2024-224-E-Human Resouces-Select Physical Therapy-Poet-Fit for duty testing job analyes

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1 AGREEMENT THIS AGREEMENT is by and between WorkSTEPS, Inc., a Texas corporation located at University Business Park, 3019 Alvin Devane, Suite 150, Austin, Texas , 78741 (“WorkSTEPS”), Select Subsidiaries, Inc. on behalf of its subsidiaries and affiliates, with corporate offices located at 4714 Gettysburg Road, Mechanicsburg, PA 17055 (“PROVIDER”) and Orange County, a local political subdivision of the State of North Carolina, located at 200 South Cameron Street, Post Office Box 8181, Hillsborough, North Carolina . (“COMPANY”), collectively (“THE PARTIES”). WHEREAS: COMPANY is desirous of implementing a functional employment testing program as a part of its work injury and disability management program, to, among other reasons, effectuate a reduction of on- the-job injuries by trying to determine if an applicant or employee can safely perform the essential functions of the job. WHEREAS: WorkSTEPS has developed functional employment testing protocols and procedures that COMPANY desires to utilize for its functional employment testing program, and WHEREAS: WorkSTEPS desires to assist COMPANY in implementing the WorkSTEPS functional employment-testing program, THEREFORE, THE PARTIES HERETO DO HEREBY AGREE AS FOLLOWS: Based on the functional employment test(s) and services that have been identified below the price for the test(s) and services shall be: Functional Testing Services Price Approve (Initial)  Comprehensive Post Offer Functional Employment Testing $200.00  Post-Employment/Fit-For-Duty/Return to Work Testing $200.00  Basic Carpal Tunnel Evaluation N/A  Upper Quadrant / Carpal Tunnel / Post-Offer Evaluation N/A  Job Analysis and Validation Process (*$200.00 per hour plus travel expenses related to transportation, lodging, meals, tec., to be billed at the rate incurred) $200.00*  No Show Fee (24-hour cancellation required) $200.00  Centralized Billing (one time set up fee) Waived  Test Development(per test protocol) $1,200/test COMPANY acknowledges that WorkSTEPS provides it testing services to Company through a licensed network of independent third-party providers and therefore Company acknowledges each licensed provider utilized to provide Company services will be treated as a party to this contract with regard to p ayment for services rendered. All WorkSTEPS Providers who have provided WorkSTEPS testing services to COMPANY will be compensated within thirty (30) days of receipt of invoices. 1. Job Analyses. Job Analyses is the foundation of the COMPANY’S functional employment testing program. A job analyses is a measurement of the physical demands and requirements of the essential functions of a specific job. Accurate and current job ana lyses are the COMPANY’S responsibility. Job Specific Authorization Forms that document essential function requirements must be executed by COMPANY’S representative and provided to WorkSTEPS before testing can begin. COMPANY managers should use professionals experienced in assisting with job analyses or other trained and certified ergonomic assessment specialists to assist in the preparation of job analyses and documentation of essential functions. The job analyses should be based on a close, careful examination of the specific job by an individual trained and competent in making the physical measurements of the essential functions of the specific job. The job analysis provides specific job content validity to COMPANY’s functional employment testing program, which seeks to simulate the specific physical demands necessary to perform essential job functions. Accurate DocuSign Envelope ID: FFA73DD9-C106-407B-89D5-4182E5B591FE