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HomeMy WebLinkAboutCA Claims Administration Services 2014Department: City Attorney
Prepared by: Lisa A. Goldfien
Assistant City Attorney
Agenda
Agenda Item No: 3 * b
gell
Meeting Date: August 18, 2014
ity Manager Approval: ki, .
Consideration of Adoption of a Resolution Approving and Authorizing the City Manager to
Execute an Agreement with George Hills Company for the Provision of Third -Party Liability
Claims Administration Services for a Five -Year Period (July 1, 2014 to June 30, 2019)
RECOMMENDATION:
Staff recommends that the City Council adopt the Resolution renewing the contract with George
Hills Company for a new 5 -year period.
BACKGROUND:
In 2001, after an extensive RFP process to qualify, investigate and interview candidates to
administer the City's third -party liability claims, the City awarded a contract to George Hills
Company, a long-established Northern California provider of third -party liability claims
administration for public entities. Since then, George Hills has handled the City's liability
claims out of its Sonoma and Solano County offices. The claims have been handled efficiently,
promptly and at reasonable cost.
ANALYSIS:
For cities the size of San Rafael, with our level of staffing, it is not possible to reliably maintain
the capacity to manage claims adjustments, investigations and other liability claims
administration functions in-house. Therefore, the City will continue to need to contract for these
services. City staff has been happy with the services provided by George Hills Company. Ms.
Diane Caravello, the account manager for the City's claims, has established an excellent working
relationship with all City Departments; consequently City staff has confidence in the company's
ability to effectively manage the City's liability claims. Staff therefore recommends renewing
the current agreement with George Hills Company for third -party claims administration services.
The City's past contracts with George Hills Company have all had 3 -year terms. This year, the
company has suggested a 5 -year term instead, which would allow the company to offer reduced
rates, as shown below:
111:4-AE41,11
Council Meeting.
Disposition:
SAN RAFAEL CITY COUNCIL AGENDA REPORT / Page: 2
Under the 3 -year proposal, the average annual cost to the City would be $86,676, while under the
5 -year proposal, the average annual cost would be $86,000. Staff recommends renewing the
agreement for a 5 -year term, which will result in overall savings to the City and desirable
continuity of services. A draft proposed agreement is attached to this staff report.
FISCAL IMPACT:
Under the proposed 5 -year contract, the compensation for the first contract year would be
slightly less than the amount paid in 2013-2014, and would rise by approximately 5% total over
the 5 -year term of the contract, a modest increase staff believes to be reasonable. There are
sufficient funds and current -year appropriations in the City's general liability internal service
fund to support the proposed contract.
OPTIONS:
I Adopt the Resolution as recommended, approving and authorizing the City Manager to
renew the City's agreement with George Hills Company for a five (5) year term from
July 1, 2014 through June 30, 2019; or
2. Adopt a modified Resolution approving and authorizing the City Manager to renew the
City's agreement with s® Hills Company for a three (3) year term from July 1, 2014
through June 30, 2017; or
3. Refer the matter back to Staff with directions to explore other options.
ACTION REQUIRED:
Adopt the attached Resolution Approving and Authorizing the City Manager to Execute an
Agreement with George Hills Company for the Provision of Third -Party Liability Claims
Administration Services for a Term of Five (5) Years (July 1, 2014 to June 30, 2019).
ATTACHMENTS:
Resolution
Draft Agreement
Previous Contracts
New Three (3) Year
New Five (5) Year
Contract
Contract
2009-10
$77,175
2010-11
$77,175
2011-12
$81,262
2012-13
$8207
2013-14
$841545
2014-15
$841545
$841500
2015-16
$86,659
$84!500
2016-17
$88,825
$85!500
2017-18
$8700
2018-19
$881500
Under the 3 -year proposal, the average annual cost to the City would be $86,676, while under the
5 -year proposal, the average annual cost would be $86,000. Staff recommends renewing the
agreement for a 5 -year term, which will result in overall savings to the City and desirable
continuity of services. A draft proposed agreement is attached to this staff report.
FISCAL IMPACT:
Under the proposed 5 -year contract, the compensation for the first contract year would be
slightly less than the amount paid in 2013-2014, and would rise by approximately 5% total over
the 5 -year term of the contract, a modest increase staff believes to be reasonable. There are
sufficient funds and current -year appropriations in the City's general liability internal service
fund to support the proposed contract.
OPTIONS:
I Adopt the Resolution as recommended, approving and authorizing the City Manager to
renew the City's agreement with George Hills Company for a five (5) year term from
July 1, 2014 through June 30, 2019; or
2. Adopt a modified Resolution approving and authorizing the City Manager to renew the
City's agreement with s® Hills Company for a three (3) year term from July 1, 2014
through June 30, 2017; or
3. Refer the matter back to Staff with directions to explore other options.
ACTION REQUIRED:
Adopt the attached Resolution Approving and Authorizing the City Manager to Execute an
Agreement with George Hills Company for the Provision of Third -Party Liability Claims
Administration Services for a Term of Five (5) Years (July 1, 2014 to June 30, 2019).
ATTACHMENTS:
Resolution
Draft Agreement
RESOLUTION NO. 13782
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF SAN
RAFAEL APPROVING AND AUTHORIZING THE CITY MANAGER
TO EXECUTE AN AGREEMENT WITH GEORGE HILLS
COMPANY FOR THE PROVISION OF THIRD -PARTY LIABILITY
CLAIMS ADMINISTRATION SERVICES FOR A TERM OF FIVE (5)
YEARS (JULY 19 2014 TO JUNE 30,2019)
WHEREAS, the City Council has determined that the general liability claims
administration services provided by George Hills Company for the past several years have proven
to be exceptional; and
WHEREAS, George Hills Company and the City wish to continue their agreement for
such services for additional years into the future; and
WHEREAS, George Hills Company has offered to continue to provide the City with
general liability claims administration services for an additional five (5) year period at a modest
increase in cost.
NOW, THEREFORE, BE IT RESOLVED, that the City Council of the City of San
Rafael hereby approves and authorizes the City Manager to execute an Agreement with George
Hills Company for the Provision of Third Party Liability Claims Administration Services for a
Term of Five (5) Years (July 1, 2014 To June 30, 2019), in the form attached hereto as Exhibit "A"
and incorporated herein, as finally approved by the City Attorney.
11, Esther C. Beirne, 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 San Rafael
City Council held on the 18th day of August, 2014, by the following vote to wit:
AYES: Councilmembers: Bushey, Colin, Connolly, McCullough & Mayor Phillips
NOES: Councilmembers: None
ABSENT: Councilmembers: None
ESTHER C. BEIRNE, City Clerk
AGREEMENT BETWEEN CITY OF SAN RAFAEL AND GEORGE HILLS
COMPANY FOR THE PROVISION OF THIRD PARTY -LIABILITY
CLAIMS ADMINISTRATION SERVICES FOR A FIVE YEAR PERIOD
(JULY 19 2014 TO JUNE 309 20 19)
This contract is made and entered as of the /5io* _ day of 4JCQ-V_, 20147
by and between THE CITY OF SAN RAFAEL, hereinafter called CLIENT, and
GEORGE HILLS COMPANY, INC., hereinafter referred to as the CLAIMS
ADMINISTRATOR.
The CLAIMS ADMINISTRATOR is a California Corporation doing business as
licensed, independent insurance adjusters and administrators, with John E. Chaquica,
President in charge of daily operations. The company's corporate office is located at
3043 Gold Canal Dr, Suite 200, Rancho Cordova, California, 95670, telephone, (916)
859-4800.
The CLIENT is the City of San Rafael at P.O. Box 151560, San Rafael, CA,
IT IS HEREBY AGREED by and between the parties signing this agreement as
follows:
I. GENERAL
CLIENT is desirous of availing itself of property and liability claims adjusting an•
administrative services. The CLAIMS ADMINISTRATOR is a claim administrative fir
experienced in the handling of self-insured claims and is ready and capable o
performing such services. As such, the CLAIMS ADMINISTRATOR shall act as
representative with the investigation, adjustment, processing, supervision an
evaluation of general liability, motor vehicle, and potential money damage claim
assigned by third parties against clients, or against parties for whom the CLIENT i
alleged to be legally responsible, which are premised upon allegations of willful
intentional, negligent or carless acts and/or omissions.
II. SCOPE OF SERVICES
CLAIMS ADMINISTRATOR agrees to provide complete claim handling services
on each accident or incident which is or may be the subject of a claim. Such services
shall include the following:
CLAIMS ADMINISTRATOR agrees to provide complete investigative services
including, but not limited to:
1) Receipt and examination of all reports of accidents or incidents that are or
may be the subject of claims.
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C. LEGAL SUPPORT SERVICES
CLAIMS ADMINISTRATOR agrees to provide the following legal support
services on each claim in which a third party claimant has commenced or threatened to
commence litigation:
1) Upon notification by the CLIENT that litigation has been filed on an open
claim, contact and provide counsel with all information and files concerning the claim.
2) Cooperate with and assist any counsel assigned to litigation of open claims
and provide such investigative services as directed during pre-trial and trial stages.
3) Assist in responding to discovery or preparing discovery.
4) At the request of the CLIENT, attend mandatory settlement conferences on
behalf of CLIENT.
5) At the request of the CLIENT appear on behalf of CLIENT in small claim
actions filed against CLIENT on open claims handled by CLAIMS ADMINISTRATOR.
6) Review, evaluate and adjust counsel statements for services.
7) Regularly and reasonably discuss, review, and direct investigation issues,
discovery, and case strategy with counsel.
8) Review and evaluate case evaluations, correspondence and status reports
forwarded to CLAIMS ADMINISTRATOR by counsel.
9) Cooperate with counsel as a team with an open communication approach on
each case to obtain the most economical and best result for the CLIENT.
D. REPORTS AND PROCEDURES:
CLAIMS ADMINISTRATOR agrees to provide the following:
1) Within thirty (30) days of assignment, or sooner if practicable, required, or
requested, CLAIMS ADMINISTRATOR will provide CLIENT with a full factual report,
showing name(s) of claimant(s), type of claim, date of loss, comments on liability,
reserve recommendations, settlement recommendations, and other pertinent
information. Subsequent to the initial thirty (30) day report, the CLAIMS
ADMINISTRATOR will report at least every thirty (30) days until the claim closes unless
extended diary is appropriate.
2) All original reports, documents, and claim data of every kind or description,
that are prepared in whole or in part by or for the CLAIMS ADMINISTRATOR in
connection with this agreement shall be CLIENT's property and constitute the CLAIMS
ADMINISTRATOR'S work product for which compensation is paid. A copy of all
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reports, documents, and claim data of every kind or description that is in whole or in part
by or for the CLIENT is the property of the CLAIMS ADMINISTRATOR. Addonal
copies of original reports, documents, and data requested by the CLIENT will be at the
CLIENT's expense in accordance with this agreement.
3) CLAIMS ADMINISTRATOR agrees that CLIENT or its auditors shall have
access to and the right to audit and reproduce any of the CLAIMS ADMINISTRATORs
relevant records to ensure that the CLIENT is receg all services to which the
CLIENT is entitled under this Agreement or for the purpose relating to the Agreement.
OTTIV Clail
1) Utilize its "State of the Art" claims information system.
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3) Provide CLIENT Read only on-line access to the claims data system, if
desired by CLIENT.
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5) Provide annual claims data report for actuary and auditors upon request.
7) Provide assistance to CLIENT in developing customized reports when
requested (may require additional charge).
8) If applicable, provide conversion of claims data beginning with the
fiscal year at a cost not to exceed
F. CLAIM REVIEW MEETINGS
CLAIMS ADMINISTRATOR shall, upon request, meet and review with CLIENT to
discuss claims inventory and claims results of past period and delivery of services by
CLAIM ADMINISTRATOR.
G. FINANCIAL ACCOUNTING
1) Establish and maintain a trust fund for the purpose of paying indemnity and
expenses that may be due on the claims. The amount to be maintained in the trust fund
shall be determined by the CLIENT.
2) Maintain a copy of all checks drawn by the CLAIMS ADMINISTRATOR to pay
benefits on claims and claims related expenses.
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rM Moll
4) Complete or update Attachment B "Preferred Method of Check Processing"
for check processing options.
If, during the course of GHC handling a general liability and/or subrogation claim
for CLIENT, the institution of a civil action is determined by CLIENT to be the best
course of action and in the best interest of CLIENT, then CLIENT may, at CLIENT"s
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It is agreed that CLIENT has granted $25,000 authority to the CLAIMS
ADMINISTRATOR for the purpose of compromising and/or settling any claims against
CLIENT being handled by the CLAIMS ADMINISTRATOR. Prior approval to
compromise or settle any claim, or pay any expense will be obtained from the
designated CLAIM's officer or employee on matters exceeding the authority granted
above.
10:1111111
CLAIMS ADMINISTRATOR shall retain in accordance with the CLIENT's recor
retention policy up to a maximum of 7 years. For the first year paper files will b"
retained. For years 2 through 7 the files will be scanned and paper files shredded. Afte
1
7 years, unless requested by the CLIENT to retain at its own expense, CLAIM,4-
1 DMINISTRATOR shall delete the scanned files in accordance with the timeline state •
in Attachment C.
V. CONFIDENTIALITY
All data, documents, discussions, or other information developed or received by
or for CLAIMS ADMINISTRATOR in performance of this agreement are confidential and
not to be disclosed to any person except as authorized by CLIENT or CLIENT's
designee, or as required by law.
V1. CONFLICT OF INTEREST
In the event the CLAIMS ADMINISTRATOR receives a claim from the CLIENT i
which there arises a "conflict of interest," the CLAIMS ADMINISTRATOR sha
immediately notify CLIENT. CLIENT may then, at their expense choose to hire anothe
well-qualified claims firm to handle that particular claim to a conclusion. The CLAIM
ADMINISTRATOR covenants that it presently has no interest, direct or indirect, whic
would conflict in any manner with the performance of services required under thi
agreement.
1) CLIENT shall cooperate with Claims Administrator as may be reasonably
necessary for Claim Administrator to perform its services.
2) CLIENT agrees to provide direction to Claims Administrator as requeste*,
regarding particular project requirements.
3) CLIENT shall identify primary contact person for account as well as for billing
and loss run submission. In addition, CLIENT shall be responsible for reporting all
changes thereto.
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4) CLIENT shall be responsible for reporting all Bodily Injury Claims in addition
to all other items noted in Attachment A "Medicare, Medicaid, and SCHIP Extension Ad
of 2007 (MMSEA)II
5) CLIENT shall be responsible for calculating and maintaining pool aggregate
information.
4
CLIENT agrees to pay CLAIMS ADMINISTRATOR for services described in
Section 11 — Scope of Services.
1) CLIENT agrees to pay CLAIMS ADMINISTRATOR for services described in
Section 11- Scope of Services an annual fee of $84,500 for the first two years t, $859500
for the third year, $87,000 for the fourth year, and $88,500 for the fifth year of this five
agreement.
2) Subrogation Fee: Upon CLIENT's request, CLAIMS ADMINISTRATOR shall
provide subrogation services in a scope and at a fee to be agreed upon at the time of
the request. Such agreement shall be made by execution of a written Addendum to this
Agreement.
IX. PAYMENT SCHEDULE
The CLAIMS ADMINISTRATOR will submit its bills to CLIENT, and payment
shall be made by CLIENT, within a reasonable period of time, not to exceed thirty (30)
days.
A 140al iv, I
The term of this contract shall be from July 01 1 2014 to and including June 30,
For the purpose of maintaining the continuity of claims administration for CLIENT
upon the end of the term of this Agreement, or upon termination pursuant to Section XI
herein, CLAIMS ADMINISTRATOR may continue to perform services as outlined in
Section 11 on a month-to-month basis, at the rates then in effect.
X1. TERMINATION
CLIENT and CLAIMS ADMINISTRATOR shall have the right to terminate this
agreement without cause, by giving not less than ninety (90) days written notice of
termination.
X11. FAIR EMPLOYMENT
It is the policy of George Hills Company to provide fair and equal treatment to all
staff members. George Hills Company is an Equal Opportunity Employer and does not
discriminate in any way against any person on the basis of age, race, sex, color,
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national origin, national ancestry, physical disability, medical condition, religion, creed,
marital status, sexual orientation, gender idencation or any other classcation
deemed protected by law.
0
91 191LI k i Sq.1T,4 1W El
In performing claims administrative services herein agreed upon, the CLAIMS
ADMINISTRATOR shall have the status of an independent CLAIMS ADMINISTRATOR
and shall not be deemed to be an officer, employee, or agent of CLIENT.
The CLAIMS ADMINISTRATOR will defend, indemnify, and hold harmless
CLIENT from and against all claims, demands, actions, or causes of action, which may
arise, from the action, conduct, or failure to act by CLAIMS ADMINISTRATOR
personnel. CLIENT will defend, indemnify, and hold harmless the CLAIMS
ADMINISTRATOR from and against all claims, demands, actions, or causes of action,
which may arise, from the action, conduct, or failure to act by CLIENT. CLIENT will
defend, at no cost to the CLAIMS ADMINISTRATOR; in those cases wherein the
CLAIMS ADMINISTRATOR is named in a filed or verified complaint simply by virtue of
the fact it is the CLAIMS ADMINISTRATION firm on a given claim.
XV. INSURANCE
The CLAIMS ADMINISTRATOR shall provide CLIENT with Certificates of
Insurance duly executed by the insurance company or companies authorized to transact
business in the State of California, and said Cercates shall certify that the CLAIMS
ADMINISTRATOR has in full force and effect $1,000,000 coverage applying to bodily
injury, personal injury, property damage, errors and omissions coverage, statutory
workers compensation coverage, and shall also maintain an employee fidelity bond in
the amount of $500,000.
Thirty (30) days notice, in wrng, prior to cancellation or reduction in coverage
will be provided.
The insurance coverage required of the CLAIMS ADMINISTRATOR shall also
meet the following requirements:
1 ) The insurance shall be primary with respect to any insurance or coverage
maintained by CLIENT and shall not call upon CLIENT's insurance or coverage w
contribution.
2) Except for professional liability insurance, the insurance policies shall be
endorsed for contractual liability and personal injury.
3) Except for professional liability insurance, the insurance policies shall be
specifically endorsed to include the CLIENT, its officers, agents, and employees as
additionally named insureds under the policies.
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4) CLAIMS ADMINISTRATOR shall provide to CLIENT (a) Certificates of
Insurance evidencing the insurance coverage required herein, and (b) specific
endorsements naming CLIENT, its officers, agents and employees, as additional
insureds under the policies.
KATJ =4 Ji I
During the period of this contract, and for a period of one (1) year thereafter, th(
CLAIMS ADMINISTRATOR agrees not to solicit for employment any CLIENT employe(
contacted during the performance of this agreement; CLIENT agrees not to solicit fo
employment, or employ, during the period of this contract, and for a period of one (1
year thereafter, any employee of the CLAIMS ADMINISTRATOR contacted by th(
CLIENT during the performance of this agreement.
XV11. PERMITS,, LICENSES,, CERTIFICATES
CLAIMS ADMINISTRATOR, at CLAIMS ADMINISTRATOR'S sole expense, shal
obtain and maintain during the term of this Agreement, all permits, licenses, an(
certificates required in connection with the performance of services under thi!
Agreement, including appropriate business license.
XV111. ARBITRATION
CLAIMS ADMINISTRATOR and CLIENT •agree that in the event •of any •dispute
with regard to the provisions of the Agreement, the services rendered or the amount oi
CLAIMS ADMINISTRATOR'S compensation the dispute shall be submitted to
arbitration upon mutual agreement of the parties, under such procedures as the parties
may agree upon, or, if the parties cannot agree, then under the Rules of the American
Arbitration Association.
mww-ne-1 t[q4�
All notices to the CLAIMS ADMINISTRATOR shall be personally served or
mailed, postage prepaid, to the following address: George Hills Company, 3043 Gold
Canal Dr Ste 200, Rancho Cordova, CA 95670.
All notices to the CLIENT shall be personally served or mailed, postage prepaid,
1.
to the following address: City of San Rafael, P.O. Box 151560, San Rafael, CA 94915.
CLAIMS ADMINISTRATOR and CLIENT agree that the terms and conditions of
the Agreement may be reviewed or modified at any time. Any modifications to this
Agreement, however, shall be effective only when agreed to in writing by both the
CLIENT and CLAIMS ADMINISTRATOR.
XX. ENTIRE AGREEMENT
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CLAIMS ADMINISTRATOR and CLIENT agree that this agreement constitutes
'the entire agreement of the parties regarding the subject matter described herein and
supersedes all prior communications, agreements, and promises, either written or oral.
XIX. TIME OF ESSENCE
Time is of the essence in respect to all proons of this Agreement that specifl,,M
a time for performance: provided, however that the foregoing shall not be construed t
limit or deprive a party of the benefits of any grace or use period allowed in thi
Agreement. I
Lf BY:
Date John ./Chaquica, President
GEORGE HILLS COMPANY INC.
x/21 /• BY: L -Ci {1�
Date Nancy Mackle, City Manager
CITY OF SAN RAFAEL
-sther C. Beirne, City Clerk
Robert F. Epstein, City Aftorney'
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ATTACHMENT A
MEDICARE, MEDICAID, AND SCHIP EXTENSION ACT OF 2007 (MMSE4
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ATTACHMENT B
PREFERRED METHOD OF CHECK PROCESSING
1 Selection of Bank
a) Clients Choice
Name West America Bank
Address 1108 Fifth Ave., San Rafael, CA 94901
Please provide signature cards, sample check, starting check number,
name of contact person
b) GHC uses CA Bank & Trust F-1
2. Trust Balance Desired $ -0- (zero balance account with automatic transfers
as GHC issues checks)
3. Account funding: GHC will notify client when the balance falls below required
balance
4A. Number of Signatures Required AS IS
a) One El
b) Two on all checks F-1
c) Two on checks in excess of $ F-1
4B If two signatures are required please specify:
a) Both GHC F-1
b) One GHC, one. client
GHC signers: Michael J Kielty, CEO; John Chaquica, President; Kimberly
Santin, Finance Director
5. Accountability
a) Positive Pay Yes E] No
GHC recommends positive pray to mitigate the potential for fraud.
b) Daily check registers Yes No E]
c) Statement to be balanced by client E
d) Statement to be balanced by GHC with copies to client E]
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ATTACHMENT C
TIME LINE FOR RECORD RETENTION
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Loss Runs
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3 years from age 18 or 7 years whichever is
longer from closure
5 years after litigation is concluded
Closed + 2 years unless litigated
07irly,
Closed + 2 years unless litigated
uWayl-,
Current year end report + 7 years
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A/Ad
Aoeo�
... Hills
C 0 M P A N Y
Claims andjPA Management Services
Corporate Headquarters 3043 Gold Canal Dr., Suite 200, Rancho Cordova, CA 95670 Phone: (916) 859-4800 Fax: (916) 859-4805
Lisa A. Goldfien
City of San Rafael
1400 Fifth Avenue
San Rafael, CA 94915
RECEIVEU,
Enclosed are two (2) executed copies of the Agreement between City of San Rafael and
George Hills Company for the Provision of Third Party Liability Claims Administration
Services. Please provide us with one fully executed original for our records.
Please contact us with any questions. We look forward to providing the City with quality
service in the years to come.
Very truly yours,
GEORGE HILLS COMPANY
Maya Maas
Corporate Analyst
(916) 859-4832
F47M
Fairfield Lakeport Norco Sacramento/Rancho Cordova San Bernardino San Francisco San Jose
www.georgehills.com (800) 942-2358 Adjuster License 2607498 P.I. License 16154
j A" 1
UPI
INSTRUCTIONS: USE THIS FORM WITH EACH SUBMITTAL OF A CONTRACT, AGREEMENT,
ORDINANCE OR RESOLUTION BEFORE APPROVAL BY COUNCIL 1 AGENCY.
SRSA 1 SRCC AGENDA ITEM NO.
DATE OF MEETING: August 18, 2014
FROM: LISA A. GOLDFIEN
TITLE OF iiCUMENT: CONSIDERATION OF ADOPTION OF ♦ RESOLUTION APPROVING ♦ i
AUTHORIZING THE CITY MANAGER TO EXECUTE AN AGREEMENT WITH GEORGE HILLS
COMPANY FOR THE PROVISION OF THIRD -PARTY LIABILITY
FOR ♦ ♦' PERIOD (JULY 17 2014 TO JUNE 30,2019)
Department Head (signature)
(LOWER ♦ OF 1. O. ♦.rill ONLY)
APPROVED AS TO FORM:
VIM
City Attorney (signature)