Suspicion Testing: All emloyees are subject to a fitness for duty evaluation including a drug or alcohol test when there is reason to suspect impairment immediately prior, during, or immediately after performing job duties or while on the property. A referral for testing will be made on the basis of documented objective facts and circumstances. Such referrals will be made by supervisory personnel who are trained to detect the signs and symptoms of drug and alcohol use. 3. Post -Accident Testing: Conducted after accidents on safety -sensitive employees are required by federal regulations if they are involved in an accident involving a API vehicle (in or out of service) that result in: * * * fatality * * * an injury requiring transportation to a medical treatment facility. *** one or more vehicles incurs disabling damage where a vehicle must be towed from the scenenod the employee receives a citation under state or local law for a moving traffic violation. * * * if the employee's performance could have contributed to the accident. Following an accident under the above circumstances, any safety -sensitive employee whose performance could have contributed to the accident, as determined by API using the best information available at the time of the accident, will be given a drug and alcohol test as soon as possible after the accident. Alcohol tests must be nerfnr ned within eipht M hnnr-, after the accident Dnw tectc m» -,t he nerfhntned within 32 hours after the accident. Employees involved in accidents must refrain from alcohol use for (8) eight hours after the accident or until a drug/alcohol test is administered. Employees who leave the scene of an accident without approipriate authorization prior to the testing will be considered to have refused the test and be subject to discipline, up to and including discharge. Any other agency employee whose performance may have contributed to accidents under this section will be tested, for example, maintenance or dispatching employees. Employees who are not safety -sensitive are subjected to being tested following work - related vehicle accidents when drug or alcohol use may be involved. 4. RANDOM TESTING: All API employee positions will be subjected to random, unannounced testing. RETURN TO DUTY TESTING: All employees who previously tested positive on a drug or alcohol test, and who under the discipline policy are allowed to return to work, must test negative prior to being released for duty by a (SAP) Substance Abuse Professional. Such employees will be required to undergo frequent random drug and alcohol testing during the period of the re-entry contract. D) NOTIFICATION OF CRIMINAL OR DRIVING WHILE INTOXICATED CONVICTION: Federal regulation : Drug Free Workplace Act of 1988 require all employees to notify API of any conviction under a criminal drug stature for violation occurring on or off the property within five days of conviction. Failure to report such a conviction, or any moving violation causing the loss of driver's license, by state or local law enforcement involving drugs or alcohol will result in dicipline up to and including discharge. E) RETEST AND OBSERVED TESTS: employees who test positive for drugs may request within 72 hours of notification, a test of the split sample, as all specimens are split and the nontested portion stored for a period of time. There are certain situations that may require the employee to provide, at the collection site, another urine or breath sample (i.e. when insufficient volume or breath provides an inadequate sample or the technician has reason to suspect tampering with the sample). Under the latter circumstances, a second collection may be under observed conditions. IV) DISCIPLINE Vncler FTA regulations discinline for nrogram violations are determiner] at the local - n � level. The API discipline policy for prohibited conduct is as follows, however, individual circumstances involving any positive tests may merit additional actions, including discharge: 1. Any safety -sensitive employee who tests positive for alcohol from a random, reasonable suspicion, or post -accident at a 0.00 alcohol level or higher will be discharged. 2. Any safety -sensitive employee who tests positive for alcohol from a random, reasonable suspicion, or post -accident at a 0.00 - 0.039 level, or who test positive for the presence of illegal drugs from a random testing must successfully complete the following before being allowed to return to work: a. Removal from their safety -sensitive position. b. Referral to and assessment by an SAP. c. Complete a treatment and rehabilitation program as developed by the SAP. d. Suspensions as they may apply consistent with work rules. e. Return to duty random drug and alcohol tests. f. Return to work agreement that is developed in conjunction with the SAP outlining terms of return to work , including ongoimg treatment, aftercare conditions, and additional random testing for up to five years, with a minimum of six tests the first year. g. Any employee who has a second positive test under any testing circumstance within five years will be discharged. 3. Any safety -sensitive employee who tests positive from reasonable suspicion or post -accident testing for the presence of drugs will be subject to discipline, up to and including discharge, in accordance with the existing work rules, and at a minimum as outlined in Paragraph 2 of this Discipline Section. 4. Any employee who tests positive for alcohol at a 0.00-0.19 level will be given a written warning and be provided information about available help. With a second test at this level within 12 months, appropriate discipline will apply. V) EDUCATION AND TRAINING It is the policy of API that training and education programs will be made aysailable to all company employees . Supervisors and managers will receive instruction on how to identify the signs of drug and /or alcohol use or impairment and what to do in such reasonable suspicion cases. The General Manager is responsible for administering the Drug and Alcohol Abuse Policy. Any questions about the policy or testing nrogram may he addressed to the General Manager at 24R-795'1- -7-- T"` ACCESS PARATRANSIT, INC. 612 N. 16 AVE YAKIMA, WA. 98902 (509) 248-2229 EXHIBIT "I" PGS 1-3 DRUG AND ALCOHOL ABUSE POLICY MISSION STATEMENT Access Paratransit,Inc. provides vital public services to our community. To ensure that this service is delivered safely, we are dedicated to providing and maintaining a drug and alcohol free working environment. It is the policy of Access Paratransit,Inc., hereafter referred to as API, to do the following: a) Assure that employees and independent contractors have the ability to perform assigned duties in a safe , healthy, and productive manner. b) Create a workplace free from the adverse effects of drug and alcohol abuse or misuse. c) Prohibit the unlawful distribution, possession, or use of controlled substances. API cares about the health and well-being of its employees/ independent contractors. Those who are involved in the use of or the trafficking of drugs on or off the job have an adverse impact on the workplace and impair the company's ability to maintain a safe work environment. We urge anyone who believes that they are having an alcohol or chemical dependency problem to seek treatment before their job performance and employment are endangered. ZERO TOLERANCE DRUG POLICY Employees must not report for duty -perform service -enter company property under the influence of controlled substances. Any employee who test positive for a controlled substance (or its metabolite) in their urine is conclusively presumed to be under the influence of drugs. The use -possession- sale of controlled substances by employees while on company property us strictly prohibited. Employees must not report for duty or perform sevice under the influence or be impaired by prescription drugs -medication -other substances that may in any way n_, adversely affect their alertness -coordination -reaction -response -or safety. PHOTO ID REQUIRED AT CHECK-IN Urine Specirnen TAMPERING WE Be Reported. f( Urine Specimen TEMPERATURES Are out Of Normal Range, Patient Must Produce Another Specimen. YAKIMA 206 South 11th Ave Suite 48 "- — - (509) 575-5058 TCPPENISK a 502 West 4th Avenue Toppenish Hospital (509) 865-1555 DATE EMPLOYEE SSN EMPLOYEE NAME - COMPANY PHONE AUTHORIZED BY REPORT TO CIRCLE LOCATION WHERE PATIENT SHOULD REPORT Business Health YAKIMA Emergency YAKIMA Business Health TOPPENISH Emergency TOP PEN ISH REPORT FOR DRUG SCREEN CIRCLE ONE NON -DOT DRUG SCREEN Pre -Employment Post -Accident Random Suspicious Cause NON -DOT BREATH ALCOHOL Pre -Employment Post -Accident Random Suspicious Cause URINE HAIR EXPRESS DOT DRUG SCREEN Pre -Employment Post -Accident Random Suspicious Cause DOT BREATH ALCOHOL Pre -Employment Post -Accident Suspicious Cause ON-THE-JOB INJURY TREATMENT SEND CLAIM FORM IF POSSIBLE Is Light/Modified Duty Available? YES NO Self -Insured Claim # Wash L/I Claim # PHYSICAL EXAM CIRCLE SERVICE DESIRED NON -DOT PHYSICAL Pre -Employment DOT PHYSICAL Pre -Employment Annual i Observed Behavior Reasonable Cause Recording Form Driver's name: Date of observation Month Time of observation: Day From: a.m. P.M. To: a.m. p.m. Observed personal behavior: (Check all appropriate items) 1. Speech [ j Normal [ j Slurred 2. Balance [ ] Normal [ ] Incoherent [ ] Whispering [ ] Swaying [ ] Confused [ ] Silent [ j Staggering Year [ ] Falling 3. Walking and Turning [ ] Normal [ ] Stumbling [ ] Swaying [ ] Falling [ ] Arms raised for balance [ ] Reaching for support 4. Awareness [ ] Normal [ ] Confused [ j Sleepy or stupor [ j Paranoid [ ] Lack of coordination 5. Other observed actions or behaviors: Above behavior witnessed by: Signed: Date: TRIS FORM MUST BE PREPARED EVERY TEWE A PERSON IS SUSPECTED OF DRUG USE BY ACTIONS, APPEARANCE, OR CONDUCT WHILE ON DUTY. ft nni 8, . ACCESS PARATRANSIT, INC. TECHNICAL PLAN QUESTION # 3 AND # 4 DRIVER TRAINING AND SAFETY PROGRAMS ACCESS PARATRANSIT, INC. " PROVIDING PEOPLE ACCESS TO THEIR COMMUNITY" EXHIBIT "J" PGS 1-12 EMPLOYMENT APPLICATION PACKAGE Thank you for obtaining an application for employment for a position with Access Paratransit, Inc. Access Paratransit, Inc. (API), is a specialized transportation company that provides specialized transportation services, under contract, for persons with special needs. API has been providing such services for more than five (5) years. All work is contracted, and therefore, API operates under the guidelines of successful contract acquisitions. API provides "Demand Response" service to passengers while under contract. Our service involves either "one on one" or "grouped" ride scenarios. All transportation is coordinated through our dispatch center and as assigned with contracting agencies. API provides services to persons who are elderly, physically or mentally challenged. Services are provided to persons who use an array of mobility devices (walkers, wheelchairs, scooter, etc.), and to persons who may be visually impaired or who have "non-visible" conditions. Therefore, all API employees are required to recognize sensitivity issues and to treat all passengers with respect. API is seeking potential employees who are willing to be professional, who have a desire to work with an array of people, and are willing to be a team player. All applications are reviewed carefully, and each applicant is welcomed. However, prior to completing this application packet, please carefully review the job description as well as requirements of the position you are applying for. Thank you for your interest in employment opportunities with Access Paratransit, Inc. ACCESS PARATRANSIT, INC. IS A "DRUG FREE" WORK PLACE ACCESS PARATRANSIT, INC. "Providing People Access to their Community" APPLICATION FOR EMPLOYMENT Name: Last First Address: Street Telephone: ( ) Date: Middle city Social Security #: _ Position Applied For: Salary Desired: (A Seperate application must be submitted for each position applied for.) Date Available: Referred By GENERAL INFORMATION Are you legally eligible for employment in this country? (Proof of eligibility will be required upon employment.) Are you at least 18 years old? If not, do you have a work permit? If your are applying for a Driver position, are you over age 21? Have you ever been convicted of a felony? Are you bondable? Available for travel as needed? Do you have a valid drivers license? License No./State: State Zip ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Expiration Date: Per ADA, are you able to perform the tasks of the position you are applying for with or without an accommodation? Yes No. If you need accommodation, please indicate how you would perform the tasks and with what accommodation. (You may request a copy of the position description or job announcement) U.S. MILITARY SERVICE Have you served in the Armed Forces? Branch: From: To: Type of Discharge: Transpro, Inc. Employment :application (gemne) 2 Revised Dec=iber 21, 1999 EMPLOYMENT HISTORY Beginning with your present or last job, Oprovide the following information about your employment record for the previous 5 years. If additional space is needed, continue with the same format on a separate sheet of paper. Explain any gaps in employment in the "APPLICANTS NOTES ON EMPLOYMENT" section that follows. Please complete thoroughly and DO NOT substitute resume' for this section. 1. Firm Name: Phone: Address: City/State: Zip: Position Title: _ Supervisor: Beginning Pay: Ending Pay: Employed From: To - Summary of Duties: Reason for Leaving: 2. Firm N Address - Position Title: May we contact? Yes No, Phone: City/State: Zip Supervisor - Beginning Pay: Ending Pay: Employed From: To - Summary of Duties: Reason for 3 Firm N Address: Position Title: May we contact? Yes No Phone- City/State- Zip: Supervisor - Beginning Pay: Ending Pay: Employed From: Summary of Duties - To Reason for Leaving: May we contact? Yes No Transpro, Inc. Employment application (9mmic) 3 Revised Deco tuber 21, 1999 APPLICANT'S NOTES ON EMPLOYMENT Please explain any gaps in employment record- SPECIAL ecord SPECIAL QUALIFICATIONS AND SHILLS List special skills and abilities which you acquired through employment or other experiences that relate to the position for which you are applying, such as typing and computer experience as well as licenses, certifications, equipment operated, EDUCATION - circle the highest grade completed 9-10-11-12-13-14-15-16-17-18 Other. Type of school Name / City & State Graduated YIN Major Studied Degree Earned High School College Other REFERENCES Please provide the name, address and phone number of persons you have known for at least three years that are not related to you whom we may contact regarding your character, reliability and other personal information relevant to your application for employment. Do not list previous employers. Name ADDRESS PHONE # YEARS Transpro, Inc Employment Application (generic) 4 Revised December 21, 1999 Driver and Mechanic applicants, please complete the following: DRIVING RECORD tj Do you possess more than one driver's license? ❑Yes ❑ No If yes, please explain Have you ever had your license revoked, suspended, canceled or been disqualified from obtaining a commercial license? 3. Have you ever been convicted of any traffic violations anywhere? (With exception of parking) Yes _ No If yes, Please explain 4. Have you ever been employed as a commercial motor vehicle operator within the preceding ld years'' Yes No If yes, please explain 5. List all traffic arrests, convictions, bond forfeitures, citations, license suspensions and accidents in the past three (3) years: LIMITATIONS: The "Demand Response" industry requires as much flexibility in shift schedules as possible to accommodate peak and general service demand. Therefore flexibility should be considered. I am seeking employment for: ❑ FULL TIME ❑ PART TIME ❑ SPLIT SHIFT ❑ ON CALL Please list/describe any limitations on shifts, shift hours or days of the week you are unavailable. Transpro, Inc. Employm-t Application (generic) Revised December 21, 1999 PLEASE READ AND SIGN BELOW. THIS APPLICATION IS NOT COMPLETE WITHOUT YOUR SIGNATURE. APPLICATIONS WHICH ARE INCOMPLETE AND/OR ILLEGIBLE WILL NOT BE CONSIDERED FOR PROCESSING. I certify that all information on this application is true and correct. I am aware that any misrepresentation or omission may preclude an employment offer, or may result in withdrawal of an employment offer or separation of employment. Applicant Signature Date Transpro, Inc. Employment Application (generic) Revised December 21, 1999 ACCESS PARATRANSIT, INC. ALL NEW EMPLOYEES, UPON BEING HIRED AS A "FULL TIME" EMPLOYEE OF ACCESS PARATRANSIT, INC., YOU WILL BE PLACED ON A NINETY -DAY (90) PROBATIONARY PERIOD. THIS PROBATIONARY PERIOD WILL START ON THE FIRST DAY OF WORK ( AFTER THE SUCCESSFUL COMPLETION OF INITIAL TRAINING) AND END NINETY -DAY'S (90) THEREAFTER. UPON BEING HIRED AS A "PART TIME", OR "ON CALL" EMPLOYEE OF API, YOU WILL BE PLACED ON A ONE -HUNDRED AND TWENTY -DAY (120) PROBATIONARY PERIOD THIS WILL START ON THE FIRST DAY OF WORK (AFTER THE SUCCESSFUL COMPLETION OF INITIAL TRAINING) AND END ONE HUNDRED AND TWENTY -DAY'S (120) THEREAFTER. DURING YOUR PROBATIONARY PERIOD YOU WILL BE EVALUATED ON, BUT NOT LIMITED TO, YOUR ABILITY TO SAFELY OPERATE ASSIGNED VEHICLES, ROUTING OF ASSIGNED TRIPS, CUSTOMER SERVICE, RADIO USE AND PROCEDURES, ATTENDANCE, AND OVERALL PERFORMANCE. AFTER AN EVALUATION, API, HAS THE RIGHT TO TERMINATE SUCH EMPLOYEE WITHOUT CAUSE OR REASON. IF YOU AGREE WITH THE ABOVE DESCRIBED PLEASE SIGN AND DATE ON THE SPACE PROVIDED BELOW. EMPLOYEES SIGNATURE PAGE 7 DATE OFFICE USE ONLY INTERVIEW NOTE SKEET Interviewer, please use this sheet during the interview to make key notes relative to the applicant. Such notes MUST accompany the original application. Applicant's Name: Interviewer's Name: NOTES. Date: Attach any additional notes to this sheet and application. Transpro, Inc. Employment Application (generic) Revised December 21, 1999 ACCESS PARATRANSIT, INC. SUPPLEMENTAL APPLICATION PACKET FOR "VEHICLE OPERATOR / SPECIALIZED TRANSPORTATION DRIVER" PLEASE REVIEW THE CONTENTS OF THIS PACKET CAREFULLY! (PLEASE COMPLETE ALL FORMS WITHIN, THAT REQUIRE COMPLETION) JOB REQUIREMENTS Initial Requirements: Must have at least (5) five years or driving experience and possess a valid Washington State Driver's License. Must possess the physical ability to perform duties as described in the job description. Must have a good working knowledge of the safe operation of vehicles and the State of Washington Mortor Vehcile Laws. Must be able to work with the elderly and physically challenged. Requires a willingness to identify and perform various job related duties, as situations require, strong sense of teamwork, and ability to work cooperatively with others. As a Specialized Transportation Driver the following qualifications are requirements in order to operate a vehicle as a professional and while under contract. All Drivers must possess certifications of training completion for these course studies: *Drug and Alcohol Awareness/Prevention *Customers Service Skills *ADAPTS (ADA Passenger Techniques and Safety) *Defensive Driving *First Aid / CPR *Fire Suppression The above requirements must have been provided, documented, and certificates issued by a recognized and certified instructor. Additional Requirements: Drivers must be able to: 1) Maintain an acceptable driving record 2) Move or manipulate 50 pounds 3) Drive in adverse traffic and weather conditions 4) Complete required daily forms and logs legibly 5) Have a good knowledge of Yakima City and surrounding areas ACCESS PARATRANSIT, INC. APPLICATION FOR PRE-EMPLOYMENT TRAINING I, , having made an application for employment with Access Paratransrt, Inc., hereby make such an application for and request training as a Specialized Transportation Driver. In making this appplication, I acknowledge the following: Access Paratransit, Inc.'s agreement to enroll me into its training program is without charge or fee to me, and therefore, constitutes a commitment by API to make significant expenditures for time and money, without assurance to API that such expenditures may be recovered. The training which API provides is primarily for my benefit by providing me with skills which are valuable in the labor market and which will qualify me for employment either with API or elsewhere. My success at training is directly related to the energy and dedication I give it. I understand the importance of my attendance and all course work, including "classroom" instruction and "behind the wheel" instruction, the of all "homework" assignments and the importance of adequate preparation for any tests or final exams. I will not perform nor will I be required to perform any revenue service for API during this training. I will be under the supervision and observation of employees, including training instructors of API. My complete cooperation with these company employees is important to my successful completion of training. My entry into the training program does not make me an employee of API. My status thoughout training will be that of a "student". The successful completion of training is only one prerequisite, among several, to employment with API. API makes no guarantees, promises or assurances to me that it will offer me employment upon completion of training, nor am I obligated to accept an offer of employment with API if extended to me. f INN (Signature) SALARY: The salary is based on commission which is based on a "by ride" percentage rate. If in any event your ride count does not meet minimum wage for the amount of hours you have worked, you will be paid at that minimum wage rate for the hours you have worked, or whichever is greater. Potential "hires" who elect to receive their training through other sources may do so at their own rate and time frame. Such training, in order to be considered as "valid" must be verified through certificates and approved authenticity of a bon a fide training agency. Training options must be approved by the manager of API. Successful potential "hires" who have completed training through API and who have been "hired" as a Specialized Transportation Driver, will receive a $250.00 signing bonus on their completion date of their probationary period. I HAVE READ AND UNDERSTAND THE JOB DESCRIPTION, REQURIEMENTS, AND SALARY RANGES. APPLICANTS PRINTED NAME APPLICANTS SIGNATURE 107rMA ACCESS PARATRANSIT 612 N. 16'$ Avenue Yakima, Washington. 98902 (509) 248-1119 OPERATOR TRAINING EXHIBIT -K PAGE 1-13 DAY- 1 IN SERVICE DRIVER 'DRAINING 8 HOURS Instruction & Evaluation * Introduction to Paratransit * Introduction to ADA * Passenger Assistance Training * Customer Service Skills DAY -2 IN SERVICE DRIVER TRAINING (Cont) 8 HOURS * Customer Service Skills (Cont part one) * Passenger Assistance Training (Cont part one) * Roll Play DAY -3 ** DEFENSIVE DRIVING COURSE 8 HOURS ** DDC- 4 and test (70% or higher needed to pass course) 'ADA passenger technique & safety (ADAPTS) Passenger Profile * Hearing loss * Vision Impairment * Hidden Disabilities * Mental Impairments * Alzheimer Walk on assistance * Handrails * Clearance Role play * Vision Impairment (W/blindfold) * Hearing Impairment * Ride in wheelchair in a van Wheel chair management * Attachments (Foot rests, handgrips, brakes) * Procedures for reporting defective wheelchairs Securement Procedures * Types of securement and how there used * Lap belts * Hands on training securing a wheelchair DAY -4 8 HOURS Radio Procedures * Introduction to radio operation * Radio Procedures Paper work * Daily maintenance * Daily sheets * Trip reports * Accident reports * Accident reporting procedures * Incident reports Drug & alcohol awareness program & Training * Video & discussion Fleet Introduction * Pre -trip inspection * Safety equipment * First Aid kit * Reflective triangles * Fire suppression class * On the road training DAY 5 8 HOURS **CPR -BASIC FIRST AID TRAINING Blood born pathogens NOTE: All training listed above will be completed prior to a new Operator assuming his or her duties. All existing drivers currently employed will be required to renew as required. Single asterisk will be updated every two years. Training indicated by double asterisks will be updated every three years. ACCESS PARATRANSIT, INC. CHECKLIST FOR TRAINING OF EMPLOYEES QTWO (2) DAY IN SERVICE DRIVER/TRAINING INSTRUCTION AND EVALUATION AT LEAST EIGHT (8) HOURS A DAY. DEFENSIVE DRIVING - FOUR (4) HOUR CLASS WITH VIDEO AND TEST. PASSENGER ASSISTANCE TRAINING PASSENGER PROFILE HEARING LOSS VISION IMPAIRMENT HIDDEN DIABILITIES MENTAL IMPAIRMENTS ALZHEIMER'S WALK - ON ASSISTANCE HANDRAILS CLEARANCE PHYSICAL ASSISTANCE DOOR -TO - DOOR STEPS IN AND OUT OF SEATS ROLE PLAY VISION IMPAIRMENT (BLINDFOLDED) HEARING IMPAIRMENT RIDE INA WHEELCHAIR INA VAN WHEELCHAIR MANAGEMENT ATTACHMENTS (FOOT RESTS, HANDGRIPS, BRAKES PROCEDURES FOR REPORTING DEFECTIVE WHEELCHAIRS TIE -DOWN PROCEDURES (RATCHET STYLE, LAP BELTS, SHOULDER HARNESS) BOARDING AND DISEMBARKING CURBS AND STEPS TWO-STEP RULE POSITIONING TRAINING CHECKLIST PAGE 2 QPAPERWORK DAILY SHEETS (PRE -TRIP INSPECTION, SETTLEMENT SHEET, RIDE ROSTER) ZONE CHART (CITY LIMITS MAP) ACCIDENT/ INCIDENT PROCEDURES ACCIDENT REPORT FORM (WSP AND COMPANY) ACCIDENT PACKET (FROM YEHICM INCIDENT AND COMPLAINT FORMS ® DRUG AND ALCOHOL POLICY AND VIDEO QCUSTOMER SERVICE SKILLS QFLEET INSTRUCTION AND SAFETY CHECK WHERE TO FIND FIRE EXTINGUISHER, FIRST AID KIT, AND REFLRCTNE TRIANGLES FIRE SUPPRESSION CLASS (CERTIFICATE AT END OF CLASS) QFIRST AID AND CPR CLASS PRIMARY TRAINERS SIGNATURE CO -TRAINERS SIGNATURE APPROVED BY * CEO OR MANAGER (8) HOUR CLASS WITH CERTIFICATE AT THE END OF CLASS DATE DATE DATE l I I 1 ~-gple►� LAST NAME FIRST NAME DRIVERS LICENSE # CLASSIFICATION SOCIAL SECURITY # BIRTHDATE HIRE DATE SEPARATION DATE CERIFICATION, LICENSES AND/OR OTHER REQUIREMENTS - ISSUE DATE >CERTIFICSATION OF DRIVERS LICENSE: >FIRST AID CARD (REQUIRES RENEWAL): >CPR CARD (REQUIRES RENEWAL): >FIRE SUPPRESSION TRIANING : >DEFENSIVE DRIVING COURSE (4 HRS): >PASSENGER ASSISTANCE TECHNIQUES: (PAT - EQUIPMENT AND SENSITIVITY) >CUSTOMER SERVICE SKILLS: >SUBSTANCE ABUSE FOR S/S PERSONNEL: EXPIRE DATE ""'S/S = SAFETY SENSITIVE PERSONNEL INCLUDES DRIVERSM DISPATCHERS, RESERVATIONISTS COMMENTS: ACCESS PARATRANSIT, INC. PRE -TRIP INSPECTION SHEET DATE D£G1N MILEAGE I`LViD LEVELS: VEHICLE # DRIVER A. OIL OK LOW ADDED QT B. COOLANT OK LOW C. DRAKE I:LV1D OK LOW D. TRANSMISSION OK LOW ADDED QT (check wlic" engim is hot. mrke sure to pusli -tick town to prevent over fiM"5) E. POWER STEERING I`LVID OK LOW TIRES: OK LOW (BAD) RI` LP RR LR SPARE CABLES Mf-SSVR£ SANDBAGS £QV1rM NT: LIGHTS: SEATDELTS HEADLIGHTS GLASS TAIL LIGHTS RADIO DRAKE LIGHTS A / C TURN SIGNALS HEATER INTERIOR LIGHTS MIRRORS MARKER LIGHTS W/C LII=T HAZARD LIGHTS W/C S£CVRE1�tENTS DASH LIGHTS EMERGENCY BRAKE EMERGENCY EQWMENT: FIRST AID KIT TRIANGLES FIRE EXTINGUISHER DODY 1=LVIDS KIT STRAP CVTTER PROBLEM AREAS: ACCESS PARATRANSIT, INC. POST TRIP INSPECTION/DEFECT REPORT DATE ENDING MILEAGE VEHICLE # SHVT DOWN: SET PARKING BRAKE TVRN LIGHTS OFF TURN RADIO Off TVRN ENGINE Off INTERIOR WALK Tt ERV: PICK VP TRASH CLOSE WINDOWS STOW SECVREMENTS Dlovut TOTAUMlL£AG£ POST TRIP EXTERIOR WALK AROVND: NEW DAMAGE LOCK DOORS REMINDER FOR TURN IN: KEYS _ DAILY TRIP SHEETS _ VEHICLE PRE Fr POST INSPECTIONS DEFECT • � DRAKES _ STEERING _ W/C DOOR DVZZER HORN _ WIPERS _ TIRES _ W/C SECVREMENTS _ PARKING DRAKE _ SEATS _ HAND RAILS _ GAVGES _ INTERIOR LIGHTS _ EXTERIOR LIGHTING _ GLASS CHIPPED TRANSMISSION _ LIFT/DOOR _ SUSPENSION _ ENGINE _ EminGENCY EowPMENT SPILL KIT _ FIRST AID KIT _ EXTINGUISHER TRIANGLES _ VEHICLE CLEANLINESS INTERIOR _ EXTERIOR TRUNK SCRATCHED MECHANICAL DEFECTS DRIVER'S SIGNATURE CRACKED ACCESS PARA TRANSIT. INC. DAILY SETTLEMENT DATE - - AMB TOTAL # = A/T TOTAL # = W/C TOTAL # = NAME VEHICLE # OFFICE TRIPS i � s # OF DAR TICKETS = $ FOR DAR TRIPS = N/S DAR TRIPS = OFFICE TRIPS / OFFICE NO SHOWS = OFFICE NO SHOWS CONTRACT TRIPS X$ PRIVA TE PA Y X$ = S DAR TICKETS SOLD BOOK # TO BOOK # TO BOOK # TO BOOK # TO BOOK # TO BOOK # TO BOOK # TO BOOK # TO BOOK # TO BOOK # TO BOOK # TO BOOK # TO BOOK # TO BOOK # TO BOOK # TO BOOK # TO TOTAL # BOOKS SOLD TOTAL $ BOOKS SOLD TOTAL CASH TURNED IN (TRIPS & BOOKS) = ACCESS FARATRANSIT, INC. Driver Trip Record Date Time In ________ Time Out Total ________ Gallons of gas --------- Car # ________ Mileage: Start _______ End _______ Total ______ Tor C ed Vacate Address d Miles/Time Picress ♦♦♦ ������ 1 I ♦♦♦ — — — o — 10 ♦ to ♦♦ — a — — — ♦ �♦♦ — — — — — ♦ -...�... �_...... ------ 10 to 40 ----ate 10 40 to 40 foo 40 Vo 40 — — — — — r 10 '♦ — — — — — ♦ — — — — — — to to 10 40 10 to — — — — — — — — — — — ♦ ♦♦ ♦ — — — — — — — — — — ♦ ♦♦♦ to — — — — — ♦ 40 10 ♦ — — — — — to ACCESS PARATRANSIT, INC. 612 N. 16TH AVENUE YAKIMA, WASH. 98902 DATE: TIME: AMIPM VEHICLE # DRIVER PASSENGER(S) ACCIDENT LOCATION PASSENGER INJURY NO SHOW TARDY RUDENESS BEHAVIOR PROBLEM VIOLENT ILLNESS VEHICLE TREE LIMBS DRIVEWAY BACKING UP MECHANICAL FAILURE MOVING TURNING STANDING SITLL DISCRIPTION: DRIVER'S SIGNATURE: REPORTED TO: DATE: DISPOSITION: ,NED BY: DATE INTERAGENCY CONFLICT NO FAMILY ASSISTANCE P/U TIME CONFLICT 2 OR MORE STAIRS COMPLAINTS COMPLIMENTS OTHER OTHER ACCESS PARATRANSIT, INC. 612 N. 16TH AVENUE YAKIMA, WASH. 98902 KLA -1I dill DATE: TIME: AM/PM VEHICLE # PERSON MAKING COMPLAINT: LOCATION: PASSENGER/ DRIVER INJURY NO SHOW TARDY RUDENESS BEHAVIOR PROBLEM VIOLENT ILLNESS DISCRIPTION: VEHICLE MOVING BOARDING BACKING UP STANDING STILL DAMAGE TO VEHICLE UNLOADING CLEANLINESS / ODOR SIGNATURE OF PERSON TAKING COMPLAINT DATE: REPORTED TO: DATE: f71±-I1olit 9 Nl'l PERVISOR SIGNATURE: DATE: INTERAGENCY CONFLICT NO ASSISTANCE P/U TIME CONFLICT ADDRESS DROP OFF CONFLICT HYGENE DOOR TO DOOR DAMAGE TO HELP DEVICES OTHER ACCESS PARATRANSIT, INC. 612 N. 16TH AVENUE YAKIMA, WASH. 98902 ACCIDENT FORMS (TO BE FILLED OUT FOR ALL OCCUPATIONAL INJURIES OR ILLNESSES) EMPLOYEE NAME: JOB TITLE: EXACT TIME OF INJURY AM ! PM DATE OF INJURY: LOCATION WHERE INJURY OCCURRED: ACCIDENT REPORTED TO: TIME: NAMES OF WITNESSES: SUMMARIZE WHAT YOU THINK HAPPENED WHAT COULD HAVE YOU DONE TO AVOID THIS ACCIDENT: EXPLAIN IN DETAIL: WHAT PART OF YOUR BODY WAS INJURED? (BE SPECIFIC) IS THIS AN ORIGINAL INJURY OR RE-INJURY? IF A RE-INJURY WHEN AND WHERE WAS PREVIOUS INJURY? WHO WAS THE EMPLOYER? CLAIM # WOULD YOU BE WILLING TO PERFORM LIGHT-DUTY WORK DURING YOU RECOVERY? YES NO DATE AND TIME YOU SOUGHT MEDICAL ATTENTION: WHOM DID YOU SEE? OFFICE HOSPITAL EMPLOYEE SIGNATURE: DATE: (THIS FORM IS TO BE RETURNED TO YOUR EMPLOYER AS SOON AS POSSIBLE) NAME OF EMPLOYER THAT RECIEVED THIS FORM: DATE: NOTE: WASHINGTON ADMINISTRATIVE CODE NUMBER 296-24-026 (6) STATES: EMPLOYEES RESPONSIBILITY, "EMPLOYEES SHALL MAKE A PROMPT REPORT TO THEIR IMMEDIATE SUPERVISOR OF EACH INDUSTRIAL INJURY." Performance EXHIBIT "L" PGS 1-7 Appraisal PLEASE PRINT Employee Name Title Department Employee Payroll # Reason for Review ❑ Annual ❑ Promotion ❑ Peer Appraisal ❑ Unsatisfactory Performance ❑ Merit ❑ End of Introductory Period C3 Other Date employee began present position/ / Date of last an raisal __L__L_ Scheduled appraisal date / Instnictrons: Carefully evaluate employee's work performance in relation to the essential functions of the job. Check Rating box that indicates the emplayee's performance. Indicate N/A if not applicable. Assign points for each Rating within the Scale and write that number in the corresponding Points box Points will be totaled and averaged for an overall performance score. Definitions of Performance Ratings 0 - Outstanding. Performance is exceptional in all areas and I - Improvement Needed. Performance is deficient in certain is recognizable as being far superior to others. areas. Improvement is necessary V - Very Good Results clearly exceed most position U - Unsatisfactory Results are generally unacceptable and requirements_ Performance is of high quality and is achieved on reqs immediate unnrovement No went mcrease should be a consistent basis. granted to uidividuals with this eating. G - Good Competent and dependable level of performance. Meets performance standards of the job. NIA - Not Applicable or too soon to rate. General Factors Rating Scale Su ortive Details or Comments 1 Quality - The extent to which an employee's O ❑ 100-90 Points work is accurate, thorough and neat. V ❑ ' 89-80 G. ❑ 79-70 I ❑ 69-60 U ❑ Below 60 Z. Productivity - The extent to which an O ❑ 100-90 Points employee produces a significant volume V ❑ 89-80 of work efficiently in a specified period G ❑ 79-70 of time. I ❑ 69-60 U I❑ Below 60 3. Job Knowledge - The extent to which O ❑ 100-90 Pomts an employee possesses the practical/technical V ❑ 89-80 knowledge required on the job. G ❑ 79-70 I ❑ 69-60 U ❑ Below 60 4. Reliability - The extent to which an O ❑ 100-90 Points employee can be relied upon regarding V ❑ 89-80 task completion and follow-up. G ❑ 79-70 I ❑ 69-60 U ❑ Below 60 5. Attendance - The extent to which an O ❑ 100-90 Points employee is punctual, observes prescribed V ❑ 89-80 work break/meal periods and has an G ❑ 79-70 acceptable overall attendance record. I ❑ 69-60 U ❑ Below 60 6. Independence - The extent to which an O ❑ 100-90 Points employee performs work with little or V ❑ 89-80 no supervision. G ❑ 79-70 I ❑ 69-60 U ❑ I Below 60 General Factors Rating Scale Supportive Details or Comments 7. Creativity - The extent to which an 0 ❑ 100-90 Points employee proposes ideas, finds new V ❑ 89-80 and better ways of doing things. G ❑ 79-70 I ❑ 69-60 U ❑ Below 60 8 Initiative - The extent to which an employee 0 ❑ 100-90 Points seeks out new assignments and assumes V ❑ 89-80 additional duties when necessary. G ❑ 79-70 I ❑ 69-60 U ❑ Below 60 9 Adherence to Policy - The extent to which an 0 ❑ 100-90 Pomts employee follows safety and conduct rules, V ❑ 89-80 other regulations and adheres to company ❑ 79-70 policies. I ❑ 69-60 U ❑ Below 60 I Points 10 Interpersonal Relationships - The extent to which an employee is willing and demonstrates 0 V ❑ ❑ 100-90 89-80 the abilityto cooperate, work and G ❑ 79_70 communicate with coworkers, supervisors, I ❑ 69-60 subordinates I and/or outside contacts. U ❑ Below 60 11. Judgment - The extent to which an employee 0 ❑ 100-90 Points demonstrates proper judgment and decision- V ❑ 89-80 making skills when necessary G ❑ 79-70 I ❑ 69-60 U ❑ Below 60 Rate employee's overall performance in comparison to position duties and responsibilities. ❑ Outstanding 100-90 ❑ Very Good 89-80 Points ❑ -Number Factors RatedEl = 1:1Overall Rating ❑ Good 79-70 ❑ Improvement Needed 65 - 60 Total of Complete all of the following sections. 1. Accomplishments or new abilities demonstrated since last renew 2. Specific areas of needed improvement 3 Recommendations for professional development (seminars, tratn__ng, schooling, etc.) 4. Absences: Number of incidents Employee's Comments* T necessary, additml sheets may be attached. Number of days Discussed with individual on / / Employee's Signature 7 aGmowledpe that this PeAcrmancs Appraisal was discussed with m•. Follow-up requested/desired ❑ Yes ❑ No Follow-up Date / Evaluator's Signature Date / l Employee Warning Notice PLEASE PRINT Emplovee Name Date of Warning Employee/Payroll 9 Department Shift Type of Violation ❑ Attendance ❑ Carelessness Cl Insubordination ❑ Lateness or Early Quit I ❑ I Failure to Follow Instructions ' ❑ I Violation of Safety Rules F7Willfl I Rudeness to Employees or Customers ❑ Damage t umge o ( Material or Equipment ❑ Working Matters g on Personal ❑ Unsatisfactory Work Quality ❑ Violation of Company Policies or Procedures ❑ other Previous Warnings ORAL WRITTEN DATE BY WHOM 1 t Warning 2ndWarning 3rdWarning Statement Employee Statement —Employer AM Date of Incident / / Time PM ❑ I agree with Employer's statement. ❑ I disagree with Employer's description of violation for these reasons: r i EMPLOYEE SIGNATURE DATE Action to be taken ❑Warning ❑ Probation ❑Suspension []Dismissal ❑ Other Consequence should incident occur again I have read this Employee Warning Notice and understand it SIGNATURE OF EMPLOYEE SIGNATURE OF SUPERVISOR WHO ISSUED WARNING DATE DATE Employee Name Employee #i Department Shift Do you generally agree with the details stated above ❑ Yes ❑ No Please enter any comments below: Signature of Employee - Date of Occurrence Time of Occurrence FLocation Details: ❑ Yes `tiL Z.. ❑ No ❑ Yes Print name of person preparing this report Signature Date Do you generally agree with the details stated above ❑ Yes ❑ No Please enter any comments below: Signature of Employee - Date Details Written Report Prepared ❑ Yes ❑ No ❑ Yes `., ❑ No ❑ Yes :. ❑ No Z, ci My signature below acknowledges that I have been advised of the action to be taken Q. subsequent to this reprimand. " Employee's Signature Date Action Approved by (Signature) Title Date COPY DISTRIBUTION ❑ Employee ❑ Personnel ❑ Plant Manager _ C�JCopyright 1981 — SELECTFORM, INC. ❑ Supervisor ❑ ❑ _ Box 3045, Freeport, MY 11520 Form 25—Printed in U.S.A. ACCESS PARATRANSIT, INC. RANDOM VERIFICATION OF DRIVER INSPECTION FORM DRIVER NAME: - .-11 T NOV 9, 2001 NOV ,. „ DEC����������i���■ Separation Notice PLEASE PRINT Information TO BE COMPLETED BY EMPLOYEE'S SUPERVISOR Employee Name Position Department Employee/Payroll # Shift Supervisor Hire Date / / Last Day Worked / / Effective Separation Date Separation Meeting Date I / Time o m. Location List individuals present during separation meeting TO BE COMPLETED BY EMPLOYEE'S SUPERVISOR (CHECK ALL BOXES THAT APPLY.) TW of Separation ❑ DISCHARGE ❑ RESIGNATION ❑ FAILED TO RETURN ❑ RETIREMENT FROM LEAVE ❑ OTHER ❑ LAYOFF Remarks Final Employee Evaluation TO BE COMPLETED BY EMPLOYEE'S SUPERVISOR Qw QUALITY ❑ ❑ ❑ PRODUCTIVITY ❑ ❑ ❑ JOB KNOWLEDGE ❑ ❑ ❑ RELIABILITY ❑ ❑ ❑ ATTENDANCE ❑ ❑ ❑ INDEPENDENCE ❑ 01 1 ❑ (ANSWER QUESTION BELOW IF ALLOWABLE BY COMPANY POLICY.) Would you rehire" ❑ Yes ❑ No ❑ N/A Remarks Reason for Separation UNACCEPTABLE. ❑ OTHER EMPLOYMENT ❑ PERFORMANCE ❑ PERSONAL ❑ ATTENDANCE ❑ BETTER POSITION ❑ CONDUCT ❑ OTHER Remarks CREATIVITY ❑ ❑ 11INITIATIVE ❑ ❑ 11ADHERENCE TO POLICY ❑ 11 11INTERPERSONAL RELATIONSHIPS ❑ 13 13JUDGMENT ❑ 13El SKILLS ❑ ❑ ❑ Evaluator's Signature Date I / Separation Issues Discussed With Employee TO BE COMPLETED BY HUMAN RESOURCES PERSONNEL ❑ COBRA RIGHTS ❑ RETIREMENTISAvws ❑ 401(k)l403(b) OPTION PROCESSED ❑ INSURANCE COMPANIES NOTIFIED Cl_ MATERIALS! DISTRIBUTION OPTIONS ❑ COBRA NOTIFICATION PROCESSED ❑ DENTAL EQUIPMENT RETURNED ❑ TRADE SECRET/CONFIDENTIALITY ❑ DIRECT -DEPOSIT INSTITUTION NOTIFIED ❑HEALTH (MAJOR MEDICAL 3 MEDICAL) ❑ FINAL PAY OBLIGATIONS ❑ EMPLOYEE RECORDS ARCHNED ❑ LIFE INSURANCE ❑ LIFE INSURANCE CONVERSION ❑ VACATION DUE: ❑ FACILfry/sYSTEMS RIGHTS FINALIZED ❑ SEPARATION NOTED IN PERSONNEL RECORDS ❑ MAILIPICK UP LAST PAYCHECK DAYS C]PAYROLL ADJUSTMENT FORMS PROCESSED ❑ OUTSTANDING EXPENSE HOURS ❑ REPORTSIADVANCES ❑ Employee provided copy ❑ Yes ❑ No If yes, date: Supervisor Signature Date I I Human Resources Signature Date / / Payroll/Status Change Notice PLEASE PRINT Routing ❑ Payroll ❑ ❑ Effective Date of -Change % ❑ New Hire ❑ Change ❑ Separation Employee Name LAST FIRST MIDDLE Social Security # Employee/Payroll # Dept. New Hire Information Address STREET CIN STATE ZIP CODE Telephone # ( ) Date of Birth (for administrative use only) Status: ❑Full -Time ❑ Part -Time ❑ Full -Time Temporary ❑ Part-TimeTemporary ❑ Other Job Title ❑ Exempt ❑ Non -Exempt ❑ HourlyW-4 attached" Yes []No Change(s) for Current Employee TYPE FROM TO COMMENTS ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ Address Chang e Demotion Departinent 401(k)/403(b) Contribution Insurance Eligibility Job Title Change of Insurance Layoff Length of Service Increase Ment Increase End of Introductory Period Promotion Re-evaluation of Current Job Rehire Resignation Retirement Salary/Wage Separation Shift Change Transfer Union Scale Other Leave of Absence BEGIN LEAVE / RETURN FROM LEAVE / ❑ Educational ❑ Personal ❑ Family/Medical Leave (INCLUDING PREGNANCY) ❑ Short -Term Disability ❑ Long -Term Disability ❑ Other Separation SEPARATION DATE / / LAST DAY WORKED / / LAST DAY PAID ❑ Voluntary Separation ❑ Involuntary Separation Notice of COBRA Rights provided on / / Election of COBRA ❑ Yes ❑ No Start date of coverage If yes, describe type of coverage elected Additional Comments Employee Signature (OPTIONAL) Date NAME AND TITLE Supenisor/Designated Manager Signature Date / NAME AND TITLE Human Resources/Payroll Manager Signature Date NAME AND TITLE r EXHIBIT "M" PGS 1-28 ACCESS PARATRANSIT, INC. 612 N. 16th Avenue yakima, Washington 98902 (509) 248-1119 Element # 1 PAGE Management commitment 1 Manager responsibilities 2 Supervisor responsibilities 3 ELEMENT # 2 Employee Participation Employee responsibilities 4 Safety bulletin board 5 Safety committee 6 Work place hazards 7 Safety rules 8 Additional job related safety rules 9 Disciplinary policy 10 ELEMENT # 3 Emergency Plan If injury occurs 11 Fire evacuation 12 ELEMENT # 4 Training 13 ACCESS PARATRANSIT 612 N 16 AVE VAKIMA, WA 98902 (509)248-1119 Access Paratransit, Inc. places a high value on the safety of its employees. Access Paratransit, Inc. is committed to providing a safe work environment for all employees, and has developed a program for accident prevention as a systematic way of involving management, supervisors, and employees in identifying and eliminating hazards that may develop during our work process. It is the Basic Safety Policy of this company that "no task is so important that an employee must violate a safety rule or put himself or herself at risk of injury or illness in order to get it done". Employees are required to comply with all company safety rules and are encouraged to actively participate in ways to make our compay a safer place to work. Supervisors are responsible for the safety of all employees, and as part of their daily duties must monitor the work environment for unsafe conditions, and for unsafe actions by employees, and take prompt action to eliminate any possible hazards. Management will insure the implementation of this program by devoting the resources necessary to form a safety committee composed of management and elected employees representatives. The safety committee will develop procedures for identifying and correcting hazards, and planning for foreseeable emergencies. We will provide initial and ongoing training for employees and supervisors, and implement a disciplinary policy to insure that company safety policies are followed. Safety is a team effort -- let's work together to keep this a safe and healthy workplace. Kim Colby, Manager ACCESS PARATRANSIT INC. 612 N. 16th Avenue Yakima, Washington 98902 (509) 248-1119 SUPERVISORS RESPONSIBILITIES (1) Ensure that each employee supervised has received an initial orientation before beginning work and that the orientation is documented. (2) Ensure that each employee supervised is competent, or receives training on the safe operation of specific equipment or tasks before starting work on that project or equipment. (3) Complete a daily walk around to check for safety on all vehicles and/or work areas, and promptly take corrective action for any hazards discovered. (4) Periodically observe work performance of employees supervised for compliance with safety rules. (5) Set a good example established safety training. for employees by following rules and attending required (6) Complete a preliminary investigation of all accidents and report findings to management. (7) Provide information to management. Suggest changes to work practices or equipment that will improve employee safety. ACCESS PARATRANSIT 612 N. 16TH Avenue Yakima, Washington 98902 (509) 248-1119 GOALS FOR 2402 The following is the list of goals to achieve for the year 2002. OBJECTIVES (1) Develop a safety incentive program to reward personnel for achieving A high standard of safety. (2) Ct mtimuc �jnhrdulCd training and m4wittaitm =33irm5 fvr ctt'Vlt3yCC5. (3) Maintain an accident free year for 2002. (4) Set next Years $owls by 31 December 2002. (5) Continue with safety meetings in a more timely manner. ACCESS PARATRANSIT. INC. 612 N. 16th Avenue Yakima, Washington 98902 (509) 248-1119 GENERAL MANAGER RESPONSIBILITIES (1) Insure that a plant wide safety committee is formed and is implementing its responsibilities as listed in that section of this program. (2) Insure that adequate resources in terms of employee time, funds for safety equipment and training, and program commitment from management are available to implant the safety program. (3) Evaluate supervisors annually to insure they are implementing their responsibilities as defined in this program. (4) Insure the accidents are fully investigated and corrective action taken to prevent recurrence of the hazardous conditions or behaviors. (5) Insure that a record of injuries and illnesses is maintained and posted as described elsewhere in this program. (6) Set a good example for employees by following established safety rules and attending required training. (7) Report any unsafe practices or conditions observed to the supervisor of the area where the hazard was observed. ACCESS PARATRANSIT, INC. 612 N. 16th Avenue Yakima, Washington 98902 (509) 248-1119 SUPERVISORS RESPONSIBILITIES (1) Ensure that each employee supervised has received an initial orientation before beginning work and that the orientation is documented. (2) Ensure that each employee supervised is competent, or receives training on the safe operation of specific equipment or tasks before starting work on that project or equipment. (3) Complete a daily walk around to check for safety on all vehicles and/or work areas, and promptly take corrective action for any hazards discovered. (4) Periodically observe work performance of employees supervised for compliance with safety rules. (5) Set a good example for employees by following established safety rules and attending required training. (6) Complete a preliminary investigation of all accidents and report findings to management. (7) Provide information to management. Suggest changes to work practices or equipment that will improve employee safety. ACCESS PARATRANSIT INC. 612 N. 16th Avenue Yakima, Washington 98902 (509) 248-1119 EMPLOYEE SAFETY ORIENTATION CHECKLIST Instructions: Each employee shall receive a safety orientation before beginning work. This checklist documents that each required item was covered in the orientation. The supervisor is to place a check in each box to indicate that the item was covered. Employees are not to sign this form unless all items have been covered and all questions have been answered satisfactorily. The employee has been: Informed about the elements of the written safety program that outlines the company's safety efforts. Given a copy of the employee safety manual and general safety rules, and has read it. Told who his/her elected safety committee representative is. Told to report all injuries and shown how to do this. Shown where the first aid supplies are located and who to call for first aid. Shown where the exits are located and the route from the assigned workstation. Told what to do during any emergencies that could be expected to occur. Shown how to operate a fire extinguisher. Trained on the safe methods to perform the specific job the employee was assigned including any hazards associated with that job. Initial job assignment: Given any personal protective equipment (PPE) required and trained on how to use and care for it. PPE required for this job: Provide any formal as proper lifting, training given: training required to do his/her job such chairlift operation etc. Initial formal Page 2 The signatures completed on th for maintaining Date: below document that the above orientation was e date listed. Both parties accept responsibility a safe and healthful work environment. Supervisor: Date• Employee- ACCESS PARATRANSIT 612 N. 16'n Avenue Yakima, Washington. 98902 (509) 248-1119 SAFETY COMMTTEE Access Paratransit has formed a Safety Committee to provide a method for employees and management to work together in identifying potential safety issues, develop solutions to safety problems, review accident reports, and evaluate the overall effectiveness of the safety program. The committee is made up of management, designated representatives and one employee elected to represent each department (office, shop, drivers). (A) Employees in each department will elect from among themselves a representative to be on the committee. If there is only one volunteer or nomination, the employees will approve the person by voice vote. If there is more than one volunteer or nomination, a paper vote will be used to elect the representative. (B) A chair person will be selected by majority vote of the committee members each year. If a vacancy occurs the same method will be used to select a replacement. (C) In addition to the committee responsibilities explained above, the duties of safety committee members include the following: (1) Perform monthly self inspection of the area the represent. (2) Communicate with the employees the represent, on safety issues (3) Insure that safe work habits are being used by coworkers. (D) The regularly scheduled meeting will be held in conjunction with the drivers meeting, once a quarter in the employee break room. (E) A committee member will be designated each quarter to keep the minutes of the safety meeting. A copy of the minutes will be posted on the bulletin board, after each meeting. After being posted for one month the minutes and will be kept on file for one year. ACCESS PARATRANS IT INC 612 N. 16th Avenue Yakima, Washington 98902 (509) 248-1119 EMPLOYEE RESPONSIBILITIES (1) Follow established safety rules and standards contained in this program and in the training you have recieved. (2) Report unsafe conditions or actions in writing to your supervisor or safety committee representative as soon as you become aware of them. (3) Report all injuries to your supervisor promptly regardless of the severity of the injury, both verbally and in written form. (4) Promptly report all near -miss accidents to your supervisor, both verbally and in written form. (5) Always use Personal Protection Equipment (PPE) that is in good working condition when and where it is required. (6) Encourage co-workers to use safe work habits on the job. (7) Make suggestions to your supervisor, safety committee representative, or management any changes to work practices that you think will improve employee safety. ACCESS PARATRANSIT, INC. -IWW 612 N. 16th Avenue Yakima, Washington 98902 (509) 248-1119 Access Paratransit is committed to aggressively identifying hazardous conditions and practices which are likely to result in injury or illness to employees, and will take prompt action to eliminate those hazardous conditions. In addition to reviewing injury records and investigating accidents for their causes, management and the safety committee have implemented several methods of identifying those hazardous conditions before they result in injury to workers. ANNUAL SITE SURVEY Once a year an inspections team made up of members of the safety committee will do a wall-to-wall thorough inspection of the entire worksite. They will note any safety hazards or potential hazards during the walk through. Anything noted during the inspection will be reported to management for immediate attention. QUARTERLY SAFETY INSPECTIONS Each quarter every vehicle will have a bumper to bumper safety inspection to insure no items on said vehicle are determined to be safety hazards. These inspections will be conducted by the shop mechanic. Anything that is determined by the mechanic to be a potential safety hazard will be repaired immediately. ACCESS PARATRANSIT, INC. 612 N. 16th Avenue Yakima, Washington 98902 (509) 248-1119 ELIMINATING WORK PLACE HAZARDS Access Paratransit is committed to eliminating or controlling work place hazards that could cause injury or illness to our employees. We will meet the requirements of state safety standards where they have specific rules about a hazard or potential hazard in our work place. Whenever possible we will modify or design our facilities and equipment to eliminate employee exposure to hazards. When these engineering controls are not possible or not fully effective, we will require the use of PPE. Personal Protection Equipment consists of foot protection, safety glasses and/or like equipment suited for the task you are doing. 0 0 RECORD OF HAZARD OBSERVED Dm Repanecl by 1. Nature and location ...... . . .. . . ........ . . . . . ...... . .. ......................... .... . ................ . ..... . ..... . .. . .......... . .. . . . . .............. . ... . ........... . ........ ........................................... . ........... ...... . ......... . ...... . ......... . . ..... . ......................................... . ............ . ...... . ........ . . ...... 2. Date and action taken . . .......... . .......... . . ...................... ............... I .............................. . . . .......... ------•----•---•-••-----...._...-------............................................................. ......................... . . ............... . ............ ................................................................... ... . . ....... . ...._...-•----..-. ............................... -PY whom (Please P&t) — - – --------- *,*** ...... *-,* -------- - * --- - - --- *---* -------- Labor Jt Industries White: Safety Cesnnunft Cormultation Services C&n=Y' Supervisor PO Box 44640 Pink: Follow-up & origins! Olympia WA 995044640 F417-0"-000 6.94 Appendix D Department of Labor and Industries JOB HAZARD ANALYSIS Job or Task: Service Location: Due of Analysis: Analysis Initiued by: ❑ Employee ❑ St�,lsor ❑ Safery 8t Health Coocdmaoot ❑Other Industrial Safety & Health Division Consuimm called: Name: Yes ❑ No JOS OR TASK STEPS HAZARD PROTECTION OR PREVENTION F417-084000 job hazard analysis 2-93 Supervisors Signature Appendix G A('CESS PARATRANSIT INC 612 N. 16th Avenue Yakima, Washington 98902 (509) 248-1119 The following basic safety rules have been established to help make our company an efficient and safe place to work. These rules are in addition to specific safety rules established for particular jobs. Failure to comply with these rules will result in disciplinary action. (1) You will not do things which are unsafe in order to get the job done. If a necessary act is unsafe, report it to your supervisor or safety committee representative so it can be evaluated and an alternate method developed. (2) No person may operate a piece of equipment unless they have been trained and are authorized to do SO. (3) Use your personal protection equipment whenever it is required. (4) Obey all safety warning signs. (5) Working while under the influence or consumption of alcohol and/or illegal drugs is strictly prohibited. (6) Firearms are not permitted on company property. (7) Smoking is only permitted in designated "smoking" areas. (8) Horseplay, running, and fighting are prohibited. (9) Good housekeeping is an important part of accident prevention. Clean up spills immediately. Replace all tools and supplies after use. Do not allow scraps to accumulate where they will become a hazard. ACCESS PARATRANSIT, INC. 612 N. 16th Avenue Yakima, Washington 98902 (509) 248-1119 JOB RELATED SAFETY RULES We have established the following safety rules, and they are to be adhered to when performing the following tasks. ALL VEHICLE OPERATORS (1) Wear your seat belt at all times. (2) You are responsible for your passengers safety. This is a door to door policy. (3) Daily inspections of vehicles to determine if there are any safety hazards present. (4) No speeding. Practice your defensive driving. VAN DRIVERS (1) Do not jump on and off the lift when deployed. (2) Do not take anyone in a wheelchair up or down more that 2 (two) steps. (3) Wear back support. LIFTING SAFETY - ALL LOCATIONS (1) Do not lift on slippery surfaces. (2) Get help if load is too heavy. (3) Do not overexert. (4) Do not lift while in an awkward position. (5) Back injury claims are painful for the worker and expensive for the company. If you have to lift something or someone, lift safely. Page 2 MECHANIC (1) Keep shop floor clean and free from spills. (2) Keep tools and other things in proper places. Do not leave them scattered all over the floor. (3) Insure safety inspections are done on all vehicles. Be sure to document all inspections. ACCESS PARATRANSIT, INC. 612 N. 16th Avenue Yakima, Washington 98902 (509) 248-1119 December 3, 1997 TO: ALL ACCESS PERSONNEL RE: SAFETY BULLETIN BOARD We at API will provide a Safety Bulletin Board located inside the break room. We will post notices required by law, and other information that may help to make this a safe workplace. Employees and supervisors should check this board regularly for new notices. There will be nothing else posted on this board without approval of a safety committee representative. We will also post on this board any citation and notice documents we receive from the Department of Labor & Industries if we are inspected. MINUTES of SAFETY CON VaTTEE MEETING Iv[eeting dale _ _ _ Loc..Ifim �a ' Employee Members Present A Mm agement Members Preset Members Absent (Use additional pages if necessary to describe events fully) L Read/approve/correct minutes from previous meeting. II. Old business (progress report on items and/or hazards from previous meetings). M. New business (assign someone to research, follow-up, etc. on each hazard and/or item listed). IV. Review accident and inspection reports. V. Other business (describe). VI. Items referred to Safety Director/Management. next meeting Tune Chairperson (signature) F417-087-000 minutes of safety committee meeting 3-94 Appendix B I ACCESS PARATRANSIT - 612 N. 16TH Avenue Yaldma, Washington 989002 (509) 248-1119 ACCIDENT INVESTIGATION Whenever there is an accident that results in a serious injury or one that has immediate symptoms, a preliminary investigation will be conducted by Russ Keen, CEO, and Kim Colby, General Manager. The investigation team will take written statements from witnesses, photograph the scene and equipment involved, and note the conditions of equipment and/or vehicles. The team will make a written report of its findings, including a sequence of events leading up to the accident, conclusions about the accident and any recommendations to prevent the accident from recurring. The accident report will be reviewed by the safety committee at its next regularly scheduled meeting. In the event of a fatality, probable fatality, or when two or more employees are admitted to a hospital as a result of an accident, Access Paratransit will contact the Department of Labor and Industries within 8 hours after becoming aware of the accident. Their phone number is 1-800-321-6742. The notification must be verbal conversation with a representative of the department. The notification will include the following: Name of employee, location of accident, time of accident, number of employees involved, the extent of injuries or illness, a brief description of what happened and the name and phone number of a contact person. ACCESS PARATRANSIT, INC._ 612 N. 16th Avenue Yakima, Washington 98902 (509) 248-1119 DISCIPLINARY POLICY Employees of Access Paratransit, Inc. are expected to use good judgement when doing their work and to follow established safety rules. We have instituted a disciplinary policy to provide appropriate consequences for failure to follow safety rules established by this company. The disciplinary procedure is designed not so much to punish, but to bring unacceptable behavior to the employee's attention in a way that the employee will be motivated to make corrections. The following consequences apply to the violation of the same rule or the same unacceptable behavior. (A) First instance: Verbal warning, notation in employee file, and instruction on proper actions. (B) Second instance: 1 (one) day suspension without pay, written reprimand, and instruction on proper actions. (C) Third instance: 1 (one) week suspension without pay, written reprimand, and instruction on proper actions. (D) Fourth instance: Termination of employment. An employee may be subject to immediate termination when a safety violation places the employee, co-worker, or any other person at risk of permanent disability or death. ACCESS PARATRANS IT. INC. 612 N. 16th Avenue Yakima, Washington 98902 (509) 248-1119 INJURY POLICY (1) There are 2 first aid kits in the office, one located in dispatch and one in the warehouse near the stairs. Each vehicle in the fleet is equipped with a ten package kit located in the trunk. These kits will be checked monthly by a member of the safety committee. (2) All employees are required to have first aid and CPR cards. A list of current first aid and CPR certified employees is posted on the safety bulletin board along with expiration dates. (3) Report all injuries promptly. In case of serious injury, do not move the injured person unless absolutely necessary. Only provide assistance to the limit of your training. If you are alone with the injured party you need to call 911. If there are other people around ask one of them to call 911 and you remain with the injured party. (4) AIDS/HIV and Hepatitis B are the primary infectious diseases of concern in blood. All blood should be assumed to be infectious. These diseases can both be deadly. Employees are responsible for the passengers in their vehicles. In the event of a bleeding injury, gloves should be used to prevent exposure to blood borne diseases. The injured person can often help by applying pressure to the wound. Gloves and a mouth barrier for rescue breathing are available in the first aid kits. If an employee is exposed to blood or any other body fluids he/she must wash immediately with soap and water and report the incident to a supervisor. The appropriate follow up procedure will be initiated. EXHIBIT "N" PGS 1-2 AUTOMOBILE ACCIDENT REPORT File No Nam' Policy No. POLICY Home Address Home Phone No. HOLDER Street and No. Cts or Town State Business Business Address Street and No. City or Town State Phone No. _ POLICY- Year Make Model Body Type Car's Mileage HOLDER'S Serial No ?rotor No. Car's Registration No- AUTOMOBILf Name of Driver Driver's License No. Age AND Address of Driver Phone No. DRIYER Street and No. City or Town State For What Purpose Was Automobile Being U.1cd TIME AND Date of Accident or Loss 19 Hour Dt. PLACE Place of Accident Street and No. City or Town State Names Age Address Phone No. 1. 2. 3. 4. Nature and 1. Extent of Injuries 2. 3. 4. If Doctor Was Galled Give Name Address Ff"aere Were Injured Taken By Whom DAMAGE TO PROPERTY OF OTHERS Owner of Property Damaged Driver of Other Car If Automobile, Year Make Addr -" Addrecc 1)ri:er's License No. Car's Registration No. Kind of Property and Extent of Damage Names of Occupants of Policyhcldces Car Address Phone No. JAMES AND WDRESSES OF VITNESSES Other Witnesses Address MPORTANT JAXAGE TO iR LOSS =F POLICY• Cause of Loss or Damage (Fire—Theft—Windstorm—Collision—ete.) .OLDER`S Automobile can be inspected at AR THE ACCIDENT Direction Your Car Was Goin Side of Street Speed Direction of Other Car Did You Give Warning Signal _What Kind Did Other Driver Cave Signal What Kind Side of Street Speed Were Your Lights Or._�� Wrre His Lights On Wrathr; at Time of Accident Condition of Road at Place of Accident Did Polive Alakr a Report of This Acctdertt cty, County or State Driver's Description of Accident or Lova Policeman's No. DATE OF L 19 Signature of Driver Age THIS REPORT Signature of Policyholder t Show on diagram position V of each car, vehicle or in ; DIAGRAM jureddicatin in erson. OF p g by arrow —e direction of each Indicate points of compass. ACCIDENT t t N. E. S. W. SIDEWALK STREET CENTER 1 ,' SIDEWALK t ,� IMPORTANT t t , if street or view obstructed In t any wrap, indicate where and how. • also indicate any street eas or tracks, and traffic signal or signs. Employee's- Report of an. accident (to be filed out for alt occtrpational injuries or illnesses) Employee's name: Job title: Exact time of injury: Date of injury: Plant location where injury occurred: Name of person to whom this incident was reported: ---Time: Names of witnesses: Summarize what you think happened: What could have been done to avoid this accident? EXPLAIN IN DETAIL: What part of your body was injured? BE SPECIFIC Is this an original injury or a re-injury? If a re-injury, when and where was previous injury? Who was the employer? Chaim number: Would you be willing to perform light-duty work during your recovery?, Date and time you sought medical attention: Whom did you see?, Cffice/hospital Employee signature: Date: This form is to be returned to your employer as soon as possible. Date employer received report: NOTE: Washington Administrative Code number 296-24-025(6) states: Employee's responsibility: "Employees shall make a prompt report to their immediate supervisor of each industrial injury.' Appendix E 41 THIS IS YOUR RECORD—KEEP IN YOUR FILE 411 SUPEDYISOR'S REPORT OF AN ACCIDENI NAME OF INJURED EIdPL OYE_E: DATE OF REPORT AGEI LENGiH Ar PLAmr OF EMPLOYUfiNT CN ICs OVARTMF-MT SECTION 01 HEAD ❑ 71EYES HANDS ❑ WOUNDS ❑ AMPUTATION DEATH U LOST TIME (_ LEGS L7STRAIN 3 SPRAIN ❑ BURNS ❑ FIRST AID ❑ TRUNK I TOES ❑ HERNIA ❑ FOREIGN BOOP ONLY ❑ ARMS ❑ INTERNAL ❑ FRACTURE ❑ SKIN (occupational ! L� DUE TO DELAYED MEDICAL TRF-ATL46W REMARKS. r�� W) ❑ REMARKS. ENFORCE I REMARKS. DATE OF INJURY HOUR I DEPARTMENT I EXACT LOCATION EYEWITNESSES DESCRIBE ACCIDENT, INCLUDE THE MACHINE. EQUIPMENT, OBJECT OR SUBSTANCE INVOLVED ALL DETAILS USE BACK SPACE IF NECESSARY CAUSE: Mark bask cause I'Xj Mark contributing cause, if any l� UNSAFE CONDITIONS UNSAFE ACTS t Lj INADEQUATELY GUARDED I ❑ OPERATING WITHOUT AUTHORITY r7 2 _' UNGUARDED 2❑ OPERATING AT UNSAF= SPEED 3 ❑ DEFECTIVE TOOLS. EQUIPMENT, OR SUBSTANCE 3 ❑ MAKING SAFETY DEVICES INOPERATIVE 4❑_ UNSAFE DESIGN OR CONSTRUCTION 4 ❑ USING UNSAFE EQUIPMENT OR SCUIPMENT UNSAFELY 5 IHAZAROCUS ARRANGEMENT 5 ❑ UNSAFE LOADING. PLACING. MIXING 6 UNSAFE ILLUMINA T 1CN 6 ❑ TAKING UNSAFE POSITION 7 L_ UNSAFE VENTILATION 7 U WORKING ON MCVING OR DANGEROUS SCUIPMENT 8 ❑ UNSAFE CLOTHING 8 ❑ DISTRACT ION, TEASING. HORSE PLAY 9 ❑ INSUFFICIENT INSTRUCTION 9 ❑ FAILURE TO USE PERSONAL PROTECTIVE DEVICES WHY WAS THE UNSAFE ACT COMMITTED? WHY 010 THE UNSAF= CONDITION 'EXIST? ANY PHYSICAL DISABILITIES?. NUMBER OF PREVIOUS DISABLING INJURIES? GUIDES TO CORRECTIVE ACTION BASED ON THE CAUSE CHECKED ABOVE, I AM TAKING THE FOLLOWING CORREC nVE ACTION: UNSAFE ACT UNSAFE CONDITION I/ Supervisor Can t Handle. Then I ❑ 2 STOP THE WORKER STUDY THE JOB ❑ I ❑ REMOVE 5 RECOMMEND TO• (a) ❑ OWN BOSS. OR (b) ❑ SAFETY COMMITTEE. OR 2 GUARD 3 INSTRUCT (tell—$Paw—try—check) ❑ 3 WARN cc) MAINTENANCE DEPT., OR 4 FOLLOW UP ❑ a SUPERVISORY r�� W) ❑ ❑ 5 ENFORCE TRAINING 6 FOLLOW UP WHAT I AM ACTUALLY DOING TO PREVENT SIMILAR INJURIES WHAT FURTHER RECOMMENOA71ONS-7 SIGNATURES iuMEu1Ari .: PASR CSCROR FOAE1+AN ��— Wi7.0+3-�0 w�.��oP�'cjon a(�a rs�trac (:�9+ "r•� � —.. _...— AEC 9r PLAN' MAN.GaA OA SUP' Appendix F ACCESS PARATRANSIT INC 612 N. 16th Avenue Yakima, Washington 98902 (509) 248-1119 FIRE EVA 21A -ION PLAN An evacuation map for the building is posted by each exit in the building, and one is posted in the break room. It shows the location of exits, fire extinguishers, first aid kits and the gathering location outside. A copy of the map is attached to this program. All employees will receive training in the use of fire extinguishers as part of their initial orientation. A fire evacuation drill will be conducted once a year during the first week of May. (1) If you discover a fire: (a) Notify another person immediately. Call or have them notify 911 and supervisor. If the fire is small (such as in a wastebasket) and there is minimal smoke, you may attempt to Put it out with a fire extinguisher. (b) If the fire grows or there is thick smoke, do not continue to fight the fire. (c) Notify others in the area to evacuate the building. (d) Go to the designated point outside the building (south parking lot beyond bay door). (2) If you are the supervisor notified of a fire in Your area. (a) Instruct your employees to evacuate to the designated gathering location. (b) Insure that all employees have been evacuated from your area. (c) Verify that 911 has been called. Page Z (d) (e) (f) Determine if the fire has been extinguished. r If the fire has grown or there is thick smoke, evacuate any employees attempting to fight the fire. Notify supervisors in other areas to evacuate the building. Go to the designated gathering location and verify that all your employees are accounted for. if an employee is missing, do not re- enter the building! Notify fire personnel that an employee is missing and may be in the building. •r ACCESS p RATRANSIT, ING. 612 N. 16th Avenue Yakima, Washington 98902 (509) 248-1119 TRAINING Training is an essential part of our plan to provide a safe work place at Access Paratransit. To insure that all employees receive the required training needed to assume the duties of their job, we have designated a training coordinator whose name is posted on the safety bulletin board. The training coordinator is responsible to: verify that all employees have received an initial orientation by their supervisor, that they have received any training required to do their job safely, and that their training file documents the training. COURSE BASIC ORIENTATION BASIC FIRST AIDICPR FIRE EXTINGUISHER SAFETY DEFENSIVE DRIVING SAFE LIFTING WHO MUST ATTEND All employees (provided by emp. supervisor) All drivers All employees All drivers Any emp. who lifts over 20 pounds ACCESS PARATRANSIT, INC. EXHIBIT "O" PGS 1-3 612 N. 16TH AVENUE YAKIMA, WASH. 98902 DATE: TIME: AM1PM VEHICLE # DRIVER PASSENGER(S) ACCIDENT LOCATION PASSENGER INJURY NO SHOW TARDY RUDENESS BEHAVIOR PROBLEM VIOLENT ILLNESS DISCRIPTION: DRIVER'S SIGNATURE: REPORTED TO: DISPOSITION: VEHICLE TREE LIMBS DRIVEWAY BACKING UP MECHANICAL FAILURE MOVING TURNING STANDING SITLL DATE: SIGNED BY: DATE INTERAGENCY CONFLICT NO FAMILY ASSISTANCE P/U TIME CONFLICT 2 OR MORE STAIRS COMPLAINTS COMPLIMENTS OTHER OTHER Incident Investigation Report PLIEASE PRINT NAME List all attendees. Attach additional sheets if necessary. - - -NAME - - -- - -NAME - - - - -NMIE- - - - -- -- - - -NAME ----- Purpose of Meeting TITLE - - TITLE TITLE - TITLE TITLE Incident pertained to Harassment - Dissatisfaction with Retaliation -' Witness Report Work Procedures Unfaimess/Inconsistency of Name of person whose behavior is in question Job Title Department Location where incident occurred Date of Incident Time of incident AM >s'At Describe the incident in specific detail (include words said, gestures made, if and where physical contact occurred, any other physical actions, objects or weapons used). Include additional sheets if necessary Has the person in question been involved in any other incident? Yes No Not Known If yes, was it reported? - Yes No Reported to Date How was that incident handled? Have the employees been involved in any prior incident(s)? -- Yes - No If yes, please provide details. f• List anyone who saw or heard the incident. + sit f f List anyone, in addition to/other than the witnesses, who might be able to contribute information to an investigation of this incident. List anyone you know of who also may have been the target of a similar incident. What action, to settle the incident, would satisfy complainant? t f t f Summary of action taken Verbal warning issued to Date -- Written warning issued to (attach copy) Date Suspension Date Termination Date Other ATTACH COPIES OF ANYSUPPORTING DOCUMENTS. Investigating Manager/Exwutive Date i • • • Date Form of Action Result Initials ACCESS PARATRANSIT, INC. TECHNICAL PLAN QUESTION # 5 AND # 6 DRIVER TRAINING AND SAFETY PROGRAMS ACCESS PARATRANSIT, INC. EXHIBIT `P' DISPATCH PROCEDURES POSITION PURPOSE: Dispatches on -duty drivers to clients with time or will call returns in a timely manner, so clients can reach their destinations safely and dependably. PRINCIPAL ACCOUNTABILITIES: - Be aware at all times the locations and status of all drivers. - Notify appropriate personnel of any and all mechanical problerns that occur during their shift. - Notify appropriate personnel up to and including emergency services if needed. - Relay to drivers all pertinent information regarding a client, i.e., status change, location if other that is shown on the screen. - Notify office staff of any client status changes, whether permanent or temporary, complaints, transport problems. - Research and provide directions to the drivers if needed. - Use proper radio etiquette, including the memorization of all radio codes and their proper use. - Responsible for dispersement and recording of vehicle fluids. - Responsible for maintaining key and fuel card records. - Notify management of any and all accidents, no matter how minor. - Maintain daily dispatch log of incidents that take place. DISPATCH PROCEDURES Page 2 1) Note time of pick up. 2) Dispatch a ride one half hour before time call to the driver. 3) Receive a `check' from the driver indicating that he/she has obtained the information. 4) On the computer hit F-3 = that will show a "D" on the ride meaning it has been dispatched. it will time stamp the dispatch time. S} When the driver calls in, hit F-4 = showing a "P" meaning the driver has picked up. It will time stamp the pick up. 6) when driver calls in that he/she has vacated, hit F-5 = showing a "V" meaning the driver is now vacant and ready for more trips. It will time stamp the vacate time. 7) If there are no trips waiting, Dispatch will then place the driver in a line-up = 1 St, 2nd, 3rd, etc., to be dispatched accordingly. DISPATCH The Dispatch Module is a powerful and flexible way to dispatch rides in a real-time scenario. The dispatcher selects the day to open and can sort the rides two different ways to accommodate their style of dispatching. As the rides are dispatched the screen shows which passengers are dispatched, picked up, and delivered. The dispatcher can easily see how many rides are scheduled, cancelled, no showed. The following section will describe all the functions and their uses. OPEN DAY CONTROL SCREEN QUICK EDIT SCREEN OPEN DAY COUNT RIDES DISPATCH FUNCTION KEYS EXPANDED F KEY DEFINITIONS From the menu the user selects Dispatch, and a pull down menu will open with the option to Open Day. A screen will appear enabling the user to select the date that they want to use in the format mm/dd/yyyy. If a date is entered for which no Ride Day database has been made using the Start Day Module a pop up list will appear in the upper left hand corner of the screen showing the user which days are available. When the user selects a valid date the Control Screen will appear at the bottom of the screen. FI F2 F3 Alt -F3 or Alt -D F4 or Ctrl -P Alt --F4 or Alt -P F5 or Ctrl --V Alt -F5 or Alt -V F6 or Ctrl -W F7 F8 DISPATCH FUNCTION KEYS Help Go To Record Dispatch Ride Un -Dispatch Ride Pick Up Passenger Un -Pick Up Ride -Puts `D' in status Vacate Vehicle Un -deliver ride - puts `P' on status Brings up Client Info screen Ride day summary Individual run totals F9 Alt -F9 Ctrl -A Ctrl -N Ctrl -E Ctrl -Q Alt -U or Insert Key Alt -K Ctrl -K Ctrl -T Ctrl -O Ctrl -L VIEWING RECORDS OPTION Dispatched rides Picked up rides Late days Add some day record Edit current record Brings up Quick Edit screen First up Module Find all records for a client Find all records for the current client Toggle off ride No show ride Cancel ride As the rides are performed throughout the day only those rides that are current are available for viewing. When a ride has been performed there will be `V' in the status field on the Dispatch screen and after 5 seconds the Dispatch screen will be refreshed and any rides that have a `V' will disappear from view. To view rides that have already been processed the user presses the `All Records' radio button on the control panel and then re - selects a sorting option. The user now can see all records including Cancellation `C', No Shows `N', Dispatched records `D', Picked Up records `P', and the Vacated records `V'. Changes can be made to records at this point. For the most part the user will usually only view current records. Federal Communications Commission Gettysburg, PA 17325-7245 RADIO STATION LICENSE Licensee Name: ACCESS PARATRANSIT INC Radio Service: LX TAXICAB Call Sign: WPFJ581 File Number: Frequency Advisory No./Service Area: 011110-00 ACCESS PARATRANSIT INC PAMELA SCOTT 612 N 16 AVE YAKIMA WA - EXHIBIT 11011 License issue Date- 07/21/1999- 9907R405201 7/21/19999907R405201 License Expiration Date: 09/23/2004 -- Pagers.t�txrtxirtt- - -990721U --376 L `1R 98902 REGULATORY STATUS: PMRS FCC I.D. tat m: Frequencies Station No. of Emission (MHz) Class Units Designator . e0 h nica.. .peat_ tc'SPON11 - Output E.R.P. Ground Power {tNatts! Eleva (1Nattsl Ant. Hgt. Antenna To Tip Latitude Antenna Longitude A: 152.27000 'B l 20KOF3E 75.000: 35.000: 351: 15 '46-36-37 .120-30-34 157.53000 )10 20 20KOF3E 75.000 'TRANSMITTER 8TREE1T ADDRESS CITY COUNTY STATE A: 506 N 1ST ST, YAKIMA YAKIMA WA REA: OF OPERATION ITE: A: 80 KMRA�- 46-36-37N 120-30=34W YAKIM:A YAKIMA WA ONTROL POINTS: 512 If. 16 AVE YAKIMA WA ONTROL POINT PHONE: 509-248-1119 he !latitude/lonj5itude arm authorised in North American Datum 1927 (NAD27). 3ditionally, the antenna height to tip, ground elevation, AAT and area of. peeation units are authorized in metric. +FISSION DESIGNA�TOR(S:) CONVERTED TO CONFORM 'TO DESIGN�TOR(�) �',T OUT IN PART 2 OF THE tOMMISSIOX'S RULES.: FEDERAL f COMMUNICATIONS . COMMISSION PAGE 1 OF 1 This authorization becomes invalid and must be returned to the Commission if the station are not placed in operation within eight months, unless an extension of time has bee. granted. EXCEPTIONS. 1) 800 MHz trunked and certain 900 MHz station licenses cance automatically if not constructed within 1 year 2) IVDS authorizations automatically cance if service is not made available in accordance with Section 95.833(a) of the Commission' Rules 3) There are no time limitations for placing GMRS stations in operation. FCC 574-L April 1998 Printed on:10/20/20 atll:49:53 11 Rides Scheduled 1 Amb`Wheelchair Sort EXHIBIT "R" PGS 1-3 Ride Report Rides Scheduled roz-:10/21/1901 00:00 STARIT, ESTHER 700 N 40 AVE NAZARENE CHURCH (FIRST) A DAR -A (509)453-4425 3300 ENGLEWOOD # 312 PONDEROSA - REG CARD s:15 08:45 AMO, RAYMOND 401 POPLAR HOME - 0 A DAR -A (509)248-0576 206 N 5 AVE ST JOESEPH CHURCH 08:15 08:45 WICHERS, JULIE A 1010 S 9 ST **COND CARD** # 306 MEADOWS APTS - MESSAGE #453-0943 0 A DAR -A (000)000-0000 1705 W CHESTNUT FOUR SQ CHURCH 09:15 09:45 ANDERSON, HELEN 2712 CLINTON WY 1 -WAY HOME - REG CARD 0 A DAR -A (509)453-1528 707 W SPRUCE COMMUNITY OF CHRIST 09:15 09:45 ANDERSON, IVA G 2712 CLINTON WY 1 -WAY HOME - REG CARD 0 A DAR -A (509)453-1528 707 W SPRUCE COMMUNITY OF CHRIST 09:30 10:00 WICHERS, JULIE A 1705 W CHESTNUT FOUR SQ CHURCH 0 A DAR -A (000)000-0000 1010 S 9 ST **COND CARD** # 306 MEADOWS APTS - MESSAGE #453-0943 09:30 10:00 STARIT, ESTHER 3300 ENGLEWOOD # 312 PONDEROSA - REG CARD 0 A DAR -A (509)453-4425 700 N 40 AVE NAZARENE CHURCH (FIRST) 10:15 10:45 AMO, RAYMOND 206 N 5 AVE ST JOESEPH CHURCH 0 A DAR -A (509)248-0576 401 POPLAR HOME - 10:30 11:00 BELTON, MURPHY 206 S 10 AVE GRDN VLG - REG CARD 0 A DAR -A (509)453-4854 1302 S 8 ST PILGRIM REST CHURCH 11:00 11:30 BARRON, DONA M 1702 W PRASCH 1 -WAY # A HOME - EXPIRES 12-12-2001 0 A DAR -A (509)966-7787 705 S 38 AVE # 5 L D S CHURCH -- 38 12:45 13:15 BELTON, MURPHY 1302 S 8 ST PILGRIM REST CHURCH 0 A DAR -A (509)453-4854 206 S 10 AVE GRDN VLG - REG CARD Printed on:10/20/20 atll:49:53 11 Rides Scheduled 1 Amb`Wheelchair Sort 08:45 Ride Report Rides Scheduled For:10/21/1901 5100 W NOB HILL #130 BLSM HSE - REG CARD 444 08:30 09:00 WOODWARD, LORALEE J 2707 KING CT W/PCA HOME - REG CARD V W DAR -W (509)452-2873 310 N 16 AVE SAL ARMY - 16 -:45 09:15 KAPP, HENRY R 4007 TIETON R C C 444 W DAR -W (509)966-4560 3902 SUMMITVIEW WESTPARK METHODIST CHURCH 08:45 09:15 STRINGER, LINDA 4007 TIETON R C C - REG CARD 444 W DAR -W (509)966-4500 3902 SUMMITVIEW WESTPARK METHODIST CHURCH 08:45 09:15 DAWSON, MARGARET 5100 W NOB HILL #130 BLSM HSE - REG CARD 444 W DAR -W (509)972-7862 9 S 8 AVE FIRST PRESBYTERIAN CHURCH 09:30 10:00 DANKO, JOHN L 702 N 16 AVE 1/F GOOD SAM - REG CARD 444 W DAR -W (509)248-5320 1118 MC KINLEY UNITED PENECOSTAL CHURCH 09:30 10:00 LANE, ESTHER 115 N 10 ST HARITAGE GDNS 444 W DAR -W (509)248-4173 700 N 40 AVE NAZARENE CHURCH 10:40 11:10 STRINGER, LINDA 3902 SUMMITVIEW WESTPARK METHODIST CHURCH 444 W DAR -W (509)966-4500 1705 W CHESTNUT FOUR SQ CHURCH 10:45 11:15 DAWSON, MARGARET 9 S 8 AVE FIRST PRESBYTERIAN CHURCH 444 W DAR -W (509)972-7862 5100 W NOB HILL #130 BLSM HSE - REG CARD 11:00 11:30 CHELLY, DEBORAH 810 N 6 AVE PCA 1 -WAY #101 HOME - REG CARD 444 W DAR -W (509)248-7037 901 S 7 ST CHURCH 12:05 12:35 LANE, ESTHER 700 N 40 AVE NAZARENE CHURCH 444 W DAR -W (509)248-4173 115 N 10 ST HARITAGE GDNS 12:30 13:00 DANKO, JOHN L 1118 MC KINLEY UNITED PENECOSTAL CHURCH 444 W DAR -W (509)248-5320 702 N 16 AVE 1/F GOOD SAM - REG CARD 12:40 13:10 STRINGER, LINDA 1705 W CHESTNUT FOUR SQ CHURCH 444 W DAR -W (509)966-4500 4007 TIETON R C C - REG CARD 12:45 13:15 KAPP, HENRY R 3902 SUMMITVIEW WESTPARK METHODIST CHURCH 444 W DAR -W (509)966-4500 4007 TIETON R C C 15 13:45 WOODWARD, LORA-LEE J 310 N 16 AVE SAL ARMY - 16 44 W DAR -W (509)452-2873 2707 KING CT W/PCA HOME - REG CARD Printed on:10/20/20 at11:49:54 14 Rides Scheduled 3 Amb\Wheelchair Sort Ride Repo r t Rides Scheduled For:10/21/1901 10:30 11:00 EVANS, RUTH 206 S 10 AVE GARDEN VILLAGE - REG CARD SEDAN AT DAR-A/T (509)453-4854 1302 S 8 ST PILGRIMS REST CHURCH .:45 13:15 EVANS, RUTH 1302 S 8 ST PILGRIMS REST CHURCH 0 AT DAR-A/T (509)453-4854 206 S 10 AVE GARDEN VILLAGE - REG CARD SEDAN Printed on:10/20/20 at11:49:53 2 Rides Scheduled 2 EXHIBIT "S" PGS 1-2 EILERS. INC, 1003 W. YAKIMA AVENUE • SELAH, WASHINGTON 98942 PHONE. (509) 697-6346 • FAX (509) 698-4869 June 21 st, 2001 Russ Keen Access Paratransit, Inc. 612 No. 16th Ave. Yakima, WA 98902 RE: Renewal of Lease Dear Russ, As you know the lease we currently have with Access Paratransit, Inc. expired on October 31 st, 2000, and we have been operating on a month to month basis ever since until your contract with the City of Yakima expires and/or we enter into a new lease if and when your contract is renewed with the city. I felt it would be a good idea to contact you at this time to discuss some changes that we plan to make with regards to the lease. I'm assuming you will know something by September or October with regards to the renewal of your contract with the city. Under the terms of our original lease agreement, we leased Access Paratransit the portion of the warehouse and office space that you now occupy and the parking spaces adjoining the warehouse Access Paratransit was responsible for all maintenance within the interior of the building and we were responsible for maintenance to the exterior as well as the asphalt parking area. During the term of the lease we had the roof completely recovered and installed a new heating and air conditioning system for the offices. We also agreed to allow parking of extra vehicles in the graveled area behind the shop which was not included in the original terms of the lease and we allowed the washing of company vehicles in the parking area adjacent to the warehouse although there is not a proper drainage system set up for vehicle washing. Assuming your contract with the city is renewed and we enter into a new lease agreement, the following changes will be made to the lease: 1. The Term of the lease will run concurrently with the Term of your contract with the City. 2. The monthly lease payments will be as follows: 1 st year: $ 1,800.00 per month 2nd year: $ 1,890.00 per month 3rd year: $ 1,985.00 per month 4th year: $ 2,080.00 per month 5th year: $ 2,190.00 per month 3. The graveled parking area will be included as part of the leased premises within the terms of the lease. 4. We will continue to pay the water and sewer bili. Access Paratransit will be responsible for all other utilities. 5. The asphalted parking area will be overlayed and restripped. 6. Any interior maintenance for the offices and warehouse area will continue to be the responsibility of Access Paratransit. If you have any questions please feel free to contact me at your convenience. I'd also appreciate being notified as soon as you know when your contract with the City might be renewed. Sincerely, da� Craig Eilers ACCESS PARATRANSIT, INC. TECHNICAL PLAN QUESTION # 9 VEHICLE MAINTENANCE ACCESS PARATRANSIT, INC. TECHNICAL PROPOSAL VEHICLE MAINTENANCE PROGRAM (SCHEDULED PREVENTATIVE MAINTENANCE) ACCESS PARATRANSIT, INC. EXHIBIT "T" PGS I-9 612 N 16TH AVE YAKIMA, WASHINGTON 98902 PH. (509) 248-2229 Fax: (509) 248-9350 VEHICLE MAINTENANCE AND REPORTING PROCEDURES Most of the vehicle maintenance for Access Paratransi, Inc. (API) is performed in-house. Our mechanic is available to us 24 hours a day, when needed. Our mechanic has had many years of experience in repairing and maintaining all makes of vehicles. Major repairs are sent out to ASE certified shops and mechanics. Each operator is responsible for maintaining the interior of the vehicle they are driving. This is to say that all trash is kept picked up and out of vehicle at all times. Any articles that may have been left behind by clients is to be turned into the office immediately so that arrangements may be made to return the item(s). All problems that are deemed to be a potential safety issue must be reported immediately to management and mechanic in writing. Under NO circumstances will a vehicle be driven if there are safety issues in question. All repairs that are deemed a safety issue are given the highest priority. Vehicles with a safety issue are pulled off the road immediately for repair, and are not returned to service until such repairs have been completed, inspected, and tested. Preventative maintenance is performed on every vehicle and its equipment regardless of vehicle make, model, or type. This service is performed every 3,000 miles or once every week. Vehicle or client accidents or incidents are all reported to the General Manager and CEO for investigation and review. All these files are kept in General Managers office. Every incident or accident will be reported regardless of how insignificant it might seem to the operator and or the client. ACCESS PARATRANSIT, INC PROCEDURES FOR REPORTING DAILY VEHICLE MAINTENANCE THE FOLLOWING PROCEDURES HAVE BEEN IMPLEMENTED TO INSURE THAT EVERY ACCESS PARATRANSIT VEHICLE IS BEING MAINTAINED TO THE FULLEST CAPACITY, AND WILL BE ENFORCED WITHOUT FAIL. (1) DAILY DRIVER INSPECTION FORM TURNED IN NIGHTLY (2) RANDOM VERIFICATION OF DRIVER INSPECTION FORM CHECKED BY MANAGEMENT DAILY (3) FULL SAFETY MAINTENANCE CHECK EACH VEHICLE EACH VVTEEK (4) NORMAL PREVENTATIVE/ SCHEDULED MAINTENANCE RECORDS CURRENTLY AVAILABLE (5) REPAIR / REPLACE BASED ON DAILY INSPECTION FORMS EVERY DRIVER WILL USE THE DAILY DRIVER INSPECTION REPORTS, THESE ARE AVAILABLE WITH THE DAILY RIDE SHEETS IN THE LOUNGE. ANY DRIVER(S) THAT DO NOT CHECK THE VEHICLE BEFORE YOUR FIRST RUN, WILL BE SENT HOME FOR THAT DAY. YOU MUST BE WILLING TO DO YOUR PART IN THE "SAFETY FIRST" ROUTINE. DAILY VEHICLE INSPECTIONS BY DRIVERS IS REQUIRED. FRAILURE TO DO SO WILL BE CONSIDERED GROUNDS FOR SUSPENSION OR TERMINATION. ACCESS PARATRANSIT, INC. PRE -TRIP INSPECTION SHEET DATE BEGIN MILEAGE 1`LVID LEVELS: VEHICLE � DRIVER A. OIL OK LOW ADDED QT B. COOLANT OK LOW C. BRAKE IFLViD OK LOW D. TRANSMISSION OK LOW ADDED QT (check when c"s iw is hot, mAke sure to push Sipstick Sown to prevent over ft".5) E. POWER STEERING 1=LVID OK LOW TIRES: OK LOW (BAD) RF LP RR LR SPARE CABLES PRESSURE SANDBAGS EQVIrMENT: LIG14TS: SEATBELTS HEADLIGHTS GLASS TAIL LIGHTS RADIO BRAKE LIGHTS A / C TARN SIGNALS HEATER INTERIOR LIG14TS MIRRORS MARKER LIGHTS WIC UfT HAZARD LIGHTS W/C S£CVREMENTS DASH LIGHTS EMERGENCY BRAKE EMERGENCY EQUIPMENT: FIRST AID KIT TRIANGLES FIRE EXTING"SHER BODY 1=LV1DS KIT STRAP CUTTER PROBLEM AREAS: ACCESS PARATRANSIT, INC. POST TRIP INSPECTION/DEFECT REPORT DATE ENDING MILEAGE VEHICLE * SHVT DOWN: SET PARKING BRAKE TVRN LIGHTS OFF TVRN RADIO OFF TVRN ENGINE OFF INTERIOR WALK THRV: PICK VP TRASH CLOSE WINDOWS STOW SECVR£MENTS DRIVER TOTALMILEAGE POST TRIP EXTERIOR WALK AROVWD: NEW DAMAGE LOCK DOORS REMINDER FOR 1%" IN: KEYS _ DAILY TRIP SHEETS VEHICLE PRE £r POST INSPECTIONS DEFECT C�hi:I AP] BRAKES _ STEERING _ W/C DOOR BVZZ£R _ HORN _ WIPERS _ TIRES _ W/C SECVREMENTS _ PARKING DRAKE _ SEATS _ HAND RAILS _ GAVGES _ INTERIOR LIGHTS _ EXTERIOR LIGHTING _ GLASS CHIPPED TRANSMISSION _ LIFT/DOOR _ SVSP£NSION _ ENGINE _ EMERGENCY EQVIPMENT SPILL KIT _ FIRST AID KIT _ EXTINGVISHER _ TRIANGLES _ V£141CLE CLEANLINESS INTERIOR _ EXTERIOR _ TRVNK SCRATCHED MECHANICAL DEFECTS DRIVER'S SIGNATURE CRACKED ACCESS PARATRANSIT, INC. PREVENTATIVE DEFECT REPORT DATE VEHICLE # VEHICLE DEFECT: DRIVER NAME DO NOT WRITE BELOW THIS LINE - MAINTENANCE DEPQARTMENT USE ONLY DATE START: DATE COMPLETED: MILEAGE: REPAIR PERFORMED: SEE ATTACHED WORK ORDER FORM VEHICLE INSPECTION AND ROAD TEST C�NORMALCNEEDS ATTENTIOI REPAIR/REPLACE ADJUSTED NiA NOT APPLICABLE BRAKE OPERATION ENGINE PERFORMANCE TRANSMISSION OPERATION STEERING AND HANDLING GAUGES AND INDICATORS HEATER AND AIR CONDITIONING WIPERS AND WASHERS EMERGENCY BRAKE OPERATION INTERIOR AND EXTERIOR LIGHTS WHEELCHAIR LIFT OPERATION HORN OPERATION COMMENTS: MECHANIC OIL LEVEL TRANSMISSION FLUID LEVEL POWER STEERING FLUID LEVEL COOLANT LEVEL BRAKE FLUID LEVEL BATTERY LEVEL ANY FLUID LEAKS HOSE CONDITION BELT CONDITION AND TENSION SAFETY EQUIPMENT SUPERVISOR DATE: VEHICLE #: LICENSE #: ODOMETER AT SERVICE DATE: MATERIAL USED IN SHOP WORK PART # TASK QTY SORCE DESCRIPTION ACCESS PARATRANSIT MAINTENANCE RECORD WORK ORDER # CHECK IF THIS IS A CONTINUATION PREVIOUS RELATED WORK ORDER # STATUS DATE / TIME SERVICE REQUEST RECEIVED I SERVICE STARTED SERVICE FINISHED I CLASS OF SERVICE REASON SCHEDULED ACCIDENT UNSCHEDULED BREAKDOWN ROAD CALL NORMAL WEAR REWORK DRIVER ABUSE COVERED BY WARRANTY SEASONAL PREP. EQUIPMENT TOWED BY PRESERVICE THEFTNANDAL OTHER SHOP WORK PER CAPITAL IMPROV ORMED SUPPLIES INVENTORY FOR JOB TASK HOURS INVOICE # SUPPLIER SERVICE AUTHORIZED BY: ACCEPTED BY: ACCESS PARATRANSIT, INC. REGULAR MAINTENANCE INSPECTION SCHEDULE VEHICLE # WORK ORDER # (1) ROAD TEST INSPECTION (5) BRAKE WARNING LIGHT PARKING BRAKE AND WARNING LIGHT WINDSHIELD WIPERS AND WASHERS IGNITION SWITCH STARTER ENGINE CRANK AND START TIME ENGINE OPERATION WHILE COLD CHARGING SYSTEM OIL PRESSURE HIGH BEAM LIGHT INDICATOR BRAKE PEDAL PRESSURE HORN OPERATION GEARSHIFT POSITION INDICATOR STEERING COLUMN CONDITION AND PLAY REVERSE WARNING DEVICE HEATER AND DEFROSTER OPERATION AIR CONDITONER OPERATION MIRRORS (TIGHTNESS AND VIBRATION) TRANSMISSION OPERATION SPEEDOMETER OPERATION ACCELERATOR OPERATION ENGINE PERFROMANCE ENGINE NOISE TIRE NOISE BEARING NOISE TEMPERATURE GAUGE LISTEN FOR GROANS, CREAKS, RATTLES ENGINE WARM IDLE ENGINE SHUT DOWN ANY OTHER PROBLEMS NOTED THE FOLLOWING WILL BE INSPECTED FLUID LEAKS COOLANT ENGINE OIL TRANSMISSION FLUID POWER STEERING FLUID DIFFERENTIAL BRAKE FLUID FUEL EXHAUST SYSTEM ENGINE AND TRANSMISSION MOUNTS BRAKE PADS AND SHOES BRAKE LINES AND HOSES FUEL LINES BODY MOUNTS PAGE 1 MILEAGE DATE (2) THE FOLLOWING ITEMS WILL BE LUBRICATED FRONT AXLE SPENDLE PINS STEERING LINKAGES DRIVESHAFT UNIVERSAL JOINTS AUTOMATIC TRANSMISSION LINKAGE WHEELCHAIR LIFT DOOR LOCKS AND HINGES (3) CHANGE THE FOLLOWING ITEMS ENGINE OIL ENGINE OIL FILTER AIR FILTER PCV VALVE (4) TIRE CHECK ON HOIST FRONT WHEEL BEARING KING PINS TIRES AND WHEELS CRACKS OR DAMAGE TIRE DEPTH LEFT FRONT RIGHT FRONT LEFT REAR OUTER LEFT REAR INNER RIGHT REAR OUTER RIGHT REAR INNER ROTATE TIRES (IF NEEDED) REAR SPRINGS FOR CRACKS SHOCKS FOR LEAKS OR WEAR PARKING BREAK LINKAGE (ADJUST) DRIVE SHAFT AND U -JOINTS (PLAY) (6) INSPECT FLUID CONDITION AND LEVEL POWER STEERING BATTERY WASHER ACCESS PARATRANSIT, INC. PREVENTATIVE MAINTENANCE INSPECTION SHEET VEHICLE 9 WORK ORDER # MILEAGE DATE (7) CHECK FOLLOWING LIGHTS AND SWITCHES PARKING LIGHTS HEAD LIGHTS TURN SIGNALS BRAKE LIGHTS EMERGENCY FLASHERS DASH LIGHTS CLEARANCE LIGHTS BACKUP LIGHTS INTERIOR LIGHTS EMERGENCY EXIT LIGHTS (8) UNDER HOOD INSPECTION ALL BELTS ALL COOLANT HOSES CHECK BATTERY POST CHECK FAN AND FAN SHROUD TEST WATER PUMP FOR BEARING PLAY CLEAN TWO WAY RADIO CONNECTION AIR CONDITIONER HOSES (9) EXTERIOR INSPECTION CONDITION OF MIRRORS CONDITION OF WINDOWS AND WINDSHIELD LICENSE PLATE AND TABS GENERAL BODY CONDITION TORQUE WHEEL LUG NUTS CLEAN TWO WAY RADIO ANTENNA MECHANIC SIGNATURE COMMENTS 7Tej;w (10) INTERIOR INSPECTION CONDITION AND PLACEMENT OF WARNING SIGNS WORN, TORN, OR DAMAGED INTERIOR CHECK SEATS FOR LOOSENESS OPERATION OF ALL EMERGENCY EXITS CONDITION OF ASSIST BARS CONDITION OF SEAT BELTS CONDITION OF WHEELCHAIR SECUREMENTS CONDITION OF HEADLINER ( 11) EMERGENCY EQUIPMENT FIRST AID KIT FIRE EXTINGUISHER REFLECTOR TRIANGLES SPILL KIT ACCIDENT PACKAGE REGISTRATION AND INSURANCE CARD ( 12) WHEELCHAIR LIFT INSPECTION MISALIGNMENT STRESS CRACKS IN LINKAGE WORN PARTS CONDITION OF ELECTRICAL WIRING AND SWITCHES HYDRAULIC LEAKS SMOOTH OPERATION SUPERVISER SIGNATURE ACCESS PARATRANSIT BI- WEEKLY VEHICLE INSPECTION SHEET (N) - NEEDS ATTENTION (R) - REQUIRES REPAIR - NORMAL (NA) - NOT APPLICABLE COMMENTS VEHICLE # - MAKE - VIN # - YEAR - LICENSE # - ODOMETER - ROAD TEST / ENGINE COMPARTMENT INTERIOR CHECKS 1 HORN OPERATION ALL ENGINE FLUIDS 2 20 OIL AND COOLANT LEAKS 3 WINDOWS AND LOCKS HOSE CONDITION 4 23 BATTERY AND CONNECTIONS 5 FLOORING BELT TENSION AND CONDITION 6 26 BRAKE OPERATION 7 INSURANCE / REGISTRATION PAPERS EMERGENCY BRAKE OPERATION 8 29 ENGINE PERFORMANCE 9 1WHEELCHAIR LIFT PROPER OPERATION, TRANSMISSION OPERATION 10 31 STEERING AND HANDLING 11 GAUGES AND INDICATORS 12 33 HEATER AND AIR CONDITIONING 13 REAR SUSPENSION WIPERS AND WASHERS 14 36 REAR DEFROSTER 15 TIRES HEAD LIGHTS HIGH AND LOW BEAM 16 STOP, BACKUP,TURN, MARKER LIGHTS 17 ENGINE, TRANNY, MOUNTS PASS / FAIL - DATE - RETEST PASS / FAIL `DATE - 18 HORN OPERATION 19 INTERIOR LIGHTS 20 REARVIEW / SIDE MIRRORS 21 WINDOWS AND LOCKS 22 SEATBELTS WORKING AND SECURE 23 SEATS SEAT UPHOLSTERY 24 FLOORING 25 HEAD LINER 26 DOOR PANELS / HANDLES 27 INSURANCE / REGISTRATION PAPERS 28 FIRE EXTINQUISHER, FIRST AID KIT, TRIANGLES 29 TRACTION DEVICES SEASONAL 30 1WHEELCHAIR LIFT PROPER OPERATION, TIE DOWNS CLEAN SMOOTH OPERATION 31 GLASS CONDITION 32 FRONT STEERING AND SUSPENSION 33 U -JOINTS / DRIVE LINE 34 REAR SUSPENSION 35 FRONT / REAR BRAKES 36 LUGS, RIMS, CRACKS, HUBS 37 TIRES 38 BODY AND PAINT JOB DESCRIPTION EXHIBIT "U" DETAILER JOB DESCRIPTION: VEHICLE DETAILER REPORTS TO: MANAGER/ OPERATIONS COORDINATOR DESCRIPTION OF JOB DUTY: Vehicle detailer must clean vehicle completely inside and out. The following must be completed on every vehicle in the fleet every weekend. API will provide all cleaning fluids and cleaning materials. If the shampooing of carpet is needed in any vehicle, notify management immediately. (1) Wash all windows inside vehicle with window cleaner. (2) Wipe down all of interior with cleaner provided by API. This includes all door panels, dash and related parts of dash, vinyl seats, etc. (3) Vaccum all upholstry and capets. (4) Make sure that the floors in vans are cleaned thoroughly. (5) All hand railing in vans must be wiped down. (6) Walls in vans are to be wiped down. (7) All vehicles are to be washed on the outside with the pressure washer at API. Make sure all of the vehicle is washed including the wheels. (8) After washing the vehicle inside and out, park the vehicle in a space vacant on paved parking lot to dry. ACCESS PARATRANSIT, INC. TECHNICAL PLAN QUESTION # 10 VEHICLE LISTING ACCESS PARATRANSIT, INC. VEHICLE LISTING EXHIBIT "V" FAGS 1 & 2 VEHICLE # # OF W/C # OF AMB POSITIONS DISPOSITION UPON RECIEVING CONTRACT PLATE # YEAR MODEL VIN # CURRENT MILEAGE POSITIONS D-1 1991 CHEV CAPRICE lGlBL5372MW219995 89948.2 0 5 WILL REMOVE FROM SERVICE 677 LTP I I I I I AND REPLACE WITH 1994 D-2 1991 CHEV CAPRICE 1G1BL53E2MR135575 247466 0 5 WILL REMOVE FROM SERVICE 249 HIL AND REPLACE WITH 1994 D-3 1991 CHEV CAPRICE 1G1 BL53EXMR127899 189233.8 0 5 WILL REMOVE FROM SERVICE 252 HIL I I I I AND REPLACE WITH 1994 D-4 1991 CHEV CAPRICE 1G1 BL5370MR126536 123537 0 5 WILL REQUEST A WAIVER 807 LQJ D-61992 CHEV CAPRICE 1G1 BL5376NR134271 153902.7 0 5 WILL REQUEST A WAIVER 676 LTP D-8 11991 CHEV CAPRICE 1G1BL53F8MR128128 235362.8 0 5 WILL REMOVE FROM SERVICE 246 HIL AND REPLACE WITH 1994 V-1 1993 FORD E-350 1 FDKE30MXPHB57041 229068.7 4 9 WILL REQUEST A WAIVER 444 LIV V-7 1988 FORD E-350 1 FDKE30G7JHB52431 110014.1 5 2 WILL REQUEST A WAIVER 996 KGT V-8 1993 FORD E-350 1 FDKE30MSPHB80596 261902 4 9 WILL REQUEST A WAIVER 036 KTW TM -1 1984 FORD F-150 I 1 FMEE11 F3EHB22842 142803.7 I 3 I I 1 WILL REMOVE FROM SERVICE A71.1 AND REPLACE WITH 1994 "NOTE" WE WILL BE REPLACING THE OTHER 1991 VEHICLES WITHIN (4) FOUR MONTH INTERVALS ACCESS PARATRANSIT, INC. VEHICLE LISTING VEHICLE # # OF WIC # OF AMB POSITIONS DISPOSITION UPON RECIEVING CONTRACT PLATE # YEAR MODEL VIN # CURRENT MILEAGE POSITIONS D-2 REPLACE 1994 CHEV CAPRICE 1G1 BL52W2RR144343 UNKNOWN 0 5 WILL BE REPLACING D-2 D-3 REPLACE 1994 CHEV CAPRICE lGlBL52W3RRO145503 UNKNOWN 0 5 WILLBE REPLACING D-3 D-8 REPLACE 1994 CHEV CAPRICE 1G1BL52PXRR125211 UNKNOWN 0 5 WILL BE REPLACING D-8 D- BACKUP 1994 CHEV CAPRICE 1G1 BL62P1 RR126159 UNKNOWN 0 5 POSSIBLE PURCHASE FOR BACKUP D- BACKUP 1994 CHEV CAPRICE 1G1BL52P6RR125142 UNKNOWN 0 5 POSSIBLE PURCHASE FOR BACKUP D- BACKUP 1994 CHEV CAPRICE 1G1 BL52PXRR124706 UNKNOWN 0 5 POSSIBLE PURCHASE FOR BACKUP "NOTE" WE ARE UNABLE TO GET ANY THIRD PARTY INFORMATION UNTIL NOVEMBER 3RD. THE AUCTION IS SET FOR NOVEMBER 17, 2001, AT WHICH TIME WE WILL PURCHASE AT LEAST (4) FOUR OF THESE VEHICLES IF NOT MORE.