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ICSA Addendum to TADTS Service Agreement

ICSA Addendum to existing Agreement for Services

This is an official Addendum to an existing agreement between TADTS and Company Name entered below ("Client") and will be considered authorized by client and executed on the date of consent.

Addendum to TADTS Service Agreement

This is an Addendum to the service agreement between client listed above and TADTS for Drug & Alcohol Testing Program Administration.
AUTHORIZATION FORM

                      

 

 

ADDENDUM TO AGREEMENT FOR DRUG AND ALCOHOL ADMINISTRATION PROGRAM

 

 

This addendum is made on the date of signature(DATE) by and between TADTS and Company Name Listed Above (“Client”).

 

Whereas TADTS and Client are parties to an Agreement for Drug and Alcohol Testing Program Administration Services (“Agreement”) already in effect.

 

Now, TADTS and Client do wish to add additional service to the Agreement and do mutually agree as follows:

 

1.      The Specifications of work to be performed shall change from the original Agreement to add

 

SERVICE DESCRIPTION

Cost

Client has left the Independent Carriers Safety Association / Mohave Insurance program and requests to enter into a direct agreement with TADTS.

See the updated pricing below

 

Service pricing as of the date of this addendum:

A. Initial Program Fee/Membership: (per employee)

$25.00

B. Administration fee per pre-employment test after initial set-up

$10.00

C. DOT drug screen specimen collected at a facility other clinic location or after hours

$68.00

D. Breath alcohol testing (Confirmation cost included – if necessary)

$35.00

E. DOT drug screen specimen collection procedure collected at TADTS offices during business hours

$53.00

F. NDOT drug screen specimen collection procedure collected at TADTS offices during business hours

$50.00

G. NDOT drug screen specimen collected at a facility other clinic location or after hours

$65.00

H. Administrative Fee for Positive DOT urine/BAT tests:  FMCSA Clearinghouse reporting

$15.00

I. Medical examinations (DOT required for Commercial Driver’s License purposes)

$100.00

J.  On site fee if the service required occurs between 8am-5pm

    Time fee is per collector requested

$50.00/hr

(2 hr Min.)

K. STAT/Emergency Collection:  Post Accidents, Reasonable suspicion including services required 

    between 5pm & 8am

$65.00/hr

(2 hr min.)

L. Mileage from port to port.  Fee is per Collector requested

$0.60/mile

M. DOT Drug & Alcohol Testing Policy

$100.00

N. DOT Supervisor Online Training (Per Person)

$125.00

O. Reinstatement Fee:  Fee to place company back into program after being removed due to Non-

     Compliance

$125.00

P. Detailed Client Audit

$125/occurrence

 

2.      All other terms and conditions of the original Agreement shall remain in full force and effect.

 

 

 

Whereas TADTS has provided this electronic addendum to Client, and by consent and agreement, Client, by their duly authorized representatives, has executed this addendum.

 

 

Click here to consent and agree to the updated terms.(Required)