Joffe & PMH Laboratory Clinic Appointment Form

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Name of organization* This field is required.
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Organizer name* This field is required.
First Name
Last Name
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Address of Covid testing clinic location* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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United States
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Nigeria
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Other
Country
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Phone Number* This field is required.
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How many people in your organization need testing* This field is required.
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E-mail* This field is required.
example@example.com
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Which test do you want to use for your organization?* This field is required.
PCR (Nasal Swab Covid Test)
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Date of clinic* This field is required.Please provide a date that you are interested in hosting the COVID testing clinic on your site. Minimum of one week from today if available. We will send a Google Calendar invite shortly to confirm dates or provide alternative day. Covid clinics start at 9:30am. If your organization needs to schedule an alternative time, please modify the time field below. The clinic can handle 16 participants per hour. Clinics are Monday-Thursday for organization out of Southern California to eliminate any delays in shipping and results.
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Terms and Conditions* This field is required.STATEMENT OF WORK: COVID-19 TESTING SERVICES Project: COVID-19 Testing Contract Community Name: Community Address: Client Contact(s): Name, Title Contract Term: Date of Testing Joffe agrees to provide the following services to Client: COVID-19 testing services: Testing will be conducted by certified EMTs who have gone through training to effectively carry out the QPCR testing. Training has been conducted in compliance with known Federal and State Regulations. Procedures for testing have been established by Joffe and are based on training, precautions and access to the appropriate personal protective equipment (PPE). Request Lab Materials: Once the contract has been executed and payment received, we will initiate a request for lab materials. There is no cost associated with acquiring the test materials, this is covered by the CARES Act and other government programs that are in place. Sample Collection and Shipment: Once the sample is collected, it is sealed with client forms and deposited in a Fedex overnight bag. It takes approximately 24 Hours to get the results to the lab for processing, and then 48 Hours for the lab to turnaround results. Results: Results are provided in a HIPAA compliant patient portal accessed by email. Client will receive a confirmation of the total number of tests, along with the number of positives and negatives. Client Responsibilities & Support Services: Provide a safe location and set up equipment required to render the testing services. If our EMT determines that the environment is not safe and or CDC Guidelines on physical distancing are not followed, Joffe reserves the right to immediately halt the testing, and no refund will be issued. If short term lack of safety is perceived, Joffe may stop carrying out testing, until it is deemed safe to do so. Fees For Testing Services: $750 per EMT for Half day of testing (4 Hours) Payment Terms: Payment is due upon execution of this contract. This Statement of Work is subject to all terms and conditions of the Master Services Agreement (MSA) for COVID-19 Testing Services, as amended (and attached) by the parties. The Statement of Work and Master Services Agreement as amended, shall not be amended except in writing signed by both parties. Exhibit A Joffe Emergency Services Master Services Agreement This Master Services Agreement ( "Agreement") is made effective as of the date indicated on the Statement of Work, by and between client (indicated on the Statement of Work) ("Client"), and Joffe Emergency Services, a California corporation ("Joffe"). Recitals Joffe is an all-in-one provider of expert emergency response training, event safety, and security services for individuals, schools, non-profits, small businesses, and corporations (the “Services”). Client desires to retain Joffe to perform the Services described in one or more Statement of Work and Joffe desires to be engaged to provide the Services, all pursuant to the terms and conditions set forth herein. Now, therefore, in consideration of the foregoing recitals, which are hereby incorporated by this reference, the mutual promises and covenants contained herein, and for other good and valuable consideration, the receipt and adequacy of which are hereby acknowledged, the parties hereby agree as follows: 1. ENGAGEMENT AND DESCRIPTION OF SERVICES. Client hereby engages Joffe to perform the following services and the services set forth in one or more Statements of Work. 2. CLIENT RESPONSIBILITIES. Client agrees to the Client Responsibilities and Support Services specified in one or more Statements of Work. 3. PERFORMANCE OF SERVICES. The manner in which the Services are to be performed will be controlled by Joffe. 4. PAYMENT TERMS. Client shall pay Joffe for the Services as set forth in the applicable Statement of Work. 5. EXPENSE REIMBURSEMENT. Joffe shall be entitled to reimbursement from Client for all "out-of-pocket" expenses (excluding day-to-day travel) but only with written pre-approval from the contact designated in the most recent Statement of Work ("Client Contact") except in the event of an Emergency, in which case no written pre-approval is required. 7. JOFFE STAFF. Joffe's employees who perform services for Client under this Agreement shall also be bound by the provisions of this Agreement. 8. INSURANCE. Joffe shall secure and maintain Commercial General Liability Insurance that shall protect Joffe from all claims of bodily injury, property damage, personal injury, death, other injury, and medical payments arising from Services performed under this Agreement. To the extent injuries to Joffe Staff are or would be covered by insurance that is customary and necessary in the ordinary course for a provider of the Services, Joffe waives any rights to recovery from Client for any injuries that Joffe (and/or Joffe Staff) may sustain while performing services under this Agreement that are a result of the negligence or intentional misconduct of Joffe or Joffe Staff, except to the extent such injury is caused by Client's negligence, gross negligence, or intentional misconduct. 9. INTELLECTUAL PROPERTY. All intellectual property rights owned by either party hereto prior to or independent of this Agreement, shall remain the sole property of such party, and nothing in this Agreement shall confer in the other party any title to or, except as necessary for the provision of the Services hereunder, right to use such intellectual property. Except as otherwise agreed by the parties in writing or set forth in a Statement of Work, all intellectual property created in the provision of the Services by Joffe shall be the sole property of Joffe. 10. CONFIDENTIAL INFORMATION. “Confidential Information” may include, but is not limited to medical and health information, business plans, financial statements, banking information, security plans, event planning documents, historical records of incidents, insurance and legal records, and personally identifiable information of Client and Client’s employees and others who Client is entrusted to protect. Joffe will hold all Confidential Information in trust and confidence, and will not use, disclose, communicate, convey, or allow this information to be used, disclosed, communicated, or conveyed, either directly or indirectly, except as may be necessary in the performance of the Services or in meeting regulatory requirements associated with the Services. Joffe understands that unauthorized disclosure could be damaging to Client. Joffe will not allow unauthorized persons to inspect or have any unauthorized access to any Confidential Information, and will report unauthorized access to Client as soon as Joffe becomes aware of it. Joffe will not remove any Confidential Information or records containing Confidential Information from Client, unless authorized to do so, and will return such records to Client upon request. 11. RELATIONSHIP OF PARTIES. It is understood by the parties that Joffe and Joffe Staff are independent contractors with respect to Client and not an employee, officer, or agent of Client. Joffe’s services are not a part of Client’s usual business operations. Client will not provide fringe benefits, including health insurance benefits, paid vacation, or any other employee benefit, for the benefit of Joffe Staff. Joffe agrees to defend, indemnify and hold Client harmless for any wage claims made by Joffe Staff. Nothing herein shall be construed to create a partnership, joint venture, or employment relationship between the parties. 12. LIMITED WARRANTY AND DISCLAIMER OF REPRESENTATIONS AND WARRANTIES. Joffe shall provide the Services in accordance with the Statement of Work and in a professional and worklike manner. Joffe makes no other representations or warranties, whether written, oral, express or implied, with respect to the Services, and hereby disclaims any other express or implied warranties. 13. LIMITATION ON LIABILITY. Except for a party's indemnity obligations pursuant to this agreement, in no event shall either party be liable for any special, indirect, consequential or incidental damages arising out of this agreement or otherwise, regardless of whether such party had notice of the possibility of any such loss or damage. Except in the event of Joffe's negligence, gross negligence or willful misconduct, Joffe shall not be liable to Client, for any amounts, in the aggregate, in excess of the greater of (a) the fees paid by Client to Joffe in the twelve (12) months prior to the claim and (b) the amounts paid pursuant to Joffe's applicable insurance policies. Nothing in this Section 13 is intended to limit amounts payable by the insurer(s) under Joffe's insurance policies. Client acknowledges and agrees that Joffe would not enter into this Agreement for the consideration given by Client but for the limitations of liability and damages contained in this Section 13, and the right to receive the Services for the limitations in this Section 13 and the other consideration given by Client for the Services constitute a bargain that is fair and reasonable. 14. INDEMNIFICATION. Client, to the fullest extent provided by law shall indemnify, defend and hold Joffe and its officers, directors, shareholders, independent contractors, affiliates, employees, and agents (collectively, the "Joffe Parties"), harmless from and against all claims, liabilities, demands, causes of action, losses or damages (including without limitation all liability for personal injury, property damage or commercial loss) and all costs and expenses (including without limitation attorneys' fees) (collectively, "Losses") incurred in connection therewith that may be asserted against or by or incurred by any of the Joffe Parties in connection with Joffe's provision of the Services or any other services to or for the benefit of Client, except to the extent such claim, injury or loss is caused solely by Joffe's negligence, gross negligence or intentional misconduct or Joffe’s breach of this Agreement. This includes claims that Client infringed on a third party’s copyright or other intellectual property right. Joffe shall indemnify, defend and hold Client and its officers, directors, independent contractors, affiliates, employees and agents (collectively, the “Client Parties”), harmless from and against all claims, liabilities, demands, causes of action, losses or damages (including without limitation all liability for personal injury, property damage or commercial loss) and all costs and expenses (including without limitation attorney fees) (collectively “Losses”) incurred in connection therewith that may be asserted against or by or incurred by any of the Joffe Parties in connection with (a) except as set forth in Section 8, Joffe's provision of the Services or any other services to or for the benefit of Client, except to the extent such claim, injury or loss is caused solely by Client’s gross negligence or intentional misconduct or (b) Client's breach of this Agreement. This provision will survive the termination or expiration of this Agreement. 15. NON-SOLICITATION. Client covenants that they will not offer or solicit employment to Joffe Staff who were involved in performing the Services, during the term of this Agreement and for a period of two (2) years from the date of termination or expiration of this Agreement, provided that the foregoing shall not prohibit any general solicitation not targeted at such employees directly and any hire or termination resulting from such general solicitation. The parties agree that in the event Client hires an employee of Joffe in breach of this Section 15, the resulting actual damages to Joffe would be costly, and extremely difficult and inconvenient for the parties to determine. Client also acknowledges that Joffe has expended a large amount of effort, resources and training in connection with developing its employees' skills and that replacing employees is difficult and expensive. Therefore, the parties agree that in addition to Joffe’s right to any available equitable remedy, Client shall pay to Joffe liquidated damages in the amount of 150% of the employee's annual salary, for each employee of Joffe hired by Client. The parties agree that the amounts stated herein as liquidated damages are fair and reasonable under the circumstances existing as of the date of this Agreement. 16. TERM AND TERMINATION. This Agreement shall be in effect through the dates outlined in the Statement of Work, provided that Joffe shall not provide Services until the Start Date. Either party may immediately terminate this Agreement upon a material breach of this Agreement, provided that it provides written notice of the facts constituting the material breach to the other party. In the event Joffe terminates this Agreement for a material breach by Client, all funds paid to Joffe shall be deemed earned and Joffe shall retain all such funds and have no requirement to provide further Services. In the event Client terminates this Agreement for a material breach, Joffe shall refund a prorated amount of the funds paid to it under this Agreement. 17. NOTICES. All notices required or permitted under this Agreement shall be in writing and shall be deemed delivered when delivered in person, by email or deposited in the United States mail, postage prepaid, and certified, addressed as follows: To Joffe: Support@JoffeEmergencyServices.com P.O. Box 7125 Santa Monica CA, 90406 To Client: The Client address or email contact provided on the Statement of Work 18. ENTIRE AGREEMENT. This Agreement, including the Statements of Work executed by both parties, contains the entire agreement of the parties and there are no other promises or conditions in any other agreement whether oral or written. This Agreement supersedes any prior written or oral agreements between the parties. 19. AMENDMENT. This Agreement may be modified or amended if the amendment is made in writing and is signed by both parties. 20. SEVERABILITY. If any provision of this Agreement shall be held to be invalid or unenforceable for any reason, the remaining provisions shall continue to be valid and enforceable. 21. WAIVER OF CONTRACTUAL RIGHT. The failure of either party to enforce any provision of this Agreement shall not be construed as a waiver or limitation of that party's right to subsequently enforce and compel strict compliance with every provision of this Agreement. 22. ARBITRATION. To the fullest extent provided by law, all disputes concerning the interpretation, validity, or performance of this Agreement or any of its terms and provisions, including without limitation, the issue of whether or not a dispute is arbitrable, shall be resolved by binding arbitration. The parties shall submit such dispute for binding arbitration before a retired judge selected from JAMS, Inc. or any similar organization mutually acceptable to the parties. The parties shall mutually agree on one (1) arbitrator from the list provided by the arbitrating organization; provided that if the parties cannot agree, then each party shall select one (1) arbitrator from the list, and the two (2) arbitrators so selected shall agree upon a third arbitrator chosen from the same list, which third arbitrator shall determine the dispute. The arbitration shall take place in Los Angeles County, California, and shall be conducted in accordance with the then prevailing rules of the arbitrating organization. The parties shall have all rights for depositions and discovery as provided under the rules of the selected arbitration organization. The arbitrator shall apply California law to the proceeding. The arbitrator shall have the power to grant all legal and equitable remedies including provisional remedies and award compensatory damages provided by law, but the arbitrator may not order relief in excess of what a court could order. The arbitrator shall prepare and provide the parties with a written award including factual findings and the legal reasoning upon which the award is based. The arbitrator may award the prevailing party all reasonable attorneys’ fees, expert witness fees, and other litigation expenses, expended or incurred in such arbitration or litigation, unless the laws related to the claim that the party prevailed on preclude a court from awarding attorneys’ fees and costs to the prevailing party. Any court having jurisdiction may enter judgment on the award rendered by the arbitrator, or correct or vacate such award as provided by applicable law. The parties understand that by agreeing to binding arbitration, they are giving up the rights they may otherwise have to trial by a court or a jury and all rights of appeal, and to an award of punitive or exemplary damages. The application for or enforcement of any provisional remedy by a party shall not operate as a waiver within the agreement to submit a dispute to expedited binding arbitration. 23. APPLICABLE LAW. This Agreement shall be governed by the laws of the State of California. 24. ATTORNEYS' FEES. Should legal action or arbitration be instituted to enforce any of the provisions of this Agreement, or by reason of breach or default in any of the covenants, representations, warranties, terms or conditions of this Agreement, the prevailing party shall be entitled to recover costs and attorney's' fees in such amount as the court or arbitrator in such action shall adjudge reasonable. 25. SUCCESSORS AND ASSIGNS. This Agreement and each of its provisions shall be binding upon and shall inure to the benefit of the parties hereto and their respective administrators, successors, and assigns. 26. ASSIGNMENT. Neither party may assign this Agreement or any right or obligation hereunder without the prior written consent of the other party; provided, however, in the event of any sale of all or substantially all of the assets or stock, or a merger, consolidation, conversion or other reorganization involving a party, any successor to such party shall succeed to all of such party's rights and obligations under this Agreement, without the necessity of the consent of the other party. 27. COUNTERPART EXECUTION. “Joffe” and “Client” signature on the Statement of Work shall bind Joffe and Client to this Master Services Agreement. This Agreement may be executed in one or more counterparts, each of which shall be deemed an original but all of which together shall constitute one and the same instrument.
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ORDER SUMMARY
Total costUSD
COVID-19 TestingCOVID-19 testing at schools for a half-day clinic consisting of one (1) EMT for 4 hours, 48 tests
$750.00+
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Please provide any information that we need to know to to better understand your organizations needs. (Special clinic times, set up areas, driving directions, etc.)
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COVID testing clinic appointments can be confirmed with more than 7 days lead time. An email will be sent upon filling out this form with detailed information on the clinic and forms to fill out. A Google Calendar invite will confirm the date of your clinic. Test results are provided to your participants in a confidential portal within 48-60 hours. All Covid testing clinics start promptly at 9:30am unless otherwise scheduled. The lab has a minimum participation of 15 participants in California or a minimum of 25 in any other state in the USA. Each licensed Joffe Medical Professional is able to conduct up to 48 tests per 1/2 day clinic (4 hours). If testing more than 48 participants in a day, it is recommended to have a second Joffe Medical Professional scheduled for the clinic to complete the testing in a 4 hour period. If the Joffe Medical Professionals work more than 6 hours, they will need two 15 minute breaks and a 30 minute lunch break.
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