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X. Appendix B - Designated Personnel and Service Agents <br />CONSORTIUM/THIRD PARTY ADMINISTRATOR (C/TPA) <br />Name: Drug and Alcohol Testing Compliance Services <br />Address: 4000 US HWY 259 N. Longview TX 75605 <br />Phone Number: 903-234-1136 <br />DESIGNATED EMPLOYER REPRESENTATIVE (DER)/ALCOHOL &DRUG PROGRAM MANAGER <br />Name: Jim Rodino <br />Address: 712 Richmond St, Elkhart, IN 46516 <br />Phone Number: 712 Richmond St, Elkhart, <br />MEDICAL REVIEW OFFICER (MRO) <br />Name: Donald S. Freedman, MD <br />Address: PO Box 550749, Jacksonville, FL 32255 <br />Phone Number: 904-332-0472 <br />SUBSTANCE ABUSE &MENTAL HEALTH ADMINISTRATION (SAMHSA/HHS) LABORATORY <br />Name: Alere Laboratories <br />Address: 1111 Newton, Gretna, LA 70053 <br />Phone Number: 800-433-3823 <br />COLLECTION SITE(s) -DRUG AND BREATH ALCOHOL <br />Collection site procedures, processes and personnel requirements will follow Part 40, Subpart C, <br />Subpart D, Subpart E, Subpart J, Subpart K, Subpart L, Subpart M and Subpart N. A list of collection <br />site facilities, utilized by the Company, will be available upon request. <br />LIST OF APPROVED EVIDENTIAL BREATH TESTING DEVICES (EBTS) UTILIZED: <br />The Company will only utilize alcohol testing technicians who conduct the testing using DOT -approved <br />devices. These devices are approved by the National Highway Traffic Safety Administration. A list of <br />breath testing devices, utilized by the Company, will be available upon request. <br />SUBSTANCE ABUSE PROFESSIONAL (SAP) <br />Name: Pamela Forsev <br />Address: 2319 Edison Rd, South Bend IN 46615 <br />Phone Number: 574-233-4183 <br />EMPLOYEE ASSISTANCE PROGRAM (EAP) <br />Name: Pamela Forsev <br />Address: 2319 Edison Rd, South Bend, IN 46615 <br />Phone Number: 574-233-4183 <br />Premium Concrete Services, Inc.- PHMSA DRUG/ALCOHOL PLAN <br />U IiATIONhL COMPLIANCE MANAGEMENT SERVICE, INC. (NGMS) 2011 (update 20211. The NGMS plan le 39 <br />IM1e suhjec� o(e regls�eto0 wpytl9ht and is protected Uy copyright Ia�45 in Ilia U.S. and alsevfiare. All tlglils <br />eseived <br />