Kegley & Associates/DOCS/Fire/24,375/Engaging4Health InitativeTom Kegley d/b/a Kegley & Associates
DOCS and Fire Department —2016
Appropriation #43-509.00; P.O. # 33659,$1.2,187.50 P.O. #24846, $12,187.50
Contract Not To Exceed $24,375.00
AGREEMENT FOR PROFESSIONAL SERVICES
THIS AGREEMENT FOR PROFESSIONAL SERVICES ("Agreement") is hereby made and entered into by
and between the City of Carmel, Indiana, acting by and through its Board of Public Works and Safety (hereinafter
"City"), and Tom Kegley d/b/a Kegley & Associates (hereinafter "Professional").
RPrITAI R
WHEREAS City owns and is responsible for the operation and maintenance of its property, personnel, public
works and infrastructure; and
and
WHEREAS, from time to time, City needs professional assistance in fulfilling its foregoing responsibilities;
WHEREAS, Professional is experienced in providing and desires to provide to City the professional services
("Services") referenced herein; and
WHEREAS, City desires to engage Professional as an independent contractor for the. purpose of providing to
City the Services referenced herein;
NOW, THEREFORE, in consideration of the foregoing recitals and the covenants and conditions set forth
herein, City and Professional mutually agree as follows:
L\
SECTION 1. INCORPORATION OF RECITALS
The foregoing Recitals are hereby incorporated into this Agreement and made a part hereof.
SECTION 2. SCOPE OF SERVICES
2.1 City desires to engage Professional as an independent contractor for the Services set forth in attached
Exhibit A, incorporated herein by this reference.
2.2 Professional understands and agrees that City may, from time to time, request Professional to provide
additional or modified Services to City. When City desires additional Services from Professional, the City
shall notify Professional of such additional Services desired, as well as the time frame in which same are to
be provided. Only after City has approved Professional's time and cost estimate for the provision of such
additional Services,..has encumbered sufficient monies to pay for same, and has authorized Professional, in
writing, to provide such additional Services, shall such Services be provided by Professional to City. A copy
of the City's authorization documents for the purchase of additional Services shall be numbered and attached
hereto in the order in which they are approved by City.
2.3 Time is of the essence of this Agreement.
JXAConqu'ds1P KS%n & Goods Svcs\D0CSU0161Ke61ey & Associates Pmfmional Scrvim FORM Rcvjunc 2012.doc:711212016 11:47 AMj
1
Tom Kegley d/b/a Kegley & Associates
DOCS and Fire Department - 2016
Appropriation #43-509.00; . P.O. # 33659, $12,187.50 P.O. #24846, $12,187.50
Contract Not To Exceed $24,375.00
SECTION 3. CITY'S RESPONSIBILITIES
3.1 City shall provide such information as is reasonably necessary for Professional to understand the Services
requested.
3.2 City shall provide all data required for provision of Services. Professional may assume that all data so
provided is correct and complete.
3.3. City shall arrange for Professional to enter upon public and private property as reasonably required for
Professional to perform the Services.
3.4 City shall designate payment of the Services from City budget appropriation number 43-509.00 funds.
3.5 City shall designate the Mayor or his duly authorized representative to act on City's behalf on all matters
regarding the Services.
SECTION 4. PROFESSIONAL'S RESPONSIBILITIES
4.1 Professional shall perform the Services pursuant to the terms of.this Agreement and within any applicable
time and cost estimate.
4.2 Professional shall coordinate with City its performance of the Services.
4.3 Professional shall provide the Services by following and applying at all times reasonable and lawful
standards as accepted in the industry.
SECTION 5. COMPENSATION
5.1 Professional estimates that the total price for the Services to be provided to City hereunder shall be no more
than Twenty Four Thousand Three Hundred Seventy Five Dollars ($24,375.00) (the "Estimate"). Professional
shall submit an invoice to City no more than once every thirty (30) days for Services provided City during the
time period encompassed by such invoice. Invoices shall be submitted on a form containing the same
information as that contained on the Professional Services Invoice attached hereto as Exhibit B, incorporated
herein by this reference. City shall pay Professional for all undisputed Services rendered and stated on such
invoice within thirty five (35) days from the date of City's receipt of same.
5.2 Professional agrees not to provide any Services to City that would cause the total cost of same to exceed the
Estimate, without City's prior written consent.
[X:\Conlracls\PrUf S,ts & Goods S%vs\DOCS\2016\Kcgley & Associates Professional Services FORM Revjune 2012.doc:7/12I2016 11:47 AM]
FA
Tom Kegley d/b/a Kegley & Associates
DOCS and Fire Department - 2016
Appropriation #43-509.00; P.O. # 33659, $12,187.50 P.O. #24846, $12,187.50
Contract Not To Exceed $24,375.00
SECTION 6. TERM
Unless otherwise terminated in accordance with the termination provisions set forth in Section 7.1
hereinbelow, this Agreement shall be in effect from the Effective Date through December 31, 2016, and shall,
on the first day of each January thereafter, automatically renew for a period of one (1) calendar year, unless
otherwise agreed by the parties hereto.
SECTION 7. MISCELLANEOUS
7.1 Termination.
7.1.1 The obligation to provide all or any portion of the Services under this Agreement may be terminated
by City or Professional, without cause, upon thirty (30) days' notice.
7.1.2 The obligation to provide all or any portion of the Services under this Agreement may be terminated
by City, for cause, immediately upon Professional's receipt of City's "Notice To Cease Services."
7.1.3 In the event of full or partial Agreement termination, and as full and complete compensation
hereunder, Professional shall be paid for all such Services rendered and expenses incurred as of
the date of termination that are not in dispute, except that such payment amount shall not exceed
the Estimate. Disputed compensation amounts shall be resolved as allowed by law.
7.2 Binding Effect.
City and Professional, and their respective officers, officials, agents, partners and successors in interest are
bound to the other as to all Agreement terms, conditions and obligations.
7.3 No Third Party Beneficiaries.
Nothing contained herein shall be construed to give rights or benefits to anyone other than the parties
hereto.
7.4 Relationship.
The relationship of the parties hereto shall be as provided for in this Agreement, and neither Professional nor
any of its agents, employees or contractors are City employees. Professional shall have the sole
responsibility to pay to or for its agents, employees and contractors all statutory, contractual and other
benefits and/or obligations as they become due. Professional hereby warrants and indemnifies City for and
from any and all costs, fees, expenses and/or damages incurred by City as a result of any claim for wages,
benefits or otherwise by any agent, employee or contractor of Professional regarding or related to the subject
matter of this Agreement. This indemnification obligation shall survive the termination of this Agreement.
[XAContmctsTroMvs @. Goods Ssts\DOCS@016UCcg1cy 1@. Associates Professional Services FORM R-junc 2012.doc:7112I2016 11:47 AK
Tom Kegley d/b/a Kegley & Associates
DOCS and Fire Department -. 2016
Appropriation #43-509.00; P.O. # 33659, $12,187.50 P.O. #24846, $12,187.50
Contract Not To Exceed $24,375.00
7.5 Insurance.
Professional shall procure and maintain with an insurer licensed to do business in the State of Indiana such
insurance as is necessary for the protection of City and Professional from all claims under workers'
compensation, occupational disease and/or unemployment compensation acts, because of errors and
omissions, because of bodily injury, including, but not limited to, the personal injury, sickness, disease, or
death of any. of Professional's employees, agents or contractors and/or because of any injury to or
destruction of property, including, but not limited to,* any loss of use resulting therefrom. The coverage
amounts shall be no less than those amounts set forth on attached Exhibit C. Such insurance policies shall
not be canceled without thirty (30) days' prior written notice to City. .
7.6 Liens.
Professional shall not cause or permit the filing of any lien on any of City's property. In the event such a lien
is filed and Professional fails to remove it within ten (10) days after the date of filing, City shall have the right
to pay or bond over such lien at Professional's sole cost and expense.
7.7 Default.
In the event Professional: (a) repudiates, breaches or defaults under any of the terms or conditions of this
Agreement, including Professional's warranties; (b) fails to perform the Services as specified; (c) fails to
make progress so as to endanger timely and proper completion of the Services and does not correct such
failure or breach within five (5) business days after receipt of notice from City specifying same; or (d)
becomes insolvent, files, or has filed against it, a petition for receivership, makes a general assignment for
the benefit of creditors or dissolves, each such event constituting an event of default hereunder, City shall
have the right to terminate all or any part of this Agreement, without liability to Professional and to exercise
any other rights or remedies available to it at law or in equity.
7.8 Government Compliance.
Professional agrees to comply with all laws, executive orders, rules and regulations applicable to
Professional's performance of its obligations under this Agreement, all relevant provisions of which being
hereby incorporated herein by this reference, to keep all of Professionals' required professional licenses and
certifications valid and current, and to indemnify and hold harmless City from any and all losses, damages,
costs, liabilities, damages, costs and attorney fees resulting from any failure by Professional to do so. This
indemnification obligation shall survive the termination of this Agreement.
7.9 Indemnification.
Professional shall indemnify and hold harmless City and its officers, officials, employees and agents from all
losses, liabilities, claims, judgments and liens, including, but not limited to, all damages, costs, expenses and
attorney fees arising out of any intentional or negligent act or omission of Professional and/or any of its
employees, agents or contractors in the performance of this Agreement. This indemnification obligation shall
survive the termination of this Agreement.
[X:1ContractsNroLS%vs & Goods Sws1DOCS12016UCeg1ey i4. Associates Professional Services FORM R-june 2012.doc:7/12/2016 11:47 AM]
4
Tom Kegley d/b/a Kegley & Associates
DOCS and Fire Department - 2016
Appropriation #43-509.00; P.O. # 33659, $12,187.50 P.O. #24846, $12,187.50
Contract Not To Exceed $24,375.00
7.10 Discrimination Prohibition.
Professional represents and warrants that it and each of its employees, agents and contractors shall comply
with all existing and future laws prohibiting discrimination against any employee, applicant for employment
and/or other person in the subcontracting of work and/or in the performance of any Services contemplated by
this Agreement with respect to hire, tenure, terms, conditions or privileges of employment or any matter
directly or indirectly related to employment, subcontracting or work performance hereunder because of race,
religion, color, sex, handicap, national origin, ancestry, age, disabled veteran status or Vietnam era veteran
status. This indemnification obligation shall survive the termination of this Agreement.
7.11 E -Verify
Pursuant to I.C. § 22-5-1.7 et seq., Professional shall enroll in and verify the work eligibility status of all of its
newly -hired employees using the E -Verify program, if it has not already done so as of the date of this
Agreement. Professional is further required to execute the attached Affidavit, herein referred to as Exhibit D,
which is an Affidavit affirming that: (i) Professional is enrolled and is participating in the E -verify program, and
(ii) Professional does not knowingly employ any unauthorized aliens. This Addendum incorporates by
reference, and in its entirety, attached Exhibit D. In support of the Affidavit, Professional shall provide the City
with documentation that it has enrolled and is participating in the E -Verify program. This Agreement shall not
take effect until said Affidavit is signed by Professional and delivered to the City's authorized representative.
Should Professional subcontract for the performance of any work under this Addendum, the
Professional shall require any subcontractor(s) to certify by affidavit that: (i) the subcontractor does not
knowingly employ or contract with any unauthorized aliens, and (ii) the subcontractor has enrolled and is
participating in the E -verify program. Professional shall maintain a copy of such certification for the duration
of the term of any subcontract. Professional shall also deliver a copy of the certification to the City within
seven (7) days of the effective date of the subcontract.
If Professional, or any subcontractor of Professional, knowingly employs or contracts with any
unauthorized aliens, or retains an employee or contract with a person that the Professional or subcontractor
subsequently learns is an unauthorized alien, Professional shall terminate the employment of or contract with
the unauthorized alien within thirty (30) days ("Cure Period"). Should the Professional or any subcontractor of
Professional fail to cure within the Cure Period, the City has the right, to terminate this Agreement without
consequence.
The E -Verify requirements of this Agreement will not apply, should the E -Verify program cease to exist.
7.12 Severability.
If any provision of this Agreement is held to be invalid, illegal or unenforceable by a court of competent
jurisdiction, that provision shall be stricken, and all other provisions of this Agreement that can operate
independently of same shall continue in full force and effect.
JXAContracts\Prof.Stcs & Goods Sves1DOCSt2016Wcg1ey & Associates Professional Services FORM Revjune 2012.doc:7/12/2016 11:37 AMS
Tom Kegley d/b/a Kegley & Associates
DOCS and Fire Department - 2016
Appropriation #43-509:00; P.O. # 33659, $12,187.50 P.O. #24846, $12,187.50
Contract Not To Exceed $24,375.00
7.13 Notice.
Any notice, invoice, order or other correspondence required or allowed to be sent pursuant to this Agreement
shall be written and either hand -delivered or sent by prepaid U.S. certified mail, return receipt requested,
addressed to the parties as follows:
CITY:
City of Carmel
Department of DOCS & Fire
One Civic Square
Carmel, Indiana 46032
ATTENTION: Mike Hollibaugh or Dave Haboush
PROFESSIONAL:
Kegley & Associates
10431 Spring Highland Drive
Indianapolis, Indiana 46290
Douglas C. Haney
Corporation Counsel
One Civic Square
Carmel, Indiana 46032
Notwithstanding the above, City may orally provide to Professional any notice required or permitted by this
Agreement, provided that such notice shall also then be sent as required by this paragraph within ten (10)
business days from the date of such oral notice.
7.14 Effective Date:
The effective date ("Effective Date") of this Agreement shall be the date on which the last of the parties
hereto executes same.
7.15 Governing Law; Lawsuits.
This Agreement shall be governed by and construed in accordance with the laws of the State of Indiana,
except for its conflict of laws provisions, as well as by all ordinances and codes of the City of Carmel,
Indiana. The parties agree that, in the event a lawsuit is filed hereunder, they waive any right to a jury trial
they may have, agree to file such lawsuit in an appropriate court in Hamilton County, Indiana only, and agree
that such court is the appropriate venue for and has jurisdiction over same.
7.16 Waiver.
Any delay or inaction on the part of either party in exercising or pursuing its rights and/or remedies hereunder
or under law shall not operate to waive any such rights and/or remedies nor in any way affect the rights of
such party to require such performance at any time thereafter.
7.17 Non -Assignment.
Professional shall not assign or pledge this Agreement nor delegate its obligations hereunder without City's
prior written consent.
[X:1ContractslPmMts & Goods SvesT0CS\2016UCeg1ey & Associates Professional Services FORM Revjune 2012.doc:7/12/2016 11:47 AM]
Tom Kegley d/b/a Kegley & Associates
DOCS and Fire Department - 2016
Appropriation #43-509.00; P.O. # 33659, $12,187.50 P.O. #24846, $12,187.50
Contract Not To Exceed $24,375.00
7.18 Entire Agreement.
This Agreement contains the entire agreement of and between the parties hereto with respect to the subject
matter hereof, and no prior agreement, understanding or representation pertaining to such subject matter,
written or oral, shall be effective for any purpose. No provision of this Agreement may be amended, added to
or subtracted from except by an agreement in writing signed by both parties hereto and/or their respective
successors in interest. To the extent any provision contained in this Agreement conflicts with any provision
contained in any exhibit attached hereto, the provision contained in this Agreement shall prevail.
7.19 Representation and Warranties.
Each party hereto represents and warrants that it is authorized to enter into this Agreement and that any
person or entity executing this Agreement on behalf of such party has the authority to bind such party or the
party which they represent, as the case may be.
7.20 Headings.
All headings and sections of this Agreement are inserted for convenience only and do not form a part of this
Agreement nor limit, expand or otherwise alter the meaning of any provision hereof.
7.21 Advice of Counsel.
The parties warrant that they have read this Agreement and fully understand it, have had an'opportunity to
obtain the advice and assistance of counsel throughout the negotiation of same, and enter into same freely,
voluntarily, and without any duress, undue influence or coercion.
7.22 Copyright.
City acknowledges that various materials which may be used and/or generated by Professional in
performance of Services, including forms, job description formats, comprehensive position questionnaire,
compensation and classification plan and reports are copyrighted. City agrees that all ownership rights and
copyrights thereto lie with Professional, and City will use them solely for and on behalf of its own operations.
City agrees that it will take appropriate action with its employees to satisfy its obligations with respect to use,
copying, protection and security of Professional's property.
7.23 Personnel.
Professional represents that it has, or will secure at its own expense, all personnel required in performing the
services under this agreement. Such personnel shall not be employees of or have any contractual
relationship with City. All of the services required hereunder will be performed by Professional or under his
supervision and all personnel engaged in the work shall be fully qualified to perform such services.
7.24 Records and Inspections
Professional shall maintain full and accurate records with respect to all matters covered under this
agreement for three (3) years after the expiration or early termination of this Agreement. City shall have free
access at all proper times to such records and the right to examine and audit the same and to make
transcripts there from, and to inspect all program data, documents, proceedings and activities.
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Tom Kegley d/b/a Kegley & Associates
DOCS and Fire Department - 2016
Appropriation #43-509.00; P.O. # 33659, $12,187.50 P.O. #24846, $12,187.50
Contract Not To Exceed $24,375.00
7.25 Accomplishment of Project
Professional shall commence, carry on, and complete the project with all practicable dispatch, in a sound
economical and efficient manner, in accordance with the provisions thereof and all applicable laws. In
accomplishing the project, Professional shall take such steps as are appropriate to ensure that the work
involved is properly coordinated with related work being carried on within City's organization.
7.26 IRAN CERTIFICATION.
Pursuant to I.C. § 5-22-16.5, the Professional shall certify that, in signing this Agreement, it does not engage
in investment activities within the Country of Iran.
7.27 ACCESS TO PUBLIC RECORDS ACT
Professional understands and agrees that any "public record", as that term is defined in Indiana Code 5-14-3-
2(m), as amended, that is related to the subject matter of this Agreement, whether the same is in the
possession or control of the Professional or the City, shall be subject to release under and pursuant to the
provisions of Indiana's Access to Public Records Act, as codified in Indiana Code 5-14-3-1, et seg., as
amended.
(remainder of page intentionally left blank)
JX:\ConnctslProf.SAcs & Goods Sm\DOCSt20161Keg1ey R Associates Professional Senices FORM Rerjune 2012.doc:7/12/2016 11:47 AMI
Tom Kegley d/b/a Kegley & Associates
DOCS and Fire Department - 2016
Appropriation #43-509.00; P.O. # 33659, $12,187.50 P.O. #24846, $12,187.50
Contract Not To Exceed $24,375.00
IN WITNESS WHEREOF, the parties hereto have made and executed this Agreement as follows:
CITY OF CARMEL, INDIANA
by and through its Board of Public
Works and Safety
BY:
Aia� 0- ("et
James Brainard, Presiding Officer
Date:
Mary n Burke, Mqm ber�
Date:
Lori
Date:
TOM KEGLEY d/b/a
KEGLEY & ASSOCIATES
BY:
Authorized Signature
Printed Name: (bits Wl.C-"
Title:%Mtbu4m —
FID/TIN: `2 - AS2-or? 2 -
Last Four of SSN if Sole Proprietor:
Date: 'z f v s (Z0110
ATTEST:
C�Christi a S.Pu k t r
Date: ao
jXACC.U=Wj1'0r.%.@ aow, S%.q)0C5a616`XCG1'� A A6 Lllatrot-WW smim FORM Re jdm20124=7J W16 1:47 AMS
INFORMATION SYSTEMS CONSULTING
Engaging4Health Initiative
for
City of Carmel
June 21, 2016
1+9
AI(LIV k AsiO(IATIs
INFORMATION SYSTEMS CONSULTING
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INFORMATION SYSTEMS CONSULTING
Executive Summary
This proposal is to provide a detail design and implementation Plan for the Engaging4Health
initiative for the City of Carmel, Indiana
Assumption for this phase
Tom Kegley engaged as contracted resource of City scheduled at 25 hours per week. This
detail design phase is estimated to require 13 weeks of effort at hourly rate is $75 per hour.
Billing will occur on biweekly basis
Advisory Board (MD/PhD) will be formed to support, advise and be utilized as additional
contracted resource where required — Snell, Rodefeld, Rhoades, Fletcher — see attached
backgrounds. Initial lunch planning sessions to start followed by monthly lunch or dinner
planning/advisory sessions beginning in July.
"Steering Committee" will be formed of all stakeholders with Health systems representatives,
Carmel senior living centers directors, grocery chains, City FD, City Community Services,
Regenstrief, SEP, Telamon, plus the Advisory Board to meet quarterly.
Set up service providers - IT services provided by Software Engineering Professionals and/or
1150 Academy. Financial service company TBD contracted (to do bookkeeping, billing, financial
reporting, etc.).
Consideration of Dietary advisor to include Culinary Medicine Guru Dr. John La Puma.
Sponsors — Lilly, Roche, Cook, IBM, Apple, Fitbit, Microsoft, others with suggested contribution
$50k each to tE4H? Request trackers as donation to City's engaging4health. See Page 9
Agree how investment money managed and shared/allocated. Establish budget for additional
trackers, software, and promotional considerations such as T-shirts and other marketing
material.
Regenstrief to explore grants with BioCrossroads, Fed and State plus Insurers.
The second statement of work could include a bid for supplementary consulting that might be
considered out of scope for the first statement of work or needed to support the implementation
required in Phases I - IV. If sufficient funding raised in design portion, then compensation would
be provided through The Engagement for Health Inc..
Page 2
EXHIBIT JA_
241
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9WO k N UTATls
INFORMATION SYSTEMS CONSULTING
Statement of Work #1
MAJOR TASKS:
Planning phase July 1 — August 30 dates below are tentative subject to details
agreed with City and Regenstrief
- Agreement with Mayor that the City does embrace this as a Citywide initiative — March
31 introductory meeting set with City. Action TK & City March 31 Now May 26
- Work with City and Regenstrief on draft of all public communications as a joint
initiative — hopefully begin soon. Action - City & Regenstrief & TK August 16
- Technical Layout including registration of web sites, meet and qualify tracker band
providers including Apple & Fitbit, meet and agree with IT Service Providers 1150
Academy, SEP and others Action TK July 22
- Dietary design with potential to consider Dr. John La Puma as Dietary consultant to
City, Senior Living Facilities and Grocery stores. Action City & TK July 22.
- Finalize list of other Carmel senior facilities to engage with this process before going
public — I need City to follow up on competing facility profile Action City June 30.
- Engage with Justus Companies to consider Woodland Terrace as a "pilot" location to
get the design finalized. Add Reserve at Spring Mill to pilot phase Action TK
and Regenstrief July 14.
- Begin work on short term sponsor/investor possibilities... IBM, Apple, Microsoft — big
technology players who may want to participate, as well as Indiana life science
companies such as Lilly, Roche, Cook. Simultaneously, jointly pursue insurers &
government funding as source of long term funding. We need to agree who takes lead
and when. Action Regenstrief & City & TK July 8
- Talk with our local Health Systems (Community, IU Health, St. Vincent, Franciscan) to
determine how to enroll, screen and obtain consents — Again we need to decide who
Page 3
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INFORMATION SYSTEMS CONSULTING
takes lead on this. Involve Chief of CFD in monitoring and follow up for Chronic Disease
residents. Action Regenstrief & City & TK July 22.
- Talk to all senior living facilities in City of Carmel about their support and agree
participation. Obtain statement of intents. Action City & TK July 22.
- Talk with groceries about their participation. Obtain statement of intents. Action City &
TK July 11
- Announce to public — press conference. Action City & Regenstrief July 22
After detail planning completed and funding initiated - contractual agreements (letter of
Intent) with senior facilities, grocery chains, technology (tracker) companies etc. are
finalized and Budget completed — once initial funding set up with sponsors phase I-IV
would be funded by monies collected and not by City through The Engagement for
Health Inc..
Deliverables by Regenstrief and City agreed (see note 1). Agree level of City of Carmel
FD Engagement with 4 integrated Health Systems. Need to work on Outcomes
measures planning with Regenstrief and Health Systems.
Phase I Implementation Auqust 1 — November 1 - Enrollment and start up - enrollment
continues. Basis for activity is steps per day then adding other items — miles, flights,
weight, sleep etc. provided by nightly feeds from tracker companies to Regenstrief.
Planning for Phase II begins
Phase II Implementation November 1 - January 31, 2017 — Dietary Engagement based
on self -reporting and facility/grocery reporting. Planning for Phase III begins
Phase III Implementation February 1, 2017- April 31, 2017 - Social Engagement — self
reporting. Planning for Phase IV begins
Phase IV Implementation May 1,2017 — July 31, 2017 - City of Carmel participation in
Chronic Disease management with Health Systems
This is a multiphase multiyear Study on Aging — impacts and variables probably with 5
year study horizon at minimum
Page 4
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INFORMATION SYSTEMS CONSULTING
DELIVERABLES;
1. Detail Plan for Phase I with Regenstrief and City — initial focus on activity monitoring
through reporting of Step by resident participant.
2. High level plan for Phases I-IV to include dietary, social engagement and chronic
disease follow up.
3. Budget and Operation Plan for first year.
4. Signed letters of intent from all stakeholders.
5. Creation of not-for-profit The Engagement for Health LLC
6. Definition of Outcomes agreed
7. Public Announcement by City and Regenstrief
8. Others as agreed to support rollout of all four phases — see below
POPULATION HEALTH
Chronic Disease
Management
Clinical
Wellness Remote Patient
& Activity Dietary Soclal Monitoring
Engagement Solution
Palladium
Based on the
Ordering Food plus
Mobile Integrated
FitBitCommunity Nutritionaltralnin Morton Center
g
Healthcare Practice
Apple Wealth Shopping, Dining
Program
other fitness trackers and Movie Events
with Carnet Fl)
For those with
---------WELLNESS ------------ >
Chronic
Disease
Page 5
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INFORMATION SYSTEMS CONSULTING
Professional Biography of Principal
Tom Kegley
With over 40 years' experience providing information services to various clients, Tom Kegley
has developed a broad base of knowledge and practical understanding of business needs.
During his career at Roche Diagnostics and SmithKline Beecham, he led all aspects of the
information systems functions.
Tom was Vice President of Information Technology for Roche Diagnostics (1992-2007) where
he led the development of the first International Standards and IT Strategy. His organization
was twice recognized by Information Week Magazine as one of the most Innovative (#54 on IW
500 List 2005) and his ERP team was recognized as one of the Top 25 Competency Centers in
the Americas by SAP.
While at SmithKline Beecham (1989-1991) his team supported the US corporate information
needs and provided consulting services to various operating business units as well as the North
America integration. Prior to their merger with Smith Kline and French Tom led Information
Services for Beecham Laboratories (1968-1989) where he transformed the company to an
online computing environment supporting all commercial information needs.
Tom has acted as advisor to five of the top twenty Pharmaceutical companies in the world. As a
25 year member of the Pharmaceutical Information Systems Association, he served as
Executive Director for three different terms. He chaired the Community Hospitals of Indiana IT
Advisory Committee, served as President for the Society of Information Management for
Indianapolis and on the Board of Indiana HIMSS.
Tom's educational background includes a B.S. degree in Business Administration from East
Tennessee State University and completion of the Tennessee Executive Development Program
at the University of Tennessee.
Over his career, efforts were focused on producing high quality, cost effective technology
products and a high degree of client satisfaction. Utilizing this same philosophy, Tom has
founded Kegley & Associates to support other companies in providing the high levels of
customer service and quality results
Page 6
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Advisory Board for The Engagement for Health Inc
Ernie Fletcher, MD - CEO Alton Healthcare, LLC
Location - Greater Atlanta Area
Ernie Fletcher is the CEO of Alton Healthcare, LLC, a company that focuses on wellness and
prevention with a special emphasis on heart disease and stroke prevention. He served as an Air
Force fighter pilot, engineer, family physician, state legislator, and United States Congressman
from 1998-2003 before serving as Governor of the Commonwealth of Kentucky from 2003-
2007. Dr. Fletcher worked as a family practice physician in Lexington from 1987-1998, including
serving two years as CEO of the Saint Joseph Medical Foundation. In Congress, he served as a
member of the House Committees on Energy and Commerce and was selected to chair the
Policy Subcommittee on Healthcare.
Alan Snell, MD, MMM - President, RISE Healthcare, LLC - Innovation,
Clinical Informatics, Virtual Care
Location - Indianapolis, Indiana Area
Innovation, Clinical Integration, Care Transformation and Virtual Care strategies for healthcare
enterprises. Also provides development expertise in emerging technologies for entrepreneurial
companies. Practiced and taught Family Medicine for over 20 years in South Bend, IN.
Conceptualized and helped build one of nation's first successful and sustainable Health
Information Exchanges. Led projects to deploy electronic records in physician practices,
hospitals and bring remote care to the forefront for accountable care.
Specialties: Innovation, Care Transformation, Medical Informatics, Data Analytics, Virtual Care,
and Physician Leadership Training involving lecturing nationally and internationally
Mark Rodefeld MD - Assistant Professor of Surgery in the Section
of Cardiothoracic Surgery at the Indiana University School of
Medicine
Location - Indianapolis, Indiana Area
Dr Rodefeld is conducting research supported by a grant from National Institutes of Health and
actively collaborates with engineers at Purdue University. Dr. Rodefeld has clinical privileges
and teaching appointments at Riley Children's, IU University, St. Vincent Children's Hospital and
Page 7 AA
EXHUT
A
91WQ 4 ASWIATAS
INFORMATION SYSTEMS CONSULTING
IU Health Hospitals. He is actively engaged in research exploring highly innovative circulatory
support strategies to improve treatment for children born with single ventricle heart disease. Dr.
Rodefeld attended Indiana University and Indiana University School of Medicine and performed
his general and cardiothoracic surgical residency training at the Washington University School
of Medicine in St. Louis, Missouri where he spent two years as a Research Fellow of the
National Heart Lung and Blood Institute. He also completed a Congenital Cardiac Surgical
Fellowship at Stanford University and the University of California, San Francisco. He returned to
Indiana in 2001 to join the faculty of the IU School of Medicine and is actively engaged in clinical
practice.
Rod Rhoades, PhD - Professor of Physiology IU School of
Medicine - Retired
Location - Indianapolis, Indiana Area
Dr. Rhoades is Professor of Physiology IU School of Medicine — Retired and has done much
research and has published numerous papers. He recently published a book "Mind * Body
Spirit - Connections" on staying healthy
Page 8
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INNOVATEINDIANA
KELLEY SCHOOL OF BUSINESS
INDIANA UNIVERSITY
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Page 9
Invoice
Name of Company.
Address & Zip:
Telephone No.:
Fax No.:
Project Name:
Invoice No.
Purchase Order No:
Date:
Signature
Printed Name
Goods
Services
Person Providing
Date
Goods/Services Provided
Cost Per
Hourly
Total
Goods/Services
Goods/
(Describe each good/service
Item
Rate/
Service
separately and in detail)
Hours
Provided
Worked
GRAND TOTAL
Signature
Printed Name
EXHIBIT C
INSURANCE COVERAGES
Worker's Compensation & Disability
Employer's Liability:
Bodily Injury by Accident/Disease:
Bodily Injury by Accident/Disease:
Bodily Injury by Accident/Disease:
Property damage, contractual liability,
products -completed operations:
General Aggregate Limit (other than
Products/Completed Operations):
Products/Completed Operations:
Personal & Advertising Injury
Policy Limit:
Each Occurrence Limit:
Fire Damage (any one fire):
Medical Expense Limit (any one person):
Statutory Limits
$100,000 each employee
$250,000 each accident
$500,000 policy limit
$500,000
$500,000
$500,000
$250,000
$250,000
$ 50,000
Comprehensive Auto Liability (owned, hired and non -owned)
Bodily Single Limit:
Injury and property damage:
Policy Limit:
Umbrella Excess Liability
Each occurrence and aggregate:
Maximum deductible:
$500,000 each accident
$500,000 each accident
$500,000
$500,000
$ 10,000
EXHIBIT D
AFFIDAVIT
7h.jzc—�A�Lt` being first duly sworn, deposes and says that
he/she is familiar with and has personal knowledge of the facts herein and, if called as a witness in this
matter, could testify as follows:
1. I am over eighteen (18) years of age and am competent to testify to the facts contained
herein.
2. I am now and at all ties relevant herein have been employed by
(the "Employer")
in the position of 1 ��
3. I am familiar with the employment policies, practices, and procedures of the Employer and
have the authority to act on behalf of the Employer.
4. The Employer is enrolled and participates in the federal E -Verify program. Documentation
of this enrollment and participation is attached and incorporated herein.
5. The Employer does not knowingly employ any unauthorized aliens.
6. To the best of my information and belief, the Employer does not currently employ any
unauthorized aliens.
7. FURTHER AFFIANT SAYETH NOT.
EXECUTED on the Aday of , 20"
Printed: t
I certify under the penalties for perjury under the laws ited States of America and the State of
Indiana that the foregoing factual statements and re resentat' s a're tlrue and c rrect.
Printed: ", �4
Authorization
Signed & Accepted by:
Tom Kegley, Presidg
Kegley & Associates
City of Carmel Date
Title
Page
10
919
11MO � ASSOUATES
P90101AMON SYSYFMSCONSIRTING
City ®f Carmel
INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO. 003120165 002 0
Page 1 of 1
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
33659
ONE CIVIC SQUARE
35-6000972
THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL, INDIANA 46032-2584
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
6/29/2016
370770
KEGLEY & ASSOCIATES
Dept of Community Service
VENDOR 10431 SPRING HIGHLAND DRIVE
SHIP 1 Civic Square
TO Carmel, IN 46032 -
INDIANAPOLIS, IN 46290 -
PURCHASE ID
BLANKET
CONTRACT
PAYMENTTERMS
FREIGHT
6050
QUANTITY
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE EXTENSION
Department: 1192 Fund: 101 General Fund
Account: 43-509.00
1 Each Fees for detail design and implementation plan for $0.00 $0.00
Engaging4Health Initiative
1 Each Twenty -Five Hours a week x 13 weeks at $75 an hour to be $12,187.50 $12,187.50
split between DOCS and Fire - DOCS Portion
Sub Total $12,187.50
Send Invoice To:
Dept of Community Service
1 Civic Square
Carmel, IN 46032 -
a 1f .
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT I PROJECT I PROJECTACCOUNT I AMOUNT
PAYMENT $12,187.50
SHIPPING INSTRUCTIONS ' AfP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A
PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN
*SHIP PREPAID. AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
'C.O.D. SHIPMENT CANNOT BE ACCEPTED. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
'PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL
`THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
TITLE e�
CONTROL No. 33659 CLERK -TREASURER
i
City ®f Carmel
INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO.003120155 002
Page 1 of 1
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
24846
ONE CIVIC SQUARE
35-6000972
THIS NUMBER MUSTAPPEARON INVOICES, AR
CARMEL, INDIANA 46032-258,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE
PURCHASE ORDER DATE
DATE REQUIRED REQUISITION NO.
VENDOR NO.
DESCRIPTION
6/30/2016
370770
Engaging for Health Initiative for City of Cannel - Fire Portio
KEGLEY & ASSOCIATES
Fire Department
VENDOR 10431 SPRING HIGHLAND DRIVE
SHIP 2 Civic Square
TO Cannel, IN 46032 -
INDIANAPOLIS, IN 46290 -
PURCHASE ID BLANKET CONTRACT
PAYMENT TERMS FREIGHT
6075
QUANTITY UNIT OF MEASURE
DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 Fund., 101 General Fund
Account: 43-509.00
1 Eac Fees for detail design and implementation plan for
Engaging4Health Intitiative
1 Eac Twenty -Five hours a week x 13 weeks at $75 an hour to
be split between Fire and DOCS - FIRE PORTION
Send Invoice To:
Fire Department
2 Civic Square
Carmel, IN 46032-
F UA
1
$0.00
$12,187.50
$0.00
$12,187.50
Sub Total $12,187.50
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT I AMOUNT
PAYMENT $12,187.50
SHIPPING INSTRUCTIONS ' A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P 0 NUMBER IS MADE A
'SHIP PREPAID.
'C.O.D. SHIPMENT CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS
*THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN
AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
ORDERED B)
Denise Snyder Steve Engelking
TITLE Budget & Accreditation Manager Administration
CONTROL NO. 24846 CLERK-TREASUREI
Authorization
Signed & Accepted by:
Tom Kegley, President
Kegley & Associates
City of Carmel
Title
Received
k
�o
Page
10
Date
Date
9A
9MIQ k OSSO(I M
INFORMATION SYSTEMS CONSULTING
EXE I I rB1 IT