HomeMy WebLinkAboutCC Resolution 9934 (Claims Administration Services)RESOLUTION NO. 9934
A RESOLUTION AUTHORIZING THE SIGNING OF AN AGREEMENT WITH
ACCLAMATION INSURANCE MANAGEMENT SERVICES FOR WORKERS'
COMPENSATION CLAIMS ADMINISTRATION SERVICES (10/1/97 - 9/30/99)
THE CITY COUNCIL OF THE CITY OF SAN RAFAEL RESOLVES as follows:
The MAYOR and CITY CLERK are authorized to execute, on behalf of the City of San
Rafael, an Agreement with Acclamation Insurance Management Services for Workers'
Compensation Claims Administration Services from October 1, 1997 to September 30, 1999.
I, JEANNE M. LEONCINI, Clerk of the City of San Rafael, hereby certify that the
foregoing resolution was duly and regularly introduced and adopted at a regular meeting of the
City Council of said City on Monday, the 20th day of October, 1997, by the following vote, to
wit:
AYES: COUNCILMEMBERS: Cohen, Heller, Miller, Phillips & Mayor Boro
NOES: COUNCIIIMEMBERS: None
ABSENT: COUNCILMEMBERS: None
A
JE M. LEONC`INI, City Clerk
AGREMMENT
FOR WORKERS' COMPENSATION
CLAIMS ADMINISTRATION SERVICES
This Agreement is made and entered into this 2 0 th day of OCTOBER , 1997, by and between
the CITY OF SAN RAFAEL (hereinafter "CITY"), and Acclamation Insurance Management Services
(hereinafter "CONTRACTOR").
RECITALS
WHEREAS, the City of San Rafael desires comprehensive Workers' Compensation Claims
Administration services; and
WHEREAS, Acclamation Insurance Management Services represents that it has the experience, the
expertise and the ability to provide said services, and is willing to provide said services,
AGREENIENT
NOW, THEREFORE, the parties hereby agree as follows:
1. PROJECT COORDINATION
The City Manager shall be the representative of the CITY for all purposes under this
Agreement. The Assistant to the City Manager is hereby designated the PROJECT
MANAGER for the CITY, and said PROJECT MANAGER shall supervise all aspects of the
progress and execution of this Agreement.
CONTRACTOR shall assign a single PROECT DIRECTOR to have overall responsibility for
the progress and execution of this Agreement for CONTRACTOR The Vice President is
hereby designated as the PROJECT DIRECTOR for CONTRACTOR. Should circumstances
or conditions subsequent to the execution of this Agreement require a substitute PROJECT
DIRECTOR for any reason, the CONTRACTOR shall notify the CITY within ten (10)
business days of the substitution.
2. DUTIES OF CONTRACTOR
CONTRACTOR shall provide Workers' Compensation Claims Administration Services as
described in CONTRACTOR's Proposal for Workers' Compensation Claims Administration
Services dated August 8, 1997 and by this reference incorporated herein.
1 COPY
CONTRACTOR shall perform said services in a manner compatible and consistent with the
standards of CONTRACTOR's profession, and shall use reasonable care and due diligence in
Performing its obligations under this Agreement.
3, DUTIES OF CITY
CITY shall cooperate with CONTRACTOR in the performance of this agreement, and
compensate CONTRACTOR for the performance under this agreement.
4. RELATIONSHIP
CONTRACTOR (including CONTRACTOR's agents, officers and employees) is not an agent
or employee of CITY, but is an independent contractor solely responsible for
CONTRACTOR's acts` and this Agreement shall not be construed as an agreement for
employment.
COMPENSATION
A For the full performance of the services described herein by CONTRACTOR, CITY
shall pay CONTRACTOR the sum of sixty-seven thousand three hundred and seventy-
five dollars ($67,375) per year. Said sum shall be paid in quarterly installments of
$16,843.75, due and deliverable to CONTRACTOR upon receipt by Project Manager
of invoices submitted by the CONTRACTOR in every December, March, June and
September, during the term of this Agreement, unless this payment schedule is altered
by written mutual agreement of the parties hereto.
B. The parties hereto agree that the $67,375 fee structure is based upon a cap of 40 new
Indemnity claims and 80 new Medical Only claims on average per year. Ii; during the
term of the Agreement, the average number of new indemnity claims or medical only
claims for the prior three fiscal years as documented on the Public Self Insurer's
Annual Reports exceeds the cap, City agrees to pay Contractor an additional fee of
$795 per Indemnity claim in excess of the cap and $115 per Medical Only claim in
excess of the cap. However, the total annual fee shall not exceed $70,000, regardless
of the number of new claims.
C. Paragraphs (A) and (B) notwithstanding, CITY agrees to consider an increased fee
during the second year of this Agreement provided that:
1) such increase in fee be specifically requested in writing by CONTRACTOR
at least thirty days prior to the anniversary date of the Agreement; and
2) such increase shall not exceed 75% of the annual CPI increase. "Annual
CPI increase" shall mean the percentage change in the consumer price index for
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California, All Urban Consumers, San Francisco -Oakland -San Jose areas, as
published by Bureau of Labor Statistics, San Francisco, over the most recent
twelve (12) month period for which figures are available through the month
preceding the anniversary date of this Agreement.
TERM OF AGREE%ffiNT
The term of this Agreement shall be for two (2) years commencing on October 1, 1997 and
ending on September 30, 1999. Upon mutual agreement of the parties, and subject to the
approval of the City Manager, the term of this Agreement may be extended for an additional
period of up to three (3) years, not to exceed a total term of five (5) years.
TERM NATION
Either party hereto shall have the right to terminate this Agreement at any time upon giving the
other party hereto sixty (60) days written notice prior to the effective date of such termination,
unless a sr orter period is mutually agreed.
Upon termination of the Agreement, CONTRACTOR shall be entitled to only that pro rata fee
based upon work actually accomplished as of the effective date of the termination. Any monies
paid to the CONTRACTOR in excess of the pro rata fee shall be refunded to CITY.
ASSIGNABILITY
The parties agree that they shall not assign or transfer any interest in this Agreement nor the
performance of any of their respective obligations hereunder, without the prior written consent
of the other parry, and any attempt to so assign this Agreement or any rights, duties or
obligations arising hereunder shall be void and of no effect.
INSURANCE
A During the term of this Agreement, CONTRACTOR shall maintain, at no expense to
CITY, the following insurance policies:
a comprehensive general liability insurance policy in the minimum amount of
one million ($1,000,000) dollars per occurrence for death, bodily injury,
personal injury, or property damage;
2. an automobile liability (owned, non -owned, and hired vehicles) insurance
policy in the minimum amount of one million (S 1,000,000) dollars per
occurrence;
3 a professional liability insurance policy in the minimum amount of one million
$1,000,000) dollars to cover any claims arising out of the CONTRACTOR's
performance of services under this Agreement.
B. The insurance coverage required of the CONTRACTOR by section 8. k shall also
meet the following requirements:
The irprance shall be primary with respect to any insurance or coverage
maintained by CITY against all claims arising out of the performance of the
work described herein, caused in whole or in part by any negligent act or
omission of CONTRACTOR, or anyone directly or indirectly employed by
them, for whose acts CONTRACTOR may be liable, except where caused by
the sole negligence or willful misconduct of the City.
?. Except for professional liability insurance, the insurance policies shall be
endorsed for contractual liability and personal injury.
3. essional liability insurance, the insurance policies shall be
Except for prof
specifically endorsed to include the CITY, its officers, agents, employees, and
volunteers, as additionally named insureds under the policies.
1. CONTRACTOR shall provide to PROJECT MANAGER, (a) Certificates of
Insurance evidencing the insurance coverage required herein, and (b) specific
endorsements naming CITY, its officers, agents, employees, and volunteers, as
additional named insureds under the policies.
S. The insurance policies shall provide that the insurance carrier shall not cancel,
terminate or otherwise modify the terms and conditions of said insurance
policies except upon thirty (30) days written notice to CITY's PROJECT
MANAGER.
6. If the insurance is written on a Claims Made Form, then, following termination
of this Agreement, said insurance coverage shall survive for a period of not less
than five years.
7. The insurance policies shall provide for a retroactive date of placement
coinciding with the effective date of this Agreement;
8. The insurance shall be approved as to form and sufficiency by PROJECT
MANAGER and the City Attorney.
C. If it employs any person, CONTRACTOR shall maintain workers' compensation and
employer's liability insurance, as required by the State Labor Code and other applicable
laws and regulations, and as necessary to protect both CONTRACTOR and CITY
against all liability for injuries to CONTRACTOR's officers and employees.
D. Any deductibles or self-insured retentions in CONTRACTOR's insurance policies must
be declared to and approved by the PROJECT MANAGER and the City Attorney. At
CITY's option, the deductibles or self-insured retentions with respect to CITY shall be
reduced or eliminated to CITY's satisfaction, or CONTRACTOR shall procure a bond
guaranteeing payment of losses and related investigations, claims administration,
attorney's fees and defense expenses.
10. INDEMNIFICATION
CONTRACTOR shall indemnify, hold harmless and defend CITY, its officers, agents, employ-
ees, and volunteers, against any and all claims, demands, suits, loss, liability, cost and damages
including attorney's fees, litigation expenses, and cost of administration (whether in contract,
tort or strict liability, including but not limited to personal injury, death at any time and property
damage) alleged against CITY, CONTRAC'T'OR or any other person, and from any and all
claims, demands and actions in law or equity (including attorney's fees, Irtigation expenses, and
cost of administration, arising or alleged to have arisen directly or indirectly out of the services
provided under this Agreement. CONTRACTOR's obligations under the preceding sentence
shall apply regardless of whether City or any of its officers, agents, employees or volunteers are
actively or passively negligent, but shall not apply to any loss, liability cost or damages caused
solely by the active negligence or willful misconduct of CITY.
11. RECORDS OWNERSHIP
All claim files, loss reports, payroll information and other documents and materials shall be the
property of the CITY. Said documents are subject to audit by an independent agent or
contractor of CITY's choice and at CITY's expense. Adequate notice of such an audit shall be
thirty (30) days. All information and reports described in this section shall be delivered to
CITY upon termination of this Agreement. Additionally, all documentation generated by
Contractor in performance of this Agreement shall be made available for review and copying by
the CITY upon reasonable notice.
CONTRACTOR agrees not to release any report, or portion thereof, or any result of any
investigation it may undertake on behalf of CITY to any outside person or agency without the
express written consent of CITY, except as provided in this Agreement.
12. NONDISCRUVE NATION.
CONTRACTOR shall not discriminate, in any way, against any person on the basis of age, sex,
race, color, religion, ancestry, national origin or disability in connection with or related to the
performance of its duties and obligations under this Agreement.
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13. COMPLIANCE WITH ALL LAWS
CONTRACTOR shall observe and comply with all applicable federal, state and local laws,
ordinances, codes and regulations, in the performance of its duties and obligations under this
Agreement. CONTRACTOR shall perform all services under this Agreement in accordance
with these laws, ordinances, codes and regulations. CONTRACTOR shall release, defend,
indemnify and hold harmless CITY, its officers, agents and employees from any and all
damages, liabilities, penalties, fines and all other consequences from any noncompliance or
violation of any laws, ordinances, codes or regulations.
14. NO THIRD PARTY BENEFICIARIES
CITY and CONTRACTOR do not intend, by any provision of this Agreement, to create in any
third party, any benefit or right owed by one party, under the terms and conditions of this
Agreement, to the other party.
15. NOTICES
All notices and other communications required or permitted to be given under this Agreement,
including any notice of change of address, shall be in writing and given by personal delivery, or
deposited with the United States Postal Service, postage prepaid, addressed to the parties
intended to be notified. Notice shall be deemed given as of the date of personal delivery, or if
mailed, upon the date of deposit with the United States Postal Service. Notice shall be given as
follows:
TO CITY: Sharon E. Andrus
Assistant to the City Manager
City of San Rafael
1400 Fifth Avenue
PO Box 151560
San Rafael, CA 94915-1560
TO CONTRACTOR Darlene Tuell
Vice President
Acclamation Insurance Management Services
2000 Powell Street, #1000
Emeryville, CA 94608
16. ENTIRE AGREEMENT — AMENDMENTS
The terms and conditions of this Agreement, all exhibits attached, and all documents expressly
incorporated by reference, represent the entire Agreement of the parties with respect to the
subject matter of this Agreement. No other agreement, promise or statement, written or oral,
0
relating to the subject matter of this Agreement, shall be valid or binding, except by way of a
written amendment to this Agreement. If any conflicts arise between the terms and conditions
of this Agreement, and the terms and conditions of the attached exhibits or the documents
expressly incorporated by reference, the terms and conditions of this Agreement shall control.
17. WAIVERS
The waiver by either party of any breach or violation of any term, covenant or condition of this
Agreement, or of any ordinance law or regulation, shall not be deemed to be a waiver of any
other term, covenant, condition, ordinance, law or regulation, or of any subsequent breach or
violation of the same or other term, covenant, condition, ordinance, law or regulation. The
subsequent acceptance by either party of any fee, performance, or other consideration which
may become due or owing under this Agreement, shall not be deemed to be a waiver of any
preceding breach or violation by the other party of any term, condition, covenant of this
Agreement or any applicable law, ordinance or regulation.
18. APPLICABLE LAW
The laws of the State of California shall govern this Agreement.
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IN WITNESS WHEREOF, the parties have executed this Agreement as of the day, month and year
first above written.
CITY OF SAN RAFAEL
Albertd: Boro yor
ATTEST:
Je46e M. Leoncini, City Clerk
8
Name7bDvl kh,c: 1 vsso
Title:*��
ACORD CERTIFICA, E OF LIABILITY INSL ANC1tccD� 1 D09/29/97
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Heffernan Petersen Ins Brokers HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
120 Howard Street, Suite 550 1 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
San Francisco CA 94105 1 COMPANIES AFFORDING COVERAGE
Peter Picetti COMPANY
Phone No. 415-778-03.00_ Fa:No.415-778-0301 A Atlantic Mutual
INSURED
COMPANY
B Travelers/Aetna
Acclamation Insurance COMPANY
RECEIVED
Management Services
2000 Powell St., Ste. 1000 COMPANY -
Emeryville CA 94608 D
COVERAGES
L
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE
BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLI�Qa
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF
ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE
BEEN REDUCED BY PAID CLAIMS.
POLICY EFFECTIVE f POLICY EXPIRATION
TYPE OF INSURANCE
TR POLICY NUMBER
DATE (MM/DD/YYI I DATE (MM/DD/YYI LIMITS
GENERAL LIABILITY
GENERAL AGGREGATES 2, 0 0 0, 0 0 0
A X COMMERCIALGENERALLIABILITY 432301107
01/01/97 01/01/98 j PRODUCTS-COMPIOPAGG IS1,000F000
CLAIMS MADEFX OCCUR
I PERSONAL & ADV INJURY I S 1, 0000 0 0
OWNER'S BCONTRACTOR'S PROT
I EACH OCCURRENCE I $ 1, 000,, 000
��
I FIRE DAMAGE (Any one fire) $ 100,000
MED EXP (Any one person) $5F000
AUTOMOBILE LIABILITY
A ANY AUTOCOMBINED
432301107
i
SINGLE LIMIT $1,000,000
01/01/97 01/01/98
ALL OWNED AUTOS
X SCHEDULED AUTOS
BODILY INJURY
(Per person) S
X HIRED AUTOS
X j NON -OWNED AUTOS
BODILY INJURY S
+ (Per accident)
(PROPERTY DAMAGE S
GARAGE LIABILITY
I AUTO ONLY - EA ACCIDENT $
ANY AUTO
+ OTHER THAN AUTO ONLY,
EACH ACCIDENT S
AGGREGATE S
EXCESS LIABILITY
I EACH OCCURRENCE $5,000,000
A NUMBRELLA FORM 1432301107
01/01/97 01/01/98 1 AGGREGATE $5,000,000
OTHER THAN UMBRELLA FORM
S J
WORKERS COMPENSATION ANDOT
RYTLIM JOFR I
ChIPLOiERS' LiABILIT'
.S i
THE PROPRIETOR/ n
EL EACH ACCIDENT $ j
INCL
PARTNERS/EXECUTNE
jl
I! EL DISEASE - POLICY LIMIT S
I~
OFFICERS ARE: EXCL
EL DISEASE - EA EMPLOYEE $
I OTHER
B Fiidelity Bond 100794606BCA
12/01/95 12/01/98 $500,000
:Coverage
I
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
,
Certificate holder is named as additional
insured as respect to liability
per the attached CG2010 Endorsement.
CERTIFICATE HOLDER
CANCELLATION
CITY -SR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
City of San Rafael
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
Attn : Sharon E. Andrus
1400 5th
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
Avenue
PO BOX 151560
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
ni
San Rafael CA 94915-1560
OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. i
AUTHO E ESENT :
Pet i Rvt)0
ACORD 25-S (1/95)
CACORD CORPORATION 1988
iKNAN
y Ki
1107 TIMTS
Insurance Brokers
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART.
WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization show in the Schedule,
but only with respect to Liability arising out of 'your work" for that insured by or for you.
Named Insured: Acclamation Insurance 2000 Powell Street
Name of Person or Orcianization:
SCHEDULE
City of San Rafael
1400 5th Avenue
PO Box 151560
San Rafael, CA 94915-1560
CG 2010 (11.85) Copyright, Insurance Services Office, Inc.,
120 Hnward itrppt Rnita 5Fn Can rrnnricrn r`alifnrnin GA1nr A1C/770 ncnn CAV A1C/770 none nccnneo
October 1, 1997
Certificate Holder:
City of Rafael, c/o Ms. Sharon E. Andrus
P. O. Box 151560
San Rafael, CA 94915-1560
Certificate of Insurance
This certificate is issued as a matter of information only and confers no rights upon the Certificate Holder. This
Certificate does not amend, extend or alter the coverage afforded by the policy listed below. Limits shown may have
been reduced by paid claims.
Named Acclamation Insurance Management
Insured:
2000 Powell Street. Ste. 1000
Emeryville, CA 94608
This is to certify that the policy of insurance listed below has been issued to the Insured named above and is in force
at this time.
Insurance Company: Lexington Insurance Company
Type of Insurance: Professional Liability Insurance
Policy Number: 5633246
Effective Date: 12/12/96
Expiration Date: 12/12/97
Retroactive Date: 12/12/89
Limit per Claim:
Limit Aggregate:
Services Insured:
1,000,000
1,000,000
Insurance Adjusting,
Certificate Number: 0114
Deductible: 7,500
CANCELLATION: Should the above descibed policy be cancelled before the expiration date thereof, the issuing
Company will ENDEAVOR to mail 10 days written notice to the above named Certificate Holder, but failure to mail
such notice shall impose NO obligation or liability of any kind upon the Company.
NOTE: If the Named Insured is the same as the above Certificate Holder, written Notice of Cancellation will be
provided to the Named Insured in accordance with the provisions of the policy and any applicable state law.
Certificate holder is an additional insured on the policy, but only as respects the actions of the Named
Insured.
Kevin R. Miller
c
�
C
EASTERN SPECIAL RISK
INSURANCE AGENCY
ti
68 BROWN ROAD, P.O. BOX 218
K
�
HARVARD, MASSACHUSETTS 01451
0
PHONE (508) 456-8200
FACSIMILE (508) 456-3245
WATS (800) 341-1110
October 1, 1997
Certificate Holder:
City of Rafael, c/o Ms. Sharon E. Andrus
P. O. Box 151560
San Rafael, CA 94915-1560
Certificate of Insurance
This certificate is issued as a matter of information only and confers no rights upon the Certificate Holder. This
Certificate does not amend, extend or alter the coverage afforded by the policy listed below. Limits shown may have
been reduced by paid claims.
Named Acclamation Insurance Management
Insured:
2000 Powell Street. Ste. 1000
Emeryville, CA 94608
This is to certify that the policy of insurance listed below has been issued to the Insured named above and is in force
at this time.
Insurance Company: Lexington Insurance Company
Type of Insurance: Professional Liability Insurance
Policy Number: 5633246
Effective Date: 12/12/96
Expiration Date: 12/12/97
Retroactive Date: 12/12/89
Limit per Claim:
Limit Aggregate:
Services Insured:
1,000,000
1,000,000
Insurance Adjusting,
Certificate Number: 0114
Deductible: 7,500
CANCELLATION: Should the above descibed policy be cancelled before the expiration date thereof, the issuing
Company will ENDEAVOR to mail 10 days written notice to the above named Certificate Holder, but failure to mail
such notice shall impose NO obligation or liability of any kind upon the Company.
NOTE: If the Named Insured is the same as the above Certificate Holder, written Notice of Cancellation will be
provided to the Named Insured in accordance with the provisions of the policy and any applicable state law.
Certificate holder is an additional insured on the policy, but only as respects the actions of the Named
Insured.
Kevin R. Miller