Fair Advantage Consortium Vaccine Agreement

This Agreement dated ______is between Fair Advantage Consortium (FAC) at 1963 Memorial Parkway, Ste. 5, Huntsville, AL 35801 and ______(Practice) with an address of ______. Practice wishes to become an affiliate member of FAC and participate in FAC’s vaccine purchasing program, subject to the terms set forth in FAC’s vaccine agreement.

  1. Contract Term: The contract, effective ______is for automatically renewing one-year terms. FAC may terminate this agreement should the Practice not comply with the provisions of the vaccine agreement upon 30 (thirty) days written notice should the practice fail to cure its noncompliance. Practice may terminate this Agreement with 30 (thirty) days written notice to FAC.
  2. Pricing: Practice shall be extended the manufacturers prices as set forth in such contracts with FAC. FAC shall notify Practice of any pricing changes upon notice from manufacturer(s). FAC may receive an administrative service fee from the manufacturer(s) for its administration of the program.
  3. Practice Participation Requirements: Practices that purchase the Pediatric series agree to comply with the terms of the FAC vaccine agreements, which requires that purchases of DtaP (Daptacel, Tripedia), HIB (ActHIB, TriHibit), Polio (IPOL), DtaP-IPV, HIB (Pentacel), as well as TdaP (ADACEL)doses by the practice are obtained from Sanofi Pasteur. Practices that DO NOT purchase Pediatric vaccines – but vaccinate adolescents and adults agree to purchase TdaP (ADACEL) and Menactra (if applicable). Practices that order Fluzone vaccine agree to accept 95% of their reserved number of doses.
  4. FAC has secured the most cost effective pricing for your private patients with Sanofi Pasteur. It is fully anticipated that those offices who participate in the Vaccine for Children Program (VFC) will utilize the same sanofi pasteur products (where available) for their VFC patients.
  5. Eligibility: The Practice shall be notified of the effective date of affiliation with Sanofi, and shall not be party to these agreements until formal notification is provided by FAC. FAC shall not be held responsible should manufacturer(s) at any time decline eligibility to Practice.
  6. Confidentiality: Practice and FAC shall keep the terms and conditions of this Agreement confidential.
  7. Enrollment Fee: Enrollment fee is waived for Affiliate membership.
  8. Affiliate members will receive a 1% rebate on the total of their FAC contract purchases annually (excluding Fluzone). The FAC fiscal year runs from 8/1 to 7/31. Rebates will be issued within 120 days of the end of the FAC fiscal year.
  9. Entire Agreement: This Agreement (and its attachments) constitutes the entire agreement between FAC and the Practice with respect to the subject matter hereof, and supercedes any and all prior agreements or understandings between the parties in relation thereto. Both parties acknowledge that any statements or documents not specifically referenced and made part of this Agreement shall not have any effectiveness.

Fair Advantage ConsortiumPractice

By:______By:______

Title:______Title: ______

Date: ______Date: ______

Fair Advantage Consortium

Member Commitment Form

Sanofi Pasteur Immunization Agreement

Practice Name: ______

Physician Names:DEA Numbers:

______

______

______

______

______

______

______

______

______

______

______

Practice Address: ______

______

Practice Phone: ______Fax: ______

Practice email: ______

Sanofi Pasteur Acct # ______

Please call Robin Riggs, Fair Advantage Consortium, if you have any questions regarding this program at 256-265-2464.

Fax this form to Robin Riggs at 256-265-2467