Common Council Meeting — Agenda Packet
City of Greenfield · Milwaukee County · Common Council · meeting of Jun 16, 2026 · Agenda packets
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Common Council Agenda - June 16, 2026 - Page 1
Common Council Chambers – City Hall Room 100
7325 W Forest Home Ave, Greenfield, Wisconsin
COMMON COUNCIL MEETING AGENDA
Tuesday, June 16, 2026 - 7:00 PM
A. Call to Order & Roll Call
B. Opening Prayer
C. Pledge of Allegiance
D. Approval of the May 19, 2026 Common Council minutes
E. Mayor’s Report
F. Aldermanic Reports
G. Announcements
H. Citizen Commentary
I. Public Hearings
1. Public Hearing on a Special Use Permit for Valentin Studios, a proposed permanent makeup studio, to
be located at 4160 S. 108th St., Suite #6, submitted by Bethzaida Valentin, d/b/a Valentin Studios. (Tax
Key No. 567-9972-004) (PC-5/12/26 Kastner)
a. Approve a Resolution for a Special Use Permit for Valentin Studios, a proposed permanent
makeup studio, to be located at 4160 S. 108th St., Suite #6, submitted by Bethzaida Valentin,
d/b/a Valentin Studios. (Tax Key No. 567-9972-004) (PC-5/12/26 Kastner)
b. Approve a Site Review for Valentin Studios, a proposed permanent makeup studio, to be located
at 4160 S. 108th St., Suite #6, submitted by Bethzaida Valentin, d/b/a Valentin Studios. (Tax Key
No. 567-9972-004) (PC-5/12/26 Kastner)
2. Public hearing on the discontinuance of general right-of-way of W. St. Francis Ave., commencing at S.
31st St. and continuing east for approximately 120 feet. (PC-5/12/26 Kastner)
a. Approve a Resolution discontinuing general right-of-way of W. St. Francis Ave., commencing at S.
31st St. and continuing east for approximately 120 feet. (PC-5/12/26 Kastner)
J. Old Business
1. Appointments to various committees and commissions:
a. Mayor appointments, confirmed by Council:
i. Two members to the Civil Service Commission for terms to expire 5/1/27 (formerly David
Podeszwa and Paul Leu)
ii. Three members to the Civil Service Commission for a term to expire 5/1/29 (currently
Robert Sherwood, David Shore, Veronica Wallace-Kraemer)
iii. One member to the Fire & Police Commission for a term to expire 5/1/31 (currently Dennis
Clark)
K. New Business
1. Appointments to various committees and commissions:
Page 1 of 125
Common Council Agenda - June 16, 2026 - – Page 2
a. Mayor appointments, confirmed by Council:
i. Two members to the Public Library Board for a term to expire 7/1/29 (currently Amber
Lococo, Marie Cardenas)
2. Approve applications for 2026-2027 operator licenses (Goergen)
3. Approve an application for a 2026-2027 Combination "Class B" Fermented Malt Beverage and Liquor
Retailer's License for Mike's Tap LLC, Michael G Koklas, Agent, for the property at 4500 W. Forest
Home Ave. (Mike's Tap). 1st floor and basement of a 2 story brick building. Serving alcohol on 1st floor
at bar and tables. Alcohol to be stored in coolers and shelves behind bar in basement. Records are
stored in office in corner of basement located at 4500 W. Forest Home Ave. (Goergen)
4. Approve renewal applications for the following licenses to expire June 30, 2027: Combination "Class B"
Fermented Malt Beverage & Liquor, Combination "Class A" Fermented Malt Beverage & Liquor,
Entertainment, Pawnbroker/Secondhand Article Dealer, and Operator's Licenses (approval of all
licenses should be subject to the City of Greenfield ordinances regarding code compliance and
payment of charges). (Goergen)
5. Discussion/decision to sign a 60-month lease with Pitney Bowes for a new mailing system/postage
machine. (Goergen)
6. Adopt a resolution under Sec. 125.06(6), Wis. Stats., permitting the sale of beer at city parks by city
officials and employees. (Geary)
7. Adopt an ordinance to create section 9.16 barring loitering in medians and safety zones. (Geary)
8. Discussion/decision regarding agreement with Klemme Floats LLC. (Jaquish)
9. Discussion and decision to approve a Fire Station 92 Rooftop HVAC Unit replacement project. (D.
Weber)
10. Discussion and decision to approve a Participating Provider Agreement (PPA) with Paralign and the
WEMSA Community EMS Network. (D. Weber)
11. Discussion and decision to adopt a resolution verifying review and authorizing submittal of the
Wisconsin Department of Natural Resources 2025 Compliance Maintenance Annual Report (CMAR).
(Katz)
12. Approve an Outdoor Special Event application for the House of Harley Pop Up Music Series event #1,
to be located at 6221 W. Layton Ave., on June 20, 2026. Application includes the following
combination of licenses/permits: OSE, Temporary Class “B” Retailer’s License (beer), and Food. (Vlach)
13. Approve an Outdoor Special Event application for the House of Harley Pop Up Music Series event #2,
to be located at 6221 W. Layton Ave., on July 25, 2026. Application includes the following combination
of licenses/permits: OSE, Temporary Class “B” Retailer’s License (beer), and Food. (Vlach)
14. Approve an Outdoor Special Event application for the House of Harley Pop Up Music Series event #3,
to be located at 6221 W. Layton Ave., on August 1, 2026. Application includes the following
combination of licenses/permits: OSE, Temporary Class “B” Retailer’s License (beer), and Food. (Vlach)
15. Approve an Outdoor Special Event application for the House of Harley Pop Up Music Series event #4,
to be located at 6221 W. Layton Ave., on August 8, 2026. Application includes the following
combination of licenses/permits: OSE, Temporary Class “B” Retailer’s License (beer), and Food. (Vlach)
16. Approve an Outdoor Special Event application for the House of Harley Pop Up Music Series event #5,
to be located at 6221 W. Layton Ave., on August 15, 2026. Application includes the following
combination of licenses/permits: OSE, Temporary Class “B” Retailer’s License (beer), and Food. (Vlach)
17. Approve an Outdoor Special Event application for the House of Harley Firefighter Retiree Lunch event,
to be located at 6221 W. Layton Ave., on August 19, 2026. Application includes the following
combination of licenses/permits: OSE, Temporary Class “B” Retailer’s License (beer), and Food. (Vlach)
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Common Council Agenda - June 16, 2026 - – Page 3
18. Approve an Outdoor Special Event application for the House of Harley Veteran Suicide Awareness Ride
event, to be located at 6221 W. Layton Ave., on August 22, 2026. Application includes the following
combination of licenses/permits: OSE, Temporary Class “B” Retailer’s License (beer), and Food. (Vlach)
19. Approve an Outdoor Special Event application for the House of Harley Oktoberfest event, to be
located at 6221 W. Layton Ave., on September 19, 2026. Application includes the following
combination of licenses/permits: OSE, Temporary Class “B” Retailer’s License (beer), and Food. (Vlach)
20. Approve an Outdoor Special Event application for the Corner Club Birthday Party event, to be located
at 4309 W. Grange Ave., on July 12, 2026. Application includes the following combination of
licenses/permits: OSE and Temporary Extension of Premises. (Vlach)
21. Approve an Outdoor Special Event application for Armenian Fest, to be located at St. John the Baptist
Armenian Apostolic Church, 7825 W. Layton Ave., on Sunday, July 19, 2026. Application includes the
following combination of licenses/permits: Outdoor Special Event, Temporary Class “B” Retailer’s
License (beer), Temporary Operator’s License, commercial electrical, and plumbing permits, sign
permit, and Extension of Premises (band, dancing, folk dancing). (Vlach)
22. Discussion and decision to adopt an ordinance amending Section 8.04 of the Greenfield Municipal
Code regarding a parking restriction on the west side of S. 84th Street, south of W. Forest Home
Avenue. (BPW, 5/26/26, Ald. Bailey)
23. Discussion and decision to adopt an ordinance amending Section 8.04 of the Greenfield Municipal
Code regarding stop signs on Midland Avenue and 47th Street and on Ohio Avenue and 45th
Street. (BPW, 5/26/26, Ald. Bailey)
24. Discussion and decision to adopt an ordinance amending Section 8.04 of the Greenfield Municipal
Code by repealing Ordinance 647 regarding parking restrictions on South 68th Street. (BPW, 5/26/26,
Ald. Bailey)
25. Discussion and decision to adopt an ordinance amending Section 8.04 of the Greenfield Municipal
Code by repealing Ordinance 1084 regarding U-turns on South 68th Street. (BPW, 5/26/26, Ald. Bailey)
26. Discussion and decision to adopt an ordinance amending Section 8.04 of the Greenfield Municipal
Code by repealing Ordinance 1104 regarding U-turns on South 68th Street. (BPW, 5/26/26, Ald. Bailey)
27. Approve a Site and Landscape Plans for a parking lot redesign for the CITGO Gas Station, located at
4715 S. 27th St., submitted by Bilal Amjad, d/b/a Ali’s Investments. (Tax Key No. 622-9999-000) (PC-
6/9/26 Kastner)
28. Approve Site, Landscaping, and Architectural Plan Review for Tuckaway Heights Apartments, located
at 5470 S. Tuckaway Ln., submitted by Matthew Stasik, d/b/a Point Real Estate Management, LLC (Tax
Key No. 645-9999-005) (PC-6/9/26 Kastner)
29. Approve a Special Use Review and Site Review for Mezcalero Food Truck, a proposed food truck
business, located at 6869 W. Forest Home Ave., submitted by Juanita Campos, d/b/a Mezcalero
Restaurant and Bar (Tax Key No. 571-8957-002) (PC-6/9/26 Kastner)
30. Approve a Special Use Review and Site Review for an expansion of Game Together MKE, an existing
used merchandise store, to be located at 4635 S. 108th St., submitted by Steven Barron d/b/a Game
Together MKE. (Tax Key No. 609-0033-001) (PC-6/9/26 Kastner)
31. Approval of schedules of disbursements in the amount of $10,972,656.46. (Schafer)
32. Approval of mileage reimbursements in the amount of $183.44. (Schafer)
33. Accept Investments and reinvestments for April 2026. (Schafer)
34. Common Council to go into closed session pursuant to Wis. Stat. § 19.85 (1)(b) & (f), considering
licensure, social or personal history, or medical information, for purposes of issuing the following:
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Common Council Agenda - June 16, 2026 - – Page 4
a. 2026-2027 Operator License to Olivia Nicole Fallon
b. 2026-2027 Cigarette and Tobacco Products Retail License to Yash Patel, Officer of Falcon One Inc
d/b/a Nexus Vape N Smoke (CC-5/19/26)
c. 2026-2027 Cigarette and Tobacco Products Retail License, Class "A" Fermented Malt Beverage
Retailer's License, and "Class A" Liquor - Cider Only Retailer's License to Bryan Peck, Agent of
Speedway LLC d/b/a Speedway #4154 (Goergen)
35. Common Council to remain in closed session pursuant to Wis. Stat. § 19.85(1)(c) to consider
employment, promotion, compensation or performance evaluation data of any public employee over
which the governmental body has jurisdiction or exercises responsibility to discuss employment
contract and compensation (Foley)
36. Adjourn closed session and reconvene into open session.
37. Decision re: 2026-2027 Operator's License for Olivia Nicole Fallon (Goergen)
38. Decision re: 2026-2027 Cigarette and Tobacco Retail License for Falcon One, Inc's Officer, Yash Patel
(Goergen) (CC-5/19/26)
39. Decision re: 2026-2027 Cigarette and Tobacco Products Retail License, Class "A" Fermented Malt
Beverage Retailer's License, and "Class A" Liquor - Cider Only Retailer's License to Bryan Peck, Agent of
Speedway LLC d/b/a Speedway #4154 (Goergen)
40. Decision to approve Agreement between the City of Greenfield and Mikayla Cancilla (Foley)
41. Decision regarding closed session item (Foley)
L. Items for future agenda
M. Adjourn
PLEASE NOTE: Upon reasonable notice, efforts will be made to accommodate the needs of disabled individuals
through sign language interpreters or other auxiliary aids. For additional information or to request this service,
contact the Department of Human Resources at 329-5208, (FAX) 543-6158, TDD 1-800-947-6644 (Wisconsin
Telecommunications Relay System), or by writing to the Director of Human Resources/ADA Coordinator at
Greenfield City Hall, 7325 West Forest Home Avenue, Room 101, Greenfield, WI 53220. Greenfield City Hall is
wheelchair accessible from the west and south entrances.
Page 4 of 125
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RESOLUTION NO. ______
Special Use Permit for Valentin Studios, a proposed permanent makeup studio, to be located at
4160 S. 108th St., Suite #6, submitted by Bethzaida Valentin, d/b/a Valentin Studios.
(Tax Key No. 567-9972-004)
WHEREAS, Bethzaida Valentin, d/b/a Valentin Studios, duly filed with the City Clerk an
application for a Special Use Permit, pursuant to Sec. 21.04.0603, Sec. 21.04.0700 and Sec.
21.08.0103 of the Municipal Code, to establish Valentin Studios, a proposed permanent makeup
studio, to be located at 4160 S. 108th St., Suite #6; and,
WHEREAS, after due notice, a public hearing was held by the Common Council on June 16,
2026, at 7:00 p.m. or soon thereafter, in the Common Council Chambers, to consider the
application; and,
WHEREAS, the Common Council, having carefully considered the evidence presented at the
meeting and the following pertinent facts noted:
1. The applicant, Bethzaida Valentin, d/b/a Valentin Studios, resides at 4218 N. 40 th St.,
Milwaukee WI 53216.
2. The applicant will lease a portion of the multi-tenant commercial building owned by
James M Petr, LLC, 6013 W. Bluemound Rd., Milwaukee WI 53213.
3. Valentin Studios will occupy the approximately 100 sq. ft. of the multi-tenant
commercial building located at 4160 S. 108th St., Greenfield, Milwaukee County, Wisconsin,
more particularly described as follows:
Parcel 2 of Certified Survey Map No. 4954, being a part of the Northwest ¼ of Section 20,
Township 6 North, Range 21 East, in the City of Greenfield, Milwaukee County, Wisconsin.
Tax Key No. 567-9972-004
Said land being located at 4154-4168 S. 108 St.
4. The applicant is proposing to operate a permanent makeup studio business within the
existing multi-tenant commercial building.
5. The aforesaid premise is zoned C-4 Regional Business District under the Zoning
Ordinance of the City of Greenfield, which permits permanent makeup businesses as a Special
Use, pursuant to Sec. 21.04.0603, Sec. 21.04.0700 and Sec. 21.08.0103 of the Municipal Code.
6. The subject property is part of an area along the S. 108th St. commercial corridor.
Properties to the north, south, and west are developed as commercial. Properties to the east are
not developed and are zoned for parkland.
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7. The proposed development should not adversely contribute to traffic volumes or traffic
flow in the area.
NOW, THEREFORE, BE IT RESOLVED by the Common Council of the City of Greenfield
that the application of Bethzaida Valentin, d/b/a Valentin Studios, to establish Valentin Studios,
a proposed permanent makeup studio, to be located at 4160 S. 108th St., Suite #6, be, and is
hereby granted on the following grounds:
That the establishment, maintenance and operation of the proposed use, with the imposition of
certain conditions hereinafter set forth, reasonably satisfies the standards set forth in Sec.
21.04.0603 and Sec. 21.08.0103 of the Municipal Code, so as to permit the issuance of a special
use permit as therein provided.
BE IT FURTHER RESOLVED that said Special Use Permit is granted subject to the following
conditions:
1. Site and Landscaping Plans. The grant of this Special Use Permit is subject to and
conditioned upon the Site Plan and all other applicable conditions approved by the Plan
Commission on May 12, 2026, and by the Common Council on June 16, 2026. No alteration or
modification of the approved plan shall be permitted without approval by the Common Council.
2. Building Plans and Fire Codes. The grant of this Special Use is subject to building plans
being submitted to and approved by the Inspection Services Division and by the Fire
Department.
3. Hours of Operation. The allowable hours of operation for Valentin Studios are
10:00am to 6:00pm daily.
4. Off-Street Parking. Valentin Studios requires three (3) off-street parking spaces (2
spaces per chair plus 1 space per employee). A total of 94 off-street parking stalls are required
for the entire multi-tenant commercial building. The property will provide 80 off-street parking
stalls. Common Council may waive the shortage.
5. Signage. Signage shall be in compliance with the City’s Signage Ordinance. Any
building window signage shall not exceed twenty (20) percent of the net glazed front window
area per business premises. Rope/LED trim lighting shall not be allowed.
6. Public Nuisance. In accordance with Chapter 11 of the Municipal Code, Public
Nuisances are prohibited. Public Nuisances include blighted properties due to an accumulation
thereon of junk or other unsightly debris. Enforcement and abatement of public nuisances,
including revocation of the Special Use Permit, may take place after three (3) or more nuisance
activities have occurred at a premise on separate days during a one hundred and eighty (180) day
period.
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3
7. Marketing Displays. The use of pennants, special lighting, flags, streamers or other
signage typically temporary in nature, hanging, floating or attached to a structure or vehicle shall
not be permitted.
8. Outdoor Lighting. All outdoor lighting fixtures shall be shielded in such a manner that
no light splays from the property boundaries. Full-cut off fixtures and or house side shields must
be utilized to minimize light splay. Rope/LED trim lighting is not permitted.
9. Litter. Employees shall inspect the area and the immediate vicinity and pick up litter on
a daily basis.
10. Refuse Collection. All refuse to be provided by a commercial hauler. All refuse,
recyclables and other waste material shall be screened from by a four-sided board-on-board
refuse enclosure provided on site.
11. Pest Control. Exterior pest control shall be maintained at all times and pest control
problems shall be addressed immediately.
12. Pagers, Intercoms. The use of outdoor pagers, intercoms, or speakers shall not be
permitted on site as surrounding land use consists of residential uses.
13. Noxious Odors, Etc. The use shall not emit foul, offensive, noxious or disagreeable
odors, gases, or effluvia into the air. Mechanical systems shall be maintained to efficiently
remove noxious odors.
14. Pollution. The use shall not cause any noxious or unwholesome liquid or substance or
any dirt, mud, sand, gravel, or stone refuse or other materials to be deposited upon any public
right of way or flow into any sanitary sewer, storm sewer, or water supply system, or onto
adjacent properties.
15. Deliveries and Refuse Pickup. The property will be required to abide by the City of
Greenfield health/public nuisance rules per Chapter 12 of the Municipal Code. Because there is a
residential neighborhood adjacent to the site, delivery operations and refuse pick up shall only be
permitted during daytime hours. These functions shall not be permitted between the hours of
9:00 p.m. and 7:00 a.m.
16. Expiration of Special Use Permit. Any special use approved by the Common Council
shall lapse and become null and void one (1) year from and after that approval if the use has not
commenced, construction is not underway, or the owner has not obtained a valid building permit.
An extension of these time limitations may be granted without a public hearing by the Common
Council by resolution reauthorizing the special use in accordance with the following criteria:
A. The applicant requesting the extension shall complete a planning application available from
the Community Development Division and shall submit a $350.00 special use permit
review/amendment fee.
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B. A written explanation for the extension of time shall accompany the planning application
along with a timeline/schedule for obtaining necessary permits, zoning, state and municipal
approvals and a target date for construction start;
C. The request for extension shall be submitted within sixty (60) days of the expiration of the
special use permit;
D. The extension, if granted, shall be valid for a period of six (6) months. If no building permit
has been issued and construction has not commenced within six (6) months from and after the
extension has been granted, the special use shall become null and void.
17. Miscellaneous.
A. Applicants are advised that the foregoing conditions are reasonably necessary to protect the
public interest and to secure compliance with the standards and requirements specified in Sec.
21.04.0603 and Sec. 21.08.0103 of the Municipal Code; that the issuance of the special use is
expressly subject to compliance with said conditions.
B. The use, as granted herein, is subject to applicants' compliance with all other state and local
laws and regulations which may be applicable to the proposed use of the real estate in question.
C. The special use, as granted herein, shall run with the land and benefit and restrict all future
owners and occupants of the property, unless the use shall lapse or be terminated and the use will
not be altered or extended (including structural alterations and/or additions) without the approval
of the Common Council, following public hearing, all as provided in Sec. 21.04.0603 and Sec.
21.08.0103 of the Municipal Code.
18. Lapse. If the applicant does not meet all of the terms and conditions set forth in this
grant of a special use within one year of the granting thereof, then the Special Use Permit shall
lapse and become null and void and the applicant shall forfeit any right to use the property as
conferred by the Special Use Permit. The failure of the applicant to meet the terms and
conditions of the Special Use Permit shall subject the permit to being declared void by the
Common Council after notice to the applicant and a hearing before the Common Council. Upon
a finding by the Common Council on the matter, the applicant and/or any interested person may
make comments regarding the matter to the Common Council prior to the Common Council's
next regular meeting following the hearing recommendation. Upon the Common Council's
finding that the Special Use Permit has lapsed and become void, the applicant shall cease all
operations at the property.
19. Termination of Special Use. If the person or entity granted the special use violates,
allows or suffers the violation of the ordinances of the City of Greenfield, the State of Wisconsin
or the United States on the premises covered by the special use, then the special use may be
terminated.
20. Acknowledgement. That the applicants sign an acknowledgment that he/she/they
has/have received these terms and conditions and will abide by them.
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The undersigned applicant agrees to the terms and conditions and has agreed that the grant of the
Special Use Permit is conditioned on meeting the terms and conditions of this resolution.
_____________________________________________
Bethzaida Valentin, d/b/a Valentin Studios
Provided to applicant on the
______day of ____________, 2026.
_______________________
Gina Vlach, City Planner
PASSED AND ADOPTED by the Common Council of the City of Greenfield on the _____
day of ________________, 2026.
APPROVED:
_______________________________
Michael J. Neitzke, Mayor
ATTEST:
______________________________________
Jennifer Goergen, City Clerk
S:\Planning\Plan Commission\2026\5-12-26\Valentin Studios - SUP\Res - Valentin Studios SUP 6-16-26.docx
Page 9 of 125
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RESOLUTION NO. ____
RESOLUTION DISCONTINUING THE W. SAINT FRANCIS AVE. RIGHT-OF-WAY
COMMENCING AT S. 31 ST. AND CONTINUING EAST
FOR APPROXIMATELY 120 FEET
WHEREAS, West Saint Francis Avenue has been duly laid out and improved as a street
within the City of Greenfield; and
WHEREAS, following due notice and publication the Common Council has conducted a
public hearing to determine whether it is appropriate to discontinue the West Saint Francis
Avenue right-of-way commencing at S. 31st Street and continuing east for approximately 120
feet; and
WHEREAS, based upon the materials on file and the comments received at the public
hearing, the Common Council has determined that the public interest requires the vacation of
120 feet of the West Saint Francis Avenue right of way that is more specifically shown and
described in the attached Exhibit A; and
WHEREAS, the Common Council further finds that the public road right of way which is
hereby to be vacated lies within one-quarter mile of a state trunk highway or connecting
highway, and does not contain a railroad crossing within its boundaries;
NOW, THEREFORE, BE IT RESOLVED by the Common Council of the City of
Greenfield, that the 120 feet of the West Saint Francis Avenue right of way that is more
specifically shown and described in the attached Exhibit A is hereby vacated and discontinued.
BE IT FURTHER RESOLVED, that the public road right of way so vacated and
discontinued shall, upon passage and publication of this Resolution, forever vest in the owner of
the lands which immediately abut thereto, and shall be annexed thereto, free and clear of any
right, title or interest in the public as road right of way except for the rights of the public to a
public purpose easement for utilities within the vacated area pursuant to the provisions of
sections 66.1003 and 66.1005 of the Wisconsin Statutes.
INTRODUCED by the Common Council of the City of Greenfield on the 21st day of April,
2026.
PASSED AND ADOPTED by the Common Council of the City of Greenfield on the 16th day of
June, 2026.
APPROVED:
______________
Michael J. Neitzke, Mayor
ATTEST:
________
Jennifer Goergen, City Clerk
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Exhibit A
Legal Description:
That part of the Southeast ¼ of Section 13, Township 6 North, Range 21 East, in the City of
Greenfield, Milwaukee County, Wisconsin, which is bounded and described as follows:
Commencing at that Northeast corner of said ¼ Section; thence S 88°04’10” W along the North
line of said ¼ Section, 1320.36 feet to a point; thence S 00°35’12” E, 630.00 feet to a point;
thence S 88°04’10” W, 30.00 feet to a point, said point being the Southeast corner of Lot 20,
Block 1 of Lynndale, a recorded subdivision, and the point of beginning of lands to be described;
thence S 00°35’12” E, 60.00 feet to a point, said point being the Northeast corner of Lot 1, Block
8 of Lynndale, a recorded subdivision; thence S 88°04’10” W along the North line of said Lot 1,
120.00 feet to a point, said point being the Northwest corner of said Lot 1; thence N 00°35’12”
W, 60.00 feet to a point, said point being the Southwest corner said Lot 20; thence N 88°04’10”
E along the South line of said Lot 20, 120.00 feet to the point of beginning.
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Exhibit A:
Map of Street Discontinuance:
Page 12 of 125
06/11/2026
CITY OF GREENFIELD
OPERATOR LICENSE APPLICANTS
CITY, STATE, ZIP
OPERATOR'S REGULAR
ADDRESS
NAME
Milwaukee, WI 53223
6209 W Hustis
Araceli Serna Rangel
Greenfield, WI 53220
3965 S 50th ST
Ashley Kay Zierath
Milwaukee, WI 53218
5079 N 58th ST
Christopher Vandell Markham
Waukesha, WI 53186
237 Frame AVE
Dustin Lowell Nelson
Franklin, WI 53132
7804 W Elm CT
Eric Alan Buckner
Milwaukee, WI 53220
3603 S 82nd ST
Erik Michael Pfarrer
Franklin, WI 53132
8143 W Winston WAY
Gabrielle Janee Gawlitta
Milwaukee, WI 53207
3437A S New York AVE
Gina Marie Scherr
Greenfield, WI 53221
4055 W Howard Ave
Hannah Catherine Schroeder
Greenfield, WI 53228
3975 S 117th ST
Isaac Thomas Fiedler
West Allis, WI 53214
1547 S 64th ST
Janet Welch
Milwaukee, WI 53219
7451 W Honey Creek DR
Kalei Jade Dombrowski
Mount Pleasant, WI 53406
32 S Hillock DR
Kyle Lance Caskey
West Allis, WI 53219
2835 S 74th ST
Michelle Marcou
Greenfield, WI 53228
4145 S 92nd ST
Nicole Felkl
Greenfield, WI 53220
6420 W English Meadows DR #G-205
Perry L Perkins
West Allis, WI 53219
2877 S 47th ST
Sarah Elizabeth Hug
Greenfield, WI 53228
4145 S 92nd ST
Scott Thomas Jedrzejewski
Franklin, WI 53132
6363 S 35th ST
Vivek Etineni
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06/11/2026
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CITY OF GREENFIELD
7325 West Forest Home Avenue
Greenfield, Wisconsin 53220
LEGAL NAME
AGENT
BUSINESS ADDRESS
BUSINESS NAME
CLASS B LIQUOR - COMBO
Carrabba's Italian Grill
4765 S 76th ST
Carrabba's Italian Grill, LLC
Michael Morin, Agent
Premise Description:
ONE STORY, 5,576 SF BUILDING WITH 789 SF PATIO ON A 61,480 SF LOT LOCATED AT 4765 S. 76TH ST.
Honey Berry Pancakes & Cafe
4900 S 76th ST
4900 76th Co, A Wisconsin
Corporation
Osama A Dabash, Agent
Premise Description:
THE PREMISES IS A FREESTANDING BUILDING CONTAINING APPROX 5,310 SF OF SPACE. ALCOHOLIC BEVERAGES WILL BE STORED ONLY
BEHIND THE BAR, DESIGNATED FOR EMPLOYEES ONLY. BEVERAGE ORDERS ARE TAKEN BY RESTAURANT STAFF EITHER AT INDIVIDUAL TABLES
OR THE BAR; ORDERS ARE PREPARED AT THE BAR AND DELIVERED TO THE CUSTOMER DIRECTLY BY THE BARTENDER OR BY A SERVER TO
INDIVIDUAL TABLES. BEER/WINE/LIQUOR INVOICES ARE KEPT IN THE MANAGER'S OFFICE LOCATED AT 4900 S 76H ST.
Kyoto Group LLC
7453 W Layton AVE
Kyoto Group LLC
Yi Wu, Agent
Premise Description:
BEVERAGES SERVED IN BAR AREA AND GENERAL DINING ROOM. BEVERAGES STORED IN LOCKED STORAGE CLOSET AND COOLER UNIT IN
EXISTING SPACE. ALL RECORDS STORED IN THE OFFICE LOCATED AT 7453 W LAYTON AVE.
Los Mariachis Restaurant
4305 W Layton AVE
Los Mariachis Mexican
Restaurant Inc
Sandra Madrigal, Agent
Premise Description:
RESTAURANT/BAR AREA, STORED IN BACK ROOM AND BASEMENT, LOCATED AT 4305 W LAYTON AVE.
Outback Steakhouse
8625 W Sura LN
Outback Steakhouse of Florida
LLC
Ashley Hubal, Agent
Premise Description:
6,525 SF BUILDING WITH STORAGE FOR ALCOHOL, LOCATED AT 8625 W SURA LN
Shots and Tequila Sport Bar LLC
5175 S 27th ST
Shots and Tequila Sport Bar LLC
Armando Lara Iniguez, Agent
Premise Description:
SHOTS AND TEQUILA HAS 4 NICE AREAS FOR SOCIALIZING AND HAVING FUN BAR AREA, DJ SPACE, DANCE AREA, PATIO), OFFICE AND ROOM
FOR STORAGE, AND WE HAVE A BIG PARKING LOT LOCATED AT 5175 S 27TH ST
LEGAL NAME
AGENT
BUSINESS ADDRESS
BUSINESS NAME
CLASS A LIQUOR COMBO
Sendik's Food Market
7901 W Layton AVE
Sendik's Greenfield LLC
Theodore Balistreri, Agent
Premise Description:
SOLD ON SALES FLOOR, STORED IN SECURE AREA AND BROUGHT TO 2 DESIGNATED PARKING STALLS LOCATED TO THE SOUTH OF THE MAIN
ENTRANCE FOR PICKUP, RECORDS AVAILABLE AT STORE ELECTRONICALLY AND ALSO AT SUPPORT CENTER IN MILWAUKEE, LOCATED AT 7901
W LAYTON AVE
Walmart #1394
10600 W Layton AVE
Wal-Mart Stores East LP
Trenton Little, Agent
Page 14 of 125
Premise Description:
1 ROOM, 1 STORY, APPROXIMATELY 148,000 SQ FT, INCLUDING 32 STALLS AND/OR CANOPY LOCATIONS IN THE SOUTHWEST CORNER OF
PARKING LOT SPECIFICALLY DESIGNATED FOR ONLINE GROCERY PICKUP LOCATED AT 10600 W LAYTON AVE
LEGAL NAME
AGENT
BUSINESS ADDRESS
BUSINESS NAME
ENTERTAINMENT
Los Mariachis Restaurant
4305 W Layton AVE
Los Mariachis Mexican
Restaurant Inc
Sandra Madrigal, Agent
Premise Description:
INDOOR: LIVE MARIACHI BAND AND LATINA JAZZ BAND OUTDOOR: N/A LOCATED AT 4305 W LAYTON AVE
Shots and Tequila Sport Bar LLC
5175 S 27th ST
Shots and Tequila Sport Bar LLC
Armando Lara Iniguez, Agent
Premise Description:
INDOOR: THERE ARE AREAS FOR SOCIALIZING AND HAVING FUN, BAR AREA, DANCE AREA, DJ AND KARAOKE AREA AND SOME TABLE GAMES.
OUTDOOR: N/A LOCATED AT 5175 S 27TH ST.
Sky Zone Greenfield
4940 S 76th ST
Hot Gates LLC
Gregory Schmatz, Manager
Premise Description:
INDOOR: TRAMPOLINES, PLAYGROUNDS, ZIP LINES AND OBSTACLE COURSES; OUTDOOR: NONE LOCATED AT 4940 S 76TH ST
LEGAL NAME
AGENT
BUSINESS ADDRESS
BUSINESS NAME
PAWNBROKER/SECONDHAND
Best Buy #25
4610 S 76th ST
Best Buy Stores, LP
Robert Jamsa, Agent
Premise Description:
CONDUCT SALE OF SECONDHAND ARTICLES LOCATED AT 4610 S 76TH ST. MESHACH BELLE, AHMAD BRACEY, ALLEN HADLOCK, ROBERT JAMSA,
JAKE JENSEN-CORDOVES, JASMINE RODRIGUEZ, MATTHEW SCHWANDA, ARIA TOSO - MANAGERS/PERSONS IN CHARGE
Brew Town Trading Co, LLC
4285 S 76th ST
Brew Town Trading Co, LLC
Jeremy Frantz, Agent
Premise Description:
CONDUCT SALES OF SECONDHAND ARTICLES AT 4285 S 76TH ST
JEREMY FRANTZ, RYAN BROWN, THOMAS RHYNER - MANAGERS/PERSONS IN CHARGE
Volta Records LLC
5026 S 74th ST
Volta Records LLC
Jennifer Ann Young, Agent
Premise Description:
CONDUCT SALE OF SECONDHAND ARTICLES LOCATED AT 5026 S 74TH ST
JENNIFER ANN YOUNG - MANAGERS/PERSONS IN CHARGE
14
Grand Total Licenses:
Page 15 of 125
06/16/2026
CITY OF GREENFIELD
OPERATOR LICENSE APPLICANTS
CITY, STATE, ZIP
OPERATOR'S REGULAR
ADDRESS
NAME
Greenfield, WI 53228
3915 S 84th ST 3
Alissa Ann Jackson
Greenfield, WI 53219
4957 W Midland DR
April M Drankiewicz
Greenfield, WI 53220
5047 S Stonehedge DR
Ariana Raquel Morton
Greenfield, WI 53228
8983 W Allerton AVE
Brandon Charles Crisp
West Allis, WI 53214
1539 S 73th ST
Brianna Nichole Gaines
Milwaukee, WI 53215
3708 W Ohio AVE
Corrin Marie Alexander
Greenfield, WI 53221
6785 S 18th ST
Debra Lynn Rosales
Milwaukee, WI 53210
2418 N 37th ST
Demetrick D Porter
Franklin, WI 53132
6625 S 46th ST
Gurpreet Singh
Milwaukee, WI 53204
1010 W Rogers ST
Hevir Torres Acosta
St Francis, WI 53235
3749 S Packard AVE #23
Jackie Lynn Eisch
Milwaukee, WI 53221
6770 S 20th St
Jacqueline Quin Sommerfelt
New Berlin, WI 53146
20181 W Lincoln AVE
Jacquelyn Sunn
Greenfield, WI 53221
5200 S Tuckaway BLVD 106D
Jeffrey A Wisniewski
Milwaukee, WI 53220
3971 S 51st ST
Jennifer B Zindl
West Allis, WI 53219
6308 W Manitoba ST
Jesse John Vega
Kenosha, WI 53142
6707 30th AVE
Jesus Antonio Guzman
West Allis, WI 53227
11029 W Wildwood LN #210
John Alin Mizener
Greenfield, WI 53220
4889 S 72nd ST
Julie Ann Wiltzius
Franklin, WI 53132
6625 S 46th ST
Jyotsna R Patel
Milwaukee, WI 53227
2513 S 88th ST
Kevin Michael Doonan
Hales Corners, WI 53130
10524 W Scharles AVE
Kristin E Brown
Franklin, WI 53132
7883 S Scepter DR 2
Melissa Marie Martin
West Allis, WI 53219
2240 S 80th ST
Morgan Ann Zakrzewski
Greenfield, WI 53228
4002 S 84th ST 84th
Qyinn M Applin
WAUWATOSA, WI 53222
11221 Synergy DR #542
Shedric Maurice Spencer
Waterford, WI 53185
7160 N Tichigan RD
Stacey Ann Litscher
Greenfield, WI 53220
4880 S Katelyn CIR #104
Timothy J. Finley
Page 16 of 125
Committee: Finance & Human Resources Committee Item Number:
Introduced By: Jennifer Goergen, City Clerk
Date Introduced: June 10, 2026
RELATING TO: Discussion/decision to sign a 60-month lease with Pitney Bowes for a new
mailing system/postage machine.
SUMMARY:
The lease on our current mailing system with Pitney Bowes will end on August 16, 2026. The
mailing system we lease is used to process all mail from all city departments and is the most
efficient method for doing so. Pitney Bowes has provided pricing for a new five-year lease, which
is under the competitive pricing agreement subject to the NASPO contact used for the state of
Wisconsin and Wisconsin local governments. The pricing per month would be $410.50 for the
duration of the 60-month lease, or $1,231.50 quarterly. Installation, delivery and training, as well
as fixed costs, are included in the lease.
We have leased our mailing systems from Pitney Bowes in the past, so staff is already familiar
with how the equipment works. Since everything is already set up with this vendor, the transition
to the new equipment is expected to be quick and seamless and would require minimal training
for staff. We have had a positive experience working with Pitney Bowes in the past and would
anticipate the same in the future.
I recommend approval of the 60-month lease with Pitney Bowes for a SendPro Mail Center in the
amount of $410.50 per month.
ATTACHMENTS:KEY ISSUES ___ BACKGROUND _X__ RESOLUTION ___ FISCAL NOTE ___
MOTION ___ OTHER ___
Page 17 of 125
RESOLUTION NO. _________
A Resolution Under Sec. 125.06(6), Wis. Stats., Permitting the Sale of Beer at City Parks by City
Officials and Employees
The Common Council of the City of Greenfield do ordain as follows:
WHEREAS, pursuant Wis. Stat. 125.06(6), and City Resolution No. 3569, adopted by
the Common Council on September 20, 2016, the City, through its officers and employees, is
authorized to sell beer at the City’s Konkel Park; and,
WHEREAS, the Common Council now desires to expand its right to similarly sell beer
at all other City parks, including without limitation Kulwicki Park, Dan Jansen Park, The
Greenfield Community Center, and The Turf, and also at any other City parks that may
subsequently be established.
NOW THEREFORE BE IT RESOLVED, that the City of Greenfield Common
Council, by the authority granted to it by Sec. 125.06(6), Wis. Stats., hereby approves the sale
of beer in any City park by designated City officials and employees, without need for further
license or permit.
PASSED AND ADOPTED by the Common Council of the City of Greenfield on the
_____ day of June, 2026.
APPROVED:
Michael J. Neitzke, Mayor
ATTEST:
Jennifer Goergen, City Clerk
Page 18 of 125
ORDINANCE NO. ____
AN ORDINANCE TO CREATE SECTION 9.16 BARRING LOITERING IN MEDIANS AND SAFETY ZONES
The Common Council of the City of Greenfield do ordain as follows:
PART I. Section 9.16 of the Greenfield Code of Ordinance be, and hereby is, created to read:
“9.16 Loitering in Medians or Safety Zones
(1) Definitions. In this section:
(a) “Median” means a paved or unpaved area, whether elevated/grassed or
not, dividing a street or highway that separates lanes of traffic.
(b) “Safety zone” means the area or space defined in s. 340.01(55), Wis.
Stats.
(2) Loitering prohibited. No person shall stand, sit, or stay upon any median or any
safety zone. It is prima facie evidence of a violation of this section if a person
stays on a median through two consecutive opportunities, which may include a
change in the traffic control signal or lack of traffic, as applicable, to cross the
highway in a safe and legal manner. This provision shall not apply to:
(a) Persons using a crosswalk or safety zone to cross a street or to board or
alight from a public conveyance.
(b) Law enforcement officers or public employees acting within the scope
of their duties.
(c) Fire or emergency employees providing emergency assistance.
(d) Street or utility construction and maintenance workers performing
authorized construction or maintenance work.
(3) Locations; installation of signs. The superintendent of public works shall install
appropriate signs to indicate the prohibition of sub. 2 applies to these specific
locations.
(4) Penalty. Any person found violating this section shall upon conviction be
punished by a forfeiture not less than $50 nor more than $200, together with the
cost of prosecution.”
PART II. This ordinance shall take effect and be in force from and after its passage and
publication.
PASSED AND ADOPTED by the Common Council of the City of Greenfield on the ___
day of ________________, 2026.
APPROVED:
ATTEST:
__________________________
_____________________________ Michael J. Neitzke, Mayor
Jennifer Goergen, City Clerk
Published:
Page 19 of 125
Page 20 of 125
Page 21 of 125
Committee: Common Council Item Number:
Introduced By: Mikayla Cancilla, Recreation Supervisor
Scott Jaquish, Director of Parks and Recreation
Date Introduced: April 2, 2025
RELATING TO:
Discussion/decision regarding agreement with Klemme Floats LLC.
The 4th of July Parade will take place Saturday July 4th at 12:15PM traveling east on Layton Ave
concluding at Konkel Park.
Agreement allows for Klemme Floats to construct float, deliver and pick-up upon parade’s completion.
Float will highlight and promote the many different Parks and Recreation events throughout the year.
Thank You
Department of Parks and Recreation
ATTACHMENTS:KEY ISSUES ___ BACKGROUND ___ RESOLUTION ___ FISCAL NOTE ___
MOTION ___ OTHER _x__
Page 22 of 125
Committee: F&HR Item Number:
Introduced By: Assistant Chief Dan Weber Date Introduced: 6/10/2026
RELATING TO: Discussion and decision to approve a Fire Station 92 Rooftop HVAC unit
replacement project.
SUMMARY:
The current rooftop unit above the dorm at Fire Station 92 is not cooling properly and needs
replacement. An RFP was circulated and the City of Greenfield has completed a review of
the submitted proposals for the Fire Station 92 Rooftop HVAC Unit Replacement project.
The City received proposals from the following contractors:
• Dillett Mechanical Service, Inc. – $15,540.00
• J.M. Brennan, Inc. – $19,500.00
• Southport Mechanical LLC – $26,000.00
After evaluating the proposals based on project scope, qualifications, scheduling, warranty
information, and overall cost, Dillett Mechanical Service, Inc. has been selected for the
project. This project will be paid for using existing funds from the Fire Department
operating budget.
Recommendation:
Approve project
Page 23 of 125
Overview for Fire and EMS Leadership
Purpose of This Memo
This memorandum accompanies the Provider Participation Agreement (the “ Agreement”).
The Agreement is the governing legal document. The purpose of this memorandum is to
explain, in practical and policy terms, the structure of the program, the rationale for its
design, and the implications for departments evaluating participation.
The Structural Problem This Program Is Designed to Address
Across the country, fire departments and EMS agencies have developed Mobile Integrated
Health and Community Paramedicine (MIH-CP) capabilities in response to clear community
needs. Departments possess the operational capacity, clinical expertise, and public trust
necessary to deliver these services effectively.
What is typically absent is a durable, scalable reimbursement pathway from health plans.
Most departments that provide MIH-CP services rely on grants, municipal funding, or
limited pilot arrangements with hospital systems. While these sources can support initial
program development, they do not provide a stable long-term funding model.
If a department seeks to secure reimbursement directly from health plans (commercial
insurers, Medicaid managed care organizations, or Medicare Advantage plans), it faces a
practical policy decision regarding how that funding will be pursued and sustained.
One option is to continue operating without payer reimbursement and rely on municipal
appropriations, grants, or other local funding sources. Many departments have successfully
launched MIH-CP services in this manner. However, these funding streams are often time-
limited, subject to annual budget pressures, or dependent on external grant cycles.
A second option is for the department to negotiate and administer contracts independently
with each health plan operating in its region. This approach requires the department to
assume responsibility for contract negotiation, legal review, compliance oversight, billing
infrastructure, credentialing, audit response, and ongoing reporting obligations. These are
not one-time activities; they are continuing administrative functions that must be
maintained year after year. In practice, independent contracting, though technically
available, is operationally burdensome and difficult to scale.
Page 24 of 125
A third approach is participation in a coordinated contracting structure that brings
together fire departments and EMS agencies across the state to centralize payer negotiation
and administrative functions, while preserving each department’s local governance and
operational authority. Under this model, the department continues to deliver services
within its jurisdiction under its existing leadership and clinical oversight. However, the
contracting, billing, compliance, and reporting obligations associated with health plan
reimbursement are administered through a network designed specifically for that purpose.
The WEMSA Clinically Integrated Network, Powered by Paralign Health
In Wisconsin, the coordinated contracting structure operates as the WEMSA Clinically
Integrated Network (CIN), powered by Paralign Health. This framework is designed to
centralize payer negotiation and administrative execution across participating fire
departments and EMS agencies, while preserving each department’s local governance and
operational authority.
Under this model, the network negotiates and enters into health plan contracts on behalf of
the participating agencies and departments. Participating departments continue to deliver
defined MIH-CP services within their jurisdictions under their existing leadership, clinical
oversight, and municipal structure. The network administers the payer-facing components
of the program, including contracting, billing, reporting, compliance coordination, and
ongoing communication with health plans.
The CIN is a legally structured framework that allows independent municipal agencies to
participate in coordinated payer contracts without consolidating operations. Participation
does not transfer staffing control, alter command structure, or diminish local decision-
making authority. Departments remain independently governed public entities.
In practical terms, participation in the CIN means that a department does not negotiate
separate contracts with each health plan, does not independently manage payer-specific
reporting systems, and does not build or maintain standalone billing infrastructure for each
insurer. Instead, the department participates in a unified contracting platform that health
plans can implement at scale across the state.
Health plans generally prefer to contract with a coordinated network rather than numerous
individual agencies. The CIN structure enables statewide implementation under consistent
terms and reduces administrative fragmentation for both departments and payers. Absent
such coordination, broad expansion of MIH-CP reimbursement across a market is unlikely
to occur at scale.
In effect, the WEMSA CIN powered by Paralign separates operational delivery, which
remains local, from contracting and administrative execution, which is centralized for
efficiency and sustainability
Page 25 of 125
Scope of Commitment Under the Agreement
By executing the Provider Participation Agreement, the department agrees to participate in
the WEMSA Clinically Integrated Network for the limited purpose of receiving
reimbursement from health plans for eligible MIH-CP services. In practical terms, this
means the department will continue providing community paramedicine services as it does
today, will document those services according to agreed standards so that they can be billed
properly, and will allow Paralign to handle the submission of claims and receipt of payment
from health plans on the department’s behalf. Funds received for covered services are then
distributed to the department in accordance with the Agreement.
The Agreement is limited in scope. It does not require exclusivity, does not transfer
governance authority, and does not merge or consolidate the department into another
entity. Participation does not alter municipal oversight, chain of command, or local clinical
decision-making. The department remains free to pursue other partnerships or funding
arrangements outside this framework. Operational control remains fully with the
department and its municipal leadership.
Health Plan Context and the Decision Before You
Health plans are increasingly seeking structured partnerships with fire departments and
EMS agencies to address high-utilization populations, reduce avoidable emergency
department visits, and improve care coordination. There is growing recognition that
community paramedicine programs, when implemented consistently and measured
appropriately, can produce meaningful system-level impact.
At the same time, health plans require administrative consistency, reporting reliability, and
sufficient scale to justify statewide implementation. A fragmented, department-by-
department contracting approach rarely meets those requirements. Without coordination,
reimbursement opportunities tend to be limited, uneven, and difficult to sustain. The CIN
model is intended to address that gap. It creates a unified contracting structure that health
plans can implement at scale, while allowing each department to remain operationally
independent.
If pursuing health plan reimbursement for MIH-CP services is part of your department’s
long-term strategy, a structural decision follows. The question is not whether to seek
reimbursement, but how the contracting and administrative responsibilities required to
support it will be handled. Those responsibilities can remain fully internal to the
department, or they can be addressed through participation in the coordinated WEMSA CIN
structure powered by Paralign.
Page 26 of 125
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PARALIGN MIH-CP PROGRAM:
PROGRAM TERMS FOR PARTICIPATING PROVIDERS
These “Program Terms” govern participation in the Paralign Community Paramedicine Program
(“Program”). They form a contract between your organization and Paralign CIN, LLC, a Delaware
limited liability company (“CIN”) which is a subsidiary of Paralign Health, Inc. (the “MSO”). CIN is a
clinically and financially integrated network through which participating providers work together to offer
the Program, in collaboration with MSO, as described in these Program Terms. Throughout these Program
Terms, your organization may be referred to as “You, “Your,” or the “Provider”1. You, as the Provider,
and CIN may each be called a “Program Party” or collectively, the “Program Parties.” By accepting
these Program Terms, You are agreeing to provide services as a participating provider in the Program
CIN.
MSO provides non-clinical management services necessary to implement the CIN’s initiatives,
administering the CIN’s day-to-day operations and promoting the Program to prospective participating
providers, payers, and other stakeholders. CIN has contracted with MSO for such support and pays
management fees to MSO to secure the infrastructure required for CIN’s activities. Providers who
participate in the CIN pool their resources together through the CIN to purchase the MSO’s services. This
creates efficiencies and cost-savings that allow CIN participants to focus their resources on clinical
integration initiatives, and to offer more cost-efficient care. Many of CIN’s obligations under these
Program Terms are performed by MSO under the contract between CIN and MSO, with direction from
the CIN Leadership Council. The “CIN Leadership Council” is comprised of Council Members
nominated by and affiliated with participating provider organizations, as described in greater detail at
Exhibit B.
By accepting these Program terms, You also confirm your participation in the CIN Organized
Health Care Arrangement, as described at Exhibit C, and agree to the Paralign General Terms set forth in
Exhibit D (“Paralign General Terms”) and the Business Associate Agreement set forth in Exhibit E.
Recitals2
• Participating providers, such as city or county based fire departments, Fire Protection Districts,
city or county based EMS agencies, or Ambulance Districts offer mobile integrated health-
community paramedicine (“MIH-CP”) through the CIN for purposes such as the following: (a) to
help stabilize patients with chronic conditions and prevent avoidable emergency department visits;
(b) to extend the reach of physicians and other primary care providers, acting as their “eyes and
ears” in the patient’s home environment; (c) to connect patients to other resources for their well-
being, such as behavioral health support, community-based organizations, and health plan case
management teams; (d) to re-engage disengaged patients who are often disconnected from primary
care or behavioral health follow-up.
• CIN is comprised of only those organizations who have voluntarily elected to become Participating
Providers in the Program and engage in the following additional activities to enhance the quality,
affordability, and accessibility of their services: (a) participation in clinical integration activities,
1 Whenever the context requires, the references to Provider will be inclusive of Provider's Individual Providers.
2 These Recitals are incorporated into and made part of these Program Terms.
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including development and adherence to care pathways tailored to patient diagnosis and aligned
with the CIN’s quality and patient experience initiatives; (b) collection and analysis of quality-
focused performance metrics; and (c) participation in financial integration programs tied to quality
and cost-efficiency.
• CIN contracts with organizations on a non-exclusive, voluntary basis, such that Provider is free to
contract with Payers outside of this Program, directly or through other provider networks, and to
continue its existing business outside of this Program;
• CIN has entered into or intends to enter into agreements with Payers for services rendered by
Participating Providers to Payers’ beneficiaries (“Payer Contracts”); and
• Provider provides services through Individual Providers who each, individually, are qualified and
licensed to deliver such services (as applicable); and
• CIN and Provider want to enter into an agreement, through these Program Terms, such that
Provider, through Individual Providers, will serve as a Participating Provider and provide services
upon all the terms and conditions of such Payer Contracts.
ARTICLE I
Definitions
The terms below will have the following meanings in these Program Terms. Any capitalized term
in these Program Terms not defined below shall be as defined in the Exhibits to these Program Terms.
1.1 “Benefit Plan” means a Payer’s health benefit plan or program, including a health
maintenance organization plan, preferred provider arrangement, exclusive provider arrangement, health
insurance plan, or other managed care arrangement for providing or arranging health benefits for its
members or beneficiaries.
1.2 “Business Associate” has the meaning assigned to such term under HIPAA, including, but
not limited to, 45 CFR § 160.103.
1.3 “Business Associate Agreement” has the meaning assigned to such term under HIPAA,
including, but not limited to, 45 CFR § 160.103.
1.4 “CIN Representatives” has the meaning set forth in Section 3.7.
1.5 “Contract Requirements” means all requirements and conditions, including, but not
limited to, those specified in the Payer Contracts, other guidance and regulations issued by Payers, laws
and regulations applicable to CIN and/or Provider, and these Program Terms, including all schedules and
exhibits attached hereto.
1.6 “Cost-share” means a charge for which a Covered Individual is directly responsible for as
an additional out-of-pocket payment for Covered Services, regardless of whether defined as a copayment,
deductible, coinsurance, or otherwise in the relevant Payer’s Benefit Plan. Not all Covered Services have
a Cost-share. A Cost-share may be calculated in different ways, such as a fixed-amount or percentage of
the total payment due for the Covered Services.
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1.7 “Covered Individual” means an individual who is a beneficiary of a Benefit Plan sponsored
by a Payer that has entered into a Payer Contract, pursuant to which the Covered Individual is entitled to
receive healthcare services, or such other definition as may be included in a Payer Contract.
1.8 “Covered Services” means those services that a Provider is licensed, equipped and staffed
to provide and which Provider provides to Covered Individuals and for which a Payer is required to pay
pursuant to a Payer Contract (including any corresponding definition therein of covered services).
1.9 “Covered Site” means the clinic of a Participating Provider, or the home or other remote
location in which a Covered Individual receives such Covered Services, whether in person through MIH-
CP or via telehealth.
1.10 “Exclusion Database” means the National Practitioner Database and the U.S. Department
of Health and Human Services Office of Inspector General List of Excluded Individuals and Entities.
1.11 “Individual Providers” are those individual employees or contractors of a Provider
involved in the delivery of care to Covered Individuals on behalf of Provider under these Program Terms.
1.12 “HIPAA” means the Health Insurance Portability and Accountability Act of 1996, Public
Law 104-191, the Health Information Technology for Economic and Clinical Health Act of 2009, Public
Law 111-5, the HIPAA Privacy Rule modifying 45 CFR Parts 160 and 164, and the HIPAA Security Rule,
modifying 45 CFR Parts 160, 162 and 164, together with their implementing regulations.
1.13 “Individual Guarantor” has the meaning set forth in Section 3.6.
1.14 “Non-Covered Services” has the meaning set forth in Section 3.5.
1.15 “Participating Providers” means those organizations who have contractually agreed to
participate in CIN’s Payer Contracts. A current roster of Participating Providers will be made available
to Provider upon request.
1.16 “Payer Contracts” means those contracts entered into between CIN and a “Payer” (any
third-party sponsor of a Benefit Plan) for the provision and payment of Covered Services by Participating
Providers.
1.17 “Term” has the meaning set forth in Section 4.1.
ARTICLE II
Participating Provider Responsibilities
2.1 Services. Provider agrees it shall provide and perform (through its Individual Providers,
as applicable) those Covered Services identified at Exhibit A to Covered Individuals and to accept as
payment for such services the amounts set forth therein. Provider agrees to abide by the applicable
policies, procedures, and requirements in the Program Manual(s) (defined in the Paralign General Terms)
related to the administration of these Program Terms.
2.2 Credentialing. Provider shall meet any credentialing standards or other applicable
standards of participation set by any Payer with regard to any Payer Contract in which Provider
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participates, in addition to any qualification standards set by CIN or the MSO for participation in these
Program Terms. Provider must satisfy any credentialing requirements of a Payer before participation in
a Payer Contract and participation in CIN is not a substitute for such credentialing.
2.3 Payer Contracts.
2.3.1 Abide by Contracts. Provider agrees to be, and shall hereby become, bound by all
the terms and conditions of such Payer Contracts as CIN may enter into with Payers that may reasonably
be applied to Provider in the same manner and with the same obligations to Payers and Covered
Individuals as if Provider were a directly contracting party thereto, subject to the provisions of these
Program Terms. Provider shall be bound by each Payer Contract without further or advanced notice,
unless the amount(s) payable to Provider for the Covered Services it provides under such Payer Contract
are less than the amount(s) specified at the then-current Exhibit A. In the event that a Payer Contract
would reimburse Provider in amount(s) less than the amount(s) specified at the then-current Exhibit A,
Provider shall not be bound by such a Payer Contract except upon execution of an agreement to participate,
which specifies the amounts Provider will be reimbursed. Unless Provider executes such an agreement to
participate, Provider shall have elected not to provide Covered Services under any Payer Contract under
which the amounts payable to Provider would be less than the amount(s) specified at the then-current
Exhibit A.
2.3.2 Non-Exclusivity. The contractual relationship established between CIN and
Provider shall not be exclusive in that Provider may enter into any third-party payer contract or participate
in any other network as it may desire. Provider shall not by virtue of these Program Terms have exclusive
rights as to the provision of Covered Services with respect to any Payer Contract. Nothing in these
Program Terms guarantees Provider’s participation in any Payer Contract. Provider recognizes and
acknowledges that Provider’s eligibility to participate in a particular Payer Contract may vary based on
geographic location, the clinical needs of the Covered Individuals and other factors. Provider recognizes
that its eligibility for participation in any individual Payer Contract is subject to the discretion of the
involved Payer and CIN. For example, the CIN may enter into a Payer Contract with a Payer that does
not offer coverage in the geographic area in which Provide offers services. Except as otherwise provided
in these Program Terms, non-participation in a specific Payer Contract(s) shall have no effect on or
consequence to participation in, or rights or obligations under, any other Payer Contract or the CIN
generally.
2.3.3 Payer Contract List. CIN will maintain a listing of Payer Contracts in which Payer
is participating through the CIN and periodically update such listing and furnish it to Provider. Listings
of Payer Contracts may be provided to Provider through electronic access or by other means. Provider
will abide by the terms of these Program Terms as to a Payer Contract entered into by the CIN, even if a
listing of Payer Contracts has not yet been updated to include such Payer Contract.
2.4 Assist Payer and Covered Individuals. Provider agrees to reasonably assist Covered
Individuals to understand and utilize their benefits under a Payer Contract in connection with Covered
Services offered by Provider. Provider acknowledges that Payers may place certain obligations upon CIN
and Provider regarding the quality of care received by Covered Individuals and that certain Payers may
have the right to oversee and review the quality of care administered to Covered Individuals. Provider
shall be bound by the terms of all such quality assurance and utilization review programs imposed by any
Payer Contract that is the subject of these Program Terms or by a Program Manual and shall cooperate
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with each Payer and/or CIN’s review of the quality of care administered to Covered Individuals. Provider
hereby authorizes CIN and the MSO to release to Payers, without Provider’s prior consent, any and all
information, records, summaries of records, and statistical reports specific to Provider and/or its Individual
Providers (including, but not limited to, utilization profiles pertinent to the provision of Covered Services,
professional qualifications, and credentialing information) using Provider’s name, Individual Providers’
names or any applicable code numbers, as requested by Payers. CIN and the MSO may use such
information, records and reports for internal program monitoring and may disclose such information,
records, and reports to Payers, other Participating Providers, prospective Participating Providers, and the
public so long as any public disclosure identifying an Individual Provider’s name or code number is
presented to Provider no fewer than ten (10) business days in advance. If Provider objects to any proposed
disclosure within the ten (10) day period required by this paragraph, no public disclosure may be made of
the specific identity of the Individual Provider.
2.5 Clinical and Financial Integration. Provider agrees to participate in the CIN’s clinical
and financial integration activities, as selected and overseen by the CIN Leadership Council, which is
responsible for developing, reviewing, and revising care pathways and other clinical support tools, as well
as holding the CIN and its participants accountable to defined quality metrics through ongoing data
analytics. Additional information regarding the clinical integration activities in which Provider will be
expected to participate are described in the Program Manuals. Provider shall always retain full
professional discretion within Provider’s scope of practice. While the CIN encourages adherence to care
pathways and the use of clinical support tools, nothing in these Provider Terms or any Program Manual
shall be construed to override or interfere with Provider’s independent clinical judgment in individual
patient care decisions. In instances where Provider elects to deviate from a recommended care pathway,
Provider is encouraged to provide feedback on the rationale to the CIN Leadership Council to support
continuous pathway evaluation and refinement. Provider agrees to nominate a candidate to serve as a
Council Member if requested by MSO, in accordance with the CIN Leadership Council Charter at Exhibit
B, and to participate in providing input to the CIN Leadership Council on an ongoing basis, both
informally through its interaction with Council Members, and in response to formal requests. Provider
acknowledges that as part of the CIN’s financial integration efforts, participation in clinical integration
activities, and the results of such activities, may impact Provider’s compensation as described in Exhibit
A.
2.6 Provider’s Representations and Warranties. Provider affirms and incorporates herein
by reference those representations and warranties contained in the Paralign General Terms.
ARTICLE III
Compensation
3.1 System Integration to Facilitate Payer Reporting and Claims Submission. Clinical
records related to the provision of Covered Services in this Program must be maintained by Provider in
an electronic record platform capable of integration with the MSO’s software for billing and data reporting
purposes. Such an integration must be complete and functional, as determined in the sole discretion of
the CIN, before a Provider can participate in this Program. Provider shall authorize and direct such
implementation in collaboration with CIN and MSO. CIN (through its contract with the MSO) will extract
the necessary data from the Provider’s records of clinical encounters to submit claims or invoices to Payers
and report other performance data, both as required by the Payer Contracts. Clinical records maintained
by Providers must substantiate the services provided and such substantiating records will be provided to
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CIN upon request to facilitate payment and/or verify their sufficiency. Provider shall cooperate with the
coordination of benefits efforts by CIN and Payers.
3.2 Compensation. Provider shall be compensated for Covered Services in accordance with
Exhibit A.
3.3 Collection and Provider Payments.
3.3.1 CIN will bill and collect from the various Payers in accordance with the terms and
conditions contained herein and the applicable Payer’s Payer Contract.
3.3.2 CIN will collect and distribute payment to Provider in the amounts specified herein
for Covered Services rendered to Covered Individuals. CIN will use reasonable efforts to issue payment
to Provider within ten (10) business days after CIN’s receipt of payment for services rendered by Provider
under these Program Terms.
3.3.3 CIN shall have no liability to Provider or any Participating Provider for any
non-payment by a Payer or a Covered Individual. Providers may seek payment from CIN for Covered
Services only to the extent and up to the amount received by CIN from the Payer and/or Covered
Individuals and as limited by the terms set forth in these Program Terms and the exhibits hereto.
Professional services rendered by Provider outside the scope of these Program Terms shall not be billed
by or through CIN, nor shall any Payer have responsibility or liability whatsoever in connection with such
services, nor shall these Program Terms have any force or effect with respect to such services.
3.4 Cost-shares. In connection with the claim submission and reconciliation process, CIN
will receive information from the Payer, third-party administrator, or other persons or entities involved in
the administration of the Covered Individual’s benefits regarding any Cost-share obligations that may
arise in connection with Covered Services, if any. Based on this information, CIN will perform the billing
of the Cost-share obligations and/or direct Participating Providers of the Cost-share amounts to be billed,
up to the total reimbursement rate payable to Provider. Provider agrees to perform the billing of Cost-
share amounts or refrain from billing Cost-share amounts (i.e. to permit CIN or a third party to do so)
pursuant to CIN’s instructions and in accordance with any applicable Program Manual. Neither CIN nor
Provider shall routinely waive Cost-share obligations required by a Benefit Plan, but it is acknowledged
that some Benefit Plans and/or Covered Services will not require Cost-share obligations.
3.5 Non-Covered Services. CIN shall not make any payment to Provider for services rendered
that are not Covered Services (“Non-Covered Services”) under a Payer Contract, and Provider may bill
and collect directly from patients or Payers for such Non-Covered Services in accordance with the
provisions of the agreements among them, if any, and all legal requirements. All amounts so collected
shall be retained by Provider as compensation and shall not be credited towards or otherwise reduce the
amount of compensation payable to Provider under the terms of these Program Terms.
3.6 Hold Covered Individuals Harmless. Except with respect to the collection of Cost-share
amounts in accordance with Section 3.4, as applicable, Provider agrees that in no event, including, but not
limited to, non-payment by CIN of amounts due Provider under this contract, insolvency of CIN, or any
breach of this contract by CIN, shall Provider and its Individual Providers, assignees, or subcontractors
have a right to seek any type of payment from, bill, charge, collect a deposit from, or have any recourse
against Covered Individuals or any individual acting as a guarantor on a Covered Individual’s behalf for
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Covered Services received (an “Individual Guarantor”). The requirements of this paragraph shall survive
any termination of this contract for services rendered prior to such termination, regardless of the cause of
such termination. The Covered Individuals or any Individual Guarantor shall be third-party beneficiaries
of this paragraph only. This paragraph supersedes any oral or written agreement now existing or hereafter
entered into between Provider and such a Covered Individual or Individual Guarantor. This provision
shall not prohibit the collection of debt owed by Covered Individuals or Individual Guarantors to Provider
in connection with services rendered outside these Program Terms.
3.7 No Guarantee of Income or Earnings. Provider agrees that CIN and its affiliates,
Participating Providers and CIN and Participating Provider members, managers, shareholders, directors,
officers, agents, contractors and employees (collectively, the “CIN Representatives”) make no
implications, warranties, promises, representations, or guarantees whatsoever about earnings or income to
Provider in connection with Provider’s participation or status as a Participating Provider. The potential
earnings and income of Provider in connection with these Program Terms may vary and can depend on
many factors including economic, political, social, and regulatory changes, such as changes to the way
consumers and payers reimburse the performance of health care services, changes in the plans and
strategies of competitors of Provider and Provider’s investment of time, effort and skill into the services
related to these Program Terms. No testimonials, prior successes, or past results are a guarantee of
Provider’s income or earnings. Provider acknowledges that any examples, projections, forward-looking
statements, or promotional materials provided by CIN Representatives to Provider regarding potential
earnings or income are samples only and express only the possibility of earning potential, not actual
earnings or financial or operational performance expected. Such materials are not guarantees, promises,
or warranties of any kind, and the CIN Representatives are under no obligation to revise any such materials
in light of new information or future events. There is no assurance that Provider’s status as a Participating
Provider or its participation in CIN and its Payer Contracts will result in any income or earnings to
Provider. CIN and CIN Representatives have not authorized any individual or company to make such a
guarantee, promise or warranty. CIN and CIN Representatives expressly disclaim any warranties or
guarantees that Provider will experience any income or earnings because of these Program Terms.
ARTICLE IV
Term and Termination
4.1 Term. Once Provider has accepted these Program Terms, including the Paralign General
Terms and any Exhibits incorporated herein, the “Term” of these Program Terms will begin and shall
continue until terminated as provided by these Program Terms. CIN will notify Payers of Provider’s
participation, pursuant to the terms of the applicable Payer Contracts. Payers will then load Provider as a
Participating Provider in any systems necessary to facilitate claims/invoice submission and processing.
Provider’s participation in each Payer Contract is dependent upon completion of all applicable notice
periods, loading process and any other credentialing or approval requirements imposed by the applicable
Payer. As a result of this Process, the timing with which Provider becomes eligible to perform Covered
Services for a particular Payer or Covered Individual may vary.
4.2 Termination Because of Death. These Program Terms shall automatically terminate in
the event of the death of all of Provider’s Individual Providers.
4.3 Immediate Termination for Specific Breaches. CIN may immediately terminate these
Program Terms, at CIN’s option, as specified in the Paralign General Terms. This includes, for example
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and without limitation, Provider’s failure to remove Individual Providers from providing services upon a
loss of proper licensure or exclusion from federal or state health care programs.
4.4 Termination After Notice of Default.
4.4.1 Except for those breaches noted in Section 4.3, in the event Provider or CIN shall
default in the performance of any term of these Program Terms, the Program Party not in default may
provide to the other Program Party notice of intent to terminate these Program Terms. The notice shall
state the reason(s) for the early termination. If the default is not cured within thirty (30) days of the date
of the notice, then these Program Terms shall terminate. If the default is cured, then no termination will
occur. The rights granted hereunder shall not be in substitution for, but shall be in addition to, any and all
other rights and remedies for breach of contract available to a non-defaulting Program Party under
Applicable Law.
4.4.2 Provider’s violation of a Program Manual or refusal to accept updated Paralign
General Terms may, at CIN’s option, be treated as a default under this Section 4.4.
4.5 Termination upon Winding up of Company. These Program Terms will automatically
and immediately terminate as of the dissolution and winding up of CIN or Provider.
4.6 Termination for Legal Compliance. CIN will have the unilateral right to terminate these
Program Terms to the extent necessary to comply with applicable law if it is reasonably determined that
continued participation by CIN in these Program Terms without amendment would put either Program
Party at risk of violating any Applicable Law. Prior to termination of these Program Terms pursuant to
this paragraph, CIN will first reasonably attempt to amend these Program Terms in a manner that will
achieve the business purposes hereof and negotiate in good faith with Provider in an effort to achieve a
mutually acceptable amendment. If CIN proposes such an amendment to these Program Terms for
purposes of regulatory compliance and such amendment is unacceptable to Provider, either Program Party
may choose to terminate these Program Terms within such timeframe as necessary to comply with
applicable law. For purposes of this Section 4.6, “reasonably determined” means a determination is made
in good faith after consultation with qualified legal counsel who has experience in matters of healthcare
regulatory law, and after consideration of the relevant facts and circumstances and potential alternative
approaches that might permit continued performance without violation of Applicable Law.
4.7 Termination of Payer Contract Participation. Upon CIN’s receipt of notice from any
Payer with which CIN has executed a Payer Contract requesting, for any reason or no reason, that Provider
or an Individual Provider no longer provide services under a Payer Contract, an Individual Provider’s
participation in such Payer Contract shall terminate upon written notice to Provider. Such termination of
participation in a specific Payer Contract will not cause the termination of these Program Terms.
4.8 Termination Without Cause. These Program Terms may be terminated without cause by
either Program Party upon ninety (90) days’ prior written notice to the other.
4.9 Termination Upon Rejected Modification. These Program Terms may be terminated in
accordance with Section 5.3 (Modification) or as provided in the Paralign General Terms if You reject
updated Paralign General Terms or Program Manuals.
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4.10 Payment Following Termination. After termination of these Program Terms, Provider
shall be entitled to payment as specified herein for Covered Services rendered by Provider prior to the
date of termination. If Provider continues to provide Covered Services that were commenced before the
date of termination to Covered Individuals after the effective date of termination in accordance with the
requirements of these Program Terms, Provider shall be entitled to continue receiving payment for such
services at the rate specified herein until such Covered Services being rendered by Provider are completed.
ARTICLE V
Miscellaneous Provisions
5.1 Indemnification.
5.1.1 Provider’s Indemnification. Provider shall, to the maximum extent permissible by
law, indemnify, defend, and hold harmless CIN and MSO, including such entities’ shareholders, directors,
officers, agents, and employees (collectively, the “CIN Indemnified Parties”) for and from any and all
liability, loss, expenses (including reasonable attorneys’ fees) and claims for damages for injury arising
from acts or omissions by Provider arising from Provider’s own gross negligence or willful misconduct,
any Individual Providers (including any loss of licensure, adverse licensure or credentialing action, or
exclusion/suspension from participation in a federal or state healthcare program or other Benefit Plan) or
any officer, agent or employee of Provider, in the rendering of any healthcare services, or arising from
any breach or default on the part of Provider with respect to the representations and warranties made in
these Program Terms (including the Paralign General Terms) or in Provider’s performance of these
Program Terms. Provider, upon prompt notice from CIN or any person or entity indemnified hereunder,
shall defend, at the expense of Provider, such action or proceeding. Notwithstanding anything to the
contrary in these Program Terms, Provider’s obligations under this Section specifically exclude first party
or direct claims against Provider by an indemnified party, or any claim for which a sole and exclusive
remedy is provided under another section of these Program Terms.
5.1.2 CIN’s Indemnification. CIN agrees to indemnify, defend and hold harmless
Provider, Provider’s Individual Providers and Provider’s shareholders, directors, officers, agents and
employees (collectively, the “Provider Indemnified Parties”) for and from any and all liability, loss,
expenses (including reasonable attorneys’ fees) and claims for damages for injury arising from acts or
omissions by CIN, its officers, agents and employees, or arising from any breach or default on the part of
CIN in the performance of these Program Terms. CIN, upon prompt notice from Provider, shall defend,
at the expense of CIN, such action or proceeding. Notwithstanding anything to the contrary in these
Program Terms, CIN’s obligations under this Section specifically exclude first party or direct claims
against CIN by an indemnified party, or any claim for which a sole and exclusive remedy is provided
under another section of these Program Terms.
5.1.3 Payment Adjustments for Insurance Proceeds. Payments by an indemnifying party
under section 5.1.1 or 5.1.2 are limited to the amount of any liability, loss or damage that remains after
deducting therefrom any insurance proceeds and any indemnity, contribution, or other similar payment
actually received by the indemnified party in respect of the indemnity claim, less any related costs and
expenses, including the aggregate cost of pursuing any related insurance claims and any related increases
in premiums or other charge-backs. An indemnified party shall use commercially reasonable efforts to
seek to recover any insurance proceeds available in connection with an indemnity claim. Promptly after
realization of any insurance proceeds, indemnity, contribution, or other similar payment, an indemnified
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party shall reimburse the indemnifying party for such reduction in losses for which it was paid under
section 5.1.1 or 5.1.2 before the realization of reduction of such losses.
5.1.4 Cooperation. Each Program Party may from time to time be faced with certain
legal issues, actions or claims arising from or relating to these Program Terms. Each Program Party
recognizes the value of cooperating with the other in good faith in such event, to the extent such
cooperation does not violate applicable law, result in a breach of any insurance policy, or result in a breach
of any confidentiality or privilege. Each Program Party agrees to notify the other promptly, and within
fourteen (14) days, of receipt of any lawsuit, claim, regulatory action, or notice of intent to file a lawsuit
based in any part on these Program Terms or services provided hereunder. Each Program Party agrees to
provide the other with any and all information it possesses which is necessary to the other Program Party’s
defense in litigation arising under or related to these Program Terms and which is not reasonably available
from another source or subject to laws of confidentiality, attorney-client privilege and work product. The
Program Parties shall cooperate in good faith, using best efforts, to address issues in a manner that strongly
encourages full cooperation between the Program Parties.
5.2 Assignment. These Program Terms shall be binding upon and inure to the benefit of the
Program Parties hereto. Neither CIN nor Provider may assign or transfer their rights and responsibilities
under these Program Terms without the written consent of the other Program Party, provided that CIN
may subcontract and/or assign its rights and responsibilities to the MSO (which may subcontract and/or
assign the same), or in connection with a merger, acquisition, or sale of all or substantially all of its assets,
or to any subsidiary or parent company of CIN, or to any affiliate of the Innovator companies in connection
with a corporate reorganization.
5.3 Modification. CIN may periodically update the terms of these Program Terms with no
fewer than thirty (30) days’ advanced notice. If at any time such an update is not acceptable to you, you
must notify CIN within thirty (30) days of the notice of the update. In response to a notice that you have
rejected any updated term or condition of these Program Terms, CIN will have the option to terminate
these Program Terms upon thirty (30) days’ notice. Amendments and updates may be made via electronic
means as described in the Paralign General Terms. The rights of the Program Parties under this paragraph
are not intended to limit and are subordinate to the rights granted by Section 4.6 (Termination for Legal
Compliance).
5.4 Entire Agreement. The entire agreement between the Program Parties is comprised of:
(a) these Program Terms, together with its exhibits; (b) the Paralign General Terms, except where
expressly contradicted by the terms of these Program Terms (see Exhibit D); (c) all Business Associate
Agreements required in connection with these Program Terms (see Exhibit E); (d) the Organized Health
Care Arrangement Acknowledgment required in connection with these Program Terms (see Exhibit C),
and (d) all Program Manuals relevant to these Program Terms. Any prior agreement of the Program
Parties, including, but not limited to, prior written or oral agreements, promises, negotiations or
representations relating to the subject matter of these Program Terms that are not contained in the
documents listed in this paragraph are of no force and effect.
5.5 Third-Party Rights. The Provider Indemnified Parties and CIN Indemnified Parties shall
be third-party beneficiaries of Section 5.1 only. Third-party rights and beneficiary status shall otherwise
be as described in the Paralign General Terms.
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5.6 Maintenance of Records after Termination. Both Program Parties will maintain records,
and Provider shall ensure that its Individual Providers maintain records and provide such information to
the other Program Party and to appropriate state and federal authorities as may be necessary for
compliance by the Company with the provisions of applicable law. This obligation is not terminated upon
a termination or expiration of these Program Terms.
5.7 Quality Metrics. Notwithstanding any provision of these Program Terms regarding the
confidentiality or proprietary nature of information, it is agreed that CIN and MSO are expressly permitted
to disclose and publish information concerning the quality and price of care delivered pursuant to these
Program Terms where such information has been aggregated with that of other Participating Providers
and where such disclosure is permitted under applicable law.
5.8 HIPAA Compliance. Both Program Parties agree to abide by applicable law regarding
confidentiality of protected health information and other personally identifiable information. The
disclosure or use of protected health information in connection with these Program Terms will generally
be made as part of the CIN Organized Health Care Arrangement (“Paralign OHCA”) in accordance with
Exhibit C. CIN and MSO have entered into Business Associate Agreements with the Paralign OHCA for
the services they provide for the Paralign OHCA. By accepting these Program Terms, You agree to the
terms of such Business Associate Agreements, copies of which are set forth at Exhibit E and incorporated
herein by reference.
5.9 Survival. The Paralign General Terms shall survive the termination of these Program
Terms as specified in the Paralign General Terms. In addition, the terms of these Program Terms that by
their terms or nature are intended to survive termination will survive termination, including, without
limitation, Article III (as to services rendered prior to termination), Section 4.10 (Payment Following
Termination), Section 5.1 (Indemnification), Section 5.2 (Assignment), Section 5.4 (Entire Agreement),
Section 5.5 (Third-Party Rights), Section 5.6 (Maintenance of Records after Termination), section 5.7
(Quality Metrics), Section 5.8 (HIPAA Compliance), Section 5.10 (Further Assurances), Section 5.11
(Incorporation by Reference), Section 5.12 (Notices), and such terms as may be specified as surviving
termination in the General Terms, Business Associate Agreement, and any other exhibit or document
incorporated into these Program Terms by reference.
5.10 Further Assurances. Provider and CIN shall execute all documents and instruments and
take all further actions as may be reasonably necessary or convenient in order to effectuate the terms of
these Program Terms and the intentions of the Program Parties.
5.11 Incorporation by Reference. Every exhibit and Program Manual attached to these
Program Terms or referred to herein is incorporated in these Program Terms by reference. The terms and
conditions of the Paralign General Terms are incorporated herein, except where expressly contradicted by
the terms of these Program Terms.
5.12 Notices. All notices between the Program Parties will be made in accordance with the
Paralign General Terms.
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Exhibit C: Paralign OHCA
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Exhibit A: Services and Reimbursement
Scope of Services
As a Provider in the Paralign MIH-CP Program, You will provide community paramedicine and mobile
integrated health services through Individual Providers who meet state law requirements with regard to
their training and licensure to provide such services. Such Individual Providers may include, without
limitation, community paramedics, community emergency medical technicians, and community health
workers. As a Provider, You are responsible for verifying the qualifications and licensure of each
Individual Provider and satisfying all other requirements under the General Terms. You shall at all times
ensure that Individual Providers offer only such services as fall within their scope of practice, considering
Applicable Law (including state EMS regulations), local medical director protocols, and the certification
and training levels of the Individual Providers.
You grant CIN and MSO the authority to enter into Payer Contracts concerning Your services in
accordance with the Program Terms and this Exhibit A.
Reimbursement Rates
You will be compensated at a pre-determined minimum rate (the “Minimum Rate”) of One Hundred
Thirty Five Dollars ($135.00) per hour for Covered Services rendered under these Provider Terms,
rounded to the nearest fifteen (15) minute increment, provided that total compensation for a single home
visit shall not exceed the Minimum Rate. Your records of clinical care provided must include an accurate
representation of time spent delivering Covered Services. Your actual reimbursement rate will consist of
the reimbursement rate payable under the applicable Payer Contract held by the CIN, less a risk-sharing
withhold (the “Withhold”) established by the CIN Leadership Council. The CIN Leadership Council may
not authorize a Withhold that would result in a payment rate to You that is less than your Minimum Rate.
Each Withhold amount shall be held by the CIN in a dedicated fund referred to as the “Risk Pool.” Risk
Pool funds shall be available for additional performance-based payments to participating providers in
accordance with performance-based payment methodologies established by the CIN Leadership Council,
which shall at all times comply with Applicable Law. No performance-based payment methodology may
take into account the volume or value of referrals or business generated among participating providers.
At the end of a calendar year, Risk Pool funds unclaimed in connection with such performance-based
payment methodologies may be reinvested by the CIN Leadership Council into shared resources in
connection with furtherance of quality improvement activities and objectives. You agree to accept the
Minimum Rate as payment in full, or such greater rates as may be negotiated by the CIN with respect to
a Payer Contract.
CIN may enter into and terminate a Payer Contract at any time in its sole discretion and in accordance
with the termination provisions of such Payer Contract. CIN and Payers may amend Payer Contracts from
time to time without Your consent. You agree to participate in, and become bound by, the terms and
conditions of the CIN’s Payer Contracts as may be reasonably be applied to You in the same manner as if
You were a directly contracting party to such Payer Contracts. You shall be bound by and begin
participation in any Payer Contract entered into by CIN without further notice, unless the amount payable
to You for Your Covered Services would be less than the Minimum Rate specified in Table I, as may be
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Exhibit C: Paralign OHCA
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modified from time to time in accordance with this Exhibit A. In the event that a Payer Contract would
reimburse You in an amount less than the Minimum Rate, You shall not be bound by such Payer Contract
or required to deliver services in connection with such Payer Contract, unless you agree in writing in
advance to participate in such Payer Contract at a different rate, which shall have no impact on the
Minimum Rate applicable to Your services under other Payer Contracts.
Management Fees
You will not be required to pay any upfront fees to join this Program. MSO charges a management
fee for performing the operations required to successfully implement and operate this program,
including negotiation of payer contracts, claim/invoice submission, disbursement of funds to
participating providers, management of the risk pools, data analysis and reporting to Payers and the CIN
Leadership Council, assistance with the development of care pathways, and day-to-day administration of
the Program. MSO’s management fee shall not reduce the rate otherwise payable to a participating
provider for the delivery of Covered Services under a Payer Contract. Rather, CIN (through the
assistance of the MSO) will negotiate with Payers and request additional performance-based
reimbursement under the Payer Contracts, such as payments based on achievement of certain target
metrics or cost-savings.
When the CIN is successful in negotiating performance-based reimbursement and earns performance-
based payments under a Payer Contract, the total performance-based payment received shall be allocated
among the MSO, the Wisconsin EMS Association (“WEMSA”), and the CIN Risk Pool as described in
this paragraph. Such payments to the MSO under the first tranche shall be payment in full of MSO’s
management fee. MSO shall receive the initial tranche of funds, in an amount not to exceed Three
Hundred and Fifty Dollars ($350.00) per patient (Benefit Plan member) to whom Covered Services were
delivered under the applicable Payer Contract during the time period to which the performance-based
payment relates (the “Tranche Cap”). If the total funds available allow, WEMSA shall receive the next
tranche, also not to exceed the Tranche Cap. If funds remain available thereafter, the CIN Risk Pool
shall receive the subsequent tranche, also not to exceed the Tranche Cap. The foregoing three tranches
shall constitute the full allocation sequence per patient, each in an amount not to exceed the Tranche
Cap, until the total performance-based payment received by CIN has been distributed. In the event the
circumstances of a specific Payer Contract make a different dollar amount appropriate for the Tranche
Cap, MSO shall propose such alternate Tranche Cap to the CIN Leadership Council, and You agree that
the CIN Leadership Council may approve application of the alternate Tranche Cap for such specific
Payer Contract without MSO or CIN obtaining Your approval or the approval of each participating
provider. (For example, if a Payer Contract requires a substantial investment by MSO at the outset,
MSO may request a higher Tranche Cap to recoup such up-front expenditure.)
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Exhibit C: Paralign OHCA
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Exhibit B: CIN Leadership Council Charter
Purpose and Scope
The CIN Leadership Council (“Council”) is hereby established to provide strategic oversight and
coordination regarding the clinical and financial integration activities of the Paralign Clinically Integrated
Network (“CIN”), and across its key operational domains, in collaboration with Paralign Health (“MSO”),
including:
• Healthcare quality improvement, including development and refinement of care pathways
• Payer and provider contracting, including value-based and risk-bearing initiatives
• Information technology, digital infrastructure and data governance
The Council provides direction and input to MSO and collaborates with MSO to implement the Paralign
MIH-CP Program (the “Program”). The Council ensures alignment of CIN activities with its mission to
lower costs of care and improve clinical outcomes through deployment of mobile resources to patient
homes and community settings to proactively manage patient health.
The Council works in collaboration with MSO to develop and refine:
• Strategic initiatives and policies related to IT systems and data governance
• Care pathways, best practices regarding patient experience, and clinical support tools
• Provider Manual content related to the delivery of clinical care
Together, the Council and MSO:
• Guide payer contracting strategies, including negotiation and execution of value-based agreements
• Monitor performance metrics and ensure accountability across CIN participants
The Council does not engage in the general corporate governance of CIN or in contravention of its Articles
of Organization as a Delaware limited liability company.
MSO does not interfere with the professional judgment of participating providers, or the provider-patient
relationship and the Council represents the voice of the participating providers in reviewing Program
materials to guard against such interference. The Council promptly notifies MSO of any concerns in that
regard.
Council Members
The Council is comprised of Council Members appointed by MSO. Individuals affiliated with
participating provider organizations may apply to serve as a Council Member by submitting a statement
of interest outlining the candidate’s qualifications and commitment to CIN’s mission. A minimum of two
signatures of support from representatives of a different participating provider organization within the
CIN must accompany the statement of interest.
A determination of the appropriate Council size and appointment decisions will be made by MSO on an
annual basis after input from the current Council (after the initial year of implementation) and
consideration of the following criteria:
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Exhibit C: Paralign OHCA
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• Candidates’ experience and expertise in clinical care, healthcare operations, technology,
compliance matters, or payer contracting
• Representation from a diverse mix of provider organizations, areas of expertise, clinical licensure
types, practice settings and geographies
• Candidates’ historical commitment to service on subcommittees or workgroups, and other forms
of collaboration with other CIN participants
• The need to ensure overall sufficiency of clinical input and participation across the CIN
In the event an insufficient number of applications are received, or the applications received do not, in the
discretion of MSO, after input from the current Council, achieve adequate levels of clinical participation
or diversity across provider types, practice settings, or geographies, MSO may require any or all
participating provider organizations to nominate a candidate and supply information outlining such
nominee’s qualifications for the role.
To promote continuity and institutional knowledge within the Council, Council Member’s terms are
staggered as follows:
• Each Council Member serves a two-year term, with the option for renewal upon re-election
• In the first year of implementation, the MSO will designate half of the initial Council Members to
serve one-year terms, after which they may be reelected to a full two-year term.
Meetings
The Council meets at least quarterly, or more frequently as needed. A quorum is achieved by a simple
majority of Council Members. Guests may be invited or permitted in the discretion of the Council, and
individuals wishing to attend a meeting or comment on an agenda item may request attendance by
contacting any Council Member. Meeting agendas and minutes are distributed in advance and archived
for reference, and both are made available for review by all participating providers. Decisions are made
by simple majority vote of Council Members present at a meeting or may be made by written consent of
a majority of Council Members.
Council Members elect a Chair annually by plurality vote of the Council Members. The Council Chair or
their designee, if unavailable, presides over meetings. To promote inclusive participation across the
geographically dispersed CIN, meetings shall generally be conducted virtually or in hybrid format.
Subcommittees and Workgroups
The Council promotes collaboration among participating providers and between participating providers
and MSO, and champions continuous improvement of the CIN and its participating providers through
data-driven insights.
The Council may establish subcommittees or workgroups, in its discretion, to focus on specific domains,
such as the following:
• Digital Infrastructure Subcommittee: Provides input into IT infrastructure related to the program,
data standards, interoperability, vendor selection, privacy and security.
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Exhibit C: Paralign OHCA
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• Quality Oversight Subcommittee: Develops and revises care pathways, monitors quality metrics,
and supports clinical decision-making tools.
• Contracting Subcommittee: Evaluates payer and provider contracting opportunities, including
value-based contracts and risk-sharing, and supports financial modeling.
Subcommittees and workgroups, if any, shall report regularly to the full Council, and may include as
members individuals who are not Council Members.
Compliance
The Council works to ensure CIN activities and initiatives comply with applicable laws and regulations
and the ethical duties of participating providers with respect to their patients. The Council may adopt
policies and procedures to assist CIN and its participating providers in meeting their legal and ethical
obligations. The Council is particularly mindful of maintaining the privacy and security of personal
health information and compliance with HIPAA and state-law equivalents, and of ensuring collaboration
among participating providers is procompetitive in nature in accordance with state and federal antitrust
guidance, and does not violate state or federal fraud and abuse laws, such as the False Claims Act, Anti-
Kickback Statute, Physician Self-Referral Law, Civil Monetary Penalties Law, or the Beneficiary
Inducement Statute.
The Council may maintain a confidential peer review process to evaluate concerns regarding patient
safety, quality of care, unprofessional conduct, or other conduct inconsistent with the expectations and
requirements of the Program. The Council endeavors to conduct peer review activities in accordance
with such state and federal protections as may be available based on the relevant geography and
circumstances to provide immunity and/or evidentiary privilege and encourage candid review. Peer
review activities must be conducted in good faith and the Council does not allow such processes to be
used for political or economic gain or to address interpersonal disputes unrelated to the legitimate
purposes of the peer review process.
Review and Amendment
The Council reviews this Charter annually and amends it as needed by majority vote, subject to approval
by the MSO.
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Exhibit D: Paralign General Terms Page 1
MBF\894496\0001\52209014.v1-11/25/25
Exhibit C: Paralign OHCA Declaration
Paralign CIN, LLC is a clinically and financially integrated network (“CIN”) comprised of participating
providers who hold themselves out to the public as participating in a joint arrangement whereby they
engage in the delivery of coordinated mobile integrated health and community paramedicine in
collaboration with Paralign Health (the “Paralign MIH-CP Program”). To assist the OHCA and its
participating Covered Entities in the delivery of coordinated mobile integrated health and community
paramedicine, as further described in the Program Terms for Participating Providers in the Paralign MIH-
CP Program, MSO and CIN shall each independently act as a Business Associate to the Covered Entities
of the OHCA. The participating providers are Covered Entities who engage with one another and with
Paralign Health to deliver the Paralign MIH-CP Program to payers and patients, including, without
limitation, the following activities:
• Quality assessment and improvement activities in which information regarding treatment provided
by participating providers is assessed by other participants and/or Paralign Health; and
• Sharing of financial risk for delivering health care, in which PHI created by a participating provider
may be reviewed by other participating providers and/or Paralign for purposes of administering
the sharing of financial risk.
Together, the CIN’s participating providers who have accepted Program Terms to participate in the
Paralign MIH-CP Program are an Organized Health Care Arrangement (the “Paralign OHCA”) pursuant
to the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) because of such
activities. This Declaration is effective beginning on the dates such activities begin and shall remain
effective until such activities cease, provided that when any individual Covered Entity ceases
participation in the Paralign MIH-CP Program (as evidenced by termination of the Program Terms and
any subsequent activities required thereby in connection with care rendered prior to such termination),
such individual Covered Entity shall no longer participate in the Paralign OHCA, except with respect to
the exchange of information related to the activities of the OHCA involving such Covered Entity during
the Covered Entity’s time as a participant in the Paralign OHCA.
Paralign CIN, LLC makes this OHCA declaration by the below signature of its Manager, Paralign
Health, Inc.
SO DECLARED:
___________________________
[Paralign authorized representative]
This ____ day of ________, 2025
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Exhibit D: Paralign General Terms Page 2
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Exhibit D: Paralign General Terms
Please read these Paralign General Terms carefully, because they impact Your organization’s
legal rights and responsibilities and include important topics such as confidentiality,
indemnification, disclaimers of implied warranties, and limits on liability.
Throughout these Paralign General Terms, your organization may be referred to as “You, “Your,” or as
a “Partner.” Paralign programs each have a program-specific set of Program Terms, which specify
activities and obligations specific to the program. To achieve consistency across programs and avoid
repetition of standard terms in and across numerous documents, these Paralign General Terms are
incorporated by reference into all Program Terms and may be incorporated by reference (where
explicitly noted) into other agreements between You and Paralign. If Program Terms expressly conflict
with these Paralign General Terms, the Program Terms prevail. Whenever possible, however, Program
Terms and Paralign General Terms will be interpreted as complementary and supplementary to one
another. When You enter into Program Terms with Paralign or one of its wholly owned subsidiaries,
these Paralign General Terms are incorporated into such Program Terms and references to “Paralign” in
the Paralign General Terms refer to the Paralign company 3 that is a Program Party to such Program
Terms. Throughout these Paralign General Terms, Paralign may be referred to as “We,” “Our,” or “Us.”
1. Independence of Partners. In connection with Paralign programs, some Partners are authorized
to use Paralign’s brands or to describe their affiliation with Paralign using phrases like “in
partnership with Paralign.” Similarly, when providing services in connection with a program, a
Partner may be permitted to use certain Paralign brands. These might include, for example,
“Paralign,” “Paralign MIH-CP Program,” or various taglines and service marks specific to a
program. References to these brands or to a third party as a “Partner” to Paralign are not
intended to suggest any ownership, employment, endorsement or agency relationship between
Paralign and any health care facility, health care provider, or other third party, which is
expressly disclaimed. Paralign helps health plans and healthcare providers identify and engage
with one another and patients in need of their services and benefits. The use of Paralign
branding by such a business Partner means only that the third party has satisfied certain
requirements set by Paralign and received a license to use of one or more Paralign brands.
Claims, obligations, liabilities, or causes of action (whether in contract, common or
statutory law, equity or otherwise) that arise out of or relate to services delivered by a
Partner (including, without limitation, a healthcare provider or health plan, and any
representation made by such a company) may be asserted only against the Partner and
not Paralign. Paralign shall have no liability for any such claims, obligations, liabilities
or causes of action and You hereby waive and releases any liability, claim, cause of action
or obligation against Paralign in connection with the obligations, actions or omissions of
other third-party Partners. For example, You agree that if you believe another Partner has
performed services, such as clinical health care services, in a manner that is negligent, You can
pursue claims and other remedies against the Partner who was the provider of the services but
may not assert a claim for such negligence against Paralign. Paralign does not take on liability
3 The Paralign companies include Paralign Health, Inc. and its wholly owned subsidiaries. The Program Parties for each
program are specified in the Program Terms. Where these General Terms are incorporated into an agreement between You
and Paralign other than Program Terms, “Paralign” refers to the one or more Paralign companies that are party to such
agreement.
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Exhibit D: Paralign General Terms Page 3
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for the conduct of its Partners. Paralign is not itself a healthcare provider or a health
plan and is not responsible for the provision of healthcare services or health benefits. As
a Partner, You acknowledge that the terms of this paragraph apply to Your own activities and
use of Paralign brands. To the extent Paralign offers forums for communication between
Partners, patients, and/or other interested individuals/organizations, We will not be directly or
indirectly liable for any content posted by a third party. The limitations on liability and
disclaimers contained in this paragraph will survive the termination of all Program Terms and
these Paralign General Terms.
2. Partner’s Indemnification. You agree, to the maximum extent permitted by law, to indemnify,
defend and hold harmless Paralign, and the directors, officers, employees, agents, employees
and affiliates of any Paralign entity (the “Indemnified Parties”), from and against any and all
losses, claims, damages, liabilities, costs and expenses (including, without limitation,
reasonable attorneys’ fees and costs) advanced by third parties and arising from your
representations under these Paralign General Terms or any Program Terms or Your failure to
perform obligations under these Paralign General Terms or any Program Terms. This
indemnification obligation applies whether you purchase, deliver, sell or perform products or
services in connection with any Program Terms. For purposes of this paragraph, your actions
include those of your employees, agents, affiliates or representatives. The terms of this
paragraph will survive the termination of all Program Terms and these Paralign General Terms.
The terms of this paragraph set a minimum indemnification obligation, and additional
indemnification obligations may be included in Program Terms, which shall be supplementary
and in addition to the indemnification terms of this paragraph.
3. Third-Party Beneficiaries. Except with respect to the right to indemnification of Indemnified
Parties under paragraph 2 above, these Paralign General Terms are not intended to give any
legal or equitable right, remedy, or claim to any third party, and there are no third-party
beneficiaries to these Paralign General Terms.
4. Confidential Information. All information and material disclosed in contemplation of or in
connection with your participation in a Program which is not generally known to the public and
which in the ordinary course of business is maintained by Paralign or a Partner as confidential
shall be “Confidential Information” and remain proprietary to the disclosing company. You
agree not to disclose or use such Confidential Information, and Paralign agrees not to disclose
or use such Confidential Information except: (i) as explicitly permitted by Program Terms; (ii)
as required to provide services or products or otherwise perform obligations described in
Program Terms; (iii) upon the express written consent of the disclosing company; (iv) as
required by any Applicable Law; (v) Paralign or a Partner may disclose Confidential
Information to its lenders, legal and business advisors who have agreed to the obligations in
this paragraph for its own internal purposes. Before disclosing Confidential Information in
accordance with any legal proceeding or based on the belief that such disclosure is required by
Applicable Law, commercially reasonable efforts must be made to notify the company to which
the Confidential Information belongs, unless providing such notice is legally prohibited or the
legal process or obligation involves a danger of death or serious physical injury. Confidential
Information shall not include any information that is or becomes generally available to the
public other than as a result of a breach of the confidentiality requirements of these Paralign
Page 45 of 125
Exhibit D: Paralign General Terms Page 4
MBF\894496\0001\52209014.v1-11/25/25
General Terms, Program Terms or another legal obligation, and shall not include information
that was rightfully in the recipient’s possession prior to receipt from the disclosing company in
connection with a Paralign program. Paralign may disclose your identity as a Partner to carry
out their obligations under Program Terms and to generally promote Paralign programs. This
means that Paralign may disclose to third parties that you are a Partner and/or that you have
entered into one or more agreements with Paralign. Upon termination of your participation in
a program (in accordance with applicable Program Terms), or if you decide after review not to
participate in a program to which Confidential Information relates, You and Paralign will return
or destroy all Confidential Information received in connection with such program, provided that
each receiving party shall be permitted to retain copies solely for archival, audit, disaster
recovery, legal or regulatory purposes and will not be required to search archived electronic
back-up files in order to purge Confidential Information from its archived files. Any
Confidential Information retained beyond the termination Program Terms, or Your decision
not to enter into Program Terms, remains subject to the obligations and restrictions contained
in this paragraph regarding Confidential Information, which shall survive the termination of all
Program Terms and/or these Paralign General Terms. We may, but are not required to, provide
You opportunities to post text, photographs, videos or other content in forums accessible by
other Partners. You represent that you own all the rights to any content you post, or that you
have permission from the owner of such content. You do not transfer ownership of content by
posting it, but grant Us an irrevocable, perpetual and non-exclusive license to reproduce,
encode, store, copy, transmit, publish, post, broadcast, display, create derivative works from,
and otherwise use the content You post to a forum, without any obligation to you. This license
does not extend to any Protected Health Information, as defined under Applicable Law.
5. Use of Brands and Description of Programs. Partners may use the names, trademarks, service
marks, domain names, logos and other distinctive brand features of other Partners only in
connection with and during the term of a Program Terms and only in accordance with these
Paralign General Terms, and any brand guidelines that may be issued by the owner of such
intellectual property from time to time. For example, a Partner that is a healthcare provider may
use the logo of a Partner that is a health benefit plan to illustrate to its staff or patients that it is
an “in network” provider for such health benefit plan. All uses not in compliance with a
Partner’s brand guidelines require the express written approval of the Partner who owns such
intellectual property. No Partner is under any obligation to continue its current affiliation with
any of its own affiliates and each Partner agrees to immediately cease all use of the intellectual
property of any affiliate of another Partner upon written request by Paralign or the applicable
Partner. Each Party will immediately cease all use of the brands or intellectual property of the
other Party upon termination of all Program Terms (and, as applicable, Program Management
Terms) and You will immediately cease all use of the brands or intellectual property of other
Partners upon termination of Program Terms involving such Partners, unless authorized by
separate agreements directly with another Partner. If you want to develop your own
descriptions, summaries and/or promotional materials describing any Paralign program,
you agree to obtain Paralign’s prior written approval of all such materials. The purpose of
such approval is to comply with various state law requirements and to avoid inadvertent
misstatements or consumer confusion. Descriptions, summaries and/or promotional materials
you develop are subject to your indemnification obligations under these Paralign General
Terms, in addition to any other remedies available to Paralign or its Partners at law and equity.
Page 46 of 125
Exhibit D: Paralign General Terms Page 5
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For example, if Paralign becomes the subject of a lawsuit alleging Your description of a
Program misrepresents the nature, scope or services available in connection with the Program,
You will at a minimum defend and indemnify Paralign against all such claims. Your use of
descriptions, summaries and/or promotional materials supplied by third parties other than
Paralign (including your consultants, marketing agency, or other vendors) is subject to the same
pre-approval process as materials you develop directly, and your use of such materials is
subject to your indemnification obligations under these Paralign General Terms. You agree not
to alter or edit any materials provided by Paralign describing a Program, except with Paralign’s
express permission.
6. Program Manuals. Paralign and its Partners may develop manuals of administrative and
operational policies and procedures specific to a program (each a “Program Manual”).
Paralign will provide You with any Program Manual that applies to the Program(s) You join.
You agree to abide by these Program Manuals, as may be amended from time to time by
Paralign or the applicable Paralign affiliated Program Party and agree that all Program Manuals
are Confidential Information. If the contents of a Program Manual are in direct conflict with the
terms or legal obligations arising from related Program Terms or these Paralign General Terms,
the Program Terms, and these Paralign General Terms will prevail and apply over the Program
Manual. Whenever possible, these Paralign General Terms, Program Terms, and Program
Manuals will be interpreted as complementary and supplementary. At no time will any policy,
manual or procedure set by Paralign, whether contained in a Program Manual or elsewhere,
interfere with any professional service provider’s exclusive authority and control over the
practice of such profession. For example, policies and procedures will not interfere with a
health care provider’s exclusive authority and control over the practice of medicine or other
professional health care services, such as determinations of diagnosis or treatment. New or
modified Program Manual terms become effective automatically if you do not reject them
within thirty (30) days per the commercially reasonable instructions in the notice provided to
You of the new or modified Program Manual terms. If You reject any updated Program Manual,
Paralign has the option to terminate any Program Terms you previously accepted upon thirty
(30) days’ written notice, unless otherwise specified in your Program Terms. If you reject an
update to the Program Manual, and the corresponding Program Terms are not terminated by
Paralign, the version of the Program Manual predating the rejected update will remain in effect.
7. Assignment. Neither Paralign nor any Partner may assign or transfer any interest in the Program
Terms or these Paralign General Terms, in whole or in part, without the prior written consent
of the other Party, except that Paralign may assign the Program Terms and these Paralign
General Terms to the purchaser of all or substantially all of its assets or business related to the
same, so long as the assignee must comply with these Paralign General Terms and all Program
Terms. Paralign may subcontract its obligations or lease, assign, or allow third-party payers,
administrators and other organizations (including, for example, coalitions of self-funded
employers) to access Programs and include them in offerings to their customers, provided that
the third-party must comply with all terms and conditions of any applicable Program Terms,
these Paralign General Terms, and Applicable Law. If you provide health care services in a
Program, Paralign will provide to you, upon your request, a written or electronic list of all
current payors and administrators to which your services have been sold, leased, assigned,
assumed or otherwise delegated. If you acquire or merge with another organization or
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Exhibit D: Paralign General Terms Page 6
MBF\894496\0001\52209014.v1-11/25/25
acquire a controlling equity interest in another organization, you must notify Paralign so
that we may evaluate the eligibility of such organization to participate in each Program
in which you participate. You acknowledge that Programs do not automatically extend
to any third party you acquire or merge with, and that Paralign must confirm their
eligibility for various Programs.
8. Amendments. You are encouraged to keep up to date copies of Program Terms and these
Paralign General Terms for Your own files related to any Programs You join. Paralign may
periodically update these Paralign General Terms. The updated version of these Paralign
General Terms will automatically apply to Program Terms You accept after the date of the
update. You will be provided notice of updates to the Paralign General Terms with respect to
any Programs you have already joined. Updates become effective automatically if you do not
reject them within thirty (30) days per the commercially reasonable instructions in the notice.
Please let us know if you have any questions or concerns about an update. If you reject any
updated Paralign General Terms, Paralign has the option to terminate any Program Terms you
previously accepted upon thirty (30) days’ written notice, unless otherwise specified in your
Program Terms. If you reject updated Paralign General Terms and Paralign does not terminate
Your participation in one or more programs under Your existing Program Terms, the version
of the Paralign General Terms in effect prior to the rejected update will remain in effect. Except
as provided in this paragraph, Paralign General Terms may only be modified upon written
agreement of You and Paralign.
9. Notices. All notices between You and Paralign will be effective: when displayed electronically
to you upon log-in to an electronic account assigned to You by Paralign; upon sending by
electronic mail; upon hand delivery; three (3) business days after deposit in the United States
mail postage prepaid; or when delivered by a nationally recognized overnight delivery service.
The email and mailing addresses Paralign will use to provide you notice are those designated
on the Paralign Intake Form as the email and/or mailing address for all legal notices to You, or,
if no such central addresses have been provided, to the contact information provided to Us
when you joined a Program. You or Paralign may change the contact information to be used
for notice purposes by giving notice to the other in accordance with this paragraph. Currently,
the mailing address for Paralign is _____________________ and the appropriate email address
for notices required under these Paralign General Terms or any notice due to Paralign in
connection with Program Terms is: hello@paralignhealth.com. Notice from any Paralign
company to You will be deemed to have been given by all Paralign companies with respect to
the subject matter of the notice, and notice from You to a Paralign company will be deemed to
have been given to all Paralign companies with respect to the subject matter of the notice, in
order to eliminate unnecessary redundant notices.
10. Limited Use. You agree not to: (i) license, sublicense, sell, resell, transfer, assign, distribute or
otherwise commercially exploit or make available to any third party the goods or services
provided by Paralign in any way without the express written consent of Paralign; (ii) modify or
make derivative works based upon the goods or services provided by Paralign; or (iii) access,
use or disclose the goods or services provided by Paralign in order to build a competitive
product or service. For the avoidance of doubt, nothing in this paragraph shall be deemed to
prohibit you from utilizing the materials and services provided by Paralign for your internal
Page 48 of 125
Exhibit D: Paralign General Terms Page 7
MBF\894496\0001\52209014.v1-11/25/25
business purposes in connection with any Program Terms. This paragraph is not intended to
establish exclusivity for the supply, delivery, or purchase of any goods or services, rather to
prevent the unauthorized development of derivative works or the use of services, goods or other
works that belong to Paralign in connection with any competitive product or service.
11. Law and Forum Selection. Except as otherwise expressly provided by Program Terms, these
Paralign General Terms and all Program Terms will be construed and enforced in accordance
with the substantive laws of the State in which Provider maintains its primary business address,
without regard to conflict of law provisions, and the sole venue for any action concerning any
dispute related to these Paralign General Terms or Program Terms shall be the state or federal
courts located in such jurisdiction. In these Paralign General Terms, “Applicable Law” means
any and all applicable federal, state, local, common, foreign and intergovernmental laws, rules,
regulations, directives and guidelines, including, but not limited to, HIPAA, the Anti-Kickback
provisions of the Social Security Act and related regulations, Section 1877 of the Social Security
Act (known as the physician self-referral law and commonly referred to as the “Stark Law”) and
related regulations.
12. Severability. The invalidity or unenforceability of any particular provision of these Paralign
General Terms or any Program Terms will not affect the validity or enforceability of any other
provisions, and the remainder of the Paralign General Terms or Program Terms will be
construed in all respects as if such invalid or unenforceable provision were omitted.
13. Waiver of Breach. The waiver of a breach or violation of any provision of the Paralign General
Terms or Program Terms is not a waiver of any subsequent breach of the same or other
provisions.
14. Headings. The section titles and other headings used in these Paralign General Terms and in
Program Terms are for convenience of reference only and do not affect their meaning or
interpretation.
15. Interpretation. You and Paralign waive the application of any rule that ambiguous or conflicting
terms or provisions should be construed against the party who (or whose attorney) prepared
these Paralign General Terms or any Program Terms. Unless context otherwise clearly
requires, references to the plural include the singular and the singular, the plural. The words
"hereof," "herein," "hereunder" and similar terms refer to these Paralign General Terms or the
applicable Program Terms as a whole and not to any particular provision, unless otherwise
specified. References that a person or entity “will” do something indicate an obligation to do
such thing. Examples and references to “includes” and “including” are illustrative and not
exhaustive.
16. Limitation of Liability. Regardless of whether there is a total and fundamental breach of
the agreements between You and Paralign or whether any remedy provided under these
Paralign General Terms and/or Program Terms fails of its essential purpose, in no event
shall Paralign be liable for any amounts representing loss of revenues, loss of profits, loss
of business, the multiple portion of any multiplied damage award or incidental, indirect,
consequential, special or punitive damages, whether arising in contract, tort (including
Page 49 of 125
Exhibit D: Paralign General Terms Page 8
MBF\894496\0001\52209014.v1-11/25/25
negligence) or otherwise, regardless of whether it has been advised of the possibility of
such damages. The maximum aggregate amount You may recover in any claim or action
against Paralign is the total fees You paid to Paralign under Exhibit A in the twelve
(12) months immediately preceding the occurrence of the event giving rise to the claim or
action, provided that this cap shall not apply to a damage award arising from a judgment
finding Paralign committed gross negligence or willful misconduct. Nothing in this
paragraph is intended to waive or limit the professional liability claims or damages which may
be asserted by a patient against a health care provider (or by a patient’s representative or estate
when permitted by state law governing professional liability of healthcare providers). Some
jurisdictions restrict the ability to limit liability for certain types of damages. Should any one or
more of the limitations in this paragraph be held invalid or inoperable under Applicable Law,
each limitation in this paragraph shall be construed as severable and separately enforceable to
the fullest extent permitted by Applicable Law, provided that no limitation on liability will apply
that is prohibited by Applicable Law.
17. Entire Agreement. These Paralign General Terms and any Program Terms You accept,
including any exhibits to either, form the entire agreement between You and Paralign and
contain all of the mutual promises between You and Paralign. Oral statements or prior written
material not expressly incorporated into these Paralign General Terms or Program Terms are of
no force or effect. You acknowledge that you have relied solely upon the representations and
mutual promises contained in these Paralign General Terms and any Program Terms You
accept, which supersede any and all other agreements, either written or oral, between You and
Paralign with respect to the same subject matter.
18. Disclaimer of Warranties. ALL GOODS AND SERVICES PROVIDED BY PARALIGN
OR ARE PROVIDED “AS IS,” “AS AVAILABLE” AND “WITH ALL FAULTS.”
PARALIGN DISCLAIMS ALL WARRANTIES, WHETHER EXPRESS, IMPLIED,
STATUTORY OR OTHER, AND SPECIFICALLY DISCLAIMS ALL IMPLIED
WARRANTIES OF MERCHANTABILITY, NON- INFRINGEMENT, FITNESS FOR
A PARTICULAR PURPOSE, AND ALL WARRANTIES ARISING FROM COURSE
OF DEALING, USAGE OR TRADE PRACTICE. WITHOUT LIMITING THE
FOREGOING, PARALIGN MAKES NO REPRESENTATIONS OR WARRANTIES
OF ANY KIND CONCERNING: SUITABILITY OR ADEQUACY OF ANY SERVICE
OR MATERIAL FOR AN INDIVIDUAL OR COMPANY’S NEEDS,
UNINTERRUPTED SERVICE, OR ACHIEVEMENT OF ANY INTENDED RESULT.
PARALIGN DOES NOT OFFER ANY WARRANTIES. Paralign representatives are not
authorized to make any representation outside of or inconsistent with the written terms of these
Paralign General Terms or the written terms of Program Terms. Neither are other Partners
authorized to make any representation, warranty or promise on behalf of Paralign.
19. Nature of Agreement; Independent Contractor. Nothing in these Paralign General Terms or the
Program Terms is intended to create (i) a partnership, joint venture or other joint business
relationship between You and Paralign or any of their affiliates or between You and any other
Partner, or (ii) a relationship of employer and employee between You and Paralign or any
affiliates of Yours or Ours. References to any organization as a Paralign “Partner” are intended
to reflect the collaborative nature of the desired working relationship and are not indicative of
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any partnership business structure or tax status.
20. Electronic Signatures, Counterparts and Clickthrough Communication. By accepting these
Paralign General Terms, you are agreeing to conduct business electronically. Acceptance
of these Paralign General Terms, Program Terms, or amendments to any of these, may be
executed manually or electronically, in one or more counterparts, each of which shall be
deemed an original, but all of which together shall constitute one and the same document.
Electronic signatures and manual signatures transmitted by electronic means shall be as
effective and binding as any manually signed original. When, in the sole discretion of Paralign
You are provided the opportunity to convey your acceptance or consent by clicking a button,
pop-up window, checkbox, dialog box or checklist indicating “I Agree,” “I Accept,” or similar
terms, your actions clicking, selecting, or marking these options (“Clickthrough
Communications”) will have the same force and effect in manifesting your assent as an
electronic or manual signature accepting, agreeing and/or consenting to the applicable terms
and conditions. Conversely, your actions clicking “I Decline,” “I Do Not Agree,” or similar
terms (which shall also be considered Clickthrough Communications) will convey rejection of
the terms, conditions, or amendments, in the same manner as a written communication signed
manually or electronically. From time to time, Paralign may expressly designate other phrases
you may use in Clickthrough Communications or other written or electronic communications
to indicate acceptance or rejection of terms or conditions. You agree that we may send to You
(including via electronic mail) information and promotional materials regarding services,
products and programs offered by Paralign. You have the right to withdraw consent to conduct
business and receive records electronically and may do so by sending notice of the same to
Paralign in accordance with the notice provisions of these Paralign General Terms.
Withdrawing consent will not affect the legal validity of any records exchanged or business
conducted electronically prior to withdrawal. For paper copies of an electronic record, please
send a request to Paralign using the contact information provided for notice purposes. At this
time there are no fees for obtaining paper copies or withdrawing consent to do business
electronically.
21. Force Majeure. Neither You nor Paralign shall be liable for failure to perform or delay in
performance of obligations when such failure or delay is caused by conditions beyond its
control, including, but not limited to, war, terrorism, third-party labor dispute, fire, flood,
tornado, hurricane, government intervention, embargo, shortage of raw materials, breakdown,
shortage or non-availability or failure of transportation facilities or equipment, pandemic,
epidemic, outbreak of infectious disease, or public health emergency, or any Act of God or any
other condition not occasioned by such entity’s negligence, provided that the entity asserting
an event of force majeure (the “Affected Entity”) uses commercially reasonable efforts to
attempt to remedy the event of force majeure and perform its obligations as soon as is
reasonably practicable. The Affected Entity shall, in each instance, provide the other with
notice of the event of force majeure within a reasonable time after knowledge thereof and shall
use commercially reasonable efforts to remedy the effect of such event as soon as is practicable.
If an Affected Entity declares force majeure hereunder, Program Terms shall remain in full
force and effect for a period of sixty (60) days from said declaration. If the event of force
majeure continues longer than sixty (60) days from the declaration, then after the expiration of
said sixty (60) days, Paralign or the Partner not claiming force majeure may terminate the
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affected Program Terms(s).
22. Transactions Prior to Termination. These Paralign General Terms, as amended from time to
time in accordance with their terms, together with any Program Terms you accept, govern any
transaction of services or products made in connection with a Paralign program. Termination
of Program Terms shall have no effect on the rights and obligations Paralign, or applicable
Partners engaged with you in a Program, arising out of any prior transaction.
23. Default Process for Termination of Program Terms. If Program Terms specify a term or
termination processes inconsistent with this paragraph, those terms govern the termination of
the Program Terms supersede this paragraph. If Program Terms are silent as to the procedure
for termination, then Paralign or any party to the Program Terms may terminate such Program
Terms upon thirty (30) days’ notice to Paralign and any other party/parties to the Program
Terms.
24. No Guarantee of Income, Earnings, or Cost-Savings. You agree that Paralign, its affiliates,
members, managers, shareholders, directors, officers, agents, contractors and employees
(collectively, “Representatives”) make no implications, warranties, promises, representations
or guarantees whatsoever about earnings, income, or cost-savings to you in connection with
any Program Terms or any Paralign program. Your potential earnings, income or savings in
connection with Paralign programs may vary and can depend on many factors including
economic, political, social and regulatory changes, such as changes to the way consumers and
payers reimburse the performance of health care services, changes in the plans and strategies
of competitors, your investment of time, effort and skill into related programs. No testimonials,
prior successes or past results are a guarantee of your income, earnings or cost-savings. You
acknowledge that any examples, projections, forward-looking statements or promotional
materials provided by Representatives regarding potential earnings, income or cost-savings are
samples only and express only the possibility of earning or cost-saving potential, not actual
earnings, cost-savings or financial or operational performance expected. Such materials are not
guarantees, promises or warranties of any kind, and the Representatives are under no obligation
to revise any such materials in light of new information or future events. There is no assurance
that your participation in any program, or any Program Terms will result in any earnings, income
or cost-savings. No Representatives are authorized to make such a guarantee, promise or
warranty, which is expressly disclaimed.
25. Non-Solicitation Covenant. Except with Paralign’s express permission, You agree not to
directly or indirectly solicit or hire any individual who performed services for you on behalf of
Paralign until a period of twelve (12) months have elapsed from the last date such individual
performed services for You on behalf of Paralign. Program Terms may specify additional
restrictive covenants applicable to one or more program(s) in which you participate.
26. Drafting Counsel. These Paralign General Terms were prepared by legal counsel to Paralign.
You acknowledge your right to seek independent counsel and that Paralign’s legal counsel does
not represent You in preparing these Paralign General Terms or any Program Terms.
27. Access to Books and Records. The Parties will make these Paralign General Terms, all
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applicable Program Terms, and their books, documents and records available to the Secretary
of Health and Human Services, to the Comptroller General or to their duly authorized
representatives to the extent required by Section 1861(v)(1) of the Social Security Act, as
amended, and any rules and regulations thereunder.
28. Established Business. You represent and warrant that You are duly organized, existing and in
good standing under the laws of each state in which you conduct business with the power and
authority to carry on your business as it is conducted, including the performance of the
obligations required by these Paralign General Terms. You represent and agree that at least one
(1) officer, director or managing agent of your organization has been engaged in a business
offering services comparable to any services or products you may offer in connection with a
Paralign program for at least twenty-four (24) months prior to the date you begin offering such
services or products through a Paralign program. You further represent that you have made a
good faith determination that during the first year of offering products or services in one or
more Paralign program(s) the projected revenues generated by the services or products You
intend to offer in such program(s) will not exceed twenty percent (20%) of your total annual
revenue derived from the delivery of products or services of the nature of those offered in
connection with Paralign programs (such as emergency medical services). In other
words, You are capable of performing an analysis of historical and projected earnings or a
market analysis or otherwise demonstrating reasonable expectations that your organization will
derive at least eighty percent (80%) of its revenue independent of your participation in Paralign
programs during the first year of your participation. You represent you are experienced and
knowledgeable in your existing business and that any controls or assistance that will be
provided by Paralign will relate only to Paralign programs and not to the operation of your other
business activities. You have independently investigated and evaluated the risks of becoming
involved in Paralign programs and of payment of all related fees. Based on the representations
in this paragraph, You and Paralign intend that to the extent your business relationship could be
construed as a franchise business, disclosure is exempt under 16 C.F.R. § 436.8(a)(2).
29. Intentionally omitted and reserved for future use.
30. Individual Providers. If you elect to offer health care services within a Paralign program, it is
understood that you will deliver such health care services to patients through individual health
care providers (each an “Individual Provider”). You represent that you, and each of the
Individual Providers delivering your services, possess all licenses, certifications, permits and
registrations necessary to deliver such services in each jurisdiction in which the services will
be provided. You represent that each Individual Provider shall be and remain professionally
trained and experienced in the performance of the services supplied in connection with a
Paralign program, and You represent each Individual Provider will take all actions necessary
to maintain such training and experience required by the appropriate licensing authorities and
to remain board certified or board eligible, if such designations are broadly applicable to their
provider type.
You represent and warrant that you have the ability and authority to bind each of the Individual
Providers delivering health care services in connection with a Paralign program to these
Paralign General Terms and the terms of any Program Terms You accept, and that to your
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knowledge, after due inquiry, the execution and delivery of and performance of these terms do
not and will not, either directly or indirectly, contravene, conflict with or breach any provision
of any contract, agreement or undertaking by you or any of your Individual Providers. You
agree to the following:
a. You will provide to Paralign a roster listing each health Individual Provider who will
deliver health care services in connection with any Program Terms and specify in which
Program Terms each will participate. You will update such roster by prompt written
notice to Paralign within no more than five (5) days of any roster change. You will also
furnish such additional information about your Individual Providers as may reasonably
be requested or required by Paralign.
b. You covenant and agree to obligate each Individual Provider to comply with these
Paralign General Terms and any accepted Program Terms in which the Individual
Provider participates. You agree to monitor Individual Providers to ensure that all
Individual Providers are providing services within the scope of such Individual
Provider's practice, as specified in relevant licensure laws and regulations.
c. Prior to assigning an Individual Provider to provide services in connection with any
Program Terms, you will: (i) conduct a criminal background check on such Individual
Provider; (ii) complete a satisfactory search of the National Practitioner Database and
the U.S. Department of Health and Human Services Office of Inspector General List of
Excluded Individuals and Entities (“Exclusion Database”) and the Centers for
Medicare & Medicaid Services Preclusion List to confirm that an Individual Provider
has not been precluded, debarred, excluded, suspended or otherwise become ineligible
to participate in any federal or state health care program, to the extent applicable; and
(iii) ensure that each Individual Provider has not been convicted of a felony for any
health-care-related crime. You will complete a satisfactory search of the Exclusion
Database with regard to each Individual Provider at least monthly.
31. Required Notifications. You must immediately, and within no more than five (5) business days,
notify Paralign of the following:
a. Any license, certification (including board certification), accreditation, permit or
registration held by you or an Individual Provider is temporarily or permanently denied,
terminated, suspended or otherwise subject to adverse action or change in status,
whether by operation of law, voluntary surrender or otherwise (in any jurisdiction);
b. Any facility or payer denies an application for, suspends, terminates or initiates
corrective or professional review action against an Individual Provider’s medical staff
membership, privileges or credentials (other than as a result of incomplete or untimely
medical records or other administrative reasons, temporary suspensions of fewer than
fifteen (15) days' duration, or as a result of voluntary surrender or reduction in
privileges, except if such surrender or reduction occurs during an investigation or to
avoid an investigation, or in response to any corrective or professional review action as
to such privileges);
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c. Cancellation or termination of insurance coverage required of You or an Individual
Provider under these Paralign General Terms or any Program Terms, or reduction in
coverage below the limits so required;
d. A professional disciplinary action, civil lawsuit (including a malpractice action) or
criminal action is initiated or in progress against You or an Individual Provider which,
if proven, would constitute a felony, which involves care delivered to a patient in
connection with Program Terms or any exchange or transaction through a Paralign
program, or which involves fraud/abuse or controlled substances;
e. The exclusion, suspension or other ineligibility to participate in a federal or state health
care program of You or any Individual Provider;
f. A final adverse determination or finding, or entry into a corporate integrity agreement
or a consent decree, involving You or an Individual Provider in any administrative or
legal proceeding initiated by any regulatory or enforcement agency for matters
concerning the provision of patient care or concerning fraud/abuse that are criminally
or civilly proscribed;
g. Upon discovery that any submission or provision of information (whether by You or an
Individual Provider) in response to any request by Paralign, or any regulatory authority,
was inaccurate or misleading, including any misrepresentation with respect to the
warranties and representations contained in this these Paralign General Terms;
h. Any Individual Provider's incapacitation or unavailability that is reasonably likely to
result in a reduction or elimination of the services or products You offer through a
Paralign program or under any Program Terms.
32. Your Representations and Warranties as a Provider.
a. Medical Records. You agree to maintain and cause Individual Providers to maintain
appropriate medical records for all patients to whom you render health care services in
accordance with and for no less than the minimum period of time required by Applicable
Law. All such records must be legible, promptly completed and maintained in accordance
with prudent recordkeeping practices and Applicable Law. You agree to make medical
records available to Paralign or payers on a concurrent or retrospective basis to facilitate
the review of medical necessity (if applicable) and appropriateness of the care provided,
when consistent with Applicable Law. To the extent required by Applicable Law, You will
make medical records available to appropriate state and federal authorities and their
agencies involved in assessing the accessibility and availability of care or investigating
member grievances or complaints and to comply with the applicable state and federal laws
related to privacy and confidentiality of medical records. Patients shall not be held
responsible for any reasonable costs associated with medical record transmission or
duplication to have a claim adjudicated.
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b. Medically Necessary Services. You will not withhold medically necessary services within
your Individual Providers' scope of practice and qualifications from any patient based on
considerations of cost or reimbursement under Program Terms You have accepted. Any
breach of this requirement is and shall be grounds for immediate termination of Program
Terms under which You provide services.
c. Insurance. You agree to maintain at your expense: (i) professional liability; and (ii)
general liability insurance, to cover any loss, liability or damage alleged to have been
committed by You, Your Individual Providers and Your employees and agents involved
in the business of providing services or goods in connection with a Paralign program,
which insurance shall provide coverage on a claims-made or occurrence basis with a per
occurrence limit of not less than One Million Dollars ($1,000,000) per occurrence and
Three Million Dollars ($3,000,000) per annual aggregate, or such higher coverage limit as
may be required by Applicable Law. To the extent that any such insurance coverage is
provided on a claims-made basis, you agree to maintain coverage for an extended
reporting period (tail coverage) for a minimum duration of the maximum statute of
limitations for filing claims of claims of professional liability (including medical
malpractice) arising out of services provided in connection with all Program Terms. You
will provide Paralign with documentation substantiating the existence of any insurance
required by this paragraph within fourteen (14) days of Paralign’s request. It is understood
that you may maintain any insurance required by this paragraph regarding the services of
an Individual Provider by causing such Individual Provider to secure and maintain such
insurance, but You remain responsible for assuring such insurance is in place.
33. Professional Control. You are solely and exclusively in control of all aspects of the delivery of
health care services by You and Your Individual Providers. Paralign shall neither have nor
exercise any control or direction over the methods by which any healthcare provider delivers
health care services. Nothing in these Paralign General Terms or any Program Terms will alter,
or in any way affect, the legal, ethical and professional relationship between and among You,
Your Individual Providers and patients, or abrogate any right, privilege or obligation arising
out of or applicable to the provider-patient relationship. Paralign will not practice medicine or
provide health care services or assume responsibility for the care of any patient, which such
responsibility rests solely with the applicable healthcare providers. You acknowledge that all
Paralign services, as well as Paralign policies and procedures, licensing or credentialing
requirements, and any recommendations Paralign may make to You or available to You, such
as information regarding care pathways recommended by third parties or quality committees
established as part of Paralign programs, the practices of other healthcare providers, or quality
metrics will not be construed as interference with, or direction or substitution of, Your due
diligence and judgment in the provision of health care services, and You and/or Your Individual
Providers will review and assume full responsibility for any policies, procedures and processes
that could impact clinical care. In rendering health care services, You may not represent or
imply that such services are being rendered by or on behalf of Paralign. You agree that all
health care services rendered in connection with a Paralign program or any Program Terms in
any way shall be provided in strict accordance with currently approved methods and standards
of care. You acknowledge that the operation of Your facilities and equipment and the selection
and supervision of personnel shall remain solely and exclusively under Your control and not
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Paralign.
34. Equal Treatment. You agree You will provide or perform services under Paralign programs in a
manner which does not discriminate based upon source of payment, ethnicity, sex, religion,
sexual orientation, gender identity, health status, disability, race, or any illegal basis. You agree
to provide services to patients seen in connection with all Paralign programs on a basis and in
a manner no less favorable than similar services are made available to Your general patient
population.
35. Continuation of Services. Upon termination of Your participation in a Paralign program
(termination of the applicable Program Terms), when required by Applicable Law or requested
by Paralign, You agree to continue to provide and be compensated for health care services under
the terms and conditions of each Program Terms under which You provided health care services
until the earlier of such time that: (i) each patient provided services in connection with such
Program Terms has completed the current course of treatment; or (ii) reasonable and medically
appropriate arrangements have been made for another suitable health care provider to render
such health care services to such patients. You will have no right to continue providing services
or to receive compensation for such services under this paragraph if Paralign or another Partner
has provided notice to You that reasonable and medically appropriate arrangements have been
made for another suitable health care provider to render the health care services You were
providing patients. Nothing in this paragraph will affect or impair any rights or obligations
arising prior to or on the effective date of any termination of the applicable Program Terms(s),
except to the extent such rights or obligations are nullified or impaired by virtue of supervening
law or illegality.
36. Out of Pocket Amounts. Your obligation, if any, to collect applicable copayments, coinsurance,
deductibles or other personal financial obligations of patients, including financial responsibility
for non-covered services, shall be subject to the Program Terms and policies and procedures
of Program Manuals.
37. Primary and Wrap Networks.
a. You agree to cooperate with Paralign upon request if program implementation requires that
We verify whether You are an in-network preferred provider within certain primary provider
network(s) and/or applicable wrap network(s) payers use outside of Paralign programs for
patients who may access Your services through a Paralign program. You acknowledge that
if You are not in-network with the primary provider network(s) and/or applicable wrap
network(s) used by a health plan participating in a Program, or if any contractual agreements
You have entered with a provider network restrict Your participation in a Program, patients
may be encouraged to seek care from providers who are in-network or who lack such
restrictions and patients may be informed that You are outside of the patients’ primary
provider network and/or wrap network, or, as applicable, subject to contractual restrictions.
b. Except in emergencies, or in connection with specified workflows in a Program Manual, You
agree to refer patients to health care providers who are in-network preferred providers with
the primary provider network(s) and/or applicable wrap network(s) through which the
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patient receives health care benefits, so long as such referral is consistent with sound medical
judgment, and except for referrals based on patient preference for a provider who does not
meet such criteria. The purpose of this requirement is to assist patients in avoiding increased
expenses associated with out-of-network care.
38. State Specific Terms and Conditions. Different rules and regulations may apply depending on
the jurisdiction in which services/goods are provided or where the supplier or recipient of
services or goods exchanged in connection with a Paralign program may be located. Some states
require the inclusion of specific terms in agreements of this nature. In order to address the
requirements of individual state laws that may be applicable, the terms of Schedule I to the
Paralign General Terms are incorporated herein by reference as follows: (i) each term of
Schedule I will apply only to exchanges of services or goods subject to the jurisdiction of the
state to which such term applies and not in any other state; (ii) each term of Schedule I shall,
to the extent possible, be read to be consistent with the other terms of the Paralign General
Terms;
(iii) if a term of Schedule I cannot be read as consistent with any provision of these Paralign
General Terms, subject to item (iv) below, the term in Schedule I will prevail, but only to the
extent of the conflict and only in the applicable state and to the extent required by law; and (iv)
if a state law or regulation subordinates itself or any part of it to the contractual agreement of
the parties (e.g. the law states, in effect, that the term in question is applicable “unless otherwise
agreed”), then the Paralign General Terms will prevail over the subordinated state law or
regulation.
39. Survival. Section 1 (Independence of Partners), Section 2 (Partner’s Indemnification), Section
3 (Third-Party Beneficiaries), Section 4 (Confidential Information), Section 5 (Use of Brands
and Description of Programs), Section 7 (Assignment), Section 9 (Notices), Section 10
(Limited Use), Section 11 (Law and Forum Selection), Section 12 (Severability), Section 13
(Waiver of Breach), Section 14 (Headings), Section 15 (Interpretation), Section 16 (Limitation
of Liability), Section 17 (Entire Agreement), Section 18 (Disclaimer of Warranties), Section
19 (Nature of Agreement), Section 20 (Electronic Signatures), Section 22 (Transactions Prior
to Termination), Section 24 (No Guarantee of Income), Section 25 (Non-Solicitation
Covenant), Section 26 (Drafting Counsel), Section 27 (Access to Books and Records), Section
30 (Individual Providers), Section 31 (Required Notifications), Section 32 (Your
Representations and Warranties), Section 33 (Professional Control), Section 35 (Continuation
of Services), and Section 38 (State Specific Terms and Conditions, as applicable) of these
Paralign General Terms, together with all terms necessary to their interpretation or
enforcement, shall survive despite the conclusion of any transaction made in connection with
a Paralign program or the termination of any and all Program Terms.
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SCHEDULE I: STATE SPECIFIC TERMS FOR PROVIDERS
Wisconsin:
• If You provide healthcare services in the State of Wisconsin, You will comply with Wis. Stats.
§ 609.24 and the notice posting requirements of Wis. Admin. Code INS 9.35(1m), as and when
applicable.
Illinois:
• If Your activities in a Paralign program include acting as a primary care physician under a
discounted health care services plan requiring a gatekeeper option, You must provide Paralign
with a list of all patients using You as a gatekeeper within five (5) business days after the date
that You either give or receive notice of termination of the applicable Program Terms involving
such services, in accordance with 50 Ill. Adm. Code 2051.290(f).
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Exhibit E: Business Associate Agreement
HIPAA generally requires that Covered Entities and Business Associates enter into business associate
agreements to safeguard Protected Health Information. This is such a business associate agreement and
referred to as the “BAA” between our organizations. When the term “Business Associate” is used in this
BAA it refers to Paralign Health, Inc. or its wholly owned subsidiary, Paralign CIN, LLC, whichever
entity is acting as Your business associate with respect to the creation, receipt, use or transmission of
Protected Health Information (“PHI”). This BAA should be interpreted as a separate business associate
agreement between You and each of these Paralign companies. MSO and CIN are referenced here
together to avoid the need for You to enter into two separate identical BAAs. Your organization is referred
to in this BAA as the “Covered Entity.” This BAA will be effective as soon as it is accepted and replaces
any prior business associate agreement You may have had with either Paralign company for the services
it provides to You in connection with any Paralign program.
Article I. Definitions
Section 1.01 Catch-All Definition. The term “HIPAA” means the Privacy, Security, Breach
Notification and Enforcement Rules set forth at 45 CFR Parts 160, 162 and 164, as modified by the
Health Information Technology for Economic and Clinical Health Act of 2009, and all
implementing regulations. Terms used but not otherwise defined in this BAA are as defined by
HIPAA, including the following terms: Breach, Data Aggregation, Designated Record Set,
Disclosure, Health Care Operations, Minimum Necessary, Notice of Privacy Practices, Required
by Law, Secretary, Security Incident, Subcontractor, Unsecured Protected Health Information and
Use.
Section 1.02 Specific Definitions.
(a) Individual. “Individual” shall have the same meaning as the term “individual” in 45 CFR §
160.103 and shall include a person who qualifies as a personal representative in accordance with
45 CFR § 164.502(g).
(b) Privacy Rule. “Privacy Rule” shall mean the Standards for Privacy of Individually Identifiable
Health Information at 45 CFR Part 160 and Part 164, Subparts A, D and E.
(c) Protected Health Information. “Protected Health Information” or “PHI” shall have the same
meaning as the term “protected health information” in 45 CFR 160.103, including PHI transmitted
by or maintained in electronic media, limited to the information created, received or used by
Business Associate from or on behalf of Covered Entity.
(d) Security Rule. “Security Rule” shall mean the Security Standards at 45 CFR Part 160 and Part
164, Subparts A and C.
Article II. Obligations and Activities of Business Associate
Section 2.01 Regulatory Compliance. Business Associate agrees that it shall comply with the provisions
of the HIPAA Rules to the extent such regulations apply directly to Business Associate and as
provided at Section 2.11 of this BAA.
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Section 2.02 General. Business Associate agrees not to Use or Disclose PHI other than as permitted or
required by this BAA or as Required by Law.
Section 2.03 Safeguards. Business Associate agrees to implement and use appropriate administrative,
physical and technical safeguards to prevent Use or Disclosure of PHI other than as permitted by
this BAA, and to comply with the Security Rule, where applicable.
Section 2.04 Mitigation. Business Associate agrees to mitigate, to the extent practicable, any harmful
effect that is known to Business Associate of a Use or Disclosure of PHI by Business Associate in
violation of the requirements of this BAA, including, without limitation, any Breach.
Section 2.05 Reporting Unauthorized Uses/Disclosures (including Security Incidents and Breaches).
(a) Business Associate agrees to promptly after discovery report to Covered Entity any Use or
Disclosure of PHI that is not permitted by this BAA or the Business Arrangements. This reporting
duty includes any Security Incident or Breach of Unsecured PHI, unless Business Associate is
prevented from doing so by 45 CFR § 164.412 concerning law enforcement investigations.
Business Associate may make the initial report orally but shall promptly follow an oral report with
a written report to Covered Entity.
(b) Each report (oral or written) shall include, if the following information is known to (or can be
reasonably obtained by) the Business Associate: (i) contact information for individuals who were
or who may have been impacted (e.g., first and last name, mailing address, street address, phone
number, email address); (ii) a brief description of the circumstances, including the date of the
unauthorized Use/Disclosure and date of discovery; (iii) a description of the types of Unsecured
PHI involved (e.g., names, Social Security number, date of birth, address(es), account numbers of
any type, disability codes, diagnostic and/or billing codes and similar information); (iv) a brief
description of what the Business Associate has done or is doing to investigate, mitigate harm to
the individuals impacted and to protect against future unauthorized Uses/Disclosures. Business
Associate shall appoint a liaison and provide contact information for this individual to Covered
Entity so that Covered Entity may ask questions or learn additional information. Business
Associate will have a continuing duty to inform Covered Entity of new information learned by
Business Associate regarding the unauthorized Use/Disclosure, including, but not limited to, the
information described in items (i) through (iv), above.
(c) For purposes of reporting an improper Use/Disclosure, discovery shall occur as of the first day on
which such Use/Disclosure is known to the Business Associate or, by exercising reasonable
diligence, would have been known to the Business Associate.
(d) Business Associate agrees to cooperate with Covered Entity and provide other information as
necessary for Covered Entity to assess and respond to an improper Use/Disclosure.
Section 2.06 Agents and Subcontractors. Business Associate agrees to ensure that any third party,
including any agent and/or Subcontractor, that creates, receives, maintains or transmits Covered
Entity’s PHI on behalf of Business Associate, agrees to the same obligations, restrictions and
conditions that apply to Business Associate with respect to such information under this BAA and/or
the HIPAA Rules, including, without limitation, restrictions, conditions and requirements regarding
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implementation of reasonable and appropriate safeguards to protect electronic PHI, and to notify
Business Associate of Breaches, Security Incidents and other improper Uses or Disclosures of PHI.
Section 2.07 Access to PHI. In the event Business Associate maintains PHI in a Designated Record Set,
Business Associate agrees to provide access, within ten (10) days of Covered Entity’s request, to
PHI in a Designated Record Set to Covered Entity in order to meet the requirements under 45 CFR
164.524 (Individuals' rights to access). In the event that an Individual makes a request for access
directly to Business Associate, Business Associate shall notify Covered Entity of such request
within three (3) business days.
Section 2.08 Amendment of PHI. In the event Business Associate maintains PHI in a Designated
Record Set, Business Associate agrees to make any amendment(s) to PHI in a Designated Record
Set that Covered Entity directs or agrees to pursuant to 45 CFR 164.526 within twenty (20) days of
Covered Entity’s request for such amendment. In the event a request for amendment is made
directly to Business Associate by an Individual, Business Associate will notify Covered Entity of
such request within three (3) business days.
Section 2.09 Access and Inspection. Business Associate agrees to make internal practices, books and
records, including policies and procedures relating to the Use and Disclosure of PHI received from,
created by or received by Business Associate on behalf of Covered Entity, available to Covered
Entity or to the Secretary of the Department of Health and Human Services for purposes of
determining compliance with the HIPAA Rules and this BAA.
Section 2.10 Accounting of Disclosures. Business Associate agrees to document its disclosures of PHI
and information related to such disclosures as would be required for Covered Entity to respond to
a request by an Individual for an accounting of disclosures in accordance with 45 CFR 164.528,
and to provide such documentation to Covered Entity within twenty (20) days of Covered Entity’s
request.
Section 2.11 Performance of Covered Entity Obligations. To the extent the Business Arrangements
require Business Associate to carry out Covered Entity’s obligations under the Privacy Rule,
Business Associate shall comply with the requirements of the Privacy Rule that apply to Covered
Entity in the performance of such obligation(s).
Article III. Permitted Uses and Disclosures by Business Associate
Section 3.01 General Use and Disclosure. Except as otherwise limited in this BAA, Business Associate
may Use or Disclose PHI to perform functions, activities, or services for or on behalf of Covered
Entity in connection with the Business Arrangements.
Section 3.02 Minimum Necessary. Business Associate shall Use and Disclose PHI, as well as requests
for PHI, in accordance with the principle of "Minimum Necessary" Use and Disclosure, i.e., only
the minimum PHI necessary to accomplish the intended purposes may be Used or Disclosed.
Section 3.03 Use for Business Purposes. Except as otherwise limited in this BAA, Business Associate
may Use PHI for the proper management and administration of Business Associate or to carry out
the legal responsibilities of Business Associate.
Page 62 of 125
SCHEDULE I: STATE SPECIFIC TERMS FOR PROVIDERS
MBF\894496\0001\52209014.v1-11/25/25
Section 3.04 Disclosure for Business Purposes. Except as otherwise limited in this BAA, Business
Associate may Disclose PHI for the proper management and administration of Business Associate,
provided that such Disclosures are (a) Required By Law; or (b) Business Associate obtains
reasonable assurances, prior to disclosure, from the person to whom the information will be
disclosed that it will remain confidential and be Used or further Disclosed only as Required by Law
or for the purpose for which it was disclosed to the person, and the person notifies the Business
Associate of any instances of which it is aware in which the confidentiality of the information has
been Breached.
Section 3.05 Data Aggregation. Except as otherwise limited in this BAA, Business Associate may Use
PHI to provide Data Aggregation services related to the Health Care Operations of Covered Entity
as permitted by 45 CFR 164.504(e)(2)(i)(B) if so requested by Covered Entity.
Section 3.06 De-Identification. Business Associate may de-identify Covered Entity's PHI in accordance
with 45 CFR § 164.514(b) and use and disclose such de-identified information without restriction.
Article IV. Obligations of Covered Entity
Section 4.01 Notification to Business Associate. Covered Entity shall notify Business Associate of: (i)
any limitation(s) in its Notice of Privacy Practices in accordance with 45 CFR 164.520, to the extent
that such limitation may affect Business Associate’s Use or Disclosure of PHI; (ii) any changes in,
or revocation of, permission by Individual to Use or Disclose PHI, to the extent that such changes
may affect Business Associate’s Use or Disclosure of PHI; and (iii) any restriction to the Use or
Disclosure of PHI that Covered Entity has agreed to in accordance with 45 CFR 164.522, to the
extent that such restriction may affect Business Associate’s Use or Disclosure of PHI.
Section 4.02 Requests. Covered Entity shall not request Business Associate to Use or Disclose PHI in
any manner that would not be permissible under the Privacy Rule if done by Covered Entity.
Article V. Term and Termination
Section 5.01 Term and Termination. This BAA shall remain in effect until terminated in accordance
with the terms of this Article, provided, however, that termination shall not affect the respective
obligations or rights of the parties arising under this BAA prior to the effective date of termination,
all of which shall continue in accordance with their terms. For compliance reasons, any termination
of this BAA may result in a reduction of service or product offerings available under the Paralign
programs or other agreements that depend upon this BAA for regulatory compliance.
Section 5.02 Automatic Termination Without Cause. This BAA will automatically terminate when
Covered Entity’s participation in all Paralign programs involving Business Associate’s services to
Covered Entity has ended.
Section 5.03 Termination with Cause. Either Covered Entity or Business Associate may terminate this
BAA if the other fails to cure a breach of this BAA after ten (10) days' written notice thereof.
However, Covered Entity may terminate this BAA by written notice to Business Associate if
Covered Entity makes a reasonable determination that the Business Associate has breached a
material term of this BAA or has violated any provision of the HIPAA Rules or other applicable
federal or state privacy law relating to the obligations of Business Associate under this BAA.
Page 63 of 125
SCHEDULE I: STATE SPECIFIC TERMS FOR PROVIDERS
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Section 5.04 Return or Destruction of Information. Upon termination of this BAA for any reason,
Business Associate agrees either to return to Covered Entity or to destroy all PHI received from
Covered Entity, or otherwise through the performance of services for Covered Entity that is in the
possession or control of Business Associate or any third party that has received such information
from Business Associate or in connection with the performance of services under this BAA.
Business Associate shall certify such return or destruction in writing to Covered Entity. In the case
of PHI which is not feasible to “return or destroy,” Business Associate shall provide written notice
to Covered Entity of the PHI retained and extend the protections of this BAA to such PHI, including,
without limitation, Business Associate’s reporting obligations under Section 2.05 of this BAA, and
limit further Uses and Disclosures of such PHI to those purposes that make the return or destruction
infeasible, for so long as Business Associate maintains such PHI. Business Associate further agrees
to comply with other applicable state or federal law, which may require a specific period of
retention, redaction or other treatment of such PHI.
Article VI. Miscellaneous
Section 6.01 Injunctive Relief. The Parties acknowledge that the remedy at law for any breach of the
terms of this BAA are inadequate and that the damages resulting from such breach are not readily
susceptible to being measured in monetary terms. Accordingly, in the event of a breach or
threatened breach of this BAA by Business Associate, or any of its Subcontractors, Covered Entity
shall be entitled to immediate injunctive relief and may obtain a temporary order restraining any
threatened or further Breach.
Section 6.02 Regulatory References. A reference in this BAA to a section in the HIPAA Rules means
the section as in effect or as amended.
Section 6.03 Amendment. No oral modification of any of the provisions of this BAA shall be binding
on either Party, provided, however, that upon the effective date of any amendment or enactment of
any law, regulation, court decision or relevant government publication and/or interpretive guidance
or policy that either Party believes in good faith will adversely impact the Use or Disclosure of PHI
under this BAA or the compliance of this BAA, such Party may amend this BAA to comply with
such law, regulation, court decision or government publication, guidance or policy by delivering a
written amendment to the other Party, which shall be effective thirty (30) days after receipt, or
sooner, if required by law.
Section 6.04 Survival. Article I and Sections 5.04 (Return or Destruction of Information) and 6.01
(Injunctive Relief) of this BAA and all other terms necessary to their interpretation or enforcement
shall survive the termination of this BAA and all Program Agreements, together with such Paralign
General Terms as are specified therein as surviving.
Section 6.05 Interpretation. Any ambiguity in this BAA shall be resolved to permit compliance with
the HIPAA Rules.
Section 6.06 Incorporation of Paralign General Terms. The Paralign General Terms are incorporated
in this BAA, except where expressly contradicted by the terms of this BAA.
Page 64 of 125
Compliance Maintenance Annual Report
Greenfield Sewage Collection System Last Updated: Reporting For:
5/20/2026 2025
Financial Management
1. Provider of Financial Information
Name:
Paula Schafer
Telephone:
414-329-5283 (XXX) XXX-XXXX
E-Mail Address
(optional):
Paula.Schafer@greenfieldwi.gov
2. Treatment Works Operating Revenues
2.1 Are User Charges or other revenues sufficient to cover O&M expenses for your wastewater
treatment plant AND/OR collection system ?
Yes (0 points)
No (40 points)
If No, please explain:
2.2 When was the User Charge System or other revenue source(s) last reviewed and/or revised?
Year:
2025
0-2 years ago (0 points)
3 or more years ago (20 points)
N/A (private facility)
2.3 Did you have a special account (e.g., CWFP required segregated Replacement Fund, etc.) or
financial resources available for repairing or replacing equipment for your wastewater treatment
plant and/or collection system?
Yes (0 points)
No (40 points)
0
REPLACEMENT FUNDS [PUBLIC MUNICIPAL FACILITIES SHALL COMPLETE QUESTION 3]
3. Equipment Replacement Funds
3.1 When was the Equipment Replacement Fund last reviewed and/or revised?
Year:
2025
1-2 years ago (0 points)
3 or more years ago (20 points)
N/A
If N/A, please explain:
3.2 Equipment Replacement Fund Activity
3.2.1 Ending Balance Reported on Last Year's CMAR $ 488,643.00
3.2.2 Adjustments - if necessary (e.g. earned interest,
audit correction, withdrawal of excess funds, increase
making up previous shortfall, etc.)
$ 0.00
3.2.3 Adjusted January 1st Beginning Balance $ 488,643.00
3.2.4 Additions to Fund (e.g. portion of User Fee,
earned interest, etc.) + $ 178,592.00
Page 65 of 125
Compliance Maintenance Annual Report
Greenfield Sewage Collection System Last Updated: Reporting For:
5/20/2026 2025
3.2.5 Subtractions from Fund (e.g., equipment
replacement, major repairs - use description box
3.2.6.1 below*) - $ 62,907.00
3.2.6 Ending Balance as of December 31st for CMAR
Reporting Year $ 604,328.00
All Sources: This ending balance should include all
Equipment Replacement Funds whether held in a
bank account(s), certificate(s) of deposit, etc.
3.2.6.1 Indicate adjustments, equipment purchases, and/or major repairs from 3.2.5 above.
Purchase of sanitary sewer support truck
3.3 What amount should be in your Replacement Fund? $ 604,328.00
Please note: If you had a CWFP loan, this amount was originally based on the Financial
Assistance Agreement (FAA) and should be regularly updated as needed. Further calculation
instructions and an example can be found by clicking the SectionInstructions link under Info
header in the left-side menu.
3.3.1 Is the December 31 Ending Balance in your Replacement Fund above, (#3.2.6) equal to, or
greater than the amount that should be in it (#3.3)?
Yes
No
If No, please explain.
0
4. Future Planning
4.1 During the next ten years, will you be involved in formal planning for upgrading, rehabilitating,
or new construction of your treatment facility or collection system?
Yes - If Yes, please provide major project information, if not already listed below.
No
Project
#
Project Description Estimated
Cost
Approximate
Construction
Year
1 Cold Spring sanitary sewer repair (2024 #09). Relay of approximately 150 LF of
30" sanitary sewer to remove a bridge H-pile obstruction. Project design started in
2024, with construction originally anticipated in early 2025. Due to high bid prices,
we are looking at a project re-design with construction now anticipated in 2027.
$1,100,000 2027
2 Sanitary sewer installation project (92nd St bypass sewer). While originally
conceptualized as a developer led project as part of development work that was
initially planned for 2025, this became a City project (2025 #10) that was bid in the
summer of 2025. Construction began in September 2025 and was substantially
completed in the spring of 2026.
$1,800,000 2026
3 Sanitary sewer cleaning (2024 #18). A City project to contract out sewer cleaning
for some of our hard to reach, and larger diameter sewers that City crews are not
able to clean. This project was completed in 2025.
$205,000 2025
4 68th St siphon reroute (2024 #10). Rather than replace an aging sanitary sewer
siphon that runs under I-894, the City is proposing to reroute sewer flows and
remove/abandon the siphon. Project has been split into two phases. Phase 1 (2024
#13) started and is expected to be completed in 2026.
$400,000 2026
5 68th St siphon reroute (2024 #10). Rather than replace an aging sanitary sewer
siphon that runs under I-894, the City is proposing to reroute sewer flows and
remove/abandon the siphon. Project has been split into two phases. Phase 2 (2024
#10) is anticipated to start in 2027. Phase 2 required land acquisition and
easement items which required additional time to coordinate before we could start
construction.
$1,100,000 2027
Page 66 of 125
Compliance Maintenance Annual Report
Greenfield Sewage Collection System Last Updated: Reporting For:
5/20/2026 2025
6 Sanitary sewer installation project (2024 #19) at the City's TURF skatepark for
approximate 235 LF of 8" sewer and 2 manholes.
Project is anticipated to be installed in 2026.
$30,000 2026
7 PPII Investigation (2025 #9). A City project that was being designed to perform
property investigation, dyewater flooding and sanitary lateral inspection for up to
112 properties in an area that as part of previous PPII metering efforts in basin
GF1004. Funding for this project was going to utilize MMSD PPII program funding.
$150,000 2026
5. Financial Management General Comments
None
ENERGY EFFICIENCY AND USE
6. Collection System
6.1 Energy Usage
6.1.1 Enter the monthly energy usage from the different energy sources:
COLLECTION SYSTEM PUMPAGE: Total Power Consumed
Number of Municipally Owned Pump/Lift Stations: 0
Electricity Consumed
(kWh)
Natural Gas Consumed
(therms)
January 0 0
February 0 0
March 0 0
April 0 0
May 0 0
June 0 0
July 0 0
August 0 0
September 0 0
October 0 0
November 0 0
December 0 0
Total 0 0
Average 0 0
6.1.2 Comments:
N/A
6.2 Energy Related Processes and Equipment
6.2.1 Indicate equipment and practices utilized at your pump/lift stations (Check all that apply):
Comminution or Screening
Extended Shaft Pumps
Flow Metering and Recording
Pneumatic Pumping
SCADA System
Self-Priming Pumps
Submersible Pumps
Variable Speed Drives
Page 67 of 125
Compliance Maintenance Annual Report
Greenfield Sewage Collection System Last Updated: Reporting For:
5/20/2026 2025
Other:
6.2.2 Comments:
N/A
6.3 Has an Energy Study been performed for your pump/lift stations?
No
Yes
Year:
By Whom:
Describe and Comment:
6.4 Future Energy Related Equipment
6.4.1 What energy efficient equipment or practices do you have planned for the future for your
pump/lift stations?
N/A
Total Points Generated 0
Score (100 - Total Points Generated) 100
Section Grade A
Page 68 of 125
Compliance Maintenance Annual Report
Greenfield Sewage Collection System Last Updated: Reporting For:
5/20/2026 2025
Sanitary Sewer Collection Systems
1. Capacity, Management, Operation, and Maintenance (CMOM) Program
1.1 Do you have a CMOM program that is being implemented?
Yes
No
If No, explain:
1.2 Do you have a CMOM program that contains all the applicable components and items
according to Wisc. Adm Code NR 210.23 (4)?
Yes
No (30 points)
N/A
If No or N/A, explain:
1.3 Does your CMOM program contain the following components and items? (check the
components and items that apply)
Goals [NR 210.23 (4)(a)]
Describe the major goals you had for your collection system last year:
1) Comply with WPDES permit containing SSO's
2) Minimize the occurrence of preventable overflows
3) Minimize the life cycle ownership costs of the collection system
4) Improve or maintain system reliability
5) Reduce the potential threat to human health from SSO's
6) Provide adequate capacity to convey peak flow and manage I/I
7) Protect collection system worker health and safety
8) Operate a continuous CMOM program
Did you accomplish them?
Yes
No
If No, explain:
Organization [NR 210.23 (4) (b)]
Does this chapter of your CMOM include:
Organizational structure and positions (eg. organizational chart and position descriptions)
Internal and external lines of communication responsibilities
Person(s) responsible for reporting overflow events to the department and the public
Legal Authority [NR 210.23 (4) (c)]
What is the legally binding document that regulates the use of your sewer system?
Greenfield Municipal Code
If you have a Sewer Use Ordinance or other similar document, when was it last reviewed and
revised? (MM/DD/YYYY) 2019-09-17
Does your sewer use ordinance or other legally binding document address the following:
Private property inflow and infiltration
New sewer and building sewer design, construction, installation, testing and inspection
Rehabilitated sewer and lift station installation, testing and inspection
Sewage flows satellite system and large private users are monitored and controlled, as
necessary
Fat, oil and grease control
Enforcement procedures for sewer use non-compliance
Page 69 of 125
Compliance Maintenance Annual Report
Greenfield Sewage Collection System Last Updated: Reporting For:
5/20/2026 2025
Operation and Maintenance [NR 210.23 (4) (d)]
Does your operation and maintenance program and equipment include the following:
Equipment and replacement part inventories
Up-to-date sewer system map
A management system (computer database and/or file system) for collection system
information for O&M activities, investigation and rehabilitation
A description of routine operation and maintenance activities (see question 2 below)
Capacity assessment program
Basement back assessment and correction
Regular O&M training
Design and Performance Provisions [NR 210.23 (4) (e)]
What standards and procedures are established for the design, construction, and inspection of
the sewer collection system, including building sewers and interceptor sewers on private
property?
State Plumbing Code, DNR NR 110 Standards and/or local Municipal Code Requirements
Construction, Inspection, and Testing
Others:
Overflow Emergency Response Plan [NR 210.23 (4) (f)]
Does your emergency response capability include:
Responsible personnel communication procedures
Response order, timing and clean-up
Public notification protocols
Training
Emergency operation protocols and implementation procedures
Annual Self-Auditing of your CMOM Program [NR 210.23 (5)]
Special Studies Last Year (check only those that apply):
Infiltration/Inflow (I/I) Analysis
Sewer System Evaluation Survey (SSES)
Sewer Evaluation and Capacity Managment Plan (SECAP)
Lift Station Evaluation Report
Others:
0
2. Operation and Maintenance
2.1 Did your sanitary sewer collection system maintenance program include the following
maintenance activities? Complete all that apply and indicate the amount maintained.
Cleaning 34.1 % of system/year
Root removal 34.1 % of system/year
Flow monitoring 1.3 % of system/year
Smoke testing 0 % of system/year
Sewer line
televising 12.8 % of system/year
Manhole
inspections 0.7 % of system/year
Lift station O&M 0 # per L.S./year
Manhole
rehabilitation 0.7 % of manholes rehabbed
Mainline
rehabilitation
Page 70 of 125
Compliance Maintenance Annual Report
Greenfield Sewage Collection System Last Updated: Reporting For:
5/20/2026 2025
0.1 % of sewer lines rehabbed
Private sewer
inspections 0 % of system/year
Private sewer I/I
removal 0 % of private services
River or water
crossings 100 % of pipe crossings evaluated or maintained
Please include additional comments about your sanitary sewer collection system below:
None
3. Performance Indicators
3.1 Provide the following collection system and flow information for the past year.
35.80 Total actual amount of precipitation last year in inches
34.57 Annual average precipitation (for your location)
149.5 Miles of sanitary sewer
0 Number of lift stations
0 Number of lift station failures
0 Number of sewer pipe failures
18 Number of basement backup occurrences
45 Number of complaints
4.8 Average daily flow in MGD (if available)
Peak monthly flow in MGD (if available)
Peak hourly flow in MGD (if available)
3.2 Performance ratios for the past year:
0.00 Lift station failures (failures/year)
0.00 Sewer pipe failures (pipe failures/sewer mile/yr)
0.00 Sanitary sewer overflows (number/sewer mile/yr)
0.12 Basement backups (number/sewer mile)
0.30 Complaints (number/sewer mile)
0.0 Peaking factor ratio (Peak Monthly:Annual Daily Avg)
0.0 Peaking factor ratio (Peak Hourly:Annual Daily Avg)
4. Overflows
LIST OF SANITARY SEWER (SSO) AND TREATMENT FACILITY (TFO) OVERFLOWS REPORTED **
Date Location Cause Estimated
Volume
None reported
** If there were any SSOs or TFOs that are not listed above, please contact the DNR and stop work
on this section until corrected.
5. Infiltration / Inflow (I/I)
5.1 Was infiltration/inflow (I/I) significant in your community last year?
Yes
No
If Yes, please describe:
Page 71 of 125
Compliance Maintenance Annual Report
Greenfield Sewage Collection System Last Updated: Reporting For:
5/20/2026 2025
5.2 Has infiltration/inflow and resultant high flows affected performance or created problems in
your collection system, lift stations, or treatment plant at any time in the past year?
Yes
No
If Yes, please describe:
Significant rain event occurred on August 9th dropping approximately 9.5" of rain in a 24-hour
period which led to areas of flooding and some basement backups.
5.3 Explain any infiltration/inflow (I/I) changes this year from previous years:
The city continued to work to address I/I in our system in 2025. City residents are encouraged
to participate in the MMSD PPII Pipe Check program. Since 2022, Greenfield no longer has any
non-compliant sewersheds
5.4 What is being done to address infiltration/inflow in your collection system?
The city continues to follow standard, accepted practices and procedures for operating and
maintaining its collection system.
The city follows an 8/4-year cleaning and televising program where all mains are televised at
least once every 8 years and cleaned at least once every 4 years. Sewer televising is our
primarily means of rating pipes for structural and I/I deficiencies.
Using sewer main assessment and rating data, the city has developed and is following an
informal long-range sanitary sewer rehabilitation plan to address known needs in our system due
to aging infrastructure.
In 2025, the city rehabilitated 630 LF of sewer main. We are also working to replace a large
diameter sewer (30") that has a hole in it from a bridge piling being driven through it. We are
also working on rerouting sewers so that we can abandon an existing aging siphon sewer that
runs under I-894. Following these major sewer repair/preplacement projects, we intend to
continue with a grouting and lining program to address our older, aging sewers.
Total Points Generated 0
Score (100 - Total Points Generated) 100
Section Grade A
Page 72 of 125
Compliance Maintenance Annual Report
Greenfield Sewage Collection System Last Updated: Reporting For:
5/20/2026 2025
Grading Summary
WPDES No: 0047341
SECTIONS LETTER GRADE GRADE POINTS WEIGHTING
FACTORS
SECTION
POINTS
Financial A 4 1 4
Collection A 4 3 12
TOTALS 4 16
GRADE POINT AVERAGE (GPA) = 4.00
Notes:
A = Voluntary Range (Response Optional)
B = Voluntary Range (Response Optional)
C = Recommendation Range (Response Required)
D = Action Range (Response Required)
F = Action Range (Response Required)
Page 73 of 125
Compliance Maintenance Annual Report
Greenfield Sewage Collection System Last Updated: Reporting For:
5/20/2026 2025
Resolution or Owner's Statement
Name of Governing
Body or Owner:
Date of Resolution or
Action Taken:
Resolution Number:
Date of Submittal:
ACTIONS SET FORTH BY THE GOVERNING BODY OR OWNER RELATING TO SPECIFIC CMAR
SECTIONS (Optional for grade A or B. Required for grade C, D, or F):
Financial Management: Grade = A
Collection Systems: Grade = A
(Regardless of grade, response required for Collection Systems if SSOs were reported)
ACTIONS SET FORTH BY THE GOVERNING BODY OR OWNER RELATING TO THE OVERALL
GRADE POINT AVERAGE AND ANY GENERAL COMMENTS
(Optional for G.P.A. greater than or equal to 3.00, required for G.P.A. less than 3.00)
G.P.A. = 4.00
Page 74 of 125
RESOLUTION NO.
RESOLUTION VERIFYING REVIEW AND AUTHORIZING SUBMITTAL OF THE
2025 WISCONSIN DEPARTMENT OF NATURAL RESOURCES
COMPLIANCE MAINTENANCE ANNUAL REPORT (CMAR)
WHEREAS, Public sanitary sewer collection is a basic responsibility of local, county and state
governments; and
WHEREAS, It is the responsibility of local, county and state governments to properly operate and
manage wastewater collection systems so as to protect public safety and health; and
WHEREAS, Proper inspection, rehabilitation, and operation and maintenance of the sanitary
sewer collection system would promote cost-effective performance of the system over its design life; and
WHEREAS, Revisions to Chapter NR 208, Wisconsin Administrative Code became effective
January 2006 requiring permitted wastewater collection systems to submit a Compliance Maintenance
Annual Report (CMAR) with a resolution verifying Common Council review, statement of corrective
actions if necessary and authorization of submittal.
NOW, THEREFORE, BE IT RESOLVED, that the Common Council of the City of Greenfield
hereby verifies its review and authorizes the submittal of the 2025 Compliance Maintenance Annual
Report (CMAR) for the City of Greenfield.
BE IT FURTHER RESOLVED that a copy of this resolution be forwarded to the Wisconsin
Department of Natural Resources (DNR).
PASSED AND ADOPTED by the Common Council of the City of Greenfield on this _______
day of ____________, 2026.
APPROVED:
Michael J. Neitzke, Mayor
ATTEST:
Jennifer Goergen, City Clerk
Page 75 of 125
Committee: Common Council Item Number:
Introduced By: Gina Vlach, City Planner
Date Introduced: June 16, 2026
RELATING TO:
Outdoor Special Event application for the House of Harley Pop Up Music Series event #1, to be
located at 6221 W. Layton Ave., on June 20, 2026.
SUMMARY:
Application includes the following combination of licenses/permits: OSE, Temporary Class “B”
Retailer’s License (beer), and Food.
All various dept. review/approval has occurred.
Event Date Start Time End Time
Saturday, June 20 9:00 a.m. 5:00 p.m.
Set-up: Saturday, 6/20, 8:00 a.m.
Breakdown: Saturday, 6/20, 7:00 p.m.
Live music 9:00 a.m. - 5:00 p.m. Alcohol sales 9:00 a.m. – 5:00 p.m. Event held on House of
Harley premises.
Recommendation: Approve the Outdoor Special Event application for the House of Harley Pop
Up Music Series event #1, to be located at 6221 W. Layton Ave., on June 20, 2026 and all
applicable licenses/permits.
ATTACHMENTS:KEY ISSUES ___ BACKGROUND ___ RESOLUTION ___ FISCAL NOTE ___
MOTION ___ OTHER __
Page 76 of 125
Committee: Common Council Item Number:
Introduced By: Gina Vlach, City Planner
Date Introduced: June 16, 2026
RELATING TO:
Outdoor Special Event application for the House of Harley Pop Up Music Series event #2, to be
located at 6221 W. Layton Ave., on July 25, 2026.
SUMMARY:
Application includes the following combination of licenses/permits: OSE, Temporary Class “B”
Retailer’s License (beer), and Food.
All various dept. review/approval has occurred.
Event Date Start Time End Time
Saturday, July 25 9:00 a.m. 5:00 p.m.
Set-up: Saturday, 7/25, 8:00 a.m.
Breakdown: Saturday, 7/25, 7:00 p.m.
Live music 9:00 a.m. - 5:00 p.m. Alcohol sales 9:00 a.m. – 5:00 p.m. Event held on House of
Harley premises.
Recommendation: Approve the Outdoor Special Event application for the House of Harley Pop
Up Music Series event #2, to be located at 6221 W. Layton Ave., on July 25, 2026 and all
applicable licenses/permits.
ATTACHMENTS:KEY ISSUES ___ BACKGROUND ___ RESOLUTION ___ FISCAL NOTE ___
MOTION ___ OTHER __
Page 77 of 125
Committee: Common Council Item Number:
Introduced By: Gina Vlach, City Planner
Date Introduced: June 16, 2026
RELATING TO:
Outdoor Special Event application for the House of Harley Pop Up Music Series event #3, to be
located at 6221 W. Layton Ave., on August 1, 2026.
SUMMARY:
Application includes the following combination of licenses/permits: OSE, Temporary Class “B”
Retailer’s License (beer), and Food.
All various dept. review/approval has occurred.
Event Date Start Time End Time
Saturday, August 1 9:00 a.m. 5:00 p.m.
Set-up: Saturday, 8/1, 8:00 a.m.
Breakdown: Saturday, 8/1, 7:00 p.m.
Live music 9:00 a.m. - 5:00 p.m. Alcohol sales 9:00 a.m. – 5:00 p.m. Event held on House of
Harley premises.
Recommendation: Approve the Outdoor Special Event application for the House of Harley Pop
Up Music Series event #3, to be located at 6221 W. Layton Ave., on August 1, 2026 and all
applicable licenses/permits.
ATTACHMENTS:KEY ISSUES ___ BACKGROUND ___ RESOLUTION ___ FISCAL NOTE ___
MOTION ___ OTHER __
Page 78 of 125
Committee: Common Council Item Number:
Introduced By: Gina Vlach, City Planner
Date Introduced: June 16, 2026
RELATING TO:
Outdoor Special Event application for the House of Harley Pop Up Music Series event #4, to be
located at 6221 W. Layton Ave., on August 8, 2026.
SUMMARY:
Application includes the following combination of licenses/permits: OSE, Temporary Class “B”
Retailer’s License (beer), and Food.
All various dept. review/approval has occurred.
Event Date Start Time End Time
Saturday, August 8 9:00 a.m. 5:00 p.m.
Set-up: Saturday, 8/8, 8:00 a.m.
Breakdown: Saturday, 8/8, 7:00 p.m.
Live music 9:00 a.m. - 5:00 p.m. Alcohol sales 9:00 a.m. – 5:00 p.m. Event held on House of
Harley premises.
Recommendation: Approve the Outdoor Special Event application for the House of Harley Pop
Up Music Series event #4, to be located at 6221 W. Layton Ave., on August 8, 2026 and all
applicable licenses/permits.
ATTACHMENTS:KEY ISSUES ___ BACKGROUND ___ RESOLUTION ___ FISCAL NOTE ___
MOTION ___ OTHER __
Page 79 of 125
Committee: Common Council Item Number:
Introduced By: Gina Vlach, City Planner
Date Introduced: June 16, 2026
RELATING TO:
Outdoor Special Event application for the House of Harley Pop Up Music Series event #5, to be
located at 6221 W. Layton Ave., on August 15, 2026.
SUMMARY:
Application includes the following combination of licenses/permits: OSE, Temporary Class “B”
Retailer’s License (beer), and Food.
All various dept. review/approval has occurred.
Event Date Start Time End Time
Saturday, August 15 9:00 a.m. 5:00 p.m.
Set-up: Saturday, 8/15, 8:00 a.m.
Breakdown: Saturday, 8/15, 7:00 p.m.
Live music 9:00 a.m. - 5:00 p.m. Alcohol sales 9:00 a.m. – 5:00 p.m. Event held on House of
Harley premises.
Recommendation: Approve the Outdoor Special Event application for the House of Harley Pop
Up Music Series event #5, to be located at 6221 W. Layton Ave., on August 15, 2026 and all
applicable licenses/permits.
ATTACHMENTS:KEY ISSUES ___ BACKGROUND ___ RESOLUTION ___ FISCAL NOTE ___
MOTION ___ OTHER __
Page 80 of 125
Committee: Common Council Item Number:
Introduced By: Gina Vlach, City Planner
Date Introduced: June 16, 2026
RELATING TO:
Outdoor Special Event application for the House of Harley Firefighter Retiree Lunch event, to be
located at 6221 W. Layton Ave., on August 19, 2026.
SUMMARY:
Application includes the following combination of licenses/permits: OSE, Temporary Class “B”
Retailer’s License (beer), and Food.
All various dept. review/approval has occurred.
Event Date Start Time End Time
Wednesday, August 19 9:00 a.m. 5:00 p.m.
Set-up: Wednesday, 8/19, 8:00 a.m.
Breakdown: Wednesday, 8/19, 7:00 p.m.
Live music 9:00 a.m. - 5:00 p.m. Alcohol sales 9:00 a.m. – 5:00 p.m. Event held on House of
Harley premises.
Recommendation: Approve the Outdoor Special Event application for the House of Harley
Firefighter Retiree Lunch event, to be located at 6221 W. Layton Ave., on August 19, 2026 and all
applicable licenses/permits.
ATTACHMENTS:KEY ISSUES ___ BACKGROUND ___ RESOLUTION ___ FISCAL NOTE ___
MOTION ___ OTHER __
Page 81 of 125
Committee: Common Council Item Number:
Introduced By: Gina Vlach, City Planner
Date Introduced: June 16, 2026
RELATING TO:
Outdoor Special Event application for the House of Harley Veteran Suicide Awareness Ride
event, to be located at 6221 W. Layton Ave., on August 22, 2026.
SUMMARY:
Application includes the following combination of licenses/permits: OSE, Temporary Class “B”
Retailer’s License (beer), and Food.
All various dept. review/approval has occurred.
Event Date Start Time End Time
Saturday, August 22 9:00 a.m. 5:00 p.m.
Set-up: Saturday, 8/22, 8:00 a.m.
Breakdown: Saturday, 8/22, 7:00 p.m.
Live music 9:00 a.m. - 5:00 p.m. Alcohol sales 9:00 a.m. – 5:00 p.m. Event held on House of
Harley premises.
Recommendation: Approve the Outdoor Special Event application for the House of Harley
Veteran Suicide Awareness event, to be located at 6221 W. Layton Ave., on August 22, 2026 and
all applicable licenses/permits.
ATTACHMENTS:KEY ISSUES ___ BACKGROUND ___ RESOLUTION ___ FISCAL NOTE ___
MOTION ___ OTHER __
Page 82 of 125
Committee: Common Council Item Number:
Introduced By: Gina Vlach, City Planner
Date Introduced: June 16, 2026
RELATING TO:
Outdoor Special Event application for the House of Harley Oktoberfest event, to be located at
6221 W. Layton Ave., on September 19, 2026.
SUMMARY:
Application includes the following combination of licenses/permits: OSE, Temporary Class “B”
Retailer’s License (beer), and Food.
All various dept. review/approval has occurred.
Event Date Start Time End Time
Saturday, September 19 9:00 a.m. 5:00 p.m.
Set-up: Saturday, 9/19, 8:00 a.m.
Breakdown: Saturday, 9/19, 7:00 p.m.
Live music 9:00 a.m. - 5:00 p.m. Alcohol sales 9:00 a.m. – 5:00 p.m. Event held on House of
Harley premises.
Recommendation: Approve the Outdoor Special Event application for the House of Harley
Oktoberfest event, to be located at 6221 W. Layton Ave., on September 19, 2026 and all
applicable licenses/permits.
ATTACHMENTS:KEY ISSUES ___ BACKGROUND ___ RESOLUTION ___ FISCAL NOTE ___
MOTION ___ OTHER __
Page 83 of 125
Committee: Common Council Item Number:
Introduced By: Neighborhood Services (Vlach)
Date Introduced: June 16, 2026
RELATING TO:
Outdoor Special Event application for the Corner Club Birthday Party event, to be located at
4309 W. Grange Ave., on July 12, 2026.
SUMMARY:
Application includes the following combination of licenses/permits: Outdoor Special Event and
Temporary Extension of Premises.
All various dept. review/approval has occurred.
Event Dates Start Time End Time
Sunday, July 12 Music, dancing, band 10:00am 6:00pm
Set-up: 10:00am on July 12 th
Breakdown: 6:00pm on July 12 th
Recommendation: Approve an Outdoor Special Event application for Outdoor Special Event
application for the Corner Club Birthday Party event, to be located at 4309 W. Grange Ave., on
July 12, 2026, and all applicable licenses/permits.
ATTACHMENTS:KEY ISSUES ___ BACKGROUND ___ RESOLUTION ___ FISCAL NOTE ___
MOTION ___ OTHER __
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Page 101 of 125
Board of Public Works Meeting Item Number:
Introduced By: Department of Neighborhood Services (Katz)
Date Introduced: May 26, 2026
RELATING TO:
Discussion and decision to adopt an ordinance amending Section 8.04 of the Greenfield
Municipal Code regarding a parking restriction on the west side of S. 84th Street, south of W.
Forest Home Avenue.
SUMMARY:
“No parking, at any time, on the west side of S. 84th Street, from West Forest Home Avenue,
southerly to a point 615 feet north of West Holmes Avenue.”
FINANCIAL:
None
RECOMMENDATION:
Adopt an ordinance amending Section 8.04 of the Greenfield Municipal Code regarding a
parking restriction on the west side of S. 84th Street, south of W. Forest Home Avenue.
ATTACHMENTS: KEY ISSUES ___ BACKGROUND ___ RESOLUTION X FISCAL NOTE ___
MOTION ___ OTHER ___
Page 102 of 125
ORDINANCE NO. ####
AN ORDINANCE AMENDING SECTION 8.04 OF THE
MUNICIPAL CODE OF THE CITY OF GREENFIELD
The Common Council of the City of Greenfield do ordain as follows:
PART I. Section 8.04 of the Greenfield Municipal Code is hereby amended as follows:
“No parking, at any time, on the west side of S. 84th Street, from West Forest Home
Avenue, southerly to a point 615 feet north of West Holmes Avenue.”
City staff is hereby directed to modify the City’s official traffic map accordingly and add or modify
signage as necessary to effectuate this ordinance.
PART II. The terms and provisions of this ordinance are severable. Should any term or
provision of this ordinance be found to be invalid by a court of competent jurisdiction, the remaining
terms and provisions shall remain in full force and effect.
PART III. All ordinances or parts of ordinances contravening the provisions of this ordinance are
hereby repealed.
PART IV. This ordinance shall take effect and be in force from and after its passage and
publication.
PASSED AND ADOPTED by the Common Council of the City of Greenfield on the 16th day of
June, 2026.
APPROVED:
Michael J. Neitzke, Mayor
ATTEST:
Jennifer Goergen, City Clerk
Page 103 of 125
Board of Public Works Meeting Item Number:
Introduced By: Department of Neighborhood Services (Katz)
Date Introduced: May 26, 2026
RELATING TO:
Discussion and decision to adopt an ordinance amending Section 8.04 of the Greenfield
Municipal Code regarding stop signs on Midland Avenue and 47th Street and on Ohio Avenue
and 45th Street.
SUMMARY:
At the intersection of W. Midland Avenue and S. 47th Street, all eastbound and westbound traffic
must stop before entering the intersection.
At the intersection of W. Ohio Avenue and S. 45th Street, all traffic in all directions must stop
before entering the intersection.
FINANCIAL:
None.
RECOMMENDATION:
Adopt an ordinance amending Section 8.04 of the Greenfield Municipal Code regarding stop
signs on Midland Avenue and 47th Street and on Ohio Avenue and 45th Street.
ATTACHMENTS: KEY ISSUES ___ BACKGROUND ___ RESOLUTION ___ FISCAL NOTE ___
MOTION ___ OTHER ___
Page 104 of 125
ORDINANCE NO. ####
AN ORDINANCE AMENDING SECTION 8.04 OF THE
MUNICIPAL CODE OF THE CITY OF GREENFIELD
The Common Council of the City of Greenfield do ordain as follows:
PART I. Section 8.04 of the Greenfield Municipal Code is hereby amended as follows:
At the intersection of W. Midland Avenue and S. 47th Street, all eastbound
and westbound traffic must stop before entering the intersection.
At the intersection of W. Ohio Avenue and S. 45th Street, all traffic in all
directions must stop before entering the intersection.
City staff is hereby directed to modify the City’s official traffic map accordingly and add or modify
signage as necessary to effectuate this ordinance.
PART II. The terms and provisions of this ordinance are severable. Should any term or
provision of this ordinance be found to be invalid by a court of competent jurisdiction, the remaining
terms and provisions shall remain in full force and effect.
PART III. All ordinances or parts of ordinances contravening the provisions of this ordinance are
hereby repealed.
PART IV. This ordinance shall take effect and be in force from and after its passage and
publication.
PASSED AND ADOPTED by the Common Council of the City of Greenfield on the 16th day of
June, 2026.
APPROVED:
Michael J. Neitzke, Mayor
ATTEST:
Jennifer Goergen, City Clerk
Page 105 of 125
Board of Public Works Meeting Item Number:
Introduced By: Department of Neighborhood Services (Katz)
Date Introduced: May 26, 2026
RELATING TO :
Discussion and decision to adopt an ordinance amending Section 8.04 of the Greenfield
Municipal Code by repealing Ordinance 647 regarding parking restrictions on South 68
th Street.
SUMMARY:
Ordinance 647 created a no parking zone in front of the properties at 4136 South 68
th Street and
4140 South 68 th Street.
The no parking zone is no longer needed.
FINANCIAL:
None.
RECOMMENDATION:
Adopt an ordinance amending Section 8.04 of the Greenfield Municipal Code by repealing
Ordinance 647 regarding parking restrictions on South 68
th Street.
ATTACHMENTS: KEY ISSUES ___ BACKGROUND ___ RESOLUTION ___ FISCAL NOTE ___
MOTION ___ OTHER ___
Page 106 of 125
ORDINANCE NO. ####
AN ORDINANCE AMENDING SECTION 8.04 OF THE
MUNICIPAL CODE OF THE CITY OF GREENFIELD
The Common Council of the City of Greenfield do ordain as follows:
PART I. Section 8.04 of the Greenfield Municipal Co de is hereby amended by repealing
Ordinance 647 which reads as follows:
“Parking is hereby prohibited at 4136 South 68
th Street and 4140 South 68 th
Street.”
City staff is hereby directed to modify the City’s official traffic map accordingly, and remove or modify
signage as necessary to effectuate this ordinance.
PART II. The terms and provisions of this ordinance are severable. Should any term or
provision of this ordinance be found to be invalid by a court of competent jurisdiction, the remaining
terms and provisions shall remain in full force and effect.
PART III. All ordinances or parts of ordinances con travening the provisions of this ordinance are
hereby repealed.
PART IV. This ordinance shall take effect and be in force from and after its passage and
publication.
PASSED AND ADOPTED by the Common Council of the City of Greenfield on the 16th day of
June, 2026.
APPROVED:
Michael J. Neitzke, Mayor
ATTEST:
Jennifer Goergen, City Clerk
Page 107 of 125
Board of Public Works Meeting Item Number:
Introduced By: Department of Neighborhood Services (Katz)
Date Introduced: May 26, 2026
RELATING TO :
Discussion and decision to adopt an ordinance amending Section 8.04 of the Greenfield
Municipal Code by repealing Ordinance 1084 regarding U-turns on South 68
th Street.
SUMMARY:
Ordinance 1084 restricted U-turns on S. 68
th Street at the north end of the median in the 4100
block of S. 68 th Street. There are no U-turn issues here and it has not been signed for many
years.
FINANCIAL:
None.
RECOMMENDATION:
Adopt an ordinance amending Section 8.04 of the Greenfield Municipal Code by repealing
Ordinance 1084 regarding U-turns on South 68
th Street.
ATTACHMENTS: KEY ISSUES ___ BACKGROUND ___ RESOLUTION ___ FISCAL NOTE ___
MOTION ___ OTHER ___
Page 108 of 125
ORDINANCE NO. ####
AN ORDINANCE AMENDING SECTION 8.04 OF THE
MUNICIPAL CODE OF THE CITY OF GREENFIELD
The Common Council of the City of Greenfield do ordain as follows:
PART I. Section 8.04 of the Greenfield Municipal Co de is hereby amended by repealing
Ordinance 1084 which reads as follows:
“No U-turns on S. 68
th Street at the north end of the median in the 4100 block
of S. 68 th Street.”
City staff is hereby directed to modify the City’s official traffic map accordingly, and remove or modify
signage as necessary to effectuate this ordinance.
PART II. The terms and provisions of this ordinance are severable. Should any term or
provision of this ordinance be found to be invalid by a court of competent jurisdiction, the remaining
terms and provisions shall remain in full force and effect.
PART III. All ordinances or parts of ordinances con travening the provisions of this ordinance are
hereby repealed.
PART IV. This ordinance shall take effect and be in force from and after its passage and
publication.
PASSED AND ADOPTED by the Common Council of the City of Greenfield on the 16th day of
June, 2026.
APPROVED:
Michael J. Neitzke, Mayor
ATTEST:
Jennifer Goergen, City Clerk
Page 109 of 125
Board of Public Works Meeting Item Number:
Introduced By: Department of Neighborhood Services (Katz)
Date Introduced: May 26, 2026
RELATING TO :
Discussion and decision to adopt an ordinance amending Section 8.04 of the Greenfield
Municipal Code by repealing Ordinance 1104 regarding U-turns on South 68
th Street.
SUMMARY:
Ordinance 1104 restricted U-turns on S. 68
th Street at the south end of the median in the 4100
block of S. 68 th Street. There are no U-turn issues here and it has not been signed for many
years.
FINANCIAL:
None.
RECOMMENDATION:
Adopt an ordinance amending Section 8.04 of the Greenfield Municipal Code by repealing
Ordinance 1104 regarding U-turns on South 68
th Street.
ATTACHMENTS: KEY ISSUES ___ BACKGROUND ___ RESOLUTION ___ FISCAL NOTE ___
MOTION ___ OTHER ___
Page 110 of 125
ORDINANCE NO. ####
AN ORDINANCE AMENDING SECTION 8.04 OF THE
MUNICIPAL CODE OF THE CITY OF GREENFIELD
The Common Council of the City of Greenfield do ordain as follows:
PART I. Section 8.04 of the Greenfield Municipal Co de is hereby amended by repealing
Ordinance 1104 which reads as follows:
“No U-Turn at the south end of the median in the 4100 block of S. 68
th
Street.”
City staff is hereby directed to modify the City’s official traffic map accordingly, and remove or modify
signage as necessary to effectuate this ordinance.
PART II. The terms and provisions of this ordinance are severable. Should any term or
provision of this ordinance be found to be invalid by a court of competent jurisdiction, the remaining
terms and provisions shall remain in full force and effect.
PART III. All ordinances or parts of ordinances con travening the provisions of this ordinance are
hereby repealed.
PART IV. This ordinance shall take effect and be in force from and after its passage and
publication.
PASSED AND ADOPTED by the Common Council of the City of Greenfield on the 16th day of
June, 2026.
APPROVED:
Michael J. Neitzke, Mayor
ATTEST:
Jennifer Goergen, City Clerk
Page 111 of 125
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RESOLUTION NO. ______
Special Use Permit for Mezcalero Food Truck, a proposed food truck business, located at 6869
W. Forest Home Ave., submitted by Juanita Campos, d/b/a Mezcalero Restaurant and Bar
(Tax Key No. 571-8957-002)
WHEREAS, Juanita Campos, d/b/a Mezcalero Restaurant and Bar, duly filed with the City Clerk
an application for a Special Use Permit, pursuant to Sec. 21.04.0603, Sec. 21.04.0700 and Sec.
21.08.0103 of the Municipal Code, to establish Mezcalero Food Truck, a proposed food truck
business, to be located at 6869 W. Forest Home Ave.; and,
WHEREAS, after due notice, a public hearing was held by the Common Council on June 16,
2026, at 7:00 p.m. or soon thereafter, in the Common Council Chambers, to consider the
application; and,
WHEREAS, the Common Council, having carefully considered the evidence presented at the
public hearing and the following pertinent facts noted:
1. The applicant, Juanita Campos, d/b/a Mezcalero Restaurant and Bar, is based out of 6869
W. Forest Home Ave., Greenfield WI 53220.
2. The property is owned by Rosales Products and Services LLC, located at 6869 W. Forest
Home Ave., Greenfield WI 53220.
3. The Mezcalero Restaurant and Bar currently occupies the entirety of the commercial
building located at 6869 W. Forest Home Ave., Greenfield, Milwaukee County, Wisconsin, more
particularly described as follows:
That part of the Northwest ¼ Section of 22, Township 6 North, Range 21 East, in the City of
Greenfield, Milwaukee County, Wisconsin which is bounded and described as follows:
Commencing at a point located 1,062.93 feet North of the Southeast corner and 175.38 feet West
of the East line of said ¼ Section; thence South 168.28 feet; thence Southwesterly 136.80 feet;
thence Northwesterly 267.20 feet; thence Northeasterly 115.80 feet; thence East 51.70 feet;
thence Southeasterly 90.80 feet; thence East 98.39 feet to the point of beginning. Excepting
therefrom those parts taken for public street purposes.
Tax Key No. 571-8957-002.
Said land being located at 6869 W. Forest Home Ave.
4. The applicant is proposing to increase the previously approved number of food trucks
from two (2) trucks to three (3) trucks utilizing the existing commercial building as a home base.
5. The aforesaid premise is zoned C-2 Community Commercial District under the Zoning
Ordinance of the City of Greenfield, which permits mobile food services as a Special Use,
pursuant to Sec. 21.04.0603, Sec. 21.04.0700 and Sec. 21.08.0103 of the Municipal Code.
Page 113 of 125
2
6. The subject property is part of the W. Forest Home Ave. commercial corridor. Properties
to the north are developed for utility and park & recreational uses. Properties to the west and east
are developed for residential uses. Properties to the south are developed for commercial uses.
7. The proposed development should not adversely contribute to traffic volumes or traffic
flow in the area.
NOW, THEREFORE, BE IT RESOLVED by the Common Council of the City of Greenfield
that the application of Juanita Campos, d/b/a Mezcalero Restaurant and Bar to establish
Mezcalero Food Truck, a proposed food truck home base, to be located at 6869 W. Forest Home
Ave., be, and is hereby granted on the following grounds:
That the establishment, maintenance and operation of the proposed use, with the imposition of
certain conditions hereinafter set forth, reasonably satisfies the standards set forth in Sec.
21.04.0603 and Sec. 21.08.0103 of the Municipal Code, so as to permit the issuance of a special
use permit as therein provided.
BE IT FURTHER RESOLVED that said Special Use Permit is granted subject to the following
conditions:
1. Site and Landscaping Plans. The grant of this Special Use Permit is subject to and
conditioned upon the Site Plan and all other applicable conditions approved by the Plan
Commission on June 9, 2026 and by the Common Council on June 16, 2026. No alteration or
modification of the approved plan shall be permitted without approval by the Common Council.
2. Building Plans and Fire Codes. The grant of this Special Use is subject to building plans
being submitted to and approved by the Inspection Services Division and by the Fire
Department.
3. Hours of Operation. The allowable hours of operation for Mezcalero Food Truck will
be 10:00am to 10:00pm, daily.
4. Off-Street Parking. A total of 95 off-street parking stalls are required for the property.
The property will provide 47 off-street parking stalls, 5 (five) of which will be occupied by the
food trucks. The Common Council may waive the shortage.
5. Signage. Signage shall be in compliance with the City’s Signage Ordinance. Any
building window signage shall not exceed twenty (20) percent of the net glazed front window
area per business premises. Rope/LED trim lighting shall not be allowed.
6. Public Nuisance. In accordance with Chapter 11 of the Municipal Code, Public
Nuisances are prohibited. Public Nuisances include blighted properties due to an accumulation
thereon of junk or other unsightly debris. Enforcement and abatement of public nuisances,
including revocation of the Special Use Permit, may take place after three (3) or more nuisance
activities have occurred at a premise on separate days during a one hundred and eighty (180) day
period.
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3
7. Marketing Displays. The use of pennants, special lighting, flags, streamers or other
signage typically temporary in nature, hanging, floating or attached to a structure or vehicle shall
not be permitted.
8. Outdoor Lighting. All outdoor lighting fixtures shall be shielded in such a manner that
no light splays from the property boundaries. Full-cut off fixtures and or house side shields must
be utilized to minimize light splay. Rope/LED trim lighting is not permitted.
9. Litter. Employees shall inspect the area and the immediate vicinity and pick up litter on
a daily basis.
10. Refuse Collection. All refuse to be provided by a commercial hauler. All refuse,
recyclables and other waste material shall be screened from by a four-sided board-on-board
refuse enclosure provided on site.
11. Pest Control. Exterior pest control shall be maintained at all times and pest control
problems shall be addressed immediately.
12. Pagers, Intercoms. The use of outdoor pagers, intercoms, or speakers shall not be
permitted on site as surrounding land use consists of residential uses.
13. Noxious Odors, Etc. The use shall not emit foul, offensive, noxious or disagreeable
odors, gases, or effluvia into the air. Mechanical systems shall be maintained to efficiently
remove noxious odors.
14. Pollution. The use shall not cause any noxious or unwholesome liquid or substance or
any dirt, mud, sand, gravel, or stone refuse or other materials to be deposited upon any public
right of way or flow into any sanitary sewer, storm sewer, or water supply system, or onto
adjacent properties.
15. Deliveries and Refuse Pickup. The property will be required to abide by the City of
Greenfield health/public nuisance rules per Chapter 12 of the Municipal Code. Because there is a
residential neighborhood adjacent to the site, delivery operations and refuse pick up shall only be
permitted during daytime hours. These functions shall not be permitted between the hours of
9:00 p.m. and 7:00 a.m.
16. Expiration of Special Use Permit. Any special use approved by the Common Council
shall lapse and become null and void one (1) year from and after that approval if the use has not
commenced, construction is not underway, or the owner has not obtained a valid building permit.
An extension of these time limitations may be granted without a public hearing by the Common
Council by resolution reauthorizing the special use in accordance with the following criteria:
A. The applicant requesting the extension shall complete a planning application available from
the Community Development Division and shall submit a $350.00 special use permit
review/amendment fee.
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B. A written explanation for the extension of time shall accompany the planning application
along with a timeline/schedule for obtaining necessary permits, zoning, state and municipal
approvals and a target date for construction start;
C. The request for extension shall be submitted within sixty (60) days of the expiration of the
special use permit;
D. The extension, if granted, shall be valid for a period of six (6) months. If no building permit
has been issued and construction has not commenced within six (6) months from and after the
extension has been granted, the special use shall become null and void.
17. Miscellaneous.
A. Applicants are advised that the foregoing conditions are reasonably necessary to protect the
public interest and to secure compliance with the standards and requirements specified in Sec.
21.04.0603 and Sec. 21.08.0103 of the Municipal Code; that the issuance of the special use is
expressly subject to compliance with said conditions.
B. The use, as granted herein, is subject to applicants' compliance with all other state and local
laws and regulations which may be applicable to the proposed use of the real estate in question.
C. The special use, as granted herein, shall run with the land and benefit and restrict all future
owners and occupants of the property, unless the use shall lapse or be terminated and the use will
not be altered or extended (including structural alterations and/or additions) without the approval
of the Common Council, following public hearing, all as provided in Sec. 21.04.0603 and Sec.
21.08.0103 of the Municipal Code.
18. Lapse. If the applicant does not meet all of the terms and conditions set forth in this
grant of a special use within one year of the granting thereof, then the Special Use Permit shall
lapse and become null and void and the applicant shall forfeit any right to use the property as
conferred by the Special Use Permit. The failure of the applicant to meet the terms and
conditions of the Special Use Permit shall subject the permit to being declared void by the
Common Council after notice to the applicant and a hearing before the Common Council. Upon
a finding by the Common Council on the matter, the applicant and/or any interested person may
make comments regarding the matter to the Common Council prior to the Common Council's
next regular meeting following the hearing recommendation. Upon the Common Council's
finding that the Special Use Permit has lapsed and become void, the applicant shall cease all
operations at the property.
19. Termination of Special Use. If the person or entity granted the special use violates,
allows or suffers the violation of the ordinances of the City of Greenfield, the State of Wisconsin
or the United States on the premises covered by the special use, then the special use may be
terminated.
20. Acknowledgement. That the applicants sign an acknowledgment that he/she/they
has/have received these terms and conditions and will abide by them.
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The undersigned applicant agrees to the terms and conditions and has agreed that the grant of the
Special Use Permit is conditioned on meeting the terms and conditions of this resolution.
_____________________________________________
Juanita Campos, d/b/a Mezcalero Restaurant and Bar
Provided to applicant on the
______day of ____________, 2026
_______________________
City Planner
PASSED AND ADOPTED by the Common Council of the City of Greenfield on the _____
day of ________________, 2026.
APPROVED:
_______________________________
Michael J. Neitzke, Mayor
ATTEST:
______________________________________
Jennifer Goergen, City Clerk
S:\Planning\Plan Commission\2026\6-9-26\Mezcalero Food Truck - SUR\Resolution - Mezcalero Food Truck SUR 6-16-26.docx
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RESOLUTION NO. ______
Special Use Permit for an expansion of Game Together MKE, an existing used merchandise
store, to be located at 4635 S. 108th St., submitted by Steven Barron d/b/a Game Together MKE.
(Tax Key No. 609-0033-001)
WHEREAS, Steven Barron d/b/a Game Together MKE, duly filed with the City Clerk an
application for a Special Use Permit, pursuant to Sec. 21.04.0603, Sec. 21.04.0700 and Sec.
21.08.0103 of the Municipal Code, to expand Game Together MKE, an existing used
merchandise store, located at 4635 S. 108th St.; and,
WHEREAS, after due notice, this item was reviewed by the Common Council on June 16, 2026,
at 7:00 p.m. or soon thereafter, in the Common Council Chambers, and,
WHEREAS, the Common Council, having carefully considered the evidence presented at the
meeting and the following pertinent facts noted:
1. The applicant, Steven Barron d/b/a Game Together MKE, is based out of 4635 S. 108 th
St., Greenfield WI 53228.
2. The property is owned by Forest Park Real Estate Co., located at 2765 S. 27 th St.,
Milwaukee WI 53215.
3. Game Together MKE will occupy the entirety of the two (2) approximately 1,500 sq. ft.
tenant spaces in the multi-tenant commercial building located at 4633-35 S. 108th St.,
Greenfield, Milwaukee County, Wisconsin, more particularly described as follows:
Lots 2, 3, 4 and 5 of Block 1 of Valley View Heights, a recorded subdivision, plus the East 1/2 of
a vacated alley adjacent on the West, all being a part of the Southeast 1/4 of Section 19,
Township 6 North, Range 21 East, in the City of Greenfield, Milwaukee County, Wisconsin.
Tax Key No. 609-0033-001
Said land being located at 4629-4663 S. 108th St.
4. The applicant is proposing to expand their existing used merchandise business to a
neighboring tenant space within the existing multi-tenant commercial building.
5. The aforesaid premise is zoned C-4 Regional Business District under the Zoning
Ordinance of the City of Greenfield, which permits used merchandise stores as a Special Use,
pursuant to Sec. 21.04.0603, Sec. 21.04.0700 and Sec. 21.08.0103 of the Municipal Code.
6. The subject property is part of an area along the S. 108th St. commercial corridor.
Properties to the north, south, and east are developed as commercial. Properties to the west are
developed as residential.
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7. The proposed development should not adversely contribute to traffic volumes or traffic
flow in the area.
NOW, THEREFORE, BE IT RESOLVED by the Common Council of the City of Greenfield
that the application of Steven Barron d/b/a Game Together MKE, to expand Game Together
MKE, an existing used merchandise store, located at 4635 S. 108th St., be, and is hereby granted
on the following grounds:
That the establishment, maintenance and operation of the proposed use, with the imposition of
certain conditions hereinafter set forth, reasonably satisfies the standards set forth in Sec.
21.04.0603 and Sec. 21.08.0103 of the Municipal Code, so as to permit the issuance of a special
use permit as therein provided.
BE IT FURTHER RESOLVED that said Special Use Permit is granted subject to the following
conditions:
1. Site and Landscaping Plans. The grant of this Special Use Permit is subject to and
conditioned upon the Site Plan and all other applicable conditions approved by the Plan
Commission on June 9, 2026, and by the Common Council on June 16, 2026. No alteration or
modification of the approved plan shall be permitted without approval by the Common Council.
2. Building Plans and Fire Codes. The grant of this Special Use is subject to building plans
being submitted to and approved by the Inspection Services Division and by the Fire
Department.
3. Hours of Operation. The allowable hours of operation for Game Together MKE are
11:00am to 7:00pm Sunday through Thursday, and 11:00am to 12:00pm (noon) Friday and
Saturday.
4. Off-Street Parking. Game Together MKE will require fifteen (15) parking stalls. A total
of 78 off-street parking stalls are required for the entire multi-tenant building. The property will
provide 69 off-street parking stalls. Common Council may waive the shortage.
5. Signage. Signage shall be in compliance with the City’s Signage Ordinance. Any
building window signage shall not exceed twenty (20) percent of the net glazed front window
area per business premises. Rope/LED trim lighting shall not be allowed.
6. Public Nuisance. In accordance with Chapter 11 of the Municipal Code, Public
Nuisances are prohibited. Public Nuisances include blighted properties due to an accumulation
thereon of junk or other unsightly debris. Enforcement and abatement of public nuisances,
including revocation of the Special Use Permit, may take place after three (3) or more nuisance
activities have occurred at a premise on separate days during a one hundred and eighty (180) day
period.
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7. Marketing Displays. The use of pennants, special lighting, flags, streamers or other
signage typically temporary in nature, hanging, floating or attached to a structure or vehicle shall
not be permitted.
8. Outdoor Lighting. All outdoor lighting fixtures shall be shielded in such a manner that
no light splays from the property boundaries. Full-cut off fixtures and or house side shields must
be utilized to minimize light splay. Rope/LED trim lighting is not permitted.
9. Litter. Employees shall inspect the area and the immediate vicinity and pick up litter on
a daily basis.
10. Refuse Collection. All refuse to be provided by a commercial hauler. All refuse,
recyclables and other waste material shall be screened from by a four-sided board-on-board
refuse enclosure provided on site.
11. Pest Control. Exterior pest control shall be maintained at all times and pest control
problems shall be addressed immediately.
12. Pagers, Intercoms. The use of outdoor pagers, intercoms, or speakers shall not be
permitted on site as surrounding land use consists of residential uses.
13. Noxious Odors, Etc. The use shall not emit foul, offensive, noxious or disagreeable
odors, gases, or effluvia into the air. Mechanical systems shall be maintained to efficiently
remove noxious odors.
14. Pollution. The use shall not cause any noxious or unwholesome liquid or substance or
any dirt, mud, sand, gravel, or stone refuse or other materials to be deposited upon any public
right of way or flow into any sanitary sewer, storm sewer, or water supply system, or onto
adjacent properties.
15. Deliveries and Refuse Pickup. The property will be required to abide by the City of
Greenfield health/public nuisance rules per Chapter 12 of the Municipal Code. Because there is a
residential neighborhood adjacent to the site, delivery operations and refuse pick up shall only be
permitted during daytime hours. These functions shall not be permitted between the hours of
9:00 p.m. and 7:00 a.m.
16. Expiration of Special Use Permit. Any special use approved by the Common Council
shall lapse and become null and void one (1) year from and after that approval if the use has not
commenced, construction is not underway, or the owner has not obtained a valid building permit.
An extension of these time limitations may be granted without a public hearing by the Common
Council by resolution reauthorizing the special use in accordance with the following criteria:
A. The applicant requesting the extension shall complete a planning application available from
the Community Development Division and shall submit a $350.00 special use permit
review/amendment fee.
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B. A written explanation for the extension of time shall accompany the planning application
along with a timeline/schedule for obtaining necessary permits, zoning, state and municipal
approvals and a target date for construction start;
C. The request for extension shall be submitted within sixty (60) days of the expiration of the
special use permit;
D. The extension, if granted, shall be valid for a period of six (6) months. If no building permit
has been issued and construction has not commenced within six (6) months from and after the
extension has been granted, the special use shall become null and void.
17. Miscellaneous.
A. Applicants are advised that the foregoing conditions are reasonably necessary to protect the
public interest and to secure compliance with the standards and requirements specified in Sec.
21.04.0603 and Sec. 21.08.0103 of the Municipal Code; that the issuance of the special use is
expressly subject to compliance with said conditions.
B. The use, as granted herein, is subject to applicants' compliance with all other state and local
laws and regulations which may be applicable to the proposed use of the real estate in question.
C. The special use, as granted herein, shall run with the land and benefit and restrict all future
owners and occupants of the property, unless the use shall lapse or be terminated and the use will
not be altered or extended (including structural alterations and/or additions) without the approval
of the Common Council, following public hearing, all as provided in Sec. 21.04.0603 and Sec.
21.08.0103 of the Municipal Code.
18. Lapse. If the applicant does not meet all of the terms and conditions set forth in this
grant of a special use within one year of the granting thereof, then the Special Use Permit shall
lapse and become null and void and the applicant shall forfeit any right to use the property as
conferred by the Special Use Permit. The failure of the applicant to meet the terms and
conditions of the Special Use Permit shall subject the permit to being declared void by the
Common Council after notice to the applicant and a hearing before the Common Council. Upon
a finding by the Common Council on the matter, the applicant and/or any interested person may
make comments regarding the matter to the Common Council prior to the Common Council's
next regular meeting following the hearing recommendation. Upon the Common Council's
finding that the Special Use Permit has lapsed and become void, the applicant shall cease all
operations at the property.
19. Termination of Special Use. If the person or entity granted the special use violates,
allows or suffers the violation of the ordinances of the City of Greenfield, the State of Wisconsin
or the United States on the premises covered by the special use, then the special use may be
terminated.
20. Acknowledgement. That the applicants sign an acknowledgment that he/she/they
has/have received these terms and conditions and will abide by them.
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The undersigned applicant agrees to the terms and conditions and has agreed that the grant of the
Special Use Permit is conditioned on meeting the terms and conditions of this resolution.
_____________________________________________
Steven Barron d/b/a Game Together MKE
Provided to applicant on the
______day of ____________, 2026.
_______________________
Gina Vlach, City Planner
PASSED AND ADOPTED by the Common Council of the City of Greenfield on the _____
day of ________________, 2026.
APPROVED:
_______________________________
Michael J. Neitzke, Mayor
ATTEST:
______________________________________
Jennifer Goergen, City Clerk
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PACKETS FOR WEDNESDAY, 6 / 10 / 2026 FINANCE MEETING
AP DISBURSEMENT SCHEDULES:
AP CHECKS 5/15/2026 $ 767,703.16
AP CHECKS - Manual Check 5/15/2026 $ 10,000.00
AP CHECKS 5/22/2026 $ 236,981.75
AP CHECKS 5/29/2026 $ 742,604.76
AP CHECKS 6/5/2026 $ 1,665,793.04
WIRE TRANSFERS - MAY 2026 $ 7,214,143.26
P-CARDS - APRIL 2026 $ 335,430.49
TOTAL $ 10,972,656.46
CC: PAULA
CC: FINANCE FOLDER
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March Ending Balance 42,448,173.47$
2 Deposit (s) in April 8,175,645.32
0 Withdrawal(s) in April -
April Earnings @ 3.69% 152,403.21
TOTAL 50,776,222.00$
LOCAL GOVERNMENT INVESTMENT POOL
April 2026 Statement
C:\Users\Paula_s\AppData\Local\Microsoft\Windows\INetCache\Content.Outlook\6LAVDTLI\2026 LGIP
STATEMENT 6/5/20269:48 AM
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APRIL 2026
INVESTMENTS
Institution Princ Amt Investment Maturity Yield Interest Earned ID #
Invested Date Date
Money Mkt/Tri-City Bank $2,026,154.04 12/31/2001 variable $83.27 21901270
Ehlers Investment Partners X-2055705 GRD GEN INV $7,536,224.82 12/9/2014 variable
Ehlers Investment Partners X- GRD 2021A INV $0.00
Ehlers Investment Partners X- GRD 2021B $0.00 7/1/2021 variable
Ehlers Investment Partnes X - ARPA $211,396.81
Ehlers Investment Partnes X - 2022A X-3025 $78,802.41
Associated Bank Investments $7,102,433.99 3/15/2022 variable
Totals $16,955,012.07 $83.27
2026 INVESTMENTS\APR26 Page 1 6/5/2026
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Source: City of Greenfield website. First collected Oct 16, 2026.