Wisconsin In-Network Transportation Provider Checklist

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(B) The Content may not be copied, distributed, republished, uploaded, posted ortransmitted in any way without the prior written consent of Logisticare, except that usersmay print out a copy of this Agreement or the Content solely for the intended use of theSoftware. In doing so, Users may not remove or alter, or cause to be removed or altered,any copyright, trademark, trade name, service mark or any other proprietary notice orlegend appearing on any of the Content.(C) Provider or Users may not reverse engineer, de-compile, disassemble, alter,duplicate, modify, rent, lease, loan, sublicense, make copies of, create derivative worksfrom, distribute or provide others with the Software in whole or part, or transmit orcommunicate the Software over a network.XV.EXPORT RESTRICTIONSUsers may not export, ship, transmit or re-export software in violation of anyapplicable law or regulation including but not limited to Export AdministrationRegulations issued by the U.S. Department of Commerce.XVI. DISCLAIMER OF WARRANTIESLOGISTICARE AND ITS SUPPLIERS PROVIDE THE SOFTWARE ANDSERVICES "AS IS", WITH ALL FAULTS, AND ON AN “AS AVAILABLE” BASIS,AND HEREBY DISCLAIM ALL WARRANTIES AND CONDITIONS, EITHEREXPRESS, IMPLIED OR STATUTORY, REGARDING THE SOFTWARE ANDSERVICES, INCLUDING BUT NOT LIMITED TO ANY (IF ANY) IMPLIEDWARRANTIES OR CONDITIONS OF MERCHANTABILITY, PERFORMANCE,CONDITION OF TITLE, SATISFACTORY QUALITY, QUIET ENJOYMENT,FITNESS FOR A PARTICULAR PURPOSE, OR NON-INFRINGEMENT OF THIRDPARTY INTELLECTUAL PROPERTY RIGHTS. LOGISTICARE DOES NOTWARRANT THAT THE SOFTWARE OR SERVICES ARE SECURE OR FREEFROM BUGS, VIRUSES, INTERRUPTION, ERRORS, IDENTITY THEFT, THREATOF HACKERS, OTHER PROGRAM LIMITATIONS, OR THAT THE SOFTWAREOR SERVICES WILL MEET USERS REQUIREMENTS. THE ENTIRE RISKARISING OUT OF THE USE OR PERFORMANCE OF THE SOFTWARE ANDSERVICES IS WITH PROVIDER AND/OR USERS.XVII. LIMITATION OF DAMAGESTO THE MAXIMUM EXTENT PERMITTED BY APPLICABLE LAW, IN NOEVENT WILL LOGISTICARE OR ITS SUPPLIERS BE LIABLE FOR ANYCONSEQUENTIAL, INCIDENTAL, DIRECT, INDIRECT, SPECIAL, PUNITIVE OROTHER DAMAGES WHATSOEVER ARISING OUT OF OR IN ANY WAYRELATED TO THE USE OF OR INABILITY TO USE THE SOFTWARE ORSERVICES AND WHETHER BASED ON CONTRACT, TORT, NEGLIGENCE,PRODUCT LIABILITY, STRICT LIABILITY OR OTHERWISE, EVEN IFLOGISTICARE OR ANY SUPPLIER HAS BEEN ADVISED OF THE POSSIBILITYPage 72
OF SUCH DAMAGES. THIS EXCLUSION OF DAMAGES WILL BE EFFECTIVEEVEN IF ANY REMEDY FAILS OF ITS ESSENTIAL PURPOSE.XVIII. SEVERABILITYIf any portion of this Agreement is adjudicated to be invalid or unenforceable inthe governing jurisdiction, the remainder shall remain in full force and effect and shall beenforceable against LogistiCare and Provider, and the invalid or unenforceable portionshall be reformed, if possible, to be as close to the invalid or unenforceable portion asenables said reformed portion to be valid and enforceable, and said reformed portion shallreflect a most favorable interpretation of the invalid or unenforceable portion, both inletter and inferences to the advantage of LogistiCare.XIX. NO WAIVERNo waiver of any right under this Agreement will be deemed effective unlesscontained in writing signed by a duly authorized representative of the party against whomthe waiver is to be asserted, and no waiver of any past or present right arising from anybreach or failure to perform will be deemed to be a waiver of any future rights arising outof this Agreement.XX.ENTIRE AGREEMENTThis Agreement constitutes the entire agreement between the Parties with respectto its subject matter, and supersedes all prior agreements, proposals, negotiations,representations or communications relating to the subject matter. No oral statements orprior written material not specifically incorporated herein shall be of any force or effect,and no changes in or additions to this Agreement shall be recognized unless incorporatedherein by amendment as agreed in writing by the Parties, such amendment to becomeeffective on the date stipulated in such amendment, unless unilateral amendment ispermitted pursuant to Section XXII (C).XXI. INDEMNIFICATION(A) Provider hereby agrees to indemnify, defend and hold LogistiCare, itsaffiliates, subsidiaries, parents, shareholders, directors, officers, employees, agents,contractors, licensors, and representatives harmless from and against any and all claims,loss, damage, tax, liability and/or expenses (including attorneys’fees) arising out of, oralleged to arise out of or be in connection with Provider’s use of the services under thisAgreement or violation of the terms of this Agreement).(B) Provider further agrees to indemnify and hold Logisticare, its affiliates,subsidiaries, parents, shareholders, directors, officers, employees, agents, contractors,licensors, and representatives harmless from any claim or demand, including reasonableattorneys’ fees, made by any third party due to, arising out of, or alleged to arise out ofUsers’ use of the Software or Services, Users’ violation of the terms and conditions inPage 73
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Please return all documents to:1275
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TRANSPORTATION AGREEMENT(the “Agr
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Provider may be withdrawn by LGTC,
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ii)iii)iv)scheduled B-Leg pick up t
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utilized by Provider.ii) The number
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• ADA regulations;• Client Cont
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vi)type of vehicle in which it is i
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and satisfactorily cleared a nation
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ix)a Participant, or in the presenc
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iv)Provider warrants that it has no
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a) name, date of birth and social s
Page 23 and 24: from establishing or maintaining se
Page 25 and 26: the dispute shall be referred for b
Page 27 and 28: EXHIBIT ALIQUIDATED DAMAGESThe Part
Page 29 and 30: Requirement:Provider must perform t
Page 32 and 33: To determine the payment amount LGT
Page 34 and 35: Exhibit B - Execution PageLOGISTICA
Page 36 and 37: scope of the employment or other pr
Page 38 and 39: or created or received by BUSINESS
Page 40 and 41: presenting a preponderance of the e
Page 42 and 43: EXHIBIT EMedicare Advantage Program
Page 44 and 45: information and data necessary for:
Page 46 and 47: e reviewed and approved by Health P
Page 48 and 49: Non-Emergency Medical Transportatio
Page 50 and 51: LOGISTICARE INSURANCE CREDENTIALING
Page 52 and 53: Please describe your hours of opera
Page 54 and 55: Network Development503 Oak Place, S
Page 56 and 57: AFTER HOURS CONTACTINFORMATION SHEE
Page 58 and 59: Form W-9 (Rev. 1-2003) Page 2Exampl
Page 60 and 61: Form W-9 (Rev. 1-2003) Page 4Part I
Page 62 and 63: Dear LogistiCare Transportation Pro
Page 64 and 65: Electronic Data Interchange (EDI) A
Page 66 and 67: Date: __________________________Log
Page 68 and 69: Software User AgreementWHEREAS, Log
Page 70 and 71: III.OWNERSHIPThe Software is protec
Page 72 and 73: X. THIRD PARTY WEBSITESThe Software
Page 76 and 77: this Agreement, or the infringement
Page 78 and 79: LogistiCare Driver ListLegal name D
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Wisconsin In-Network Transportation Provider Checklist

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