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HomeMy WebLinkAboutHR LWP Claims Administration Agreement; Second AmendmentSECOND AMENDMENT TO THE CLAIMS ADMINISTRATION AGREEMENT WITH LWP CLAIMS SOLUTIONS, INC. FOR WORKERS' COMPENSATION CLAIMS ADMINISTRATION SERVICES THIS SECOND AMENDMENT to the Claims Administration Agreement by and between the CITY OF SAN RAFAEL (hereinafter "CITY"), and LWP CLAIMS SOLUTIONS, INC. (hereinafter "CONSULTANT"), is made and entered into as of 04/08/2025 RECITALS WHEREAS, the CITY and CONSULTANT entered into a Claims Administration Agreement dated May 1, 2018, to perform professional services in connection with CITY'S workers' compensation claims administration, for an amount not to exceed $904,089 (the "Agreement"); and WHEREAS, the CITY and CONSULTANT informally entered into a First Amendment to the Agreement dated May 1, 2023, to extend the Agreement term by three years, for an amount not to exceed $586,826 and increasing the total not to exceed under the Agreement to $1,490,915; and WHEREAS, under the terms of the Agreement, the Term of the Agreement is to expire on April 30, 2026; however CITY and CONSULTANT, agreed informally that the Term of the Agreement would be extended, and now wish to ratify and memorialize that extension; and WHEREAS, the CITY and CONSULTANT wish to amend the Agreement to modify the total compensation payable to CONSULTANT so as to authorize CONSULTANT to continue providing worker's compensation claims administration services. AMENDMENT TO AGREEMENT follows NOW, THEREFORE, the parties hereby agree to amend the Agreement as 1 The First Amendment to the Agreement is hereby ratified. 2 Article I of the Agreement, entitled "TERM", is hereby amended, to extend the Agreement term by two (2) months, through June 30, 2026. 3 Article VIII of the Agreement, entitled "COMPENSATION' is hereby amended to include additional compensation payable to CONSULTANT in an amount of $33,570 for the annual fee, and in a not to exceed amount of $54,600 for additional services described in Exhibit A to this Second Amendment, on a basis in accordance with the Exhibit A, changing the total not -to -exceed amount under the agreement to $1,745,311, subject to funds being appropriated in the Fiscal Year 2025-26 budget. 3. Except as specifically amended herein, all of the other provisions, terms and obligations of the Agreement between the parties shall remain valid and shall be in full force. IN WITNESS WHEREOF, the parties have executed this Second Amendment on the day, month, and year first above written. CITY OF SAN RAFAEL CONSULTANT CRISTINE ALILOVICH, City Manager ATTEST: LINDSAY LARA, City Clerk APPROVED AS TO FORM: Anl)mv Viur"Awarw indma 1,—,h—, i 11p, B, 207S B 59 P01'� ANDREA VISVESHWARA, Chief Assistant City Attorney 2 Name: Judy Adlam Title: President & CEO [If Consultant is a corporation, add signature of second corporate officer] M Name: Title: CLAIMS SERVICING AGREEMENT - Amendment 2 THIS Amendment #2 to the Claims Servicing Agreement between the City of San Rafael and LWP Claims Solutions is made effective on the 121h day of March, 2025, by and between LWP Claims Solutions, Inc., a California Corporation ("Claims Administrator"), and the City of San Rafael ("Client"). WHEREAS, the parties executed an agreement on May 1, 2018, and amended that agreement May 1, 2023, they now agree to extend the service period of this agreement until June 30, 2026. This Amendment does not otherwise alter any of the terms or conditions of the agreement. The parties agree to amend the Agreement to include the following: 1. In consideration of the services to be provided hereunder, Client agrees to pay Claims Administrator service fees as follows: The annual fee for claims administration for 5/1/2023-4/30/2024 S 189.856 5/1/2024-4/20/2025 5 195.552 5/1/2025-6/30/2026 (14 months) S 234.988 In Witness whereof, the parties hereto have caused this agreement to be executed by authorize representatives on the dates hereinafter appearing. LWP Claims Solutions, Inc. BY dy Adam TITLE President & CEO DATE March 12, 2025 City of San Rafael Avd1a aachu BYMan— San -(I., N,-1 J9 is POT) TITLE HR Director 03/24/2025 DATE Exhibit A - City of San Rafael- Amendment 2 Final Audit Report 2025-03-24 Created: 2025-03-22 By: alissa curtin (alissa.curtin@cityofsanrafael.org) Status: Signed Transaction ID: CBJCHBCAABAADfQwZbaJ002KczKghWik BXXQBWHIHT "Exhibit A - City of San Rafael- Amendment 2" History Document created by alissa curtin (alissa.curtin@cityofsanrafael.org) 2025-03-22 - 4:29:12 PM GMT ► Document emailed to Marissa Sanchez (marissa.sanchez@cityofsanrafael.org) for signature 2025-03-22 - 4:29:16 PM GMT Email viewed by Marissa Sanchez (marissa.sanchez@cityofsanrafael.org) 2025-03-24 - 3:35:32 PM GMT 6a Document e-signed by Marissa Sanchez (marissa.sanchez@cityofsanrafael.org) Signature Date: 2025-03-24 - 3:36:03 PM GMT - Time Source: server Agreement completed. 2025-03-24 - 3:36:03 PM GMT Adobe Acrobat Sign RAP 1< < �1 �lY wiTH P�^� CONTRACT ROUTING FORM INSTRUCTIONS: Use this cover sheet to circulate all contracts for review and approval in the order shown below. TO BE COMPLETED BY INITIATING DEPARTMENT PROJECT MANAGER: Contracting Department: Human Resources Project Manager: Alissa Curtin for Marissa Sanchez Extension: 3069 Contractor Name: LWP Claims Solutions, Inc. Contractor's Contact: Judy Adlam Contact's Email: j_adlam@lwpclaims.com ❑ FPPC: Check if Contractor/Consultant must file Form 700 Step RESPONSIBLE DESCRIPTION COMPLETED REVIEWER DEPARTMENT DATE Check/Initial 1 Project Manager a. Email PINS Introductory Notice to Contractor Click here to enter a date. b. Email contract (in Word) and attachments to City 3/11/2025 amc Attorney c/o Laraine.Gittens@cityofsanrafael.org 3/21/2025 2 City Attorney a. Review, revise, and comment on draft agreement and return to Project Manager 3/21/2025 A NT b. Confirm insurance requirements, create Job on PINS, send PINS insurance notice to contractor ® NT 3 Department Director Approval of final agreement form to send to 3/24/2025 _amc_ contractor 3/24/2025 © _amc 4 Project Manager Forward three (3) originals of final agreement to Project Manager contractor for their signature ❑ N/A 5 When necessary, contractor -signed agreement agendized for City Council approval * *City Council approval required for Professional ®amc Services Agreements and purchases of goods and Or services that exceed $75,000; and for Public Works 4/7/2025 Contracts that exceed $175,000 Date of City Council approval PRINT CONTINUE ROUTING PROCESS WITH HARD COPY 6 Project Manager Forward signed original agreements to City Attorney with printed copy of this routing form 7 City Attorney Review and approve hard copy of signed agreement 8 _ City Attorney Review and approve insurance in PINS, and bonds (for Public Works Contracts) 9 City Manager / Mayor Agreement executed by City Council authorized official Attest signatures, retains original agreement and 10 City Clerk forwards copies to Project Manager LWP Second Amendment 2025 Final Audit Report 2025-04-15 Created: 2025-04-08 By: alissa Curtin (alissa.curtin@cityofsanrafael.org) Status: Signed Transaction ID: CBJCHBCAABAAWbOryoBnlxOSOYcZFbJrOSJjgPrWz3-B "LWP Second Amendment 2025" History Document created by alissa curtin (alissa.curtin@cityofsanrafael.org) 2025-04-08 - 6:36:55 PM GMT E`'. Document emailed to Judy Adlam 0_adlam@Iwpclaims.com) for signature 2025-04-08 - 6:37:01 PM GMT C'► Document emailed to Laraine Gittens (laraine.gittens@cityofsanrafael.org) for approval 2025-04-08 - 6:37:01 PM GMT P+ Document emailed to Andrea Visveshwara (andrea.visveshwara@cityofsanrafael.org) for signature 2025-04-08 - 6:37:02 PM GMT E'-. Document emailed to Lindsay Lara (city.clerk@cityofsanrafael.org) for approval 2025-04-08 - 6:37:02 PM GMT E_4' Document emailed to Cristine Alilovich (cristinea@cityofsanrafael.org) for signature 2025-04-08 - 6:37:02 PM GMT El+ Document emailed to Lindsay Lara (city.clerk@cityofsanrafael.org) for signature 2025-04-08 - 6:37:02 PM GMT Email viewed by Judy Adlam O_adiam@lwpciaims.com) 2025-04-08 - 6:37:40 PM GMT b© Document e-signed by Judy Adlam Q_adiam@lwpclaims.com) Signature Date: 2025-04-08 - 6:44:18 PM GMT - Time Source: server Email viewed by Andrea Visveshwara (andrea.visveshwara@cityofsanrafael.org) 2025-04-08 - 8:58:32 PM GMT 6o Document e-signed by Andrea Visveshwara(andrea.visveshwara@cityofsanrafael.org) Signature Date: 2025-04-08 - 8:59:07 PM GMT -Time Source: server Q Adobe Acrobat Sign ,n Email viewed by Lindsay Lara (city.clerk@cityofsanrafael.org) 2025-04-08 - 9:02:06 PM GMT b© Document approved by Lindsay Lara (city.clerk@cityofsanrafael.org) Approval Date: 2025-04-08 - 9:02:30 PM GMT - Time Source: server Email viewed by Lindsay Lara (city.clerk@cityofsanrafael.org) 2025-04-08 - 9:02:56 PM GMT 0) Document signing delegated to Lindsay Lara (lindsayl@cityofsanrafael.org) by Lindsay Lara (city.clerk@cityofsanrafael.org) 2025-04-08 - 9:03:30 PM GMT b© Document e-signed by Lindsay Lara (lindsayl@cityofsanrafael.org) Signature Date: 2025-04-08 - 9:03:41 PM GMT - Time Source: server Email viewed by Cristine Alilovich (cristinea@cityofsanrafael.org) 2025-04-08-11:38:23 PM GMT 6© Document e-signed by Cristine Alilovich (cristinea@cityofsanrafael.org) Signature Date: 2025-04-08 - 11:39:08 PM GMT - Time Source: server Email viewed by Laraine Gittens (laraine.gittens@cityofsanrafael.org) 2025-04-14 - 4:47:57 PM GMT &0 Document approved by Laraine Gittens(laraine.gttens@cityofsanrafael.org) Approval Date: 2025-04-15 - 5:23:52 PM GMT - Time Source: server ® Agreement completed. 2025-04-15 - 5:23:52 PM GMT E3 Adobe Acrobat Sign