HomeMy WebLinkAbout13-Fire Department
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CITY OF SAN BERNARDINO - REQUEST FOR COUNCIL ACTION
From: Larry R. Pitzer, Fire Chief Subject:
ORIGiNAL
Resolution authorizing the Purchasing Manager
to issue a purchase order to Fitness Appraisal,
Inc. in the amount of $28,700.00 to perform
physical baseline evaluations for the Fire
Department Wellness and Fitness Program.
Dept: Fire
Date: August 26, 2003
MC/C Meeting Date:
September 15, 2003
Synopsis of Previous Council Action:
03/18/02
Resolution #2002-91 authorization to submit a grant application to the Federal Emergency
Management Agency (FEMA) in the amount of$105,728.
RECOMMENDATION:
Adopt resolution.
Contact Person: Larrv R. Pitzer. Fire Chief
Phone: 384-5286
Supporting data attached: Staff Report and Resolution
Ward: Citywide
FUNDING REQUIREMENTS: Amount:
$28.700.00
Source:
(Acct. No.) 123-706-5505
(Acct. Description) Federal & State Program-
Wellness Fitness Grant-Other Professional Services
Finance:
Council Notes:
K~o;I.iLC:CJ:S--d .sl;.-~
Agenda Item No.
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STAFF REPORT
SUBJECT
Resolution authorizing the Purchasing Manager to issue a purchase order to Fitness Appraisal,
Inc. in the amount of $28,700.00 to perform physical baseline evaluations for the Fire
Department Wellness and Fitness Program.
BACKGROUND
On March 18,2002, the Mayor and Common Council approved resolution #2002-91 authorizing
the Fire Department to submit a grant application to the Federal Emergency Management
Agency for fire operations and firefighter safety to develop and implement a Wellness and
Fitness Program.
The San Bernardino City Fire Department (SBCFD) was awarded the grant in December 2002
and was required to match 30% of the cost to develop and implement the program. Due to
budget issues the City's General Fund in Fiscal Year 2002/2003 was unavailable to fund the cost
share.
San Manuel Band of Mission Indians donated the required cost share, $45,312.00, to implement
the program. This joint venture has allowed the SBCFD and San Manuel Indian Fire Department
(SMIFD) to proceed to establish a Wellness and Fitness Program within respective departments.
One of the elements of this program was the establishment of a Wellness and Fitness Program.
The Wellness and Fitness Program will be designed to improve the health and longevity of
firefighters and increase their productivity and performance. The program will follow the
International Association of Fire Chiefs and Firefighters Wellness and Fitness Program
guidelines. We will utilize the funds to purchase equipment for all fire stations, physical and
assessment examinations, and an immunization program.
On August 5, 2003 notices were distributed to the San Bernardino Area Chamber of Commerce,
the City's Web Site, and advertised in The Sun Newspaper inviting bids from qualified vendors
for health assessment services for Fire Department Wellness and Fitness Program. Bid
Specification #F 04-016 packages were mailed to five (5) vendors including 2 local vendors. On
August 21, 2002 the city received and reviewed one (1) bid response from Fitness Appraisal, Inc.
SBCFD is requesting authorization to issue a purchase order to Fitness Appraisal, Inc. to perform
physical baseline evaluations on 144 of SBCFD safety employees and 20 of SMIFD safety
employees; for a total of 164 firefighters. The evaluations conducted will assess each fire safety
employee on how to develop and maintain appropriate levels of physical fitness.
Pursuant to the City's bidding process, it is recommended that Fitness Appraisal, Inc. meets
technical specifications and be issued a purchase order under Bid #F 04-016 for services to
provide physical baseline evaluations.
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FINANCIAL IMPACT
The total dollar amount of $28,700 IS available III account number 123-706-5505 (Other
Professional Services)
RECOMMENDATION
Adopt resolution.
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RESOLUTION N~V
RESOLUTION OF THE MAYOR AND COMMON COUNCIL OF THE CITY OF SA;-'!
BERNARDINO AUTHORIZING THE PURCHASING MANAGER TO ISSUE A
PURCHASE ORDER TO FITNESS APPRAISAL, INC. IN THE AMOUNT OF 528,700.00
TO PERFORM PHYSICAL BASELINE EVALUATIONS FOR THE FIRE DEPARTMENT
WELLNESS AND FITNESS PROGRAM.
BE IT RESOLVED BY THE MAYOR AND COMMON COUNCIL OF THE CITY OF SAN
BERNARDINO AS FOLLOWS:
SECTION 1. Fitness Appraisal, Inc. is the only responsible bidder to perform physical
baseline evaluations for the fire department (Attachment A), for total amount not to exceed
$28,700.00, in accordance with Bid Specification F 04-0]6, and, as such the Purchasing Manager is
authorized to issue a standard purchase order to Fitness Appraisal, Inc.;
SECTION 2. The Fitness Appraisal, Inc. Purchase Order shall incorporate by reference this
Resolution and Bid Specification F 04-016;
SECTION 3. The authorization to execute the above referenced Purchase Order is rescinded
ifnot issued within sixty (60) days of the passage of this Resolution.
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RESOLUTION OF THE MAYOR AND COMMON COUNCIL OF THE CITY OF SAN
BERNARDINO AUTHORIZING THE PURCHASING MANAGER TO ISSUE A
PURCHASE ORDER TO FITNESS APPRAISAL, INC. IN THE AMOUNT OF S28,700.00
TO PERFORM PHYSICAL BASELINE EVALUATIONS FOR THE FIRE DEPARTMENT
WELLNESS AND FITNESS PROGRAM.
I HEREBY CERTIFY that the foregoing resolution was duly adopted by the Mayor and
Common Council of the City of San Bernardino at a
meeting thereof, held on the
day of
,2003, by the following vote, to wit:
Council Members
AYES
NAYS
ABSTAIN ABSENT
ESTRADA
LONGVILLE
McGINNIS
DERRY
SUAREZ
ANDERSON
McCAMMACK
Rachel G. Clark, City Clerk
The foregoing resolution is hereby approved this
day of
,2003.
Judith Valles, Mayor
City of San Bernardino
Approved as to form
and legal content:
James F. Penman
City Attorney
B{f- ?fh_
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Attachment "A"
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Submitted By:
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Bob Antonacci, MS
Exercise Physiologist
President & CEO
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FITNESS APPRAISAL, INC.
RFQ F-04-016
HEALTH CARE SERVICES
FOR FIRE DEPARTMENT
WELLNESS AND FITNESS
PROGRAM
Fitness Appraisal, Inc. (FAI) was established in 1981 to provide a system of
wellness, medical and fitness services for public agencies. FAI is one of the
largest wellness providers for public sector groups in the United States.
We mobilize our services to the work site. A staff of two Exercise Physiologists
will administer the confidential wellnesslfitness screenings to one fire fighter at a
time.
In business for twenty-one years, Fitness Appraisal, Inc. has a long list of fire
department clients and other public safety entities including:
=> Solana Beach Fire Department
=> Big Bear Lake Fire Department
=> Rancho Santa Fe Fire Department
=> Murrieta Fire Department
=> Benicia Fire Department
=> Lakeside Fire Department
=> Apple Valley Fire Department
=> California Department of Fish & Game
=> California Department Of Forestry.
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STATEMENT OF COMPLIANCE
Fitness Appraisal's Wellness-Fitness Program complies with the following
agencies requirements and recommendations:
. Fitness Component outlined in the IAFC & IAFF Service Joint Labor
Management Well ness-Fitness Initiative
. NFPA 1583 Standards on Recommended Practice For Fire Fighter Physical
Performance and Conditioning Program
. OSHA Safety Order Section 5144 concerning respirator compliance
certificates
"A program of physical fitness, health and wellness should be an
objective at every fire department as a means for potentially
reducing fire fighter injuries. The program should be designed to
enable members of the department to develop and maintain
appropriate levels of physical fitness. /I
CONFIDENTIALITY POLICY
Fitness Appraisal, Inc. will comply with the following recommendations regarding
confidentiality.
"Confidentiality of medical information is a critical aspect of the WellnesslFitness
Initiative The Task Force agrees that all information obtained from the medical and
physical evaluations is confidential, and the employer will only have access to
information regarding fitness for duty, necessary work restriction, and appropnate
accommodations. The Task Force also agrees that all medical information must be
maintained 111 separate files from all other personnel information"
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WELLNESS PROGRAM
ADMINISTRATION QUALIFICATIONS
Blood Draw:
Lydia White is a certified Phlebotomist who has been conducting blood draws for
Fitness Appraisal, Inc. since 1993.
WellnessIFitness Assessments:
Bob Antonacci, MS Exercise Physiologist and President of Fitness Appraisal, Inc.
will be administering the wellnesslfitness assessments.
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BOB ANTONACCI
P.o. Box 130517
Carlsbad, Ca 92013
(760) 436-2965
EDUCATION: Iowa State University, Ames, Iowa
Master of Science in Education, Applied Exercise Physiology
. Awarded in August May 1978
Bachelor of Science Dooree in Phvsical Education
. Awarded in May 1976
PROFESSIONAL EXPERIENCE:
.
1981-Present President & CEO
Fitness Appraisal, Inc~, Carlsbad, CA
CERTIFICATIONS:
* California Preliminary Single Subject Teaching Credential-
Physical Education
* American College of Sports Medicine Exercise Technician
* American College of Sports Medicine Exercise Specialist
* Advanced Cardiac Life Support
* Basic Life Support
PUBLICATIONS:
PacifiCare Health And Wellness Guide, 1994
PacifiCare Senior Version Health And Wellness Guide, 1995
ATHLETIC ACHEIVEMENTS:
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Broke Guinness Book Of World Records For Most Push-Ups In 30 Minutes: 1,630
Two-Time All-American Wrestler At Iowa State University
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WELLNESS/FITNESS TESTING PROTOCOL
1. Lifestyle Questionnaire
2. Three Day Dietary Analysis
3. Blood Profile
. Glucose
. BUN
. Creatinine
. Cholesterol
. HDL
. LDL
. Triglycerides
. Total Bilirubin
.
. Calcium
. Phosphorus
. Sodium
. Potassium
. Chloride
. Uric Acid
. Total Protein
. Albumin
. Alkaline
Phosphates
. LDH
. SGOT/AST
. SGPT/AL T
. Globulin
. A1G Ratio
. ChollHDL Ratio
. GGT
4. Resting Blood Pressure & Heart Rate
5. Height & Weight
6. Respiratory Assessment (Pulmonary Function)
. FVC
. FEV1
7. EKG Monitored Sub-Maximal Treadmill Exercise Test
8. Body Composition Analysis- (skinfolds & hydrostatic)
9. Lower Back Flexibility Assessment- A series of back flexibility
measurements in the lower back, hamstrings and hip flexor (back pain
prevention)
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10. Grip Strength- Utilizing a grip hand dynamometer
11. Maximum Push-Ups
12. Two Minute Abdominal Curls Test
13. Vertical Jump
14. Computerized Reports And Consultation
. Reports on screening parameters
. Heart disease risk reduction profile
. Back injury and pain prevention program
. Exercise program recommendations (strength, cardiovascular & flexibility)
Nutrition recommendations
. Physical Perfonnance Standards Score
. Muscular Strength Age Score
. Muscular Endurance Age Score
. Cardiovascular Age Score
. Body Type Age Score
. Flexibility Age Score
. Overall Physical Fitness Score
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IMPLEMENTATION STRUCTURE:
The blood draws will be conducted in early September. Six days will be allocated to
accommodate two days per shift. Blood draws will be administered from 7:30-9:30
each day. The blood draw will be conducted at a centrally located fire station.
The Lifestyle Questionnaire and the Respiratory Questionnaire (if this option is
selected) will be distributed at the blood draw. These forms need to be completed
prior to the wellnesslfitness assessment.
The wellnesslfitness assessment will be schedule one week following the blood
draw. One fire fighter will be evaluated at a time in a confidential setting every 90
minutes. It takes 60 minutes to conduct the wellnesslfitness screenings and 30
minutes for consultations. Each fire fighter will receive a copy of their lab results and
a twenty page wellnesslfitness report displaying wellnesslfitness scores and
guidelines conceming nutrition and exercise at the end of the 90 minute sessions.
After the completion of the wellnesslfitness screenings A corporate summary report
will be processed displaying average scores in all health and fitness parameters,
number of fire fighters outside physiological and health parameter ranges and the
number of fire fighters with high health risk factors. Furthermore, overall fire
department recommendations will be issued concerning nutrition and exercise.
Four to six fire fighters will be evaluated per day. Approximately seven weeks will be
allocated for screening 170 fire fighters. If the blood draws begin the week of
,
September 8, 2003 and the screenings begin September 15, 2003. The screening
process can be completed by November 1, 2003.
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FIRE FIGHTER PHYSICAL PERFORMANCE
SCORE
The following physiological parameters have a high statistical correlation
(utilizing criterion-related validity tests) with actual fire fighter job tasks. Thus,
the combination of these physiological parameters is used to calculate a
wellness-fitness score.
o Max V02 Consumption- (predicted from a sub-maximal treadmill test)
o Body Composition Analysis- Lean Body Weight & Body Fat %
(skinfolds & hydrostatic weighing techniques)
o Grip Strength (upper body strength)
o Vertical Jump (lower body power)
o Abdominal Curts (muscle endurance)
o Cardiovascular Disease Risk Profile (blood pressure, smoking, activity status,
cholesterol, HDL and glucose)
The Physical Performance Score ranges between 900-1800. Recommendations for
improvement will be provided for fire fighters who are deficient (below the ideal
values displayed in the literature for a fire fighter) in selective parameters. Improving
in the deficient area(s) will result to an increase in the wellness-fitness score.
Emphasis will be placed on the improvement of the well ness-fitness score, not the
absolute value.
The Physical Performance Score is intended to be used as a measurement against
the fire fighter's previous examinations. The importance of comparing the well ness-
fitness score each year is demonstrated in the following study. The study displays
the relationship between increasing the wellness-fitness score (regardless of the
absolute score) and the lower risk of job related injury.
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PHYSICAL PEROFRMANCE SCORE AND
WORKER'S COMPENSATION STUDY
Summary:
o Over a six-year period, police officers experiencing an increase in the
Physical Performance Score were significantly less likely to file a
Workers' Compensation claim. Individuals experiencing a decrease in
scores were more likely to file a claim.
Study:
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o The study population consisted of 61 police officers from Escondida,
California (EPD), who completed a Fit-Far-Duty evaluation. The study
group was screened annually during the study period of 1988 - 1993.
o The Physical Performance Score was calculated from the following
biometrics data: Body fat percentage, lean body weight, aerobic
capacity, muscular strength & endurance, leg power, total cholesterol
& HDL, blood pressure, glucose intolerance and smoking.
Results:
=:> On average, the EPD experienced 21 claims per year, at an approximate cost of
$3,200 per claim.
=:> Physical Performance Scores must increase at least 30 points per year, to avoid
increases in Workers' Compensation claims (Arrow 2).
=:> If no annual improvements occurred in the Physical Performance Scores, a
company of 100 employees would experience an overall increase of 7 claims per
year. (Arrow 1)
::;!; For a company with 100 employees, an annual Wellness-Fitness Score increase of 40 -
50 points relates, on average, to a decrease of 3 Workers' Compensation claims per
year. (Arrow 3).
Fit-For-Duty Scores and
Workers' Compensation Claims
a.~ in Annual Clabn. per 100 anploy...
/5
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-/0
Otang:r in Annual Pcrfonnancr Score
(1988 - 1993)
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PHYSICAL PERFORMANCE STANDARDS
SCORE CALCULATIONS
PARAMETER
POINTS EARNED
Fat %
Every 1 % of body fat will decrease score by 1.64
points.
Ex. Body fat % of 19% will decrease score by 31
points.
Body Weight
Every pound will decrease score by .63.
Ex. 180X.63=-113.
Lean Body Weight (LBW)
Every pound of LBW will increase score by 2.64.
Ex. LBW of 150.160 X 2.64= 422 points.
Grip Strength
Every 1 kg of grip strength will increase score by
2.64 points.
Ex. Grip strength of 60 kg. 60 X 2.64= 158
points.
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Two Minute Abdominal Curls
Every one abdominal curl will increase score by
2.08.
Ex. Abdominal curls =80. 80 X 2.08= 166 points
Vertical Jump
Every inch of vertical jump will increase score by
5.74 points.
Ex. Vertical jump = 18. 18 X 5.74 103 points
Maximum Oxygen Consumption Every 1 ml will increase the score by (2-3
points).
Ex. V02 = 45. 42 X 2.8 = 126 points.
Maximal Heart Rate
Every heart beat will increase the score by .95
points.
Ex. Maximum heart rate = 188. 188 X .95= 179
points.
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Coronary Disease Risk Score*" Score 18-25= +40 Points.
Score 26-35= (3&-Score) X 4 points.
Score 36 += Score X-4 points.
Constant Each score will receive a constant of 451 points.
Taraet Phvsical Performance Score = 1.500
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FITNESS APPRAISAL, INC. PUBLIC AND PRIVATE
. CLIENT REFERENCES - 2003 CURRENT
Kyrene School District (completed a 4 year program in 2002)
Administration of comprehensive wellness services for 18 school sites.
1999 participation rate was 728 (62%).
Sharla Reid
480-783-4017
YAVAPAI County Combined Trust (completed a 4 year program in 2003(
Administration of comprehensive wellness services for YAVAPAI County,
Prescott City, Presocott Fire & Police Department, YAVAPAI County Sheriff,
YAVAPAI County Community College.
Mark Alver
520-776-6201
Department Fish & Game
Administration of physical performance standards test for incentive pay
program
Jack Edwards
(916) 653-9950
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California Department Of Forestry
Administration of physical performance standards test for fire fighters
Dqn Diroll
,
(916) 445-8241
Escondido Police Department (completed a 14 year program in 2001)
Administration of Fit For Duty program
Dana Ray
(760) 741-4747
Novato Fire Department
Administration of Fit For Duty program
Dan Norton
(415) 878-2690
Solana Beach Fire Department
Administration of Fit For Duty program
Chief Holmerud
(619) 755-1179
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Big Bear Lake Fire Department
Administration of Fit For Duty program
John Morley
(909) 866-7566
Murrieta Fire Department
Administration of Fit For Duty program
Mario Monroy
(909) 698-8977
Rancho Santa Fe Fire Department
Administration of Fit For Duty Program
Nick Pavone
(619) 756-5971
Apple Valley Fire Department
Administration of Fit For Duty Program
Chief Art Bishop
(760) 247-7618
Lakeside Fire Department
Administration of Fit For Duty Program
Ken Kremensky
(619) 390-2365
Befleica Fire Department
Administration of Fit For Duty Program
Mike Tessier
707-746-4272
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PRICE SCHEDULE
WELLNESS/FITNESS PROGRAM COST PER PARTICIPANT:$175.00
OPTIONAL SERVICES (cost per participant):
Six Month Well ness/Fitness Evaluation $85.00
(Blood Pressure, Body Fat-skinfold technique, Grip Strength, Vertical Jump, EKG
Treadmill, Physical Performance Score, Pre-Post Comparisons Reports & Consult)
Optional Blood Parameters:
. PSA for males 40 and over $45.00
. CBC $25.00
. C-Reactive Protein (CRP) $45.00
CRP levels (produced by the liver) increase in the blood when the
arteries are inflamed. Heart attacks are triggered when inflammation
causes deposits (high cholesterol causes fatty buildups in the blood
vessels) to break off and clog an artery. Males with elevated CRP levels
have a 3-fold increase in heart attack or stroke risk and females with
elevated CRP levels have a 7 -fold increase in heart attack or stroke risk.
CRP can identify risk for heart disease among a population with normal
cholesterol levels. Half of all heart attacks in the U.S. occur in people
with normal cholesterol levels,
. Heb C Antigen (exposure)
. Heb B Antigen (exposure)
. Hearing & Vision
$60.00
$50.00
$40.00
Respiratory Compliance Questionnaire Administration
!~... f( '/
Bob Antonacci, MS
President & CEO
$10.00
8113103
Fitness Appraisal, Inc.
P.O. Box 130517
Car1sbad, CA 92013
760436.2965
760436-2976 (FAX)
fitnessappraisal.com
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APPENIX A
FITNESS APPRAISAL, INC. EKG TREADMILL
POLICY
The NFP A 1582 Standard on Medical Requirements For Fire Fighters (1992 Edition) stated in
Section B-3.2 Periodic Medical Evaluations, "No finn guidelines for stress electrocardiography
in asymptomatic individuals have been developed. There have been problems with false
positive results from this testing, especially in younger age groups."
False positive test occur more frequently in asymptomatic individuals who are stressed beyond
85 percent of their maximal efforts. Thus, it is the policy of F AI to conduct sul>-maximaJ stress
test to determine functional capacity (Max V02), a paramount performance parameter for fire
fighters.
The American College Of Sports Medicine (ACSM) Guidelines For Exercise Testing and
Prescription states that physician supervision is not recommended when administering suI>-
maximal stress test on asymptomatic apparently healthy and higher risk males and females
regardless of age. However, if conducting maximal stress testing on males 40 and over and
females 50 and over requires physician supervision. We comply with the ACSM
recommendations.
We utilize the EKG monitor to accurately determine heart rate (used in the prediction of the
Max V02 score and the determination of85% heart rate) and to observe rhythm abnormalities.
Furthennore, we monitor blood pressure as guideline for test termination in the event of a
hypertensive or hypotensive response. If we observe rhythm and/or conduction abnormaIities
on the EKG, exercise induced chest discomfort, extreme leg fatigue, dizziness, hypertensive
and hypotensive response during the treadmill test we referrer this individual to participate in a
maximal treadmill exam conducted with physician supervision.
Furthermore, we recommend males who are 40 and over and females who are 50 and over
who have high cholesterol (24 Or more), low HDL (below 35) high blood pressure and
diabetes participate in a maximal treadmill stress test with physician supervision. This complies
with the NFPA 1582 Standard on Medical requirements for Fire Fighters (8-3.2 Periodic
Medical Evaluations) and the Guide to Clinical Preventive Services report of the U.S.
Preventive Services Task Force.
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PRICE FORM
REQUEST FOR QUOTES:
RFQ F-04-016
DESCRIPTION OF RFQ:
Health Care Services for Fire Department Wellness
and Fitness Program
FITNESS APPRAISAL, INC.
BIDDER'S NAME/ADDRESS:
P.O. BOX 130517
CARLSBAD, CA 92013
NAMEfTELEPHONE NO. OF
AUTHORIZED REPRESENTATIVE
ROBERT ANTONACCI 760-436-2965
.
ANNUAL PURCHASE ORDER
Effective on or about July 1, 2003 through June 30, 2004 plus two single year options,
for City's partial requirements, on an as-needed basis, with no guaranteed usage for
flealth Care Services for Fire Department Wellness and Fitness Program.
Option year one, if exercised, shall be effective July 1, 2004 through June 30, 2005.
Option year two, if exercised, shall be effective July 1, 2005 through June 30, 2006.
Actual option year pricing shall be negotiated with the successful Bidder(s) prior to
exercising of any given option year. Option years shall become effective only upon
issuance by the City of a duly authorized Purchase Order.
Please provide detailed Firm Fixed Price cost information in the spaces provided below
and any other incidental or additional costs required to complete the Technical
Specification requirements.
Price per participant: $175.00
Optional Services:
Respiratory Medical Questionnaire Administration: $10.00/participant
C-reactive Protein Blood Profile: $45.00/participant
PSA- Prostrate Cancer Screening for males 40 and over: $45.00/each
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ATTACH YOUR PRICE PROPOSAL TO THIS BID DOCUMENT
.
Are there any other additional or incidental costs that will be required by your . m in
order to meet the requirements of the Technical Specifications? Yes / No
(circle one). If you answered "Yes", please provide detail of said additional costs:_
Please indicate any elements of the Technical Specifications that cannot be met by
your firm.
Have you included in your bid all informational items and forms as reqUested?(~~)
~ (circle one). If you answered "No", please explain:
.
This offer shall remain firm for 90 days from RFO close date.
Terms and conditions as set forth in this RFO apply to this bid.
Cash discount allowable
Net thirty (30) days,
%
days; unless otherwise stated, payment terms are:
In signing this bid, Bidder warrants that all certifications and documents requested herein are
attached and properly completed and signed.
From time to time, the City may issue one or more addenda to this RFO. Below, please
indicate all Addenda to this RFO received by your firm, and the date said Addenda was/were
received.
.
Verification of Addenda Received
.
Addenda No: ~~_____n_ Received on: __________
Addenda No: ____n____ Received on: _________
Addenda No: _n_______ Received on: _________
AUTHORIZED SIGNATURE:
PRINT SIGNER'S NAME AND TITLE:
ROBERT ANTONACCI, PRESIDENT
DATE SIGNED:
8/13/03
COMPANY NAME & ADDRESS:
FITNESS APPRAISAL, INC.
P.O. BOX 130517
CARLSBAD, CA 92013
PHONE: 760-436-2965
FAX: 760- 436-2976
.
IF SUBMITTING A "NO BID", PLEASE STATE REASON(S) BELOW;
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NON. COLLUSION AFFIDAVIT
TO:
THE COMMON COUNCIL, CITY OF SAN BERNARDINO
In accordance with Title 23, United States Code, Section 112, the undersigned hereby
states, under penalty of perjury:
That he/she has not, either directly or indirectly, entered into any agreement.
participated in any collusion, or otherwise taken action in restraint offree
competitive bidding in connection with RFQ F-04-016.
Business Name___~~!~!~_~_~~!'.!l_A_I s~~.!-_~~~.:.
Business Address___~-=~.__~~~_!_3_~~~~~_<:"~~LSBAD, CA 9201:
Signature of bidder x____ct_____~___
___~~S_~~IT~~J__Q~____________
Place of Residence
Subscribed and sworn before me this ___L~___ day of _!.2~ t<{) r.._____.
Q08
Notary Public in and for the County of __~__j)_~___, State of
California.
My commission expires _________.rj.22______. 209_~.
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"CommissIon 111265<<3 -
~ -.: - Notary Publlc - Cofifaria f
I Son Diego Counly . f
- ~: ~ ~~~~~~~~~
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STAFF REPORT
SUBJECT /
Resolution authorizing the Purchasing Manager to issue a purchase order tOi~ess Appraisal,
Inc. in the amount of $28,700.00 to perform physical baseline eval~tions for the Fire
Department Wellness and Fitness Program. /
BACKGROUND ~
On March 18,2002, the Mayor and Common Council approved solution #2002-91 authorizing
the Fire Department to submit a grant application to the ederal Emergency Management
Agency for fire operations and firefighter safety to devel and implement a Wellness and
Fitness Program.
The San Bernardino City Fire Department (SBCFD) w, s awarded the grant in December 2004
and was required to match 30% of the cost to dev op and implement the program. Due to
budget issues the City's General Fund in Fiscal Ye 2002/2003 was unavailable to fund the cost
share.
San Manuel Band of Mission Indians donated e required cost share, $45,312.00, to implement
the program. This joint venture has allowed e SBCFD and San Manuel Indian Fire Department
(SMIFD) to proceed to establish a Wellnes and Fitness Program within respective departments.
One of the elements of this program w s the establishment of a Wellness and Fitness Program.
The Wellness and Fitness Program ill be designed to improve the health and longevity of
firefighters and increase their pro ctivity and performance. The program will follow the
International Association of Fir Chiefs and Firefighters Wellness and Fitness Program
guidelines. We will utilize the nds to purchase equipment for all fire stations, physical and
assessment examinations, and immunization program.
On August 5, 2003 notices ere distributed to the San Bernardino Area Chamber of Commerce,
the City's Web Site, and a vertised in The Sun Newspaper inviting bids from qualified vendors
for health assessment rvices for Fire Department Wellness and Fitness Program. Bid
Specification #F 04-01 packages were mailed to five (5) vendors including 2 local vendors. On
August 21, 2002 the ty received and reviewed one (I) bid response from Fitness Appraisal, Inc.
SBCFD is request" g authorization to issue a purchase order to Fitness Appraisal, Inc. to perform
physical baselin evaluations on 144 of SBCFD safety employees and 20 of SMIFD safety
employees; for total of 164 firefighters. The evaluations conducted will assess each fire safety
employee on ow to develop and maintain appropriate levels of physical fitness.
Pursuant t the City's bidding process, it is recommended that Fitness Appraisal, Inc. meets
technical specifications and be issued a purchase order under Bid #F 04-016 for services to
provide hysical baseline evaluations.
** FOR OFFICE USE ONLY - NOT A PUBLIC DOCUMENT **
RESOLUTION AGENDA ITEM TRACKING FORM
Meeting Date (Date Adopted): q - 15().3 Item #
Vote: Ayes 1- '1 Nays ..er
'lDO'3-> ;;;JS~
\3 Resolution #
Abstain 1Cr
Absent .g-
Change to motion to amend original documents:
Reso. # On Attacbments: / Contract term:
Note on Resolution of Attacbment stored separately: ---==---
Direct City Clerk to (circle 1): PUBLISH, POST, RECORD W/COUNTY By:
Date Sent to Mayor: q - \ '1- 0.5
Date of Mayor's Signature: q _. I ~l-O?,
Date ofClerklCDC Signature: c'l-lO'--Q",
Date M o/Letter Sent for Signature:
60 Day Reminder Letter Sent on
90 Day Reminder Letter Sent on 45th day:
See Attached:
See Attached:
e
Request for Council Action & Staff Report Attached:
Updated Prior Resolutions (Other Than Below):
Updated CITY Personnel Folders (6413, 6429, 6433,10584,10585,12634):
Updated CDC Personnel Folders (5557):
Updated Traffic Folders (3985, 8234, 655, 92-389):
Copies Distributed to:
City Attorney /
Parks & Rec.
Code Compliance Dev. Services
Police Public Services Water
Notes:
NullNoid After: loG D~r;, ( 11- "....\ -0 3
Reso. Log Updated: "../
Seal Impressed: ------
Date Returned: -
Yes~ No By
Yes No-?- By
Yes NoL By
Yes No v By
Yes No v' By
EDA
Finance /
Se..e
MIS
Others:
BEFORE FILING, REVIEW FORM TO ENSURE ANY NOTATIONS MADE HERE ARE TRANSFERRED TO THE
YEARLY RESOLUTION CHRONOLOGICAL LOG FOR FUTURE REFERENCE IContract Term, etc.)
Ready to File: _
Date:
Revised 0i/12/01