THIS AGREEMENT, made and entered into this day, ______, by and between ABC Industries and Team Rehab, a Minnesota-based corporation, certified by the Minnesota Department of Health, organized and existing under the laws of the State of Minnesota, Anytown, Minnesota.
Team Rehab agrees to provide services for ABC Industries in Yourtown, MN. Team Rehab shall provide adequate and qualified personnel in providing the Occupational Health Services specified in this agreement.
Team Rehab agrees to provide the following services within the framework of the WorkWell Systems
protocol for Occupational Health Services:
1. Functional Job Analysis (FJA) of the production associate jobs at a rate of $ per hour.
· The FJA will be a collaboration process with ABC Industries management, production associated, and Team Rehab professionals.
2. Functional Job Descriptions (FJD) for production jobs (charge included in Functional Job Analysis).
· The FJD will be a collaboration process with ABC Industries management and Team Rehab professionals.
3. Prework Screening (PWS) development for production jobs (charge included in Functional Job Analysis).
· The PWS process will include validation of the screens by ABC Industries representative(s) to assure they are fair and accurate.
4. Implementation of Prework Screening on new hires for production jobs at ABC Industries at a rate of $ per completed screen and $ per uncompleted screen.
· ABC Industries may also choose to utilize Prework Screening on other individuals as deemed necessary.
· Results will be made known to designated ABC Industries representatives immediately following each screen.
· Team Rehab will be available to conduct Prework Screening within two working days of contact by designated ABC Industries representative(s).
· ABC Industries will provide equipment (specific to the company) that is deemed necessary to conduct the Prework Screening fairly and accurately.
Up dated Functional Job Analysis reports, Functional Job Descriptions and Prework Screen forms will be provided to ABC Industries to have on file. All original forms will be kept on file at Team Rehab.
Additional services will include but not be limited to the following:
· Annual review by Team Rehab team of the production associate jobs to assure the Functional Job Descriptions and Prework Screening tools continue to accurately reflect the jobs. ABC Industries may exercise the right to request additional consultation to update reports and screening tools if jobs, equipment, or process standards change significantly before the yearly review. On-site review of the jobs will be charged at a rate of $ per hour.
· Tracking of all Prework Screens conducted by Team Rehab at no charge. A year-end report will be provided in January, summarizing the activity of the previous calendar year.
Completion of the Functional Job Analysis, development of the Functional Job Descriptions and validation of the Prework Screens will be completed within 6 weeks of initiation of services.
This agreement may be amended from time to time by an agreement in writing. This agreement will be automatically renewed each year on its anniversary date.
Either party with 30 days prior written notice may terminate this agreement to that effect.
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Team Rehab Contact / Date
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ABC Industries Representative / Date