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DocuSign Envelope ID:9A043OD9-7ACC-4C25-8C5E-7A2CO072060E <br /> Health Department(hereinafter referred to as"OCHD") <br /> Additional Terms and Conditions <br /> These are additional terms and conditions to the Agreement between Orange County and the <br /> (PROVIDER) to the Countywide ASL Interpreter Translator Contract of$15,000 or less. The <br /> additional terms and conditions shall supersede any terms in the original contract and are hereby <br /> incorporated as follows: <br /> Add to Section 2.b <br /> vi the Provider is required to sign the OC,HD Conditions of Contract <br /> Statement containing the confidentiality, Title X and public health activities <br /> in emergency situations information which is hereby incorporated by <br /> reference <br /> Add to Section 2 d.i 3 the following sentence: <br /> the Provider should generally instruct clients to call the Health <br /> Department front desk staff or the Spanish voicemail line at 644-3350 <br /> (when language appropriate) to schedule an appointment or to inquire <br /> about services <br /> Add Section 2 e <br /> e Medical Documentation Prior to beginning work,the Provider is required to: <br /> i.. Provide proof of immunity to varieella, measles,mumps and rubella Proof <br /> of immunity must be one of the following: medical records diagnosing the <br /> disease, laboratory records confirming the disease, laboratory records <br /> documenting positive disease titers, or medical records documenting receipt <br /> of 2 doses of each vaccine (Exception: If the Provider has documentation <br /> of only one dose of vaccine, the Provider must provide documentation of a <br /> second dose within 60 days of the first day of contract work.) <br /> ii Provide proof of a IB screening and results to OCHD the screening can <br /> be one of the following: <br /> 1 Receipt of a TB skin test (ISI) if the Provider has no history of IB <br /> infection/disease or of a positive TSI (Note: If the Provider has not <br /> had an additional I S I within the pr evious 12 months, a second T S I <br /> will be required one week after the first to establish an accurate <br /> baseline.) <br /> 2 Completion of a TB Screening Form by a medical provider if the <br /> Provider has a history of IB disease or of having a positive I SI <br /> iii.Provide proof of Idap vaccine. <br /> iv Provide proof of current influenza(flu)vaccine. <br /> Revised 06/15 6 <br />