STATE OF VERMONT CONTRACT SUMMARY AND CERTlFIC~A~T~1O~,:,N.:.-=-!F:"o,:,rm~A~A~:-~1:4~;{:",IfI".!L

Amendment #: 1
Contractor Vendor No: 182150

Contract #: 10962
Agency/Department:
Agency ofl-Iuman Services/Dept of COlTections
Contractor:
Prison Hcalth Services, Inc
105 Westpark Drive, Suite 200, Brentwood, TN 37Q27
Contractor Address:
23-2108853
Federal ID or SS#:
Starting Date:
1/29/2007
Ending Date:
1/31/2009
Summary of contract or amendment: Correct Monthly Payment
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·Maximllm Payab~26,839,822
Prior Maximum: [lli364,367
I Prio£ Contract # (If Renewal):
CUlTent Amendment: I $2.475.455 I Cumulative amendments:.
$ 2,475,455
% Cumulative Ch<ll1j;~6%
Maximum # Units: I! - II # Unit Change:
!
__
Prior # Units: i # - - _.~======Rilte:
. $.
. Prior Rate:
$ _.-__
I
Source of Funds - Business Unit(s): 03480
0/<,-,,-0
Other Fund:
General Fund: 100 %
Federal Fund:
Fund Code:
%
Dept ID:
Dept. ID:
Dept. ID: l't80004010
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Yes

D

No

D
D

Yes
Yes

~
~

No
No

Does this contractor meet aJ] 3 parts of the "ABC" definition of independent contractor?
(See Bulletin 3.5) Ifnot, please indicate why this work is being arranged tln·ough a contract.
Is agency liable for income tax withholding or FICA?
Should contractor be paid on the state payroll?

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The agency has taken reasonable steps to control the price of the contract and to allow qualified businesses to compete for the
work authorized by this contract The agency has done this through:
~ Standard bid or RFP
D Simplified Bid
D Sole Sourced
D Qualification Based Selection
D Other
~ Personal Service

D

Construction

D

Architect/Engineer

D

Commodity

D

Privatization*

D Other

By signing below, I certify that no person ablc to control or influence award of this contract had a pecuniary interest in its award
or performance, either personally or through a member of his or her household, family, or business.

D

~ No

Is there an "appearance" of a conflict of interest so that a reasonable person may conclude that this
contractor was selected for improper reasons: (If yes, explain)

~ Yes

D

D

Yes

No
~ No

D

Yes

[:i:<J No

D

Yes

~ No

Contract must be approved by the Attorney General under 3 VSA §311 (a)(1 0)
I request the Attorney General review this contract as to fornl
(initial)
No, Already performed by in-house AAG or counsel:
Contract must be approved by the CIO/Commissioner of DII; for IT hardware, software or services and
Telecommunications over $150,000
Contract must be approved by the CMO; for Marketing services over $15,000
Contract must be approved by the Secretary of AdministTation

Yes

~ Yes

D

No

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Date

CIO (init)

Date

CMO (initial)

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CHANGE # 3

AMENDMENT
It is agreed by and between the State of Vermont, Department of Corrections (hereafter called "State") and Prison Health

Services, Inc of Brentwood, TN, Vermont (hereafter called "Contractor") that contract #10962 dated 1/26/2007 between
said State and Contractor is hereby amended as follows:
To change Page I, 3. Maximum Amount to $26,839,822
Attachment B, I) Base Compensation: To replace first paragraph with the following:
The State will pay Contractor annual base compensation (the "Base Compensation") in the amount of
$12,514,530 for the first year of the Agreement which shall commence on January 29,2007 and continue
through January 31, 2008. The Base Compensation is comprised of the following: (i) the annual Actual Costs
(defined below) of providing health care services which have been initially budgeted by the parties as
$11,161,823 (the "Budgeted Costs")(three months at $845,607.75 and 9 months at $958,333.33) and (ii) a
annual fixed management fee of$I,352,707 (the "Management Fee"). The Base Compensation shall be paid as
follows: three (3) monthly installments of$958,333.33 and nine (9) monthly installments of$I,071,058.91.
Contractor will invoice the State thirty (30) days before the first day ofthe month in which services are
rendered The State agrees to pay Contractor on or before the first (I st) day of the month for which services will
be rendered. In the event the Agreement should commence or terminate on a date other than the first or last day
of any calendar month, the Base Compensation will be prorated accordingly for the shortened month.
The State will pay Contractor annual base compensation (the "Base Compensation") in the amount of
$13,880,924 for the second year of the Agreement which shall commence on February I, 2008 and continue
through January 31, 2009. The Base Compensation is comprised of the following: (i) the annual Actual Costs
(defined below) of providing health care services which have been initially budgeted by the parties as
$12,420,000 (the "Budgeted Costs") and (ii) an annual management fee of$I,460,924 (the "Management Fee").
The Base Compensation shall be paid in twelve (12) equal monthly installments of$I,156,743.67. This
incorporates the annualization of the first year Budgeted Costs as well as the increase outlined in Attaclunent B,
2) Increases to Base Compensation in Subsequent Years.
Except as modified by this above amendment, and any and all previous amendments to this contract, all provisions of this
contract #10962 dated 1/26/2007 shall remain unchanged and in full force and effect.
The effective date of this amendment is 01/29/2007.

APPROVED AS TO FORM

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Atto~~al's Office

Date:·J/~ _ _

STATE OF VERMONT
AGENCY OF HUMAN SERVICES
DEPARTMENT OF CORRECTIONS

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.~ D. Hofmann, COlTIlTIlSSlOner
Date:

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(Please PRINT Signature)

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Address: 105 Westpark Drive, Suite 200
Brentwood, TN 37027
SS#/Fed ID#: 23-210885

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