CITY OF DALLAS
REQUEST FOR QUALIFICATIONS (RFQ)
BKZ1534
INDEPENDENT MEDICAL REVIEW
For the City of Dallas
SUBMITTAL DUE DATE/TIME:
LOCATION:
10/22, 2015 BY 2:00PM
City Hall
1500 Marilla St.
Bus. Dev. & Procurement Services
Conference Room 3FN
Dallas, Texas 75201
City of Dallas
Request for Qualifications BKZ1534
Independent Medical Review
BACKGROUND
The City of Dallas (sometimes hereafter referred to as the “City”) is seeking submittals from a
company with credentialed physicians (sometimes hereinafter called “Firm” or, plural, “Firms”) to
this Request for Qualifications (the “RFQ”) for the purpose of providing Independent Medical
Examination, Peer Review and Bill Review Services for a wide range of insurance lines,
including bodily injury, automobile, workers’ compensation, disability and federal insurance
programs by reviewing documents and advising the City in matters pertaining to the evaluation
of medical and health-related claims for accuracy and legitimacy.
Based on the consideration of the responses to this RFQ, the Dallas City Council may select
one or more physician firms with which to contract for the City’s independent medical review
services.
The number of contracts resulting from this RFQ, the determination of whether the contract
should be awarded to one or more firms, and the type of medical review issues assigned to the
firm/s are matters strictly within the discretion of the City.
Required services for the independent medical review are described in the Required Services
section of this RFQ. In addition to required services, the RFQ describes qualifications,
evaluation criteria, and form of response required. The City will evaluate the submittals from
each respondent (“Respondent”) for potential award of a contract or contracts according
to the evaluation criteria outlined in the corresponding section for each service.
The City reserves the right to: (1) negotiate and award a contract(s) resulting from the RFQ; (2)
not award a contract(s) resulting from the RFQ; (3) extend the RFQ due date; (4) amend the
RFQ; (5) cancel the RFQ; and, (6) waive minor technicalities. The cost of preparing a response
is solely that of the Respondent and the City will not be liable for any corresponding expenses.
The City reserves the right to negotiate all resulting contract terms with selected Respondents.
GENERAL INFORMATION ABOUT THE CITY OF DALLAS
The City is a political subdivision located in Dallas, Denton, Collin and Rockwall Counties
operating as a Home-Rule City under the laws of the State of Texas and a charter approved by
the voters in 1907. The City operates under the City Council/Manager form of government
where the Mayor is elected for a four-year term and fourteen City Council members are elected
for two-year terms. A mayor’s term is limited to two consecutive terms and Council members
are limited to four consecutive terms. The City Council formulates operating policy for the City
while the City Manager is the Chief Administrative Officer. The City is the third largest city in
Texas and the ninth most populous city in the United States.
COMMUNICATION AND INQUIRIES
After the RFQ has been issued, Respondents are prohibited from communicating with the City
staff regarding the RFQ or submittals, except with the Office of Business Development and
Procurement Services.
Verbal questions and explanations are not permitted. Do not rely on oral instructions or
clarifications. Verbal agreements or representations are not binding.
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RFQ BKZ1534
City of Dallas
City of Dallas
Request for Qualifications BKZ1534
Independent Medical Review
Questions concerning this RFQ shall be directed in writing to:
Doug Shelton, Sr. Buyer
City of Dallas
Business Development and Procurement Services
1500 Marilla St., Room 3FN
Dallas, TX 75201
Email: [email protected]
The last day for questions to be submitted is 5pm CDT on the day after the pre-submittal
meeting. The Firm should carefully examine the complete RFQ. Failure to do so will be at the
Firm’s risk. If the meaning of any part of this RFQ is unclear, submit written questions no later
than the day and time above. Responses to all questions received will be distributed as an
addendum to all prospective firms. The City shall not meet with representatives of any
Respondent to discuss submittals. The City reserves the right to contact Respondent for
clarification after responses are opened and/or for further negotiation with any Respondent, if
such is deemed desirable by the City.
Respondent shall not contact City employees or Officers to explain, clarify or discuss their
submittals before an award has been made, except as set out in this section. Violation of these
provisions by Respondent may lead to disqualification of its submittal.
FORMAT OF SUBMITTAL CONTENT
Submittals shall be structured and formatted as follows:
1) Transmittal Letter (Executive Summary of Services):
All submittals shall include a completed transmittal letter signed by an employee of the
institution who is authorized to contractually bind the Respondent.
a. Maximum length of two pages on company letterhead.
b. Identify the service(s) for which the response has been submitted.
c. Include an offer to negotiate indicating the Respondent’s understanding and
agreement to comply with the terms of this RFQ and all related addenda, and
stipulating that the submittal set forth remains effective for a minimum period of 150
days.
d. Include Firm's name, address and telephone number.
e. Include the name, addresses, and telephone number of a single contact person for
all correspondence and notifications regarding this RFQ.
f.
Include names, addresses, and telephone numbers of any other person(s)
authorized to represent the Firm.
g. The original signature of a partner, principal, or officer of the Respondent with a
statement that the signatory is authorized to submit the submittal.
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2) Table of Contents:
Submittals shall be submitted with a Table of Contents with appropriate page numbers
for locating the required information and attachments as specified in the Submittal
Requirements.
3) Submittal
a. Each submittal shall be typed.
b. Each submittal shall be bound on the left side.
c. Refer to each section for details on submittal contents.
d. Required City documents to be submitted as follows:
RFQ Signature Page
Proposal
Requested number of copies
Business Information Form (BDPS-FRM-140)
Conflict of Information Form
Insurance Affidavit Form (BDPS-FRM-122)
Business Inclusion and Development Affidavit (BDPS-FRM-203)
Ethnic Workforce Composition Report (BDPS-FRM-204)
RFP/RFQ Contractors affidavit history of MWBE utilization form (BDPS-FRM205)
RFP/RFQ Contractors affidavit type of work by prime and sub consultant form
(BDPS-FRM-206)
Copy of contractor’s internal affirmative action plan or policy
Environmental Affidavit
SUBMITTAL OF RESPONSES
Responses to the RFQ shall be made according to the instructions set forth in this section for
content and format. Each firm’s submittal shall be typed and submitted as one (1) original,
seven (7) identical legible copies and one (1) electronic copy on CD or Flash Drive in a sealed
package. The original submittal shall be the actual document received by the City of Dallas.
Faxed or emailed responses are not acceptable. Any additional or alternative bids shall be
submitted in a separate sealed package and labeled accordingly. The original submittal shall be
clearly marked "Original' and signed in ink, by hand, in the space marked Authorized Signature.
Each copy shall be clearly marked “Copy”. The exterior of the sealed package shall reference
the RFQ name and number. The City of Dallas is not responsible for submissions not properly
identified.
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RFQ BKZ1534
City of Dallas
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Request for Qualifications BKZ1534
Independent Medical Review
The submission envelope should be clearly marked with the firm’s name and address with
notation “RFQ # BKZ1534 – Independent Medical Review Services.” All submittals shall be
received by the due date and should be directed to:
City of Dallas
Business Development and Procurement Services
Attention: Doug Shelton
1500 Marilla St., Room 3FN
Dallas, TX 75201
Submittal responses delivered to the City after the due date and time will not be accepted or
considered and will be returned unopened. The City of Dallas reserves the right to reject any
and all submittals or to accept submittals deemed to be in its best interest.
INSURANCE REQUIREMENTS
The awarded vendor shall provide a certificate of insurance evidencing proof of insurance
coverage listed in Attachment 1 – “Insurance Requirements” within 15 days of award. The City
of Dallas will be provided a Waiver of Subrogation waiving Rights of Recovery against City of
Dallas on the Workers’ Compensation/Employers Liability policy. The City will be shown as the
certificate holder. This insurance shall stay in force for the duration of the contract.
RFQ DISCLOSURES
APPROVAL BY CITY COUNCIL AND OFFERING OF CONTRACT
Contract award shall be subject to approval by the Dallas City Council. The City of Dallas will
require the Consultant to sign the necessary contract documents prepared by the City
Attorney’s Office prior to going to Council.
ADDENDA AND SUPPLEMENTAL INFORMATION
Addendum/Addenda to the RFQ shall be provided on-line at:
https://bids.dallascityhall.com/webapp/VSSPROD/AltSelfService
It may be necessary for the City to request supplemental information from individual
Respondents after submittals have been submitted and reviewed. Such information will be
requested in writing to the specific Respondent and will be used by the City in evaluating the
submittal and will not be shared with other Respondents during the evaluation and award
process.
OPENING OF SUBMITTALS
Upon receipt, all submittals become the property of the City of Dallas, which will not be liable for
any costs incurred by any firm responding to this RFQ. All submittals submitted shall remain
valid for one hundred and fifty (150) days following the deadline date unless requested to be
longer by the buyer.
LATE AND WITHDRAWN SUBMITTALS
Submittals received by the City after the time and date will not be considered. Any submittal
may be withdrawn prior to the scheduled due date.
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Request for Qualifications BKZ1534
Independent Medical Review
REJECTION OR ACCEPTANCE OF SUBMITTALS
This Request for Qualifications does not commit the City to award any contract.
The City of Dallas reserves the right to reject any or all submittals, to waive technicalities or
irregularities, and to accept any submittal it deems to be in the best interest of the City. The City
reserves the right to reject specific elements contained in all submittals.
DISQUALIFICATION OF RESPONDENTS
Respondents may be disqualified for non-compliance with requirements and, for any, but not
limited to, the following reasons:
1. Reason to believe collusion exists among the submitters.
2. The Respondent is involved in any litigation against the City of Dallas.
3. The Respondent is in arrears on an existing contract or has failed to perform on a
previous contract with the City of Dallas.
4. The Respondent’s lack of financial stability.
5. The Respondent’s failure to use the City of Dallas approved forms or follow City of
Dallas guidelines, procedures, rules or regulations.
CONFIDENTIALITY
Any information deemed confidential, shall be clearly noted as such on each page or pages.
Efforts will be made to keep the marked information confidential; however, the City cannot
guarantee it will not be compelled to disclose all or part of any public record under the Texas
Open Record Act.
Submittals will be opened by the City so as to avoid disclosure of contents to competing
Respondents, and kept secret and confidential during the process of negotiation. It is the
responsibility of the submitter to clearly mark and identify all portions of the submittal that
contain trade secrets, confidential information and other proprietary information. Such
information contained in the submittals and clearly identified will not be made open for public
inspection at any time, even after the contract has been awarded and executed, and whether or
not the Respondent wins the contract. If a third party challenges the trade secret or confidential
nature of certain information, it will be the responsibility of the Respondent to defend the
challenge to the State Attorney General’s office.
CONFLICT OF INTEREST
The Respondent acknowledges that the following section of the Charter of the City of Dallas
prohibits certain transactions between the City and its officers and employees, to wit:
CHARTER XXII Sec. 11 FINANCIAL INTEREST OF EMPLOYEE OR OFFICER
PROHIBITED
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Independent Medical Review
No city official or employee shall have any financial interest, direct or indirect, in
any contract with the city, or be financially interested, directly or indirectly, in the sale
to the city of any land, materials, supplies or services, except on behalf of the city as
a city official or employee. Any violation of this section shall constitute malfeasance
in office, and any city official or employee guilty thereof shall thereby forfeit the city
official’s or employee’s office or position with the city. Any violation of this section,
with knowledge, express or implied, of the person or corporation contracting with the
city shall render the contract involved voidable by the city manager or the city
council. The alleged violations of this section shall be matters to be determined
either by the trial board in the case of employees who have the right to appeal to the
trial board, and by the city council in the case of other employees. The prohibitions
of this section shall not apply to the participation by city employees in federallyfunded housing programs, to the extent permitted by applicable federal or state law.
This section does not apply to an ownership interest in a mutual or common
investment fund that holds securities or other assets unless the person owns more
than 10 percent of the value of the fund. This section does not apply to nonnegotiated, form contracts for general city services or benefits if the city services or
benefits are made available to the city official or employee on the same terms that
they are made available to the general public. This section does not apply to a
nominee or member of a city board or commission, including a city appointee to the
Dallas Area Rapid Transit Board. A nominee or member of a city board or
commission, including a city appointee to the Dallas Area Rapid Transit Board, shall
comply with any applicable conflict of interest or ethics provisions in the state law
and the Dallas City Code. (Amend. of 8-12-89, Prop. No. 1; Amend. of 8-12-89, Prop.
No. 15; Amend. of 11-4-14, Prop. Nos. 2 and 9) 11
INDEMNITY
The selected RESPONDENT agrees to defend, indemnify and hold the City, its officers, agents
and employees, harmless against any and all claims, lawsuits, judgments, costs, and expenses
for personal injury (including death), property damage or other harm for which recovery of
damages is sought, suffered by any person or persons, that may arise out of or be occasioned
by the selected Respondent’s breach of any of the terms or provisions of the contract, or by any
other negligent or strictly liable act or omission of the selected Respondent, its officers, agents,
employees, or subcontractors, in the performance of the contract; except that the indemnity
provided for in this paragraph shall not apply to any liability resulting from the sole negligence or
fault of the City, its officers, agents, or employees and in the event of joint and concurrent
negligence or fault of the selected Respondent and City, responsibility, and indemnity, if any,
shall be apportioned comparatively in accordance with the laws of the State of Texas, without
waiving any governmental immunity available to the City under Texas law and without waiving
any defenses of the parties under Texas law. The provisions of this paragraph are solely for the
benefit of the parties hereto and are not intended to create or grant any rights, contractual or
otherwise, to any other person or entity.
COMMITMENT TO DIVERSITY.
It is the policy of the City of Dallas to involve Minority and Women-Owned Business Enterprises
to the greatest extent feasible on the City’s construction, procurement, and professional
services contracts. The City and its contractors shall not discriminate on the basis of race,
color, religion, national origin, or sex in the award and performance of contracts. In
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consideration of this policy, the City of Dallas has adopted the Business Inclusion and
Development Plan (BID Plan) for all City of Dallas contracts. The information shall be submitted
with the submittal and shall include:

The Ethnic Workforce Composition Report (BDPS-FRM-204).

Submission of documentation showing the RFQ/RFQ Contractor’s Affidavit History of
M/WBE Utilization Form (BDPS-FRM-205) on previous contracts on the form provided.
Firm (s) Team make-up includes a significant number of diverse M/WBE firms in
meaningful roles on the project. Please submit the RFQ/RFQ Contractor’s Affidavit Type
of Work by Prime and Sub-consultant Form (BDPS-FRM-206).
The name, address and telephone number of each M/WBE; (b) the description of the
work to be performed by each M/WBE; and (c) the approximate dollar
amount/percentage of the participation.
Evidence of acknowledgement of the City’s Business Inclusion and Development (BID)
Plan, signed Business Inclusion and Development Affidavit (BDPS-FRM-203) that
demonstrates intent to comply with the policy and evidence of M/WBE inclusion to meet
the BID goal for the project.



Assistance in preparing the Business Inclusion and Development (BID) forms may be obtained
by contacting Resource Link team member, Laura Hurtado, at 214-243-2130, or by sending an
email to [email protected].
The City of Dallas reserves the right to consider any other factors that may be relevant to its
needs including other value added services that may be proposed.
COMMUNICATION
The need to respond quickly and clearly is essential to the City. Respondents shall answer
written correspondence from the City within three (3) working days; vendors shall have a
company employee (not an answering service or answering machine) answer the phone during
normal business hours, or provide either a cell phone number or a pager number. Phone
messages shall be returned within two hours.
SELECTION OF BEST QUALIFIED SUBMITTAL
The City of Dallas will review the submittals of all Respondents. On the basis of the evaluation
criteria, the City of Dallas will determine which submittals are best qualified for the award of the
contract. The City of Dallas may at any time, investigate a Respondent’s ability to perform
work. The City of Dallas may ask for additional information about a company and its work on
previous contracts. Respondents may choose not to submit such information in response to City
of Dallas’ request; however if failure to submit such information does not clarify the City’s
questions concerning the ability to perform, the City may discontinue further consideration of a
particular submittal. Please be aware that the City of Dallas may use sources of information not
supplied by the Respondents concerning the abilities to perform this work. Such sources may
include current or past customers of the organization; current or past suppliers; articles from
industry newsletters or other publications or from non-published sources made available to the
City of Dallas.
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Independent Medical Review
SCOPE OF SERVICES
Purpose
The firm or firms selected to provide independent medical review services is expected to act in
that capacity for the City with respect to a wide range of insurance lines, including bodily injury,
automobile accidents, workers’ compensation, disability and federal insurance programs.
Firms shall be able to provide all services described in “Required Services.”
Required Services
1. Provide expert independent medical review on a continuing basis, as needed, to
assist the City Attorney’s Office in evaluating medical and health related claims made
by third parties for the accuracy and legitimacy of the claim.
2. Assist the City’s legal staff in review of hospital, physician and other medical staff
billing statements to verify coding, UCR pricing and utilization review; review surgical
cost estimates for any medical procedures.
3. Provide expert reports and controverting affidavits, as needed, for trial, pre-trial and
mediation proceedings.
4. Provide necessary testimony for trial and mediation proceedings, including expert
depositions and trial testimony.
5. Attend meetings with City staff for testimony preparation
6. Provide any other independent medical review services as requested by the City.
Submittal Contents
Following is a list of the information to be provided by the Respondent for the medical review
services sought. A submittal that does not include the information required below may be
deemed non-responsive and subject to rejection.
1. Management and Qualifications
a. Describe the medical review services which your Firm could provide to the City.
State whether your Firm can provide all of the services in the RFQ Scope of
Services. Identify any services that your Firm cannot provide and how you would
propose to fulfill the scope of services under those circumstances.
b. State the names of the physicians and other trained medical staff on your current
roster who would be assigned to the City’s account, describe the medical
specialty of each and the expected services to be provided by each professional.
Provide their resumes and describe their anticipated availability to perform
services, as needed, for the City’s account. Identify the firm manager who will be
the contact person for the City and in charge of finding the appropriate person to
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fill each request for services and, for this manager, provide three (3) client
references relating to engagements similar to the one described in this RFQ.
c. Describe your Firm’s experience related to the City’s Scope of Services to be
provided in response to the RFQ, including a brief summary of any notable
cases, testimony, issues and/or matters handled by your Firm which best
demonstrate your Firm’s expertise and capabilities, including, but not limited to,
your firm’s specific experience related to:
(i.) Cities comparable in size to the City of Dallas and comparable in types
of medical claims litigation.
(ii.) Location of professionals throughout the United States in a widevariety of unique specialties that will be available to the City for its very
wide-range of medical review requirements.
(iii.) Identifying specific notable cases that your Firm has worked on as
independent medical experts in the last five (5) years, including, but not
limited to, the date of the trial, the type of claims involved, name of expert
witness, and the case outcome.
(iv.) Approach to be taken by your Firm with regard to independent
medical review assignments.
(v.) Identifying all of the areas of medical claims in which your Firm has
particular expertise or specialization.
d. Provide a detailed description of:
(i) Any litigation or administrative proceeding in which the Firm was
named as a party in any matter related to the professional activities of the
Firm during five (5) years prior to the date of this RFQ;
(ii) Litigation, investigation, or proceeding in which a court or
administrative agency is addressing any question relating to the
professional activities of the Firm or its members; and
(iii) Any notice of official action, administrative inquiries, or formal
challenges pertaining to any independent medical review performed by
the Firm.
e. Describe the process, procedures and controls used by the Firm to control
documents and subsequent changes.
f.
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Describe the names, proposed roles, medical background, office location and
availability of personnel on your current roster that would work on the City’s
account.
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SELECTION CRITERIA
A comprehensive, fair, and impartial evaluation will be made of all submittals received in
response to this RFQ. Each submittal received will be analyzed to determine overall
qualifications under the RFQ. An Evaluation Committee comprised of City staff will determine
the responsiveness and acceptability of each submittal and recommend an award be made to
the firm whose submittal is determined to be in the best interest for the City of Dallas. Final
selection will be approved by the City Council.
The Evaluation Committee will consider the following factors:
1. Experience and Qualifications: Experience of medical professionals who would be
available to work on specific cases and claims for the City. This would include the
variety of expertise available and past experience in providing the services. Reponses
by references will be included to evaluate the experience and qualifications of the Firm.
(50 points)
2. Firm’s location and availability to City staff: Firm’s ability to have an evaluator or
expert witness readily available in order to address urgent issues that may arise in a
case or during a trial. (20 points)
3. Approach to the Assignment: The Firm’s approach to providing the services and to
representation of the City, including the types of services offered by the Firm, including
the expertise, roles and responsibilities of each participant. (15 points)
.
4. Business Inclusion and Development: It is the policy of the City of Dallas to involve
Minority and Women-Owned Business Enterprises to the greatest extent feasible on the
City’s construction, procurement, and professional services contracts. The City and its
contractors shall not discriminate on the basis of race, color, religion, national origin, or
sex in the award and performance of contracts. In consideration of this policy, the City
of Dallas has adopted the Business Inclusion and Development Plan (BID Plan) for all
City of Dallas contracts. The information shall be submitted with the proposal and shall
include:
1. Submission of an Affirmative Action Plan and/or Policy. If the Firm does not have
an Affirmative Action Plan the Business Inclusion and Development Staff can
provide the Affirmative Action Requirements (BDPS-PRO-204) which will serve
as a template to be utilized for this criterion.
2. The Ethnic Workforce Composition Report (BDPS-FRM-204)
3. Submission of documentation showing the RFP/RFQ Contractor’s Affidavit
History of M/WBE Utilization Form (BDPS-FRM-205) on previous contracts on
the form provided.
4. Firm (s) Team make-up includes a significant number of diverse M/WBE firms in
meaningful roles on the project. Please submit the RFP/RFQ Contractor’s
Affidavit Type of Work by Prime and Sub-Consultant Form (BDPS-FRM-206)
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(a) The name, address and telephone number of each M/WBE; (b) the
description of the work to be performed by each M/WBE; and (c) the
approximate dollar amount/percentage of the participation.
Evidence of acknowledgement of the City’s Business Inclusion and Development (BID)
Plan, signed Business Inclusion and Development Affidavit (BDPS-FRM-203) that
demonstrates intent to comply with the policy and evidence of M/WBE inclusion to meet
the BID goal for the project. (15 points)
AWARD AND TERM OF CONTRACT
METHOD OF AWARD
The selection and award of this RFQ will be made to the Respondent on the basis of
demonstrated competence and qualifications to perform the services at fair and reasonable
prices. All awards shall be based on the evaluation criteria.
The independent medical review services contract will commence on or about October 1,
2015. The term of this contract will be for three (3) years, with two one-year renewal
options at the sole discretion of the City. The contract will be awarded to the
Respondent whose submission is approved by City Council.
The City will require the selected Respondent to execute a professional services contract in
substantially the same form as the sample attached (Attachment A). No work shall commence
until the contract document(s) are signed and Respondent has provided necessary evidence of
insurance as required in RFQ. In the event the parties cannot negotiate and execute a contract
within the time specified, the City reserves the right to terminate negotiations with the selected
Respondents and commence negotiations with another Respondent. If selected to provide the
services, responses to the RFQ will be considered as part of the Firm's contractual
responsibilities. Misrepresentation of the Respondent’s ability to perform as stated in the
submittal shall result in cancellation of the contract award. The City of Dallas reserves the right
to withdraw or reduce the amount of an award, or to cancel the contract resulting from this
procurement if adequate funding is not available. Contract award may be subject to approval by
the Dallas City Council. The City of Dallas will require the Contractor to sign the necessary
contract documents prepared by the City Attorney’s Office prior to going to City Council.
Contract documents are not binding on City until approved by the City Attorney and executed by
the City Manager or appointee. The City reserves the right to reject any or all submittals and to
waive any irregularity in submittals received; and accept other than the lowest offer subsequent
to receipt and evaluation of submittals and completion of interviews. Respondent understands
and agrees that if selected, it and persons designated by it to provide services in connection
with a contract(s), is and shall be deemed to be an independent contractor of the City,
responsible for its respective acts or omissions; and the City shall in no way be responsible for
Respondent’s actions, and that neither party hereto will have authority to bind the other or to
hold out to third parties, that is has such authority.
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