1582 service annual firefighters physical quote

City of El Mirage — Regular Meeting (2026-05-19)

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City of El Mirage Fire Department
Proposal for Services
Thursday, April 30, 2026
To: 
Chris  Richardson
City of El Mirage Fire Department
From:
Paul Granstrom - President of 1582 Medical Group, LLC, aka, Burroff and Associates, LTD
RE: Proposal for Services for 1582 Compliant Examinations with Ultrasound Screening
Asst. Chief Richardson,
1582 Medical Group with the assistance of 1582, LLC, aka, Burroff and Associates, LTD, is pleased to 
present this Proposal for Services by providing 1582 Medical Examinations and Comprehensive 
Ultrasound Screenings used for Cancer and Disease Identification.
1582 specializes in serving Fire Departments and Fire Districts throughout the Western States by providing 
On-Site Medical Testing.  1582 is headquartered and located at 1855 N. McCarran Blvd., Sparks, NV 
89431. 
Sincerely,
Paul Granstrom       
President       
1582 Medical Group / 1582, LLC 
(775) 846-3413
paul@1582exam.com

City of El Mirage Fire Department
Proposal for Services
COST PROPOSAL
COST PER MEMBER FOR ONSITE 1582 COMPLIANT EXAM:
1582 Examination Component
Number of Members
Cost Per Member
Total Cost
1582 Compliant Exam
35
$675
$23625
1582 Ultrasound Screening
35
$200
$7000
 1582 Onsite Fee
 $2,500
$2500
 Total Project Cost
$33,125.00
We acknowledge and accept the expensive cost for Travel to your area -
We pay for all Hotels, Car Rentals, Per Diem, Airfare included in Total Project Cost.  We cover all expenses, as 
well as staffing costs for providing the Setup, Labs, Medical Professionals, including working with our 
Licensed Physicians to conduct testing, review all results and answer questions each member has and provide 
results to each member and Department/District.
CANCER BLOOD TESTING OPTIONS:
1582 Cancer Testing:
Number of Members
Cost Per Member
Total Cost
Cancer Guard Test
$650
$0
EPISEEK Test
$650
$0
*Blood draw must be conducted at Question Diagnositics for these tests
ADDITONAL TESTING OPTIONS:
1582 Additional Testing Options
Number of Members
Cost Per Member
Total Cost
QuantiFERON Gold TB Screening
$80
$0
T-SPOT TB Screening (Quest Only)
$80
$0
Purified Protein Derivative (Skin PPD)
$80
$0
HazMat Urine (24 Hour Urine)
$125
$0
HazMat Blood (Arsenic, Cadmium 
Mercury and Lead)
$125
$0
TERMS are NET 30 upon completion
Members will receive a copy of all results in real-time and electronically online via Citrix ShareFile, all records will
be scanned to a PDF document for easy retrieval and members encouraged to bring them to their physician to review.
1582 Medical Group only uses a LICENSED PHYSICIANS.
The department may elect to receive an Aggregate Data Report of the findings without member name detail.
**City of Tucson Pricing Extended - Contract # 222846-02

City of El Mirage Fire Department
Proposal for Services
1582 Company History / Background: 
1582, LLC (hereafter referred to as “1582”) was formed for the purposes of providing NFPA 1582 compliant
examinations ON-SITE for Fire Departments throughout the Western States.  We believe the conducting these
examinations ON-SITE can save Fire Departments large sums of money, by eliminating down time, paid overtime
and units and staff being out of service.  Additionally, bringing the medical specialists to the Fire Department will
provide the best possible experience for serving large groups of Firefighters.
NEVADA
Our parent company, ARC Health & Wellness Centers was formed in 2009 to specialize in conducting NFPA 1582
Examinations for Firefighters and Comprehensive Public Safety Examinations for Police officers.  Over the years,
the ARC Health & Wellness book of business grew rapidly to include all agencies with the State of Nevada as well as
all major cities and counties in Nevada including Police and Fire Departments in the Cities of Reno, Sparks, Las
Vegas, North Las Vegas, and Henderson.    We’ve been proudly serving nearly every Fire Department in the State
of Nevada for the past 18 years. 
Proudly Serving over 30 Nevada Fire Departments including notable clients (dates listed are start dates):
Sparks Fire Department (2007)
Reno Fire Department (2008)
Carson City Fire Department (2010)
Las Vegas Fire & Rescue (2011 – Fire Rescue Clinic)
North Las Vegas Fire Department (2011)
Amentum Fire and Security (DOD Contractor - Nevada Test Site – 2022)
In 2017, we formed a Limited Liability Corporation, known as 1582, LLC – (“1582” for Short) as the name is more
synonymous with Firefighter Medical Examinations, we expanded services in the states of Colorado, Arizona,
California, Oregen and Hawaii.  As a result, 1582 has become the leading provider of NFPA 1582 compliant physical
exams in the Western United States conducting more than 14,000 annual exams per year.
Currently, our organization(s) have a total of (2) two medical facilities under ARC Health & Wellness in Nevada
(Las Vegas and Reno) and (1) one medical facility under 1582 in Tucson, Arizona.  In addition, 1582 is
headquartered in Sparks, NV and has a fleet of six (6) mobile medical units to provide on-site services for our
clients.

City of El Mirage Fire Department
Proposal for Services
CALIFORNIA
Our first California client – Nevada County Consolidated Fire District started working with us in 2015. Since then,
1582 has expanded greatly throughout  California  and been serving numerous Fire Department/District clients
including a few notable clients:
 North Lake Tahoe Fire Department (2019)
Merced Fire Department (2019)
Sonoma Valley Fire Protection District (2022)
Sonoma County Fire Protection District (2023)
Monterey Fire Department (2023)
Petaluma Fire Department (2023)
South San Joaquin County Fire Authority (2023)
Alameda Fire Department (2023)
Fresno Fire Department (2023)
Santa Rosa Fire Department (2024)
San Jose Fire Department (2025)
ARIZONA
Contacted by Kingman Fire Department in 2015, they are still our original client from Arizona.  1582 has also been
growing greatly in Arizona proudly serving over 40 Fire Departments/Districts including notable clients: 
Kingman Fire Department (2015)
Bullhead City Fire Department (2016)
Casa Grande Fire Department (2019)
Northwest Fire District (2020)
Golder Ranch Fire District (2020)
Prescott Fire Department (2020)
Tucson Fire Department (2021)
Lake Havasu City Fire Department (2022)
Central Arizona Fire Medical Authority (2025)
1582 was awarded the contract to serve Northwest Fire District (the largest Fire District in Arizona – 325
Firefighters) in 2019 and other departments have enacted the Mutual Use Clause of that contract to begin working
with us; including Golder Ranch Fire District and Prescott Fire Department.  In 2021, 1582 was awarded a multi-
year contract to serve the State of Arizona’s 2nd largest Fire Department (over 700 Annual Firefighters) in Arizona -
Tucson Fire Department.
HAWAII
1582 has been expanding operations to the islands of Hawaii, proudly serving five (5) Islands, including Kauai,
Maui, Molokai, Lanai and now a new great feat – the Island of Oahu.  This has been a major accomplishment as an
organization to successfully operate in the middle of the Pacific Ocean.  The team really enjoys spending nearly 6
months a year to serve these great Fire Departments on the Islands.
1582 has been serving Fire Departments in Hawaii including notable clients: 
Kauai Fire Department (2022)
Maui County Fire Department (2023)
Pacific Missile Range Facility (PMRF) - Barking Sands Fire & Emergency Services (2025)
Honolulu Fire Department (2025)

City of El Mirage Fire Department
Proposal for Services
 
 
CONCLUSION
 
Conducting NFPA 1582 Compliant Exams is not merely a product line for 1582, it is our primary business.  As
indicated previously, 1582 has been providing the services submitted in this Proposal for Services since 2009.  Very
few medical providers understand the complexities of conducting NFPA 1582 compliant physicals.  The
principals/key personnel of 1582 have collectively been conducting these exams for over 40 years!   1582’s dedicated
clinical and management team has a depth of expertise which only comes from having extensive working experience
in the industry they serve.
 
Our founding Medical Director, Mark Gaetke, MD is one of the most experienced physicians in conducting Annual
Police and Fire Exams in the country.  He has been conducting these exams for the past 27 years…first as Medical
Director of Concentra (one of the nation’s largest Occupational Medicine Providers) and then as Corporate Medical
Director of 1582 / ARC Health & Wellness Centers.
 
Robert Keller, MD has extensive experience as a physician holding numerous prestigious positions spanning his
career.  Prior to joining 1582, Dr. Keller was Medical Director and Chief Medical Officer of the Health & Family
Practice and Occupational Center of the Pebble Beach Company.  He also served as Senior Partner of the Monterey
Bay Emergency Physician group serving the Community Hospital of the Monterey Peninsula.  Dr. Keller also held
the position of Chairman of the Medical Board of California, Medical Quality Review Committee and Chairman of
the District #8 for the State of California.  Dr. Keller currently serves as our Medical Director for 1582 Medical
Group in California.
 
1582 currently employs a total of approximately 35 team members including seven (7) licensed physicians who
conduct 1582 compliant physical exams.  We only use specialists that are trained in their area of expertise such as our
Exercise Physiologists and Sonographers.  Our Exercise Physiologists are all trained with certified to conduct
Cardiac Stress Testing at a Collegiate level with Degrees in Exercise Physiology.  Our Sonographers are certified and
experienced in Emergency Medicine Hospital settings to understand and quickly identify concerning findings with
the body parts and organs.  Most importantly, we only use our licensed Physicians to serve your members. 
 
NFPA 1582 dictates that complaint medical examinations should be conducted by the Department Physician, not
a mid-level provider like a Nurse Practitioner or Physician Assistant, like other groups use.

City of El Mirage Fire Department
Proposal for Services
METHODOLOGY OPTIONS:
Examinations will be conducted ONSITE inside your Fire Station.  We will bring our equipment to your
facility and set up for testing at the desired city location most convenient for the Department.  Enclosed are
pictures of ONSITE Exams showing how we can set up virtually anywhere.
Step # 1 – Identify the best time of year to complete the exams
Step # 2 – Identify the best FIRE LOCATION to conduct the testing
Step # 3 – Identify how many exams are to be completely weekly and how weeks are needed
Step # 4 – Identify exams are completed ON DUTY/OFF DUTY and best scheduling option
Step # 5 – Identify the options for completing the examinations (1 Visit / 2 Visit)
Step # 6 – Rollout schedules and planning
Private Room/Area - Ultrasound Screenings
Area for Stress EKG Testing
Audiogram, Vision, Spirometry
PHYSICIAN EXAM ROOM: 
Private room / Private office for the Physician to conduct the examination and discuss all the results.  This
can be a Captain’s Office, private room or storage room.

City of El Mirage Fire Department
Proposal for Services
OPTION # 1 - TRADITIONAL TESTING METHODOLOGY DESCRIPTION
Two separate visit event, Part 1 visit is for Diagnostic Testing that requires the results to be compiled before the Part
2 Visit.
Part 1 Visit – 15 Patients per Day scheduled every 30 Minutes.
Time needed per member is one (1) hour per member.
Blood Draw and Urinalysis
Biometric Screening
Spirometry
Audiogram
Ultrasound
Chest X-Ray, if medically indicated
Part 2 Visit – 15 Patients per Day scheduled every 30 Minutes.
Time needed per member is one (1) hour per member.
Resting EKG
Cardiac Stress Test
Fitness Assessment
Physician Examination and Skin Cancer Screening
Traditional Testing Methodology (2 Visit Event)
Sample Schedule – 64 patients per week
Comments: If we plan on working four day increments, we can target 3 different Battalion Shifts to maximize 
flexibility and rotate the weeks so that we can provide an equal number of days for Each Battalion Shift.
SAMPLE SCHEDULE – Two Visit Event includes Blood Draw / UA Collection
Part 1 – Vision, Spirometry, Audiogram, Ultrasounds
Part 2 – Stress EKG / Physician

City of El Mirage Fire Department
Proposal for Services
OPTION # 2 – EXAM ONE TESTING METHODOLOGY
****PREFFERED METHOD****
This method is least disruptive to the Department as the exam is compressed into ONE VISIT.  We must get the lab 
work completed ahead of time at either Quest Diagnostics or LabCorp in locations nearest and most convenient for 
member(s). 
Step # 1 – Member receives Lab Order to go to Quest or LabCorp for Bloodwork before exam dates.
EXAM ONE VISIT – 14 Patients per Day scheduled every 30 Minutes.
Time needed per member is two (2) hours per member.
This is the PREFERRED scheduling option is we complete all testing in ONE VISIT.  We must get the Labs
completed ahead of time for the physician to be able to review the results with the member to determine any potential
concerns or make a Fitness for Duty Determination.
At the end of the visit, the member will receive a copy of the results to present to their primary care provider for
treatment recommendations by 1582.  All copies of results will be provided including Labs, Ultrasound Results,
Stress EKG tracings and comments from the physician detailing areas of concern.
EXAM ONE - Testing Methodology (2 Visit Event)
Sample Schedule – 54 patients per week
Comments: If we plan on working four-day increments, we can target 3 different Battalion Shifts to maximize
flexibility and rotate the weeks so that we can provide an equal number of days for Each Battalion Shift.  We’ll
complete 54 patients weekly in this scenario.
SAMPLE SCHEDULE - NFPA 1582 Exams
In this scenario, we start a little earlier to have the first Doctor’s
appointment at 0830, the physician will complete his last exam at
1600 and complete about 1630.
At the end of the visit, the members may request to receive a copy
of the results to present to their primary care provider for treatment
recommendations by 1582.  All copies of results will be provided
including Ultrasound Results, and comments from the physician
detailing areas of concern.  Results are transmitted via Citrix
ShareFile to their email address on file.

CALIFORNIA PHYSICIAN REPRESENTATIVE RESUMES
ROBERT P.K. KELLER, MD
EMERGENCY MEDICINE
Medical School
Surgical Residency
Emergency Medicine
University of Utah College of Medicine, 1974
University of Utah College of Medicine, Affiliated Hospitals General Surgery, 1973 - 
1975
Northwestern-Rush Presbyterian-St. Luke’s-Christ Residency Hospitals, Emergency 
Medicine Residency Program, Chicago, 1978
Medical Director / California
ARC Health & Wellness Centers – 2018 - Present
1582 – 2018 - Present
Past Positions:
Chairman, Appointed by the Governor of California
Medical Board of California
Medical Quality Review Committee
District #8 for the State of California
Senior Partner, Member of the Board, and Staff ED Physician
Monterey Bay Emergency Physicians, Inc
Community Hospital of the Monterey Peninsula
Monterey, CA
Medical Director & CMO
Pebble Beach Company
Health & Wellness Family Practice and Occupational Center
Pebble Beach, CA
Chairman
Community Hospital of the Monterey Peninsula
Emergency Department
Monterey, CA
Medical Director
Community Hospital of the Monterey Peninsula
Employee Health/ Workers Compensation
Monterey, CA
Certification & Affiliations:
California Medical Association
Monterey County Medical Society
AACS - American Academy of Cosmetic Surgery Associate Member
ASLSS - American Society of Lipo-Suction Surgery Member
ACP - American College of Phlebology Member
ACEP – American College of Emergency Physician
FAA Senior Aviation Examiner
Arizona Medical License - # 59562

City of El Mirage Fire Department
Proposal for Services
CALIFORNIA PHYSICIAN REPRESENTATIVE RESUMES
KEITH C. ARNOLD, MD, MPH
FAMILY MEDICINE
University of Arizona College of Medicine 2012 - 2017
Mountain Area Health Education Center 2017 - 2020
B.A. Political Economy 2002 - 2006
Medical School
Family Medicine 
Residency
University of California at
Berkeley
Staff Physician
1582 – 2022 - Present
Dr. Arnold is a Bi-Lingual (English/Spanish) Physician with experience in Family 
Medicine, Urgent Care, Critical Care Access. He is currently working on obtaining his 
California Medical Licensure. He holds a dual degree in Medicine and master’s in 
public health.
Past Positions:
Vista Staffing Solutions – Hospitalist Locum | 6/22 – 12/22
Flagstaff Family Care Clinics – Family Medicine Physician | 10/20 – 1/22
Certification & Affiliations:
MAHEC Spirit of MLK Jr Award – Emerging Leader 01/19
Kaiser Permanente Excellence in Teaching Award – UNC School of Medicine. 
08/18
Family Medicine Community Scholar Award – UACOM 05/17
Phi Kappa Tau Fraternity – President, U.C. Berkeley 01/05-01/06
Varsity Rugby – U.C. Berkeley

City of El Mirage Fire Department
Proposal for Services
CALIFORNIA PHYSICIAN REPRESENTATIVE RESUMES
WILLIAM (MARK) ELLIOTT, II, MD
FAMILY MEDICINE
The Medical College of Virginia 1976 – 1980
North Carolina Baptist Hospital 1981 - 1983
Wake Forest University
Bowman Gray School of Medicine
Medical School
Family Medicine 
Residency
Staff Physician
1582 – 9/2021 - Present
Dr. Elliott has worked full time as a physician since 1983 in Family Practice and
Emergency Medicine. He has successfully served many 1582 clients with raving
reviews from our Firefighters about great attention to detail and very personable.
Past Positions:
Adean Region Medical Center 6/20 – 9/21
Greenfield Area Medical Center 6/18 – 6/20
Stonewall Jackson Memorial Hospital 9/17 – 9/21
Pocahontas Memorial Hospital 4/18 – 8/18
Certification & Affiliations:
The American College of Emergency Physicians Member since 1999
Fellow since 2007
The American Medical Association Member since 1983

City of El Mirage Fire Department
Proposal for Services
CALIFORNIA PHYSICIAN REPRESENTATIVE RESUMES
BRIAN KUHN, MD
EMERGENCY MEDICINE
McMaster University Medical School 1976
McMaster University Residency Program 1976 - 1978
Fellow American Board of Emergency Medicine 1995
University of Arizona, Tucson 2005-2006
Medical School
Family Medicine 
Residency
Anesthesia Residency
Staff Physician
ARC Health & Wellness Centers – 2016 – Present
1582 – 2018 - Present
Dr. Kuhn is a multi-disciplined Emergency Medicine Physician with experience in
Family Medicine, Urgent Care, Diving and Underwater Medicine, Nautical Medicine
as well as High Altitude Medicine serving as a Trek Physician on Mt. Everest,
Himalayas and Nepal. Dr. Kuhn was a former resident of Tucson from 2005 – 2007, he
proudly speaks about participating in the Tour De Tucson four times.
Past Positions:
Holland America Cruise Ship Physician 2008-2013
St. Mary’s Hospital (Reno) 1988-2005
Barton Memorial Hospital (Lake Tahoe) 1986-1987
Certification & Affiliations:
Arizona Medical License - # 57693
California Medical License - # C38871
Nevada Medical License - # 5074

City of El Mirage Fire Department
Proposal for Services
CALIFORNIA PHYSICIAN REPRESENTATIVE RESUMES
HOWARD CHEN, MD
FAMILY MEDICINE
Medical School
Family Medicine 
Residency
University of Rochester 1997 - 2001
University of Washington 2001 - 2004
Family Medicine Residency Program
Bowman Gray School of Medicine
Medical School
Family Medicine 
Residency
University of Rochester 1997 - 2001
University of Washington 2001 - 2004
Family Medicine Residency Program
Bowman Gray School of Medicine
Staff Physician
1582 – 6/2024 - Present
Dr. Chen has worked full-time as a physician since 2004 in Family Practice starting
with Renown Health Wellness and Integrative Medicine Services and Medical
Acupuncture. He has successfully served many 1582 clients with raving reviews from
our Firefighters about great attention to detail and very personable.
Past Positions:
The Chen Center for Integrative Medicine 4/19 – Present
Renown Health, Wellness and Integrative Medicine Services 7/10 – 3/18
Renown Advanced Wound Care and Hyperbaric Oxygen Therapy 7/10 – 7/18
Family Medicine / Urgent Care – Renown 9/07 – 7/10
Foreign Languages:
Medical Spanish
Mandarin Chinese

City of El Mirage Fire Department
Proposal for Services
REFERENCES
RENO FIRE DEPARTMENT
ANDY ANCHO
Division Chief / Emergency Manager
(775) 432-3805 - Cell
(775) 333-7774 - Work
AnchoA@Reno.Gov
We provide NFPA 1582 Compliant Examinations for City of Reno Fire Department since 2008 with Mark Gaetke,
MD as the Medical Director of ARC Health & Wellness Centers, sister company to 1582, LLC.  With a project date
since 2008 over the last 15 years.
TUCSON FIRE DEPARTMENT
LEWIS M. HARRIS
Assistant Chief - ​Administrative and Personnel Services Bureau
(520) 406-9652 - Cell
(520) 837-7090 - Work
Lewis.harris@tucsonaz.gov
We provide NFPA 1582 Compliant Examinations for City of Tucson Fire Department with a project date since 2021
with Mark Gaetke, MD as the Medical Director of 1582, LLC.
FRESNO FIRE DEPARTMENT
BILLY ALCORN
Fire Chief
(209) 777-2359 - Cell
(559) 621-4101 - Work
Billy.alcorn@fresno.gov
We provide ONSITE NFPA 1582 Compliant Examinations for Fresno Fire Department with a project date from 
2021.

CONTRACT ADDENDUM 
CITY OF TUCSON BUSINESS SERVICES DEPARTMENT
255 W. ALAMEDA, 6TH FLOOR, TUCSON, AZ  85701
P.O. BOX 27210, TUCSON, AZ  85726 
PHONE: (520) 837-4139 
Troy.Rombough@tucsonaz.gov 
ISSUE DATE: 9/14/2025
CONTRACT #222846–02
CONTRACT ADDENDUM NUMBER: FIVE (5)
PAGE 1 of 2 
PRINCIPAL CONTRACT OFFICER: TROY ROMBOUGH 
Occupational Health Services for Tucson Fire Department and Tucson Police 
Department  
THIS CONTRACT IS AMENDED AS FOLLOWS:
ITEM ONE (1): RENEWAL 
In accordance with Contract Special Terms and Conditions, Section F.5., “Term and Renewal”, the City hereby exercises 
its option to renew the contract for the period of September 22, 2025 through September 21, 2026. 
ITEM TWO (2): STANDARD TERMS AND CONDITIONS ADDITION 
In accordance with Contract #222846-02, “Standard Terms and Conditions”, Subsection H.45. “Prevention of Heat-
Related Illnesses and Injuries” the City hereby adds the following language upon execution of this addendum: 
H.45. PREVENTION OF HEAT-RELATED ILLNESSES AND INJURIES
If Contractor’s employees or contract workers will perform work under this Contract in an outdoor environment, Contractor 
must have and implement a written plan listing the preventative and proactive measures that Contractor will take to 
protect those employees and contract workers from heat hazards (the “Heat Safety Plan”) while performing that work. The 
City may request a copy of this Heat Safety Plan and documentation of all heat safety and mitigation efforts currently 
implemented by Contractor to prevent heat-related illnesses and injuries for work done under this Contract. The Heat 
Safety Plan must also be posted where it is accessible to employees. At a minimum, the Heat Safety Plan must include 
each of the following elements as it relates to heat safety: 
1. Availability of sanitized cool drinking water free of charge at locations that are accessible to all employees and contract
workers.
2. Ability to take regular and necessary breaks as needed and additional breaks for hydration.
3. Access to shaded areas and/or air conditioning.
4. Access to air conditioning in vehicles with enclosed cabs.
5. Effective acclimatization practices to promote the physiological adaptation of employees or contract workers newly
assigned or reassigned to work in an outside environment.
6. Training of employees and contract workers, no later than one week prior to being deployed to work in an outdoor
environment, on heat illness and injury that focuses on environmental and personal risk factors, prevention, how to
recognize and report signs and symptoms of heat illness and injury, how to administer appropriate first aid measures, and
how to report heat illness and injury to emergency medical personnel.
7. The posting of signage at the job site that contains information, in both English and Spanish, explaining how to (a)
recognize and report signs and symptoms of heat illness and injury; (b) administer appropriate first aid measures, and (c)
report heat-related illness and injury to emergency medical personnel. The signage must also include a phone number for
reporting heat violations to OSHA/ADOSH.
8. Providing written notification to all employees and contract workers regarding their new worker protections under this
provision. This notification shall be provided to existing employees and during the onboarding process for new employees.
The notification shall be provided to each worker in the language preferred by that worker and must be posted in the
workplace.

CONTRACT ADDENDUM 
CITY OF TUCSON BUSINESS SERVICES DEPARTMENT
255 W. ALAMEDA, 6TH FLOOR, TUCSON, AZ  85701
P.O. BOX 27210, TUCSON, AZ  85726
PHONE: (520) 837-4139
Troy.Rombough@tucsonaz.gov
ISSUE DATE: 9/14/2025
CONTRACT #222846–02
CONTRACT ADDENDUM NUMBER: FIVE (5)
PAGE 2 of 2 
PRINCIPAL CONTRACT OFFICER: TROY ROMBOUGH
Contractor will incorporate this section in all subcontracts with subcontractors or other entities or individuals who may 
perform work under this Contract, including the requirement that those subcontractors impose the same obligations under 
any sub-subcontractors. It is the obligation of Contractor to ensure compliance with this provision by its subcontractors. 
City may terminate this Contract for failure to comply with this provision. 
***END OF ADDENDUM ITEMS***
ALL OTHER PROVISIONS OF THE CONTRACT SHALL REMAIN IN THEIR ENTIRETY.
CONTRACTOR:  1582, LLC
CONTRACTOR HEREBY ACKNOWLEDGES RECEIPT OF
AND UNDERSTANDING OF THE ABOVE ADDENDUM
Signature of person authorized to sign
Date
Name and Title (typed or printed legibly)
Company Name
Address
Email Address
City
State
Zip
Contact information for Sales/Account 
Representative for daily business operations:
Name and Title (typed or printed legibly)
Phone Number
Email Address
CITY OF TUCSON:
THE ABOVE REFERENCED CONTRACT ADDENDUM
IS HEREBY EXECUTED THIS ____________________ DAY
OF____________________, 2025, AT TUCSON, ARIZONA.
_________________________________________________
Director of Business Services and not personally
21st
October
for

REQUEST FOR PROPOSAL 
RFP # 222846
OCCUPATIONAL HEALTH SERVICES FOR THE TUCSON 
FIRE DEPARTMENT AND TUCSON POLICE DEPARTMENT 
CITY OF TUCSON 
BUSINESS SERVICES DEPARTMENT 
255 W. ALAMEDA, 6TH FLOOR 
TUCSON, AZ 85701 
ATTN: JENN MYERS / LADD LYONS 
PROPOSAL DUE DATE AND TIME: 
FRIDAY, JULY 30th, 2021 at 2:00 PM

LETTER OF TRANSMITTAL 
July 30, 2021 
City of Tucson 
Business Services Department 
255 W. Alameda, 6th Floor 
Tucson, AZ 85701 
RE:  RFP # 222846 – Occupational Health Services for Tucson Fire 
Department and Tucson Police Department 
Attn:  Jenn Myers / Ladd Lyons 
1582 is pleased to present to the the City of Tucson our proposal to provide medical evaluations 
for firefighters in response to RFP # 222846.   
Upon careful review of RFP # 222846– Occupational Health Services for TFD and TPD, 1582 
LLC has a complete understanding of the work that is to be performed under this RFP within 
the time period specified. We acknowledge receipt of any and all amendments to the RFP.  The 
proposal, including pricing, will be valid for 90 days after the due date and time of receipt by 
City of Tucson. 
Primary Organization responding to RFP: 
1582, LLC 
Primary contact person: 
Paul Granstrom 
Title:   
President 
Telephone:  
 
775-846-3413
Email:  
Paul@1582exam.com
Corporate Headquarters for 1582: 
1582, LLC 
1855 N. McCarran Blvd 
Sparks, NV 89431 
 
Nearest office location in Arizona: 
1582  
1925 W. Orange Grove Rd. 
Suite 304 
Tucson, AZ 85704 
Should you have any questions or concerns regarding our response, please contact Paul Granstrom, 
President of 1582, via phone at 775 846-3413 or by email: Paul@1582exam.com.

CITY OF TUCSON 
CERTIFICATION OF LIVING WAGE PAYMENTS 
(This form must be completed by the Contractor and each applicable subcontractor.) 
Contract Number:  
Contractor or Sub Name:  
(Please Check Only One of the Following Two Options) 
_____ I do hereby agree to pay all eligible employees working on the above-referenced contract a minimum of 
$10.86 per hour and provide health benefits.  I also agree to pay at least 50% of the eligible employees’ health 
benefits premium. Our firm’s health insurance provider(s) are listed below:   
Name of Health Insurance Company:  
Address:  
Telephone:  
Fax Number:  
Plan or Program Number:  
Monthly premium paid by employer: _____ Monthly premium paid by employee _____ 
Name of Health Insurance Company:  
Address:  
Telephone:  
Fax Number:  
Plan or Program Number:  
Monthly premium paid by employer: _____  Monthly premium paid by employee _____ 
_____ I do hereby agree to pay all eligible employees working on the above-referenced contract a minimum of 
$12.15 per hour. I do not offer health benefits to eligible employees working on this contract and/or I do not pay 
at least 50% of the eligible employees’ health benefits premium. 
 
By 
(Contractor /Sub-Contractor Name) 
(Signature) 
 
(Date) 
(Title) 
222846
1582, LLC
X
1582, LLC
President
7/30/2021

CITY OF TUCSON 
PROPOSAL NO. 222846 
BUSINESS SERVICES DEPARTMENT 
Page 71 of 81 
SHARED SERVICES PROCUREMENT DIVISION 
RESPONSIBLE CONTRACT OFFICER: Jenn Myers 
255 W. ALAMEDA, 6TH FLOOR, TUCSON, AZ 85701 
PH: (520) 837-4137 
OFFER AND ACCEPTANCE
OFFER 
TO THE CITY OF TUCSON: 
The Undersigned hereby offers and shall furnish the material or service in compliance with all terms, scope of work, conditions, 
specifications, and amendments in the Request for Proposal which is incorporated by reference as if fully set forth herein. 
For clarification of this offer, contact: 
 
 
Name:  
Company Name 
 
 
Title:  
Address 
 
 
Phone: 
City 
State 
Zip 
Fax: 
Signature of Person Authorized to Sign 
E-mail:  
Printed Name 
 
 
Title 
ACCEPTANCE OF OFFER 
The Offer is hereby accepted. The Contractor is now bound to sell the materials or services specified in the 
Contract. This Contract shall be referred to as Contract No. ________________. 
CITY OF TUCSON, a municipal corporation 
Approved as to form: 
Awarded: 
This ________ day of _______________ 20_____ 
This ________ day of _______________ 20_____ 
As Tucson City Attorney and not personally 
As Director of Business Services and not 
personally 
1582, LLC
Tucson
AZ
85704
1925 W. Orange Grove Rd., Suite # 304
Paul Granstrom
President
775-846-3413
602-581-3030
paul@1582exam.com
Paul Granstrom - President

1582 Submission for City of Tucson 
Page # 
1 
E. Vendor Response
E.1 Method of Approach
1.
Method of Approach to Scope of Work
1582 understands the Scope of Work listed in this RFP.  We offer our services to the City of Tucson a
in a limited capacity as we are NOT able to provide Workers Compensation nor traditional day-to-
day Occupational Health Services.
Specialty Area 
Section 
1582 Submission Interest 
1.A
Tucson Fire Injury 
NO 
1.B
Tucson Fire New Hire/Annual Exams 
YES 
2.A
Tucson Police Injury 
NO 
2.B
Tucson Police New Hire Exams 
NO 
1582 is prepared to offer our services to the City of Tucson serving aspects under Section # 1.B – 
Tucson Fire New/Annual Evaluation and Exam Services for Tucson Fire Department (TFD) 
Commissioned Personnel to meet the responsibilities as outlined, per the City of Tucson’s request. 
2.
Distinguish Tasks
1582 is prepared to undertake the following tasks as listed in this RFP under Section # 1.B
Referencing Section B.2 (Page 16 of 82) – Specialty Group 1.B New Hire/Annual 
Evaluation  
A. 
Preventative Medicine/Physical Fitness Program and Mental Health 
YES 
B. 
TFD Annual Screening Program 
YES 
C. 
Physiological Testing Equipment for measurements of physical standards 
YES 
D. 
TFD Follow Up Program 
YES 
E. 
Review and Administration of physical fitness program with TFD 
YES 
F. 
Supply regular department profile reports 
YES 
G. 
Continue to update, validate and defend standards 
YES 
H. 
Conduct Physical Abilities Test (PAT) using the PAT Protocol 
YES 
    Referencing Section B.2.1 (Page 16/17 of 82) – Pre-Employment Physical Examinations 
A. 
Pre-employment physical examinations will be completed in accordance 
YES 
B. 
Contractor to provide form detailing results to City 
YES 
C.1
Review Job Classification for Physical Requirements and Questionnaire 
YES 
C.2
Medical History 
YES 
C.3
Physical Examination 
YES 
C.4
Objective Spinal Testing 
YES 
C.5
Drug Test 
YES 
C.6
Laboratory Tests as agreed upon to City and Contractor 
 YES 
C.7
X-Rays
YES 
C.8
Pulmonary Function Test with OSHA Respiratory Questionnaire 
YES 
C.9
Audiogram 
YES 
D. 
Determination of employee/candidate’s ability to perform in the position 
YES 
E. 
Prior authorization from applicable group contract representative 
YES

1582 Submission for City of Tucson 
Page # 
2 
F. 
Results shall be sent to PSPRS and Pass/Fail 
YES 
G. 
Pre-employment medical examinations per NFPA 1582 
YES 
H. 
Any other procedures require prior approval 
YES 
I. 
Hepatitis Profile Screening 
YES 
J. 
Pulmonary Function Assessment to determine SCBA classification 
YES 
Referencing Section B.2.2 (Page 18-21 of 82) – Annual Physical Examinations 
A. 
Assist TFD on performance standards, maintain annual screening 
YES 
B. 
Physiological Testing using NFPA 1582, 1583 and WFI 
YES 
C. 
Maintain Follow Program 
YES 
D. 
Actively participate in the review and administration of fitness program 
YES 
E. 
Update, validate, and defend physical standards 
YES 
F. 
Conduct Physical Abilities Test (PAT) 
YES 
G.1.
Medical History and Physical Examination 
YES 
G.2.
CAD Risk Factor Assessment including Ultrasound 
YES* 
G.3.
Blood lipid profile, including TC, HDL, LDL, Trig, TC/HDL ratio 
YES 
G.4
Percent of body fat and muscle 
YES 
G.5
Physiological testing including hearing, vision and pulmonary function 
YES 
G.6
UA, CBC, T4, TSH, NMP22, CRP, Hemoccult, PSA, Hep Profile 
YES 
G.7
Tetanus 
YES 
G.8
Tuberculin Test 
YES 
G.9
Critical Review of Physical Fitness Test 
YES 
G.10
Chest X-Ray 
YES 
G.11
Development of improvement program 
YES 
G.12
Secure Password Protected HIPAA compatible computer portal… 
YES 
G.13
Continuation of testing for personnel approaching 60 years old… 
YES 
G.14
Follow Up Fitness Counselling at required intervals 
YES 
G.15
Contractor to work with firefighter found unfit for duty and TFD. 
YES 
G.16
Contractor to provide each firefighter with identified problems… 
YES 
G.17
Contractor will review and maintain an epidemiologic surveillance prog. 
YES 
G.18
Complete the Annual Physical Evaluation of all members in Fiscal Year 
YES 
G.19
Contractor shall provide telephone or in-person professional medical… 
YES 
*G.2 – our provider’s will interpret the Carotid Artery Ultrasound at no additional charge and
patients will be referred to their PCP for follow up or additional testing.  A cardiology
interpretation will require a diagnostic Ultrasound which will increase the cost and time to
complete.  Options will be provided in pricing if this is critical.
Referencing Section B.3 (Page 21-25 of 82) – Drug and Alcohol Testing 
A. 
All drug and alcohol testing requires authorization… 
YES 
B. 
Breath Alcohol Testing shall be performed using instruments approved… 
YES 
C. 
Contractor is responsible for notifying the attending supervisor/escort… 
YES 
D. 
Employee leaves facility prior to completion of the test… 
YES 
E. 
Contractor will provide MRO services as required under FMCSA 
YES 
F. 
All Non-DOT drug and alcohol testing will be conducted using the 
correct… 
YES 
G. 
In the event a collector uses an expired CCF, an affidavit… 
YES 
H. 
The BAT must provide a signed statement, on agency letterhead… 
YES 
I. 
The BAT must provide a signed statement that they fully understand… 
YES 
J. 
The BAT must observe the 15-minute minimum waiting period… 
YES 
K. 
If the EBT device produces two consecutive air blank reading greater… 
YES

1582 Submission for City of Tucson 
Page # 
3 
L. 
The collector must always direct the employee to empty his/her pockets… 
YES 
M. 
The collector must explain/describe the procedures required for directly… 
YES 
N. 
Collector must obtain a sufficient specimen within three hours… 
YES 
O. 
The technician is required to explain or show the employee the instruct… 
YES 
P. 
The technician is required to accurately describe the required actions… 
YES 
Q. 
All BATs must be signed up for ODAPC’s list serv. 
YES 
R. 
The Collector must explain the base collection procedure to the emp. 
YES 
S. 
The Collector must direct the employee to read and complete Step 5. 
YES 
T. 
If the collector finds any material that could be used to tamper with… 
YES 
U. 
If the employee admits to the collector or the MRO to having adulterated. 
YES 
V. 
In the event an employee provides an initial sample which is adulterated… 
YES 
W. 
Contractor will provide random selection services for two drug and alcohol 
testing pool (CDL and Safety Sensitive) 
YES* 
X. 
Blood Alcohol Draw may be requested by any employee who shows… 
NO 
Y. 
Contractor must be available for random, post-accident, and reasonable… 
NO 
Z. 
Contractor 
must 
notify 
City 
of 
Tucson 
Identified 
Contract 
Representative… 
YES 
AA. 
Contractor will keep the City informed of FMCSA compliance rule 
updates… 
YES 
BB. 
Contractor will submit a biannual report to City of Tucson… 
YES 
CC. 
Contract will abide by the Federal Calibration schedule for BAT ma 
YES 
DD. 
Contractor will only use HHS certified laboratories 
YES 
EE. 
Contractor will use certified Breath Alcohol and Urine Collection Techs 
YES 
FF. 
In the event of a report negative dilute specimen with a creatinine… 
YES 
GG. Tests for breath alcohol concentration will be conducted utilizing NHTSA 
YES 
HH. Contractor may not redirect employee services to another location… 
YES 
*W - 1582 is happy to offer the services of Sinnett Consulting Services, an excellent
organization for random selections and make that part of our contract and services.  We
currently don’t provide random selection services for any of our clients but can help coordinate
this if you select us/Sinnett Consulting Services to assist.
NO RESPONSE 
We responded that we are UNABLE to provide 24/7 services under Section # X and Y, 
we are not currently equipped with sufficient staff that will be able to respond any night 
from 5 PM to 8 AM Monday through Friday. 
IV. OTHER SERVICES
IV. 
Administer OSHA Qualitative or Quantitative Fit Testing 
YES 
       Referencing Attachment A (Page 73-75 of 82) Physical Abilities Test (PAT) Protocol 
Attachment A 
Physical Abilities Testing (PAT) Protocol 
YES 
---- 
Please refer to next page to Distinguish Tasks for Attachment B 
----

1582 Submission for City of Tucson 
Page # 
4 
Attachment B: Pre-Employment and Annual Physical Examinations 
We are prepared to serve all members of Tucson Fire (632) and prehires in the respective Fiscal Year as 
outlined under this RFP.  To demonstrate our understanding of the tasks outlined per the City’s request, 
please see confirmation below. 
Referencing Attachment B (pages 76 – 81) 
Pre-Employment and Annual Physical Examinations 
1. 
Medical History 
YES 
2. 
A. 
OSHA Respirator Protect Program 
YES 
B. 
OSHA Questionnaire 
YES 
C. 
Physical to be familiar with above OSHA Standard and Certification 
Doc 
YES 
3. 
A. 
Vital Signs 
YES 
B. 
Inspection of Head, Eyes, Ears, Nose, Throat, Neck, Mouth, Thyroid 
YES 
C. 
Inspection, auscultation, percussion and palpation of the following: 
YES 
D. 
Inspection of the Lymph Nodes 
YES 
E. 
Neurological general assessment of major cranial/peripheral nerves 
YES 
F. 
Musculoskeletal Assessment of overall range of motion of all joints 
YES 
G. 
Skin Evaluation 
YES 
4. 
A. 
Visual Acuity 
YES 
B. 
Color Perception 
YES 
C. 
Lateral and vertical phoria 
YES 
D. 
Depth Perception 
YES 
E. 
Fusion Testing 
YES 
F. 
Muscle Balance 
YES 
G. 
Employee will be referred to an optometrist for refraction testing… 
YES 
5. 
A. 
Baseline hearing testing-pre-employment 
YES 
B. 
Results compared with baseline and subsequent test results… 
YES 
C. 
Retesting as necessary 
YES 
D. 
Notification of hearing shifts 
YES 
E. 
Report back to Tucson City Risk for any OSHA 300 documentation 
YES 
F. 
Contractor’s exam shall meet OSHA 29 CFR 1910.95 
YES 
G. 
Contractor shall provide a description of Audio booth to be used… 
We use an OSHA Rated - ECKEL AB 200 Audio Booth (purchased 
new) 
YES 
6. 
A. 
CBC 
YES 
B. 
CMP 
YES 
C. 
Lipid Profile 
YES 
D. 
Hemoglobin A1C 
YES 
E. 
PSA (over 40) 
YES 
F. 
TSH 
YES 
G. 
Hs-CRP 
YES 
H. 
Vitamin D. 
YES 
I. 
GGT 
YES 
J. 
Urinalysis 
YES 
7. 
A. 
Urine Dip Stick 
YES 
B. 
Microscopic Analysis for RBC,WBC, Casts and Crystals 
YES 
C. 
Analysis for occupational chemical exposure 
YES

1582 Submission for City of Tucson 
Page # 
5 
7. 
D. 
Positive Dip Stick for hematuria shall require a follow and referral 
YES 
8. 
A. 
T-SPOT TB blood test (Exclusive Test with Sonora Quest)
YES 
i. 
PPD or QuantiFERON Gold 
YES 
B. 
Vaccinations as needed or following exposures 
YES 
i. 
Hepatitis A/B/C (no vaccination for HEP C available) 
YES 
ii. 
Hepatitis A/B or Twinrix 
YES 
C. 
Antibody Titer test for pre-employment 
YES 
D. 
Other vaccinations at the recommendation of physician 
YES 
9. 
A. 
FVC 
YES 
B. 
FEV1 
YES 
C. 
FEV1/FVC 
YES 
D. 
Results as Absolute Value using NHANES III 
YES 
10. 
A. 
Two View Chest X-Ray at Pre-Employment Examination 
YES 
11. 
A. 
Fecal Occult Blood Test 
YES 
12. 
A. 
Bio-impedance waist circumference 
YES 
B. 
Body Weight 
YES 
C. 
Body Composition Evaluation by Skinfold 
YES 
13. 
A. 
Berlin Sleep Study Questionnaire 
YES 
B. 
Promise Questionnaire 
YES 
C. 
Members with a high index risk shall have the risks benefits 
discussion 
YES 
D. 
Results will be compared with Baseline and subsequent screenings 
YES 
E. 
Contractor will work with the TFD Mental Health Provider 
YES 
14. 
A. 
Resting 12-lead ECG 
YES 
B. 
  Result will be compared with baseline and subsequent ECGs 
YES 
C. 
  Evaluated by Cardiologist 
YES* 
15. 
A. 
CPET conduct on stationary bike (Preferred) 
YES 
B. 
  Expressing peak VO2 as a percent % predicted 
YES 
C. 
  Individual may achieve 100% of his/her predicted Vo2 Max 
YES 
D. 
  Blood Pressure and ECG are monitored 
YES 
E. 
  Asymptomatic Employee 
YES 
F. 
  ECG evaluated by Cardiologist 
YES 
16. 
A. 
Treadmill 
YES 
B. 
  Commercial Treadmill capable of obtaining 15% grade 10 MPH 
YES 
C. 
  American Heart Association AHA 
YES 
D. 
  Submaximal test only 
YES 
E. 
  Blood Pressure and ECG are monitored 
YES 
F. 
  Asymptomatic employee 
YES 
G. 
  ECG evaluated by Cardiologist 
YES* 
17. 
A. 
Step Mill 
NO 
B. 
  Commercial Step Mill calibrated to same step-per-minute rate… 
NO 
C. 
  American Heart Association AHA 
NO 
D. 
  Submaximal Test Only 
NO 
E. 
  Blood Pressure and ECG are monitored 
NO 
F. 
  Asymptomatic Employee 
NO 
G. 
  ECG evaluated by Cardiologist 
NO 
18. 
A. 
N-95 Respirator
YES 
19. 
A. 
SCBA mask fit testing with 2 OHD Quantifit testing machines 
YES 
20. 
A. 
HAZMAT Team Only Annual Questionnaire 
YES 
B. 
Arsenic, Mercury, Cadmium evaluated 
YES 
C. 
Blood Lead / ZPP 
YES

1582 Submission for City of Tucson 
 
Page # 
6 
21. 
A. 
Hand Grip 
YES 
 
B. 
Front Plank 
YES 
 
C. 
Push-Ups with Metronome for Cadence 
YES 
 
D.i. 
Optional Evaluations 
YES 
 
Dii. 
Horizontal Pull-Up 
YES 
 
Diii. Sideplank 
YES 
22. 
 
Functional Movement Screening (FMS) 
YES 
23. 
A. 
Low Dose Lung CT Scan 
YES 
 
B. 
Ultrasounds 
YES 
 
C. 
CT Calcium Scoring based on metabolic syndrome and/or Vo2 Risk 
YES 
 
D. 
Fecal Occult Stool Test 
YES 
 
E.  
Cancer Risk Questionnaire 
YES 
*14.C and 16.G – our provider’s will interpret Stress EKG’s / MET Test Results at no 
additional charge and patients will be referred to their PCP for follow up or additional testing 
needed.  A cardiology interpretation will be provided as an optional charge, if this is critical. 
 
NO RESPONSE 
We responded that we are UNABLE to provide Step Mill Testing under Section 17, we 
are not currently equipped with equipment to provide that service.  Additionally, we are 
not aware of any diagnostic testing manufacturers using Stair Steppers in a cardiology 
grade environment like what we have with the Stress Treadmill Systems or the Stationary 
Bicycle using MET Test.   
 
Please note – Step Mill Testing option may change down the road and we will substitute that 
test for the Stress Treadmill pricing option if a viable system becomes available. 
 
 
 
 
Administrative Process for Method of Approach 
 
1582 specializes in conducting high quality medical examination services that focuses both on the NFPA 
1582 standards as well as Arizona’s new Cancer Bill-SB 1160. 
 
Our organization’s primary focus is to educate the firefighter regarding his/her current medical condition 
and how it relates to NFPA 1582 standards.  The results of the NFPA 1582 exam will assist the firefighter 
in determining what needs to address with their own medical provider to obtain optimal medical outcomes. 
 
We applaud the fact that the City of Tucson is ensuring that their firefighters meet the NFPA 1582 standards 
for both Medical and Physical fitness for Duty.  This policy protects the firefighters’ health and wellbeing 
as well as the City of Tucson as the employer.  1582 differentiates itself from its competitors by 
providing better optics targeting each firefighter’s overall health with the introduction of Full Body 
Ultrasound Screenings.  Cancer related deaths for Firefighters continue to be on the rise and 1582’s Full 
Body Ultrasound Screenings focus on critical areas of cancer mortality such as Thyroid, Abdominal and 
Small Parts Regions.  In addition, our Medical Staff utilizes the ultrasound screenings to educate the 
Firefighters regarding the Carotid Artery, Aortic Aneurysms, as well as other medical related issues. 
 
During this time of Covid 19 which apparently will be with our society for quite some time, it is critical 
that our first responders have the ability to avoid exposure…at least while they are being provided their

1582 Submission for City of Tucson 
 
Page # 
7 
pre-employment and annual examinations.  1582 has the unique ability to conduct examinations either on-
site at Tucson Fire or in our 1582 Specialty Medical Facility setting which only serves firefighters! All 
services are provided by appointment only thus eliminating unnecessary waiting times which occur in the 
typical medical office settings which allow walk-ins and emergency type visits. 
 
ONSITE SERVICES: 
 
Over Two-Thirds (2/3) of our Fire clients (81 Fire Departments/Districts) elect to have services 
conducted ONSITE at their Fire Station.  Fire departments that select this option generally prefer to conduct 
the examinations while the Firefighters are ONDUTY.  This is a great option, but the Engines must be 
browned out to ensure we have patients available on allocated time slots.  In this scenario, we set up a Clinic 
at your Training Center, Fire Station or other City Property.   
 
Soft Cost Benefits of conducting examinations in this scenario are: 
• 
Elimination of Overtime Paid to complete Department Mandated Exam  
• 
Elimination of Travel Time  
• 
Elimination of Long Wait Times  
• 
Convenience of completing the Medical Exam on your Turf 
• 
Various other cost saving situations 
 
By selecting this ONSITE option, 1582 will complete EVERYTHING at your designated location at the 
same affordable rate as selecting our Office.  In this scenario, we bring in our own equipment and our team 
of Medical Specialists and Physicians to your location.   
 
This ONSITE experience is the Ultimate convenience for our clients.  We require a minimum of 15 
examinations per day, over two (2) different visits. 
 
Enclosed are pictures of 1582 conducting ONSITE examinations using CPET MET Testing, Stress 
Treadmill Testing, Ultrasound, Blood Draws…we do it all at your Facility.

1582 Submission for City of Tucson 
 
Page # 
8 
 
 
 
 
 
1582 OFFICE: 
 
We have a beautifully equipped office at 1925 W. Orange Grove, Suite # 304 by the Northwest Medical 
Center that is prepared to serve your Firefighters with their Annual Examinations.   
 
Furthermore, 1582 is willing to discuss opening an additional Medical Facility in Central/Eastern 
Tucson if necessary, if that will better serve the members of Tucson Fire Department. 
 
Similar to our ONSITE services, we conduct our examinations in two (2) different visits.  The 
rationale behind this is a quality of medicine standard, all diagnostic tests should be completed 
prior to the Physician actually seeing your Firefighter.  Your Firefighters are going to have 
many questions with our specialized testing and our providers are here to help your Firefighters 
navigate these new scenarios and how to get the help they need. 
 
Part 1 Visit: 
 
 
 
 
Part 2 Visit: 
Blood Draw / Urinalysis 
 
 
Electrocardiogram 
Ultrasound Screening  
 
 
Maximal Stress EKG 
Audiometric Testing 
 
 
 
Skin Cancer Assessment 
Spirometry Testing 
 
 
 
Physician Examination 
Biometric Screening/Vision Screening 
 
 
 
CPET Testing  
 
 
 
Optional Enhancements: 
Fitness Testing (if applicable) 
 
 
Echo Cardiogram 
Chest X-Ray (if applicable) 
 
 
Mental Health Consultation 
 
It’s important to note that 1582 works very well with Labor, Management, Human Resources

1582 Submission for City of Tucson 
 
Page # 
9 
and Risk Management.  Our goal is clear…provide the BEST possible medical examination 
your employees have ever experienced by identifying Cardiac Issues and finding potential 
Cancer or Disease Concerns in early stages.  We work closely with your Firefighters 
encouraging them to get a Primary Care Provider (if they don’t have one) to address our 
findings.  Each Firefighter will receive all testing results (on average about a 50 - 60+ page 
report) with a letter from our Physician detailing what they should be focusing on.   
 
Administrative Process Explanation: 
 
1. Scheduling 
Part 1 – Blood Draw and various Tests/Screenings 
We schedule appointments every 30 minutes, with medical assistants/techs 
working we’ll move the Firefighter through the entire process in about 1 hour, 15 
minutes depending upon components selected.  We can see as many as four (4) 
firefighters at the same time and can have all four completed in about 2 hours. 
 
Part 2 – Physician Exam / Stress Testing 
We schedule appointments every 30 minutes, each Firefighter will need about one 
(1) hour with us, 30 minutes for the Stress Testing, 30 minutes with the Physician. 
 
2. On Site versus In Clinic 
 
We can set up a location at your station or have your members report to the 1582 
Office to complete the examination process. 
 
3. On Duty versus Off Duty 
 
We are flexible to schedule On Duty or Off Duty.  Our preferred method is Off 
Duty enabling us to focus on productivity and not have late or missed appointments 
due to a crisis happening in the community, however many Fire clients perform 
exams ON DUTY.  We are open to discussion on this topic. 
 
 
4. Time Management 
Administratively, we focus on a structured process to ensure all components of the 
examination process are completed smoothly with seamless transition. 
 
5. Reporting of Results 
We understand the sense of urgency involving critical TIER 4 – Not Physically Fit 
for Duty or TIER 5 – Not Medically Fit for Duty concerns as per NFPA 1582.  Any 
change in status of Fitness for Duty is immediately reported both via Phone and 
via Email to the respective Chief in charge of this sensitive information, as well as 
the HR Representative. 
 
Results of the tests are provided to members Electronically or Paper Originals 
within a maximum of three (3) weeks of completion.  All results are scanned and 
electronically archived on our multiple servers for easy transmittal at a future 
date.

1582 Submission for City of Tucson 
Page # 10 
Pre-Employment Results are transmitted same day, including Tier Fit Paperwork, 
Respirator Clearance Paperwork and PSPRS paperwork via electronic portal 
and/or via email if preferred. 
Careful attention to patient privacy is always recognized. 
6.
Billing
We provide easy to understand billing (we do not use HICFA’s) at set structured 
rates for the panels will be emailed as per the terms of the contract.  We can 
provide itemized billing or batch billing whatever is easiest and desired by the City 
of Tucson. 
3.
Offeror shall provide information on:
a.
Facility Location – 1925 W. Orange Grove Rd, Suite # 304, Tucson, AZ 85704 – willing
to open an additional location for this contract if it benefits the City of Tucson.
Hours – 8 AM to 5 PM, by appointment only on Monday through Friday
b.
Days and Hours of the Certified Occupational Medicine Doctor is available:  By
Appointment if Occ Med Doc is requested.
c.
Cleanliness and condition of facility and equipment:  Office is newly remodeled,
equipment is virtually all brand new for new office.
d.
Working Environment – very pleasant, clean, organized
Staffing – exceptional staff that resides in Tucson, Yuma, Phoenix, Nevada and Utah –
we bring in trained specialists to serve your members until we find local members that
can meet our standards of quality.  We can provide CV and Resumes upon request.
Systems – we utilize Electronic Medical Record system known as AdvancedMD as well
as other internal systems including Office365, etc.
Customer Service – we excel at customer service, always available.
e.
Laboratories – we partner with LabCorp and have nine (9) Patient Service Centers in
Tucson area and over 2,000 nationwide.  We provide our own phlebotomists to draw
your Firefighters blood as our preferred method of Blood Draws.
f.
Immediate Appointment / Walk-Ins – this is very difficult for us as we are set up for
scheduled appointments.  We can accommodate these requests from time to time.  We
plan on conducting examinations every other week in our Tucson Offices
4.
Site Visits – your always welcome to come by.

1582 Submission for City of Tucson 
 
Page # 11 
5. Firm’s Philosophy / Orientation – 
1582 has a different philosophy than most Medical Practices.   
 
Today’s Medical Practices are focus on Quantity (Providers seeing 40-50 patients per day) 
over Quality (1582 averages 15-20 patients per day), we have the different approach to 
serving our clients.  With 1582, the City of Tucson is going to get the best possible experience 
as we’re focused exclusively Firefighters and Public Safety.  Working with 1582, our team is 
not inundated with the pressure to take constant Phone Calls, Walk-in Appointments, Urgent 
Care, Family Practice or Workers Compensation needs.  In contrast, your Firefighters will 
experience a CONCEIRGE type medical practice.    
 
The 1582 examination which will be experienced by your firefighters begins with our 
beautifully appointed specialty medical facility which serves ONLY firefighters!  Your staff 
will not be sitting next to a sick child, injured patient or a family practice patient.  Since we 
require appointments only, upon arrival your firefighter will normally be seen immediately by 
our medical team.  The systems flow of patient management that we have developed over the 
years is very efficient and seamless.  Feedback that we typically receive from our fire 
department clients is that 1582 is “light years” ahead of our competition and that we 
provide a service that they never imagined would be possible in a medical setting.  
 
Based on your volume of firefighters, we envision conducting between 50-60 examinations per 
month over a two-week period thereby completing the entire Tucson Fire Department over a 
period of one year.  1582 is capable of conducting On-Duty or Off-Duty whether On-Site or 
In-Office for maximum flexibility. However, we are normally not able to accomplish STAT 
requests due to the fact that our Physicians, Sonographers and Team members will only be 
staffed during established weeks of the month which will be mutually decided by 1582 and 
Tucson Fire.  
 
Upon approval of the contract, we’ll work closely with Tucson Fire Department to determine 
which of our many flexible scheduling and location options will successfully serve your 
organization and its members.  We’ll also be working closely with HR and/or Risk 
Management to understand any special requirements and needs to focus on to ensure a 
successful transition.  Each Firefighter will receive an introduction letter about 1582 detailing 
the experience, time required for each visit, location information and other details needed such 
as Fasting Instructions, Schedule Changes, Stress EKG Instructions etc… 
 
 
6. Self-Checking and Tracking System 
1582 focus is on providing consistency and continuity of care to ensure a high-quality 
examination.  For example, we believe that ALL firefighters should receive the same 
components of the 1582 examination regardless of age or gender. 
For example, the Maximal Stress Test as outlined under Table C.2.1.3 and NFPA 1582 
section # 8.2.2.1.4: 
 
At levels at or below 8 METs, a prescribed aerobic fitness program shall be required, and 
the AHJ shall be advised to consider restriction from essential job tasks 1, 2, 4, 5, 6, 7, 8, 9, 
and 13

1582 Submission for City of Tucson 
 
Page # 12 
If a deconditioned Firefighter scores less than 6 minutes 50 seconds on the WFI Protocol then 
our Providers, HAVE THE ABILITY to recommend that a Firefighter is TIER 4 as Not 
Physically Fit for Duty and may require removal from duty. 
 
For Example, if 1582 is not conducting a Stress Test, then our Providers are not able to make 
a Medical Recommendation on a Physical De-Conditioning Issue.  We simply will not have 
any objective evidence that the member is not meeting the standards.  We strongly encourage 
the City of Tucson to conduct Stress Tests on all members, regardless of age, if you have 
concerns about your Firefighters’ ability to Physically meet the demands of the job.  
Furthermore, by conducting examinations in this way, you eliminate arguments about 
preferential treatment concerns from Labor.  It’s important to point out that Sudden Cardiac 
Death events do not discriminate against age. 
 
Regarding our Quality Assurance Program, we require that each Firefighter complete a detailed 
Patient Satisfaction Survey about their overall experience and what we can do to improve.  
We ask them to rate all staff, Phlebotomists, Physicians, Sonographer, Wait Times, Cleanliness 
etc.  These results are provided to Upper Management with 1582 to review and provide process 
improvements.   Additionally, we compile, analyze and scan these results and share with our 
clients. Tucson Fire Department, as well as HR/Risk will be well informed what your 
employees have to say about our experience.  Full Transparency of this survey information is 
critical to a successful relationship.  We have an EXCELLENT OVERALL reputation with 
all clients.   
 
When we make mistakes, we own them and then we make them right – what’s different about 
our organization is that we can turn on a dime and how we deal with problems in the rare case 
they actually arise.  We’re not saying we’re perfect, but the way we address our problems is 
outstanding.  We want to know how we can improve; it will only make us better...   
 
We guarantee to immediately (within 24 hours) investigate, report back and resolve any issues 
as they come up.  The City of Tucson will have direct access to Paul Granstrom, the President 
of 1582 to address any QAP issues.  If the issue involves staffing concerns, these will be dealt 
with swiftly including removal from serving the account.   
 
7. List of Programs 
 
ü NFPA 1582 Examinations 
Our company name, 1582, says it all.  We are known for providing high quality, NFPA 
1582 examinations in Five (5) States.  If the City of Tucson asking for Physical 
Examinations based on NFPA 1582 under section B.2.C…you’ve found the right group!   
 
The sad reality is that many providers (including some submitting proposals under this 
RFP) either their provider or the group have never seen, read or reference the NFPA 1582 
guidelines. NFPA 1582 guidelines should be on the Doctor’s desk and well worn.   
 
Many provider groups will cut corners by not following the NFPA 1582 guidelines by 
allowing a Mid-Level Provider such as a Physician Assistant or Nurse Practitioner to 
conduct the Examination when this directly conflicts with the NFPA standard, and this fact 
can and will be argued in a court of law.  1582 only uses physicians as referenced 755 
times in the 2018 NFPA 1582 guidelines.

1582 Submission for City of Tucson 
 
Page # 13 
 
ü Cancer and Disease Screening 
Arizona’s SB 1160 is a game changer for Fire and Police.  Since most Cancers are now 
presumptive in Public Safety with five years of service.  We have a comprehensive and 
successful program that is being actively used in all Five States (AZ, CA, CO, NV, OH) 
on Fire Departments/Districts and in which we focus on the following:   
 
Skin Cancer Assessment 
Chest X-Ray - Baseline and 5 Year (Lung Cancer) 
Full Body Ultrasound Screenings including Thyroid, Testicular, Prostate, 
Gallbalder, Kidneys, Liver, Spleen, Pancreas, Carotid Arteries, Aortic Aneurysm 
Enhanced Cancer Lab Testing including PSA, Thyroid/TSH, BladderChek22 
 
We offer the first program focused on SB 1160 called F.A.C.T.S. – Firefighter Advanced 
Cancer Testing Screening program as a standalone product for Fire Departments/Districts 
in Arizona. 
 
ü First Responder Wellness Program 
This new Mental Health Program was designed for Public Safety, this program was 
initiated in Nevada under our sister company, ARC Health & Wellness, when the City of 
Las Vegas and other Law Enforcement Agency Clients asked us to work to create program 
to incorporate Mental Health Screenings during their Annual Examinations process.  Please 
note that Nevada requires under law that all Police and Fire get an NFPA 1582 type 
examinations annually and our sister company, ARC Health & Wellness serves nearly all 
Police, Fire and Sheriff’s Offices in Nevada.   
 
This Mental Health program screens members of Public Safety using Four (4) nationally 
recognized questionnaires that will help our Providers understand what our patient is 
dealing with.  Obviously, patient participation is needed for this to be successful.  Our 
Provider or Mental Health Professional will spend 30 minutes with each patient reviewing 
the results with the patient, help them understand the challenges they are experiencing by 
listening and asking relevant questions.  This program was not designed to get us into the 
world of Mental Health, but we have an unusual opportunity where we actually touch all 
632 Firefighters every year and what better time to do this Awareness Counseling.  We are 
fully prepared for the new Mental Health additions coming soon in the upcoming NFPA 
1582 edition. 
 
1582 is not here to “fix” or “treat” your patients, only help them understand if they have 
an issue that should need assistance, we coach them on the best path to get the help they 
need.  This usually starts with your EAP Program in which we give handouts.  If needed 
we direct the patient to the correct Mental Health Provider whether it be a Licensed Clinical 
Professional Counselor, Marriage and Family Therapist, Psychologist, Psychiatrist, 
Certified Drug and Alcohol Counselor.  We also have a Public Safety vetting process in 
place to educate the patients.   
 
The new edition of NFPA 1582, coming soon, will have extensive Mental Health 
requirement recommendations.  1582 will be prepared to meet these recommendations.

1582 Submission for City of Tucson 
 
Page # 14 
Please be advised that we are happy to refer to your patients to the Mental Health Specialist 
listed in the RFP as well. 
 
 
ü Specialist Referral Network 
All 81 of our Fire Departments / Fire Districts clients over the last fourteen (14) years have 
one thing in common…on average 70% of their Firefighters DO NOT HAVE A PCP 
(Primary Care Provider).  We are here to help in these situations. 
 
What happens when we identify (and we will) a concerning Cardiac Condition (TIER 5), 
like a 2mm ST Depression, VTAC, LBBB during the exam?  The Firefighter that doesn’t 
have a PCP, has no clue where to start.  Your Firefighter will first need to get a PCP, that 
could take a month or so, then get a referral to a Specialist which could take another few 
months.  Meanwhile the Firefighters is off duty in a traditional setting costing the 
Department Overtime to fill the spot. 
 
We have a solution for that…using our 1582 Specialist Referral Network we can directly 
refer your Firefighter into the appropriate Specialist, such as a Cardiologist, Oncologist, 
Dermatologist very quickly.  Pulmonology referrals are always a problem due to limited 
providers. 
 
ü Specialized Fire Department Medicine 
1582 is a premier medical group that specializes in exclusively serving Fire Departments 
and frequently law enforcement agencies as well.    
 
We eliminate conflict-of-interest scenarios for our clients, as we DO NOT conduct 
Primary Care, Urgent Care, Workers Compensation, nor Physical Therapy services.  
We treat our Public Safety Patients like they should be treated, with respect, with care and 
experience the best exam they’ve ever had!   
 
Our goal is simple, bring awareness to our Firefighter patients by providing a 
comprehensive 1582 examination that specifically targets concerns with Cardiac, 
Pulmonary, Physical Conditioning and a new focus on Cancer with the SB 1160 concerns.   
 
The fact is 1582 has better optics and service than other medical groups. 
 
When you chose 1582, we become your Department Physician as outlined 755 times in 
the 2018 edition of NFPA 1582.  We’ll gladly help Tucson Fire / HR / Risk Management 
navigate the muddy waters of medical or physical retirement situations.  We’ll help 
determine if an employee is truly ready to come back to work from serious critical injuries 
or extended leave issues by:  
 
§ 
First - “Boxing In” whatever provider your employee has been seeing with forcing 
them to complete 14 Essential Tasks and a letter from that Provider stating 
your Firefighter is Fit for Full Duty. 
§ 
Secondly - Directly communicating with your employee’s Provider based on what 
NFPA 1582 has to say about their medical condition if it contradicts what the 
standards state.  We will call that Provider out and address discrepancies.

1582 Submission for City of Tucson 
 
Page # 15 
§ 
Third – 1582 will conducting a new NFPA 1582 examination on your employee to 
ensure they meet all medical and physical standards and give us a chance to review 
all Medical Records and ensure the patient returning safely is achieved. 
 
We are happy to assist the City of Tucson with all Firefighter Pre-Employment, Return 
to Duty, Fitness for Duty and Annual Medical Examinations in compliance with NFPA 
1582 standards.    
 
Please note that we cannot conduct Mental Health “Fitness for Duty” Assessments only 
screenings and coaching. 
 
8. Response Times 
 
1582 provides “REAL TIME” notification to designate representatives of City of Tucson 
of TIER 4 – may require removal from duty due to a Physical Condition or TIER 5 – may 
require removal from duty due to a Medical Condition Situations. 
 
1582 provides Same Day Reporting to designate representatives of City of Tucson of Pre-
Employment, Fitness for Duty and Return to Duty Situations, assuming all results have 
been compiled from the standard two part medical examination. 
 
1582 will notify the Firefighter / Department if critical results are obtained prior to the Part 
2 Physician Visit this includes components conducted at the first visit like Labs, X-ray, 
Ultrasound, Spirometry, and so forth after the Physician has reviewed and made a 
recommendation of Fitness for Duty. 
 
Laboratory Results (Clinical Blood and Urine) from LabCorp usually reports within 48-
72 hours 
 
Laboratory Results (Drug Screens) from LabCorp usually reports less than 24 hours to our 
Medical Review Officers (MRO), MRO will contact patient on all abnormals and has three 
business dates to reach the patient or report out as Positive. 
 
X-Ray Reports (Chest X-Ray) from SimonMed usually reports within 24-48 hours 
 
9. Online Access to Results 
Yes, we offer a secure SSL Encyrpted, HIPAA compliant reporting model for designated 
members of the City of Tucson to access results of the examinations such as TIER 
Paperwork, Respirator Clearance Paperwork. 
 
Patients will have access to view their results via our EMR System to access their results. 
 
E.2. 
Qualifications & Experience 
 
 
Brief History of Specialty Area # 1.B – New Hire and Annual Exams 
 
1582 is a spinoff organization from sister company, ARC Health & Wellness in Nevada.  ARC 
Health & Wellness (hereafter referred to as “ARC”) began serving Public Entities when we were 
awarded the City of Sparks contract in 2007 to serve Police and Fire with medical exams under

1582 Submission for City of Tucson 
 
Page # 16 
NRS/NAC 617 (similar to NFPA 1582).  In 2008, ARC was awarded a similar contract to serve the 
City of Reno – Police and Fire Contract to serve Police and Fire conducting Physicals. Currently, 
ARC serves nearly every Fire Department and Law Enforcement Agency in the State of 
Nevada including:  City of Las Vegas (origin 2011), City of North Las Vegas (2011), City of 
Henderson (2014 – under WellTrac another sister company), additionally we serve 34 Nevada 
Fire Departments/Districts, 16 Sheriff’s Offices, 13 Police Departments.   
 
ARC began serving Fire Departments in 2015, when Kingman Fire approached us, then quickly 
took over the Northwestern Arizona region in 2016 adding Bullhead City Fire, Golden Valley 
Fire District, Northern Arizona Fire Protection District, Mohave Valley Fire District, Ft. 
Mojave Mesa Fire District. 
 
1582 was founded in the Fall of 2018 by mutual owners of ARC Health & Wellness as an expansion 
model to new markets.  All services out of state of Nevada now fall under the business – 1582, 
LLC.  
 
1582 began it’s incredible expansion in 2019 setting up relationships with new Fire 
Department/District clients like Casa Grande Fire Department, Buckeye Valley Fire District, 
Rural Metro Fire in Yuma and Maricopa and was awarded the Northwest Fire District Contract 
in Tucson. 1582 earned new business in California with Merced Fire and Clovis Fire as well as a 
number of other Fire Departments/Districts.  2020 has been a stellar year with new clients including 
Golder Ranch Fire District, Prescott Fire Department and many others.  2021 we’ve signed on 
new clients like Fresno Fire Department and Carlsbad Fire Department, and Akron Fire 
Department in Ohio.  1582 and its sister companies currently serve 81 Fire 
Departments/Districts and 29 Law Enforcement Agencies across Five States, we also serve 
numerous Military Installations in Nevada and California. 
 
 
2. Three Contracts of Similar Nature 
Northwest Fire District 
5225 W. Massingale Rd. 
Tucson, AZ 85743 
520-887-1010 
Chief Brad Bradley 
Contract # 20-07-C24 
March 25, 2020 – March 25, 2023 
 
Description: 
Annual Physical Exam and Occupational Health 
Services.  We provide NFPA 1582 medical examinations 
and Cancer Screening Services for Northwest Fire 
District. 
Golder Ranch Fire District 
3885 East Golder Ranch Drive 
Tucson, AZ 85739 
520-825-9001 
Chief Randy Karrer 
Mutual Use Clause - NWFD 20-07-C24 
October 2020 – Current 
 
Description: 
Annual Physical Exam and Occupational Health 
Services.  We provide NFPA 1582 medical examinations 
and Cancer Screening Services for Golder Ranch Fire 
District, we clone the exams like NWFD. 
Rural Metro Fire  
8465 N. Pima Rd. 
Scottsdale AZ 85258 
520-990-9493 
Chief Brian Gilbert 
Professional Services Agreement 
May 2019 - Current 
 
Description: 
Annual Physical Exam and Occupational Health 
Services.  We provide NFPA 1582 medical examinations 
and now Cancer Screening Services for Rural Metro Fire 
in Maricopa, Yuma and now Pima.

1582 Submission for City of Tucson 
 
Page # 17 
 
3. 
Qualifications 
In an effort to streamline this process, we’ll provide CV’s of our Providers and that are Arizona 
Licensed and will be assisting in the Tucson Market Place.  
 
Providers: 
 
 
 
 
 
 
Mark J. Gaetke, MD – Medical Director of 1582, Family Practice 
Robert Keller, MD – Emergency Medicine 
Troy Ross, MD – Occupational Health and Environmental Medicine 
Chris Pederson, MD – Preventative Medicine 
Brian Kuhn, MD – Emergency Medicine 
 
If the City of Tucson needs additional information about our Providers, Administrative and/or 
Professional Staff, we’ll be happy to provide additional information, but this is the core team that 
will be working with your Firefighters.  We have two new AZ based physicians that will be joining 
our Medical Staff soon. 
 
All of our Medical Providers have extensive training and experience in conducting and interpreting 
Cardiac Stress Tests.  We primarily focus on working with Public Safety and have a clear 
understanding NFPA 1582 guidelines.   
 
We are very selective with the personnel that we bring to the 1582 team.  We primarily focus on 
members who are excellent phlebotomists, with a great personality and clean criminal history and 
individuals that can win people over by having a great attitude.  Historically, all employees go 
through a rigorous background investigation including NCIC criminal history ran by the State of 
Nevada. 
 
    4. 
Five (5) References 
 
Northwest Fire District 
520-887-1010 
Chief Brad Bradley 
Contract # 20-07-C24 
March 25, 2020 – March 25, 2023 
 
Description: 
Annual Physical Exam and Occupational 
Health Services.  We provide NFPA 1582 
medical examinations and Cancer Screening 
Services for Northwest Fire District. 
Golder Ranch Fire District 
520-825-9001 
Chief Randy Karrer 
Mutual Use Clause - NWFD 20-07-C24 
October 2020 – Current 
 
Description: 
Pre-Employment, Annual Physical Exam 
and Occupational Health Services.  We 
provide NFPA 1582 medical examinations 
and Cancer Screening Services for Golder 
Ranch Fire District, we clone the exams like 
NWFD. 
Rural Metro Fire  
520-990-9493 
Chief Brian Gilbert 
Professional Services Agreement 
May 2019 - Current 
 
Description: 
Annual Physical Exam and Occupational 
Health Services.  We provide NFPA 1582 
medical examinations and now Cancer 
Screening Services for Rural Metro Fire in 
Maricopa, Yuma and now Pima. 
Kingman Fire Department 
928-753-2891 
Description:

1582 Submission for City of Tucson 
 
Page # 18 
Chief Jake Rhoades 
Professional Services Agreement 
August 2015 – Current 
 
Pre-Employment, Annual Physical Exam 
and Occupational Health Services.  We 
provide NFPA 1582 medical examinations 
and now Cancer Screening Services 
Bullhead City Fire Department 
928-234-2233 
Asst. Chief Scott Neal 
Professional Services Agreement 
February 2016 – Current 
 
Description: 
Pre-Employment Annual Physical Exam and 
Occupational Health Services.  We provide 
NFPA 1582 medical examinations and now 
Cancer Screening Services 
 
1. We do have a Board-Certified Occupational Health Physician on staff that serves in Arizona.  We’ll 
be happy to provide copies of the contract and Board Certification if selected. 
 
2. We are happy to schedule times for the City of Tucson to work with Troy Ross, MD, or our Medical 
Director, Mark Gaetke, MD, or any other 1582 Physician.  We are happy to assist the needs of the 
City of Tucson involving access to an Occupational Health Physician. 
 
E.3  
PRICE PROPOSAL 
 
 
 
Please refer to Attachment C – Revised Price Proposal for Details about costs. 
 
We believe that standardizing the NFPA 1582 examination to make it the same for all Fire Members 
may be a much better option for the City of Tucson to ensure consistent quality of care.  
Additionally, by following our lead members will be screened to meet both the Medical and 
Physical Requirements as outlined under NFPA 1582.  We’d also like to suggest conducting our 
Cancer Disease Screening Process as included in our F.A.C.T.S. (Firefighter Advanced Cancer 
Testing and Screening) Program to identify Cancer early as outlined in SB 1160.  The problem is 
with Cancer if it’s not caught early, it’s usually too late once the symptoms begin.  We are the 
premier group in Arizona revolutionizing this screening and have NUMEROUS success stories. 
 
If the City of Tucson is interested standardizing the exam with the NFPA 1582 Compliant 
Examination and Cancer/Disease Screening, we are prepared to conduct this package at the Low 
Rate of $725.00 per member / per year.  More details will be provided on Attachment C. 
 
E.4  
DISCOUNT FOR EARLY PAYMENT 
 
 
 
As stated in Instructions to Offerors. 
Discounts, the price(s) herein can be discounted by 0%, if the payment is made within 0 days.  
These payment terms shall apply to all purchases and payment methods. 
 
We politely decline this generous offer as 1582 only bills for the service after the service is begins. 
 
E.5 
COOPERATIVE PURCHASING PROGRAM 
 
Question:  Will 1582 provide the City of Tucson, as the lead agency on this regional contract, a 
rebate in the form of a percentage of sales based upon the other agencies sales?

1582 Submission for City of Tucson 
 
Page # 19 
Respectfully, our response is “No”, we are currently not structured to reprice our examinations 
based on additional business because of this contract.   We are happy to allow other entities to 
piggy-back on your contract if it makes it easier for them. 
 
E.6 
CREDIT CARD PAYMENT 
 
Will payment be accepted via a commercial credit card?   NO 
 
Will consideration be given to accept the card?  YES, if we can add an Additional 4% to the 
billing. 
 
E.7 
TUCSON BUSINESS LICENSE 
 
Does your firm have a City of Tucson Business License?    NO, but we are happy to get one. 
 
E.8 
FORMS TO BE FILLED OUT BY VENDOR 
 
ü Living Wage Certification Form 
ü Technical Proposal 
ü Pricing Proposal 
ü Any solicitation amendments 
ü Offer and Acceptance Form 
 
 
 
F. 
SPECIAL TERMS AND CONDITIONS 
 
F.1. 
CONFLICTS OF INTEREST – we acknowledge and understand. 
 
F.2  
COOPERATIVE PURCHSING – we acknowledge and understand. 
 
F.3  
LIVING WAGE REQUIREMENTS – we acknowledge and understand. 
 
F.4  
PRICE ADJUSTMENT – if the client wishes to exercise an extension of this agreement, both 
parties shall mutually agree on any prices adjustments that may be required. 
 
F.5  
TERM AND RENEWAL – we acknowledge and understand. 
G.  
INSURANCE REQUIREMENTS 
 
G.1. 
1. – we acknowledge and understand. 
 
2. – we acknowledge and understand. 
 
3. – we acknowledge and understand. 
 
G.2. 
COMMERCIAL GENERAL LIABILITY - we acknowledge and understand. 
 
G.3. 
COMMERCIAL AUTOMOBILE LIABILITY - we acknowledge and understand. 
 
G.4. 
WORKER’S COMPENSATION - we acknowledge and understand. 
 
G.5. 
PROFESSIONAL LIABILITY (ERRORS & OMISSIONS) - we acknowledge and understand.

1582 Submission for City of Tucson 
 
Page # 20 
G.6. 
CLAIMS MADE INSURANCE COVERAGE - we acknowledge and understand. 
 
G.7. 
ADDITIONAL INSURANCE REQUIREMENTS - we acknowledge and understand. 
 
G.8. 
NOTICE OF COVERAGE MODIFICATIONS - we acknowledge and understand. 
 
G.9. 
ACCEPTABILITY OF INSURERS - we acknowledge and understand. 
 
G.10. VERIFCIATION OF COVERAGE - we acknowledge and understand. 
 
G.11. SUBCONTRACTORS - we acknowledge and understand. 
 
G.12. EXCEPTIONS - we acknowledge and understand. 
 
H.1. 
ADVERTISING - we acknowledge and understand. 
 
H.2. 
AFFIRMATIVE ACTION - we acknowledge and understand. 
 
H.3. 
AMERICANS WITH DISABILITIES ACT (ADA) - we acknowledge and understand. 
 
H.4. 
APPLICABLE LAW - we acknowledge and understand. 
 
H.5. 
ASSIGNMENT-DELEGATION - we acknowledge and understand. 
 
H.6. 
CHILD/SWEAT-FREE LABOR POLICY - we acknowledge and understand. 
 
H.7. 
CLEAN UP - we acknowledge and understand. 
 
H.8. 
COMMENCEMENT OF WORK - we acknowledge and understand. 
 
H.9. 
CONFIDENTIALITY OF RECORDS - we acknowledge and understand. 
 
H.10. CONTRACT AMENDMENTS - we acknowledge and understand. 
 
H.11. CONTRACT - we acknowledge and understand. 
 
H.12. DEFAULT IN ONE INSTALLMENT TO CONSTITUTE TOTAL BREACH - we 
acknowledge and understand. 
 
H.13. DUPLEXED/RECYCLED PAPER - we acknowledge and understand, where this is possible. 
 
H.14. EQUAL PAY – we acknowledge and understand. 
 
H.15.  EXCLUSIVE POSSESSION - we acknowledge and understand, unless this is a program in 
development, in use and/or system, process already being utilized by 1582 LLC, Gaetke Medical 
Corporation, ARC Health & Wellness Centers, LLC, Gilbert, Gaetke Associates of Nevada, MD 
LTD, WellTrac of Nevada, et al.  Whether under Copywright and/or Trademark protection or not. 
 
H.16 
FEDERAL IMMIGRATION LAWS AND REGULATIONS - we acknowledge and understand.

1582 Submission for City of Tucson 
 
Page # 21 
 
H.17 
FORCE MAJEURE - we acknowledge and understand. 
 
H.18. GRATUITIES - we acknowledge and understand. 
 
H.19. HUMAN RELATIONS - we acknowledge and understand. 
 
H.20. INDEMNIFICATION - we acknowledge and understand. 
 
H.21. INDEPENDENT CONTRACTOR - we acknowledge and understand. 
 
H.22. INSPECTION AND ACCEPTANCE - we acknowledge and understand. 
 
H.23. INTERPRETATION-PAROL EVIDENCE - we acknowledge and understand. 
 
H.24. ISREAL BOYCOTT DIVESTMENT - we acknowledge and understand. 
 
H.25. LICENSES - we acknowledge and understand. 
 
H.26. LIENS - we acknowledge and understand. 
 
H.27. NO REPLACEMENT OF DEFECTIVE TENDER - we acknowledge and understand. 
 
H.28. NON-EXCLUSIVE CONTRACT - we acknowledge and understand. 
 
H.29. OVERCHARGES BY ANTITRUST VIOLATIONS - we acknowledge and understand. 
 
H.30. PAYMENT - we acknowledge and understand but prefer a check. 
 
H.31. PROTECTION OF GOVERNMENT PROPERTY - we acknowledge and understand. 
 
H.32. PROVISIONS REQUIRED BY LAW - we acknowledge and understand. 
 
H.33. RECORDS - we acknowledge and understand. 
 
H.34. RIGHT TO ASSURANCE - we acknowledge and understand. 
 
H.35. RIGHT TO AUDIT - we acknowledge and understand. 
 
H.36. RIGHT TO INSPECT - we acknowledge and understand. 
 
H.37. RIGHTS AND REMEDIES - we acknowledge and understand. 
 
H.38.  SEVERABILITY - we acknowledge and understand. 
 
H.39. SHIPMEND UNDER RESERVATION - we acknowledge and understand. 
 
H.40. SUBCONTRACTORS - we acknowledge and understand.

1582 Submission for City of Tucson 
 
Page # 22 
H.41. SUBSEQUENT EMPLOYMENT - we acknowledge and understand. 
 
H.42. TERMINATION OF CONTRACT - we acknowledge and understand. 
 
H.43. TITLE AND RISK OF LOSS - we acknowledge and understand. 
 
H.44. WARRANTIES - we acknowledge and understand. 
 
 
 
 
 
‘

MARK J. GAETKE, MD 
FAMILY PRACTICE 
 
Medical School  
Loma Linda University, 1987 
 
Family Practice Residency  
Loma Linda 1987-1990 
 
 
 
Corporate Medical Director / Principal  
ARC Health & Wellness Centers – 2010 – Present 
1582 – 2018 - Present 
 
Dr. Gaetke has served as Corporate Medical Director of ARC for the past eleven (11) years.  He 
is recognized as one of the leading experts in the area in conducting NFPA 1582 and NRS 617 
medical evaluations. 
 
Past Positions: 
Medical Director/Staff Physician 
Concentra Medical Centers – Reno/Sparks/Carson City, NV 1996-2010 
  
Dr. Gaetke held various staff physician and medical director positions during his 14-
year term of employment with Concentra Medical Centers.  He gained extensive 
experience in conducting heart and lung physical during his employment with 
Concentra. 
 
Hyperbaric Medicine Specialist 
US Naval Hospital – Guantanamo Bay, Cuba   1987 - 1990 
 
 
Certification & Affiliations Medical: 
Arizona Medical License - # 51408 
Nevada Medical License - # 6893 
California Medical License - #G63790 
Alabama Medical Licensure Commission - #MD36984  
American Board of Independent Medical Examiners – Certified 1997 
Advanced Cardiac Life Support Re-Certification – May 2019 
Certified: Stress ECG Testing 
Medical Review Office Certification Council

Mark Jonathan Gaetke MD
ARC Health and Wellness
2205 Glendale Ave., Suite 131
Sparks NV 89431
Phone: (775) 331-3361
License Number: 51408
License Status: Active
Licensed Date: 11/16/2015
License Renewed: 11/27/2019
Due to Renew By: 11/17/2021
If not Renewed, License  Expires: 03/17/2022
General Information
Education and Training
 
Medical School:
Graduation Date:
Loma Linda University School of Medicine
Loma Linda, CA
05/31/1987
 
Residency:
07/01/1987 - 06/30/1990 (Family Medicine)
LOMA LINDA UNIVERSITY MEDICAL CENTER     ACGME Approved
Loma Linda, CA
 
Area of Interest
Family Medicine
Area of Interest
Occupational Medicine (Preventive Medicine)
 
The Board does not verify current specialties. For more information please see the American Board of Medical
Specialties website at http://www.abms.org to determine if the physician has earned a specialty certification from this
private agency.
    MD PROFILE PAGE
Arizona Medical Board
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ROBERT P.K. KELLER, M.D. 
EMERGENCY MEDICINE 
 
Medical School  
University of Utah College of Medicine, 1974  
 
Surgical Residency  
University of Utah College of Medicine, Affiliated Hospitals General 
Surgery, 1973 - 1975 
 
 
Emergency Medicine 
Northwestern-Rush Presbyterian-St. Luke’s-Christ Residency 
Hospitals, Emergency Medicine Residency Program, Chicago, 1978  
 
 
Staff Physician / California 
ARC Health & Wellness Centers – 2018 - Present 
1582 – 2018 - Present 
 
Past Positions: 
Chairman, Appointed by the Governor of California 
Medical Board of California 
Medical Quality Review Committee 
District #8 for the State of California 
Senior Partner, Member of the Board, and Staff ED Physician 
Monterey Bay Emergency Physicians, Inc  
Community Hospital of the Monterey Peninsula 
Monterey, CA 
Medical Director & CMO 
Pebble Beach Company  
Health & Wellness Family Practice and Occupational Center 
Pebble Beach, CA 
Chairman 
Community Hospital of the Monterey Peninsula  
Emergency Department 
Monterey, CA 
Medical Director  
Community Hospital of the Monterey Peninsula 
Employee Health/ Workers Compensation 
Monterey, CA 
 
Certification & Affiliations Medical: 
California Medical Association 
Monterey County Medical Society 
AACS - American Academy of Cosmetic Surgery Associate Member 
ASLSS - American Society of Lipo-Suction Surgery Member 
ACP - American College of Phlebology Member 
ACEP – American College of Emergency Physician 
FAA Senior Aviation Examiner 
Arizona Medical License - # 59562

Robert P. Keller MD
Keller Veins Medical Corp
950 B Cass St.
Monterey CA 93940
Phone: (831) 373-1100
License Number: 59562
License Status: Active
Licensed Date: 03/10/2020
License Renewed: 10/22/2020
Due to Renew By: 11/01/2022
If not Renewed, License  Expires: 03/01/2023
General Information
Education and Training
 
Medical School:
Graduation Date:
University of Utah College of Medicine
Salt Lake City, UT
06/08/1974
 
Internship:
07/01/1975 - 06/30/1978 (Emergency Medicine)
Advocate Christ Medical Center     ACGME Approved
Oak Lawn, IL
 
Residency:
06/24/1974 - 06/23/1975 (Surgery)
University of Utah Medical Center     ACGME Approved
Salt Lake City, UT
 
Area of Interest
General Practice
 
The Board does not verify current specialties. For more information please see the American Board of Medical
Specialties website at http://www.abms.org to determine if the physician has earned a specialty certification from this
    MD PROFILE PAGE
Arizona Medical Board
Printer Friendly Version

private agency.
Board Actions
None
 
A person may obtain additional public records related to any licensee, including dismissed complaints and non-
disciplinary actions and orders, by making a written request to the Board. The Arizona Medical Board presents this
information as a service to the public. The Board relies upon information provided by licensees to be true and correct, as
required by statute. It is an act of unprofessional conduct for a licensee to provide erroneous information to the Board.
The Board makes no warranty or guarantee concerning the accuracy or reliability of the content of this website or the
content of any other website to which it may link. Assessing accuracy and reliability of the information obtained from this
website is solely the responsibility of the user. The Board is not liable for errors or for any damages resulting from the use
of the information contained herein.
Please note that some Board Actions may not appear until a few weeks after they are taken, due to appeals, effective
dates and other administrative processes.
Board actions taken against physicians in the past 24 months are also available in a chronological list.
Credentials Verification professionals, please click here for information on use of this website.

CHRISTOPHER PEDERSON, MD, MPH, DABPM 
PREVENTATIVE MEDICINE 
 
Medical School  
University of Nevada, Reno 1983 
 
Preventative Medicine Fellowship  City of Faith Medical Center 1984 - 1986 
 
 
Family Medicine Residency 
City of Faith Medical Center 1983 - 1984 
 
Medical Director – Las Vegas 
ARC Health & Wellness Centers – 2013 – Present 
 
Staff Physician / California, Nevada, Arizona 
1582 – 2018 - Present 
 
Past Positions: 
Physician Manager – Onsite Corporate Medical Department (10 years) 
Hughes Aircraft/Electronics Corporation - Los Angeles  
California Corporate practice of Preventive Medicine in a large company with 
responsibilities concentrated in the management, treatment and prevention of 
injuries/diseases, employee health promotion/education, medical surveillance 
including cardiopulmonary fitness testing, drug-free workplace programs, and pre-
placement health evaluations; Design and implementation of an on-site executive 
health evaluation program; Medical benefits analysis and modification including a 
worldwide health enhancement initiative; FAA Aviation Medical Examiner; Team 
leader for ACOEM Corporate Health Achievement competition - Winner 1997. 
Direct supervision and training of clinical staff including physicians, mid-levels, 
nurses, technicians including performance appraisals.  
 
 
Certification & Affiliations Medical: 
1995 – Present Nevada Medical License 
1986 – Present California Medical License 
1993 – Present American Board Certified in Preventive Medicine 
2014 – Present Active Physician Liceses: AZ, CO, FL, NM, NY, OR, PA 
2014 – Present FMCSA DOT Certification (National Reg. # 5585030956) 
2015 – Arizona Medical License # 49567 
 
1984-1986 - Master’s Public Health (MPH)

Chris Alan Pederson MD
Arc Health And Wellness
2500 W. Sahara Avenue
Suite 100
Las Vegas NV 89102
Phone: (702) 221-0190
License Number: 49567
License Status: Active
Licensed Date: 02/12/2015
License Renewed: 03/31/2021
Due to Renew By: 03/31/2023
If not Renewed, License  Expires: 07/31/2023
General Information
Education and Training
 
Medical School:
Graduation Date:
UNIV OF NV SCH OF MED 
RENO, NV 
05/22/1983
 
Residency:
07/01/1983 - 06/30/1984 (Family Medicine)
ORAL ROBERTS UNIVERSITY SOM     ACGME Approved
TULSA, OK
 
Area of Interest
Occupational Medicine (Preventive Medicine)
 
The Board does not verify current specialties. For more information please see the American Board of Medical
Specialties website at http://www.abms.org to determine if the physician has earned a specialty certification from this
private agency.
    MD PROFILE PAGE
Arizona Medical Board
Printer Friendly Version

Board Actions
None
 
A person may obtain additional public records related to any licensee, including dismissed complaints and non-
disciplinary actions and orders, by making a written request to the Board. The Arizona Medical Board presents this
information as a service to the public. The Board relies upon information provided by licensees to be true and correct, as
required by statute. It is an act of unprofessional conduct for a licensee to provide erroneous information to the Board.
The Board makes no warranty or guarantee concerning the accuracy or reliability of the content of this website or the
content of any other website to which it may link. Assessing accuracy and reliability of the information obtained from this
website is solely the responsibility of the user. The Board is not liable for errors or for any damages resulting from the use
of the information contained herein.
Please note that some Board Actions may not appear until a few weeks after they are taken, due to appeals, effective
dates and other administrative processes.
Board actions taken against physicians in the past 24 months are also available in a chronological list.
Credentials Verification professionals, please click here for information on use of this website.

TROY W. ROSS, MD, MPH 
OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 
 
 
 
Medical School  
Uniformed Services University, 1997 
 
Orthopedic Surgery Residency 
Eisenhower Army Medical Center, GA July 2000 – Jan. 2002 
Preventative Medicine 
Madigan Army Medical Center, WA July 2004 – June 2006 
 
Occupational Medicine Physician: 
 
ARC Health & Wellness Centers – 2016 – Present 
1582 – 2018 - Present 
 
Dr. Ross has worked with ARC and 1582 over the Past (5) Five Years.  Dr. Ross is a former US 
Army Flight Surgeon, licensed to conduct FAA and DOT Examinations, licensed to practice 
Medicine in Arizona, Colorado, Utah, Mississippi, Nevada and Alabama.   Dr. Ross is very skilled 
in conducting NFPA 1582 and NRS 617 examinations. 
 
Past Positions: 
Chief of Occupational Health Sierra Army Depot, US Army, Herlong,CA   
2012 – 2016   
Occupational medicine and utilization review physician, Concentra Health  
2010 – 2012 
Occupational medicine physician, Renown Occupational Health   
 
2009 – 2010 
State Flight Surgeon for the NV Army National Guard 
 
 
 
2009 – 2012 
Deployed as the 4th Infantry Division Preventive Medicine Physician,  
 
2007 – 2009 
Baghdad, Iraq returning to assigned position as Chief of Preventive Medicine 
Chief, Department of Preventive Medicine and Occupational Health,  
 
2004 – 2006 
       Darnall Army Medical Center, Ft Hood, TX  
 
 
 
 
 
Certification & Affiliations Medical: 
 
Arizona Medical License - # 58132 
Colorado Medical License - # 37384 
Nevada Medical License - # 13234 
Alabama Medical License - # 36979 
Utah Medical License - #10814164-1205 
Mississippi Medical License - #26504 
 
Board Certifications:  
ABPM - General Preventive Medicine, expired Jan 2017 
ABPM – Occupational Medicine, expires Jan 2020

Troy Wayne Ross MD
ARC Health and Wellness
2205 Glendale Ave, Ste 131
Sparks NV 89431
Phone: (775) 331-3361
License Number: 58132
License Status: Active
Licensed Date: 01/31/2019
License Renewed: 08/15/2019
Due to Renew By: 09/13/2021
If not Renewed, License  Expires: 01/13/2022
General Information
Education and Training
 
Medical School:
Graduation Date:
Uniformed Services University of the Health Sciences
05/12/1997
 
Area of Interest
Occupational Medicine (Preventive Medicine)
Area of Interest
Preventive Medicine /Occupational Environmental Medicine
 
The Board does not verify current specialties. For more information please see the American Board of Medical
Specialties website at http://www.abms.org to determine if the physician has earned a specialty certification from this
private agency.
    MD PROFILE PAGE
Arizona Medical Board
Printer Friendly Version

Board Actions
None
 
A person may obtain additional public records related to any licensee, including dismissed complaints and non-
disciplinary actions and orders, by making a written request to the Board. The Arizona Medical Board presents this
information as a service to the public. The Board relies upon information provided by licensees to be true and correct, as
required by statute. It is an act of unprofessional conduct for a licensee to provide erroneous information to the Board.
The Board makes no warranty or guarantee concerning the accuracy or reliability of the content of this website or the
content of any other website to which it may link. Assessing accuracy and reliability of the information obtained from this
website is solely the responsibility of the user. The Board is not liable for errors or for any damages resulting from the use
of the information contained herein.
Please note that some Board Actions may not appear until a few weeks after they are taken, due to appeals, effective
dates and other administrative processes.
Board actions taken against physicians in the past 24 months are also available in a chronological list.
Credentials Verification professionals, please click here for information on use of this website.

BRIAN J. KUHN, MD 
EMERGENCY MEDICINE 
 
 
 
Medical School  
McMaster University Medical School 
 
1976 
 
Family Medicine Residency 
McMaster University Residency Program 
1976 - 1978 
Fellow American Board of Emergency Medicine 
 
 
 
 
1995 
Anesthesia Residency  
University of Arizona, Tucson   
 
2005-2006 
 
 
Staff Physician 
ARC Health & Wellness Centers – 2016 – Present 
1582 – 2018 - Present 
 
Dr. Kuhn is a multi-disciplined Emergency Medicine Physician with experience in Family 
Medicine, Urgent Care, Diving and Underwater Medicine, Nautical Medicine as well as High 
Altitude Medicine serving as a Trek Physician on Mt. Everest, Himalayas and Nepal.   
 
Dr. Kuhn was a former resident of Tucson from 2005 – 2007, he proudly speaks about participating 
in the Tour De Tucson four times. 
 
Past Positions: 
Holland America Cruise Ship Physician 
 
 
 
 
2008-2013 
St. Mary’s Hospital (Reno) 
 
 
 
 
 
1988-2005  
Barton Memorial Hospital (Lake Tahoe) 
 
 
 
 
1986-1987 
 
 
Certification & Affiliations Medical: 
Arizona Medical License - #  57693 
California Medical License - # C38871 
Nevada Medical License - # 5074

Brian Joseph Kuhn MD
Arc Health & Wellness
2205 Glendale Ave Suite 131
Sparks NV 89431
Phone: (775) 331-3361
License Number: 57693
License Status: Active
Licensed Date: 12/20/2018
License Renewed: 03/26/2020
Due to Renew By: 04/02/2022
If not Renewed, License  Expires: 08/02/2022
General Information
Education and Training
 
Medical School:
Graduation Date:
MC MASTER UNIV 
HAMILTON, ONT 
CANADA 
05/29/1976
 
Residency:
03/01/2005 - 05/16/2006 (Anesthesiology)
University of Arizona HSC     ACGME Approved
 
Area of Interest
Emergency Medicine
 
The Board does not verify current specialties. For more information please see the American Board of Medical
Specialties website at http://www.abms.org to determine if the physician has earned a specialty certification from this
private agency.
    MD PROFILE PAGE
Arizona Medical Board
Printer Friendly Version

Board Actions
None
A person may obtain additional public records related to any licensee, including dismissed complaints and non-
disciplinary actions and orders, by making a written request to the Board. The Arizona Medical Board presents this
information as a service to the public. The Board relies upon information provided by licensees to be true and correct, as
required by statute. It is an act of unprofessional conduct for a licensee to provide erroneous information to the Board.
The Board makes no warranty or guarantee concerning the accuracy or reliability of the content of this website or the
content of any other website to which it may link. Assessing accuracy and reliability of the information obtained from this
website is solely the responsibility of the user. The Board is not liable for errors or for any damages resulting from the use
of the information contained herein.
Please note that some Board Actions may not appear until a few weeks after they are taken, due to appeals, effective
dates and other administrative processes.
Board actions taken against physicians in the past 24 months are also available in a chronological list.
Credentials Verification professionals, please click here for information on use of this website.

F.  PRICING PROPOSAL 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
ATTACHMENT C

Description
Price
Unit of Measure
General Testing
1
Hepatitis profile: Hepatitis A antibody, hepatitis B surface antibody and antigen and 
hepatitis C antibody
$100.00 Test
2 Bioelectrical impedance testing for percent body fat
$18.00 Test
3 T4 Free and TSH Non-Dialysis Thyroid Test
$35.00 Test
4 NMP22 Bladder Cancer Check
$30.00 Test
5 CRP High Sensitivity Test
$25.00 Test
7 Continuation of Service Medical Evaluation
$400.00 Exam
9 Hepatitis A antibody titer
$35.00 Vaccination
10 Hepatitis B surface antibody titer
$35.00 Vaccination
11
Hepatitis Profile Hepatitis A antibody, hepatitis B surface antibody and antigen and 
hepatitis C antibody
$100.00 Vaccination
12 Hepatitis Booster
$80.00 Vaccination
13 Hepatitis C RNA PCR (this is a RARE confirmation test and not common)
$360.00 Test
14 Urinalysis, Dip only
$12.00 Test
Pre-Employment and Annual Physical Examinations (REFER TO ATTACHMENT B)
15 Medical History (pre-employment and annual) REFER TO ATTACHMENT B
25.00
$              
Flat Fee
16 Respiratory Questionnaire (pre-employment and annual) REFER TO ATTACHMENT B
25.00
$              
Flat Fee
17 Physical Exam (pre-employment and annual) REFER TO ATTACHMENT B
125.00
$           
Exam
18 Vision Exam (pre-employment and annual) REFER TO ATTACHMENT B
15.00
$              
Exam
19 Hearing Assessment (pre-employment and annual) REFER TO ATTACHMENT B
25.00
$              
Exam
20 Blood/Urine Collection (pre-employment and annual) REFER TO ATTACHMENT B
75.00
$              
Test
21 Urine ONLY Collection (pre-employment and annual) REFER TO ATTACHMENT B
10.00
$              
Test
22 Infectious Disease Prevention (pre-employment and annual) REFER TO ATTACHMENT B
200.00
$           
Test
23 Pulmonary Testing (pre-employment and annual) REFER TO ATTACHMENT B
50.00
$              
Test
24 Chest Radiographs (pre-employment and annual) REFER TO ATTACHMENT B
65.00
$              
Test
25 Colon Cancer Screenings (pre-employment and annual) REFER TO ATTACHMENT B
30.00
$              
Test
RFP# 222846 Occupational Health Services Price Page
Specialty Area 1.B - Tucson Fire Department New Hire/Annual 
Evaluations & Exams

26 Weight and Body Composition (pre-employment and annual) REFER TO ATTACHMENT B
18.00
$              
Exam
27 Sleep Disturbance Screening (pre-employment and annual) REFER TO ATTACHMENT B
30.00
$              
Exam
28 Electrocardiograms (pre-employment and annual) REFER TO ATTACHMENT B
40.00
$              
Test
29
Cardiopulmonary Exercise Testing (CPET) (pre-employment and annual) REFER TO 
ATTACHMENT B
200.00
$           
Test
30
Cardiovascular Stress Test (Alternative 1) (pre-employment and annual) REFER TO 
ATTACHMENT B
100.00
$           
Test
31
Cardiovascular Stress Test (Alternative 2) (pre-employment and annual) REFER TO 
ATTACHMENT B
N/A
Test
32 Qualitative Fit Testing (pre-employment and annual) REFER TO ATTACHMENT B
25.00
$              
Test
33 Quantitative Fit Testing (pre-employment and annual) REFER TO ATTACHMENT B
25.00
$              
Test
34 Fitness Evaluation (pre-employment and annual) REFER TO ATTACHMENT B
25.00
$              
Exam
35
Functional Movement Screening (pre-employment and annual) REFER TO 
ATTACHMENT B
75.00
$              
Exam
36 Cancer Screenings (TBD)
150.00
$           
Exam
37 Pre-Employment Exam Total (FROM ATTACHMENT B)
725.00
$           
Exam
38 Annual Exam Total (FROM ATTACHMENT B)
625.00
$           
Exam
HAZMAT Exam
Vital Signs
Physical Exam
Fitness Testing
Complete Urinalysis
Chemistry Profile
Complete Blood Count
HDL/LDL Ratios
Pulmonary Function
Vision
Audiometry Medical Class A
Electorcardiogram
Hazardous Material Questionaire
39 Exam Total
$500.00 Exam
Epidemiologic Surveillance Program

40
A hazardous material exposure log to record on an ongoing basis relevant data on all 
specific incidents and exposures such as chemical spills or smoke inhalation.
$2,750 / year
Flat Fee
41
A data base system relating environmental and occupational exposure data with 
personal medical information collected on firefighters whether during annual evaluation 
or as a result of specific exposure incidents.  
$1,750 / year
Flat Fee
42
Special toxicology and industrial hygiene evaluations as needed to evaluate specific 
incidents.
$2,800 / year
Flat Fee
43
Statistical and epidemiologic analysis of the surveillance data to assure early detection of 
potential health problems.
$1,500 / year
Flat Fee
Additional Services
44 Research/Define/Update Firefighter Physical Performance Standards.
$800 / year
Flat Fee
45
$500 / year
Flat Fee
46 Telephone Consultations/hour 
$150.00 Hourly
47 Dietician per hour 
$85.00 Hourly
Total
$4,648.00
Please List Additional Information/Services not listed above that the City should be 
aware of here:
Additional
Tucson Prehire Preferred with CPET Test (BUNDLE PRICING)
825.00
$           
Additional
Tucson Annual Preferred with CPET Test (BUNDLE PRICING)
725.00
$           
Additional
1582 Expanded Exam with Stress EKG and Full Body Ultrasound (BUNDLE PRICING)
725.00
$           
Additional
1582 Preferred Exam with CPET and Full Body Ultrasound (BUNDLE PRICING)
825.00
$           
T-SPOT TB BLOOD TEST (exclusive Sonora Quest Test)
125.00
$           
F.A.C.T.S. Program - Standalone
295.00
$        
Ultrasound Screening for Cancer/Disease (10 Part) - Thyroid, Carotid, Aortic 
Aneurysm Appearance, Pancreas, Gallbladder, Liver, Kidneys, Spleen, and 
Male Specific Prostate/Testicular or for Females - Transabdominal (TA) Pelvic 
Ultrasound (Uterus, Cervix, Ovaries and Bladder)  
150.00
$        
Echocardiogram Ultrasound Screening
150.00
$        
CPET MET Test as part of Annual Examination with Pulmonologist Intrepretatio
200.00
$        
Research/Design/Update follow-up program to reduce health risks, correct medical 
problems and/or improve job performance capacity.

First Responder Wellness Program (Mental Health)
200.00
$        
Specialist Referral Network (Clinical Connection Fee)
25.00
$           
QuantiFERON Gold TB Test
90.00
$           
PPD Skin Test
25.00
$           
Hepatitis A Vaccine
75.00
$           
Hepatitis B Vaccine
60.00
$           
Twinrix Vaccine
105.00
$        
Tetanus Diptheria Vaccine
80.00
$           
Tetanus Diptheria and Pertussis Vaccine
80.00
$           
Varicella Vaccine
120.00
$        
Measels, Mumps, Rubella Vaccine
80.00
$           
Polio Vaccine
125.00
$        
Physician Review of Records / Lateral Transfer Paperwork
200.00
$        
DOT Physical Paperwork in conjunction Annual Exam (CDL Add-On)
45.00
$           
DOT Physical Standalone
100.00
$        
Cardiac Stress Test Test with Physician Review and Limited Patient Evalulation
250.00
$        
MRI/MRA without Contrast (SimonMed)
450.00
$        
MRI/MRA with Contrast (SimonMed)
500.00
$        
MRI/MRA with and without Contrast (SimonMed)
550.00
$        
Whole Body MRI (SimonMed)
650.00
$        
Echocardiogram Diagnostic Screening (SimonMed)
250.00
$        
Ultrasound Diagnostic Screening - Pelvic (TA & TV w/ or w/o doppler)  (SimonM
350.00
$        
Ultrasound Diagnostic Screening per Body Part (SimonMed) 
250.00
$        
Chest X-Ray (PA and LAT) with Radiology Intrepretation
CT/CTA w/o Contrast (SimonMed) 
275.00
$        
CT/CTA w/ Contrast (SimonMed) 
300.00
$        
CT/CTA with and without Contrast (SimonMed) 
350.00
$        
CT Lung Screening (SimonMed) 
225.00
$        
CT Calcium Scoring (SimonMed) 
175.00
$        
CTA Coronary (SimonMed) 
550.00
$        
PET Skull to Mid Thigh (SimonMed) 
2,500.00
$    
PET Whole Body (SimonMed) 
2,500.00
$    
Screening 3D Mammogram (SimonMed) 
250.00
$        
Diagnostic 3D Mammogram Uni (SimonMed) 
275.00
$        
Diagnostic 3D Mammogram Bilateral (SimonMed) 
150.00
$

3D Whole Breast Mammogram (per slide) (SimonMed) 
150.00
$        
Cardiology Consult - New Patient
300.00
$        
Cardiology Office Visit - Established Patient
228.00
$        
Cardiology - Treadmill Stress Test
309.00
$        
Cardiology - Nuclear Cardiolite Stress Test
1,381.00
$    
Cardiology - Echocardiogram Complete
625.00
$        
Cardiology Overread of Carotid Artery Ultrasound Screening - Addition
150.00
$        
Cardiology Overread of Electrocardiograms - Addition
150.00
$        
Cardiology Overread of Stress Test - Addition
75.00
$           
Physicial Abilities Test / Return to Work Examination by Physician
200.00
$        
Physical Abilities Test Only
75.00
$           
CA-125 Cancer Screening
30.00
$           
Heavy Metal (24 Hour Urine Occupational Exposure HazMat Testing)
125.00
$        
Blood Lead / ZPP
55.00
$           
Cholinesterase (HazMat)
76.00
$           
HIV Screening
45.00
$           
Non DOT Drug Screen with MRO Review
40.00
$           
DOT Drug Screen with MRO Review
45.00
$           
Breath Alcohol Test
30.00
$           
Breath Alcohol Confirmation Test
15.00
$           
Quantitative or Qualititative Fit Testing (if NOT part of Annual Exam)
50.00
$

City of Tucson Analysis of Panel Options
Item #
Description
Tucson Prehire 
"Alternate"
Tucson Prehire 
"Preferred"
Tucson HazMat 
Exam
Tucson 
Annual 
"Alternate"
Tucson Annual 
"Preferred"
1582 
Expanded 
Exam
1582 "Preferred" 
Exam 
1
Medical History
Included
Included
Included
Included
Included
Included
Included
2
Respiratory Questionnaire
Included
Included
Included
Included
Included
Included
Included
3
Physical Exam
Included
Included
Included
Included
Included
Included
Included
4
Vision Exam
Included
Included
Included
Included
Included
Included
Included
5
Hearing Assessment
Included
Included
Included
Included
Included
Included
Included
6
Blood/Urine Collection
Included
Included
Included
Included
Included
Included
Included
7
Urine Laboratory Tests
Included
Included
Included
Included
Included
Included
Included
8
Infectious Disease Prevention
Included
Included
Included
Included
Included
Included
Included
T-SPOT
Included
Included
N/A
N/A
N/A
N/A
N/A
PPD
N/A
N/A
Included
Included
Included
Included
Included
Hepatitis Profile Screening
Included
Included
N/A
N/A
N/A
N/A
N/A
9
Pulmonary Testing
Included
Included
Included
Included
Included
Included
Included
10
Chest Radiographs
Included
Included
N/A
N/A
N/A
N/A
N/A
11
Colon Cancer Screening
Included
Included
N/A
Included
Included
Included
Included
12
Weight and Body Composition
Included
Included
Included
Included
Included
Included
Included
13
Sleep Disturbance Screening
Included
Included
N/A
Included
Included
Included
Included
14
Electrocardiograms - Resting
Included
Included
Included
Included
Included
Included
Included
15
Cardiopulmonary Exercise - MET 
Test
N/A
Included
N/A
N/A
 Included 
N/A
 Included 
16
Cardiovascular Stress Test
Included
N/A
N/A
Included
N/A
Included
N/A
17
Step Mill
OUT OF SCOPE
OUT OF SCOPE
OUT OF SCOPE
OUT OF SCOPE
OUT OF SCOPE
OUT OF SCOPE
OUT OF SCOPE
18
Qualitative Fit Testing
N/A
N/A
N/A
Included
Included
Included
Included
19
Quantitative Fit Testing
N/A
N/A
N/A
Included
Included
Included
Included
20
HAZMAT Annual / Lab
N/A
N/A
Included
N/A
N/A
N/A
N/A
21
Fitness Evaluations
Included
Included
Included
Included
Included
N/A
N/A
22
Functional Movement 
Included
Included
N/A
Included
Included
N/A
N/A
23
Ultrasound Full Body Screening
N/A
N/A
N/A
N/A
N/A
Included
Included
Other
Hemoglobin A1C
Included
Included
N/A
Included
Included
Included
Included
Other
Thyroid Panel with TSH
Included
Included
N/A
Included
Included
Included
Included
Other
C-Reactive Protein
Included
Included
N/A
Included
Included
Included
Included
Other
CA-125 (Females)
N/A
N/A
N/A
N/A
N/A
Included
Included
Other
Prostate Specific Antigen
Included
Included
N/A
Included
Included
Included
Included
Other
NMP 22 BladderChek
N/A
N/A
N/A
N/A
N/A
Included
Included
COST
725.00
$       
825.00
$       
500.00
$       
625.00
$    
725.00
$       
725.00
$    
825.00
$       
Chest Radiographs are variable based on last one conducted with additional charge if needed at $65.00, MET Test is a Substition Test for Stress EKG

PRICING OPTION FOR RANDOM DRUG AND ALCOHOL TESTING PROGRAM
AS OUTLINED IN THIS RFP.
THIS SERVICE IS CURRENTLY OUT OF SCOPE WITH 1582 BUT MANY OF 
OUR LARGE PUBLIC ENTITY CLIENTS UTILIZE THE SERVICE OF SINNETT 
CONSULTING SERVICES IN RENO FOR THIS SERVICE.
SINNETT CONSULTING SERVICES WOULD BE A SUBCONTRACTOR OF OUR 
CONTRACT TO MEET THIS NEED IF THE CITY OF TUCSON ELECTS.

10580 N. McCarran Blvd. #115-212 | Reno, Nevada 89503 | Phone: 775-746-1616 | Fax: 775-746-1655 
July 26, 2021 
Re: Random Compliance Program Proposal 
Please let this letter serve as my proposal to conduct the random compliance programs for the City 
of Tucson. 
The proposal is for the annual random compliance programs for the City of Tucson’s DOT and 
Safety Sensitive Employees.  The DOT program includes quarterly random selections that meet the 
testing percentages per regulation, quarterly random selections for Safety Sensitive Employees, a 
Drug and Alcohol Policy that meets the DOT Regulation 382 and Educational Materials are 
provided for all employees. 
The DOT random program will be billed at $550 annually and the Safety Sensitive random program 
will be billed at $350 annually. 
The total that will be billed for the services is $900/annually. 
Regards, 
Tonica Lathrop, President 
Sinnett Consulting Services