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X. Appendix B - Designated Personnel and Service Agents <br />CONSORTIUM/THIRD PARTY ADMINISTRATOR kM I PA) <br />Name: Drug and Alcohol Testinq Compliance Services <br />Address: 4000 US HWY 259 N Longview TX 75605 <br />Phone Number: 903-234-1136 <br />DESIGNATED EMPLOYER REPRESENTATIVE (DER)IALCOHOL &DRUG PROGRAM MANAGER <br />Name: Jim Rodino <br />Address: 712 Richmond St ElkhartIN 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 WEALTH ADMINISTRATION (SAMHSAlHHS) LABORATORY <br />Name: Alere Laboratorios <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 Safeiy 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 Forsey <br />Address: 2319 Edison Rd South Bend IN 46615 <br />Phone Number: 574-233-4183 <br />EMPLOYEE ASSISTANCE PROGRAM (EAP) <br />Nalne: Pamela Forsey <br />Address: 2319 Edison Rd South Bend IN 46615 <br />Phone Number: 574-2334183 <br />Premium Concrete Services, Inc: PHMSA DRUG/ALCOHOL I°LAN 39 <br />-N,\TIOMAL t:OMPLiANCE MANAGEAVENT SERVICE, IIIC. (rICM512U1 I (upd'vle 2U21). The NCMti plan Is <br />Iba subject of aro9sie/atic'apy/ight and is pratecied by copy,ighl is/s to lne U.S, and alsee/hare. All /i9bls <br />esaved <br />