~stormont...2020/11/12 · basketball court and park amenities located at ripley park utilizing...

C. PARKS+ RECREATION- Tim Laurent

1. Consider approval of request for a Project Budget of $60,512.50 for the replacement of a basketball court and park amenities located at Ripley Park utilizing operating funds, and request approval to solicit bids for the basketball court replacement projects at Ripley and Cushinberry Parks.

2. Consider approval of request to award the bid to Martinek and Flynn in the amount of$40,166.00 for the replacement of siding and windows at Forbes Golf Course Pro Shop with funding from the Building Maintenance Fund, and an additional cost of$1,040.00 for the removal and disposal of any asbestos material (utilizing Forbes generated revenue), and authorization and execution of Contract C468-2020 for same.

D. REGISTER OF DEEDS- Rebecca Nioce

1. Consider authorization and execution of Contract C469-2020, a 4 year renewal agreement with Fidlar Technologies for document recording software services at annual costs of year one $35,647.00, year two $36,717.00, year three $37,818.00, and year four $38,952.00, utilizing the Register of Deeds Technology fund.

E. WEED DEPARTMENT- John Landon

1. Consider authorization and execution of Contract C470-2020, a lease and storage agreement with Propane Central to provide a cage and 5 propane cylinders to be stored and restocked monthly for forklift use with the cylinder cost to remain the same.

F. SHERIFF'S OFFICE- Brian Hill

I. Acknowledge receipt of correspondence from Sheriff Hill regarding renewal of the Annual Software Maintenance agreement (Contract C471-2020) with Tyler Technologies with funding split between the Sheriff's Office, DOC, Topeka Police, and Topeka Fire Department for the maintenance of the Record Management System at a cost of $91,956.21 for the Sheriff's Office and DOC's portion with funding from the 2020 budget.

2. Acknowledge receipt of correspondence from Sheriff Hill regarding the purchases off the state contract for a Chevrolet Traverse ($27,074.75) and a Dodge Ram 1500 ($24,570.52) with funding from the 2020 departmental budget.

V. ADMINISTRATIVE COMMUNICATIONS

VI. EXECUTIVE SESSIONS

~Stormont Vail EVENTS CENTER

STORMONT VAIL EVENTS CENTER ADVISORY BOARD MEETING Heritage Hall

Wednesday, November 11,2020

Roll Call Approve Minutes

Lunch at 11:30 12:00-1:00

AGENDA

Capital Expenditures - General Manager & Operations Director

STAFF REPORTS General Manager- Kellen Seitz Financial- Donna Casebier Operations - Matt Rockers Events - Martin De Jesus Livestock- Hope Hall Marketing - Allie Geist Sales/Partnerships- Kyler Tarwater

REPORTS The Vail Remodel and Expansion- SNCO Counselor, Jim Crowl Capital Plaza Hotel - Dan Clarizio Heart of America- Bob Lohmeyer Kansas State Extension - Cindy Evans

ADJOURN

NEXT BOARD MEETING

Heritage Hall December 9, 2020

I 2:00pm

SPECTRA

~.

STORMONT VAIL EVENTS CENTER ADVISORY BOARD MEETING Wednesday, October 14, 2020

Heritage Hall !2:00P.M.

The following members were present for the board meeting: Chair Rich Eckert; ViceChair Pam Walstrom; Commissioner Aaron Mays; Bruce Graham; Dave Graversen Duncan Whittier; Stacy Ricks; Bill Beach; Sean Dixon, Visit Topeka

Also, present were: Kellen Seitz, General Manager; Donna Casebier, Director of Finance; Matt Rockers, Director of Operations; Allie Geist, Director of Marketing; Kyler Tarwater, Director of Partnerships; Brie Berggren, Convention Sales Manager; Martin De Jesus, Director of Events; Hope Hall, Livestock Events Manager; Jim Crowl, SNCO Counselor/Spectra Contract Administrator; Bill Kroll, SNCO Facilities Manager; Cindy Evans, KS State Extension Director; Matt Purvis, Visit Topeka

Eckert called the meeting to order at 12:00 P.M. Roll call was taken.

Walstrom made a motion to approve the September minutes. Graham seconded the motion. Motion passed.

Capital Expenditures: Rockers' operations report is attached hereto and made a part of the minutes. There were no capital expenditures to vote on.

General Manager's report: Seitz's report is attached hereto and made a part of the minutes.

Financial report: Casebier stated we are currently behind budget by about $681,000.00. Due to the August dog show splitting into two factions, one being significantly smaller than normal, August revenues were down from last year.

Livestock report: Hall's report is attached hereto and made a part of the minutes.

Event report: De Jesus's report is attached hereto and made a part of the minutes.

Marketing report: Geist's report is attached hereto and made a part of the minutes.

Corporate Partnership report: Tarwater's report is attached hereto and made a part of the minutes.

The Vail Expansion and Remodel: Crowl stated renovation work is scheduled to be substantially completed by April2021 but possibly sooner. McCown Gordon has done a great job keeping to the schedule though the pandemic helped move things along quickly. Final budgets are being looked at. A new chiller system will most likely be added into the

1

budget as well as a few other items that will add to the patron experience while at events, as well as items that will drive revenues.

Capitol Plaza Hotel report: Clarizio was not present at the meeting.

Heart of America report: Lohmeyer stated they are pleased with the foodservice required for the equine events as well as the most recent Gun and Knife Show in Exhibition Hall.

Kansas State Extension report: Evans stated they are working with Kroll and the county to post better signage for their parking area. With all the work being done on Western Street by the city there has been some issues with The Vail clients using spaces reserved for Extension office staff and clients.

THERE BEING NO OTHER BUSINESS to come before the board, the Stormont Vail Events Center Advisory Board adjourned at 1:00 P.M.

Rich Eckert, Chair Prepared by Brianna Berggren

2

SPECTRA -BY COMCAST SPECTACOR

Memorandum To: Stormont Vail Events Center Advisory Board

From: Kellen Seitz, General Manager

Date: October 14, 2020

Re: September 2020 Advisory Board Report

September was full of equine and livestock activity which has been a mainstay of event activity as we continue to navigate the Coronavirus pandemic. But furthermore, September was a very productive month in regard to advancement of our Coronavirus relief infrastructure and moving towards final acquisition of these important pieces to help maintain safety of our guests, staff and promoters, while enhancing the patron experience with new technologies.

We have been able to get formal approval on all of our requested pieces of Coronavirus infrastructure. We have solicited three separate RFQ's for contactless and touchless patron interface items. These items include, walk through metal detectors, contactless self-service ticket scanning pedestals and contactless parking payment systems and reservation integration into our ticketing platform, Ticketmaster. We have also been able to secure a new mobile ordering platform for our food and beverage system that allows patrons to order F&B items directly from their mobile devices, tablets, and other network technologies and pick those items up at any of our concession areas.

As you know, we have already secured enough PPE and cleaning materials, higher capacity HV AC filters, clear bags and other health related items to make the transition to these new services and technologies smooth and seamless once we are able to produce events back to the normal levels we saw before March of2020.

Our events and convention sales teams have been hard at work securing events for the coming year, and increasing our focus on convention business into the new expanded Ex-Hall space in conjunction with the GTP and Visit Topeka. We have also made some new movement on increased event load with offers and event holds for live entertainment content into Q2 and Q3 of 2021. We continue to

remain optimistic as we look towards the future and are working hard on behalf of the county and our

community to charge ahead on seizing every opportunity that comes available.

This concludes my report and I will be happy to answer any additional questions you may have.

2

SPECTRA


From: Matt Rockers, Director of Operations

Date: October 8,2020

Re: September Advisory Board Report

Operations Update: During the month of September our operations team was busy with our largest equine events of the year. With a limited operations staff we were able to handle the event load and continue to provide great service to our clients. Riley Graf our chief engineer has been busy installing the new WiFi system in Exhibition Hall, Landon Arena, and Domer Arena, this system will be capable of handling all internet traffic for thousands of users simultaneously. We will also be starting to install the new digital menu boards in the coming weeks. These will provide an opportunity for Heart of America as well as our marketing and sales teams to advertise their products, upcoming events, and sponsors in a new way. We have also been using this time to try and reorganize our back of house areas so that when events do become possible we will be able to operate more efficiently than before.

Capital Expenditure Items: None at this time.

If you have any questions, I will be happy to answer them.

Matt Rockers Director of Operations

SPECTRA


From: Martin De Jesus



September was a quiet month at the Events Center as a result of coronavirus; every event in the arena,

exhibition hall and the community buildings was either postponed or cancelled. In addition, my Event

Manager resigned and returned home to Florida for personal reasons, leaving a vacancy in my

department. But like a lot of other problems that have arisen with the coronavirus, there was a silver lining on the horizon.

With Joshua's departure I was able to bring my furloughed Coordinator off the bench and back into the office. Katherine was hired just before the pandemic closed our offices in March but was unable to get

properly trained or work any events of her own. The deceleration of events gave us the opportunity to go

in detail in new responsibilities and even gave her the chance to learn some of what the manager position

entails, work that she wouldn't be privy to had Joshua still been here. In addition to this, this month gave

the Events Department the opportunity to channel our efforts into other items that we typically don't get to work on.

In August, our events and sales/marketing members started an In-house events committee which

brainstorms possible ideas for events to host during this uncertain period. One of the events that we are

working on is our Trunk or Treat event on Friday October 30th. The Trunk or Treat will look to provide a

fun, safe alternative to trick or treating this year. We are still looking to add trunks to the event; If you are

interested in joining us on that day, please reach out to myself or Allie before October 26th!

This concludes my report.

Respectfully,

Martin De Jesus

SPECTRA -BY COMCAST SPECTACOR


From: Hope Hall, Livestock and Equine Manager


Re: October Advisory Board Report

The month of September was very busy in the Domer Arena, we had a show every weekend of the month. All but one show sold out the stalls, which presented the problem of getting them cleaned and ready for the next show coming in, mostly in 48 hours. The Operations staff stepped up and we were able to complete the task and keep the shows rolling. Of course, with that many shows there were a few difficulties which we met and had to work through, mainly Western Ave. being closed, which made it difficult to keep traffic flowing to load and unload that many horses. Matt Rockers worked with the contractors and together they came up with a temporary solution and we were able to get the flow moving again. During the 30 days of September we were able to host 5 shows and 1- 4 H Clinic, which totals 21 days of occupancy in the Domer Arena and Stall Bam.

On the schedule September and October: September 5-7,2020- Cowgirl Tuff Barrel Bash September 10-13, 2020- Sunflower Slide Reining Horse Show September 18-20, 2020- National Barrel Horse Association Regional Finals September 23-27,2020- Kansas Quarter Horse Association Hope In The Heartland Show October 3-4, 2020- 4H Horse Show October 14, 2020 - KS 09 Barrel Race October 21,2020- 4H Horse Clinic October 23-25, 2020 KS 09 Barrel Race October 30- November 1, 2020 -Kansas Hunter/Jumper Show

We are continuing to follow all COVID-19 guidelines and restrictions. We are adding staffwere needed to enforce these requirements and are continuing to move forward.

This concludes my report and I will be happy to answer any questions. Hope Hall Livestock and Equine Manager

SPECTRA


From: Allie Geist, Director of Marketing

Date: September 6, 2020


While Domer Arena was hustling with events, it was a light month for the rest of the buildings. However, the Marketing Department kept busy working on potential in-house events, branding and planning the announcement of a new community event and building out our Social Media Calendar.

We continued research on our potential in-house event ideas. We have hit a few snags on several ideas due to the changing event environment. However, even the events that we decided we cannot hold this year, we have established a great jumping-off point and intend to see them through in the future. We now have relationships with eSports gaming companies, mobile escape rooms, on-site printing companies, drone racing clubs, etc.

As a team, we have been able to put together a Halloween event for the community that abides by the current health guidelines - Drive-Thru Trunk or Treat. After the Marketing Department created the branding and marketing materials, the entire admin team started reaching out to businesses and organizations that would be interested in participating in the event. We brainstormed the logistics, set-up, decor, and rules. This event will occur on Friday, October 30th.

Content creation for the Social Media Calendar was important during a month with few events. We were able to work ahead in September with the revamped calendar and focused heavily on equine and renovation highlights. Across all our social media accounts, Instagram boasted the best numbers this past month, with two of the renovation posts showing the highest reach.

Feel free to ask me questions!

Thank you,

Allie Geist

SPECTRA


From: Kyler Tarwater, Director of Partnerships - Spectra


Re: September 2020 Advisory Board Report

The Partnerships division continues to spend significant time working to move partners and their focus from 2020, into a more positive, post-Covid outlook for 2021. As fodder when speaking with prospects, I highlight industries such as travel, conventions, and entertainment that have been forced to look into what must happen in 2021 to stay afloat vs. what is happening in September of 2020.

Recently signed partner, Happy Basset Brewing Company, is one local business looking to expand promotion during Covid to better prep for a January, new-entertainment model launch. Another new partner, LBM Solutions is also prepping for the new normal and has agreed to a strong, and somewhat unique partnership for entire campus.

Both of these new partners have approached the Covid slowdown as an opportunity to improve their professional visibility and I intend to continue to target these new, smaller, potentially more aggressive promotional partners.

Also continuing from September and into October are the multiple renewals still pending and set to expire over the next 4 months. These renewal efforts are critical for the Partnerships division and vital to our continued success here at the Stormont Vail Events Center.

This concludes my September summary.

Sincerely,

Kyler Tarwater Director of Partnerships

TO:

FROM:

DATE:

RE:

OFFICE OF THE DISTRICT ATTORNEY THIRD JUDICIAL DISTRICT OF KANSAS

Michael F. Kagay, District Attorney

MEMORANDUM

Board of County Commissioners

Michael F. Kagay, District Attorney 1\IC---

November 3, 2020

Request for Diversion Fund Payments

The District Attorney's Office wishes to pay the following invoices from its Diversion Fund account:

1) City of Topeka Parking Section for subpoenaed witnesses and volunteer parking a) Invoice No. P100009476 dated October 29,2020 in the amount of$90.00

2) EPIC Business Essentials for office supplies a) Invoice No. S100410512 dated October 29,2020 in the amount of$256.55

3) Lynch, Johanna for transcript fees a) Invoice dated October 29, 2020 in the amount of $24.50 b) Invoice dated October 29, 2020 in the amount of$59.50 c) Invoice dated October 29, 2020 in the amount of $22.00

The District Attorney's Office hereby requests placement on the consent agenda for consideration of the above itemized invoices, in the total amount of $452.55, to be paid from the Diversion Fund account.

Shawnee County Courthouse 200 SE 7th Street, Suite 214 • Topeka, Kansas 66603 • (785) 251-4330

!:

QTY DESCRIPTION 1 10/1 PkNShp 1VCHR 1 1 0/15 PkNShp 6VCHR 1 10/13 PkNShp_1VCHR 1 10/20 PkNShp 1VCHR 1 10/22 PI<NShi:> 2VCHR 1 10/27 PkNShp 6VCHR

Invoice No: Invoice Amount: Invoice Date: Due Date: Customer No.:

PI00009476 $90.00 10/29/2020 11/13/2020

EXT PRICE 3.00

11.00 3.00 3.00 4.00

20.00

QTY DESCRIPTION 1 10/9 PkNShp 4VCHR 1 10/14 PkNShp 7VCHR 1 10/21 PkNShp 2VCHR 1 10/26 PkNShp 2VCHR 1 10/23 PkNShp 1VCHR

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Account Balance: $90.00

Please detach and remit with payment!

Invoice Amount: $90.00 PI00009476 10/29/2020

Invoice No: Invoice Date:

CITY OF TOPEKA

Billing lnquirie? (785) 368-3916 Payment Inquiries: (785) 368-3916

Account Balance:

CITY OF TOPEKA PARKING SECTION 620 SE MADISON UNIT 10 TOPEKA, KS 66607

Customer No.:

SHAWNEE CO DISTRICT ATTORNEY VICTIM/WITNESS 200 SE 7TH ST TOPEKA, KS 66603

$90.00

EPI€ ·BUSINESS BSfNnAlS

Remit EPIC Business Essentials LLC To: 5600 N. River Road, Suite 700

Invoice Questions: 847-261-0052 Rosemont, IL 60018

316-491-2607

Sold SHAWNEE COUNTY

To: 200 SE 7TH ST

TOPEKA, KS 66603

· Local Derwery Provided By: SALES JNVOJCE OFFICE PLUS OF KANSAS

316-491-2607

Sales Invoice Number: SI00410512

Sales Invoice Date: 10/29/20

Page: 1

Ordered By: Kathy Beach

Ship DISTRICT ATIORNEY

To: Kathy Beach

200 SE 7TH RM 214

DISTRICT ATIORNEY

TOPEKA, KS 66603

I ACCT. NO. l Sales Order No. CUSTOMER PO DEPARTMENT DUE DATE I

I PNW324425 000000

Item Number · · . Description Customer ID:

UNV21200 PAPER,XERO/DUP,WELTR,20#

Contract Item

CL014882 REFILL,F/TOILET WAND,6/PK

PAP5032315 CORRECTION, DRYLINE,S/CD

Contract Item

UNV04117 RUBBERBANDS,SIZE117, 1/4LB

Per OMNIA Contract# R190301

OFX00020G CREAMER,NON DAIRY


Amount Subject to Sales Tax

0.00

Amount Exempt from Sales Tax

256.55

11/28/20

Ord Qty Ship Qty Unit Price Total Price

6 CT 6 CT 35.99 215.94

PK PK

3 PK 3 PK 8.55 25.65

1 PK 1 PK 1.16 1.16

2 PK 2 PK 6.90 13.80

Subtotal: 256.55

Total Sales Tax: 0.00

Total: 256.55

Memorandum

Date: November 5, 2020

To: Board of County Commissioners

From: Pat Oblander, Information Technology Director

Shawnee County

Information Technology Room 205, Courthouse

200 SE 7th Street Topeka, Kansas 66603-3933

RE: Renewal of subscription with PluraiSight, LLC. {C491-2013) for an additional three years.

The Information Technology Department is requesting approval to renew a subscription for 3

years of licensing for access to online training courses for 10 staff members from PluraiSight

LLC. The courses are all focused on software development topics and are self-paced and

accessible at any time allowing greater flexibility for scheduling. This training has proven to be

of great value to our staff as they keep up with changes as they occur in the fast moving

software development industry.

Funding to support this purchase, $17,370, is included in the 2020 Information Technology

budget.

Phone 785-251-4030

Shawnee County & PLURALSIGHT

Total List Price $23,370.00

Total Price $17,370.00

Savings $6,000.00

Payment in full due with Net 30 terms

• Advanced Skill Analytics- Measuring progression of skill development for all employees with Pluralsight licenses

• Advanced Channel Analytics- Tracking completion of custom curriculum assignments based on Technical Skills Strategy Plan

• Customizable Role IQ w/advanced analytics- Measuring skill development at a role level across all employees with Pluralsight licenses

• API Access- open access to Pluralsight's API

• Custom Data Exports- enabling custom data feeds for tracking achievement data in non-standard ways

• Single Sign On

• Integration with Learning Management System -Deep linking process to provide access to Pluralsight content from within LMS and data push from Pluralsight to LMS reports

• Integration with HRMIS- Push data into HRMIS (e.g. Workday, etc.) to measure achievement data toward learning goals

• Cloud Labs

TO:

OFFICE OF THE DISTRICT ATTORNEY THIRD JUDICIAL DISTRICT OF KANSAS

Michael F. Kagay, District Attorney

MEMORANDUM


FROM: Michael F. Kagay, District Attorney ;(fC.

November 6, 2020 DATE:

RE: Request for Diversion Fund Payments

The District Attorney's Office wishes to pay the following invoices from its Diversion Fund account:

1) EPIC Business Essentials for office supplies a) Invoice No. S100410853 dated November 3, 2020 in the amount of$5.39 b) Invoice No. S100410966 dated November 4, 2020 in the amount of$215.94 c) Invoice No. S100411058 dated November 5, 2020 in the amount of$49.80

2) Office Depot, Inc. for office supplies a) Invoice No. 132506597001 dated October 23, 2020 in the amount of$25.44 b) Invoice No. 132506989001 dated October 23, 2020 in the amount of $158.81 c) Invoice No. 132500276001 dated October 26, 2020 in the amount of$55.68 d) Invoice No. 134306845001 dated October 28, 2020 in the amount of $89.94 e) Invoice No. 134306621001 dated October 29,2020 in the amount of$142.92

3) Sam A. Crow American Inn of Court for annual membership fees. a) Invoice dated November 3, 2020 in the amount of$150.00

4) Thomson West for monthly Westlaw ClearPlus [Approved by the BCC on 5/4/20 Contract C168-2020], Westlaw [Approved by the BCC on 12/2/19 Contract C44Q-2019] and monthly Thomson Reuters library plan [Approved by the BCC on 11127/2017 Contract C424-2017] a) Invoice No. 843251441 dated November 1, 2020 in the amount of$407.99 b) Invoice No. 843256519 dated November 1, 2020 in the amount of$3,489.39 c) Invoice No. 843347746 dated November 4, 2020 in the amount of$79.38

5) Underground Vaults & Storage for shred service a) Invoice No. 222625 dated October 31, 2020 in the amount of $235.00

6) Westside Stamp for employee award a) Invoice No. 186545 dated November 3, 2020 in the amount of$35.00

The District Attorney's Office hereby requests placement on the consent agenda for consideration of the above itemized invoices, in the total amount of$5,140.68, to be paid from the Diversion Fund account.

Shawnee County Courthouse 200 SE 71

h Street, Suite 214 • Topeka, Kansas 66603 • (785) 251-4330

-

EPI€ Local Delivery Provided By: SALES INVOICE OFFICE PLUS OF KANSAS

BUSINESS ESSEJUIALS Remit EPIC Business Essentials LLC To: 5600 N. River Road, Suite 700


316-491-2607

Sold SHAWNEE COUNTY

To: 200 SE 7TH ST

TOPEKA, KS 66603

316-491 -2607

ACCT. NO. I Sales Order No. CUSTOMER PO

i PNW324624 000000

Item Number Description Customer 10:

SMD77243 WALLET,2"EXP,ELAS, 11 .75X9.

Per OMNIA Contract # R190301

SMD77245 WALLET,2"EXP,ELAS, 15X10

Per OMNIA Contract # R190301


0.00


5.39

Ord Qty

1 EA

1 EA



Page: 1


Ship DISTRICT ATIORNEY

To: Kathy Beach

200 SE 7TH RM 214

DISTRICT ATIORNEY

TOPEKA, KS 66603

DEPARTMENT

Ship Qty Unit Price

1 EA 2.49

1 EA 2.90

Subtotal:

Total Sales Tax:

Total:

DUE DATE

12/03/20

Total Price

2.49

2.90

5.39

0.00

5.39

EPI€ BUSINFSS ESSEUUAlS



316-491-2607

Sold SHAWNEE COUNTY

To: 200 SE 7TH ST

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Local Delivery Provided By: SALES INVOICE OFFICE PLUS OF KANSAS

316-491-2607

Sales Invoice Number: 5100410966


Page: 1


Ship DISTRICT ATTORNEY

To: Kathy Beach

200 SE 7TH RM 214

DISTRICT ATTORNEY

TOPEKA, KS 66603

I ACCT. NO. Sales Order No. CUSTOMER PO DEPARTMENT DUE DATE I

I PNW324816 000000

Item Number Description Customer ID:

SMD77243 WALLET,2"EXP,ElAS, 11. 75X9.


UNV21200 PAPER,XERO/DUP,WEL TR,20#

3 to family law, 3 to charging

Contract Item


0.00


215.94

12/04/20


20 EA EA

6 CT 6 CT 35.99 215.94

Subtotal: 215.94


Total: 215.94

EPI€ BUSINESS ESSENnAtS



316-491-2607

Sold SHAWNEE COUNTY

To: 200 SE 7TH ST

TOPEKA, KS 66603

Local Delivery Provided By: SALES INVOICE OFFICE PLUS OF KANSAS

316-491-2607



Page: 1


Ship DISTRICT ATTORNEY

To: Kathy Beach

200 SE 7TH RM 214

DISTRICT ATTORNEY

TOPEKA, KS 66603

I ACCT. NO. I Sales Order No. CUSTOMER PO DEPARTMENT DUE DATE I I

PNW324816 000000 I

Item Number Description · Customer 10:

SMD77243 WALLET,2"EXP,ELAS, 11.75X9.

Per OMNIA Contract# R 190301

UNV21200 PAPER,XERO/DUP,WEL TR,20#

3 to family law, 3 to charging

Contract Item


0.00


49.80

12/05/20


20 EA 20 EA 2.49 49.80

6 CT CT

Subtotal: 49.80


Total: 49.80

,Office DEPOT, Inc.

FEDERAL ID:59-2663954

BILL TO:

Office Depot, Inc PO BOX 630813 CINCINNATI OH 45263-0813

ATTN: ACCTS PAYABLE 5: SHAWNEE CNTY DA ~ 200 SE 7TH ST STE 214 o TOPEKA KS 66603-3933

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ORIGINAL INVUI~t: IUUUU

THANKS FOR YOUR ORDER IF YOU HAVE ANY QUESTIONS OR PROBLEMS. JUST CALL US

FOR CUSTOMER SERVICE ORDER: (888) 263-3423 FOR ACCOUNT: (800) 721-6592

INVOICE NUMBER AMOUNT DUE PAGE NUMBER 132506597001 25.44 INVOICE DATE TERMS

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23-0CT-20 Net30

SHIP TO: SHAWNEE CNTY DA 200 SE 7TH ST STE 214 TOPEKA KS 66603-3933

Page 1 of 1 PAYMENT DUE

28-NOV-20

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Department:

All amounts are based on USD currency

SHIP TO ID ORDER NUMBER ORDER DATE SHIPPED DATE DA 132506597001 I 22-0CT-20 J23-0CT-20 ORDERED BY DESKTOP I COST CENTER KATHY BEACH I

I

U/M

I

QTY I QTY I_ QTY I UNIT I EXTENDED

# ORD SHP B/0 PRICE PRICE

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SUB-TOTAL

DELIVERY

SALES TAX

TOTAL

6 0 4.240 25.44

25A4

0.00

0.00

25.44 To retum supplies, please Ntpack: in original box and insert our packing l i .st, or copy of this invoice .. Please note probh~• so we DIS)' issue credit or . replacement, whichever you prefer. Please do not ship collect. Please do not return furniture or machines until you call us first for instructions. Shortage or damage lllJst be reported within 5 days after delivery.

CUSTOMER NAME

SHAWNEE CNTY DA

Please Send Your Check to:

BILLING ID

FLO

OFFICE DEPOT,INC. PO Box 660113 Dallas TX 75266-0113

00071().000590

DETACH HERE

INVOICE NUMBER

132506597001

INVOICE DATE

23-0CT-20

INVOICE AMOUNT ENCLOSED AMOUNT ~--------------~

25.44

002324481 1325065970014 00000002544 1 3

Please return this stub 'With your payment to ensure prompt credit to your account.

Please DO NOT staple or fold. Thank You.

00002/00005

Office DEPOT, lac.


BILL TO:


o ATTN: ACCTS PAYABLE "' SHAWNEE CNTY DA

0~ 200 SE 7TH ST STE 214 TOPEKA KS 66603-3933

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ORIGINAL INVOJGt: 1UUUU



INVOICE NUMBER AMOUNT DUE PAGE NUMBER 132506989001 158.81 INVOICE DATE TERMS

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23-0CT-20 Net 3D

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Page 1 of 1 PAYMENT DUE

28-NOV-20

1.11 ... II Ill II •• 11 ••••• 11 ••• 11 i 1.1 •••• 11 ... 11 .. 11 ••• 1 •• 1 ... 111

Ar rn11t.1T """'BER PURCHASE ORDER SHIP TO ID ORDER NUMBER ORDER DATE SHIPPED DATE 1 oooooo DA 132506989001 L22-0CT-20 123-0CT-20

BILLING ID !ACCOUNT MANAGER! RELEASE ORDERED BY DESKTOP I COST CENTER I I KATHY BEACH I

CATALOG ITEM #I I DESCRIPTION/

I U/M

I QTY I QTY I QTY I UNIT I EXTENDED

MANUF CODE CUSTOMER ITEM # ORO SHP B/0 PRICE PRICE

463620 LABEL,LSR,SHIP,WHT, 1 OOOCT BX 1 1 0 17.490 17.49 5163 463620

Department: 902212 COFFEE, VERANDA, 1 LB,GROU EA 6 6 0 15.820 94.92 SBK12413968 902212

Department: 864750 GMCR BREAKFAST BLEND BX 4 4 0 11.600 46.40 6520 864750

Department:

SUB-TOTAL 158.81

DELIVERY 0.00


SALES TAX

TOTAL

0.00

158.81 To retum supplies, please repack. in original box and insert our packing list, or copy of this invoice. Please note proble11 so we ay issue credit or replaceooant, whichever you prefer. Please do not ship collect. Please do not retum fumiture or machines until you call us first for instructions. Shortage or daiAge E.lst be reported within 5 days after delivery.

CUSTOMER NAME

SHAWNEE CNTY DA


BILLING ID

FLO


00071 ().()()0590

DETACH HERE

INVOICE NUMBER

132506989001

INVOICE DATE

23-0CT-20

INVOICE AMOUNT ENCL9SED AMOUNT ~--------------~

158.81

002324481 1325069890010 00000015881 1 3

Please return this stub with your payment to ensure prompt credit to your a.ccOunt


00003/00005

·Office DEPOT, Inc.


BILL TO:


ATTN: ACCTS PAYABLE 5l SHAWNEE CNTY DA ~ 200 SE 7TH ST STE 214 o TOPEKA KS 66603-3933

~

ORIGINAL INVOICE 10000



INVOICE NUMBER AMOUNT DUE 132500276001 55.68 INVOICE DATE TERMS

26-0CT-20 Net30

SHIP TO: SHAWNEE CNTY DA 200 SE 7TH ST STE 214 TOPEKA KS 66603·3933

PAGE NUMBER Page 1 of 1

PAYMENT DUE 28-NOV-20

J.II ... IJ ••• JI •• II ••••• II ... II.I.I •••• JI ... IJ •• IJ ... J •• I ••• JII

1 ACC:OIII\IT 1\lllfolBER PURCHASE ORDER SHIP TO ID ORDER NUMBER ORDER DATE SHIPPED DATE 1 oooooo DA 132500276001 I 23-0CT-20 126-0CT-20

I ~ILLING ID jACCOUNT MANAGER! RELEASE ORDERED BY DESKTOP I COST CENTER I I KATHY BEACH I

CATALOG ITEM #I I DESCRIPTION/ .,

I U/1'1


MANUF CODE CUSTOMER ITEI'I # ORO SHP B/0 PRICE PRICE

282127 MOUSE,WIRELESS,M325,BLAC EA 4 4 0 13.920 55.68 910-002974 282127

Department:


SUB-TOTAL

DELIVERY

SALES TAX

TOTAL

55.68

0.00

0.00

55.68 To retum supplies, please repacK. in or-iginal box and insert our packing list, or copy of this invoice .. Please note problem so we uy issue credit or replacement, whichever you prefer. Please do not ship collect. Please do not retum furniture or machines until you call us first for instructions. Shortage or damage oust be reported within 5 days after delivery.

CUSTOMER NAME

SHAWNEE CNTY DA


BILLING ID

FLO


000710-000590

DETACH HERE

INVOICE NUHBER

132500276001

INVOICE DATE

26-0CT-20

INVOICE AMOUNT ENCLOSED AHOUNT r-----------------~

55.68

002324481 1325002760015 00000005568 1 1

Please return this stub with your payment to ensure prompt credit to your account


00001/00005

-Office DEPOT, Inc.


BILL TO:


ATTN: ACCTS PAYABLE g SHAWNEE CNTY DA ~ 200 SE 7TH ST STE 214 o TOPEKA KS 66603·3933 §


THANKS FOR YOUR ORDER IF YOU -HAVE ANY QUESTIONS OR PROBLEMS. JUST CALL US


INVOICE NUMBER AMOUNT DUE 134306845001 89.94 INVOICE DATE TERMS

28-0CT-20 Net30

SHIP TO:

SHAWNEE CNTY DA 200 SE 7TH ST STE 214 TOPEKA KS 66603-3933



1,11 I ulllllllllllllllllluall,l,lllllllulllull&llllllllllll

[J\CCOIINT NUMBER PURCHASE ORDER 1 oooooo

~~lLLIN~D jACCOUNT MANAGER! RELEASE I _L

CATALOG ITEM #/ MANUF CODE !

DESCRIPTION/ CUSTOMER ITEM

SHIP TO ID DA ORDERED BY KATHY BEACH

# I U/M I

ORDER NUMBER ORDER DATE SHIPPED DATE 134306845001 I 27-0CT-20 128~0CT-20

DESKTOP I COST CENTER I

QTY I QTY I QTY

I UNIT I EXTENDED

ORO SHP B/0 PRICE PRICE

4993682 KTB003

FACE MASK,3PLY,DISP,OS,50C 4993682

BX 6 6 0 14.990 89.94

Department:


SUB-TOTAL

DELIVERY

SALES TAX

TOTAL

89.94

0.00

0.00

89.94 To return supplies, please repack in original box and insert our packing list, or copy of this invoice. Please note problem so we say issue credit or replacement, whichever you prefer. Please do not ship collect. Please do not return furniture or machines until you call us first for instructions .. Shortage or damage azst be reported within 5 days after delivery~

CUSTOMER NAME

SHAWNEE CNTY DA


BILLING ID

FLO


000710-000590

DETACH HERE

INVOICE NUMBER

134306845001

INVOICE DATE

28-0CT-20

INVOICE AMOUNT

89.94

AMOUNT ENCLOSED r-----------------~

002324481 1343068450017 00000008994 1 9

Please return this stub with your payment to ensure prompt credit to your account.

Please DO NOT staple or fold Thank Yoa

00005/00005

Office DEPOT, Inc.

FEDERAL !0:59-2663954

BILL TO:


ATTN: ACCTS PAYABLE m SHAWNEE CNTY DA

0~ 200 SE 7TH ST STE 214 TOPEKA KS 66603-3933

§




INVOICE NUMBER AMOUNT DUE 134306621 001 142.92 INVOICE DATE TERMS

29-0CT-20 Net30

SHIP TO:

SHAWNEE CNTY DA 200 SE 7TH ST STE 214 TOPEKA KS 66603·3933



I.IJ ••• II.uii •• II ..... JI ... II.J.I .... IIu.ll •• ll.ul •• l.ulll

I ACC.OIINT NUMBER PURCHASE ORDER SHIP TO ID ORDER NUMBER ORDER DATE SHIPPED DATE 1 oooooo DA 134306621001 127-0CT-20 129-0CT-20

1 BILLING ID !ACCOUNT MANAGER! RELEASE ORDERED BY DESKTOP . I COST CENTER I I KATHY BEACH I

CATALOG ITEM #I I DESCRIPTION/

I U/M


MANUF CODE CUSTOMER ITEM # ORO SHP B/0 PRICE PRICE

1385335 Kleenex Facial Tissue CT 1 1 0 43.970 43.97 KCC21400 1385335

Department:

787799 CLEANER,GLASS,WINDEX,230 EA 4 4 0 4.390 17.56 SJN313042 787799

Department:

754965 PURELL ORIG 120Z PUMP BTL CA 0 65.390 65.39 GOJ365912CT 754965

Department:

595347 WATER, NESTLE 11476087 595347

Department:


CA 4

SUB-TOTAL

DELIVERY

SALES TAX

TOTAL

4 0 4.000 16.00

142.92

0.00

0.00

142.92 To return supplies, please repack in original box and insert our packing t ist, or copy of this invoice. Please note problem so we may issue credit or replacement, whichever you prefer. Please do not ship collect. Please do not retum f urniture or uchines until you call us first for instructions. Shortage or damage llllJSt be reported within 5 days after delivery.

CUSTOMER NAME

SHAWNEE CNTY DA


BILLING ID

FLO

OFFICE DEPOT,INC. PO Box 660113

.A .

Dallas TX 75266-0113

000710-000590

DETACH HERE

INVOICE NUMBER

134306621001

INVOICE DATE

29-0CT-20

INVOICE AMOUNT ENCLOSED AMOUNT ~--------------~

142.92

002324481 1343066210017 00000014292 1 1

Please return this stub with your payment to ensure prompt credit to your account


00004/00005

0

"' "' ~ ~

Shawnee County Authorization for Voucher Payment


Charge to: District Attorney's Office Department

Pay to: Name:

Address:

Sam A. Crow American Inn of Court, AT1N: Doug

Kansas Appellate Clerks Office, 301 SW lOth, 151

City, State Zip: Topeka, KS 66612

VendorNumber: V002748 ---------------------------------

Reason for Payment (Please Detail) Annual member dues for: K.aty Garner @ $150 for Associates dues

Amount:$ 150.00 ----------------------------------Charge Account Number: 71DA000/50261 710400000/50261

By: /te!Joel £ #£;a y Department Hea'a -:bts_frl Ci /Jf-Jzrn ey

Signature: ~__,,...__

{~;ft~1 THOMSON REUTERS ACCT#

INVOICE # 843251441

DESCRIPTION

WEST INFORMATION CHARGES

IMPORTANT NEWS

SHAWNEE COUNTY DISTRICT ATTORNEY 200 SE 7TH ST TOPEKA KS 66603-3922

WEST INFORMATION CHARGES INVOICE OCT 01, 2020 - OCT 31, 2020

CHARGE

lN USD

407.99

TAX lN USD

0.00

PAGE 1

TOTAL CHARGE

lN USD

407.99

NEW RESOURCE AVAILABLE: Find information on how to read your invoice andother commonly asked billing questions under the Billing, payment, returns & refunds section online at legal.thomsonreuters.com/enlsupport.

FOR BILLING INFORMATION CALL

1-800-328-4880

JNVOICE #

JNVOICE DATE

ACCOUNT#

VENDOR#

VAT REG#

AMOUNT DUE IN USD

DUE DATE

843251441

11101/2020

41-1426973

EU826006554

407.99

12/01/2020

AMOUNT ENCLOSED IN USD ----

1000346770

RETURN BOTTOM PORTION WITH PAYMENT

Thomson Reuters - West Payment Center P.O. Box 6292

WEST JNFORMA TION CHARGES OCT 01, 2020 - OCT 31, 2020

Carol Stream, IL 60197-6292

SHAWNEE COUNTY DISTRICT ATTORNEY 200 SE 7TH ST TOPEKA KS 66603-3922

0843251441 0000000000000000000000 20201101 ZCPG 000040799 0010 1000346770 5

A

ACCT#

THOMSON REUTERS

INVOICE # 843256519

DESCRIPTION

WEST INFORMATION CHARGES

IMPORTANT NEWS

SHAWNEE COUNTY DISTRICT ATTORNEY SHAWNEE COUNTY COURTHOUSE 200 SE 7TH ST STE 214 TOPEKA KS 66603-3933

WEST INFORMATION CHARGES INVOICE OCT 01, 2020 - OCT 31, 2020

CHARGE

lN USD

3,489.39

TAX

IN USD

0.00

PAGE 1

TOTAL CHARGE

lN USD

3,489.39

NBN RESOURCE AVAILABLE: Find information on how to read your invoice andother commonly asked billing questions under the Billing, payment, returns & refunds section online at legal.thomsonreuters.com/en/support.

FOR BILLING INFORMATION CALL

1-800-328-4880

INVOICE#

INVOICE DATE

ACCOUNT#

VENDOR#

VAT REG#

AMOUNT DUE IN USD

DUE DATE

843256519

11/0112020

41-1426973

EU826006554

3,489.39

12/01/2020

AMOUNT ENCLOSED IN USD ----

1000589558 A

RETURN BOTTOM PORTION WITH PAYMENT

Thomson Reuters - West Payment Center P.O. Box 6292

WEST iNFORMATION CHARGES OCT 01, 2020 - OCT 31, 2020

SHAWNEE COUNTY DISTRICT ATTORNEY SHAWNEE COUNTY COURTHOUSE

Carol Stream, IL 60197-6292 200 SE 7TH ST STE 214 TOPEKA K.S 66603-3933

0843256519 OOOOOOODDDDDODOOOODOOO 20201101 ZCPG 000348939 0010 1000589558 2

Subscription lnvo~ce f~i5)): THOMSON REUTERS"

Page 1 of 4

Summary

"::::;:· ...

Thomson Reuters West Publishing Corporation 610 Opperman Drive Eagan MN 55123-1396

SHAWNEE COUNTY DISTRICT ATTORNEY SHAWNEE COUNTY COURTHOUSE 200 SE 7TH ST STE 214 TOPEKA, KS 66603-3933

LIBRARY PLAN CHARGES

TOTAL INVOICE AMOUNT

Billing note:

Charge USD

79.38

79.38

SHAWNEE COUNTY DISTRICT ATTORNEY

Invoice#: 84334n46 Account4 Invoice date: November 4, 2020

Total D~ USD 8 4 '7Cf,~

Payment Due December 4, 2020

Tax total USD

Total USD

86.64

86.64

NEW RESOURCE AVAILABLE: Find information on how to read your invoice and other commonly asked billing questions under the Billing,' payment, returns & refunds section online at legal.thomsonreuters.com/en/support.

,...ew Monthly Account Summary Statement

o improve your invoice experience we have a added a Monthly Account Summary statement to the end of your invoice. Items on this report include:

All open items that have been billed to your account. All items paid, returned or cancelled within the last 30 days. Any Prepayment balance (if applicable) remaining on your account.

A

Include this portion with your payment-Folding and stapling may delay your payment

SHAWNEE COUNTY DISTRICT ATTORNEY Invoice#: 843347746

Invoice date: November 4. 2020 Accountt'

Federal Tax ID: 41-1426973

VAT reg#: EU826006554

Invoice due date: December 4, 2020 Amount due in USD: 86.64

Amount enclosed ----------

Pay online:

Log on to http:l/myaccount.tr.com/westlaw

to make the payment electronically. Set up your payment to be withdrawn electronically using direct debit or credit card.

Please make checks payable to:

Thomson Reuters -West Payment Center P.O. Box 6292 Carol Stream, IL 60197-6292

0843347746 0000000000000000000000 20201104 ZCMI 000008664 0010 1000589558 3

Q:\!Y.!§ Underground Vaults & Storage, Inc. P.O. Box 1723 Hutchinson, KS 67504-1723 Telephone# 620-662-6769 Fax# 620-662-8871 FEIN: 48-0649555 Duns# 041916883 Emaft: [email protected]

Bill To

Shawnee County District Attorney's Office 200 SE Seventh Street, #214 Topeka, KS 66603

Invoice Date I Invoice#

10/31/2020 11 222625

,---------------------------------------------------------------~ I I I I I I : For invoice questions : l For those being serviced by our Manhattan & Kansas City, Salina l l locations: l I I

Contact Kathy Burroughs @ 620-662-6769 ext4209 l Email - Kathy.Burroughs@uvs4!c.com :

For those being serviced by our Wichita and Hays, Louisville, and Oklahoma City locations:

Contact Traci Brenden@ 785-625-2111 ext 2502 Email- [email protected]

I I I I I I I I I I I I I

. I

1---------------------------------------------------------------~

Please return top portion ofinvmce with your payment

Date of SeNice Description

10/02/2020 Shred Service: 4- 64 gallon container(s) 10/09/2020 Shred Service: 4- 64 gallon container(s) 10/16/2020 Shred Service: 4- 64 gallon container(s) 10/23/2020 Shred Service: 4- 64 gallon container(s) 10/30/2020 Shred Service: 4- 64 gallon container(s)

Certificate of Destruction Underground Vaults & Storage, Jnc.,certifies that the documents or materials from the Agreement of Service contract(s) referenced above (unless otherwise noted) are processed in accordance with the policies and procedures as set forth by the National Association of Information Destruction (NAID).

m f.fAN..S~l \~~~ ~<¥ ~~. Voo/ IV.: - ~ .__ ___________________ --I • ::·.·

Agreement# Amount

284629 47.00

284683 47.00 284719 47.00

284764 47.00

284809 47.00

Total $235.00

Customer Total Balance s235.00

2030 SW Fairlawn Road ; ,,: - ( • Topeka, KS 66604

WESatSIDE P:785-272-7242 '" f· -- '' 'c \: '{;: F: 785-272-1366

[email protected]

Bill To

Shawnee County District Attorney 200 SE 7th Street Topeka, KS 66603

Quantity Price Each

Invoice Date

1113/2020

Contact Sarah Luedke 785-251-4532 sarah.luedke@snco. us

P.O.# Terms

Net 15

Description

Invoice#

186545

File

File

Amount

1 35.00 CE6503 7 x 9 Curved Glass Award- Legal Intern 35.00

-

wE~r§m ~ W'\\1 n A ?n?n

ah "' v ... .w

RECEIVED BY: Subtotal $35.00

Sales Tax (O.Oo/o) $0.00

Total $35.00

Payments/Credits $0.00

Balance Due $35.00

Shawnee County DEPARTMENT OF HUMAN RESOURCES

Angela K. Lewis, Director 200 SE ih, Room B-28 Topeka, Kansas 66603 Phone: (785) 251-4435

Fax (785) 251-4901, www.snco.us

MEMORANDUM

TO: Board of County Commissioners

FROM: Angela K. Lewis, Director of Human Resources

DATE: November 6, 2021

RE: 2021 Blue Cross Blue Shield Contract

Please place this item on the Thursday, November 12, 2020, consent agenda for the regularly scheduled meeting ofthe Board of County Commissioners.

Please consider approval of the attached contract with Blue Cross Blue Shield. There is no

change to the plan deductible or co-insurance rates.

Please contact me at ext 4440 if you have any questions about this item.

Cc: Betty Greiner, Administrative Services Director James Crowl, County Counselor

ASO- Summary of Ch.-ges **SOlD** Group Name: Shawn• County ** EARLY FINAL ** MPN: 96229

Effective Period: 111t.m1 -12131ml21 ... Renew./ B.nefH.s ... •Option A ..

1. Banaftt Summary Blue Choice- Comp Major Medical $1,000/$3,000 deductible; ($2,0001$6,000 coins. @ 80120); $30 OVC With $300 Lab/Xray rider; $200 ER copay; Accidents subject to deductible and coinsurance; Unlimited Ufetime Max.; Dependents to 26; OB Benefits available to all Employee and Spouse only Excluding Dependents of Dependents; Mental Health Parity; HCR Preventive Services Including one colonoscopy @100% amually; SkUied Nursing; Annual Health Only Out of Pocket Maximum $3,0001$9,000; Includes Autism Coverage; Includes Telemedlclne with local providers (Excludes Amwell); Excludes Bective Abortions; Electronic Prosthetic Devices •ubJect to deductible and colnsu111nce to an annual benefit max. of $20,000.

• After ACA preventive benefits, cover one electric breast pump and supplies per benefit period at 100% up to $400 max In-network.

2. Monthly Elcpected Clllms -lncund B•fl SMe W:l E§f EM! A) Health 514.82 650.48 780.93 947.91

lnt:hdu&lin«fdVM'-tls.Mt:MDf -$8.96 CPC.

$514.82 $650.48 $780.93 $947.91

2A. AnnuiiiDd ElcpiiOtld Clllma• Total of Ill options $6,111.629.16

28. Aggreglle Attachment Point 0115%• TOll! uf aD options $7,021,373.63 'lnlliiii .... NIM:IItnMJPMI .. JJ.II-'DII~tnllllfii!IIIIWIMn/

3. Monllly 8111111 Chq• A) Admlnlslrallon Expense 42.00 42.00 42.00 42.00 Adlllll Exp: 2121.-. a e1411D

S) Aooalgate stop-Loss G 115% 6.21 7.82 9.38 11.36 wl Monthly Aggregate

C) Individual Stop-Lou ft $200,000 34.28 43.20 61.77 62.73 $82.49 $93.02 $103.15 $116.09

3A. Annulllztd BlUed Ch•gee• Tolar of all options $907,663.08

4. Totll Monthly Lllblllty II Elcpected $597.31 $743.50 $884.08 $1,064.00 4A. Annulll:md Lllblllty at l:xpiCled* $7,018,292.24

TotBI of sR oplfcn$ 5. Total Monthly Ulblllty 11116% $674.53 $841.07 $1,001.22 $1,206.19 6A. AMUII Uablllty 11115% $7,936,036.81

Tala/ of a6 opti0f18

*Basad On Contract Cooots of Health • Opllon A: 546 EMP -172 ECH • 47 ESP • 84 FAM

-Bt.fESEJIKJtl.IIEKT: BEH--HCR Gli4IIIFA 1HEREDGROIP. NO--MEETS MINIIfiM VALlE: Y-

\

Rlfi/OT)pefl

Signed by: DateSipd: ___ _

CLASSIFDiD: CORPORATE Group Rating IOJli/ZOlO

Group Name:

EffecHve Period:

Health

Health

ASO Op«lting Expense I stop-Loas Rates

**SOlD** Shawnee County MPN: 98229

111/2021 -1213112021 ** EARLY FINAL ** FINANCIAL CODE: 005

SlUED BY SEQUENCE 10? - NO .. Renewal Benefits "*

MONTHLY RATES GOE less Vend Adm (Rate ID Type 03) Administrafion Expense wNend Adm

EMP ECH E§f fAM 42.00 42.00 42.00 42.00 $42.00 $42.00 $42.00 $42.00

Type Benefit 096/496 (Rate 10 Type 08) Individual S-L@ $200,000

§g!! g§f 34.28 43.20 51.77

fAM 62.73

Type Benefit 0961496 (Rate 10 Type 07) Aggregate S-L @ 115% w/ M.A.

.EMf 6.Qtl ESP FAM 6.21 7.82 9.38 11.36

$34.28 (AU produc/1 IUbjtJCt to 1/op, lo#)

$43.20 $51.77 $62.73 $6.21 $7.82 $9.38 $11.36

CLASSIFIED: CORPORATE Group Rating IOJ21/Z020

+." BlueCross BlueShield

• • ofKan888 An fndependenl Licensee of tile Slue Crou Blue Shield Associa~ion.

SHAWNEE COUNTY CONTRACT ~~--'·-·"""'-· .

AGREEMENT TO PROVIDE ADMINISTRATIVE SERVICES FOR A SaF-FUNDED HEALTH BENEFIT PLAN

(INCURRED BASIS)

This Agreement is entered Into by and between BLUE CROSS AND BLUE SHIELD OF KANSAS, INC., {hereinafter "BCBSKS") and "Company" (as named below) for the purpose of providing for administration by BCBSKS of Company's self-Insured health benefit plan, which has been adopted by Company for the purpose of providing certain health benefits to all eligible members (hereinafter "participants'? under the tenns and conditions set forth herein.

1. BCBSKS Is a corporation organized and domiciled in Kansas and Is authorized by law to provide administrative services to an employer or voluntary employees' beneficiary association which provkfes health care benefits to Its employees or members.

2. Name of Company: Shawnee County Name of Benefit Plan: Shawnee County Plan Administrator for Benefit Plan: Human Resources

Benefit Plan is established by Company for beneficiaries (which term Includes "participants" or "subscribers") of the Benefit Plan.

3. The parties agree that Blue Cross and Blue Shield of Kansas, Inc., has been retained to administer claims and Is not the Insurer of this Benefit Plan. Blue Cross and Blue Shield of Kansas, Inc. provides administrative claims payment services only and does not assume any financial risk or obligation with respect to claims, except to the eldent benefits are paid under any stop foss coverage.

4. Any dispute arising between the parties to this Agreement shall be resolved according to the Dispute Resolution Procedure stated in this paragraph #4.

A. The Dispute Resolution Procedure shaD not apply to the rights of participants In pursuit of benefits, efigibHity or other participant rights under the Company's self-Insured health benefit plan.

B. The Dispute Resolution Procedure shall apply also to the parties when one of the parties Is a member of a purported class In a dass action case.

C. Description of the Ditpute Resolution Procedure.

(I) Inquiry/Reconsideration. The party asserting a disputed matter shall make written Inquiry through its signatory to this Agreement_addressed to the other party's signatory clearly identifying the subject as one made pursuant to this Dispute Resolution Procedure. The written Inquiry must Include facts stated with sufficient specialty for the other party to understand the nature of the dispute. The party receiving the inquiry shall make good faith efforts to respond In writing to the Inquiry within 30 days.

(ii) If the Inquiring party Is not satisfied with the response, It may mak8' a written appeal within 30 days after receiving the other party's response to Its Inquiry. The appeal shall state the basis of the dispute, why the response Is not satisfactory, and the proposed method of resoMng the dispute. The receiving party shall make a good faith effort to respond In writing within 30 days.

(Iii) If the matter remains unresolved after Inquiry and appeal either party may request non-binding mediation by submitting a written request within 30 days of receipt of the other party's appeal response. Mediation shall proceed only if both parties agR~e to the mediation. Upon agreement the parties thall cooperate In good faith to designate a mutually acceptable mediator who Is qualified to consider the issues likely to be raised during the mediation and within 30 days after the parties submit the dispute to mediation. The parties shall equally share the mediator's fees and costs, although each party shall be solely responsible for its costs of participation, Including its attorney fees. The mediator may terminate any

FORM AP-oo01 01121 Page1

mediation ihither party faD$ to cOmply wnn appli~b'e rul~ ~t deadlint;~s or If the parties are unable to volunblrily resolve ~tu~ir c;lispt.ite.

(hi) If the parties ate not ~ble to l"f)SQiye their dispute by the procedures described above, the matter shall ~ subrt;littc;~d to bltn,1lng arbitration pur&uant to the Federal Arbitration Act and according to tht;; then current Commercial Arbitration Rules 6f the American ArbitratiOn A~Ssociation. Either ~rty ·maY m~l<e a written demand for binding arbitration withili 30 days after It receives a ~.,onse to .its· ~p~l or the conclusion Of the lilediatlol'l Of thia dl$pute. The venUe ofth~ ~jtratlon shall be Top~~. Kansas unless otherWie;e agreed. The atbltraticm sh~ll b~ conducted by a p~n(t~ of three (3) qualified arbitrators, unless the parties otherwi~e _agree. The arbitrate~ may sanction ·a party, including ruling in favor ofthe Oth$i' party, if appJ"9Pfl$, if a party fails to comply with applicable procedures or deadlines estab~shed t;ty tho~e Arbitration Rules. ·

Each party shaH be responsible for one-half Qf the arbitration ~gency's admlnletralive f~. the arbltratoi'S' fEi" .afld other eXPense$ ~Jrectly related to C9f1ductlng thE!t arbitration. Each party 1hall othe,..Yise be solely' ~sponl!lble for any ot.h.er expenses incurred In preparing fo.r or participating In the arbitration prc:;x.:~~. lnc;:luding that party's attorney's fees.

The claimant shaD pay the a~iplicable filing tee establl$hed by th$·Ar!l~rican Al1litration Ass~!on, · but the :tiling fee may be reallcK::!it~ or teas~sed. &l;l ~rt ~t-.an arbitration aw~Jrd ~ither; In wnole orJn part, at the) qJspj-etiOi:J of Jh~ arbttrator/~J'bi~ion pahel if the c($;m~nt prevaiis upon the merit$; If thecl~im~nt WithdraW$ ~~ demand for arbit~tion; then the claimant forfeits Its filing fee and It may not be 'ssesl!led ;against BCBSKS~

The arbitrators: shalf ooolide"r eact) Claimanfs demand individually anQ shad not c'eltlfy ot Con.~der multrple clafmarit8' demanas ·a!! part of a Class action; shal!.be ~gui«.~d to issue a reasonecl wri~n deei$ioJ1 eXplaining the b~ls of tl!~!r d.eclsJon aod the manner Cif ~l.~ulating any award; shall limit ~view to wh!Mher tlr not the Benem Plan's action was arbitrary or capricious; may not award punitive, ~-contractual, treble or exemplary damages; may not vary or disregar:d.the terms of the Provider's participation agreement, the certificate of·coverage and other ag~ern~nt$, .If applicable; and .shall bEi bound by controlli!lg taw; when Issuing a decision eon~hin.9 the DispUte. Emergency relief such aJ injunctive relief may· be awarded by an arbilrator/arbttratlon panel. A party sha.O ·~ appllcetio!'l tor any such relief purauarrt to the Optional Rules for Emergency M~~ures of Protection of t~e American Arbitration Association (most recent edition). Thearbitrators' award, order or judgment shall be final and binding upon the parties. ThCJt d!'Ci&ion may be entered and enforced In any state or federal court of co.mpetent jurisdiction. Th~t arb!~l'a~9n award may only be modified, eorrected or w¢atecl for the r8a$on• set forth In the .United States Arbitration ACt (9 U.S.C. §1).

6. Pian Administrator hel"(!l:lY ~pressly delegates its authority to BCBSKS to perform the sEiJVices and prOYid,e the suppli~!il, forml!i and materials set forth In this Agreementin connection with th.e aCimlnl$8tic>n ~nd op~tiO'i'l oUhe Benefit Plan. BCBSKS agrees to peifotm the following services on behalf of Company Flhd at the ~irectlon of Company's designated Plan Adtnlriisttator;

A, Provide general aclministra.tlve. accdljhting, data processing, cost control, marketing, .claims processing, iiscal and other related senil~ to Plan Administrator on the same basis and in the satrie m~;~nneir as provided to Plan Sponsors and Plan Administrators of Benefit Plans Whase benefits are UndEiiWrltten by BCBSKS.

B. Advise and assist In a conslilta~e ~apacitY with tegard to the beh!'tfits under the 1;3e.nefit Plan and any subsequent revisions ~f the Benefit P~n as may be d~med a(:)proprlate from time to time, including .advice and assistance With respect to provisions relating to eligibility, effective dates, coverage arid ce&Sation of coverage under the aeneflt Plan.

b. Administer the Coordination of Benefits, Third Party Liability, and Pre-exl$ting Conl:litions provisions of the Senefit Plan.

D. Produce flhd provide Benefit Descriptions·and Identification Cards to Benefit Plan participantS;

E. Establish, maintain and update reCQrds relating to Benefit Plan pajticipants' eligibility for benefit$, and ti~ty respond to inqulriet~ and appe~;~ls of Benefit Plan participants and appropriate third parties regarding ben~. clams processlnQ and p~rtlclpant •~tus.

FORt-f AP-0001 01/21

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F. Advise Plan Administrator with respect to claims procedures and assist with the implementation of procedures including those for submission of claims. All claims for benefit payments shall be made on forms satisfactory to BCBSKS. BCBSKS shall, at Its own expense, design, produce and provide claims and administrative forms to Plan Administrator for the use of Benefit Plan participants.

G. Process claims and exercise full discretionary authority in construing benefits for claims submitted and determine the amount of benefits for which Benefit Plan participants are eligible In accordance with the terms and provisions of the Benefit Plan. This construction of benefits for claims shaD be the exclusive responsibOity of BCBSKS and will include the foUowing when deemed appropriate by BCBSKS:

(i) Professional evaluation of claims by BCBSKS medical staff and medical consultants;

(iO Critical examination of charges for medical services that are Identified as exceeding BCBSKS' established criteria, discussion of such charges with the providers of services as appropriate, and determination of benefits, based on BCBSKS' criteria and any such discussion with the provider of such services:

{Iii) Review of claims to establish medical necessity, cost effectiveness or experimental/Investigational status of services rendered or expenses incurred; and

(iv) In processing claims, determine if utiOzation review requirements were met. if large case management procedures were followed and determine the amount of any reductions In benefits when such requirements are not met or such procedures are not followed. BCBSKS Is responsible for and shaD provide personally or through contract for any utilization review, precertification, cost-effective or case management services.

(v) For the purposes of this Agreement, a covered service Is considered to be deemed incurred on the date of service, except for bed-patient Hospital or Medical C•re FacUlty services and Doctor's Medical Services provided to bed-patients, in which case rendered services shall be deemed Incurred:

1. For admissions occurring prior to the effective date of this Agreement, on the effective date. Benefits shaH only be provided for services rendered on or after the effective date.

2. For admissions occurring on or after the effective date of this Agreement, the date of admission. However, should this Agreement terminate prior to the release of a Benefit Plan participant from such Hospital or Medical Care Facility, benefits shall only be provided for those services rendered up to and Including the termination date. In the event the Company has Included In their benefit description a provision extending coverage for 31 days for Benefit Plan participants confined In the hospital on the termination date of their coverage, benefits shall only be provided for those services rendered up to the ear1ier of the date the Benefit Plan participant Is discharged from the hospital or end of the extension. Benefits available under any such extension of benefits provision shall be secondary to the benefits of any subsequent replacement group health benefit plan or policy Intended to provide continuous coverage as of the effective date of the replacement poficy.

H. Compute and verify the amount of benefits, and prepare and furnish each claimant an appropriate statement of benefits.

I. Make payment of approved claims or amounts due to BCBSKS participating health care providen; for health care benefits provided to Benefit Plan participants. Such payments shall be Issued In the manner described in Attachment A hereto.

J. Assist In establishing banking arrangements to provide for the payment of benefits under the Benefit Plan.

K. Fumlsh a weekly accounting to Plan Administrator of aU payments of claims made under the Benefit Plan.

L Notify claimants of denied claims and the reason for denial.

M. BCBSKS shall have discretionary authority and fiduciary responsibility for provision of full and fair review of claims, claim denials and appeals thereof. Final determination of payment or denial of claims or of appealed claims shall be made by BCBSKS following appropriate analysis and review which may include consultation

FORM AP-0001 01/21

with the Plan Administrator. Plan AdminiStrator will promptly submit to BCSSKS any request it re~lv~l? for a review of a claim for ben~fits which has ~een denle~, In order tt)at BCBSKS JJ:laY provide a full and fair review of the claim.

f\1, BCE3~KS ~~al! providE;~ Pl~n Administrator ·with sueh .claim or statistical iriformaJion and. un~twtiting and actuarial services as may· be reasonably required by and le~ally provided to Plan .Administr~tor. ·

0. Make avaRable to BenefltPian pa,tlclp$nts-who t~rrillnate their·ceytltnaQe l,lnder the ~n,~ Plan ror reasons described In the summary Plan Oescriptlpn ·an lodiviguat contract fQr benefits for health .care senilces, Which ~vail~bllity Compa!iY agr~es to d&senbe lri II}$ ~unirnary Plan Description ln a manner acceptable to Plan Adm,nistrator and.BC6SKS.

P. Prepare and file Form 1099 with the lritemal Revenue Servi¢e of the United S~ [)epartmel1t ot·the Treasury and send se~rat¢i statements to providers of medical ~tviees furlil$hitlg inform~:~tion, as required by the .Internal Revenue Code and Regulations thereunder; regardin_g ~mounts paid to those providers on behalfof Ben.ef'it.Pian.

Q. Provide Plan .Administrator with such accounting and other information at $uch tiiTI~s as 1'19q!3ssa!)' for Plan Administrator to file rE!POrbi requireCI In eonliection with ERISA, .

7. Company and Pfap_ Adrninisntar agree t9 re.imbur$e BCBSKS for all amounts properly advanced by BCBSKS for the :payment of claim$. undert!l~ B.'n·e.fit P~n. under the terms and provisions described In Attachment A 1o this Agreement. BCBSKS ·agrees ~o pay claims for benefits in a timely manner and to timely bPI Company for such benefits payments In the manner described In such Attachment A. ·

8. Company agrees tO pay BCBSKS admlnlstrtltlve fees as d~crlbe<;J in Attachment A for those services performed by BCBSKS under this Agreement.

9. ltl.s lhe P~ A~ministrator'!S responsibility to·evaluate, review, and determine Whether.applk::arits, participimts, anCI beneficiarie.• •n~ .eligible for participation based on the Eillglblfity criteria agreed tO by Company and BCBS~s. Plan Administrator agrees to proVide BCBSKS with a list of parUcipafits cover~d QY the Benefit Pial'! In such ·fQI'm and with such additional data teQan.iihg sucl"l participants Iii'S ·a~ acceptabl~ to Plan Admlnlst!lltor and ·eci3sKS. Ccimpany agrees to notifY BCBSKS in -~ timely rn~nner of any ctJanges In a partiCipanfs employment status that also laffects eligibility to participate in B~nefit Plan. BCBSKS shall not be liable for any clericaJ eri'oi'S or omi$SIOns made by Benefit PI~ which re.Suri in eXtensions of-benefits to a participant who waS not. eligible or denial of benefits to a_partieipant wl'iowas not.eliglble or deilial6fbenefit!5 tQ.a ~rtieipaiit who was eiigib~,. Any·claim~S. p~!d by BcasKs as a result of suCh error or omission shall not be a lia_bUity ~or c;ha.rg~able to acB$1<$. Notwithstanding the foregoing and :regardless Qf fault, a.CBSKS shall make a dnigent ~rt to recover overpayments or payments made in error, bUt sh~ll not Initiate legal prpceedings for any such recovery on behalf of Benefit Plan.

1 o. The ·following provisions are applicable for the administration of benefits for .the Benefit Phan participants who are not eligible for Medicare and .who choose to continue coverage unqer the ~ealth care b~neflts pi'ogram of tt,e Benefit Plan through 1Mir rights under the Colisofidated OmnlbU$ Buqget ~econciliat.iot'l Act qf Hl86 and any amendments thereto, (commonlY te"rred to as COBRA), and .of the distribution of monies associated therewith.·

A.. Tne Cornpany or Plan Administrator agrees as follows:

(1) To provide BCBSKS notice ofany Benefit Plan p~cipants who, a!il a result of a qualifying event under the provisions of COBRA. bfic<ime eligible for contlnu~d group bl!!.nE!fjts· under 90BRA. The Company or Plan AdminiStrator wQI provide such notice to sca.sKS within 14 days of the date that It becomes aware of a q1,1alifying eVeht of a partic;ipanl ·

(2) To provide the participant who becomes·ellgible for COBRA as a lllsult of a qu.alifying event; the CQBRA Declaration Form, that has been provided bY BCBSKS, so as to enroll such participant In this program of cont1n1.1ed r;Jroup benefits.

B. BCBSKS agrees as follows:

(1) Upon receipt of the notice of those participants whO a"' f;iligible for continued group llenefrts Ul'!de!' COBRA from the Beneftt Plliri, and the l'eql,iest. from the participants to be eovered under COBRA,

FORMAP-0001 01/21 Page4

establish a COBRA membership for such participants and maintain that membership until such participants' rights expire under the provisions of COBRA.

{2) BHI the participant directly for such coverage as provided under the provisions of COBRA.

(3) BCBSKS' obligations apply only to those portions of the health pran BCBSKS administers.

C. BCBSKS will collect from eligible COBRA participants the applicable Benefit Plan premium plus an additional2.0% as permitted under Federal Law. This additional2.0% will be retained by BCBSKS to offset the additional administrative expenses associated with the handling of COBRA coverage. The remaining portion of the premium will be returned to the Company or Plan Administrator less administrative fees otherwise applicable to the Benefit Plan under this Agreement Including, but not limited to, those fees enumerated under Section 7 above, as well· as any premiums associated with applicable stop loss coverage.

11. Inspection of Records:

At such reasonable times as shall be agreeable to Plan Administrator and BCBSKS, BCBSKS will make available for audit by Plan Administrator's designated auditors (during normal business hours) its files, books and records pertaining to the Benefit Plan.

12. Standard of Care:

BCBSKS shall perform its duties and obligations under this Agreement In a timely fashion and in a careful and Prudent manner. "Prudent" shall mean that level of care which a similarly situated claims administrator would· exercise under Similar Circumstances. "Similar Circumstances" shall be determined by considering factors which Include but are not limited to: (1) the nature of the claims processed; (2) the volume of claims processed: and (3) the total amount of benefits paid. To the extent BCBSKS Is functioning as a fiduciary as that term Is defined by ERISA, it shall discharge Its duties with respect to the Benefit Plan solely In the interests of Benefit Plan participants and for the exclusive purpose of providing benefits for Benefit Plan participants and defraying reasonable expenses of administering the Benefit Plan.

13. Overpayment of Claims:

A. BCBSKS wih exhaust all Prudent means of recovering all Overpayments it makes from the Benefit Plan. As used In this Agreement, woverpaymenf' means any amount which Plan Administrator and BCBSKS shall agree has been mistakenly or wrongly paid from the Benefit Plan, including dupOcate payments, mistaken payments, payments in excess of that actually owed, and any other amount not required to be paid under the terms of the Benefit Plan. The Parties will cooperate In efforts to recover Overpayments.

B. BCBSKS shall indemnify the Benefit Plan for an Overpayment If it is determined, as specified In Section C of this Paragraph, that such payment was caused directly by an act or omission by BCBSKS which was: (a) criminal, fraudulent or dishonest; or (b) in Intentional disregard of BCBSKS' obligations under this Agreement; or (c) part of a repetitive course of conduct which was so clearly In disregard of BCBSKS' obligations under this Agreement as to justify a presumption that It was Intentional.

C. A determination of whether BCBSKS' act or omission was as described In Section B of this Paragraph, that such payment was caused directly by an act or omission by BCBSKS, shaD be made by: (a) an agreement between Plan Administrator and BCBSKS; or (b).lf Plan Administrator and BCBSKS cannot reach agreement, by a determination of an arbitrator In accordance with the Rules of the American Arbitration Association.

D. Company shall Indemnify BCBSKS for direct out-of-pocket third party legal fees, disbursements and court costs incurred by BCBSKS to recover Overpayments unless, In accordance with Sections B and C of this Paragraph, BCBSKS must Indemnify Company for the amount of such OVerpayments. BCBSKS shall periodically inform Plan Administrator of the manner and status of its attempts to recover such Overpayments and costs Incurred as to the data of the status report.

E. If an Overpayment of Benefit Plan benefits was made at the written direction of Plan Administrator, Benefit Plan shall Indemnify BCBSKS for the third party legal fees, disbursements and court costs Incurred by BCBSKS to recover such Overpayment.

FORM AP-0001 01121 Page5 I

F. The provisions Of this Pail!igraph will ~urvive termi~cm of this Agreemen~

14. R~c:overies by I;ICB$J(S:

~ere may. be clrcumstance.s in which BCBSKS recoven> amount$ paid as claims ~en~e fro!Jl the prO\li~er of seJ\Ilce; from the subscriber, or from a tt)itd party. such tircumstanc~ inc;h,Jde .. ~b!iilE!s· paid-~ I;ICBS.K$ by pharmacelitieal maril.lt.icture('S based upon · t;~IT!ount$ . of claims paid by SCJ:l$KS for certain specified phatn1a~uti¢l;Jis, amo~mts· tet:9Yered .Qy BCBS!(S from healtl'! ca~ prOViders or pharmaceutical manufacturers through CEiii!iiin l~al ~~ons Instituted llY th~ company relating to the claims expense of more than one Insured, tecc;wer!es by BOB§iKS cif o~rpayments made to health care provider$ or to itisu~ds, and reco~iies ftQril Qther partie~ with whom BCBSKS contracts .or otherWise relies upon for payment or priclr)g Of _clail'il$. _In addl~_n, &!Jch recoveries might Include .recoveries-through $ubrb9ation. The follOWing rule~ gov~rri BCBSKS' actions with ·respect to such .O*:overies: ·

A. In the e~nt such Iec.pvetles rel~e tQ. claims paid more than a year .and 90 days befOre the J'Eieovery, no $dj~:-~stment Wi.ll b.e 01ade to any deductible or coinsurance paid by a Benefit Plan J?t:irticij:iant _and BCBSKS ($Ubject to the lfmitailons otherwise set rorih below) shall be entitl~ to retain $1Jch recoveries. If the re~very relates to a claim paid Within~ year and. 90 d.ays, deduc.tibles and cciin~uran·c;!9s f<lr ~ ~enefrt Plan partlcipan_t Will be adj"'sted if affeCted by the recovery, and Benefit Plan shaD retain such reCQveries as provided within this -section. '

a. If S!JCh recovery al'j1ounts to less than $500 attributable to any "cCinttaetperiod"(the period oftifneln Which the deductible or coinsurance Is calculated) tor any Benetit Pl.an panicipant, no adjliStm~nJs in (:leductible.s or coinsurances will be made, and Benefit Plan (s11.b]ect to the Hmltatiorl$ o(her'Wfse ·set forth ht?rein) shall be entitled tb retain such recoveries for itS own use.

c. If an Individual is no Jong!9r covered by fu,is ben~fit program at the time any such recovery ·I$ niadei Benefit Pial:! (subject to Orn_ita(kms otherwise set forth herein) sha11·.be erititled to retain such recovery for Its own use.

D. In the event BCBSKS i'E!t:eilles rebates frQm pharmace~_tical !l'lanufacturel'$ based upon amounts of claims paid by !;3CBSK;S. fpr certain specified pharmaceuticals, BCBSKS stiall be entitled to retain twf!.nty (20) percent of such rebates. for Its 9W11 use, and no adjustments will be made to aey claims paid on behalf Of Benefit Plan, to deductibles or coinsurances paid by Benefit Plan participants, or to any other cost-sharing amounts. BCBSKS shall crediUhe remaining eighty (80) percent of sUCh ~a~s to the company'$ ci~llll~ payment account generally on a qi.tarterly basis but in all ¢ases Wlthil"! ninety (90) d_ays of ~19lpt-by BGBSKS. If thl$ agre~nieilt has be~n tertnln~t~d by elth~l' party prior to all accrued and owed rebata funds being rerlii"ed, 8CBSKS sh_an fnstead remit the 80% share to- the Company Via check or wire transfer within the same ninety (90) day timeframe.

E. If Company no longer cantrad$ With BCBSK~ .at the time the re®yery oc.~rs, recqverit:~s otherwise owing to the Company pursuant to the foregoing will be pal~ .to the ComPi!lnY ifrequired 1.1nder .Section A above. Nothing, hoWever, oblig~tes. BCBSK~Ho continue to pursue subi'Qgation or·.other recoveries after-termination of this Agr~ement, and such active ~ul;lrogation files as BCBSKS maintains shall be returned to the Company upon such terminaijon,

i=~ BCBSKS has no obligation to pursua recovery. from health ·care providers or m~nufapturers of health care products or services on beh~lf .of .Benefit Pl~n for c.auses ~f action arising O!.lt <;If v;0iatlons of antitrust Jaw, ftaUd, ciC!ir:l'ls relating to fraud (inclu4ing claims under the Rac;kete;~ring Influenced and Corrupt Organizations ACt), and ~~ admin.istration of ~ubrogatlon provisions under the Company's Benefit Plan shall be limited in such clrcam~ta.nces solely to cases in which Benefit Plan participants have individually initiated a claim or cause of action. NotWithstanding the foregoin~·. If (a) :BCBSKS asserts a c,laim or causa of a~ioii against a party (other than Bemflt Plan itself) arising out of antitl'1.1$l violations or fraud by h&alth car~ prQiiiders. or manufacturers of health care l)rQducts or servi~s relating to claims paid by BCB.SKS under Insured c6htraots •nt:~ (b) claims payn:telll.s made by BCaSKS on behalf Of Benefit Plan and Benefit Plan participants would have beell equally a(f~c:ted ~nder the circumstances of such claim or cause of action, then. Benefit Plan assigns l9 BCBSKS Its rights under such claim ·or cause of action. If rectiverle$ by BCBSKS in such -a claim or cause of action are. Jess than aettial injury asserted W ~C:BSKS ~r ~elf .anc;l on behalf of ~ilefit Plan and other s1milarly situated Benefit Plans, then BCBSKS sh~l pay to Baoefit Plan a prora~ed &J'l1QUJ1t based u.pC!n claims costs under Ben~fit Plan compared to claim.s ~sts of BCBSKS under its insured

FORM AP-0001 01/21 PageS

programs. No adjustments of deductibles or coinsurances will be made for Benefit Plan participants in such circumstances. This assignment of a cause of action shall survive termination of this Agreement.

G. The total amount of any recoveries which are available for adjustments to claims of or payments to Company or for adjustments to cost sharing of Benefit Plan participants of the program of Company In the form of deductlbles or coinsurances will be reduced by the cost to BCBSKS to procure that recovery, including amounts paid in attorney fees, amounts paid to collection agencies or other entitles obtaining recoveries on a contingency basis, and other costs.

H. In the event Company holds a stop-loss agreement from BCBSKS, any amounts recovered by operation of the subrogation provision will be applied to reduce the Claims Expense attributed to the Company under such stop-loss agreement. The effect of such reduction will be to eliminate from claims costs applied towards the Attachment Point under such stop-Joss agreement amounts recovered through subrogation. In doing so, the following procedures will apply:

(1) The amount of subrogation recoveries applied will be the net amount of subrogation recoveries after eliminating the cost for recovery, including attorney fees, if any.

'

{2) If BCBSKS has become liable under any such sto!Hoss agreement during a Contract Period, and the effect of such subrogation recovery, whenever made, would have been to reduce or eliminate such liability, then BCBSKS shall be entitled to retain such subrogation recoveries to the extent of Its obligations under such stop-loss agreement) remitting to Company any balance.

(3) If the Company holds both an Individual and aggregate stop-loss agreement, then the recoveries shall first be applied to reduce Claims Expense of the person with respect to whom the subrogation recovery was made. If the Individual Attachment Point under the stop-loss agreement was not met with respect to the person to whom the subrogation recovery applies, but the Aggregate Attachment Point was met, then such recovery shall be applied to reduce the claims applied toward the Aggregate Attachment Point.

{4) If the subrogation recovery is related to Claims Expense for more than one Contract Period, the subrogation recovery shall first be applied to Claims Expense with respect to the first Contract Period to which such subrogation applies; if the total of such subrogation recovery exceeds Claims Expense (using the rules set forth above with respeot to /ndivfdvsl Attachment Point$ and Aggregate Attachment Points) for the first such Contract Period, then the excess shall be applied to each subsequent Contract Period successively until such subrogation recovery is exhausted.

(5) "Claims Expense• means Incurred Claims Expense If Company holds a stop-loss agreement on an incurred claims basis, and Paid Claims Expense if Company holds a stop-loss agreement on a paid claims basis.

15. Additional Charges to Company:

From time to time, BCBSKS may rely upon entities other than other Blue Cr0$S and Blue Shield plans to obtain negotiated prices for health care services. Typically, such other entities charge a percentage of the amount of claims savings they negotiate. Company agrees that BCBSKS may charge such percentages as additional claims coats to the Company under this Agreement. However, such percentages will not be charged as claim costs to beneficiaries.

16. Employment of Counsel and Resolution of Utfgation and Legal Fees:

A. In the event of utigation, each Party:

(Q reserves the right to select and retain counsel at Its own expense to protect Its interests (selection of separate counsel pursuant to this clause will not affect any duty to indemnify that is otherwise imposed by this Agreement);

l (10 wiU promptly notify the other Party after learning of litigation;

FORM AP..()Q01 01121 Page7

(iii) will cooperate fully by provlclil'lg the other Party with all nc:m-cQnfidenJial ·rei~Mmt lnform~tlon and dbcuments within it& ContrPI; ·and· ·

(IV) Will r~asonably asslsi ~e other Party in the defense of Litigation ..

8; In th~ eyent Company, benefit Plan or BCBSKS Is tfle sole named d$ni:laritln Lffigat!()h, !such PE;~rty shall have discretion to defend, settle; eomptomlse o.rotherwlse.~olve such l,.ltlgati(ln C6ns,lstentwith the tetrns of this Agreement and of the Benefit Pla.ri. Such Party shall k~ep tt)e other PE¢.y fLIIIY Informed of the status of the Lfff~atiort a.nd any dec;ision to settle, cpmpromise 9r .otherwise resolve the Litigation shall be commu~lcated to and dlscuss&C:f With the other P~rty prior to any such settlement, coropramlse or other r¢solutlon. · ·

c. In the event Company, Benefit Plan and BCBSKS are codefendant$ In Litig~tiQn,. the Parties win cooperate fully with each other to defend, $ettle, .c=Pr:npromls~ pr otherwl~ ~olv~ SIJch LHiSlatlon consistent with the terms of·thisAgreement $11d the Benefit Plan ..

D, lt1 the ·event any entity other than Company, Benefit Plan or BCBSKS, is named as a defend~nt In Liigatlcm, Plan Administrator can elect to defend, settle, compromise or otheiWi~ resolve such L!ligation witli tespect to those Other Entities consistent with the terms of this Agre.,~nt ~nd Qfthe Benefit Pial'!.

E. The unf.lelt:!klng to detehd, settle, c9mprotnis~ or otherwi~e re&Pive Litigation pursuant to Sections B, c and 0 of ttiis Pan;~glllph Includes the p~yment of S!1Y and all legal fees, disbursements; and court costs Incurred in connection With perfOrlning that undertaking.

F'. As used in this Agreement, "Negligent'' means th.e dOlf'lg Qf sOme a~ which a PtJJdem ,ciaims. administrator would not have done undet Sin'iilarOirourristan~s or ~ii!Jre to cto Wh.l!!t a Prudent claims adni_lnlstrator would have done under SinillarCircumsta!1~.

$. In the e~nt that BCBSKS decides to settle Litigation invoMng a claim tor J;teriefit P~n benefitS and any portion~ such settlement is paid or reimbursed from ej Plan Trust, thl;ln, In that event, BCBSK$ snail furnish Plan Administrator with documentation In support of -siJ.ch deciSion to •ettte th~ sflOWs that acB~KS fully considered the options ava~le and the risks iltnd benefits of !Settlement

H. The prOvisions Qfthis paragmph will survive termination of this Agreement.

17. Indemnification Agreements:

A Except as providEK!in Section c of this Patag~ph, in the event of ptlg~tlon, Company and Plan Administrator ag.ree to h1demnify E~CBSKS for ~s reasonable attorneys' fees and costs and for any judgment, award or $et(l$melit (other than aju~gment for or settlement representing punitiV$ dam~es, Whicl1 such judgment or s.ettlem~11t s.hall be the sole responsibility. of BCBSKS); proVided that BCBSKS keeps Plan Ad_mlriistrator fully Informed of the status of the Litigation and the actio.n~;~ Its counsel pl~ns to ~e during sl!c;h Lltlge~tion and provided that BCBSKS shEll! not settle or otherwise resolve such Lltigation Without prior gQnsultation with company and Plan Administ~tor.

B. Jn the ev43ntthat BCSSK~ decides to settle Utlgatlon for which Company as Plan Adrrilnlsttato:r h~s agteed to indemnify BCBSKS; SCBSKS shall furnish Company with documentation in support of its decision to s$We that shows that BCBSKS fully considered the option$ available and the riskS and ben~s of settlement

· C. Company Is not obr~ga.ted to Indemnify BCBSKS, "'nd aCBSK$ shall reimburse Company or Benefit Plan for all reasoni\'II:Jie attorneys' fees and costs ihCU~ by Benefit Plan or Company in its defense of a claim and fo.r i!JiY jl,ldgment, awa!'d or~ttlement (other than a judgment for a settlement representing punitive damages) paid by Company or the Benefit Plan, If It Is determined, as specified.ln Section D of this PE!i"CI91liPh, that suqtt fees and costs .and such judgment or settlement Was paid as a direct result Of ~n act Qr Qltlll$8ion by BCEI~.KS which was:

(i) fraud!Jient. criminal, dishonest, or Negligent (as defined in Para~raph16(F) Of this Agreement); or

(ii) intentional or in Wl11ful disregard of BCBSKS': (a) obligations U.ndE!t the terms of this Agreemen~; or (b) ~s fiduciary duties under the laws of the Stale Of Kansas.

FOJ!Uil AP-Q001 01/21 Page.B

D. A determination whether BCBSKS' act or omission was as described in Section C of this Paragraph will be made by:

(I) a final determination in litigation, or, if no such final determination was made;

(ii) by an agreement between Company and BCBSKS; or

(iii) if no agreement can be reached then by a determination of an Arbitrator in accordance wHh the rules of the American Arbitration Association.

E. Notwithstanding the provisions of this Paragraph, Company shaH Indemnify BCBSKS if BCBSKS' act or omission was taken under specific written direction of Plan Administrator.

F. The provisions of this Paragraph will suiVIve termination of this Agreement

G. In the event that this contract should be construed as an Insurance contract and premium taxes or privilege fees 8SS8$eed by any state authority or levied in any other manner upon the claims payment amounts or administrative fees paid hereunder or charged hereunder, Company hereby agrees to indemnify BCBSKS for any amounts actually paid by BCBSKS with respect to the operation of this contract under such an assessment of taxes or fees, such indemnification .to be paid in a manner mutuallY agreeable to both parties and reasonably related to the nature of the tax.

18. Confidentiality and Data Use

As used herein, "Confidential Information" means non-public Information that Includes strategic: and/or competitively sensitive Information including, but not limited to, BCBSKS, the Blue Cross Blue Shield Association, or other BCBS company trade secrets, po&cles, procedures, data and processes.

Use of Confidential Information by the Company or Plan Administrator must be strictly for the purpose for which It was disclosed, and may not be sold to any third party. Confidential Information, including claims data, obtained during the term of this Agreement may neither be de-aggregated In any manner to identify BCBSKS, other BCBS entities, and/or Member information, nor may It be comingled in any manner. Any disclosure of Confidential Information shall be limited to the minimum necessary to fulfdl the purpose for which it was disclosed. Confidential Information must be returned or securely destroyed by the Company/Plan Administrator upon conclusion of the purposes for which it was disclosed. In the event Company/Plan Administrator cannot immediately return or destroy Confidential Information due to legal, license, or other requirements, the Company/Plan Administrator agrees to maintain the confidentiality of such Information until the expiration of said requirements. Company also agrees to notify BCBSKS within 1 0 days of any change in ownership. BCBSKS maintains the right to audit the Company/Plan Administrator to ensure compliance with these provisions.

19. This Agreement may be tennlnated as follows:

A. This Agreement may be terminated by either Party as of the end of any month by giving the other Party written notice sixty (60) days in advance of such termination date.

B. If the Company fails to make any payments when due, BCBSKS shall have the right to terminate this Agreement without notice and without prejudice to any other rights BCBSKS rnay have with respect to the Company's obligations hereunder.

C. Any other date determined by prior written agreement between Company and BCBSKS.

D. In the event of termination of this Agreement, BCBSKS will, unless Plan Administrator directs and BCBSKS otherwise agrees:

(i) complete the processing of all claims payable under the Benefit Plan for seiVices provided by health care providers which were Incurred by Benefit Pfan participants prior to the tennlnation date but not processed by BCBSKS on or after the termination date. Company's liability for continuing payment In the manner desc:ribed In Attachment A for any claim which has been processed to final adjudication shall continue for eighteen (18) months following the termination date. For any claim Incurred prior to the termination date but not processed to final adjudication by BCBSKS by the end of such eighteen-

FORM AP-0001 01121 Page9

month period, Comp$!1Y shall assUJ:ne totalliC1bhity. BCBSKS ~haii transfersu~h rec;:orcf~J.as it may have in i_ts posses$ion to enable the Company to addr!9~s such fiabRities. Examples of clains which may not have been pro~sed to fln~i adjudication include claims pended for pursuit of subrogation or other thirdparty liabPiW re~ponslbility deterrrdnations; ·and

(if) r!9lease to Plan Administrator, in BCBSKS' stand.ard .format, all records and files r$1ating tp claims p~id under the Benefit Pli:ui pLirsuan·t to this AQr'eeme.nt.

E. If BCBSKS. reasonably peifonns any services porsue1nt t9 ~hi~ Agreement following its termination, incfuding J:~ut not limited to ~e!Vic~ described in tills Paragraph, BCBSKS will be entitled to the ·tees, claims .paid retmbursemeot.!5 or other charges on the same basis; and in the manner deSci'ibed in Att~m~nt A, as If t~is Agreement had continued in effect until those serVices wer~ peffotm~.

20. The Company on behalf of lts~f and .its pMicfp~nts hereby expressly acknowledges Its understanding this Agreement constitutes a contract solely between the 'Company and Blue Cross and Blue Shield cif Kansas, which is an indeperi~ent corporation ope.r.atihg under an agreement with the Blue Cross alld Blue Shield Msoc.iatJon, an as~Qcja~ion of. independent Blue Cross and Blue Shield Plans (the "ASs'6,ckrtlon"), pe.n:riitting 131ue Cross and Blue Shield of Kansas to use the BILie Ci"9$S and/orBI!,Je Shl.~ld SeNic' M~rks lri ~h_e Stat~ of Kansas and that Blue Cross and Blue Shield Of Ktm$a$ is .not contracting as the agent.Qf the Association. The Company on behalf of itself ai)d Its participants further $C:I<riowledg$S that It has l'!(;)l l[mtered into this Agreement based upon representations by any person other than Blue Cro~~ ~!'ld Blue Shield of Kansas and that no person, entity, or organiza~on qthet than Blue CJ"Qss. and Blue Shield of Kansas shall be held accountable or liabl~ to th~ Company for any of Blue Cross and Blue Shield of Kansas's Qbllgatlons to the Company cre,ted liilder this Agreern,ent. This paragraph shall not create any addltfQnal .obligations Whli!tsoever on the part of $1ue Cross and Blue Shield of Kansas other than those obligations created under o~het provlslohs of this Agreemer'!t

21. Entire Agreement:

This Agreement, including attachments, constitutes the entire' corib'~ct betWeen the Partie& and no iliPdificafion or amendment of this Agre$ment lric:luding ren~ls $hall be valid unless made In Wiitin.g and sign.ed by the Parties.

22. This Agreement shall be efff;lctlve 01/()1/2021 through 12131/2021.

1. Shawnee Coi.uitY 2. B~IJ~SS & B'-UE $HIELD OF KANSAS, INC.

BY:~~~ TITLE: ~ ~- .... ~~ I>A TE: "'/r! "2-P 2c;o

~·

BY: ______________ _

TITLE: ____________ _

DATE:. _____________________ __

fORMAP.:ooo1 01/21 P&Qe 10

+.v:::=~ • • ofKansas An Independent Licensee of the Slu& Cross Slue Sni&Id Acao.clallon.

AMENDMENT TO ADMINISTRATIVE SERVICES AGREEMENT

1. GENERAL

This is an Amendment to the Agreement To Provide Administrative Services for !!I S'elf..funded Health Benefit Plari betWeen Blue Cross and Blue Shield of Kansas, Inc.:. (BGBSKS) and "Co-rnpany" as n21med in the Agreement to which this Amendment is attached. This Amendment beCC)r:nes effectM! on ~he later Of January 1, 2007 or the effective date specified In the Agreement betWeen BCE:ISKS and th~ COmpany.

2. CHANGES BEING MADE BY THIS AMENDMENT

With the. exception of those duties Involving membership maintenance and ciaims, the Company agrees that aD other duties and responsibilities, ·fiduciary or otherwise, associated with COBRA shall solely belong to Company. These duties Include, but are not limited to: detenninatl~m of COBRA eligible participants and ben.eficlarlei, provision of COBRA notices to participants and beneficfarles, !'$POrting to BCBSKS th~e participants/beneficiaries electing COBRA coverage, and billing of participantslbeneficiarjes for COBRA premiums. Accordingly, Sectlbn 10 of tne·~sreement t0 Which this Amen'dment:is altacct\ed Is deemed deleted.

FORM AP-0043 01/10

v BlneCross . BlueShield • e ofKansas

Art Independent Licensee of thi!l Blue Cros-s Blue Shield A.uoci;~lion.

ATTACHMENT A

ThisA~E!C~_I!t~iltA to the Agreement ~een B!ue Cross and Bfue Shield ofKansas, Inc., (hereafter referred to ~~ "BCBSKS'' ~n.d $~alf(!1ee County (hereinafter "Company'! or '!Plan Adniiriistrator"} tO which It 1$ ~U!il¢hecf _qe~9~b~s the procedures to be used for payment by Company tQ BCeSf<S of claims am9tmts PEJI(:( by BCSSKS and of administriathi$ f$eS due BCBSKS liri!ier Sl!Ch ~reeinel)t,

1. Adminis~•-Fee$.~

A. The ia!irntni~~tive • pharged by ElcE!sKS fodhe services it provides under the Agreement to Wbi!:h this Is attachE!d copsist of the cost for SCSSKS to provide those serVices, which will be a~sE;~~sed as a fiXed dollar and cent amount per month per employee, set forth in the 'Surrirriary of Ohargetl document, sl!;Jned bY the Compan.y. ·

The number 9f employees sh~l b.e detemi!rted f~r the purpose of this provision by the number of ~Ugible ~l't!PIQYees !'Eij)ofled by -CompanY l9 BCBSKS as of the first day of each month. Coriipariy 11hl!iiJ remit tQ BCI;ISKS no later than the 1oth day of each month the amount due for-suCh month.

A group who remits ptei'nlum payments ~n ~ve~ge of fiVe month$ dellnqu~nt over a ·12 month cycle will be classified as habitually delinquent and will be subject to additional administrative fees atthe time of annual renewal.

B.. $ectlons 3 through 6 describe certain fees that will be charged hi eonjundion With c.laims. for health care services that are received outside the geographic area s~rved. by BCBSKS; proc~ thro.;Jgh the Bluecaroe ·program .and pre6ented to BCBSKS for payment in confprmity with network access niles of the BlueCard".Ptogram then in effect. ·

2. Ciall1t$ Refrrlbursement:

Claims incurr~ by Benefit Plan participants shaH be paid as they are received by BCBSKS Jn the same manner as claims are paid under underwritten programs. Company agrees to reim!:»urse BCB~KS by the method oUtlined below. · ·

Company agrees to pr.o.vid$ ~C!=)SKS access to fun~s through an Automated Clearing House (ACH) arrangement under whicll BCBSKS may -draw upon Company funds. B.CBSKS shall initiate an ACH t~nsfer to it fr~m Company funds for claims payments, administrative fees, if applicable, and any applicable BlueCarc:P Program te.es of Which Company has b$Ein notl"ed at 2:00 p.m. Central Time, Daylight or Standard, of the fir-St bt.~siness day following the day on which such ndtification was provldfld toCompany. ·

Chargll"!g Incurred Claims Expense. For the purpose of this attachment and the Agreement-to which it is attachf;ld; Incurred claims expense will be charged as foUows: ·

Claims expense will be charged to the Contract Period In v./hich it is incurred.

lncurr8d claims expense wliJ incJude .l!lnY ~ccess fees described in the BlueCarcfD provision of this Agreement .as set forth below (see EXhibit A fer fee de~riptions) as well as a_ny other am()unts. of discounts from provider charges retained by another Blue Cto-ss and Blue Shield Plan, provider networ1<, or other entity.

FORM AP-0005A 1121 Page1

3. Out-of-Area Services

Overview

BCBSKS has a variety of relationships with other Blue Cross and/or Blue Shield Licensees referred to generally as "Inter-Plan Arrangements. • These Inter-Plan Arrangements operate under rules and procedures issued by the Blue Cross and Blue Shield Association ("Association'~. Whenever subscribers access healthcare services outside the geographic area BCBSKS serves, the claim for those services may be processed through one of these Inter-Plan Arrangements and presented to BCBSKS for payment in accordance with the rules of the Inter-Plan Arrangements then In effect. The Inter-Plan Arrangements available to subscribers under this agreement are described generally below.

Typically, when accessing care outside the geographic area BCBSKS serves, subscribers obtain care from heslthcare providers that have a contractual agreement ("participating providersj with the local Blue Cross and/or Blue Shield Licensee in that other geographic area ("Host Blue"). In some instances, subscribers may obtain care from non-participating heaHhcare providers. BCBSKS remains responsible for fulfilling Its contractual obHgations to Company. BCBSKS' payment practices in both Instances are described below.

This disclosure describes how claims are administered for Inter-Plan Arrangements and the fees that are charged In connection with Inter-Plan Arrangements. Note that Dental Care Benefits (except when paid as medical claims/benefits), and those Prescription Drug Benefit& or Vision Care Benefits that may be administered by a third party contracted by BCBSKS to provide the specific service or services are not processed through Inter-Plan Arrangements.

Bluecarctt' Program

The BlueCardl' Program Is an Inter-Plan Arrangement. Under this Arrangement, when subscribers access covered healthcare services wNhln the geographic area served by a Host Blue, the Host Blue wll be responsible for contracting and handling all Interactions with Its participating healthcere providers. The financial terms of the BlueCarcP Program are described generally below.

A. Liability Calculation Method Per Claim

(i) Subscriber Uability Calculation Unless subject to a fixed dollar copayment, the calculation of the subscriber liability on daims for covered healthcare services processed through the BlueCarcf'D Program will be based on the lower of the participating healthcare provider's bDied covered charges or the negotiated price made available to BCBSKS by the Host Blue.

~i) Company's Uability CslcutaUon The calculation of Company's Uability on claims for covered health care services processed through the BlueCarcP Program Will be based on the negotiated price made available to BCBSKS by the Host Blue. Sometimes, this negotiated price may be greater for a given service or services than the billed charges In accordance with how the Host Blue has negotiated with its participating heaHhcare provlder(s) for $peciflc healthcare services. In cases where the negotiated price exceeds the billed charge, Company may be liable for the excesJ) amount even when the subscriber's deductible has not been satisfied. This excess amount reflects an amount that may be necessary to secure (a) the provider's participation In the network andlor (b) the overall discount negotiated by the Host Blue. In such a case, the entire contracted price Is paid to the provider, even when the contracted price is graater than the billed charge.

B. Claims Pricing

Host Blues determine a negotiated price, which is reflected In the terms of each Host Blue's provider contracts. The negotiated price made available to BCBSKS by the Host Blue may be represented by one of the following:

FORM AP-0006A 1121 Page2

(I)

(ii)

(fii)

an ac;tua! Price. A.n actual price is a negotiated payment in .effeCt at the time the claim Is processed without any other increases or decreases, or

an estimated price. A.n estimated price rs a negotil:itea iclte of payment (n effeCt-~ the time a claim IS processed, reduced or Jnc~ased by a 'pe~ntage t9' ~e [ntq account certain p~ymenUi negotlate_d WIUl·the provider i!rtd other cl!lim- and _non-clairn~rel~ ~"!il'ctions. Su~l:t ·transS,CtiQns m~y include, but are not liJ1lfti!cl tq, anti-fraud and abuse recoveries, P!'Oyidet t~nds ri()t .appliec;l on a claim-specific basis; retrospective settf(tn:nlints, and perf9rm.a~'i!"felated bonuses or incentives! or

an average price. An average,prlce is a percentage of bUie.et covt;ired 9harges .representing the aggregat$ p~ymei1t$ neQ"oti~tec;l by tHe Ho$t. BlUe with~~~ bf lts_hea!fhca~e proV!d~., or~ sin1l.latd~S$1fl¢ati.O.n Of.its provld!!irs and.oth~t cl~lm- and non-cl8im-rela~ tm.n~~~ons. S!Jch transactions rh!!IY it1CIU.de ~e same Q~s 1\l~ _n~d-~ove fOr an estimated price.

TheHQSt aiue deterrn.lnes whether It will use. an actual, estimated pr av~fageprice. The use Of estiro$<1 or average pricing may result In a difference (positive ¢r negative), betw~n the price Company Pi!IY8 on a specific claim and the actLial amount the Host Blue pa:ys Jhe provider. HQWever, the B_lueCar'dl' PI"Qgrain requires th~~ the a:mount paid I:>Y ·tne subsprjber ~nd Cqmp~ny is a final pri~; oo fUture price .adJUstment Will resu~ in il"!crea:ses qr· d_~a~!!s tq the P.ricing o(p~t cJaims. · · ·

An.Y p~itive or !'!(9{Jfltive difference In estimated or average pricing are act:ounted for through variance !i!Ccounts maintained by the. Host Blue and :are lnc6rporated Into future cl~ prices, As !1l}esutt, the amounts charged ·to Company Will be adjusted In a fullQwing year, as f!eCessa~. to a:c¢ount for over- or underestimation of pa_st years' pri~~ The Host Blue will fflrt i'!'C8iVe cotnp!'fl~_ioJ1 frol!l how the estimated price or aye~ge price methods. described above, a~ ~.Jculated. Because all amounts paid ar~ fin~!. neiUl~rP.~itiVe v~rlance a~1,1nt amounts (funds available to be paid in the fpllov.iing yeaf.), nor nege~tiV¢ variaf'!qe, amountS (the fundS needed to be received In the follOWing year), sre due to orJrom the Company. 11 Company terminates, you Will not .receive a lltfulid 91'cha~Ei-froii'l the 'lfi\liian¢8 acC;Qunt.

Va!Ulnce account ba~ncEil!! ~Ji"e small amc;~un~ relative t() the overall paid claims amounts and will be liqUidated over time. Th~ timeframe for their fiq1.1idation depends on variables, lncluiling, but not lfmited to, overall volume/number of claims processed and variance account balance. Varl.ance account balaflces may earn interest at the tecleral funds or simftar rate. Host Blu• may retain interest earned on funds held in variance accounts. ·

c. .Return of Qverp~Wmerit$

Under the Biu~Card8 PrograrT!, recoveries frorn a !-Jost Blue or its participating healthcare providers can ~ri~e In sev~tal way~. irlclu~ing, but not limited to, ariti-fraud and abuse recov~rie$, heailthe$re provjder/hospltal bill audits, credit balance audits, utilization reVIew refulidl!l, anq '-!risollclted refunds. Recovery amounts determined in this WaY wUJ be ~ppli~. In g.:toen;~l, on e!ther a claim-by-claim or prospective basis. If recovery ~moi,lnts ate pa$sed on a <:laim~by..clalm bjilsi~ from a H~t Blue to BCBSKS they will be credJtecl to Company'~ ac<;QI,IIil In some cases; th~ Host Blue will engage a third pa_rty to assist In identlftcaijon pr collection of r~cov~ry amounts. The fees of such a third party may be r;;'-Qed t_q Company as a ~rcentage of the recovery. ·

b. Bluecame Program Fees and Compen$•tlon

Company understE!ods .and .agrees to retrntn~rse BCBSK~ for C:ertaln fees ~nd .oo,mpensa~on Which we .are obDgated under the elu.ecarc:P Prog~m to pay to Host Blues, to the~sociation, and/or to BlueCarcP Program vendors. The speqlfic BlueCai'CJID Program ~$, and compensation, that are charged to Company are set forth In Exhibit A. BlueCarc:P Program Fees and compensation may .be r8Vls!9d from time ~o tjme tilS described In Section 6 below.

FOR.M AP-900!)A 1121 Page·s

E. Non-Participating Healthcare Providers Outside BCBSKS Service Area

Subscriber Uablflty C.tculatlon

(0 In Generalr When covered healthcare services are provided outside of BCBSKS service area by nonparticipating healthcare providers, the amounts a subscriber pays for such &entices will be based on the payment BCBSKS would make If BCBSKS were paying a non-participating provider Inside of BCBSKS' service area. Payments for out-of-network emergency services wMI be governed by applicable federal and state law.

(10 Exceptions 1

In some exception cases, at Company's direction, BCBSKS may pay claims from nonparticipating healthcare providers outside of our service area based on the provider's bUied charge. This may occur In situations where a subscriber did not have reasonable access to a participating provider, as determined by BCBSKS (in its sole and absolute discretion} or by applicable law. In other exception cases, at Company's dlreetion, BCBSKS may choose to negotiate a payment with such provider on an exception basis.

Unless otherwise stated, in any of these exception situations, the subscnber may be responsible for the difference between the amount that the non-participating healthcare provider bHis and the payment BCBSKS will make for the covered services as set forth In this paragraph.

4. Spacial Cases: Value-Based Programs- Blueca~Program-B):BSKS

Value-Based Programs Overview

Company's subscribers may access covered healthcare services from providers that participate In a Host Blue or BCBSKS Value-Based Program. Value-Based Programs may be delivered through either BCBSKS' provider contracts or the BlueCarc:P Program. These Value-Based Programs may include but are not limited to Accountable Care Organizations, Global Payment/Total Cost of Care arrangements, Patient Centered Medical Homes and Shared Savings arrangements.

Value-Based Programs Administration

Under Value-Based Programs, a Host Blue plan or BCBSKS, as appropriate, may pay providers for reaching agreed-upon cost/quality goals in the following ways: retrospective settlements, Provider Incentives, a share of target savings, Care Coordinator Fees and/or other allowed amounts. If the Host Blue plan is paying the provider under the Value-Based Program, the Host Blue plan may pass these provider payments on to BCBSKS, which BCBSKS wiH pass directly on to Company as either an amount Included in the price of the claim or an amount charged separately in addition to the claim. If BCBSKS is paying a provider under a Value-Based Program, BCBSKS will pass such provider payment on to Company as either an amount Included In the price of the claim or an amount charged separately in addition to the claim.

When such amounts are included In the price of the claim, the claim may be billed using one of the following pricing methods:

(i) Actual Pricing Claim Based (Actual Pricing): The charge to accounts for Value-Based Programs incentives/shared savings settlements is part of the claim. These charges are passed to Company via an enhanced fee schedule.

FORM AP-0005A 1/21 Page4

(10 Supplemen~l FactQr The ch~rge to acc()urrts for Value-Based Programs incentives/Shared-savings .settlements Js a supplemental amount that Is Included In the claim as an amount based bri. :~ :ruced supplemental factor (e.g., a small percentage increase iri tile t:!alm am.ount). The suppleii:letrtal factor ma:;~y be adjust~ from time to time. This priqing methqd may· be used onlY forno~tttib\ltecl ValuJ:~-Bas.e!i prqgra.ms. ·

wnen such ~utu;>unts .ar(! billed $eparate from the price pf the claim! they may be billed as follOws:

P.~t ME\Imber Per Month (PMP.M> Bllllngs: Per Member Per Month billings for Valu&-Base.d Prqgram$ in~ntiveslsharecl:.;.savings settlements to accounts are outside of the claim system. BCBSKS will pass these Host Slue !)r local charg!;ls through· to Company as a separately idi!Ji1tffied l!irnOJJiit Oh .. the {jrpiJp biJiin_gs. .

The amounts used ,to calcula:te eijher _the supp-lemental factor.J for estlma~ed Pri~h:rg ()r PMPM billings .. re fl>te(:l amoun~ that are eStimated fp q~ t!~~sary to finlince the cost of a particul&r Value-Based Pi'o91'13m. J:lecau.se amo!Jn~s art:~ estimates, there may be positive or negative differences based on actl!al ~peri~l1~ and such differences will be accounted for in .Iii variance ·account maintained by the Host Blue (in the .same .manner as d!!Scribed ln·the Blu$Oarcf8 Claim pricing iecticm above) until th(l .end of the applicable Valt.le-Ba$ed Program payment ana/ofteco~~ill~tion mea~urement p~tiod, The amounts ·n.eedf;ld to fund a Value~B~:sed Prog~hi hlfi!Y qe cl;\a!'Jged before th.e end of th.e m~asurernent pefio~ if it.ls d~terroilied .that ~m~unts beihg colle$~ are: projected to exceed the -amount necessary to fl,i_nd the program$ or if they .are proJected to be insufficient to fund the program. A~ th~ end of the V~;~lue~Based Program payment and/or reconciliation inea&Lil'E!ment period for these arrangements, BCBSKS or Host Blue plans will take one of the folloWing act.ions: .

(I)

(II)

Use any su!'plus in funds to fund Value-B.ased Program payments or reconciliation amounts in the next measur~rnen* period.

Address any deficit in funds through an adjustment to the p$r-member-per.,month billbig amount orthe reconcinatlon billing amount for the next mea·surement p~riod.

The Ho$t Blu.e will not receive ·compensation resulting from how estimated, ·average, or PMPM price methods, de"ci'l~I\Kl •bove; are ·calculated.. .If Company terminates, it wlll not receive .a refund or ~hatge from th.e variance account This is because any r9$ulting suq)luses or deficit wou!d be eventually exhausted through prospective adjustment to the settlem~nt billings in the CE!se c>f VaiiJ~ aased Programs. The measurement period for detfltrninlng these ~urplus.es 9r deficits may differ from the tetm of this agreement. · ·

Variance a~unt balances are small amounts relative to the overall paid claims amounts. enid Will be liquldatec;f pver time. The timeframe for the.ir liquidation depends oil variables, including, blit not llmite:d to, overall :volumefnurriber of claims pr.ocessed ahd variance accoqnt !lalance •. Variance account balances may earn interest and interest is earned at the federal funds c;>r similar rate. Host Blues maY retain Interest earried Cih funds held in ~rian¢e acci;»unt.s.

Note: Subscribers will not bear Elr1Y portion of the cost of Value-Based Programs except When BC13SKS or Host Blue pians use either average pricing or actual pricing to pay providers under ValueBased Programs.

FORM AP-OOOSA 1121 PageS

Care Coordinator Fees

Host Blue plans may also bill BCBSKS for Care Coordinator Fees for provider services which will be passed on to Company as follows:

(i) PMPM billings

Or

(II) Individual claim billings through applicable care coordination codes from the most current editions of either Current Procedural Terminology (CPT) published by the American Medical Association (AMA) or Healthcare Common Procedure Coding System (HCPCS) published by the US Centers for Medicare and Medicaid Services (CMS).

As part of this agreement, BCBSKS and Company will not Impose subscriber cost sharing for Care Coordinator Fees. ·

5. Blue Cross Blue Shield Glob ... Core

(i) Generallnformation If subscribers are outside the United states (the •BtueCard• service area"), they may be able to take advantage of Blue Cross Blue Shield Global" Core when accessing covered healthcare services. Blue Cross Blue Shield Global" Core is unlike the BlueCame Program available In the BlueCard• service area in certain ways. For instance, although Blue Cross Blue Shield GlobaP Core assists subscribers with accessing a network of inpatient, outpatient and professional providers, the network is not served by a Host Blue. As such, when subscribers receive care from providers outside the BlueCard• service area, the subscribers will typically have to pay the providers and submit the claims themselves to obtain reimbursement for these services.

{li) Inpatient Services In most cases, If subscribers contact the service center for assistance, hospitals wiD not require subscribers to pay for covered inpatient services, except for their cost-share amounts, deductlbles, coinsurance, etc. In such cases, the hospital will submit subsc:rlber claims to the service center to initiate claims processing. However, ff the subscriber paid in fuU at the time of service, the subscriber must submit a claim to obtain reimbursement for covered healthcare aervices. Subscribers must contact us to pbtain precertlfication for non-emergency inpatient services

(Iii) Outpatient Services Physicians, urgent care centers and other outpatient providers located outside the BlueCard" service area wiil typically require subscribers to pay In full at the time of service. Subscribers must submit a claim to obtain reimbursement for covered healthcare services.

(tv) Submitting a Blue Cross Blue Shield Globa~ Core Claim When subscribers pay for covered healthcare services outside the BlueCard• service area, they must submit a claim to obtain reimbursement For institutional and professional claims, subscribers should complete a Blue Cross Blue Shield Global- Core claim form and send the claim form with the provider's itemized blll(s) to the service center address on the form to Initiate claims processing. The claim form Is available from BCBSKS, the service center, or online at www.bebsglobalcore.com. If subscribers need assistance with their claim submissions, they should call the service center at 1-80D-810..BLUE (2683) or call collect at 1-804-673·1124, 24 hours a day, and seven days a week.

FORM AP-Q005A 1/21 Page6

('li) Blue Cro!S$ Blt.ie Shield Globa)li Co~e Program Related Fees Qompany .understands and agrees to i'eimbui's.e BCBSKS for certain tees and ·compensation whJch we are obligated under aP,pn~le, li'lter-P,~n Arrangemen.t requirenieilts to pay to the Host !;llueil, to the Assq¢1~tlcin, a.nd/or to vendors of Inter-Plan Arti:!nQement-rela.ted. SEiiVices, The spe¢if.ic fee,s and cornp~0$1:1tlon . that are· charged to Cpmpany l.!nder BI!Je G.ra!3S Blue Shield Glol:lale Core·are set forth in.Exhlblt.A. Fees and compensatiOn l,ltJCter applicable lnter.;.Pian Am:ingements may be revised frOm time to time a.s provided for In Section 6 below. ·

6. illlodlfications or Chail,~$s to Inter-Plan Ar'~llgE(nient f(tes ~r Q~h.:IPlP~atJon Modifications or changes to I.nte.r.Plan atrange~nt fee~ are gene~ty made ~ctlve January 1 of the ~lendar year bl!t theY may o¢tir at any tii'J'I~ .during th~ year. ·rn the case .of any such modifications or changes, a.<::;aSKS ~haiJ·proVide. Co!!!PEI!lY with at least thirty (30) days' advance written notlee of any rnodl~ca~~m or change to such Inter-Plan Arrangement fees or compensation descnbirig t~ Cha.nge and !h~ effectiVe date thereof and Company's right to terminate thi~ Ag~ment without: penah:y by ~Mng written notice of termination before the effective date ·of the Chan9E!·

If comparw fa!Hs tp tespond Jo tile nptice and does nottefi'Oinate this Agreement during the notice period, Comp~ny will be d~erned. to haye approved the proposed change, and BCBSKS will then allow such modification• to become part of this Agreement

7. Advanc.e Oeposlt. Should the Company terminate this agreement and ctioos.e not to'continu!3 claims reiilibUill'ement by.AC_I:i, Ul~ Company m~y ~ req(Jired to provide sc·asKs a11 ~dv!Jnce deposit'in an amou:nt stipul~ by QC~$KS ·a~ or prf(;)r to tl')f:l c;:omrnencement of this agreement.

BCBSKS wili use these funds to pay the Benefit Plan participant's claims obligations, and .in the event Company holds a stop-foss agreement from BCBSKS; the Benefit Plan participant's clai!TI$ l)bligatiqns Wilt be up to the stop-loss attachm$lit poln~ •P&9ifi8c! in the $top-lo$$ insu~rK:e !»nl~~ Issued ·to the Company; The Company agi'e$• to pay BCBSI<.S ~.l:!mou:nt nece~sary to restore to.lts full amount the i:t,dva.nte deposit. BCBSK$ ~ ~hange the a!Tiount of advance ·deposit by .prior notification to the COtnP.aiJY•. .

8. Additional Termloatlon j:'rovislon.~:

The Administrative Services Ag~eement to w~lch this Is a~Qhed may .be terrnlnated.by t;JCB$1<8 or by the Company as of the fiJ'$tdaY of !!.liY montil by giving ·a written notlc;:e to the other party at least 60 days plior to su(:h. dau,. Th~ Adminlstra~ive Servl~s Agreement; and the .stqp.Joss insurance a!;!reetnent., if ~ppl!(:af;)le, shall t,~IJtornatically terminate as of the earliest of the followin~ dates:

A. The .day on which the Company shall not have tnade funds a~ila!>le tor paym~nt bf all benefits reqt;lired ~o be paid from its funds iil aceordance with this Attachment A:

B. The date as of which the stop-los~ h1•urance contract Issued by BCBSKS (If any) Is t&milnat~d by (:f!ssa!i.on of premium payments;

C. The date of the tem1iriation of the Benefit Plaii.

Upon terri:ilnation of this Attachment A an~ the Agreemen~ to provide Administrative Services, the Compl1!nY sh~l ha~. the obligation for paym~t of benefits then unpaid for ctaims Incurred pi'lor to such ~ertnihatipn until the amourit of such payments results 'In attachment of BCaS.KS liability under tJIE;i ~p:. loss Insurance agreement, If· applicable. Upon te~nillnatiori of this .Ag""'ment with no .subsequent agreement signed, the Compemy shall pay to BCBSKS the ac_tuanal detel'mlnatlon of tne Incurred b.ut unpaid claims liability for which the Company may be obllgatEid, tq the ~~ent such ~d~ltlonal funds are nec~~!Y ~yand ~m.oun~fii of the advan~ depqsit s.till held by BCBSKS. The Company ag.rees to pay Ulifii al'npt:inU!l. BcasKS V4thln fiVe days from the date notification Is received. If this amourit becqmes d~pleted, BCBSKS Will request additional funds. BCBSKS will resume processing and. payirig the remaining claims upon receipt of the additional funds. If the additional funds are not received by

FORM AP'-0005A 1/21 Page7

BCBSKS within five days of the Company's receipt of notification, the remaining claims liabHity Will become the responsibility of the Company and BCBSKS shall have no further obligation for any claims processing or any claims payments. Eighteen months from the termination of this Agreement, BCBSKS shaH return Company the difference, if any, between the Company's obligation hereunder and the amounts made available to BCBSKS, thus ending all of BCBSKS' obr~gations.

9. Obligations Upon Termination:

In the event this Agreement tenninates, the per employee charge specified In Paragraph 1 of this Attachment A shall also tenninate. However. the remaining administrative fees, as well as the claims paid or Incurred, shall continue to be payable tO BCBSKS as provided in Paragraph 19, sub-paragraph D{l) of the contract to which this Attachment A Is attached.

If payment of the Administrative Fees and/or Claims Reimbursement has not been made to BCBSKS by the end of two (2) weeks following the original due date, this Agreement and the Benefit Plan to which It Is appDcable are automatically tenninated as of the date such payment(s) were due.

Agreed to this day of _"7"'""--:":":--------' ...,,..--.,.---' (day) (month} {yar)

Shawnee County Blue Cross & Blue Shield of Kansas, Inc.

By!~~~z::t.... Title: 4 ...... ;~ ~- ..,t-

By: ___________ _

Title:. ____________ _

FORM AP.Q005A 1121 PageS

Exhibit A - Schedule of Fees

Only,the ~~~.l~G~rd PrQgram Ace:~$~ F~e m~y b~ charged separately each time a claim is processed 1hrou~h.ltle E!lueCard prog~!TI· All other BlueCarcl Program-related fees ate lnoludecl in the Administ~~on Expense.

Acc~ss .F••. . . Tne Ac~$s Fee Is charged bY thE! Host Blue to BCBSKS for mal<ing its appllti;jbh9 provider network a\f!O!II!1Jblea t() Q9mpany's Benefit Plan participants. The Ac~ss Fee Will not apply lo non-P$J1icip~ting_ PI'Qvider claims. The Access Fee is charged on a p~i' claim l)~sl~ .and !$. cllarged as a per~n~ge Qf the dlscoiintldiffer~ntia:t BC8SKS ~~ives fr'Qili til.~ ~PP"~ble_ Hp~t ~lue subject tQ f.! ·m~ximum 6f $i,OQQ ~r clarm. When bhlirged, acesKS ·passE!& tM Acc~s!l Fe~ di~tly to qom.p~nY~ The ~ccess Fee Is added to the amQ•.mt paid-to th~ prQvlcler an(:! is Included ~s P\ill't.~f the claim amount on your periodic claims and adtn!olstrathte ~pens~ blllfng report

ThE! Access Fee may be charged only if the Host Blue's artailg~me~t With Its !l~lthc~~re proVIder prohibits billing members for amoilrits in excess- Of th¢ ri.~gotiated payment However; a f'!ealthcare provider 111ay bill memberS for nP"n-CoV.~red health®re servfqes·and fOI' cost sharing (for example, deductibles, copaym~nts arid/or ~insl!ran~) i't:tl$.d to a ·p~rticular ch;lim~

t:;oJT~etimes the Access Fee is a ·negative amount, which Is kriown as an Aecess Ff.!!e Credit Any Access F~;~e Credits will be credited to BCBSKS and BCBSKS wlll pass the entlreAccf!$s Fe~Crec;llt em to Company. · ·

lnsU.n®S may_ C)~ui' in Wh!ch ttle c:ltii)n payment 1$ .zero or BCBSKS pays .only a small amount becau$e the $m:ourtt$ eligible for payment were applied ·to patient cost sharing (such as a deductible or coinsuran9~). In these Instances, BCBSKS will pay'the Host BlUe's Aecess F~ ~d pass it along directly tp Company as stated above even though company paid little ot h~:~d no claim !ial:!ilitY.

Administration E~pe:n$• The Adtniliistrati0n E~pense enpompasses fees BCBSKS charges to Company for administering companyis ben~fd plan. they may include both local and Inter-Plan :tees. For purpos$5 of tbls a:greerru:mt, they include the following BlueCard Prograin-telated fees oth~r th_., th$ BlueCard Program Access Fee: namely,_Adtnhit~;ttathie Expense Allbwa~ (AEA) Fee, eentr~l Fii1131ici!!d Agency Fee, ITS Transaction Fee and 81u~ Crqss Blue Shield GlobaP Core Fees, If appftcable,

Inter-Plan Arrangement Fees: BlueCarcP program Fees Access Fees · ~-

3.97% fOd~;~werthan 1,000 subscribers of Network Savings, capped at $2,000 per claim

2.21% for 1,000 to 9,99$ subscribers of Network S.avings; ~PPE!d at $2,000 per claim 2,05% fo(1o,ooo tQ 49,999 Sllbscrlb~rs of Network Savings, capp~ at $2,000 per claim 2021 3.79% for fewer than 1,000 subscribers of Network Savings, capped at $2,000 per claim 2.11% for 1,000 to 9,999 subscribers of NetiNQrk Savlngs, capped at $2,000 _per claim 1.96% for 10,000 to 49,999 subscribers of Network SaVings, capped ~t $2;ooo per claim

Administration ExPense See ·summarv .of Chames

FORM AP.0005A 1/21 Page9

+.W KiiiSiS Bh~ Cro~s and 1311•~ Shield of K:ulSIIs is an imlepcnd~nl Jicenst~ oflhe Blue Cross Blw Shield Associ:uion.

STOP LOSS CONTRACT COMBINED INDIVIDUAL AND AGGREGATE

(Incurred Claims Basis)

This Contract describes the benefits provided by Blue Cross and Blue Shield of Kansas, Inc. (herein called "Blue Cross and Blue Shield of Kansas., or "BCBSKS"), Topeka, Ka~as, and the exclusions and limitations. This Contract may be canceled by the Company or by Blue Cross and Blue Shield of Kansas, Inc., as described In this Contract.

Blue Cross and Blue Shield of Kansas, Inc. Home Office: 1133 SWTopeka Boulevard, Topeka, Kansas 66629

This Contract Is Issued to:

Shawnee County (called "the Company" In this Contract)

In consideration of the payment of premiums by the Company, Blue Cross and Blue Shield of Kansas agrees to

provide the benefits described In this Contract. Coverage under this Contract begins at 12:01 a.m. Central Tune at

Topeka, Kansas, on 01/01/2021 (called the Contract Date In this Contract} and continues after that from year to year,

unless the Contract Is tenninaled. Premiums are due and payable in advance of the Contract Date and after that by

the first day of each successive month, unless the Company Is billed quarterly or semi-annually, In which case

premiums are due and payable In advance of the Contract Date and after that by the first day of the month In which

the premium Is due.

Blue Cross and Blue Shield of Kansas signed this Contract on --~N:y./._r~h....:2-=-="Z::;;<:)=---· I 7

FORM 8~5000 2120 Page1

.PART1. OEFINITIONS

A. Be.nefi'"iary m!'!ans a per!lo"' ~ntltiE!.d to ~E!ne~ un~r ~he {;oJllpany's self-Insured employee welfare benefit plr:in providing benefrts for ho$pl~l. ·medfcal :and surgjc~l benefits and other benefits administered by 8C8SKS.

e. a~neti. ·.means coverage provided BenefiCiaries as set forth l.n.their ben~flt desCription and t,he Adminllrtm.thle Services Agreement.(lncludin9 attachments) between BCBSKS aild ~he Comp.ny.

c. BQBSKS merms Blue Ctos$ at~d ~lue ~hlel(t of~nsas-.

o. CQmbined lndlvidu;:li and Aggregate Stop-Loss Provision means:

1. Individual Attachment Point: The Incurred ClaJms Expen&e level at, Yihlch the COmpa9ts claims liability stops for a Beneficiary In a Ccmtr~Cf: Perio(J, The CQinpany's li'ldNidual Attaehmen~ Point is $200000.

2. Aggreg.-te Attaef'Jmt!nt P~l!lt: 111~ 111Cl,lrr~c( C~alms Expense at 115% of the Expecl$cl Incurred Claims Exp~;~nse. The ll'!~ia.l Aggregate Attachment Point Will be set·forth In the 'Surrima!Y Qf'Chai'ges' docuiTielit, signet:~ by the Company, The ExpeCted Incurred Claims EXpe'ns$ will ~ry bsseq on the change ·in t~ nurnber of covered Beneficiaries. However; in no event will the Aggreg$te Attachment P~lnt d!Jring a .Co.ntract Period be leJ~S th~u1 80% of the initial AQgr$Qate A~achmelit. Point estat}ll$hed .at t~ !Jag inning. ¢the CQntract Period.

If the Company fOr any reason .does not maintain this Contract In foroe for the . entire Contract Period, the Aggiega~e Attachment Pcih1l shail be increased by multiplying 115% times the Pure Premium Monthly Rat~ ~Iiles tf'!e _number of emplayees or retirees covered On the d.ate of termlnatiori times the number of inoliths between the early date of tertriinati6n. and .the end. of the CQntrac;t_ Period. In liQ event JiOWever will the Ag~regate Attachment Point be less tll.an 80% of tbe lo!tif;il Aggregate ~chrnent Pol!'lt. ·

E. C~rnpf!ny means the pa~ fiamed on the face-of this Contract who has contraCted with BCBSKS as the insured.

F. Con~ct means this Contract between BCBSKS and the Company and inch,1deis;

H.

I.

All of the forms issued to the Coi'njlany by atue cros·s and BlUe Shield of t<ansas, in~iuding en®rsetnents, amendments, and riders; and

The appli~cm of the Company for fh~ Gontracl

Contr•~ PeriOd means the twelve-month period beginning on the Contract Pate stated on the face Of this Contract and each suceeedirig lwelve-month period until this Conbc:ict Is. c;:ariceled. GetieraUy I the ~n~ paricid is at least 12 months long; however; BCaSKS ahd tHe CC!nip~my may mutu.ally i;tgree to-~ contract peri~ 11\'~ich is other thai112 months.

Exp~~ted lnc;urred Claims Expen~ m~s th,e total amount of claims expense that the Beneficiaries of the Cpi:'np~ny are expe~d tq Incur during a Contract Period. This amount' is comp.uted _by ml,jltJplying the . Pure Premium Monthly Rates times the number Of emploYees and retire~& c()vered each month by thlE! ·contra~ for, tllca Contract Period. ·

. lncJJrted ClaimS Expen$e iTlQai'IS the a~~s for Which eith.~r the Company or BCBSKS Is Uable. A covered s.en1lce Is considej'Eid· to have been lncllrre(l on the date -the servlce.ls received except for bed-patieiit Hospital or 1\AedicaJ Care Facility $$!VIces and for Doctors Medical Services (Nori~Slu'gical) f()r bed-patients; the Benefits are deemed to have been Incurred:

1. For admission$ ()ccurrlng t,lil or after the Cont~ct D~te', on the date of adm_isslon to the, hospital or me.di~ c.are ~QiH~~ HQW~r, $hould ~111~ .CQr:t~ct terminate or coverage for a Beneficiary. terminate under this Contraqt prior to the release -of a Beneficiary froin suCh hospital or med.ical ¢are f!lcil.ilY, onlY those claims for services rendered up to and including Ute termination c;late Will be considered Incurred claims expense. In the evei:rt the Company has included In ttieir benefit description a provision extending ~verage tor 31 d.ays for B~n8ficli:lries CCl.nfined In the. hospltai on the tertrUnatton da.te of th8ir coverage, claims shall pnly be considered as incurred claims expense tor thoee services ~ndered up to the earlier of th~:~ date the Benefit Plan participant is discharged

FORM 8Q..S()OO 2/20 Page2

/

from the hospital or the end of the extension. Claims Incurred under any such extension of benefits prcwlsion will be considered incurred claims expense for the purpose of this provision only In a secondary manner to the benefits of any subsequent replacement group health benefit plan or policy intended to provide continuous coverage, as of the effective date of the replacement policy.

2. For admissions occurring prior to the Contract Date, on the Contract Date. Only the claims expense aHributable to covered benefits provided for seiVices rendered on or after the Contract Date will be considered Incurred claims expense.

J. Pure Premium Monthly Rates mean the projected monthly rates necessary to cover the monthly Incurred Claims Expense per membership.

PART2. GENERAL

A. Purpose of this Contract: BCBSKS hereby accepts the full responsibility for the Benefits which are in excess of the Combined Individual and Aggregate stop-loss Provision for the remainder of that Contract Period, It Is understood that BCBSKS has no liability under this Contract until the Company's liability has been terminated by the Combined Individual and Aggregate Stop-Loss Provision. In return, Company shall remit Pure Premium Monthly Rates and the applicable stop-loss premiums as charged by BCBSKS. BCBSKS reserves the right to increase or decrease these rates during the Contract Year in the event enrollment changes by the Company result In a significant change in projected risk as determined by BCBSKS. In addition, Company agrees to notify BCBSKS In the event of enrollment changes within 10 business days.

B. Settlement of the Individual and Aggregate Stop..Loss Provision: At least monthly BCBSKS WJ11 report to the Company the Beneficiaries who have reached the Individual Attachment Point of the Contract The Benefits which are In excess of the Individual AHachment Point will be excluded from the accumulative amount of Incurred Claims Expense for that Contract Period for determining the Aggregate Attachment Point. The amount of Benefits which are In excess of either the lndMdual or Aggregate Attachment Points will be the responsibility of BCBSKS and credited to the Company. Value-Based SeNice fees are not applied towards any Individual Attachment Point

C. Charging Incurred Claims Expense: For the purpose of this Contract, claims expense Incurred In a Contract Period wUI be charged to that same Contract Period regardless of when It is paid.

D. Umlt of Uablllty: It Is recognized that the Administrative Services Agreement between the Company and Blue Cross and Blue Shield of Kansas gives the Company the express authority to determine the right of any Beneficiary to health care benefits. If the Company determines that benefits should be paid for a Beneficiary, then the difference between the amount actually paid and the amount the Beneficiary Is eligible for under the terms of the benefit description will not be taken Into consideration when determining the liabHity of Blue Cross and Blue Shield of Kansas with regard to any contractual arrangement it has with the Company.

E. Membership, Voting, Annual Meeting and Participation: The policyholder (the person or entity to which the Insurance contract has been Issued) is a member of Blue Cross and Blue Shield of Kansas and Is entitled to vote In person or by proxy at meetings of policyholders. The annual meeting of poRcyholders Is held on the second Thursday In May of each year at 8:30 o'clock a.m. at BCBSKS' principal place of business at, 1133 Topeka Boulevard, Topeka, Kansas, or at such other place as the Chairman ofthe Board of Directors might designate in a notice of meeting given to policyholders. Printed notice In this shall be sufficient as to notification. If any dividends are distributed, the policyholder will share in them according to law and under conditions set by the Board of Directors.

F. Statements Made: All statements made by the Company will be deemed representations and not warranties.

G. Grace Period: Unless written notice of BCBSKS' intent not to renew this Contract is delivered to the Company at the Company's last address as shown In BCBSKS' records, at least 60 days prior to the premium due date, this Contract has a 10 day grace period.

This means that If a premium is not paid on or before Its due date, H may be paid during the 10 days that foHow. During the grace period this Contract will stay In force. Unless premiums are paid by the end of the grace period, this Contract will be canceled effective the date to which premiums have been paid.

FORM Bo-5000 2120 Page3

H. Rei~statement: If the premium Is not paid during .the grace peribd, this Contract will laps~. Later acCeptance of prerriiur:n by BOBSKS (or by .any .agent authoriZed to aecepf payment) without tequiring an application fQi' reinstatement, will reinstate thi~ Contract: · · ·

If BCBS~S or its agent require. an: application,, the ~ompany Wiil be given a condHional receipt for the premium. If tfie appbcatlofll~ appfQV®, 'thts· Qgntract will be retnstated as of the date .of lapse. Lacking such Eipproval, this Coht~~ Will bE! relnstat~d on the 4&th day after the date of the conditional receipt unless BCBSKS prfWlously notified th~ Qompany, in writing, of disapproval. · ·

The reinstated tontractWIII eover only loss Wliich results from an injUJy s~staine.d after the da~ of ~Instatement or sickness that starts aftt;lr such date. lri all other respects. th~ Comparw's rights and -BOBSKS' tights wm remain the sam~. subject to any provisiol'!t; noted on or attach~d to the reinstated contract.

1. Claims: The Administrative .Services Agreement and the Attachment A the~etQ, lnclud.e prd\iis_ibns t~at ate consistent with the following provisions that are othei'Wi$e requii't:!d, by ~he Ka~Ei!S lils.urao~ CQde, to be inCluded In StOp;.LOss contra~ 1ssu~d In Kansas: Nob Qf Clalrn. Cfalm ~orrns, Proofs .9f Loss, Time of Payment t>f Clalins; and Payment ofCiiilrrts.

J. Legal AttiQl.JS: No legal acUOI'J may be brought .to recover on this Conbacl Within 60 days of tlie d~te th¢ aiuse of the action occurs. No such action matbe brought aftet 5 years frOm tne datetlie c$liSe of the ·action occur$.

K. Notice:

-1. Frpfi'i BCBSKS to the CQmpany. A no~ce seot to the Company by BCBSKS is considered ''ghteil" When maHed to the Company at the latest address appearing on the records of BCBSKS.

2. From the :Co~pany to SCSSKS. Notice to BCBSKS is consider~ "given'; when .received by BGBSKS at 1133 TopekaAveiu:.e, TopeKa. Kansas.

L. Compa~y J3ankniptcy; The. Company's barikr\Jptcy or insolvency will not relieve BCBSKS frcim its obligation tO PaY cla.ims under this Contract.

M. Cancellation:

1. Canc.,llatio~ l:tY tbe ~oiJ)pany: The Company may cancE3l this Contract at any time (subject to the "Contrac.t Petiod'' pi'ov~ion_ of this Contract) by delivering or sending 60 dayi advance written notiCe to the ho!Tie office 9f BCB~KS, 1133 Topeka Avenue, Topeka, Kansas. CanceUatiCiti Will be ~ffec~ive 60 days from the date such notice is received or on the date shown In the notice, W~ichever Is later, In the event of cancellation, the unearned portion O.f anY premium paid will be promptly rehtmed. Th~;~ earned premium ·shall .be compUted on a pro-r~ basls; CanQellatfon $hall bE! Without prejudice to any claim originating prior .to the ~ffective date of ~n¢etlation. ·

2. Cancellation by BCSSKS: BCBSKS may cancel thiS Contract by giving the Company 60 days ~dvan~e written notice. Cancellation in this Instance is effective the dat' prerniuins h~ve been p~id to.

FO~ OO:SOOO 2/20 Page4

+." BlueCross BlueSbield

• • ofKansas An Independent licensee of the Blue Crost 8tue Shitld Astociation.

AMENDMENT TO STOP LOSS CONTRACT (Monthly Aggregate)

PART 1. GENERAL

This is an amendment to the Stop-Loss Contract. It becomes effective on the later of September 1, 1989; or the Contract Date specified in the Stop-Loss Contract.

The conditions described in the Stop-Loss Contract also control this amendment except where this amendment specifically states there Is a change.

PART 2. CHANGES BEING MADE BY THIS AMENDMENT

The Stop-Loss Contract Is amended to the extent necessary so that:

The Company's maximum liability on a Contract Period to date basis Is limited to 1/n of the contractual period amount where n is equal to the total number of months In the Contract Period, detennined through application of the Aggregate Stop-loss Provision, muhiplled by the number of months expired during the Contract Period. If the monthly claims expense that Is to be applied toward the Company's monthly maximum liability Is less than the monthly maximum Dabillty, the difference Is called a residual. If the monthly claims expense that Is to be applied toward the Company's monthly maximum liability Is greater than the monthly maximum liability, the difference Is called the claims expense surplus. For such month-tomonth calculations, "monthly claims expense" means claims paid during such month which were Incurred In the Contract Period, plus any residuals or claims expense surpluses carried forward. Both residuals and claims expense surpluses are cumulative and cany forward from month-to-month throughout the Contract Period. The balance in a Contract Period of the net of residuals and claims eXpense surpluses thus carried forward during the Contract Period shaD be applied toward the Aggregate Stop-Loss Provision for that Contract Period. In no event will the foregoing calculations of the stop-loss on a monthly basis cause the Company's liability to deviate from the total amount determined by application of the Aggregate Stop-Loss Provision.

Fonn No. eo-1no 01/13 Page 1

w BlueCross U BlueShield . • . .• c,fKansas

Ari lnd~pendent Licensee of the Slue Cross Slue Shield Asaoclation.

ADDENDUM TO AGREEMENT TO PROVIDE ADMINISTRArtVE Sl:RYICI:S F.OR A S~,LF~FUf'iDED :SENEFIT'PLAN EXTERNAL REVIEW PROCESS1

This Addendum to Agreem~nt to Provide Adlllil'!istr~tive services for a. S~lf-Funded Benefit Plan .("Add~nd1,1m") is entered into on this 01/01/20~1; by· and between Blue Cross.and Bl.ue Shield of l<~.ll$~s. (oc, (".BC:SSI<.S") and Shawnee County ("Company"). The purpose of this Addendum Is *() aadress CompanY's external Review Process as . t'eqllifed by the Pl.it).lic H.!!!(!lt" Service Act .("PHS!], Section 2719. BCBSKS arid CciJT1pany rriiJtt.ially :agrli!e ·tQ modify· .their Agreement to .Provide Admir'li$ln;itive Services for a Self-Funded 8enef~J Plan ("Agreerpept") as set forth In this Adderidurn. ·

1. Standard External Review Process.

A. Reque$! for J;:xtei'nal Ravlew.

The Benefit Pian2 must allow a Claimant to file a requestfor an External RevieW with tM. Benefit Plan.lf the request Is filed within four monthS after tlie date ·~teceipt.of a notice pf an Adverse Benefit Determination .or Final Internal Achtei'Se Benefit Oeteliliination ·and such determination is eligible for External Review under the appliQable DOL ar~d T~~su,Y regt.dations~ If the~ is no correspQnt!iilg .c;tate four months after the date of receipt of such a notice, _th~n 1he request mu~~ be filed by the first day of the fifth month following the receipt 9f th~a notice. For example, if the date of receipt of the ilotlc& is OCtpbet 30, because there is .no February 3.0, the re'qu~t must be flied by March 1, If toe la!'t flUng date would tall bn a Saturday, Sui:ittay; or f!i!der8l holiday, the last ~lll'ig date. !s ext~nded to the nEP<t ~SlY that IS not (II $.aturday, Sl.!nday, ~r fedei'E!I holiclay;

it:! the $Vent the B.en~flt Plan receives a request from a Claimant for External ReVIew •. Benefit fllan shall immediately notify BCBSKS and transmit such. req~.~c:;~t ·to BCBSKS.

B. Preliminary Reviaw.

Within fnre bYsiness days followi.ng the date of receipt of the External Review request, BCsSK~ rn~st c;omplete a preliminary review of the. request to dete111'1ine whether:

Q) · The Claimant 1~ or was covered !Jnder the B~nEriit Plan at the t!me the heal.~ ~~re Item ot se!Vice ~~ requested or, Iii t~e. Ca!>Ei of a retrosp~ctive review, was covered under tne BEinefrt Pl~m at the time the health care item or service was ·proviaed; ···· ·

(II) The Adver~e Benefrt Deterrn.ination or the Final Adverse Benefit Determination Is eligible for Ext~rnal Review and does not relate to the Claiinant's failure to meet the requirementS· for eligibility under the terms of the Benefit Plan. (e.g., .wqrker classification or similar determination);

1 The prpcedures set forth Itt thfs Atlcl~dum were promulgated by the U.S. Department Df labor. Etnployee Ei•nefii Security Admlrustrallon, Teclih~ R~~asfi 201Q-Q1, dated AUgust 23, 201 o.

-~ section 2719 Of the Public Heal.tl:1 Sa~w Aqt aild Technical ReleaJe 2010-01 use the term "Group Heailh Plan" In ·descti!Jing th!)Se enUtles tO. Which the ExtematRe\llew Process applies. B.~use our underlying Agreement use& thetetm "Bepeflt Plan" In .reter,lng to such erilltie~, we IJriii!Sing th~tterrjl.he~. .

FORM AP-(l0~8A Ot/14 Page 1

-------------------------------------- ------

(iii) The Claimant has exhausted the Benefit Plan's Internal Appeal process unless the Claimant is not required to exhaust the Internal Appeals process under the Interim final regulations; and

(iv) The Claimant has provided all the information and forms required to process an External Review.

Within one business day after completion of the preliminary review, BCBSKS must Issue a notification in writing to the Clalmant3• If the request is complete but not eligible for External Review, such notification must Include the reasons for Its Ineligibility and contact Information for the Employee Benefits Security Administration (toll-free number 866-444· EBSA (3272)). If the request Is not complete, such notification must describe the Information or materials needed to make the request complete and the Benefit Plan must allow a Claimant to perfect the request for External Review within the four-month fi6ng period or within the 48-hour period following the receipt of the notification, whichever Is later.

C. Referral to Independent Review Organization.

BCBSKS4 shall contract direcUy with Independent Review Organizations ("IRO") to provide the External Appeals procedures set forth in the Patient Protection and Affordable Care Act ("PPACA"). BCBSKS will contract with an IRO that Is accredited by either the Utilization Review Accreditation Committee (•URAC") or by a similar natlonaJiy recognized accrediting organization to conduct the external review. BCBSKS shall contract with at least three IROs for assignments under the Benefit Plan and rotate claims assignments among them (or incorporate other independent, unbiased methods for selection of IROs, such as random selection). The IRO shall not be eligible for any financial incentives based on the likelihood that the IRO will support the denial of benefits. The contract between BCBSKS and an IRO shall provide the following:

(I) The assigned IRO will utilize legal experts where appropriate to make coverage determinations under the Benefit Plan.

(ii) The assigned IRO will timely notify the Claimant in writing of the request's eligibility and acceptance for External Review. This notice will Include a statement that the Claimant may submit in writing to the assigned IRO within ten business days following the date of receipt of the notice additional information that the IRO must consider when conducting the External Review. The IRO is not required to, but may, accept and consider additional information submitted after ten business days.

(Hi) Within five business days after the date of assignment of the IRO, BCBSKS should provide to the assigned IRO the documents and any information considered in making the Adverse Benefit Determination or Final Internal Adverse Benefit Determination. Failure by BCBSKS to timely provide the documents and information should not delay the conduct of the External Review. If BCBSKS, on behalf of the Benefit Plan, fails to timely provide the documents and Information, the assigned IRO may terminate the External Review and make a decision to reverse the Adverse Benefit Determination or Final Internal Adverse Benefit Determination. Within one business day after making the decision, the IRO must notify the Claimant, BCBSKS, and the Benefit Plan.

(lv) Upon receipt of any information submitted by the Claimant, the assigned IRO must within one business day forward the information to BCBSKS and the Benefit Plan. Upon receipt of any such Information, the Benefit Plan may reconsider Its Adverse Benefit Determination or Final Internal Adverse Benefit Determination that is the subject of the

~ Note that, under the Interim final regulations, 1ny ~t~ference to 11 "dalmant• Include• the claimant'• aulhorized repreaentative. See 211 CFR 2590.715-2719{11)(2)(111). 4 The lang1111ge of the propoeed Addendum varies tom the teChnical release In that H spedllcally references BCBSKS Instead of ,he plan" In general.


External Review, RecpnsideratiQi1 by the ~eneflt Plan must not .clel~y the External Review. The External ReVi~ may b.e teiniinat~. a~ .!il result of the reconsideration only If the BEmefl.t Plan decide~; uppn completion of its ~consideration, to reverse Its Adverse P!!!tliafi~ I)eterminatiol1 .or Fi.nal ln~rna! Adverse Benefit D.etermination and provide ~'(~~ge or payrnent Within one business day after rriaklng siJch a -de¢ision, the Benefit Plan must provide written notice of its aeci!Sion to the :CJaimatlt, BCBSKS, -and .the assigned IRO. The assigned IRO must terminate the External Review upon receiPt of\he notice from the B$nefit Plan or acssKs.

(v) 'fhe lRO_ Wil! review aU of the lnfol'l11ation and documents timely received. In reaching · a d~i~ion, the assigned IRO will review the cliliin de novo arid .not bie bound py firiY deCisions or conclusions reached during the Benefit Plan's lrtternal.¢1a1ms t;mi;l ap.pe~s process applicable under paragraph (b) of the Interim fin~;~l regul~tiC)n~ yn,<i~ ~e~Qh ·271.9 Pf the, PliS. Ad. hi i!~dition •(;I the dociJm~l)ts an~ l!ifotmatlon provld~, the as~lgn~ IRO, to the extent the lnfotrni!ltiPn or documents ,re available and the ·n~o considers th$1T.1 appropriate, Will eonsider t!le foi!owl,ng in reaching a decision:

1. The Claimant's med.ical records;

,2. The attending health care professional's ~¢ororn~ndati()n;

·3. Reports from ~ppr6priE~~e h~a!th care pro'fesslonals and other documents sl,lbmlttt)d by the Benefit Plan or issuer, claimant, orthe Cl$i.mant's tre~tinQ proVider;

4. The terms of the Claimant's BenefltPiari to ensure that .the U:tO's dedsionis not contrary ti:l tti~ !.,fi:ns at the e~nefit Plan, i.i.nt~~ th~ i,lms ate rncoiisi$nt With appli~bl$ law; · · ·

5, :AP.pi'Qprlate practice guidelines, which must include applicable evidence-based standards and may include any other practice guldelin~ i;leveloped by the· federal .government, national or professional medical soci$lies, board~. anq as-~iatipns;

E?. Any ~[!ppUca.ble clinical revieW. criteria developed and used bY the Benefrt.Pian, llnless the crit(!Jia are inconsistent with the terms of the eeneflt Plan or with af:>pllCable law; and

7. The opli1~i1 of the IRO's clinical reviewer .or reviewer~ ¢tar considering t~e lilfotmatiO.h described in this notice to the extent the lnfQrmation or documents are avai.labje and th~ clini(:l!ll r~;Wiewer or reviewers consider appropriate;

(vO The assigned IRO must .provide written notice of the Final Extern,al Review Decision within 45 days after the IRO .receives the reques~ forth~ _Exter~l RevieW. The lBO must deliver the notlc~ bf Fined External Review Decision to ~he Claiman~ acasKS, ~:~nd the Ben~t Plan.

(vii) The assigned IRO's decision notice will contain:

1. A general descriptiQn of the ~ason fot the request for External Review, Including infotma~ioil slifflci.ent to lde.ntify the _c;laim (lnciiJd!ng the (iate ()r dates of service, the health care provider, the clt;tirii amount (If applicable), the diagnosis code and its cqrre~pondlng meaning, the treatment code and its corresponding meaning. and the reason for the previous denial}:

2. The datE! the IRO .receiVI!d tl:i~ assignment tp cqnduct the ~>¢ernaJ Review and the date Qf the IRO decision; ·

3. References to tf:ie evidence or documentation, including the speeiflc coverage provisions and evidence-based standards, considered in reaching its declsiqn;

FORM AP-Q058A 01/14

4. A discussion of the principal reason or reasons for its decision, Including the rationale for Its decision and any evidence-based standards that were relied on In making Its decision;

5. A statement that the determination Is binding except to the extent that other remedies may be available under state or federal law to either the Benefit Plan or to the Claimant;

6. A statement that judicial review may be avalable to the Claimant; and

7. Current contact information. Including phone number, for any applicable office of health insurance consumer assistance or ombudsman established under PHS Act section 2793.

(viii) After a Final External Review Decision, the IRQ must maintain records of all claims and notices associated with the External Review process for six years. An IRQ must make such records available for examination by the Claimant, Benefit Plan, or state or federal oversight agency upon request, except where such disclosure would violate state or federal privacy laws.

D. Reve111al of Benefit Plan's decision.

Upon receipt of a notice of a Final External Review Decision reversing the Adverse Benefit Determination or Final Internal Adverse Benefit Determination, the Benefit Plan Immediately must provide coverage or payment (including immediately authorizing or Immediately paying benefits) for the claim.

2. Expedited External Review for self-Insured Benefit Plans.

A. Request for expedited External Review.

The Benefit Plan must allow a Claimant to make a request for an expedited External Review with the Benefit Plan at the time the Claimant receives:

(i) An Adverse Benefit Determination tf the Adverse Benefit Determination Involves a medical condition of the Claimant for which the tfmeframe for completion of an expedited Internal Appeal under the Interim final regulations would seriously jeopardize the life or health of the Claimant or would jeopardize the Claimant's ability to regain maximum function and the Claimant has filed a request for an expedited lntem~l Appeal; or

(il} A Final Internal Adverse Benefit Determination, if the Claimant has a medical condition where the timeframe for completion of a standard External Review would seriously jeopardize the life or health of the Claimant or would jeopardiZe the Claimant's ability to regain maximum function, or if the Final Internal Adverse Benefit Determination concerns an admission, availability of care, continued stay, or health care item or service for which the Claimant received emergency services but has not been discharged from a faciUty.

B. Preliminary review.

Immediately upon receipt of the request for expedited External Review, BCBSKS must determine whether the request meets the reviewability requirements set forth in Paragraph 1.8 above for standard External Review. BCBSKS must Immediately send a notice that meets the requirements set forth In Paragraph I.B above for standard External Review to the Claimant of its eligibility determination.

C. Referral to Independent Review Organization.

Upon a determination that a request is eligible for External Review following the preliminary review, BCBSKS will assign an IRQ pursuant to the requirements set forth In


Patagtaph I.C abov¢ for ;~~nd~rd review. BGBSKS rnl.!st provld~ ·Qr transmit "'(I neces'$ary doC:urnents and lnformat!on considered In maki.n.g t~e Adverse Benefit Determination or. Final IQternaJ Adverse l3enefit Determlnatlon to the assigned lRO eie!:b,'onic;:aiiY ot by teiep~ol'le orfacsimlle or any other available expeditious methOd.

The assigned IRO, to the extent the hifonnation or·do¢i.Jments af!'! aVaiiQbie and the !RO considers them appropriate, .must considet the hlfortnation i;ir documen~ d.~s¢rjl)ed above :Under the pro~d!,lreS for $tanda.td rev!~. In reac;hing £i d~C::i!>ion, th~ as~lgned JRO must tevl~ the .ciE:~lm de novo and is not bound by any decisions or conclusions reached during fhe Benefd Pl~n·s lnt~mal claims and appeals process.

O, Notice of f:'inal External Review Decision.

BCBSt<S's cont~ct With t~e as,signed IRO shoul~ require th~ IRb ~o pr()vlc:Je Q~tiC?S 9f the Final Exter'J'1211 R~vlew D~lslon, in ~ccotdarrce with the requirements set forth in Parag'rap.b !.(:: abOve, as e;_cpecj{ti~usly as fhe Clalmanfs medical condition or circum~!!lnces require, but in no event more ,than 72 h6t:ir& after tlie JRO recei~s the request for an expedited External ReView. If the nPticets not In writing, wlthih 48 flOUf!> . .after the date Of providing that noti¢, the as$igned IRO ,must provide Written ccmfitm~~cm of the decision to the Clalrrn.~nt. BCBSKS, and ~he aenet:rt P!an.

a" Pefin!tlbns.

The terms ~Adverse Beniafit Determination," "Appeal.~ "lnteinE!I App_ei!!." "CI21irr!al'l.tt ~ex.temai ~eVIeW, • "Fimil Intern~! Adver&~ 13en~t Detel'nilnation," . "FI11a! External Re\lleW pecl~lo.n;" ·and "lnde~ndent R~view. Qrgan!Z$tion" as u~e~ lo tlils Addendum all have the same definitions ;:Is set out 1n 4~ ~.F.R. 147.1~6, as amended.

4. Fees.

BCBSKSWIII ch~rge aeoefit Plan fees in the amourtt 9f $202.90 for Its admlni~t~lon of the External Review process desclilJE!d above itJ addition to those set out In Attachment A to the Agreement, Benefrt Plan is also responsible for reimbursing BCBSKS fcir all fees charg~d by IROs In connection with External Reviews. ·

13~-----------------------

Bl~e C;:::Liue Sh~eld of Kansas •. Inc.

BY._~~ TiTLE: A ... :e. c.._,.,.-.-~~ / DATE: __ /._'/~A-¥'---~,1'-.. ....;~;;....;· _·;;;,.~....;;;_ __ _

TITLE: __ _.;;;.._...___.. ______ _

PATE:--------------------

FORM AP-0058A 01!14

November 6, 2020

Shawnee County

Sheriff's Office Sheriff Brian C. Hill

Law Enforcement Center 320 S. KANSAS, SUITE 200

TOPEKA, KANSAS 66603-3641 785-251-2200

MEMORANDUM

To: Shawnee County Commission

From: Sheriff Brian C. Hill

Re: Out of State Travel

I will be sending an officer to New Orleans, LA to attend the 2020 FBINAA National Training Conference.

Travel arrangements, per diem and other expenses will be paid out of Federal Forfeiture funds.

Please place this on your November 12, 2020 consent agenda.

If you have any questions please let me know.

Sincerely,

r

~Lib&-0 Brian C. Hill, Sheriff Shawnee County

Shawnee County

Office of the County Counselor

JAMES M. CROWL County Counselor

MEMORANDUM

TO:

FROM:

DATE:

RE:

Board of Shawnee County Commissioners

Joni C. Thadani, Assistant Shawnee County Counselor

November 9, 2020

Request for Approval of Corona virus Relief Fund Contracts (Sub-recipient Agreement)

Shawnee County Courthouse 200 SE 7th Street, Ste. 100

Topeka, Kansas 66603-3932 Office: (785) 251-4042

Fax: (785) 251-4902 Email: counselors@snco. us

Please place this item on the Thursday, November 12, 2020 Commission consent agenda.

Attached find a Coronavirus Relief Fund (CRF) Contract signed by the following sub-recipient:

North Topeka Drainage District Sunflower Soccer Association

This agreement has been reviewed and approved by the notated sub-recipient. No CRF funds are being provided to the sub-recipient until the agreement has been received and approved by the Board. After approval, sub-recipient may begin submitting valid expense documentation for reimbursement up to the amount allocated by the Board on August 13, 2020, September 17, 2020, and October 5, 2020.

Please let me know if you have any questions.

JCT/tdp

Attachments

Corona virus Relief Fund Contract C- '-( k,S - .:;l o;t. 0 1lv

'(\ TillS AGREEMENT C'Agreemenf') is entered into on this '5 day o~eV\1\.~ , 2020, bY. and between The Boar of County Co

Shawnee County, Kansas, and \ o..r-\\\- ·-o eke_ · · ... (hereinafter "Entity/City/School").

WHEREAS, securing the health, safety, and economic well-being of the citizens of Shawnee County and Entity/City/School is our top priority;

WHEREAS, the state of Kansas is facing both a public health and economic crisis -the pandemic and public health emergency of COVID-19- which has resulted in illness, quarantines, school closures, and temporary closure of businesses resulting in lost wages and financial hardship to Kansas citizens locally;

WHEREAS, the World Health Organization declared a pandemic on March 11, 2020;

WHEREAS, on March 13, 2020, the President of the United States pursuant to Sections 201 and 301 ofthe National Emergencies Act, 50 U.S.C. § 1601, et seq. and consistent with Section 1135 of the Social Security Act, as amended ( 42 U.S. C. § 1320b-5), declared a national emergency that the COVID-19 outbreak in the United States constitutes a national emergency beginning March 1, 2020;

WHEREAS, in these challenging times, Shawnee County and Entity/City/School have made it a priority to avoid immediate dangers to the health, safety, and welfare of our constituents and to prepare for future waives of COVID-19;

WHEREAS, on June 16, 2020 the Kansas State Finance Council approved the Strengthening People and Revitalizing Kansas (SPARK) Taskforce's proposal to distribute money to Kansas counties to help address the health and economic challenges inflicted by COVID-19.

WHEREAS, Shawnee County received$ 36,763,812 in Coronavirus Relief Funds.

WHEREAS, to ensure that educational and municipal entities within Kansas counties receive Coronavirus Relief Funds to help meet their respective health and economic challenges, the SPARK Taskforce Executive Committee passed a motion on June 2, 2020, to direct counties to allocate and share Coronavirus Relief Funds with public educational and municipal entities within their counties.

WHEREAS, on August 13, 2020, the Board of County Commissioners of Shawnee County, Kansas approved the county's Coronavirus Relief Fund Allocation Plan Recommendation, which intends to distribute a portion of the ftmds to cities, school districts, tax authorities, and community based programs within Shawnee County upon approval by the State ofKansas.

ursuant to the authority vested in U o vi"'- ~Re..k_ ]2 I(U~ (Board/Council/Governing Body), in order to begin the

process of safe , strategtcally, and proactively providing the resources the community needs o both mitigate ~he seread of COVID-1 . an invest in long-term economic recovery,

To ~ No ~ \v-t.c.T ~ oard/Councii/Governing Body) accepts any funds appropriated to ntity/City/School the State of Kansas through the State's Coronavirus Relief Fund as distributed by Shawnee County pursuant to the following terms designed to ensure the lawful use of funds and transparency, equity, and accountability:

SECTION 1-ALLOW ABLE USES

1. Section 5001 of the Coronavirus Aid, Relief, and Economic Security ("CARES") Act, as codified in 42 U.S.C. § 801, provides the eligible purposes for which Coronavirus Relief Fund ("CRF") payments may be used. Under 42 U.S.C. § 801(d) funds may be used for:

a. necessary expenditures incurred due to the public health emergency with respect to Coronavirus Disease 2019 (COVID-19);

b. not accounted for in the budget most recently approved for Entity/City/School as of March 27, 2020; and

c. incurred during the period that begins on March 1, 2020 and ends on December 30, 2020.

2. The following are examples of public health expenditures allowed pursuant to paragraph l.a. above and 42 U.S.C. § 801(d):

COVID-19 related expenses of public hospitals or clinics

COVID-19 testing and quarantine costs

- Payroll of employees substantially dedicated to COVID-19 mitigation or response

- Expenses for establishing and operating public telemedicine capabilities

Technological improvements to facilitate distance learning

- Improving telework capabilities

Grants to small businesses to reimburse the costs of business interruption caused by required closures

Government payroll support program

- Unemployment insurance costs related to COVID-19

SECTION 2- PROHIBITED USES

3. The following are examples of public health expenditures NOT allowed pursuant to t paragraph l.a. above and 42 U.S.C. § 80l(d):

- Damages covered by insurance

- Payroll or benefits for employees not substantially dedicated to mitigating or responding to COVID-19

- Expenses that will be reimbursed under any federal program

- Reimbursement to donors for donating items or services

Workforce bonuses other than hazard pay or overtime

Severance pay

- Legal settlements

4. Additionally, as outlined in guidance issued by the Congressional Research Service on April 14, 2020, "Coronavirus Relief Fund payments may not be used to directly account for revenue shortfalls related to the COVID-19 outbreak. Such funds, however, may indirectly assist with revenue shortfalls in cases where expenses paid for by the Coronavirus ReliefFund would otherwise widen the gap between government outlays and receipts."

SECTION 3-ENTITY ALLOCATION

5. Shawnee County is recommending to the State of Kansas in its Coronavirus Relief Fund Allocation Plan Recommendation that fb@ lo\)e.~ 'tftc,t1;1fdbl.s+...-4- (NTD{}) (Entity/City/School) be allocated up to $ \ S""b b. c 0 of th; s deployed to Shawnee County.

6. The allocations must first be approved by the state, which is anticipated on or around September 15, 2020.

7. Funds are being dispersed by Shawnee County based upon expense reimbursement; funds are not being given to any Entity/City/School as a lump sum amount. Reimbursements wilJ only be distributed to the entity after proper documentation has been received from Entity/City/School and eligibility requirements of each expense have been confirmed, as otherwise set forth in this agreement.

SECTION 4- OBLIGATIONS OF ENTITY

8. Entity/City/School understands that it may not seek reimbursement for expenses for which it has already received reimbursement (including insurance) and that it will not use the CRF Funds for any expenditure for which it has received or will receive any other federal funding, including any other funding provided by the CARES Act. If Entity/City/School receives other reimbursement for any expense for which the County has provided CRF Funds, Entity/City/School shall repay the County the amount ofthat expense within fourteen (14) days.

9. Entity/City/School agrees to prioritize its requests for reimbursement based on the organization's needs and other funding opportunities, up to the allocated dollar amount.

10. All reimbursement requests must be made using the Expense Reimbursement Form as provided by the Kansas Recovery Office to comply with the most recent Federal reporting requirements.

11. All reimbursement requests must be supported by documentation provided electronically to [email protected] in a PDF format.

12. To assist Shawnee County in completing a monthly estimation document for the State of Kansas, Entity/City/School agrees to provide a plan of the estimated reimbursement requests by month. Shawnee County will provide a template to be used for said reporting.

13. To ensure effective and timely reimbursements, Entity/City/School agrees to accept payment via ACH.

14. To ensure transparency and accountability in the receipt and use of the CRF funds, Entity/City/School will comply with all applicable requirements of the Kansas Open Meetings Act and Shawnee County.

15. Entity/City/School shall create, maintain, and preserve sufficient records of its expenditures to demonstrate compliance with the requirements of the CARES Act, and shall provide such records to the County promptly upon written request. Such records shall be maintained not less than five (5) years after the termination of this agreement.

16. The COVID-19 pandemic has disproportionally impacted racial minorities within the State of Kansas, illustrating long-standing health disparities for African-American, Latino, and other racial minority populations in the United States. Accordingly, Entity/City/School will consider and incorporate efforts to address such disproportionate impacts on racial minorities in its proposed plan.

SECTION 5-PAYROLL REIMBURSEMENTS

17. All payroll reimbursements will need to be provided with a separate line for each position for each pay period and only for payroll/benefit expenses of employees whose work duties

are substantially dedicated to mitigating or responding to the COVID-19 public health emergency.

18. For each employee Entity/City/School must provide the employee's job description (pre COVID vs. post COVID) and how his/her position has a direct nexus to COVID.

SECTION 6- AUDIT PROVISIONS AND REPAYMENT

19. Entity/City/School acknowledges and agrees that CRF Funds are subject to the Single Audit Act (31 U.S.C. §§ 7501-7507) and the related provisions of the Uniform Guidance (2 C.F.R. Part 200), 2.C.F.R. § 200.303 and §§ 200.330 through 200.332 and subpart F and that the applicable Catalog of Federal Domestic Assistance (CFDA) number is 21.019.

20. As provided in 42 U.S. C.§ 80l(t), the Inspector General of the Department of the Treasury determines whether CRF payments have been used for eligible purposes. Fund payments that are deemed to have been used for ineligible purposes are treated as a debt owed by the implementing government to Treasury. This Coronavirus Relief Fund Contract signifies that, upon approval, Entity/City/School agrees to cooperate with any audits or inquiries by the Department of the Treasury concerning CRF funds, and agrees to hold Shawnee County harmless from any ineligible expenditure of appropriated CRF funds and to repay any debt incurred to the Department of the Treasury due to ineligible expenditures of appropriated CRF funds. Entity/City/School acknowledges and agrees that it has an unconditional obligation to repay any funds that have been later determined to be ineligible pursuant to this program. Repayment shall be made immediately upon demand.

21. Entity/City/School understands that the United States Department ofthe Treasury or the Governor's Office of Recovery may issue guidance regarding the transfer, expenditure, reimbursement, or other use of CRF funds, and agrees to comply with said guidance.

SECTION 7- UNSPENT FUNDS AND RECONCILIATION

22. Entity/City/School understands that any unspent funds must be returned to the State for recoupment.

23. Entity/City/School understands that Shawnee County must return all unspent funds no later than December 30,2020, thus on or before November I, 2020, Entity/City/School will provide a detailed timeline of expected future reimbursement requests. Shawnee County will reallocate any funds not included on this detailed schedule on November 15, 2020.

24. All reconciliation documents submitted to the SPARK Taskforce will be made publicly available by the Governor's Office of Recovery, including supporting documentation submitted by Entity/City/School to Shawnee County.

This document shall be filed with the Shawnee County Clerk, and shall become effective as of the date of execution.

BOARD OF COUNTY COMMISSIONERS SHAWNEE COUNTY, KANSAS

onc...\al.. t.,_ fv\e.t.e..fi (\e5'lJ..e~ William D. Riphahn, Chair

Date: I i (I/ /z. 0 Date:

Coronavirus Relief Fund Contract C- '-(C,Co -.:{Q:t_6

THIS AGREEMENT ("Agreement") is entered into on this ___£_ day of li't"(Q~t::i.. , 2020, by and between The Board of County Commissioners of

Shawnee County, Kansas, and 5~flQ~~ Soc~ A'!>s..e.t.A\r<=>.J (hereinafter "Program").

WHEREAS, the state of Kansas is facing both a public health and economic crisis -the pandemic and public health emergency of COVID-19 - which has resulted in illness, quarantines, school closures, and temporary closure of businesses resulting in lost wages and financial hardship to Kansas citizens locally;

WHEREAS, the World Health Organization declared a pandemic on March 11, 2020;

WHEREAS, on March 13, 2020, the President of the United States pursuant to Sections 201 and 301 ofthe National Emergencies Act, 50 U.S.C. § 1601, et seq. and consistent with Section 1135 ofthe Social Security Act, as amended (42 U.S.C. § 1320b-5), declared a national emergency that the COVID-19 outbreak in the United States constitutes a national emergency beginning March 1, 2020;

WHEREAS, in these challenging times, Shawnee County has made it a priority to avoid immediate dangers to the health, safety, and welfare of our constituents and to prepare for future waives of COVID-19;

WHEREAS, on June 16, 2020 the Kansas State Finance Council approved the Strengthening People and Revitalizing Kansas (SPARK) Taskforce's proposal to distribute money to Kansas counties to help address the health and economic challenges inflicted by COVID-19.

WHEREAS, Shawnee County received$ 36,763,812 in Coronavirus Relief Funds.

WHEREAS, on August 13, 2020, the Board of County Commissioners of Shawnee County, Kansas approved the county's Coronavirus Relief Fund Allocation Plan Recommendation, which included an allocation of $5,514,572 towards community based programs within Shawnee County.

WHEREAS, on September 17, 2020, the Board of County Commissioners reviewed recommendations by the Shawnee County SPARK committee of awards to community based programs whom had submitted applications for receipt of funds, and the Board of County Commissioners approved the first round of said allocations.

WHEREAS, Program was awarded an allocation as set forth below.

THEREFORE, pursuant to the authority vested in 5' v..o) f\.Q...l ~ Soe.ce;yL A'S~.Pc(i".N (Board/Program), in order to begin the process of safely,

strategically, and proactively providing the resources the community needs to both mitigate the spread of COVID-19 and invest in long-term economic recovery, Program accepts any

funds appropriated to the Program by the State of Kansas through the State's Coronavirus Relief Fund as distributed by Shawnee County pursuant to the following terms designed to ensure the lawful use of funds and transparency, equity, and accountability:

SECTION l -ALLOW ABLE USES

1. Section 500 I of the Corona virus Aid, Relief, and Economic Security ("CARES") Act, as codified in 42 U.S.C. § 801, provides the eligible purposes for which Coronavirus Relief Fund ("CRF") payments may be used. Under 42 U.S.C. § 801(d) funds may be used for:

a. necessary expenditures incurred due to the public health emergency with respect to Coronavirus Disease 2019 (COVID-19);

b. not accounted for in the budget most recently approved for Program as of March 27,2020;and

c. incurred during the period that begins on March l, 2020 and ends on December 30, 2020.

2. The following are examples of public health expenditures allowed pursuant to paragraph I.a. above and 42 U.S.C. § 80l(d):

COVID-19 related expenses of public hospitals or clinics

COVID-19 testing and quarantine costs

Payroll of employees substantially dedicated to COVID-19 mitigation or response

Expenses for establishing and operating public telemedicine capabilities

Technological improvements to facilitate distance learning

Improving telework capabilities

Grants to small businesses to reimburse the costs of business interruption caused by required closures

Government payroll support program

Unemployment insurance costs related to COVID-19

SECTION 2- PROHffiiTED USES

3. The following are examples of public health expenditures NOT allowed pursuant to paragraph I.a. above and 42 U.S.C. § 801(d):

Damages covered by insurance

Payroll or benefits for employees not substantially dedicated to mitigating or responding to COVID-19

Expenses that will be reimbursed under any federal program

Reimbursement to donors for donating items or services

Workforce bonuses other than hazard pay or overtime

Severance pay

Legal settlements

4. Additionally, as outlined in guidance issued by the Congressional Research Service on April 14, 2020, .. Coronavirus Relief Fund payments may not be used to directly account for revenue shortfalls related to the COVID-19 outbreak. Such funds, however, may indirectly assist with revenue shortfalls in cases where expenses paid for by the Corona virus Relief Fund would otherwise widen the gap between government outlays and receipts."

SECTION 3- PROGRAM ALLOCATION

5. Program has been allocated up to $_----=1J=-o0-=--=---- of the funds deployed to Shawnee County.

6. Funds are being dispersed by Shawnee County based upon expense reimbursement; funds are not being given to any Program as a lump sum amount.

7. Reimbursements will only be distributed to the Program after proper documentation has been received from Program and eligibility requirements of each expense have been confirmed, as otherwise set forth in this agreement.

8. Program understands that any money received may be considered income and taxable as such.

SECTION 4- OBLIGATIONS OF PROGRAM

9. Program understands that it may not seek reimbursement for expenses for which it has already received reimbursement (including insurance) and that it will not use the CRF Funds for any expenditure for which it has received or will receive any other federal funding, including any other funding provided by the CARES Act. If Program receives other reimbursement for any expense for which the County has provided CRF Funds, Program shall repay the County the amount of that expense within fourteen (14) days.

10. Program agrees it shall only seek reimbursement for expenses associated with the Program which is physically located within the borders of Shawnee County, and shall not seek reimbursement for any expenses related to any portion of the Program which is located outside of Shawnee County.

II. Program agrees to prioritize its requests for reimbursement based on the organization's needs and other funding opportunities, up to the allocated dollar amount.

12. All reimbursement requests must be made using the Expense Reimbursement Form as provided by Shawnee County to comply with the most recent Federal reporting requirements.

13. All reimbursement requests must be supported by documentation provided electronically to [email protected] in a PDF format.

14. To assist Shawnee County in completing a monthly estimation document for the State of Kansas, Program agrees to provide a plan of the estimated reimbursement requests by month. Shawnee County will provide a template to be used for said reporting.

15. To ensure effective and timely reimbursements, Program agrees to accept payment via ACH.

16. To ensure transparency and accountability in the receipt and use of the CRF funds, Program will comply with all applicable requirements of the Kansas Open Meetings Act and Shawnee County.

17. Program shall create, maintain, and preserve sufficient records of its expenditures to demonstrate compliance with the requirements of the CARES Act, and shall provide such records to the County promptly upon written request. Such records shall be maintained not less than five (5) years after the termination of this agreement.

18. The COVID-19 pandemic has disproportionally impacted racial minorities within the State of Kansas, illustrating long-standing health disparities for African-American, Latino, and other racial minority populations in the United States. Accordingly, Program will consider and incorporate efforts to address such disproportionate impacts on racial minorities in its proposed plan.

SECTION 5- PAYROLL REIMBURSEMENTS

19. All payroll reimbursements will need to be provided with a separate line for each position for each pay period and only for payroll/benefit expenses of employees whose work duties are substantially dedicated to mitigating or responding to the COVID-19 public health emergency.

20. For each employee Program must provide the employee'sjob description (pre COVID vs. post COVID) and how his/her position has a direct nexus to COVID.

SECTION 6- AUDIT PROVISIONS AND REPAYMENT

21. Program acknowledges and agrees that CRF Funds may be subject to the Single Audit Act (31 U.S.C. §§ 750 1-7507) and the related provisions of the Uniform Guidance (2 C.F .R. Part 200), 2.C.F.R. § 200.303 and§§ 200.330 through 200.332 and subpart F and that the applicable Catalog of Federal Domestic Assistance (CFDA) number is 21.019.

22. As provided in 42 U.S.C. § 801 (f), the Inspector General of the Department of the Treasury determines whether CRF payments have been used for eligible purposes. Fund payments that are deemed to have been used for ineligible purposes are treated as a debt owed by the implementing government to Treasury. This Coronavirus Relief Fund Contract signifies that, upon approval, Program agrees to cooperate with any audits or inquiries by the Department of the Treasury concerning CRF funds, and agrees to hold Shawnee County harmless from any ineligible expenditure of appropriated CRF funds and to repay any debt incurred to the Department of the Treasury due to ineligible expenditures of appropriated CRF funds. Program acknowledges and agrees that it has an unconditional obligation to repay any funds that have been later determined to be ineligible pursuant to this program. Repayment shall be made immediately upon demand.

23. Program understands that the United States Department of the Treasury or the Governor's Office of Recovery may issue guidance regarding the transfer, expenditure, reimbursement, or other use of CRF funds, and agrees to comply with said guidance.

SECTION 7- UNSPENT FUNDS AND RECONCILIATION

24. Program understands that Shawnee County must return all unspent funds no later than December 30, 2020, thus on or before November 1, 2020, Program will provide a detailed time line of expected future reimbursement requests. Shawnee County will reallocate any funds not included on this detailed schedule on November 15,2020.

25. All reconciliation documents submitted to the SPARK Taskforce will be made publicly available by the Governor's Office of Recovery, including supporting documentation submitted by Program to Shawnee County.

This document shall be filed with the Shawnee County Clerk, and shall become effective as of the date of execution.

) ~Ao~\:!YL ~~t~ ~SctiATio,j (PROGRAM)

By:

Date: ? ... nP fro/ or.f


William D. Riphahn, Chair

Date:

s to Legality te I) :Q ,....~ J.l)

Fax 785-251-4941


Shawnee County

AUDIT -FINANCE OFFICE Suite 201, Courthouse

200 SE 7th Street Topeka, KS 66603-3903

From: Betty Greiner, Director of Administrative Services ~« Date: November 9, 2020

RE: Request for approval of engagement for arbitrage compliance services with The Arbitrage Group, Inc.

I am requesting approval of the attached agreement with Arbitrage Compliance Specialists, Inc. for arbitrage rebate calculation services to meet the legal requirements for the Shawnee County General Obligation Bonds, Series 2016 A&B.

The agreement has been reviewed and approved as to form and legality by the County Counselor's office. The total cost is $1 ,500 which will be paid out of the County's general expenses.

Phone 785-251-4307

1111 II liThe Arbitrage Group, Inc.

1294 Hosford Street, Suite C

Hudson, Wisconsin 54016

March 2, 2020

Betty J. Greiner, CPA Director of Administrative Services Shawnee County 200 SE 7th, Room 201 Topeka, KS 66603

Dear Ms. Greiner:

Telephone 715 3X6 X044 www.thcarbitragcgroup.com

We are pleased to submit this engagement letter, which describes the assistance we will provide to Shawnee County, Kansas ("Borrower") regarding the calculation of arbitrage earnings for the $15,855,000 General Obligation Refunding and Improvement Bonds, Series 2016A&B ("Bonds"). This letter provides our understanding of the needs of the Borrower, lists the information that is to be provided to The Arbitrage Group, Inc. ("The Group") to compute the arbitrage earnings amount, and describes the procedures to be performed.

The Borrower needs to determine the arbitrage earnings amount for the Bonds for the periods from March 16, 2016 to the first installment computation date ending September 1, 2020 ("Computation Period"). The arbitrage earnings amount is the difference between:

a. The actual earnings on nonpurpose investments purchased with gross proceeds of the Bonds during the Computation Period, and

b. The earnings which would have been earned during the Computation Period on nonpurpose investments if such investments had been invested at a rate equal to the yield on the Bonds.

The Borrower will be responsible for providing The Group with the applicable documentation required to calculate the arbitrage earnings amount. This documentation includes:

1. IRS Form 8038 and Tax Agreement(received); ii. Official Statement (received); and

iii. Trust/Escrow statements for the Computation Period funded with gross proceeds of the Bonds.

Utilizing the information provided above, the following procedures will be applied by The Group:

(1) Review the documents associated with the issuance of the Bonds to identify key characteristics of the Bonds and the related arbitrage requirements, including that: (i) the Bonds are one overall issue with a September 1st bond year elected for tax purposes; (ii) there are no transferred proceeds of the Bonds; (iii) the yield is fixed rate without the presence of expected qualified guarantee or qualified hedge amounts; (iv) there are no invested reserve or similar funds constituting replacement proceeds; (v) the Project and Issuance Cost Funds will be spent on or shortly after closing for acquisition and related issuance costs; and (vi) all trustee-held funds were uncommingled;

(2) Review the trust statements and determine that all trust statements related to the Computation Period have been provided and Borrower-provided or authorized information and representations;

•• • • The Arbitrage Group, Inc.

Shawnee County, Kansas Betty J. Greiner, Director of Administrative Services March 2, 2020 Page 2

(3) Calculate (or abstract) the bond yield for use in updating these calculations;

( 4) Assemble schedules of investment activity for each fund subject to the rebate requirements and calculate the arbitrage earnings amount for the Computation Period (with respect to Escrow Fund(s) (current/advance purposes, if not provided), assume such funds were at all times invested below the bond yield and fully allocated no later than September 1, 2019 and Bond Fund(s) assume such fund(s) operated as an excludable bona fide debt service fund);

( 5) Prepare a draft report of our findings which will include a summary of the information and computational assumptions affecting the calculations;

(6) Submit our draft report to the Borrower for review and approval; and,

(7) Complete quality reviews of the report and the supporting documentation and issue our report to the Borrower along with IRS Form 8038-T if applicable and tailored instructions.

The successful completion of this engagement will require close coordination between the personnel resources of the Borrower and The Group. Accordingly, we will assign a Project Director for this engagement to coordinate engagement activities and we would like the Borrower to do the same. We will have no obligation to update our report or to check any revised calculations because of events and transactions occurring subsequent to the date of our report.

Our report is to be issued solely for your information and assistance and is not to be quoted or referred to in other documents without our prior written consent. It is assumed that all of the appropriate documentation is available in a concise, organized, and complete manner, and that we will have access to the individuals responsible for the investment portfolio. Based on these assumptions, we estimate the fees for the defined Computation Period to not exceed $1,500. These fees would include any out-of-pocket expense incurred by us.

We look forward to working with you on this project. If you have any comments or questions regarding this engagement, please do not hesitate to call me at (715) 386-8044. To signify your acceptance of the arrangements described in this letter, please return a signed copy of this letter.

Very truly yours, The Arbitrage Group, Inc.

Gregory A. Ichel, Principal

Accepted by: Shawnee County, Kansas

By: --------------------------------

Title: ----------------------------------

Date: ----------------------------------

01-.. TE:

TO:

FROM:

RE:

November 6, 2020

Shawnee County

Office of County Clerk CYNTHIA A. BECK

785-251-4155 Fax 785-251-4912 200 SE 71

h Street Room 107 www.snco.us Topeka, Kansas 66603-3963

M E M 0 R A N D U M


cynthia A. Beck~ty Clerk

2021 Cereal Malt Beverage License

Please place on the agenda for consideration the Resolution and accompanying documents related to issuing a 2021 Cereal Malt Beverage License to Parshva LLC dba Gastrip located at 550 SE Croce Road, Topeka, Kansas.

This application has been reviewed by the Counselor's Office. The Kansas Bureau of Investigation and Township have been notified and a health inspection has been performed.

Thank you for this consideration.

~ Attachments

·.<'

A 3 ..

RESOLUTION NO. 2Q:Z0 -b '-/

WHEREAS, the Township Board, having been given notice pursuant to K.S.A. 41-2702(b ), concerning the application for a Cereal Malt Beverage License,

AND WHEREAS, the Kansas Department of Agriculture has no objection to a Cereal Malt Beverage License being issued to the applicant listed herein for the year 2020.

AND WHEREAS, the Kansas Bureau of Investigation has no objection to a Cereal Malt Beverage License being issued to the applicant listed herein for the year 2020.

AND WHEREAS, the Board of County Commissioners of Shawnee County, Kansas, knows of no reason why the following application for Cereal Malt Beverage license should not be allowed:

Parshva LLC dba Gastrip 550 SE Croco Road

Topeka, Kansas

THEREFORE BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF SHAWNEE COUNTY, KANSAS, sitting in regular session on this __ day of _____ ,, 2020 that the application for Cereal Malt Beverage License be approved and the County Clerk be authorized and directed to issue a license to the above listed applicants.

ATTEST:

Cynthia A. Beck, County Clerk


Chair

Vice-Chair

Member

Otto, Kris

From: Sent: To: Subject:

Approved as to form and legality JCB

Brzon, Jonathan Friday, November 6, 2020 1 :33 PM Otto, Kris Re: Emailing: CMB Documentation for Gastrip

>On Nov 6, 2020, at 8:57AM, Otto, Kris <[email protected]> wrote: > >

1

CORPORATE APPLICATION FOR LICENSE TO SELL CEREAL MALT BEVERAGES (This form has been prepared by the Attorney General's Office)

!Y'city or 0 County of _T_o_p_e_k_a ______________________ _

.· ...

Check One: D New License '&f.Renew License D Special Event Permit

Check One: D J,ricense to sell cereal mall beverages for consumption on the premises. ISY'License to sell cereal malt beverages in original and unopened containers and not for consumption on the licensed _premises.

Kansas Sales Tax Registration Number (required): 90-0651461

I have registered as an Alcohol Dealer with the TTB. ~Yes (required for new application)

Name of Corporation PARSHVA, LLC Principal Place of Business 550 SE Croco Rd Topeka KS 66607

Corporation Street Address 550 SE Croco Rd

Date of Incorporation 2015

Resident Agent Name MAHMADRAFIK UMARBHAI GHANCHI

Residence Street Address 1113 UNION ST

Licensed Premise (Business Location or Location of Special Event)

DBA Name Gastrip

Business Location Address 550 SE Croco Rd

City Topeka, KS 66607 State

Business Phone No. 785

_234

_7588

Business Location Owner Name(s) Mehul Shah

Zip

Corporation City Topeka I StateKS I z:s~~d; Articles of Incorporation are on file with the j rlves 0 No Secretary of State. IV '

Phone No. 785-234-7588

City EMPORIA I StateKS I Zip Code 66801

Mailing Address (If different from business address)

Name PARSHVA, LLC

Address PO 191

City A, State rvon, MN

Qi Applicant owns the proposed business location. D Applicant does not own the proposed business location.

Residence Street Address 16073 ?Oth Place N City l State Zip Code Maple Grove MN 55311

Spouse Name Position Date of Birth

Residence Street Address City I State Zip Code

Name Position Date of Birth


Spouse Name Position Age




Spouse Name Position Age


Page 1 of4

AG CMB Corporate Application (Rev. 12.27 .19)

SECTION ·4 -·QF.FICE~S; .DI~ECT;0RS;·STOCK1i0~DI;RS ·OWNI~G 25% 'OR MaRE 'C:>F . " :::· :1<,· '):: · ·< . .. STOCK·:(coNTINUED) . ;;·' > . :. ·_:· ;,,·_;-:· : ••. _-. - ,-· · .. ':. -'- :· :·: •. • ;:::, {/~· .. '-:








Residence Street Address City l State Zip Code




Residence Street Address City J State Zip Code










Residence Street Address City l State Zip Code


Residence Street Address City I State . Zip Code









Page 2 of4

AG CMB Corporate Application (Rev. 12.27.19)

My place of business or special event will be conducted by a manager or agent.

If yes, provide the following:

Manager/Agent Name MAHMADRAFIK UMARBHAI GHANCHI Phone No. 785-234-7588

Residence Street Address City Emporia 1113 UNION ST

Spouse Name Phone No.

Residence Street Address City

Within 2 years immediately preceding the date of this application, have any of the individuals identified in Sections 4 & 5 have been convicted of, released from incarceration for or released from

fives 0No

Date of Birth 6/1/72

Zip Code 66801

Date of Birth

Zip Code

probation or parole for any of the following crimes*: 0 (1) Any felony; (2) a crime involving moral turpitude; (3) drunkenness: (4) driving a motor vehicle Yes !SiNo

while under the influence of alcohol (DUI); or (5) violation of any state or federal intoxicating liquor law.

Have any of the individuals identified in Sections 4 and 5 been managers, officers, directors or stockholders owning more than 25% of the stock of a corporation which: 0 Yes (1) had a cereal malt beverage license revoked; or (2) was convicted of violating the Club and Drinking Establishment Act or the CMB laws of Kansas.

All of the individuals identified in Sections 4 & 5 are at least 21 years of age*. ISfves 0 No

Start Date Time OPM

End Date Time DAM OPM

Proceed to Section 8 on the next page.

William D. Riphahn, Chair Board of Commissioners of Shawnee County, Kansas

Page 3 of 4

AG CMB Corporate Application (Rev. 12.27 .19)

the space below, draw the area you wish to sell or deliver CMB., Include entrances, exits and storage areas. Do not include areas u do not wish to license. If you wish to' attach a drawing, check the box: 0 8 Yz" by 11" drawing attached.

I declare under penalty of pe Jury under the laws of the State of Kansas that the foregoing is true and correct and that I am authorized ~Y tJle cc poration to complete this application. (K.S.A. 53-601)

~v- 10/21/2020 SIGNATURE /...-~··u~/N-- DATE

FOR CiTY/COUNTY OFFICE USE ONLY:

\i License Fee Received Amount $ 5'0 · {) {J Date {/0 -~W-J [X},Q J' ($25- $50 for Off-Premise license or $25-200 On-Premise license)

){.$25 CMB Stamp Fee Received Date JQ -J./.tr :JQJO ~ackground Investigation ~mpleted Date I I /3/:J o;JO ~alified D Disqualified

~erlfied applicant has registered with the TIB as an Alcohol Dealer

0 New License Approved

~cense Renewed

0 Special Event Permit Approved

Valid From Date _____ to _____ By: ____ _

Valid From Date _____ to By: ____ _

Valid From Date _____ to _____ By: ____ _

A PHOTOCOPY OF THE COMPLETED FORM, TOGETHER WITH THE STAMP FEE REQUIRED BY K.S.A. 41-2702(e), MUST BE SUBMITIED WITH YOUR MONTHLY REPORT (ABC-307) TO THE ALCOHOLIC BEVERAGE CONTROL, 109 SW 9TH ST, 5TH FLOOR, PO BOX 3506, TOPEKA, KS 66601.

• Applicant's spouse is not required to meet citizenship, residency or age requirements . If renewal application, applicant's spouse is not required to meet the no criminal history requirement. K.S.A. 41-2703(b)(9)

Page4 of 4

AG CMB Corporate Application (Rev. 12.27.19)

KEEP '~?HIS LICENSE POSTED CONSPICUOUSLY AT ALL TIMES

Fee, $50.00 RETAIL No. 2021-3

DEALERS 2 .. 02:1 LICENSE

:C:E R,E 'A L MALT BE VERA. G E S

TO ALL WHOM IT MAY CONCERN:

License is hereby granted to · Parshva LLC db a Gas trip to sell. at retail in original & unopened containers and not for consumption on the premises at 550 SE Croco Road, Topeka, Kansas in the Township of Tecumseh in Shawnee County, Kansas

Application therefor, on file in the office of the County Clerk of said County, having been approved by the governing body ofsaid Township, as provided by the Laws of Kansas, and the regulations of the Board of County Commissioners.

This license will e:xpire December 31, 2021, unless sooner rev.oked, is not transferable, nor will any refund of the fee be allowed thereon.

Done by the Board of County Commissioners of Shawnee Cotmt)( Kansas, This __ day of , 2020.

Attest: ______________ _ Cynthia A. Beck Shawnee County Clerk

William D. Riphalm Chair

Common/deb/cmbllicense to retail. doc

Shawnee County

Office of the County Counselor

JAMES M. CROWL County Counselor

Shawnee County Courthouse 200 SE 71h Street, Ste. 100

Topeka, Kansas 66603-3932 Office: (785) 251-4042

Fax: (785) 251-4902 Email: [email protected]

MEMORANDUM

TO: Board of Shawnee County Commissioners

FROM: James M. Crowl, Shawnee County Counselor

DATE: November 9, 2020

RE: Resolution Creating a Public Health Technical Advisory Board

Please place the attached item on the Thursday, November 12, 2020 Commission Agenda.

The attached Resolution would create a Public Health Technical Advisory Board. This Advisory Board would have one representative each designated by the following entities:

a. Stormont-Vail Health; b. University of Kansas Health System - Topeka Campus; c. Valeo; d. GraceMed; e. A physician who resides and/or practices within Shawnee County to be appointed by

the Shawnee County Board of Health.

The Advisory Board would serve to help advise the Local Health Officer, the Health Department, and the Board of Health on public health issues. Certainly, responding to COVID 19 is the immediate, pressing issue, but the Board's role does include all public health issues facing Shawnee County. Also, the Board would assist the Board of County Commissioners in its recruitment and selection of a new Health Officer.

Please contact our Office if you have any questions about this Resolution. The Counselor's Office did coordinate its work on this Resolution with the Shawnee County Health Department.

JMC

RESOLUTION NO. 2020- G5

A RESOLUTION CREATING A PUBLIC HEALTH TECHNICAL ADVISORY BOARD

Sponsored By Commissioner Riphahn

WHEREAS, The Board of County Commissioners of the County of Shawnee, Kansas desires to create a Public Health Technical Advisory Board; and

WHEREAS, the creation of a Public Health Technical Advisory Board would benefit the citizens of Shawnee County, Kansas by providing expertise, assistance, and guidance to the Shawnee County Board of Health, the Shawnee County Health Department, and the Shawnee County Health Officer on public health issues;

NOW, THEREFORE, The Board of County Commissioners ofthe County of Shawnee, Kansas, meeting in regular session on this 12th day of November, 2020, does hereby resolve as follows:

1. Purpose. The Public Health Technical Advisory Board ("Advisory Board") shall serve in an advisory capacity on public health issues to the Shawnee County Board of Health, the Shawnee County Health Department, and the Shawnee County Health Officer. The Advisory Board should consider high-level strategies, specific interventions, and/or any necessary public health orders to address public health concerns. The Advisory Board does not have the authority to allocate county resources.

2. Composition. The Advisory Board shall contain one member designated from each of the following community health partners:

a. Stormont-Vail Health; b. University of Kansas Health System - Topeka Campus; c. Valeo; d. GraceMed; e. A physician who resides and/or practices within Shawnee County to be appointed by

the Shawnee County Board of Health.

The Advisory Board may request that additional members be added as needed to provide additional expertise and knowledge and in order to address public health issues. Members of the Advisory Board serve at the pleasure of the appointing organization.

3. Meetings, staffing, and records. The Advisory Board shall meet at a minimum on a quarterly basis and/or more frequently as needed. The Shawnee County Health Department shall provide a meeting location and make staff available to assist the Advisory Board with the scheduling of meetings (including virtual meetings), preparation of meeting agenda and minutes, and shall assist with communications and coordination between the Advisory Board, the

1

Shawnee County Board of Health, and the Shawnee County Health Officer. The Shawnee County Health Department shall keep and maintain the records of the Advisory Board.

4. Chairperson. The Advisory Board shall appoint a Chairperson to set and conduct its meetings. The Chairperson will work with the Shawnee County Health Officer and Health Department staff when setting meeting agendas. If there is a vacancy in the Health Officer position, the Advisory Board shall assist the Shawnee County Board of Health in the review of suitable candidates and shall submit at least two recommended candidates to the Shawnee County Board of Health to serve as the Shawnee County Health Officer.

5. Effective date. This Resolution shall become effective upon its adoption.

ATTEST:



Kevin J. Cook, Vice-Chair

Aaron Mays, Member

Cynthia A. Beck, Shawnee County Clerk

2

Shawnee I ~ounty '' ~ r '; P.arKs+ ~ recreation

November 4, 2020

TO:

FROM:

RE:

Board of County Commissioners Shawnee County

Tim L Laurent, Direc~ Parks + Recreation 1 t..-

Basketball Comt replacement Project Ripley and Cushinberry Parks

Purpose: Board of Commissioners approval is requested on the attached project budget totaling approximately $60,512.50 for the replacement of a basketball court and park amenities located at Ripley Park utilizing operating funds. On August 29, 2019, the department received approval for the court replacement at Cushinberry Park (utilizing 3 R Funds). S CP+R is also requesting approval to solicit bids for the comt replacement projects.

Justification: The courts at both parks are in poor condition (see photos). The courts at Ripley Park are currently located on the far east side of the park away from the regular parking lot, restrooms, playgrounds and other amenities. This project would demolish the existing comts and locate them near the west side of the park.

TLL/ctc JB Attachment

parks.snco.us

· . · · • 3137 SE 29th Street • Topeka, KS 66605 • (785) 251-6800

'

Project Name Park Improvements ----------~----~~------------------

Project Manager Curtis --------------------------------------Location: Ripley Park

----------------~~--~--------------Timeline:

3R Component Parks an Project# --------Quadrant -------

----------------------------Requires contracted professional services? Y N Est. Hours Est. Cost -----------

Requires Project Exemption Certificate? Y N

Attach a detailed description of the project and corresponding documents.

This project budget documents the estimated costs and funding source(s). The project manag

Professional services, equipment, and all other itemized costs.

Estimated Project Cost

Remove existing basketball courts and with concrete, add new

Prepared By Project Manager

Reviewed and Approved By

c:::f-f. zet ~ SCP+R Director

Operating Funds

Date: 10/ ------~

Date:

11/5/2020

2

11/5/2020

1

Shawnee 1 ~ounty "-' ~ r f; f!3fKS+ -! recreation October 26, 2020

TO:

FROM:

RE:

Board of County Commissioners Shawnee County

Tim L. Laurent, Director Parks + Recreation 'f! A ward Bid and Agreement - Martinek and Flynn Park Operations Division - Golf Course

Purpose: Board of Commissioners approval is requested to award the bid and execute the agreement with Martinek & Flynn for replacement of siding and windows at Forbes Golf Course Pro Shop. The project will utilize $40,166.00 from the SCP+R Building Maintenance Fund.

Justification: On April 6, 2020, the BCC deferred this work due to COVID-19. Two (2) vendors responded and staff recommended Martinek & Flynn as the lowest, most responsive bidder.

Andy's Siding Martinek & Flynn

Windows $3,860.00 $2,950.00

Siding $55,900.00 $37,216.00

Total $59,760.00 $40,166.00

At this time, Martinek and Flynn is honoring their original bid submission for the work specified in RFP #092-19. Martinek & Flynn has provided additional cost of $1,040 for proper removal and disposal of any asbestos material.

The project is funded utilizing Forbes generated revenue as stipulated by the Federal Lands to Parks program.

TLL/blt JM Attachments

parks.snco.us

-:- ,· .. - ' - ... •- ,. · ·-,,, ·. ·. . • 3137 SE 29th Street • Topeka, KS 66605 • (785) 251-6800

SHAWNEE COUNTY CONTRACT NO. C i(;<! -2020

INDEPENDENT CONTRACTOR AGREEMENT FOR GOODS AND SERVICES

THIS AGREEMENT is between THE BOARD OF COUNTY COMMISSIONERS OF THE COUNTY OF SHAWNEE, KANSAS (County) and MARTINEK & FLYNN (Contractor).

1. GOODS AND SERVICES TO BE PROVIDED

Contractor agrees to provide the following goods and services to the County in accordance with the terms and specifications of Shawnee County RFP# 092-19 (Attached as "A" and incorporated herein by reference):

Forbes Golf Course Pro Shop renovation includes removal and replacement of siding, asbestos removal as permitted, windows, all materials and supplies to perform such functions. Project shall be completed after roof project. Appropriate safety measures shall be implemented in order for golf services to continue for the public.

This Agreement shall commence on November __ , 2020, and shall end before April30, 2021, unless this Agreement is terminated sooner or extended in accordance with its terms.

2. PAYMENT

In consideration of the goods and services to be provided by Contractor, County agrees to pay Contractor as follows:

Goods and Services to Details Compensation be Provided

Forbes Golf Course Pro All goods and services to be provided in Payable upon Shop windows and accordance with the terms and specifications submission of siding replacement. of Shawnee County RFP# 092-19 (Attached invoice(s) after

as "A" and incorporated herein by completion of reference). project.

Windows and siding: $40,166.00

Asbestos removal and disposal to be Asbestos provided in accordance with the removal not to Contractor's response to Shawnee County exceed: RFP# 092-19 (Attached as "B" and $1,040.00 incorporated herein by reference).

Unless otherwise provided herein, Contractor shall be responsible for all expenses incurred while performing under this Agreement. This includes equipment; delivery charges;

1

supplies; telephone expenses; automobile and other travel expenses; meals and entertainment; insurance premiums; and all salary, expenses and other compensation paid to Contractor's employees or contract personnel Contractor hires to perform under this Agreement.

3. WARRANTY

Contractor warrants that the goods sold hereunder are new and free from substantive defects in workmanship and materials. This warranty is in addition to any provided by the manufacturer(s) of the goods sold hereunder.

4. TAXES

NO sales tax will be charged to County. County is exempt from sales tax and will provide an exemption certificate to Contractor. Any other taxes, tariffs and other governmental charges shall be paid by Contractor and are Contractor's responsibility.

5. INDEPENDENT CONTRACTOR STATUS AND CERTIFICATION

Contractor is an independent Contractor, not a County employee. Contractor's employees or contract personnel are not County employees. Contractor and County agree to the following rights consistent with an independent Contractor relationship:

a. Contractor has the right to perform services for others during the term of this Agreement.

b. Contractor has the sole right to control and direct the means, manner and method by which the services required by this Agreement will be performed.

c. Contractor shall not be assigned a work location on County premises, and Contractor has the right to perform the services required by this Agreement at any place, location or time.

d. Contractor will furnish all equipment and materials used to provide the services required by this Agreement.

e. Contractor has the right to hire assistants as subcontractors, or to use Contractor's employees to provide the services required by this Agreement.

f. Contractor or Contractor's employees or contract personnel shall perform the services required by this Agreement and Contractor agrees to the faithful performance and delivery of described services in accordance with the time frames contained herein; County shall not hire, supervise or pay any assistants to help Contractor.

g. Neither Contractor nor Contractor's employees or contract personnel shall receive any training from County in the skills necessary to perform the services required by this Agreement.

h. County shall not require Contractor or Contractor's employees or contact personnel to devote full time to performing the services required by this Agreement.

2

Further, Contractor hereby certifies:

1. That Contractor is not an employee of County and thereby Contractor waives any and all claims to benefits otherwise provided to employees of the County, including, but not limited to: medical, dental, or other personal insurance, retirement benefits, unemployment benefits, and liability or worker's compensation insurance.

J. Contractor must provide Federal Tax or Social Security Number on required Form W-9.

k. That Contractor understands that he/she is solely responsible, individually for all taxes and social security payments applicable to money received for services herein provided. Contractor understands that an IRS Form 1099 will be filed by the County for all payments received.

6. INDEMNIFICATION AND HOLD HARMLESS

Contractor shall save, hold harmless, and indemnify County, its officers, agents and employees, from and against all claims, causes of action, liabilities, expenses and costs, including reasonable attorneys' fees, for injury of any person or damage to property arising out of, or connected with, work performed under this Agreement which is the result of any acts or omissions, whether negligent or otherwise, of Contractor, its officers, agents, subcontractors or employees.

7. INSURANCE

The County shall not be required to purchase, any insurance against loss or damage to any personal property to which this contract relates, nor shall this contract require the County to establish a "self-insurance" fund to protect against any such loss or damage. Subject to the provisions of the Kansas Tort Claims Act (K.S.A. 75-6101 et seq.), the Contractor shall bear the risk of any loss or damage to any personal property to which Contractor holds title.

8. OWNERSHIP OF PRODUCTS/DOCUMENTS

Contractor hereby assigns to County all rights to all products, reports, documents, photographs, videos, data, and drawings produced by Contractor as a result of this Agreement.

9. TERMINATION DUE TO LACK OF FUNDING APPROPRIATION

Shawnee County is subject to the Kansas Cash Basis Law, K.S.A. 10-1101 et seq. If, in the judgment of the Financial Administrator, Audit-Finance Office, sufficient funds are not appropriated to continue the function performed in this agreement and for the payment of the charges hereunder, County may terminate this agreement at the end of its current fiscal year. County agrees to give written notice of termination to Contractor at least thirty (30) days prior to the end of its current fiscal year. The termination of the contract pursuant to this paragraph shall not cause any penalty to be charged to the County or the Contractor.

3

10. ANTI-DISCRIMINATION CLAUSE

The Contractor agrees: (a) to comply with the Kansas Act Against Discrimination (K.S.A. 44-1001 et seq.) and the Kansas Age Discrimination in Employment Act, (K.S.A. 44-1111 et seq.) and the applicable provisions of the Americans With Disabilities Act (42 U.S.C. 12101 et seq.) [ADA] and to not discriminate against any person because of race, religion, color, sex, disability, national origin or ancestry, or age in the admission of access to or treatment or employment in, its programs or activities; (b) to include in all solicitations or advertisements for employees, the phrase "equal opportunity employer"; (c) to comply with the reporting requirements set out in K.S.A. 44 1031 and K.S.A. 44-1116; (d) to include those provisions in every subcontract or purchase order so that they are binding upon such subcontractor or vendor; (e) that a failure to comply with the reporting requirements of (c) above or if the Contractor is found guilty of any violation of such acts by the Kansas Human Rights Commission, such violation shall constitute a breach of contract; (f) if the contracting agency determines that the Contractor has violated applicable provisions of ADA, that violation shall constitute a breach of contract; (g) if (e) or (f) occurs, the contract may be cancelled, terminated or suspended in whole or in part by the County. Parties to this contract understand that subsections (b) through (e) of this paragraph are not applicable to a Contractor who employs fewer than four employees or whose contract with the County totals $5,000 or less during this fiscal year.

11. ACCEPTANCE OF CONTRACT

This contract shall not be considered accepted, approved or otherwise effective until the required approvals and certifications have been given and this is signed by the Board of County Commissioners of the County of Shawnee, Kansas.

12. ARBITRATION, DAMAGES, WARRANTIES

Notwithstanding any language to the contrary, no interpretation shall be allowed to find the County has agreed to binding arbitration, or the payment of damages or penalties upon the occurrence of a contingency. Further, the County shall not agree to pay attorney fees and late payment charges; and no provisions will be given effect which attempts to exclude, modify, disclaim or otherwise attempt to limit implied warranties of merchantability and fitness for a particular purpose.

13. REPRESENTATIVE'S AUTHORITY TO CONTRACT

By signing this document, the representative of the Contractor thereby represents that such person is duly authorized by the Contractor to execute this document on behalf of the Contractor and that the Contractor agrees to be bound by the provisions thereof.

14. FORCE MAJEURE

County reserves the right to postpone any event/activities as needed due to the Covid-19 pandemic restrictions without penalty or loss of any deposits or funds paid by either party. County shall notify Contractor (or Vendor) of any such decisions and offer rescheduling

4

options as soon as possible should such efforts be warranted. Furthermore, Contractor shall have an updated emergency operations plan and address prevention strategies meeting CDC mass gathering requirements and share such plans with the Department in order to proceed with the contractual obligations.

15. TERMINATION OF AGREEMENT

This Agreement may be terminated by either party by giving the other party written notice of the intent to terminate. The notice must specify a date upon which the termination will be effective, which date may not be less than 7 calendar days from the date of mailing the notice. Only services satisfactorily performed up to the date of receipt of notice shall be compensated by County and such compensation shall be pursuant to the terms of this Agreement. Notice shall be deemed received 3 days after mailing in the United States mail, using first class mail, postage prepaid.

16. AUTOMATED CLEARING HOUSE (ACH)

Shawnee County prefers to pay its vendor invoices via electronic funds transfers through the automated clearing house (ACH) network. Shawnee County may require vendors to accept payments via ACH. To initiate payment of invoices, vendors shall execute the County's standard ACH Vendor Payment Authorization Agreement. Upon verification of the data provided, the Payment Authorization Agreement will authorize the County to deposit payment for services rendered or goods provided directly into vendor accounts with financial institutions. All payments shall be made in United States currency.

17. MISCELLANEOUS PROVISIONS

a. This Agreement shall be entered into in Shawnee County, Kansas, and shall be construed and interpreted according to the law of the State of Kansas.

b. All notices and other communications in connection with this Agreement shall be in writing and shall be considered given 3 days after mailing in the United States mail, using first class mail, postage prepaid, to the recipient's address as stated in this Agreement.

c. Contractor shall comply with all federal, state and local laws requiring business permits, certificates and licenses required to carry out this Agreement.

d. Contractor may not assign any rights or obligations under this Agreement without County's prior written approval.

e. This Agreement, along with the Shawnee County RFP and any other document specifically referenced in paragraphs 1 and/or 2 constitutes the entire agreement between the parties and may only be modified or extended by a written amendment signed by the parties hereto. If there is a conflict between the documents that make up this Agreement, the documents will control in the following order: (1) this Agreement, (2) the Shawnee County RFP, (3) any other document specifically referenced in paragraphs 1 and/or 2.

f. The invalidity, illegality, or unenforceability of any provision ofthis Agreement or the occurrence of any event rendering any portion or provision of this

5

Agreement void shall in no way affect the validity or enforceability of any other portion or provision of this Agreement. Any void provision shall be deemed severed from this Agreement, and the balance of this Agreement shall be construed and enforced as if this Agreement did not contain the particular portion or provision held to be void.

g. Nothing in this Agreement shall be construed to give any rights or benefits to anyone other than County and Contractor.

IN WITNESS WHEREOF, County and Contractor have executed this Agreement.

(Signature Page Follows)

6

CONTRACTOR MARTINEK & FLYNN

COUNTY BOARD OF COUNTY COMMISSIONERS SUA WNEE COUNTY, KANSAS

.r:- ' Wt . 1i,y1i£:1, s ~ William D. Riphahn, Chair

118 Roby Place Topeka, KS 66612 785-233-6666 [email protected]

Date: -------------------

Date: 3- I 0- 2oZo ATTEST:

SUA WNEE COUNTY PARKS+ RECREATION

TimL.

, Approved as to legality and Form: Date_~¥;"'="_

ASSI co COliN I OR


7

Item Being Bid

PROPOSAL NO.

DATE MAILED

CLOSING 2:00P.M.

092-19

11-18-19

12-16-19

Attachment A

Minimum Requirements (show additional material/pricing upgrades on a separate sheet)

Gutter Replacement

Window Replacement

Siding Replacement

Roof Replacement

Total Bid Price

Additional Items to Bid Unit

Asbestos Removal/Disposal

Decking Replacement Sheet

.ffir/(rb 0--L \L CV\d flY[ Of\

COMPANY or FIRM NAME

(Please send the original and a copy of your bid)

TOTAL BID PRICE

$ c9-4S?. oo

$ 3/ Jl fo w -=-.!...-#----

$ ___ _

Per Unit

PLEASE SUBMIT THIS AS THE FIRST PAGE OF YOUR BID

PAGE&

PROPOSAL NO.

DATE MAILED

CLOSING 2:00P.M.

092-19

11-18-19

12-12-19

All bids received on or before the specified bid closing time and date shall be publicly opened, read aloud and properly recorded on the bid tabulation sheet. Subsequent to the bid opening, all bids shall be thoroughly evaluated and a determination made as to their compliance with applicable specifications. The appropriate County department heads and the architect or engineer as applicable shall make this determination jointly. Upon completion of the above determination, an analysis of all bids submitted shall be

. prepared and formally presented to the Board of County Commissioners for acceptance and approval of the lowest and/or best bid. The Board of County Commissioners reserves the right to accept or reject any and/or all bids and to waive any irregularities or infmmalities therein.

If additional information is required, please contact Keny Golden, Director of Golf, at 785-251-6835 or [email protected].

Michele Hans aw, Purchasmg Specialist

SHOW TERMS 4Jt'" I //i )£..; '-3~ ~-4rs ~ ~J/"'''""'"' DELIVERY WILLBEMADE /1/ o/ /9/'/'L' /c /9t3LL /\

F.O.B. . ~ / /16L E . 2/?c_,{/c-/_)

SIGNED __ ~-=~--~~--~~~--~~~----

TITLE ---------------------~

PROPOSAL NO.

DATE MAILED ·

CLOSING 2:00 P.M.

092-19

11-18-19

12-12-19

SCOPE OF PROJECT:

Shawnee County is soliciting sealed bids for renovations to the Forbes Golf Course Pro Shop, located at 700 SW Capehart Rd, Topeka, KS 66619, including roof, gutters, windows and siding replacement, per the following m,inimum requirements.

>

A mandatory pre-bid meeting will be held December 3rd, 2019 at 11:30a.m. at Forbes Golf Course.

All supplies and installation by a single vendor will be prefened, but all submissions should include conesponding information and guarantees for any subcontractors to complete the scope of project.

MINIMUM REQUIREMENTS For consideration, all bid responses must include materials, color options and installation of:

Gutters 1. Five (5)-inch seamless aluminum guttering in white 2. Aluminum downspouts in white 3. Seal gutter comers and inside strip miters in white 4. Miscellaneous caulking, fasteners and sealants

Windows 1. Two (2) picture windows with commercial grade Low-E 3 66 Argon-filled dual pane glass and full frame in

white in main clubhouse 2. Two (2) picture windows with commercial grade Low-E 366 Argon-filled dual pane glass, full frame and

window sliders in white in banqu~t room , 3. Prefinished jamb extensions 4. Miscellaneous caulking, fasteners and sealants 5. Removal and covering of six ( 6) east-side windows prior to siding installation

Siding and Trim 1. Seamless steel siding with insulation and 'l4-inch fanfold backer in white 2. Steel outside comers in white 3. Wrap exterior window, porch ceiling, door and garage door trim with pre-finished aluminum trim coil in

white 4. Pre-finished aluminum soffits and fascia in white . 5. Removal of existing guttering 6. Vinyl gable vents, octagon-shaped, in white with security backing 7. Miscellaneous caulking, fasteners and sealants 8. Removal and disposal of any asbestos (price separately per square foot)

Roof 1. Remove existing layer of metal panels and shingles 2. Inspect and replace decking as necessary and agreed upon after consultation with Shawnee County Parks +

Recreation staff (provide pricing per sheet, not to exceed $2,500.00) 3. Eave and rake metal

nAI'"'n c

·I \

MARTINEK & FlYNN 118 ROBV PlACE TOPEKA. KS. 66612 PH# 233·6666 FAX# 233·6161 Email: m.~IO!!~MmltlY!I!!@~!!!!fl.~.t!~ll!.~!

Forbes Golf Course Pro Shop 700 SW Capehart Rd. Topeka, Ks 66619

Description of work to be done

12/9/19

Remove all wood siding. Enclose all windows on east side and 1 window unit on west side. (left of garage door.) Repair rotten framing on west side. I stall a 3/8" foam on entire building. Install steel vertical panel siding. Color matched caulking will be used where needed. Stainless steel fasteners will be used to secure the siding. 2 white octagon gable vents with backing will be used.

Install a sliding window unit and a picture window unit with nailing flange. Full window replacement jambs will be white. Exterior trim will be added to both windows.

Wrap window and door trim with white aluminum metal. Double fold metal on ends. Repair fascia boards. Install aluminum soffit and aluminum metal on overhangs and ceiling porch. Install aluminum metal on fascia boards. Double fold metal ends.

Install 6" seamless gutter using concealed hangers with stainless steel fasteners. 3x4 downspouts with a 2' extension will be added. Gutter seal is included.

Clean-up will occur several times a day. Magnets will be used for sweeping the premises. We will not obstruct the entrance. Materials and equipment will be removed daily.

Suggestion. You could add a different color siding on the front entrance at no extra charge for more curb appeal.

I r I I !

I I

I I

I

MARTINEK & FLYNN 118 ROBY PlACE TOPEKA, KS. 66612 PH# 233-6666 FAX# 233-6161 Email: mM!l!l~Jta:m~.fll!!ili@~~!!_UtQll.!lJ_.n_~tt

Forbes Golf Course Pro Shop 700 SW Capehart Rd. Topeka,](s 66619

Materials used for this project

Grip-Rite seal tape.

Quad Max caulking- color matched to siding color.

EZ blocks for faucets and electrical, white.

22" Octagon vents, white.

12/9/19

Mastic Trim Sheet Coil- smooth finished. Coated 32 sides- white, .019 thiclmess.

Mastic endurance triple 4 solid soffit, .016 thickness.

Mastic gutter coil, .032 thickness. Geocel tripolymer gutter sealant.

Mastic 3x4 downspouts- white, .019 thickness.

Windows are from soft-lite. Imperial LS series. 1 unit consists of 2 double sliding units, 1 unit will consist of picture windows. 3 coat Lowe and Argon gas.

Will practice lead paint safe practices, by certified renovators.

Certification number is ](S10-8213

Asbestos removal form is attached.

5 year labor warranty

[ I

MARTINEK & FlYNN 118 ROBV PLACE TOPEKA, KS. 66612 PH# 233-6666 FAX# 233-6767 Email: m~IWI.§t~JlJJ.!Jllil.!!!!@$llCf!lobai.!W!


References:.

City ofTopeka 215 SE 7th Topeka, Ks 66603

City of Topeka 215 SE 7th Topeka, Ks 66603

Habitat for Humanity 121 NE Gordon Street Topeka,Ks 66608

Richard Smith (785) 368-4469

Bob Hannigan (785)221-8822

Josh Beshears (785) 249-0751

12/6/19

I I i

I i

MARTINEK & FLYNN 118 ROBY PLACE TOPEKA, KS. 66612 PH# 233·6666 FAX# 233·6167 Email: m.P.r{!!H*!l.ll!iUllml@~~-~-!Jl~l!~lll~~


12/6/19

Martinek and Flynn is a family owned business for 61 years. We employ 20 highly trained people with an average of 15 years experience with our company. Martinek and Flynn provide sales, service and installation of several options of siding, windows, exterior doors, awnings, patio covers, sun rooms and gutter. Martinek and Flynn take pride in our work and we stand by our products and workmanship. We are a fourth generation company and look forward to a future of Quality service and growth.

Division of Environment Curtis State Office Building 1 000 SW Jackson St., Suite 400 Topeka, KS 66612-1367

Lee A. Norman, M.D., Secretary

Tony Hayes Martinek and Flynn Siding & Window 118 SW Roby PI TOPEKA, KS 66612

October 30, 2020

RE: Special Waste Disposal Authorization Number 20-1659

THIS AUTHORIZATION EXPIRES: April30, 2021

Dear Tony Hayes:

Attachment B

Phone: 785-296-1535 Fox: 785-559-4264

www.kdheks.gov

Lauro Kelly, Governor

Previously 19-187 6

We have considered your request for disposal of one (1) ton of non-friable asbestos containing material from Forbes Golf Course Pro, 700 SW Capehart Rd, TOPEKA, KS.

The environmental hazard associated with asbestos is the release of the fibers to the air which allows them to be inhaled. Appropriate measures must be taken to prevent the fibers from becoming airborne.

Approval is given to dispose of this waste at theN. R. Hamm Quarry, LLC (Permit 0394), provided the following conditions are met:

1. Approval to deliver the waste must be obtained from the landfill operator prior to transporting the waste to the landfill. The final decision on whether to accept or reject the waste rests with the landfill operator. Please contact Charles Sedlock, Director, Hamm, Inc., at 785-597-5111, to obtain approval. Ifthe landfill refuses to accept this waste, you should contact us to determine alternate disposal options.

2. Friable (material that will crumble) asbestos is required to be wetted prior to removal. While still wetted, the asbestos is required to be double bagged in clear sealable plastic bags (six mil. minimum thickness) for transport to the landfill.

3. Non-friable asbestos may be placed in clear sealable plastic bags, fiber drums, metal drums, or other appropriate containers that will prevent air emissions during transport.

4. Larger sections of structural materials such as pipe, duct work, tanks and sheets of building material removed with asbestos containing material left in place, will be wrapped in a double layer of six mil clear thick plastic sheeting for disposal purposes if they cannot be placed in containers. Edges will be securely taped prior to transport.

Bureau of Waste Management I Curtis State Office Building 11000 SW Jackson St. Suite 320 Topeka, KS 66612-1366 Phone: 785-296-1600 I Fax: 785-559-4252 or 785-559-42531 [email protected] I www.kdheks.gov/waste

5. The waste must be transported separately to the landfill and be identified to the operator upon delivery.

6. Kansas Administrative Regulation 28-29-1 08(r) (12) and (13) requires solid waste disposal facilities to maintain a log of commercial or industrial wastes received such as sludges, barreled wastes, and special wastes. The log must indicate the source and quantity of waste and the disposal location thereof. The industrial waste authorization number should be used as identification when entering the shipment into the log.

7. This approval is valid for disposal of the waste described and in the amount shown. If additional shipments are required, you must contact us to amend the disposal authorization.

8. The landfill operator should prepare a special area for the asbestos disposal. This area should be located so that landfill traffic or landfill equipment will not cause the fibers to become airborne. The area should be covered promptly.

9. Disposal of asbestos waste must comply with the requirements of 40 CFR 61.154 which includes covering the waste with six inches of soil on the day of disposal.

If you have any questions, feel free to contact me at 785-296-0681.

ABG

C Phil Schlaman, KDHE Charles Sedlock e-file

Requester phone: 785-233-6666

Sincerely,

fJb?47 Anthony (Tony) Guy Environmental Scientist Special Waste Coordinator KDHE/Bureau of Waste Management

Toby, Brian

From: Sent: To:

Brzon, Jonathan Monday, November 02, 2020 9:09AM Toby, Brian

Subject: Re: Martinek & Flynn - Forbes Pro Shop siding and windows

Approved as to form and legality JCB

On Nov 2, 2020, at 9:05AM, Toby, Brian <[email protected]> wrote:

JCB, Need a review and approval for BCC consideration on the updated ICAS for Forbes Golf Pro Shop siding and windows project that was deferred from April 2020. MF provided a new asbestos removal as attached . Thanks,

<imageO 11. png>

<11 022020 Revised ICAS signed. pdf>

Brian L. Toby Compliance and Grant Supervisor Direct: 785-251-6980 • parks.snco.us <image012.png>

<imageO 13 .png>

<image014.png>

<image015.png>

<Attachment B 20-1959 Martinek Flynn - Forbes Golf Course Pro Shop ACM.pdf> <Attachment A 092-19 Martinek and Flynn.pdf>

1

Shawnee County

Register of Deeds 200 East 7th Street

Topeka, Kansas 66603-3932 COURTHOUSE ROOM 108 785-233-8200 Ext. 4020

Rebecca J. Nioce REGISTER


From: Rebecca Nioce, Register of Deeds

Re: Request to renew contract with Fidlar Technologies


Please approve my request to extend the contract with Fidlar Technologies for software services. In 2012, the county entered into a contract with Fidlar technologies. This renewal will extend the current contract for four more years.

This software gives us the ability to record a document from start to finish as well as provide full searching capabilities. The Register of Deeds office has been very pleased with the products and services offered by Fidlar Technologies. We have been able to make major improvements in how we serve the public and provide increased protection of the integrity of the property records for Shawnee County. This software also gives us the ability to receive revenue from users that would like convenient access to our records.

The yearly cost will be $35,647 (year 1 ,) $36,717 (year 2,) $37,818 (year 3,) and $38,952 (year 4.) This will be funded through the Register of Deeds Technology fund. Kansas Statute 28-115a allows the Register of Deeds to use moneys in this fund acquire equipment and technological services for the storing , recording, archiving, retrieving, maintaining and handling of data recorded or stored in the office of the register of deeds.

Please contact me with any questions or concerns. Thank you for your consideration .

Respectfully,

~ Rebecca Nioce

D /,

~-------------------------------------------------------------------------------------------· -·

Approved as to form and legality.

JCB

On Nov 5, 2020, at 2:21PM, Crowl, James <[email protected]> wrote:

Jonathan,

Can you review this for Becky?

Thank you,

James M. Crowl Shawnee County Counselor 200 SE 7th, Room 100

Topeka, KS 66603 Phone: (785}251-4481

Fax: (785)251-4902

From: Nioce, Becky

Sent: Thursday, November 05, 2020 1:34PM

To: Crowl, James Subject: Contract

Please review this contract for renewal of our 4 year contract with Fidlar Technologies. Thanks so much!

Becky Nioce

Shawnee County Register of Deeds 200 SE 7th, Room 1081 Topeka KS 66603 0: 785.251.4020 Hours: 8:00-4:30 pm

www.PropertyFraudAlert.com -A free service in Shawnee County that alerts you to potential fraud

The Register of Deeds Office is a recording office and retains many land records for public inspection. We cannot, however, provide any searches of the records and are not responsible for missed documents. We do not offer legal advice of any kind.

SHAWNEE COUNTY CONTRACT ~ c:. ~ 6f ... .:J ~ C

~ fl OlRR

Shawnee County Kansas Register of Deeds 4 Year Land Records Life Cycle Extension

This Extension is made this _ day of , 20_ between Shawnee County, Kansas and Fidlar Technologies ("Fidlar"). Shawnee County and Fidlar hereby agree that the COMPUTER SYSTEM AND SOFTWARE LICENSE SALES AGREEMENT dated October 29, 2012 between Shawnee County and Fidlar (the "Agreement") is hereby extended for a 4-year period commencing on February 2, 2021 and terminating on February 1, 2025. Except as amended by this Extension, the terms and conditions of the Agreement, which are incorporated herein and made a part hereof, shall continue in full force and effect during the 4-year term of this Extension.

SOFTWARE SERVICES SUMMARY Fidlar Technologies Product\Service

Cost Description

Year 1 (2021)- $35,647

LifeCycle (AVID) Year 2 (2022)- $36,717 Year 3 (2023)- $37,818 Year 4 (2024)- $38 952

Receipting (Cashiering) Included

Indexing Included

elndexing Functionality Included

SSN Redaction Batch Processing Included

Automated Verification Functionality Included

eRecording Catcher Included

Property Fraud Alert Service Included

Honor Rewards Program Included

All Current LifeCycle Modules for Land Record Management Included

All Future LifeCycle Modules for Land Record Management Included

Laredo See Existing Schedule D

Tapestry See Existing Schedule D

Implementation Services Included

Project Management Included

Workflow Analysis Included

Installation I Configuration Included

Comprehensive Training Included

Recommended Hardware Not Included

LifeCycle Annual Maintenance Included

1-800 Support Included

System Upgrades Included

Training on New features & Functionality Included

State Mandated or Regulatory Updates Included

SHAWNEE COUNTY, KS REGISTER OF DEEDS

~ f I OlRR

4 YEAR PAYMENT MILESTONES AND DATES: LifeCycle Payments would continue to be invoiced on same schedule for the next 4 years: 2021 - $35,647.00 2022 - $36,717.00 2023- $37,818.00 2024 - $38,952.00

FIDLAR TECHNOLOGIES LIFECYCLE SERVICE INCLUDES:

+ The use of our AVID software product during the life of this contract

• The use of any future software product Fidlar may develop to replace AVID for the purpose of recording land records documents

• Project management, installation, conversion (excluding any needed or requested data clean-up), and training needed for the initial installation of any future Fidlar Technologies product developed to replace AVID for the purpose of recording land records documents

• The use of new add-on modules Fidlar may develop and offer to the market for the purpose of recording land records documents

• Software Maintenance to the currently licensed Fidlar developed Software Products

• Furnishing telephone support relative to the currently licensed Fidlar developed Software Products, either in their original or maintained form

• Providing legislative updates to the Fidlar developed Software Products as required by the State, except those updates that require fundamental modifications to the core design of the product

• Providing product enhancements on an ongoing basis, the frequency based on the age of the product and market requirements

FIDLAR TECHNOLOGIES LIFE CYCLE SERVICE DOES NOT INCLUDE:

• The 3rd party software and hardware necessary to operate AVID, any related modules, or any future Fidlar developed product for the purpose of recording land records documents

• The installation, maintenance, or support of 3rd party software and hardware now or in the future

• Any current or future Fidlar developed software product or service not designed or offered to the market for the purpose of recording land records documents

• Any form of ownership or perpetual license to Fidlar developed software products

• Any product, service, or responsibility, now or in the future, for the backing up, recovery, or disaster recovery of information

• Any custom development for special requests from the Client

• Any needed or requested training except as stated in the above section

• Use of Fidlar developed remote access products except as outlined in Schedule D of this contract

2


~ f I 0 lRR

• Enhancements or modifications to software programs at user's request; such work would be considered a billable extra

• Support to new or existing Fidlar Technologies Products not covered by this contract

• Operating System versions or their support or installation

• Database Management System versions or their support or installation

• Diagnosis or correction of problems caused by operator negligence

• Diagnosis or correction of problems caused by hardware, data media, or 3rct party software or other systems not covered by this Agreement

• Diagnosis or correction of problems caused by some naturally occurring event such as storm, flood, etc.

• Conversion costs for changes to database structure, if needed

BUYER REPRESENTS THAT THIS LIFECYCLE EXTENSION HAS BEEN READ AND ACCEPTED:

SHAWNEE COUNTY, KS FIDLAR TECHNOLOGIES

Dated: ___________ _ Dated: 10/30/2020

By: __________ _ rnu~ By: _______ ~-ff--~----

Name: _______________ _ Name:_A_I_e_x_R_ig::.:g::..e_n _______ _

Title: ___________ _ Title: Director

3


Rev. 10/2019 ATTACHMENT TO

SHAWNEE COUNTY CONTRACT C 'i C/f-Jo 'J.. o CONTRACTUAL PROVISIONS ATTACHMENT

The undersigned parties agree that the following provisions are hereby incorporated into the contract to which it is attached and made a part thereof, said contract being dated the ___ day of ---------20 __ .

1. TERMS HEREIN CONTROLLING PROVISIONS. It is expressly agreed that the terms of each and every provision in this attachment shall prevail and control over the terms of any other conflicting provision in any other document relating to and a part of the contract in which this attachment is incorporated.

2. AGREEMENT WITH KANSAS LAW. It is agreed by and between the undersigned that all disputes and matters whatsoever arising under, in connection with or incident to this contract shall be litigated, if at all , in and before a Court located in the State of Kansas, U.S.A., to the exclusion of the Courts of any other states or country. All contractual agreements shall be subject to, governed by, and construed according to the laws of the State of Kansas.

3. TERMINATION DUE TO LACK OF FUNDING APPROPRIATION. Shawnee County is subject to the Kansas Cash Basis Law, K.S.A. I 0-1101 et seq. If, in the judgment of the Financial Administrator, Audit-Finance Office, sufficient funds are not appropriated to continue the function performed in this agreement and for the payment of the charges hereunder, County may terminate this agreement at the end of its current fiscal year. County agrees to give written notice of termination to contractor at least thirty (30) days prior to the end of its current fiscal year. In the event this agreement is terminated pursuant to this paragraph, County will pay to the contractor all regular contractual payments incurred through the end of such fiscal year. The tennination of the contract pursuant to this paragraph shall not cause any penalty to be charged to the County or the contractor.

4. DISCLAIMER OF LIABILITY. Neither the County of Shawnee nor any department thereof shall hold harmless or indemnify any contractor for any liability whatsoever.

5. ANTI-DISCRIMINATION CLAUSE. The contractor agrees: (a) to comply with the Kansas Act Against Discrimination (K.S.A. 44-100 I er seq.) and the Kansas Age Discrimination in Employment Act, (K.S.A. 44-1111 et seq.) and the applicable provisions of the Americans With Disabilities Act (42 U.S.C. 12101 el seq.) [ADA] and to not discriminate against any person because of race, religion, color, sex, disability, national origin or ancestry, or age in the admission of access to or treatment or employment in, its programs or activities; (b) to include in all solicitations or advertisements for employees, the phrase "equal opportunity employer"; (c) to comply with the reporting requirements set out in K.S.A. 44-1031 and K.S.A. 44-1116 ; (d) to include those provisions in every subcontract or purchase order so that they are binding upon such subcontractor or vendor; (e) that a failure to comply with the reporting requirements of (c) above or if the contractor is found guilty of any violation of such acts by the Kansas Human Rights Commission, such violation shall constitute a breach of contract; (f) if the contracting agency determines that the contractor has violated applicable provisions of ADA, that violation shall constitute a breach of contract; (g) if (e) or (f) occurs, the contract may be cancelled, tenninated or suspended in whole or in part by the County. Parties to this contract understand that subsections (b) through (e) of this paragraph number 5 are not applicable to a contractor who employs fewer than four employees or whose contract with the County totals $5,000 or less during this fiscal year.

6. ACCEPTANCE OF CONTRACT. This contract shall not be considered accepted, approved or otherwise effective until the required approvals and certifications have been given and this is signed by the Board of County Commissioners of the County of Shawnee, Kansas .

7. ARBITRATION, DAMAGES, WARRANTIES. Notwithstanding any language to the contrary, no interpretation shall be allowed to find the County has agreed to binding arbitration, or the payment of damages or penalties upon the occurrence of a contingency. Further, the County shall not agree to pay attorney fees and late payment charges; and no provisions will be given effect which attempts to exclude, modify, disclaim or otherwise attempt to limit implied warranties of merchantability and fitness for a particular purpose.

8. REPRESENTATIVE'S AUTHORITY TO CONTRACT. By signing this document, the representative of the contractor thereby represents that such person is duly authorized by the contractor to execute this document on behalf of the contractor and that the contractor agrees to be bound by the provisions thereof.

9. RESPONSIBILITY FOR TAXES. The County shall not be responsible for, nor indemnify a contractor for, any federal, state or local taxes which may be imposed or levied upon the subject matter of this contract.

10. INSURANCE. The County shall not be required to purchase, any insurance against loss or damage to any personal property to wh ich this contract relates, nor shall this contract require the County to establish a "self-insurance" fund to protect against any such loss or damage. Subject to the provisions of the Kansas Tort Claims Act (K.S.A. 75-6101 er seq.), the vendor or lessor shall bear the risk of any loss or damage to any personal property to which vendor or lessor holds title .

11. AUTOMATED CLEARING HOUSE (ACH). Shawnee County prefers to pay its vendor invoices via electronic funds transfers through the automated clearing house (ACH) network. Shawnee County may require vendors to accept payments via ACH. To initiate payment of invoices, vendors shall execute the County's standard ACH Vendor Payment Authorization Agreement. Upon verification of the data provided, the Payment Authorization Agreement will authorize the County to deposit payment for services rendered or goods provided directly into vendor accounts with financial institutions. All payments shall be made in United States currency.

Director

Title:

10/30/2020

Date:



Date:

ATTEST:


---~-- - --- -----------------------.

ME MO RAND UM

Date: 11/6/2020


From: John Landon Weed Director

SHAWNEE COUNTY

WEED DEPARTMENT 2044 SW WESTERN

TOPEKA, KANSAS 66604 PHON E (785) 251-6931

JOHN LAN DON, DIRECTOR

Re: Authorization and execution of a lease and storage agreement covering propane cylinders for the forklift.

The Shawnee County Weed Department (SCWD) would like to request your approval of the attached lease documents with Propane Central. Currently staff transports propane cylinders secured inside a county vehicle to get them refilled . Staff waits at Propane Central until the canister is filled and brings it back to the shop for use with the forklift. SCWD has two cylinders available for use with the forklift.

Approval of th is request would allow for Propane Central to provide a cage and 5 propane cylinders to be stored and used by the SCWD for use with our forklift. Propane Central would restock the cag e monthly. This would remove the burden of transport off of county staff and allow for more efficient use of county time. The cost would be the same per filled cylinder cost that is currently charged when staff gets a cylinder refilled .

Thank you for your consideration of this request

I

~~::::~~m~D~O Propane Service and

Equipment lease Agreement # 44093

LocatfonAddress. ______________ City, State, ZIP--~·----~----~----

CustomerName --A\C\vi\\(li ( ... <A .. -c>\~ 1 \.\,;e>,it;c;16ustomer 10 _______________ ---t

Phone Numbers 7·1, .:, ·• ),; ") \ • !.,; ct ·;;, \ ~:<.-'\.;.,:.:.;. 140m& PhOne Cei!Phan<i

..

Email Address 'r;\ c·,,, d.-1 .o -\', .:::\•{ -1 (il ··~),\cr .• ,_;<:de I . I -----------------~-~~-~

·~ -~ ServiceAdclress_"""."'-"-';J..("""·· ."-;u~~::::-1-;--:-_;;,=S \,;.c"'-' "'~_,;·..;.: \\A~"i.:,.f''~ "''~1-c~--~~''.:..· -"..L.l. ~~.;,;:.!-¥:'!..~~--'------------'--c..:_.:.:__ '----1

Street

7c.wKc C<Juniy '

... Longltudt<

D!red1qns.--'--'-c------------------------------'-_,..---~-..,..---l

customer: 0 New Acceunt

0 rr;;~nsref ·senliee:

0Additional Service

DE~chang~.

location. Description:

0 Home . [] Cylinder E>:change

q !3f!op 0 Cy!li:idf'lr On~Slte 0 Crop Dryer D' DisjJeriser

.,. .·.

[] 1-:tansport

0 Above Ground Tank i .

D UnderGroundTar:lk DRouted

r::J.wmcau 0 Tank Monitor

0Metered 0 Temp Hea.t D------"---'---~;....,;,_~~~"7"'-'--.,.,

' .. . ·· .

.. ·. .·.

· .. ·

. ·:

. .. .. . .. ·' ..

11 Is ~xpress!)!u~derstooa tttatthe data ~f6rl;fi a~ove-a:nct the.terms ahd-condition~ptinted un the: rev~r5e side.oftl1isforin con!)~!e tll~·propanEt S€fVJce and equtpment le,ase agreement(heren'\ the "Agreemene)between the p~rtles. Custometspectfically.ackn . . . . . ,tptofttt;oPYofthis Agreement and by its execution acceptstl'le refli1s.and provisions set fort,h tinbolh sides hereof: tt.ls ,acknowle:ctgeq tnaf ..... Asree,R')ent provides the n()cessary i;llsclosures pursuant to the Consumer Leasing. Act {15 USC 1667-.etseqc). · FINANCE CHARGE t5!'!. per month •1 $%:1!1n,hu.al!y:\ ....

company BY·---'-'-~_;_~_,_;,_----'----'--~

Form #NG-i'i0001~t2'\3t2 WHITE•OfficeCopy YELLOW- Cuslom~r Copy

2. !t is uudentooc! M~ CUsTOMER is not in brmh of or otdt§mdt in p;:rfimilance cflh:: tt:nns nMl mn(11!t1t:m;;:ur ·tiJ CUSTqiv1ER, Notwiths.wndh~g_anytbing f:Dreg1'1h1A·~9 to the other <iild CUSTOMER willsurreiJderthe Equipmt'iW to normaJvJ~iW ~wd teHr 1\nv· such rzrmin-athni s:h11.1J in no v,.ra1t amount due ao a resuU of <m.ydamJl.~ to r;v6 Equi.pnltllt occu;dng

3 .• HlCATlON A~1l1JS!iOF .EQJ.HPMENT. CUSTClMER :rhJl! notmtwe Erpipm'cnt equipment. lath< cas•.: \!?mobile t:']!iipml.'llL CUStoMER agrees ()_b_tatn .thf t\:.d.~~·::n ,crJns.e!it .of f;O~iPANY :if .Rfr.h E~.1rrfprn ~nt is. t~ i~ e cotsi.m~ptit}n rJf prcpcinc,sasjtro\dded 01ly.br OJMJ>AN.Y~ For ·uh{L7rgrmmd ~uppJ.kr~ {l) C~~TDMER tlgh:es·r~ pay-CO~I~t\NY-fr!r a!!·tust'i Js:-:uc~at~J with or t2i CUSTO~tER agr'i'<1 to .pmdtase the unaerg;c(;tn14. prn:x;r;e crae1tt·q~st·Of a·new tanf. <~r sln~llar des~gJ~·.a~d tapa~·fty;

t(i J\}

Jim!< ell to COMPANY Equipmtrn 911ly.

premi>:::;; forth" prc1rpmr !Ji dl:ll~>>:ring-·pm~tf.lle :gas: i11d ~he ins~al· barriers s.o that such .ingt:ess anrl ~gT·?ss is hliilikeu or hilll1Pered. q}t\.tPAN:Y

rv ·:ti f,ire\lfuu£ condlti;Jrt."aft~r pr\lp~M ga$ h> ddl'Jeti:cl•ir . .lli~!t*·inelltis

.. " ,. : ... ,.. .

and lw·M (Of,il'i\NYlBrmlm fmm and ag•inS\ ar,y ~11,1 a!! d;;ims, liahHfJ]es, et~'~"'~ct\nriWir;b,.CIJS'l'O:r;iER"S >Wilg~, us?, or hanrlHitg of ~he EguipmenL !lf with

,,f ihe E~r:tip!i,enr to CQ,\WA:\Y, urikss saar cbi:i1$.

'in

11. lNDE~rlNIFtCATION, CUSTO~·lfR hereby tmdertakes and dUr~ts t;1 indt'mnil'y illt.J !wld (fi\WANY!Jarm!~~~, frnm :md ;H~~t!Jht mw :1111l a!J da1ms~ tiabi!idt'~, d;Hn<lgt~s~ and t\1H~n~;H) direu ly out ~)r t)l' in l'OIHlecth;n ~~~~ h CUS !'UME!C~; po:;s;!ssion ~md ccmtri.J!; Slor;!~c 1 USl\ or h,;HHillng c;f rhe Equipnwnt ~ or v;it h the !i~it.: 1.\f prnpd!h~ giis) Jl any time dh: i.'nnUnued te:n11 cf thi:; A;;rtt.~li1l'lH ;md tn f(·-d~livcJy uf dlf' Etiuipnh:nt li) CO~~IPANY, unl~ss ~;nch da!m~. !L1hi!iti~s, datna~e;~ 1W e:tpt~ns~~~ Mt; (::mstd hy the omis~iDJF nr CiJ!lHni::~irnh of COMPANY t1r COMPi\NY'S <lgents or t~mplnye,:s.ln the rvt·m nl' ;my claim or :ali! h{Hnin.:;:. COMPt\i{Y t!S G paay whkh ;nl'-;e~ mu OfSTU!dF!(S po~sl'sslnn dnd control, storat:t\ use n handling of Equipment during the term of <ilii Agreement, CUSTm,iER a~re2s tn l!lldert;ke ddcnsc of ilk claim f1r acTion on helwll z;f COMP;'.NY or. at CO)JPANY'S oprinn, to r~imburse COMr.\NY in the amount or kgal com Hnd rraS(i!iHblr morncv r•:e:; for its defense.

12. FOl\CE M,\JEURH. 'l<'itbn !rlB!i bt linhk in deli;ved, nr othe,wis;; ilffcct•:d bv or <:uiiGt'(tion with e:ipi;Jsion, strike, industrbl di>fmh:mn•. m:ident. w;;r. of produ.: t iun, stors1ge or ~r0nsport~ tion, {H' iJnY ot lwr ~~ ~t~l;<~:-; -.,; l;~u ~:.f1t'-':: r NotwiEhst;mding the nblh;ations of this c<mtr;JCi C0\1f',l'iY m:·\ customers in su~h reitson,:Jhk· man:1er as it m.w determine' :md i·n'·-IP.'·?.'

llC'rt':UlEi(?f v!\l;~n peffnrnDJKC is pP~vcnted1

tJf ~n;' ~"''':rnrnun ''~' a\ting rbipl<~t•'<i ;~::,~.:;;~G21di·"i'i:,l~;ks tn tht- GY!~O::'.~ t.::m~:":l(~fi.U. •..:d l·:·::·~~iL

(; ~r;:t,::;J :,!F\\ ~ -F~(_,:",~~ it..: ~,, '· ~;TOtfi:>,~

\

Rev. 10/Zf}J9

AlTACllMENTTO t../~-"1 ,11\ ""'C) SRA WNEE CoUNTY CONTRACT C __ I_/_ (V --< Ve{.

CONTRAC'l'UAL PROVISIONS ATTACHMENT The undorsigned parties agtee that the fo!lov.ing provisions ••• hereby incorporated into tho contract to 1jcll.it is attached an~ rvaJl.oia"art thel\.'Qf, said contract h<ing dated tho """ day of ~ Gr • , 20,ID ~- -

1. TERMS HEREIN CONTROI.L!NG PROVJSIONS. Tt is expressly agreed thnt the terms of each and every provision in this attachment shall pcevail anc\ control over the tem1S of any other conflicting provision in any other dooument relating to and a part of the contract in which this attuclunent is incorporotcd.

2. MJRf.EMENT WITH KANSAS LAW. It is agreed by and between the undersigned that all disputes and matten; whatsoever arising under, in connoction with or incident to this contract shall be litigated, if at all, in and before a Court located in the State of l<,1nsas, U.S.A., to the exclusion of the Courts of aoy other states or colintry, All contractual agreements shall be subject to, governed by, and construed according to tholuws of the Stare of Kansas.

3. TERML'IATION DUE TO LACK OF FUNDINQ Al.'PBOPRIA TIQN. ShtMnee County i• subject tu the Knnsas CIISh Basis Law, K.S,A, l0-1101 ctse'l. If, in the judgment of the Financiai Administrator, Audit-Finance Office, sufficient tunds are not appmpriated to continuo the function performed in this agreement and for the payment of the .charges hereunder, County may terminate thls a~ment at the end of its current fiscal year. County agrees in give Written notice of !ermhudion to contractor at least thirty (30) days prior to the end of its current fiScal year, In the event this agreement is tem1inated pursuant to thi• paragraph, Couuty will pay to tho contractor aU regular contracti)al payments incurred through tho end of such fhcal year. The termination of the contract purs\U!llt to this paragraph shall not cause any pellillty to he charged tu the County or the conlr&ctor.

4. DIS(l.AIMER OF. L!ABILll'Y. Neither the County of Shawnee nor any department thereof shall hold bnnnless or Indemnify any contractor for any liability whatsoever.

5. MJl·DISCRIM!NAT!ON CLAUSE. The contractor agrees: (a) to comply with the Kansas Act Against Discrimination (K.S.A. 44-1001 el seq.) and the Konsa.'! Ago Discrimination in Employment Act, (K.S.A. 44-1111 et seq.) and the applicable provisions of tho America!J.'l With Disabilities Act (42 u.s.c. 12101 et seq.) [ADA] and to not discriminate against nny p~rson because of raceJ religion, color, sex~ disability, national origin or ancestry, ot age in the admission of access to or treatment or employment in, its programs or activities; (b) to include in all solicitations or advertisements for employees, the phrase "eqnal opportunity employer"; (c) to comply with the reporting requirement. set out in K.S.A. 44-!031 and K.S,A. 44-11 16; (d) to include those provisions in every S\lb<ontract or purchase order so that they Ill'¢ binding upon sueb sub<ontractor or vendor; (e) that a failure to comply with the reporting requirementS of(c) above or if !he con!rac!Qr is found guilty of any viol•tion of such· act$ by the Knnsn$ Human J!.ighls Commission, such violation shall constitute a breach of contra~!; (f) if the contru¢ting agency determines' that the contractor has violated applicable .provisiollS of ADA, that violation shall COilstiMe a broach of contract; (g) if (e) or (f) occurs, the contract may h< eanoelled, terminated or suspended in whole ot in part by the County. Purties to this contract understand ihat subsections (b) through (e) of this paragraph numberS are not applicable to a contractor who emploY" fewer than four employ= or whose contr•ct wjth tho C<>unty totB.!s ss,oi>o or less daring this flscltl year.

6, AcCEPTANCE OF CONTRACT. This contract shall not he considered accepted,. approved or otherwise effective until the required approvals and certifications have been given and this Is. signed by the Boutd of County Commissioners of thu County of Sbnwncc, Kansas.

7. ARBITllATION, DAMAGES, WARRANTIES. Notwithstanding any ia!lgtl1lge to the contn>.ry, no intorprebltion sbnU he allowed to find U1o County has agreed to binding arbitration, or the payment of damages or penalties upon Ute occunenco of a contingency. Further, the County shall not agree to pay attorney fees and late payment chatges; and no provisions will be given effect which aUempts to exclude, modify, disclaim or ot'lerwise attempt to limit implied warranties of merchantability a!ld fitness for u particular purpose.

8. R!;PRES!\NTATIVE's A!JTIJORJTY To Col!TRACT. By signing this dooument, the reprcsenblt!ve of the cOhtrnctor thereby represent!! that such person Is duly authorized by the contractor to execute this dooument on he half of tho contrac!l)t und thot the contractor agrees to h< bound by the provisiollS therwf.

9. RESPONSJBIUTY FOR T,\XES. The County shall not be rcsporuible for, nor indemnify a contractor for, any federal, siate or lrn:a\ taxes which may b< imposed or levied upon the subject matter of ihis contract

I 0. INSURANCE. The County shall not be required tu purchase, any insurance ag~insl loss or damage !I) any pmonnl property to which this contract relates, nor shall this contract require the County to O!;tabilsh a "self·insurrince" fund to protect against any such Joss or damage. Subject to the provisions of the Kat!Slls Tort Claims Act (K.S.A. 75-6101 et seq.), the vendor or l~.;sor shall bear the risk of uny loss or damage to any personal fllOperty to which vendor or lessor holds title.

ll. AtrrOMATED C!.EARING ijO!JSE CACH). Shawnee County prefers to pay its vendor invoices vin electronic funds treasfen> thiough the uutomated clearing bouse (ACH) network. Shawnee County may "'quire vendors to accept payments via ACH. To initiate payment of invoices, vendors shall exeeut~ the County's standard ACH Vendor Payment Aulilorization Agreement. Upon verification i>f the data provided, the Payment Authorization Agteement will authorize the County to deposit payment for services rendered or goods pmvided directly into vendor accomits with financial lnstitutions. All paym¢1l!ll shall he made in United Stntes currency.

Date:


William D, Riphabn, Chair

Date:

AT'fF~T:


Fraley, Brandy

From: Sent: To: Subject:

Tracking:

Thank you

Brandy Fraley

Fraley, Brandy Friday, November 06, 2020 9:02AM Brzon, Jonathan RE: lease for propane tanks

Recipient

Brzon, Jonathan

Shawnee County Weed Department 2044 SW Westem Ave Topeka, KS 66604

Phone: 785-251-6931

From: Brzon, Jonathan Sent: Friday, November 06, 2020 8:59AM To: Fraley, Brandy Subject: Re: lease for propane tanks

Thanks With our CPA attached the contract via approved as to form and legality. JCB

Sent from my iPhone

Delivery

Delivered; 11/6/2020 9:02AM

On Nov 6, 2020, at 8:21AM, Fraley, Brandy <[email protected]> wrote:

Here is the signed contractual provisions from Propane Central.

Brandy Fraley

Shawnee County Weed Department 2044 SW Westem Ave Topeka, KS 66604

Phone: 785-251-6931

1

Shawnee County



TOPEKA, KANSAS 66603-3641 785-251-2200

MEMORANDUM

November 6, 2020

TO: Shawnee County Commission

FR: Brian C. Hill

RE: Software Maintenance Agreement

We will be renewing the Annual Software Maintenance agreement with Tyler Technologies. This software is used for our Record Management System. The maintenance period will be from December 1, 2020 to November 30, 2021 at a cost of $203,623.13. This agreement is split between the Sheriff's Office, DOC, Topeka Police, and Topeka Fire. Per the agreement, the Topeka Police & Topeka Fire Department's (City's) portion is $111,666.92. Invoices have been sent to these offices outside of the Sheriff's office for their portions. The Sheriff's Office and DOC's portion is $91,956.21, will be allocated accordingly, and we will use 2020 budget funds.

Please place this on the Thursday, November 12, 2020 consent agenda.

If you have any questions, please let me know.

Sincerely,

\

~(_~~ Brian C. Hill Sheriff, Shawnee County

•• t}!e~~!ies

Remittance:

••• •• Tyler Technologies, Inc.

···~· (FEIN 75-2303920)

•• P 0 Box 203556 Dallas, TX 75320-3556

Questions: Tyler Technologies - Public Safety

Phone 1-800-772-2260 Press 2, then 5 Email [email protected]

Invoice Invoice No Date Page 130-16833 11/01/2020 3 of6

SHAWNEE COUNTY CONTRACT llc'-f7/-~o:lo

Bill To: Shawnee County Sheriff 320 S Kansas Ave Ste 200 Topeka, KS 66603-3641

Ship To: Shawnee County Sheriff 320 S Kansas Ave Ste 200 Topeka, KS 66603-3641

Cust No.-Bii/To-ShipTo 46394 - 18840 - 18840

OrdNo 11998

Date Description Maintenance Start: 01/Dec/2020, End 30/Nov/2021

PO Number

New World Fire Mobile Unit Standard Maintenance - New World AVL

Maintenance Start: 01/Dec/2020, End 30/Nov/2021

New World Multi-Jurisdictional Base LE Records Standard Maintenance

Maintenance Start: 01/Dec/2020, End: 30/Nov/2021

Additional New World Software for LE Records Standard Maintenance - Narcotics

Mgmtllntelligence Maintenance Start: 01/Dec/2020, End: 30/Nov/2021

Additional New World Software for LE Records Standard Maintenance- Pawn Shops


Additional New World Software for LE Records Standard Maintenance - Property Room

Bar Coding Maintenance Start: 01/Dec/2020, End: 30/Nov/2021

Additional New World Software for Fire Records Standard Maintenance - Equipment

Tracking and Maintenance Maintenance Start 01/Dec/2020, End 30/Nov/2021

Currency USD

New World Federal Compliance Reporting for Fire Records Standard Maintenance - NFIRS

5.0 Electronic Reporting Maintenance Start: 01/Dec/2020, End: 30/Nov/2021

New World Fire Records Standard Maintenance Base Package


New World Third Party LE Records Interface Standard Maintenance -On-Line Global

Subjects Interface to State/NCIC Maintenance Start: 01/Dec/2020, End: 30/Nov/2021

New World Third Party LE Records Interface Standard Maintenance -On-Line Orders of

Protection Interface to State/NCIC Maintenance Start: 01/Dec/2020, End: 30/Nov/2021

New World Third Party LE Records Interface Standard Maintenance -On-Line Property

Checks Interface to State/NCIC


New World Third Party LE Records Interface Standard Maintenance -On-Line Wants and

Warrants Interface to State/NCIC Maintenance Start: 01/Dec/2020, End: 30/Nov/2021

Additional New World Standard Maintenance for Corrections Management - Commissary

Interface Maintenance Start: 01/Dec/2020, End: 30/Nov/2021

New World Corrections Compliance Federal & State Reporting MSP Standard Maintenance


New World Data Analysis and Mapping for Corrections MSP Standard Maintenance


Units

34

Terms NET30

Rate

25.70

8,820.21

1,653.67

1,102.45

1,102.45

1,653.67

2,388.64

6,063.46

1,561.80

1,561.80

1,561.80

1,561.80

1,653.67

2,388.64

1,286.19

Due Date 12/01/2020

Extended Price

873.80

8,820.21

1,653.67

1,102.45

1,102.45

1,653.67

2,388.64

6,063.46

1,561.80

1,561.80

1,561.80

1,561.80

1,653.67

2,388.64

1,286.19

•• ••• •• ... ,. Remittance: Invoice

•• Tyler Technologies, Inc. (FEIN 75-2303920) P.O. Box 203556 Dallas, TX 75320-3556


Phone: 1-800-772-2260 Press 2, then 5 Email: [email protected]

Invoice No 130-16833

Bill To: Shawnee County Sheriff

320 S Kansas Ave Ste 200 Topeka, KS 66603-3641

Ship To: Shawnee County Sheriff

320 S Kansas Ave Ste 200 Topeka, KS 66603-3641


OrdNo 11998

Date Description

PO Number

New World Third Party Corrections Interface Standard Maintenance - Inmate Telephone System Interface


New World Third Party Corrections Interface Standard Maintenance- Livescan Interface


New World Imaging Standard Maintenance- LE Public Safety Lineups/Mug Shots


Dashboards for Corrections Management Standard Maintenance


Corrections Management Data Mart Standard Maintenance - Includes 3-4 users


Dashboards for Fire Management Standard Maintenance


Fire Management Data Mart ('CAD, RMS) Standard Maintenance -Includes 3-4 users

Maintenance Start 01/Dec/2020, End: 30/Nov/2021

Dashboards for Law Enforcement Standard Maintenance


Law Enforcement Management Data Mart ('CAD, RMS) Standard Maintenance- Includes 3-4 users


New World AVL Mapping Server Standard Maintenance


New World AVL Playback Feature Standard Maintenance


New World Base CAD/NCIC/Messaging Standard Maintenance


New World Mobile Management Server Standard Maintenance (201-300 units)- Field Reporting Data Merge


New World Field Reporting Server Standard Maintenance

Maintenance Start 01/Dec/2020, End: 30/Nov/2021

Additional New World Software for LE Records Standard Maintenance - Field Investigations


New World Fire Mobile Unit Standard Maintenance- Fire Inspections


New World Federal and State Compliance Reporting for LE Records Standard Maintenance- Federal UCR/IBR


Currency USD

Units

4

4

4

250

250

250

250

250

6

Terms NET30

Rate 1,653.67

1,286.19

3,674.83

1,837.41

229.68

1,837.41

229.68

1,837.41

229.68

4.41

5.51

0 00

0.19

0.93

1,102.45

42.82

2,204.89

Date 11/01/2020

Page 4 of6

Due Date 12/01/2020

Extended Price 1,653.67

1,286.19

3,674.83

1,837.41

918.72

1,837.41

918.72

1,837.41

918.72

1,102.50

1,377.50

0 00

47.50

232.50

1,102.45

256.92

2,204.89

•• ••••• ... ,. Remittance: Invoice

••

Bill To: Shawnee County Sheriff

320 S Kansas Ave Ste 200

Topeka, KS 66603-3641

Tyler Technologies, Inc.

(FEIN 75-2303920)

P 0 Box 203556

Dallas, TX 75320-3556


Phone: 1-800-772-2260 Press 2, then 5

Email [email protected]

Invoice No 130-16833

Ship To: Shawnee County Sheriff

320 S Kansas Ave Ste 200

Topeka, KS 66603-3641


OrdNo 11998

PO Number Currency Terms USD NET30

Date Description New World Law Enforcement Mobile Unit Standard Maintenance - Mobile Message

In-Car Mapping /AVL Maintenance Start: 01/Dec/2020, End: 30/Nov/2021

New World Fire Mobile Unit Standard Maintenance - Fire CAD via Switch


New World Law Enforcement Mobile Unit Standard Maintenance - Field-Based Reporting -

LE Accident Field Reporting Maintenance Start: 01/Dec/2020, End: 30/Nov/2021


LE Accident Field Reporting Compliance Maintenance Start: 01/Dec/2020, End: 30/Nov/2021

New World Law Enforcement Mobile Unit Standard Maintenance - Mobile Message- LE

CAD via Switch Maintenance Start 01/Dec/2020, End: 30/Nov/2021


LE Field Reporting Maintenance Start: 01/Dec/2020, End: 30/Nov/2021

New World Law Enforcement Mobile Unit Standard Maintenance - Field-Based Reporting -LE Field Reporting Compliance


New World Law Enforcement Mobile Unit Standard Maintenance -Mobile Message- LE

State/NCIC via Switch Maintenance Start: 01/Dec/2020, End: 30/Nov/2021


Mobile Upload of Field Reports Maintenance Start: 01/Dec/2020, End: 30/Nov/2021

New World Law Enforcement Mobile Unit Standard Maintenance - Mobile Message

Mugshot Image Download Maintenance Start: 01/Dec/2020, End 30/Nov/2021

New World Mobile on MSP Server Integration Standard Maintenance - AVL CAD Interface

(51-1 00 units) Maintenance Start: 01/Dec/2020, End: 30/Nov/2021

New World Mobile on MSP Server Integration Standard Maintenance - MDT/MCT Base

CAD/RMS Interface (301-500 units) Maintenance Start: 01/Dec/2020, End: 30/Nov/2021

New World Site License Standard Maintenance- CAD, LERMS, and Corrections


New World Site License Standard Maintenance- Fire Records


New World Third Party Maintenance- ArcGIS Advanced Enterprise Server Integration


Units Rate 85 13.12

10 68.94

96 71.98

90 11.23

171 46.77

96 129.78

90 10.21

171 31.18

154 44.96

170 18.38

100 11.95

350 9.19

700 23.63

80 97.61

0.00

Date 11/01/2020

Page 5 of6

Due Date 12/01/2020

Extended Price 1,115.20

689.40

6,910.08

1,010.70

7,997.67

12,458.88

918.90

5,331.78

6,923.84

3,124.60

1,195.00

3,216.50

16,541.00

7,808.80

0.00

•• ••• •• ••••• ... Remittance: Invoice Tyler Technologies, Inc. (FEIN 75-2303920) Invoice No Date Page

6 of6 P 0 Box 203556

Dallas, TX 75320-3556

130-16833 11/01/2020

Bill To: Shawnee County Sheriff 320 S Kansas Ave Ste 200 Topeka, KS 66603-3641

Questions: Tyler Technologies - Public Safety Phone 1-800-772-2260 Press 2, then 5

Email: [email protected]

Ship To: Shawnee County Sheriff 320 S Kansas Ave Ste 200 Topeka, KS 66603-3641


OrdNo 11998

PO Number Currency USD

Terms NET30

Date Description

Au-+o r ;_ ru_ u0cc (

C 35~ -d-O( '1

**ATTENTION** Order your checks and forms from

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Units Rate

Subtotal

Sales Tax

Invoice Total

Due Date 12/01/2020

Extended Price

203,623.13 ~

0.00 ~

203,623.13 ~

Shawnee County



TOPEKA, KANSAS 66603-3641 785-251-2200

MEMORANDUM

October 22, 2020

To: Shawnee County Commission

From: Sheriff Brian C. Hill

Re: Purchase of Vehicles

We will be purchasing a Chevrolet Traverse off of the state contract for $2707 4. 75 and a Dodge Ram 1500 off of the state contract for $245'70.52.

We will use funds from our 2020 Budget.

Please place this on your November 12, 2020 consent agenda.

If you have any questions please let me know.

Sincerely, I

~~\\j_Q Brian C. Hill, Sheriff Shawnee County

Statewide Vehicle Page No. 10

1/2 TON PICKUP TRUCK CONTRACTOR: Davis Moore Automotive CONTRACT:45523

Base Vehicle to comply with State of Kansas Specifications for 112 Ton Pickup Trucks, 4x2 Standard Cab

MANUFACTURER MODEL G.V.W. EPA MILEAGE:

STANDARD EQUIPMENT: Alternator: Battery: Fuel Tank Capacity Tire Size Engine Size Engine HP Mirror Size:

Ram 1500 Reg Cab 4 x 2 6600 GASOLINE, COMBINED E-85, COMBINED

160 AMPS 730 CCA 32 GALS (standard cab) P265/70R17 BSW, All Season 3.6 L 305 54 SQ. IN.

20MPG 14 MPG

OPTIONS MFG. CODE NUMBER Locking rear differential Four Wheel Drive (Reg. Cab) Skid Plates (When ordered with 4X4) Cloth seats Carpet (Reg Cab) Extra set of Ignition/Door Keys (3 sets total) Extra Door key Power windows, locks and Mirrors, remote keyless entry (Standard cab) Power windows & locks (Ext. cab) Power windows & locks (Crew cab) Trailer Towing Package Quad cab with 6'4" Short bed Quad cab with 6'4': short bed and 4-wheel Quad cab with 4 Wheel drive, short bed and V-8 engine (engine size 5.7 L) 10 Ply Tires V-8 Engine Size MPG 32-gallon Fuel Tank Quad and Crew Cabs Crew cab, Two-wheel Drive and 5'5" bed Crew cab, Four-wheel Drive and 5'5" bed Upfitter switches

Topeka Lawrence Manhattan Norton Salina Garden City Pratt Hutchinson All other locations:

EXTERIOR COLORS AVAILABLE:

SHIPPING LOCATION POINT:

$192.72 $382.52 $131.40 $300.76 $113.88

Wichita, Kansas

DSA DS6L62 ADB V9X8 DLR DLR AJH

JPB JP3 JPB JP3 XFH DS1L41 DS6L41 DS6L41

TXN EZH 5.7 L 17 Combined NFX DS1L98 DS6L98 DLR

BASIS FOR PRICING OF NON-SPECIFIED FACTORY OPTIONS: INVOICE

UNIT PRICE

UNIT PRICE $450.00 $1,202.00

no charge

no charge

$91.00 $1,306.00

$Z28.oo $1,775.00

•

•

•

STANDARD WARRANTIES: TOTAL VEHICLE POWERTRAIN

36,000 MILES I 36 MONTHS 100,000 MILES I 60 MONTHS '/\ \, 'lt t 570 ~')&..

l\0\_. 0('-1

rMIDSIZE SPORT UTILITY I CROSSOVER VEHICLE

Statewide Vehicle Page No.7

CONTRACTOR: Don Hattan Chevrolet CONTRACT:45522

Base Vehicle to comply with State of Kansas Specifications for Midsize Sport Utility/Crossover Vehicle with two-wheel drive and to include cruise control, tilt steering wheel, traction control, power windows and locks, rear window defroster, 7 passenger Capacity, rear AC & heat, full size spare tire and wheel, DC power outlet, Mylink radio with Bluetooth, rear vision camera

MANUFACTURER: Chevrolet

MODEL Traverse LS

EPA MILEAGE: COMBINED 21 MPG

STANDARD EQUIPMENT:

Alternator 170 AMPS

Battery 500 CCA

Fuel Tank Capacity 19.4 GALS

Tire Size 255/65/R18

Engine Size 3.6 L

OPTIONS

'if;~fr~J~'ee•t or All wheel dr}ve

lgn'ilionfooor r<ers (3 sets total) ·

Trailer Package

DELIVERY COSTS

MFG. CODE NUMBER

ILS

INV56

DLR

DLR

UNIT PRICE

$24,069.75 •

(

UNIT PRICE

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$425.00

11!76 r. CITY UNIT PRICE PER VEHICLE

Salina

Lawrence

All other locations

SHIPPING LOCATION POINT:

EXTERIOR COLORS AVAILABLE:

Wichita, Kansas

White, Silver, Black

$90.00

$160.00

$1.00 per mile per vehicle

$ J50 ~e/,V.er'f Ct'~J-•

BASIS FOR PRICING OF NON-SPECIFIED FACTORY OPTIONS: INVOICE

STANDARD WARRANTIES: TOTAL VEHICLE: POWERTRAIN:

36,000 MILES I 36MONTHS 100,000 MILES I 60 MONTHS

~~L

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