HomeMy WebLinkAboutCity of Tamarac Resolution R-2003-222Temp. Reso #10220
Page 1
August 22, 2003
Revised on September 11, 2003
CITY OF TAMARAC, FLORIDA
RESOLUTION NO. R-2003 -�,-�—
A RESOLUTION OF THE CITY COMMISSION OF
THE CITY OF TAMARAC, FLORIDA, APPROVING
AND EXECUTING THE ASSIGNMENT,
DELEGATION AND RELEASE AGREEMENT
AMONG THE CITY OF TAMARAC, SECOND
REVIEW, INC. A FLORIDA CORPORATION (F/K/A
ADVANCED DATA PROCESSING, INC., A FLORIDA
CORPORATION) AND ADVANCED DATA
PROCESSING, INC. A DELAWARE CORPORATION
FOR RESCUE AMBULANCE BILLING AND
RELATED PROFESSIONAL SERVICES.
PROVIDING FOR CONFLICTS; PROVIDING FOR
SEVERABILITY; AND PROVIDING FOR AN
EFFECTIVE DATE.
WHEREAS, on September 22, 1999 the City of Tamarac entered into an
Agreement with Advanced Data Processing, Inc. a Florida Corporation for the provision
of Medical Billing Services via Resolution 99-239; and
WHEREAS, the City renewed the Agreement with Advanced Data Processing,
Inc. a Florida Corporation on October 1, 2002 via Resolution 2002-255; and
WHEREAS, on October 10, 2002 Advanced Data Processing, Inc. a Florida
Corporation changed its name to Second Review, Inc. Attached hereto as Exhibit A;
and
WHEREAS, on October 11, 2002, Advanced Data Processing, Inc. a Delaware
Corporation acquired the assets of Second Review, Inc., f/k/a Advanced Data
WINDOWS\CE:-MP\lPmp Resn 10220-AIDP Assymn nt.doc.
Temp. Reso #10220
Page 2
August 22, 2003
Revised on September 11, 2003
Processing, Inc., a Florida Corporation, including the rights, duties and obligations of
Second Review, Inc. as evidenced by Exhibit B attached; and
WHEREAS, Advanced Data Processing, Inc a Delaware Corporation has the
legal authority to execute this Assignment Agreement on behalf of Second Review, Inc.,
f/ka Advanced Data Processing, Inc., a Florida Corporation; and
WHEREAS, the parties desire to enter into this Assignment Agreement in order
to formalize the assignment of Second Review, Inc.'s (f/k/a as Advanced Data
Processing, Inc.) rights, obligations and responsibilities under this Assignment
Agreement with respect to the provision of medical billings, collections, and accounts
receivable services for CITY's Fire Rescue Division, attached hereto as Exhibit C.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION OF THE CITY
OF TAMARAC, FLORIDA:
SECTION 1 The foregoing "WHEREAS" clauses are hereby ratified and
confirmed as being true and correct and is hereby made a specific part of this
Resolution.
SECTION 2 Authorizing the appropriate City Officials to approve and execute
the Assignment, Delegation and Release Agreement among the City of Tamarac,
Second Review, Inc., (f/k/a Advanced Data Processing, Inc.) a Florida Corporation and
Advanced Data Processing, Inc., a Delaware Corporation for the provision of medical
billing services.
Temp. Reso #10220
Page 3
August 22, 2003
Revised on September 11, 2003
SECTION 3 All resolutions or parts of resolutions in conflict herewith are hereby
repealed to the extent of such conflict.
SECTION 4 If any clause, section, other part or application of this Resolution is
held by any court of competent jurisdiction to be unconstitutional or invalid, in part or
application, it shall not affect the validity of the remaining portions or applications of this
Resolution.
SECTION 5 This Resolution shall become effective immediately upon its passage and
adoption.
PASSED, ADOPTED AND APPROVED this 24th day of September, 2003.
ATTEST:
MARION SW ENSON, CMC
CITY CLERK
I HEREBY CERTIFY that
I have approved this
RESOLUTION as to form.
MITCHELL S. Kf
CITY ATTORN
J, E SCHREIBER,
MAYOR
RECORD OF COMMISSION VOTE:
MAYOR SCHREIBER
DIST 1: COMM. PORTNER
DIST 2: COMM. FLANSBAUM-TALABISC
DIST 3: COMM. SULTANOF
DIST 4: V/M ROBERTS
EXABIT A
Temp. Reso. #10220
0
ARTICLES OF AMENDMENT r-r;
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TO N x t
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ARTICLES OF INCORPORATION S
a- N
OF 5 N
[Orn --�
ADVANCED DATA PROCESSING, INC.
` Pursuant to -the provisions of Chapter 607, Florida Statutes,
the undersigned corporation adopts the following Articles of
Amendment to its Articles of Incorporation filed the 26th day of
july,1984, under Document Number M03196.
1.. The name of the corporation is hereby amended.
From: ADVANCED DATA PROCESSING, INC.
To: SECOND REVIEW, INC.
2. The date t e adoption of the Articles of Amendment
was the day of 2002.
3. The Amendment to the Articles of Incorporation was
unanimously adopted by all members of the Board of Directors and
all Stockholders.
DATED this /-L'—� day ofZ842d�l 2002•
ADVANCED DATA PROCESSING, INC.
B
4N.D . &IFIR.AZNZEZAS., o kholder,
r and President
BY:
PAIIL J. ZELAS, ockholder
and Director
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CT CORPORATION SYSTEM
CORPORATIONS) NAME
'I.- Advanced Data
changing name
Inc.
"43196
Temp. Reso. #10220
EX-11BIT q
Second Review,.Inc. _ s � �
2. Advanced Data Processing, inc.
T'�
() Profit
Amendment
{) Nonprofit
{) Merger
() Foreign
{) Dissolution/ Withdrawal
{) Mark
() Limited Partnership
Reinstatement
Annual
O Report
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{) LLC
O Name Registration
O Other
.
{) Fictitious Name
Change of
RA, r
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(} Certified Copy
() Photocopies
) UCC
: ;::; ,•�
O CUS
{) Call When Ready
()Call If Problem
(x) Walk I>x
Will Wait
() After 4:30
co
Mail Out
(x) Pick Up
Name 10/11/02
Availability
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Examiner
Updater `
Verifier �4 � IG c111
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W.P. Verifier
660 East Jefferson Street
Tallahassee, FL 32301
Tel. 850 222 1092
Fax 850 222 7615
— Order#: 5624868
- x 0/ 11 /02-.-0104a--017
Ref#:
Amount: $
ColtliieRlQ OCT 1 12002
A CCH LEGAL INFORMATION SERVICES COMPANY
ADVANCED Su520
01NW 765 Street Road phFax 305 5211 0653
DATA PROCESSING, INC. Miami, FL 33169 Email: adpdhartung@bellsouth.net
June 19, 2003
City of Tamarac
Attn: Chief Forsberg
VIA Email
Dear Chief Forsberg:
Subject.- Second Review, Inc.
Temp. Reso. #10220
EXHIBIT B
The contracted company with the City of Tamarac, Advanced Data Processing, Inc. (a Florida
Corporation), changed its name to Second Review, Inc. and the new Advanced Data Processing, Inc.
(a Delaware Corporation) purchased the assets of Second Review, Inc. (formerly known as Advanced
Data Processing, Inc. a Florida Corporation).
While the current contract is with the original contractor, Second Review, Inc. (formerly known as
Advanced Data Processing, Inc. a Florida Corporation) we would like to move forward with an
assignment with the new Advanced Data Processing, Inc. (a Delaware Corporation) as soon as
possible.
I hope that this assists in the explanation of the transaction that took place in October of 2002. 1 have
also attached a press release from December 2002.
Sincerely,
Darryl Hartung
Senior Manager
Advanced Data Processing, Inc.
. Y
C)NO
CX CORPORATIO SYST
CORPORATION(s) NAME
1. Advanced Data Processing, Inc.'
changing name to:
Second Review, Inc.
.c
2. Advanced Data Processing, Inc.
711 r ^,
p�
_Profit
() Amendment
{) Merger
-
--;
( on roft
oreign
() Dissolution/Withdrawal
() Mark
-�
Reinstatement
O Limited Partnership
O Annual Report
O Other
() LLC
() Name Registration
() Change of RA 1 _
t"
co
( ) Fictitious Name
() UCC
() Certified Copy
( ) Photocopies
() CUS
( ) Call When Ready (} Call If Problem () After 4.30
(x) Walk In () Will Wait (x) Pick Up
O Mail Out '
Name 10/11/02 Order#: 5624868
Availability 4 00 0 ❑8 :3 3 S 21 4-2
Document � -10/ 11 /02----01040--018
Examiner :2 114_Ref#: *****70. 00 ***W k70. 00
Updater _
Verifier
W.P_ Verifier — Amount: $
660 East Jefferson Street
Tollohossee, FL 32301
Tel. 850 222 1092
Fox 850 222 7615
A CCH LEGAL INFORMATION SERVICES COMPANY
3
APPLICATION BY FOREIGN CORPORATION FOR AUTHORIZATION TO TRANSACT
BUSINESS IN FLORIDA
IN COMPLIANCE WITH SECTION 607.1503, FLORIDA STATUTES, THE FOLLOWnVG IS SUBMITTED TO
.REGISTER A FOREIGN CORPORATION TO TRANSACT B USINESS IN THE STATE OF FLORIDA.
1. Advanced Data Processing,Inc.
(Name of corporation-, must include the word "INCORPORATED", "COMPANY", "CORPORATION" or
words or abbreviations of like import in language as will clearly indicate that it is a corporation instead of
natural person or partnership if not so contained in the name at present.)
cf7 a
Delaware t�
2. 3• being applied for-': c�
(State or country under the law of which it is incorporated) (FEI number, if applicable) ;.; -71
cry ----
4. 9-1 —O
- Pe etual r'n
Date of incorporation)
( rp ) (Duration: Year co wz1I cease to exist or "perpep<ivt) � C7
r—
6. Upon qualification
(Date first transacted business in Florida.) (SEE SECTIONS 607.1501, 607.1502 and 817.155, Z~.S.) r7 .t-
7.
600 T •vi Suite 6110 Houston TX 770 2
(Current mailing address)
Any lawful act or activity, _
(Purpose(s) of corporation authorized in home state or country to be carried out in state of Florida)
9. Name and street address of Florida registered agent: (P.O. Box or Mail Drop Box NOT acceptable)
Name: C T Corporation System
c/o CT Corporation System
Office Address: 1200 South Pine Island Road
Plantation
I0. Registered agent's acceptance:
Florida, 33324
(Zip code)
Having been named as registered agent and to accept service ofprocess for the above stated corporation at the place designated in
this application, I hereby accept the appointment as registered agent and agree to act in this capacity. I further agree to comply
with the provisions of all statutes relative to the proper and complete performance of my duties, and I am familiar with and accept
the obligations of my position as registered agent.
C T Corporation System
(Registered agent's signature)
11. Attached is a certificate of existence duly authenticated, not more than 90 days prior to dclivery of this application to the
Department of State, by the Secretary of State or other official having custody of corporate records in the jurisdiction under the law of
which it is incorporated.
12. Names and addresses of officers and/or directors: (Street address ONLY - P,O. Box NOT acceptable)
PM 9 . *7199 C T SyMEM Online
r _ !k .
A. DIRECTORS (Street address only - P.O. Box NOT acceptable)
Chairman: v d J Graham
Address: v gSuite 6110 cn o
• Houston, Texas 77002 C
Vice Chairman:
Address:�� O
w
Director: David J. Graham
Address: 600 Travis, Suite 6110
Houston, Texas 77002
Director:
Address:
B. OFFICERS (Street address only - P.O. Box NOT acceptable)
President: Doue Shamon
Address; _ a Suite 6110
Houston, Texas 77002
Vice President:
Address:
Secretary:
Gregoryn
L.
Elli t
Address:
600
Travis
Suite 6110
Houston. 'Texas 77002
Treasurer Z= SbAmga
Address: TKaviga Suite 6110
Houston Texas 770.02
NOTE: If ne a-ssary, }ru may a7h an addendum to the application listing additional officers and/or directors,
13. MIM
(Signature of Chairman, Vice 1
14• .j G ra harr
('Typed or pr
Fw19 - 9/21" c r s,%ntem online
rman, or any officer listed in number 12 of the application)
C�1r ar\
I name and capacity of person signing application)
x
DeCaware PAGE 1
the First ,state
I, HARRIET SMITH WINDSOR, SECRETARY OF STATE OF THE STATE OF
DELAWARE, DO HEREBY CERTIFY "ADVANCED DATA PROCESSING,"'-'INC." IS
DULY INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE AND IS
IN GOOD STANDING AND HAS A LEGAL CORPORATE EXISTENCE SO FAR AS
THE'RECORDS OF THIS OFFICE SHOW, AS OF THE THIRD -,DAY OF OCTOBER,
A.D. 2002.
AND I DO HEREBY FURTHER CERTIFY THAT THE SAID "ADVANCED DATA
PROCESSING, INC." WAS INCORPORATED ON THE EIGHTEENTH DAY -OF
r- r.
SEPTEMBER, A.D. 2002.
AND I.DO HEREBY FURTHER CERTIFY THAT THE FRANCHISE - E,S `n
HAVE NOT SEEN ASSESSED TO DATE. !r7
c.7 a
w +�
3555042 8300
Harriet Smith Windsor. Secretary of State
AUTHENTICATION: 2017546
020614752-DATE:._10-03-02
For Details, Contact: Advanced Data Processing, Inc.
520 NW 165 Street, Suite 201
Don Passaro Miami, FL 33169
Phone (305) 459-0652 Phone (305) 945.2280
adpdpassaro@bellsouth.net Fax (305) 945-6646
Wly ADPI news release
ADVANCED DATA PROCESSING, INC. EXHIBIT B
ACQUIRES AMBULANCE/EMS BILLING
COMPANY
Largest single -specialty EMS billing company in US to
become national leader in EMS billing & AIR
management
Miami, December 20, 2002: Advanced Data Processing, Inc. ("ADPI") has acquired the
r �
ambulance/emergency medical services ("EMS") billing operations of Advanced Data
Processing, the leading EMS billing company in the Southeast.
Based in Miami, Florida, ADPI specializes in billing and accounts receivable management
services for cities and counties that provide 9-1-1 emergency and other non -emergency
ambulance services. ADPI is the largest single specialty EMS billing company in the US serving
43 communities in three states with a combined population of over 8 million residents. ADPI
will continue to invest in its infrastructure and technology to become a national leader in EMS
billing services.
ADPI is a wholly owned subsidiary of ADPI Holding, Inc., a healthcare billing company
formed by The DeZonia Group, Inc. and The Capstreet Group, LLC.
The DeZonia Group, Inc., a management company specializing in healthcare reimbursement
services and based in Newport Beach, Calif., led the acquisition and also provided equity
investment. Since its formation in 2000, The DeZonia Group has led the successful turnaround of
Certus Corporation, a healthcare revenue -cycle management company serving over 500 hospitals
in 30 states.
Fcrlmr wdiaft Release
Deoelrnber20, 2002
Largest single -specialty EMS billing company to take national leadership Page 2
Douglas A. Shamon, co-founder of The DeZonia Group, Inc., is President, Chief Executive
Officer, and a director of ADPI. William DeZonia, co-founder of The DeZonia Group, Inc. serves
ADPI as a director and business advisor.
Prior to joining ADPI, Mr. Shamon served as Executive Vice President, Chief Financial
Officer, and Director with Certus during its turnaround phase and continues to serve on Certus'
Board of Directors. Mr. Shamon has also held various senior management positions in national
healthcare services companies since 1991. He has extensive experience in medical billing on a
national basis along with experience in medical records and hospital revenue -cycle management
services. Mr. Shamon is a Certified Public Accountant and holds Bachelor of Science degree in
Management from Boston College and a Master of Business Administration degree from San
Diego State University.
Mr. DeZonia is President and Chief Executive Officer of Certus Corporation where he led its
successful turnaround effort. Mr. DeZonia has over 25 years senior management experience in
medical billing operations.
The Capstreet Group, LLC, a private equity firm based in Houston, Texas and its affiliated
funds provided equity cash investments to complete the transaction. David Graham, a principal
with Capstreet will serve as Chairman of the Board of ADPI. George Kelly and Greg Elliot, also
principals of Capstreet, will serve as directors of ADPI.
Commenting on the acquisition Mr. Shamon noted, "Advanced Data Processing is a solid
company with excellent client relationships and 20 years of experience in EMS billing. This
acquisition provides ADPI with a highly capable and experienced management team including
Don Passaro, Vice President and Darryl Hartung, Senior Manager who will continue to play key
roles in the company. Paul Franzelas, founder of Advanced Data Processing will also continue to
support ADPI focusing his efforts on client reporting and programming needs and advising on
other business matters. We are fortunate to have such a solid foundation and strong financial
backing as we look to take our EMS billing services national."
This press release may contain forward -looking statements within the meaning of the "safe harbor" provision of the
United States Private Securities Litigation Reform Act of 1995. While these statements represent our best current
judgment, they are subject to risks and uncertainties that could cause actual results to vary. These statements may
Involve risks and uncertainties. Should one or more of these risks or uncertainties materialize, or should underlying
assumptions prove incorrect, actual outcomes may vary materially from those indicated.
City o; Tatrarac Purchasing and Contracts Division- ----- (e . ............
ASSIGNMENT, DELEGATION AND RELEASE AGREEMENT
Among
CITY OF TAMARAC
And
SECOND REVIEW, INC. A FLORIDA CORPORATION
(formerly known as ADVANCED DATA PROCESSING INC., A FLORIDA
CORPORATION
ADVANCED DATA PROCESSING INC. A DELAWARE CORPORATION
For
RESCUE AMBULANCE BILLING AND RELATED PROFESSIONAL SERVICES
THIS ASSIGNMENT, DELEGATION AND RELEASE AGREEMENT ("Assignment
Agreement") is made by and among CITY OF TAMARAC, a political subdivision of the
State of Florida, its successors and assigns, hereinafter referred to as "CITY,' through its
City Commission.
AND
SECOND REVIEW, INC. (formerly known as ADVANCED DATA PROCESSING
INC., a Florida corporation), its successors and assigns, hereinafter referred to as
"CONTRACTOR"
2 I,
ADVANCED DATA PROCESSING INC., a Delaware corporation, authorized to do
business in the State of Florida, its successors and assigns, hereinafter referred to as
"ASSIGNEE.,,
WITNESSETH
WHEREAS, CITY utilized the due diligence established by the City seeking
responses from qualified firms to provide medical billings, collections, and accounts
receivable services for CITY's Fire Rescue Division; and
WHEREAS, CONTRACTOR, on the basis of Proposal made to CITY (dated June 2,
1999) was selected by CITY to provide this service and entered into an agreement
("Agreement") with CITY dated September 22, 1999 and as amended; and
Cityof Tamarac "' •% Purchasing and Contracts Division
(.:.e* .:, 9
WHEREAS, ASSIGNEE has acquired the assets of Advanced Data Processing,
Inc., a Florida Corporation, including the rights, duties and obligations of CONTRACTOR;
and
WHEREAS, ASSIGNEE has the legal authority to execute this Assignment
Agreement on behalf of CONTRACTOR; and
WHEREAS, the parties desire to enter into this Assignment Agreement in order to
formalize the assignment of CONTRACTOR's rights, obligations and responsibilities
under this Agreement with respect to the provision of medical billings, collections, and
accounts receivable services for CITY's Fire Rescue Division for the remainder of the term
of this Agreement.
NOW, THEREFORE,
IN CONSIDERATION of the mutual terms, conditions, promises, covenants, and
payments hereinafter set forth, CITY, CONTRACTOR and ASSIGNEE agree as follows:
ARTICLE 1 - DEFINED TERMS; RATIFICATION: CONFLICTS
1.1 DEFINED TERMS. All defined terms in this Assignment Agreement shall have the
same meaning as in the Agreement except as otherwise noted.
1.2 RATIFICATION. Except as amended and modified by this Assignment Agreement,
all of the terms, covenants, conditions, and agreements of the Agreement are
hereby ratified and shall remain in full force and effect.
1.3 CONFLICTS. In the event of any conflict between the provisions of the Agreement
and the provisions of this Assignment Agreement, the provisions of this Assignment
Agreement shall control.
ARTICLE 2 - EFFECTIVENESS
The Effective Date of this Assignment Agreement shall be
, 2003. The assignment is expressly subject to and contingent
upon the approval and execution of this Assignment Agreement.
ARTICLE 3 - ESTOPPEL
The Agreement is the sole agreement pertaining to the acquisition of assets of
Advanced Data Processing, Inc. a Florida Corporation, including the rights, duties and
obligations of CONTRACTOR. Neither CITY nor CONTRACTOR has given a notice of
default under the Agreement to the other party, neither CITY nor CONTRACTOR is in
default of its obligations under the Agreement. CITY and CONTRACTOR acknowledge
and agree that all obligations of the parties under the Agreement up to the Effective Date
of this Assignment Agreement have been fully performed and paid for by the respective
parties.
K
of Tamarac � � Puo,,hasir and Contracts Division
ARTICLE 4 - ASSIGNMENT AND DELEGATION
4.1 CONTRACTOR does hereby assign and delegate to ASSIGNEE, all of its right, title
and interest in and to the Agreement including all right, title and interest in all
reports, documents, or other data prepared and/or provided by CONTRACTOR
thereunder in connection with or related to the Agreement.
4.2 ASSIGNEE hereby accepts the assignment and delegation of the Agreement and
releases CONTRACTOR from all its obligations under the Agreement after the
Effective Date of this Assignment Agreement. ASSIGNEE further agrees to assume
all of CONTRACTOR's obligations thereunder and agrees to perform and keep all of
the terms, conditions, covenants, agreements, liabilities and obligations to be
performed thereunder from and after the Effective Date of this Assignment
Agreement.
4.3 CITY hereby acknowledges and consents to the assignment and delegation by
CONTRACTOR to ASSIGNEE of the Agreement as set forth herein, and
ASSIGNEE agrees to perform its obligations hereunder and be bound to CITY
pursuant to the terms of the Agreement.
ARTICLE 5 - RELEASE
CITY and CONTRACTOR hereby release and forever discharge each other for all
agreements, promises and obligations which each party had, now has or may have,
against each other arising out of, related to, or in connection with the rights and obligations
granted and accruing under the Agreement.
ARTICLE 6 - AMENDMENT OF TERMS AND CONDITIONS OF ORIGINAL AGREEMENT
6.1 On the Effective Date of this Assignment Agreement, all references in the
Agreement to "CONTRACTOR" shall be deemed to referto "ASSIGNEE" in orderto
effectuate the intent of the parties under this Assignment Agreement.
6.2 ARTICLE 5, NOTICE, of the Agreement is hereby amended by deleting the address
for the current CONTRACTOR and inserting the following for ASSIGNEE deemed
CONTRACTOR after the Effective Date of this Assignment Agreement:
'CONTRACTOR:
Douglas Shamon, President/CEO
Advanced Data Processing, Inc.
520 NW 165 Street, Suite 201
Miami, FL 33169.
}% Of F'1lPf;ltf3S{n%g' iilI1C1 DIVli,,f()(i
ARTICLE 7 - APPLICABLE LAW AND VENUE
This Agreement shall be governed by the laws of the State of Florida as now and
1I .
hereafter in force. The venue for actions arising out of this agreement is fixed iV\�
.
Broward County, Florida. I
ARTICLE 8 - THIRD PARTY RIGHTS
Nothing in this Assignment Agreement shall be construed to give any rights or
benefits to anyone other than CITY, CONTRACTOR or ASSIGNEE.
ARTICLE 9 - SUCCESSORS AND ASSIGNS
1
This Assignment Agreement shall inure to and be binding upon the authorized
successors and assigns of the parties.
r
ARTICLE 10 - WHEREAS CLAUSES
The information contained in the Whereas Clauses set forth above is true and
correct, and is hereby incorporated into the body of this Assignment Agreement.
J,
r
ARTICLE 11 - MULTIPLE ORIGINALS
Multiple copies of this Assignment Agreement may be executed by all parties, each of
which, bearing original signatures, shall have the force and effect of an original 4,
document. (iri r
Y
Cityof Tamarac ""``'"`'
..... ................ I ................... ........... .................... ..I .....,................ Purchasing and Contracts Division
IN WITNESS WHEREOF, the parties hereto have made and executed this
Assignment: CITY OF TAMARAC signing by and through its Mayor and City Manager, duly
authorized to execute same; CONTRACTOR, signing by and through its President, duly
authorized to execute same and ASSIGNEE, signing by and through its President, duly
authorized to executed same.
CITY OF TAMARAC
Jpe Schreiber, Mayor
C
Date
QS 67�
Z. 1"W4-%-
ATTEST: Jeffrey CUIldir, City Manager
I
rJ a� d-S t13
Marion Swens n, CIVIC Date:
City Clerk
C 3 ADDrove as to f r a d legal iciency:
Date
Mitchell SAk'raft.4ENfv A orn v
............
5
City
f Tamarac"```' ''`° Purchasing and Contracts Division
ASSIGNMENT, DELEGATION AND RELEASE AGREEMENT AMONG CITY OF
TAMARAC AND SECOND REVIEW, INC. (formerly known as ADVANCED DATA
PROCESSING, INC.), A FLORIDA CORPORATION AND ADVANCED DATA
PROCESSING, INC., A DELAWARE CORPORATION FOR MEDICAL BILLINGS,
COLLECTIONS AND ACCOUNTS RECEIVABLE SERVICES FOR CITY'S FIRE RESCUE
DIVISION
WITNESSES:
Print Name
Signature
Print Name
ignature'
WITNESSES:
�)I'�'�t•� V. �Q��aAC2�7
Print ame
Signature
22
Print Name
/(' �- L
ignatur
CONTRACTOR
SECOND REVIEW, INC.
(formerly known as ADVANCED DATA
PROCESSING, INC.),
A FLORIDA CORPORATION
By
Linda Franzelas, Pre ' ent
day of c�.S '� , 20 4' 3
ASSIGNEE
ADVANCED DATA PROCESSING, INC.,
A DELAWARE CORPORATION
By
uglas Shamon, President
L"day of u t.,rl 120 123
.....................
6