BID RESPONSE PACKET SP-20-0077

BID SIGNATURE PAGE T ype or rm e o owmq m orma ,on. P . t th fi II . ti r

PROSPECTIVE CONTRACTOR'S INFORMATION

Company: Management Registry, Inc.

Address: 13218 Cottner Street

City: Omaha I State: I NE I Zip Code: 168137

Business □ Individual □ Sole Proprietorship □ Public Service Corp Designation: □ Partnership 129 Corporation □ Nonprofit

Minority and ~ Not Applicable □ American Indian □ Service Disabled Veteran

Women-Owned □ African American □ Hispanic American □ Women-Owned

Designation*: □ Asian American □ Pacific Islander American

AR Certification #: N/A * See Minority and Women-Owned Business Policy

PROSPECTIVE CONTRACTOR CONTACT INFORMATION Provide contact information to be used for bid solicitation related matters.

Contact Person: Stacev Dlouhv Title: President, Healthcare & Government Division

Phone: (888) 851-3588 Alternate Phone: (402) 779-7225 Email: Stacey. Dlouhv@manaqementreqistrv.com

CONFIRMATION OF REDACTED COPY

□ YES, a redacted copy of submission documents is enclosed. l6l NO, a redacted copy of submission documents is not enclosed. I understand a full copy of non-redacted

submission documents will be released if requested.

Note: If a redacted copy of the submission documents is not provided with Prospective Contractor's response packet, and neither box is checked, a copy of the non-redacted documents, with the exception of financial data (other than pricing), will be released in response to any request made under the Arkansas Freedom of Information Act (FOIA). See Bid Solicitation for additional information.

ILLEGAL IMMIGRANT CONFIRMATION

By signing and submitting a response to this Bid Solicitation, a Prospective Contractor agrees and certifies that they do not employ or contract with illegal immigrants. If selected, the Prospective Contractor certifies that they will not employ or contract with illegal immigrants during the aggregate term of a contract.

ISRAEL BOYCOTT RESTRICTION CONFIRMATION

By checking the box below, a Prospective Contractor agrees and certifies that they do not boycott Israel, and if selected, will not boycott Israel during the aggregate term of the contract.

129 Prospective Contractor does not and will not boycott Israel.

An official authorized to bind the Prospective Contractor to a resultant contract must sign below.

The signature below signifies agreement that any exception that conflicts with a Requirement of this Bid Solicitation will cause e rejected:

Title: President, Healthcare & Government Division

Printed/Typed Name: _S-"-t"""a"'"c"""ev~D"""lo""'u"""h_.v __________ _ Date: 4/9/20

Bid Response Packet SP-20-0077 Page 2 of 3

PROPOSED SUBCONTRACTORS FORM

• Do not include additional information relating to subcontractors on this form or as an attachment to this form.

PROSPECTIVE CONTRACTOR PROPOSES TO USE THE FOLLOWING SUBCONTRACTOR($) TO PROVIDE SERVICES.

vpe or rmt t e o owmq m ormatJon T p· hfi/1. ·ti

Subcontractor's Company Name Street Address City, State, ZIP

!xi PROSPECTIVE CONTRACTOR DOES NOT PROPOSE TO USE

SUBCONTRACTORS TO PERFORM SERVICES.

Bid Response Packet SP-20-0077 Page 3 of3

OFFICIAL BID PRICE SHEET REVISED 4/22/2020 SP-20-0077 - Nursing Services

Table A : will be used in low cost determination

ESTIMATED ESTIMATED

RN Service Bill Rate Per Hour ESTIMATED Cost for RN Services for RN Monthly Service Hours RN Total Monthly Cost Initial Term (Estimated RN

Total Monthly Cost x 12)

150 $72.00 $10,800.00 $129,600.00

Table B : will be used in low cost determination

ESTIMATED ESTIMATED

LPN Service Bill Rate Per Hour ESTIMATED Cost for LPN Services for LPN Monthly Service Hours LPN Total Monthly Cost Initial Term (Estimated

LPN Total Monthly Cost x 12)

1921 $50.00 $96,050.00 $1,152,600.00

Table C : will be used in low cost determination

ESTIMATED ESTIMATED CNA

CNA Service Bill Rate Per Hour ESTIMATED Cost for CNA Services for Monthly Service Hours CNA Total Monthly Cost Initial Term (Estimated CNA Total

Monthly Cost x 12)

3400 $26.00 $88,400.00 $1,060,800.00

Estimated Grand Total for the Initial Term $2,343,000.00

Nursing Services Contact and Staffing Information

SP-20-0077

Table A: please provide the following information

Toll-free staffing support phone number which 888-851-3588 & 402-699-8914 is available for use twenty-four (24) hours a

day, seven (7) days a week,

Email address used for staffing and communications. julie.daly@managementregistry.com

Table B: please provide the following information

Total Number of available Nursing Number of CNA 's Number of LPN's Number of RN's

Service Professionals

133 68 39 26

Client#· 144518 30MALONESTAF

ACORD,.. CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDNYYY}

4/20/2020

THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.

IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s).

PRODUCER ~f:I~cT Sherry Word J Smith Lanier & Co Columbus ri:J8NJ0 Extl: 706-324-6671 I IAIC. Nol: 706-571-9420 200 Brookstone Centre Pkwy i~DA~~ss: sword@jsmithlanier.com Suite118

INSURER(S) AFFORDING COVERAGE NAIC # Columbus, GA 31904 INSURER A: Philadelphia Indemnity Insurance 18058 INSURED INSURER B : Great American Alliance Insurance Co. 26832

Malone Staffing Solutions INSURER c : Cincinnati Insurance Co. 10677

Management Registry, Inc., etal; OBA: INSURER D : Starr Surplus Lines Insurance Company 13604

1868 Campus Place INSURER E:

Louisville, KY 40299 INSURER F:

COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.

INSR TYPE OF INSURANCE ADDL SUBA POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER fMM/DDNYYYl lfMM/DDNYYYl A X COMMERCIAL GENERAL LIABILITY PHPK1988367 06/11/2019 06/11/2020 EACH OCCURRENCE $1 000 000 ,_ D CLAIMS-MADE ~ OCCUR s~r~~H9t.~J!r?encel s1 000,000

1--MED EXP (Any one person) s20 000

I-PERSONAL & ADV INJURY s1,000,000

GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s2,000,000 Fl ~PRO- WLoc s2,000,000 POLICY JECT PRODUCTS. COMP/OP AGG

OTHER: $

A AUTOMOBILE LIABILITY PHPK1988367 !06/11/2019 06/11/202( COMBINED SINGLE LIMIT s1 ,000,000 1-- (Ea accidenl)

X ANY AUTO BODILY INJURY (Per person) $

OWNED - SCHEDULED BODILY INJURY (Per acc,denl) $ I- AUTOS ONLY ,_ AUTOS

X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accidenl} 1-- 1--

$

A J UMBRELLA LIAB ~ OCCUR PHUB678006 !06/11/2019 06/11/202( EACH OCCURRENCE s15 000 000 EXCESS LIAB CLAIMS-MADE AGGREGATE s15 000.000 OED I xi RETENTIONs10 000 s

B WORKERS COMPENSATION WC1475514 !01/01/2020 01/01/2021 X l~~frnTE I l~JH· AND EMPLOYERS' LIABILITY Y/N B ANY PROPRIETOR/PARTNER/EXECUTIVE[m WC2189024-WI !01/01/2020 01/01/2021 E.L. EACH ACCIDENT $1,000 000 OFFICER/MEMBER EXCLUDED? N N/A B (Mandatory in NH) WCE555836-FL,MA,NJ 01/01/2020 01/01/2021 E.L. DISEASE · EA EMPLOYEE $1,000 000

1r yes, describe under E.L. DISEASE · POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS below

C *Crime EMP0539032 06/11/2019 06/11/2020 $5,000,000 A "Professional PHPK1988367 06/11/2019 06/11/2020 $1,000,000/$3,000,000

Liabilitv 5,000 Deductible DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) ** Other Lines Information ••

*Crime includes client property

*Professional Liability includes Allied Healthcare Services

(A) Employment Practices Liability - Philadelphia Indemnity Insurance Policy No. PHS01452391, $1,000,000

per claim, $2,000,000 aggregate, $50,000 Deductible, policy period 06/11/2019 - 06/11/2020 claims made

(See Attached Descriptions)

CERTIFICATE HOLDER CANCELLATION

ST A TE OF ARKANSAS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

OFFICE OF STATE PROCUREMENT ACCORDANCE WITH THE POLICY PROVISIONS.

1509 West 7th Street, Room 300

Little Rock, AR 72201-4222 AUTHORIZED REPRESENTATIVE

I p ~-,.-5,. ~ .::r • ~ c,q.4', ~ -

© 1988-2015 ACORD CORPORATION. All rights reserved.

ACORD 25 (2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD #S4841256/M4739738 SYW

DESCRIPTIONS (Continued from Page 1) (D) Network Security and Privacy Liability(Cyber) - Starr Surplus Lines Insurance Company Policy No. 1000633983191, $5,000,000 per claim/ $5,000,000 aggregate, $25,000 Retention, policy period 06/11/2019 06/11/2020

SAGITTA 25.3 (2016/03) 2 of 2

#S4841256/M4739738

CONTRACT ANO GRANT DISCLOSURE AND CERTIFICATION FORM Failure to complete all of the following information may result in a delay in obtaining a contract, lease, purchase agreement, or grant award with any Arkansas State Agency. SUBCONTRACTOR: SUBCONTRACTOR NAME:

D Yes [8)No Not applicable - Management Registry, Inc. is not subcontracting any work related to a contract resulting from this IFB.

IS THIS FOR: TAXPAYER 10 NAME: Management Registry, Inc. D Goods? ~ Services?□ Both? YOUR LAST NAME: Dlouhy FIRST NAME: Stacey M.J.:L

ADDRESS: 13218 Cottner Street

CITY: Omaha STATE:NE z1PcooE:68137 couNTRY: U.S.

AS A CONDITION OF OBTAINING, EXTENDING, AMENDING, OR RENEWING A CONTRACT, LEASE, PURCHASE AGREEMENT, OR GRANT AWARD WITH ANY ARKANSAS STATE AGENCY1 THE FOLLOWING INFORMATION MUST BE DISCLOSED:

11 F O R I N D I V I D U A L S * Indicate below if: you, your spouse or the brother, sister, parent, or child of you or your spouse is a current or former: member of the General Assembly, Constitutional Officer, State Board or Commission Member, or State Emolovee:

Mark(✓) Name of Position of Job Held For How Long? \Mlat is the person{s) name and how are they related to you? Position Held [senator, representative, name of [i.e. , Jane Q_ Public, spouse, John Q. Public, Jr., child, etc.)

Current Former board/ commission, data entry, etc.] From To Person's Name(s) Relation MMIYY MM/YY

General Assembly

Constitutional Officer

State Board or Commission i Member l

State Employee I G None of the above applies

FOR AN ENTITY (BUSINESS)* Indicate below if any of the following persons, current or former, hold any position of control or hold any ownership interest of 10% or greater in the entity: member of the General Assembly, Constitutional Officer, State Board or Commission Member, State Employee, or the spouse, brother, sister, parent, or child of a member of the General Assembly, Constitutional Officer, State Board or Commission Member. or State Emolovee. Position of control means the oower to direct the purchasina oolicies or influence the manaQement of the entitv.

Mark(~) Name of Position of Job Held For How Long? What is the person(s) name and what is his/her% of ownership interest and/or what is his/her oosition of control? Position Held [senator, representative, name of

Ownership Position of Current Former board/commission, data entry, etc.] From To Person's Name{s) MM/YY MM/YY Interest{%) Control

General Assembly

Constitutional Officer

State Board or Commission Member

State Employee

[:] None of the above applies

11

11

Contract and Grant Disclosure and Certification Form

Failure to make any disclosure required by Governor's Executive Order 98-04, or a11y violation of any rule, regulation1

or policy adopted pursuant to that Order, shall be a material breach o[the terms o[this contract. Any contractor, whether an individual or entity, who fails to make the required disclosure or who violates any rule, regulation, or policy shall be subiect to all legal remedies available to the agency.

As an additional condition of obtaining, extending, amending, or renewing a contract with a state agency 1 agree as follows:

1. Prior to entering into any agreement with any subcontractor, prior or subsequent to the contract date, I will require the subcontractor to complete a CONTRACT AND GRANT DISCLOSURE AND CERTIFICATION FORM. Subcontractor shall mean any person or entity with whom I enter an agreement whereby I assign or otherwise delegate to the person or entity, for consideration, all, or any part, of the performance required of me under the terms of my contract with the state agency.

2. I will include the following language as a part of any agreement with a subcontractor:

Failure to make any disclosure required by Governor's Executive Order 98-04, or any violation of any rule, regulation, or policy adopted pursuant to that Order, shall be a material breach of the terms of this subcontract. The party who fails to make the required disclosure or who violates any rule. regulation, or policy shall be subject to all legal remedies available to the contractor.

3. No later than ten (10) days after entering into any agreement with a subcontractor, whether prior or subsequent to the contract date, I will mail a copy of the CONTRACT AND GRANT DISCLOSURE AND CERTIFICATION FORM completed by the subcontractor and a statement containing the dollar amount of the subcontract to the state a enc .

I cerlif · · e best of my knowledge and belief, all of the above information is true and correct and that I a ditions stated herein.

Vendor Contact Person--=S:..::ta==e:...,_y-=D:..:.lo::..:u::.:..h'-'-y ___ __ -=::;__ ___ _ Title President, Healthcare & Government Dai Phone No. (888) 851-3588

Agency use only

Agency Agency Number Name - -- --- -------

Agency Contact Contract Contact Person Phone No. or Grant No. ·-------- ------ ---

Equal Opportunity and Commitment to Diversity

Equal Opportunity

Malone provides equal employment opportunities to all employees and applicants for employment without regard to race, color, ancestry, national origin, gender, sexual orientation, marital status, religion, age, disability, gender identity, results of genetic testing , or service in the military. Equal employment opportunity applies to all terms and conditions of employment, including hiring, placement, promotion, termination, layoff, recall, transfer, leave of absence, compensation, and training.

Malone expressly prohibits any form of unlawful employee harassment or discrimination based on any of the characteristics mentioned above. Improper interference with the ability of other employees to perform their expected job duties is absolutely not tolerated. Any employees with questions or concerns about equal employment opportunities in the workplace are encouraged to bring these issues to the attention of the Human Resources Department. The Company will not allow any form of retaliation against individuals who raise issues of equal employment opportunity. If an employee feels he or she has been subjected to any such retaliation, he or she should bring it to the attention of the Human Resources Department.

Retaliation means adverse conduct taken because an individual reported an actual or perceived violation of this policy, opposed practices prohibited by this policy, or participated in the reporting and investigation process described below. "Adverse conduct" includes but is not limited to: (1) shunning and avoiding an individual who reports harassment, discrimination or retaliation; (2) express or implied threats or intimidation intended to prevent an individual from reporting harassment, discrimination or retaliation; or (3) denying employment benefits because an applicant or employee reported harassment, discrimination or retaliation or participated in the reporting and investigation process.

Complaints of discrimination should be filed according to the procedures described in the Harassment and Complaint Procedure.

Americans with Disabilities Act (ADA) and Reasonable Accommodation To ensure equal employment opportunities to qualified individuals with a disability, Malone will make reasonable accommodations for the known disability of an otherwise qualified individual, unless undue hardship on the operation of the business would result. Employees who may require a reasonable accommodation should contact the Human Resources Department.

Commitment to Diversity Malone is committed to creating and maintaining a workplace in which all employees have an opportunity to participate and contribute to the success of the business and are valued for their skills, experience, and unique perspectives. This commitment is embodied in company pol icy and the way we do business at Malone and is an important principle of sound business management.

TO: FROM: DATE:

Vendors Addressed Brandi Schroeder, Buyer April 22, 2020

STATE OF ARKANSAS OFFICE OF ST ATE PROCUREMENT

1509 West 7th Street, Room 300 Little Rock, Arkansas 72201-4222

ADDENDUM 1

SUBJECT: SP-20-0077, Nursing Services

The following change(s) to the above-referenced IFB have been made as designated below:

X Change of specification(s) ---x Additional specification(s) - --

--- Change of bid opening time and date Cancellation of bid

- --x Other-Revised Official Bid Price Sheet

BID OPENING DATE AND TIME

Bid opening date and time shall remain unchanged.

CHANGE OF SPECIFICATIONS

• Delete the following from page 1 and replace with the following:

OFFICE OF STATE PROCUREMENT CONTACT INFORMATION

OSP Buyer: Brandi Schroeder Buyer's Direct Phone Number:

Email Address: Brandi. Sch roeder@dfa.arkansas.gov OSP's Main Number:

OSP Website: htt12://www.dfa.arkansas.gov/offices/12rocuremenUPages/default.as12x

• Delete Section 1.1 and replace with the following:

1.1 PURPOSE

Page 1 of 4

501-682-4169

501-324-9316

This invitation for bid is issued by the Office of State Procurement (OSP) on behalf of the Arkansas Department of Veterans Affairs (ADVA), to obtain pricing and a contract(s) for Nursing Services. The State anticipates the Arkansas State Military Department will also utilize any resulting contract.

• Delete Section 2.1, 4111 Paragraph, and replace with the following:

The State anticipates the Arkansas State Military Department's Youth Challenge Program will also utilize this contract.

• Delete Section 2.1, 6th Paragraph, no replacement.

SP-20-0077 ADDENDUM 1 Page 2 of4

• Delete Section 2.7.A and replace with the following:

A. The number of monthly hours required for each Nursing Service Professional included in this IFS and on the Official Bid Price Sheet is estimated for contract bidding purposes only and may vary according to the State's needs.

ADDITIONAL SPECIFICATIONS

• Add the following to Section 2.6:

B. Arkansas State Military Department Staffing

1. The Contractors' CNA's, RN's, and LPN's shall be available to perform Nursing Services for the following shift Requirements, as needed. Please note, not all shifts are expected to be filled concurrently. However, the Contractor shall provide Nursing Service Professionals for all shifts as requested .

a. Certified Nursing Assistants (CNA)

i. 11 :30 AM - 8:00 PM, Central Time, Monday through Friday, forty-four (44) weeks per year.

b. Licensed Practical Nurse (LPN)

i. 11 :30 AM - 8:00 PM, Central Time, Monday through Friday, four (4) weeks per year.

ii. 6:00 AM - 2:00 PM, Central Time, Monday through Friday, thirty-eight (38) weeks per year.

iii. 6:00 AM - 2:00 PM, Central Time, Saturday and Sunday, thirty-eight (38) weeks per year.

iv. 11 :30 AM - 8:00 PM, Central Time, Saturday and Sunday, thirty-eight (38) weeks per year.

v. 7:00 AM - 3:30 PM, Central Time, one (1) day per week for eight (8) weeks per year.

c. Registered Nurse (RN)

i. 8:00 AM - 3:00 PM, Central Time, two (2) days per year.

2. Nursing Service Professionals shall work rotating shifts, if requested by the State.

a. Rotating shift refers to a scheduling practice used to cover various shifts. A Nursing Service Professional may work a shift mentioned above for a determined period of time, then they would rotate to work a different shift for a determined period of time.

3. Nursing Service Professionals shall work hours other than the hours specified, if requested by the State.

4. All contracted Nursing Service Professionals shall take an unpaid thirty (30) minute meal break during each shift worked.

5. The Contractor shall respond to the State within the following timeframes after the Contractor receives the request for Nursing Services:

a. When the Contractor is contacted within eight (8) hours or less from the beginning of the needed shift, the Contractor shall respond to the State via email within fifteen (15) minutes of the receipt of the request from the State.

b. When the Contractor is contacted within eight (8) hours or more from the beginning of the needed shift, the Contractor shall respond to the State via email within four (4) hours of the receipt of the request from the State.

SP-20-0077 ADDENDUM 1 Page 3 of4

c. When the Contractor is contacted for Late Calls (needs identified after a Nursing Services shift has started) the Contractor shall respond to the State via email within fifteen (15) minutes of the receipt of the request from the State.

i. For Late Calls, the Contractor may bill the State on a full shift basis using the contracted bill rate applicable to the Nursing Service Professional level provided.

ii. If the Nursing Services Professional fails to show up for the shift, the State will not pay for a Late Call.

d. When the Contractor is contacted for a crisis, as determined by the State in its absolute and sole discretion, the Contractor shall immediately respond to the State via email when practicably possible but in all instances, the Contractor shall respond within fifteen (15) minutes of receipt of the request from the State.

e. The State will seek services from another Contractor for all instances whereby the Contractor fails to respond to requests from the State for Nursing Services within the timeframes stated above.

6. For partial shifts called in in advance of the shift start time, the Contractor shall only bill the State for the actual hours worked using the contracted bill rate for the Nursing Service Professionals provided.

7. If the need arises for Nursing Service Professional to call in sick or needs to miss a shift for any reason, the Nursing Service Professional shall call in to the Contractor and to Arkansas State Military within two (2) hours prior to their shift starting time. The Contractor shall provide the same level of Nursing Service Professional as was originally provided as a backup to cover the shift affected.

8. Nursing Service Professionals shall submit their Timesheets to the State daily, prior to leaving after their shift and must include the following:

a. Full name.

b. Date.

c. Actual hours worked for the shift.

d. Locations worked for the shift.

e. Time of their meal break.

f. Arrival time initialed by the State Military designated supervisor on duty.

g. Approval and signature of the State Military's designated senior leadership on duty.

• Add the following to Section 2.6.A:

2. Arkansas State Military Estimated Yearly Hours

AR STATE MILITARY ESTIMATED YEARLY HOURS NURSING SERVICES

Registered Nurses 14 Licensed Practical Nurses 1480 Certified Nursing Assistants 1760

OTHER - REVISED OFFICIAL BID PRICE SHEET

• Delete the Official Bid Price Sheet and replace with the Revised Official Bid Price Sheet dated April 22, 2020.

SP-20-0077 ADDENDUM 1 Page 4 of 4

The specifications by virtue of this addendum become a permanent addition to the above referenced IFB. Failure to return this signed addendum may result in rejection of your bid submission.

If you have any questions please contact Brandi Schroeder at brandi.schroeder@dfa.arkansas.gov.

Date: 4/22/20