HomeMy Public PortalAboutCARL WARREN AND COMPANY AGRUMT FOR ADMINISTERING A PROGCITY OF CARSON
CONTRACT SERVICES AGREEMENT FOR
ADMINISTERING A PROGRAM OF SELF-INSURANCE
This CONTRACT SERVICES AGREEMENT ("Agreement") is made and entered
into this 7 1h day of August, 2007, by and between the CITY OF CARSON, a municipal
corporation, ("City") and Carl Warren and Company ("Consultant").
NOW, THEREFORE, the parties hereto agree as follows:
1.0 SERVICES OF CONSULTANT
1.1 Scope of Services. In compliance with all of the terms and conditions
of this Agreement, the Consultant shall perform the work or services set forth in the "Scope of
Services" attached hereto as Exhibit "A " and incorporated herein by reference. Consultant
warrants that all work and services set forth in the Scope of Services will be performed in a
competent, professional and satisfactory manner.
1.2 Compliance With Law. All work and services rendered hereunder shall
be provided in accordance with all ordinances, resolutions, statutes, rules, and regulations of
the City and any Federal, State or local governmental agency of competent jurisdiction.
1.3 Licenses, Permits, Fees and Assessments. Consultant shall obtain at its
sole cost and expense such licenses, permits and approvals as may be required by law for the
performance of the services required by this Agreement.
2.0 COMPENSATION
2.1 Contract Sum. For the services rendered pursuant to this Agreement,
Consultant shall be compensated in accordance with the "Schedule of Compensation"
attached hereto as Exhibit "B" and incorporated herein by this reference, but not exceeding the
maximum contract amount of Sixty Thousand Dollars ($60,000) ("Contract Sum").
2.2 Method of Pqymen . Provided that Consultant is not in default under
the terms of this Agreement, Consultant shall be paid on a monthly basis, except as specified
otherwise on the Schedule of Compensation.
2.3 Availability of Funds. This Agreement is valid and enforceable only if
sufficient funds are made available by the City Council of the City for the purposes of this
Agreement. The availability of funding is affected by matters outside the City's control,
including other governmental entities. Accordingly, the City has the option to void the whole
Agreement or to amend the Agreement to reflect unanticipated reduction in funding, for any
reason.
45132
3.0 COORDINATION OF WORK
3.1 Representative of Consultant. Michael Reed is hereby designated as
being the principal and representative of Consultant authorized to act in its behalf with respect
to the work and services specified herein and make all decisions in connection therewith.
3.2 C6 ntract Officer. Terry Williams, Risk Management Analyst, is hereby
designated as being the representative the City authorized to act in its behalf with respect to
the work and services specified herein and make all decisions in connection therewith
("Contract Officer"). The City Manager of City shall have the right to designate another
Contract Officer by providing written notice to Consultant.
3.3 Prohibition Against Subcontracting or Assignment. Consultant shall
not contract with any entity to perform in whole or in part the work or services required
hereunder without the express written approval of the City. Neither this Agreement nor any
interest herein may be assigned or transferred, voluntarily or by operation of law, without the
prior written approval of City. Any such prohibited assignment or transfer shall be void.
3.4 Independent Contractor. Neither the City nor any of its employees
shall have any control over the manner, mode or means by which Consultant, its agents or
employees, perforin the services required herein, except as otherwise set forth. Consultant
shall perform all services required herein as an independent contractor of City and shall
remain under only such obligations as are consistent with that role. Consultant shall not at
any time or in any manner represent that it or any of its agents or employees are agents or
employees of City.
4.0 INSURANCE AND INDEMNIFICATION
4.1 Insurance. The Consultant shall procure and maintain, at its sole cost
and expense, in a form and content satisfactory to City, during the entire term of this
Agreement including any extension thereof, the following policies of insurance:
(a) Comprehensive General Liability Insurance. A policy of
comprehensive general liability insurance written on a per occurrence basis in an amount not
less $ 1,000,000.00 per occurrence.
(b) Worker's Compensation Insurance. A policy of worker's
compensation insurance in such amount as will fully comply with the laws of the State of
California and which shall indemnify, insure and provide legal defense for both the
Consultant and the City against any loss, claim or damage arising from any injuries or
occupational diseases occurring to any worker employed by or any persons retained by the
Consultant in the course of carrying out the work or services contemplated in this Agreement.
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(c) Automotive Insurance. A policy of comprehensive automobile
liability insurance written on a per occurrence basis in an amount not less $1,000,000.00 per
occurrence. Said policy shall include coverage for owned, non -owned, leased and hired cars.
(d) Professional Liabilily Insurance. A policy of professional liability
insurance in an amount not less than $ 1,000,000. 00 per claim with respect to loss arising from
the actions of Consultant performing professional services hereunder on behalf of the City.
All of the above policies of insurance shall be primary insurance and shall name the
City, its officers, employees and agents as additional insureds. The insurer shall waive all
rights of subrogation and contribution it may have against the City, its officers, employees
and agents and their respective insurers. All of said policies of insurance shall provide that
said insurance may not be amended or cancelled without providing thirty (30) days prior
written notice by registered mail to the City. In the event any of said policies of insurance are
cancelled, the Consultant shall, prior to the cancellation date, submit new evidence of
insurance in conformance with this Section 4.1 to the Contract Officer. No work or services
under this Agreement shall commence until the Consultant has provided the City with
Certificates of Insurance or appropriate insurance binders evidencing the above insurance
coverages and said Certificates of Insurance or binders are approved by the City.
CANCELLATION:
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY
SHALL MAIL THIRTY (30) -DAY ADVANCE WRITTEN NOTICE TO
CERTIFICATE HOLDER NAMEb HEREIN.
[to be initialed]
"Agent InTiTa �s'
The Consultant agrees that the provisions of this Section 4.1 shall not be construed as
limiting in any way the extent to which the Consultant may be held responsible for the
payment of damages to any persons or property resulting from the Consultant's activities or
the activities of any person or persons for which the Consultant is otherwise responsible.
The insurance required by this Agreement shall be satisfactory only if issued by
companies qualified to do business in California, rated "A" or better in the most recent edition
of Best Rating Guide, The Key Rating Guide or in the Federal Register, and only if they are
of a financial category Class VII or better, unless such requirements are waived by the Risk
Manager of the City due to unique circumstances.
4.2 Indemnification. Consultant agrees to indemnify the City, its officers,
agents and employees against, and will hold and save them and each of them harmless from,
any and all actions, suits, claims, damages to persons or property, losses, costs, penalties,
obligations, errors, omissions or liabilities, including paying any legal costs, attorneys fees, or
paying any judgment (herein "claims or liabilities") that may be asserted or claimed by any
person, firm or entity arising out of or in connection with the negligent performance of the
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work or services of Consultant, its agents, employees, subcontractors, or invitees, provided for
herein, or arising from the negligent acts or omissions of Consultant hereunder, or arising
from Consultant's negligent performance of or failure to perform any term, provision,
covenant or condition of this Agreement, but excluding such claims or liabilities to the extent
caused by the negligence or willful misconduct of the City.
5.0 TERM
5.1 Term. Unless earlier terminated in accordance with Section 5.2 below,
this Agreement shall be effective July 1, 2007, and shall continue in full force and effect until
June 30, 2008. City shall have the right, in its sole discretion, to extend the term of the
Agreement for up to two (2) additional one (1) year terms (each of which shall be a "Renewal
Term") on the same terms and conditions of this Agreement. City must evidence its option to
extend the original term or any Renewal Tenn, as the case may be, by providing written
notice to Consultant at some point within thirty (30) days prior to the expiration of the
original term or any Renewal Term.
5.2 Termination Prior to Expiration of Term. Either party may terminate
this Agreement at any time, with or without cause, upon thirty (30) days' written notice to the
other party. Upon receipt of the notice of termination, the Consultant shall immediately cease
all work or services hereunder except as may be specifically approved by the Contract
Officer. In the event of termination by the City, Consultant shall be entitled to compensation
for all services rendered prior to the effectiveness of the notice of termination and for such
additional services specifically authorized by the Contract Officer and City shall be entitled to
reimbursement for any compensation paid in excess of the services rendered.
6.0 MISCELLANEOUS
6.1 Covenant Aaainst Discrimination. Consultant covenants that, by and
for itself, its heirs, executors, assigns and all persons claiming under or through them, that
there shall be no discrimination against or segregation of, any person or group of persons on
account of race, color, creed, religion, sex, marital status, national origin, or ancestry in the
performance of this Agreement. Consultant shall take affirmative action to ensure that
applicants are employed and that employees are treated during employment without regard to
their race, color, creed, religion, sex, marital status, national origin or ancestry.
6.2 Non-liabilily of City Officers and Employees. No officer or employee
of the City shall be personally liable to the Consultant, or any successor in interest, in the
event of any default or breach by the City or for any amount which may become due to the
Consultant or to its successor, or for breach of any obligation of the terms of this Agreement.
6.3 Conflict of Interest. No officer or employee of the City shall have any
financial interest, direct or indirect, in this Agreement nor shall any such officer or employee
participate in any decision relating to the Agreement which affects his financial interest or the
financial interest of any corporation, partnership or association in which he is, directly or
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indirectly, interested, in violation of any State statute or regulation. The Consultant warrants
that it has not paid or given and will not pay or give any third party any money or other
consideration for obtaining this Agreement. When requested by the Contract Officer, prior to
the City's execution of this Agreement, Consultant shall provide the City with an executed
statement of economic interest.
6.4 Notice. Any notice, demand, request, document, consent, approval, or
communication either party desires or is required to give to the other party or any other person
shall be in writing and either served personally or sent by prepaid, first-class mail, in the case
of the City, to the City Manager and to the attention of the Contract Officer, CITY OF
CARSON, 701 E. Carson Street, Carson, California 90745-2224, and in the case of the
Consultant, to the person at the address designated on the execution page of this Agreement.
6.5 Interpretation. The terms of this Agreement shall be construed in
accordance with the meaning of the language used and shall not be construed for or against
either party by reason of the authorship of this Agreement or any other rule of construction
which might otherwise apply.
6.6 Integration; Amendment. It is understood that there are no oral
agreements between the parties hereto affecting this Agreement and this Agreement
s upersedes and cancels any and all previous negotiations, arrangements, agreements and
understandings, if any, between the parties, and none shall be used to interpret this
Agreement. This Agreement may be amended at any time by the mutual consent of the
parties by an instrument in writing.
6.7 Severability. In the event that part of this Agreement shall be declared
invalid or unenforceable by a valid judgment or decree of a court of competent jurisdiction,
such invalidity or unenforceability shall not affect any of the remaining portions of this
Agreement which are hereby declared as severable and shall be interpreted to carry out the
intent of the parties hereunder unless the invalid provision is so material that its invalidity
deprives either party of the basic benefit of their bargain or renders this Agreement
meaningless.
6.8 Waiver. No delay or omission in the exercise of any right or remedy by
a nondefaulting party on any default shall impair such right or remedy or be construed as a
waiver. A party's consent to or approval of any act by the other party requiring the party's
consent or approval shall not be deemed to waive or render unnecessary the other party's
consent to or approval of any subsequent act. Any waiver by either party of any default must
be in writing and shall not be a waiver of any other default concerning the same or any other
provision of this Agreement.
6.9 Attorneys' Fees. If either party to this Agreement is required to initiate
or defend or made a party to any action or proceeding in any way connected with this
Agreement, the prevailing party in such action or proceeding, in addition to any other relief
which may be granted, whether legal or equitable, shall be entitled to reasonable attorneys'
fees, whether or not the matter proceeds to judgment.
6.10 Corporate Authority. The persons executing this Agreement on behalf of the
parties hereto warrant that (i) such party is duly organized and existing, (ii) they are duly
authorized to execute and deliver this Agreement on behalf of said party, (iii) by so executing
this Agreement, such party is formally bound to the provisions of this Agreement, and (iv) the
entering into this Agreement does not violate any provision of any other Agreement to which
said party is bound.
IN WITNESS WHEREOF, the parties have executed and entered into this Agreement
as of the date first written above.
CITY:
CITY OF CARSON,
a municipal corporation
_Jt.v-, D
Mayor Jim Dear
ATTEST:
City Clerk
APPROVED AS TO FORM:
ALESHIRE & WYNDER, LLP
-N. _7___
mey
City Atto Vk
CONSULTANT:
CARL WARREN AND COMPANY
By: z
Name: Tom Boylanj
Tit : Chief FinancAl Officer
By:
z�l Name: Micliael Reed
Title: Corporate Secretary
Address: P.O. Box 25161
Santa Ana, CA 92799-5161
[END OF SIGNATURES]
EXHIBIT "A"
SCOPE OF SERVICES
1. GENERAL. Consultant shall:
A. Supervise and administer the Self -Insurance Liability Program for City; and
B. Represent City in all matters related to the investigation, adjustment, processing,
supervision and resolution of claims for money damages asserted by third parties
against City; and
C. Provide to City during the term of this Agreement all the services more particularly
set forth hereinafter.
2. INVESTIGATIVE SERVICES.
A. Consultant shall provide complete investigative services including, but not limited
to:
(1) Receipt of, and examination of all reports of accidents, incidents, claims or
causes which are or may be the subject of such liability claims.
(2) The investigation of such accidents, incidents, claims or cases where
examination warrants such investigation, or when requested by City; such
investigation to include on-site investigation, photographs, interviewing
witnesses, determination of losses, and other investigative services necessary
to determine liability and losses, but not to include extraordinary professional
services as set forth in Paragraph 2-B herein.
B. Allocated Expenses: All reasonable and supportive extraordinary services requiring
expert or professional assistance, such as professional photography, independent
medical examination, professional engineering services, and laboratory services.
3. CLAIMS ADJUSTMENT SERVICES. Consultant shall provide complete claims
adjustment services on each accident or incident which is, or maybe, the subject of a liability
claim against City. Such services shall include, but are not limited to:
A. The maintenance of a claim file on each potential or actual claim reported to
Consultant.
B. Whenever its investigation results in a determination that City has sustained a
liability to a third party, Consultant shall process any such claim or potential claim
for settlement in accordance with City's instructions for settlement of such claims.
C. Notification of City's primary and excess carriers of all claims which exceed the
City's self-insurance limit. Retention and maintenance of liaison between the
insurance carriers and the City on matters affecting the adjustment of such claim.
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D. Obtain all Release Agreements on settlement of any claim or potential claim.
4. ADMINISTRATIVE SERVICES. Consultant shall provide at least the following
administrative services.
A. Assigm-nent of a City Account Adjuster to City to act as a liaison between City and
Consultant.
B. Provide City with tabulated Monthly Status Reports on all reported claims during the
term of this Agreement, indicating the status of each reported open claim assigned to
Consultant, the details of each such claim and details of all claim payments during
the month. This service is also available on-line at no charge to City. Each printed
Monthly Status Report shall be delivered to City within twenty (20) days of the close
of each calendar month.
C. Periodically review and adjustment of reserves on all open claims.
5. LEGAL SUPPORT SERVICES. Consultant shall provide at least the following legal
support services on each claim wherein the claimant has commenced litigation.
A. Upon notification by City that litigation has been filed on an open claim, Consultant
shall contact City's trial attorney assigned to handle the case by City and provide
such trial attorney with all information and files concerning the claim.
B. Maintain liaison with City's trial attorney and provide such investigation services as
are required by such attorney during pre-trial and trial stages.
C. Assist City's trial attorney in answering and responding to interrogatories and other
written discovery propounded by the claimant.
D. Assist City's personnel in small claims actions filed against City on o I pen claims
handled by Consultant by providing City with: (1) names of any witnesses to be
subpoenaed, (2) necessary evidence, and (3) assistance at the trial, including
appearance as a witness, if necessary.
6. CITY'S RESPONSIBILITIES. City sh I all provide Consultant with copies of all relevant
documents upon request from Consultant and without charge, and shall make available any
City employee for interviews by Consultant at reasonable times concerning any
investigation of a claim or incident pursuant to this Agreement.
7. CONFLICT OF INTEREST. In the event a claim or incident is reported to Consultant by
City and it is determined that the actual or potential claimants therein are also clients of
Consultant, then Consultant shall immediately notify City of such potential conflict of
interest. If City elects to have an independent investigator and adjuster, Consultant shall
provide such an investigator and adjuster.
8. DISPOSITION OF FILES ON TERMINATION OF AGREEMENT
A. All files on each claim shall be the property of City.
EXHIBIT "A"
B. In the event of expiration of the Agreement, and non -renewal thereof, Consultant shall bill
City, subject to the rates listed on Exhibit "B, " for work completed by Consultant on each
claim, and also promptly forward all completed and pending claim files to City.
C. In the event of cancellation of the Agreement by City, Consultant shall return all files to
City, unless City requests Consultant to continue to process any files, in which event
Consultant shall continue to process such files on a time -and -expense basis as are provided
in Consultant's Rate Manual at the time such services are rendered.
EXHIBIT "A"
EXHIBIT "B"
SCHEDULE OF COMPENSATION
CONSIDERATION
A. City hereby agrees to pay to Consultant and Consultant hereby agrees to accept in full
satisfaction for its services provided hereunder, compensation in the following amounts:
(1) Consultant shall be compensated in the amount of $225.00 per month for its claims
supervision, and other necessary administrative duties and the computerized Monthly
Status Reports.
(2) Consultant shall be compensated for its claims handling services, other than those in
subsection (1) above, at the rate of $52.00 per hour the first year, $53.00 per hour the
second year and $54.00 per hour the third year. In addition, Consultant shall be
reimbursed for its expenses, excluding expenses incurred in the performance of sub-
section (1) above, and including mileage g.49 per mile, $2.25 per print for color
photographs, typing at $4.50 per page, photocopy expen . ses at $0.25 per page,
telephone expenses at eight (8) percent of Consultant's services, and office expense
calculated at $2 1.00 for file make-up.
(3) Consultant shall be reimbursed for any Allocated Expenses (defined in Exhibit "All
Section 2-13) which are advanced by Consultant. Consultant shall only order such
services after obtaining prior written authorization from City, except that such
authorization may be given orally by City's City Manager or Risk Manager if the
services are urgently required.
TIME OF PAYMENT. Upon execution of this Agreement by both parties, City shall remit to
Consultant the sum of $675-00 as payment for the first three (3) months of Consultant's services
hereunder, and will remit a payment of $675.00 for each following three (3) months'period by the
first day of each such period.
If requested by City, Consultant will interim bill all charges incurred at the end of each quarter.
City of Carson
Report to Mayor and City Council
August 7, 2007
New Business Consent
SUBJECT: AGREEMENT TO PROVIDE LIABILITY CLAIM ADMINISTRATION SERVICES
FOR FISCAL YEAR 2007/08 WITH A TWO TO THREE YEAR RENEWAL OPTION �
C__.4 -41
Submitted by Jerome G. Groomes Approved*4aruwreG. Groomes
City Manager City Manager
1. SUNUqARY
Presented for Council's consideration is the renewal of general liability claim
administration services for FY2007/08. Carson has contracted for liability claim
administration services since its incorporation in 1968. This service will assist
staff in addressing the numerous claims from the general public, as well as
citizens.
II. RECONEN4ENDATION
TAKE the following actions:
1. APPROVE an agreement between the -city of Carson and Carl Warren and
Company for liability third party administration services in an amount not to
exceed $60,000.00 for FY 2007/08 and a two to three year renewal option.
2. AUTHORIZE the Mayor to execute the agreement after approval as to form
by the City Attorney.
III. ALTERNATIVES
The City Council may take another action deemed appropriate.
IV. BACKGROUND
The city received eight (8) competitive bids for its liability administration
program from Claims Management Associates, Tristar Risk Management, Engle
Martin, Corvel, NovaPro Risk Solutions, AdminSure, Carl Warren and
Company and Gregory Bragg & Associates. After bids were reviewed and
bidders interviewed, it is staff's recommendation to award the bid to Carl
Warren and Company, the incumbent company. Also, after careful analysis of
competing services, it was determine by staff that changing vendors at this time
would not be cost effective, plus the interruption in services would create undue
hardship, especially when the current service provider is performing at a high
rate of effectiveness.
Since 1978, Carl Warren and Company (CW) has provided competent adjusting
services to the city's liability claim program. Carl Warren & Company has been
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City of Carson Report to Mayor and City Council
August 7, 2007
in business in and around Los Angeles County since 1944. CW administers
liability claims services to many private entities and a large number of public
entities, including cities, school districts, counties, risk -sharing pools (California
Joint Powers Insurance Authority) and special districts. CW has approximately
200 employees and 21 service offices located across the United States and the
city has experienced an effective working relationship with CW.
Also, the $1,000.00 administrative fee is waived and the adjuster is very familiar
with and has an excellent working relationship with the city's tort claim liability
attorney and city staff. Adjuster is a certified auto appraiser, and is very familiar
with all city streets, has detailed knowledge of the city's maintenance and tree
trimming zones, and provides excellent customer relations with citizens.
V. FISCAL IMPACT
Funding for the Liability Third Party Administration is included in the proposed
FY 2007/08 budget in account number 01-50-560-003-6004.
V1. EXHIBITS
1. Service Agreement, (pgs. 1-51)
2. Insurance Coverages, (pgs. 52-62)
3. Congressional Recognition, (pg. 63)
DocumenG
Prepared by:
sf.RevO61902
Reviewed bv:
City Clerk
City Treasurer
Administrative Services
Development Services
Economic Development Services
Public Services
City of Carson Report to Mayor and City Council
August 7, 2007
Date
Action taken by City Council
Action
rz//
BY HAND DELIVERY
Mr. Terry L. Williams
Risk Manager Analyst
City of Carson
701 East Carson Street
Carson, CA 90749
Re: RFP — Claims Administration Services
Dear Mr. Williams:
June 6, 2007
On behalf of Michael Reed, the Client Relationship Manager for the City of Carson, and the other
employee -owners who have dutifully worked on your account since 1978, 1 wish to extend our thanks
to you for including us in the RFP process.
We believe that we have enjoyed a mutually beneficial working relationship with the team at the City
of Carson and hope to continue that rapport for years to come. In this business it is so important to
have a good understanding of the claims philosophy of our customers, which is why so many of our
customers have been with Carl Warren & Company for over 15 years. Delivering to you consistent,
responsive, cost-effective, professional service is something in which we take a great deal of pride.
If you have any questions about the materials contained herein, don't hesitate to call Michael Reed
directly, or any member of our team.
Very truly yours,
Caryn B. Siebert, JI)
President
cc: Michael Reed, Client Relationship Manager
Larry Hunt, Executive Vice President and Board of Directors Member
Kevin Sovereign, AVP and Service Leader
CARL WARREN & CO.
An Empfoyee-OwnedCompany
CLAIMS MANAGEMENT - CLAIMS ADJUSTERS
770 Placentia Avenue, Placentia, CA 92870-6832
Mail: P.O. Box 25180, Santa Ana, CA 92799-5180
CT$_on_e_: _(7TTY5 �-� (800)572-6900 - Fax: (714)961-8131
EXHIBIT NO.1
CARL WARREN & COMPANY BACKGROUND
In 2004,. we celebrated the 60th Anniversary
of the founding of Carl Warren & Company.
(what a scene photo would have looked like in the 1940s.)
Our firm was established in 1944 by Carl Warren. Mr. Warren had been the Los Angeles
Area Claims Manager for Gulf Insurance Company. For the next twenty-one years, Mr.
Warren worked hard to establish the firm's reputation for excellence in claims handling. He
retired in 1965 and sold his interest in the company.
Carl Warren & Company became a California Corporation in 1974. An employee stock -
ownership plan (ESOP) was implemented at that time and the firm is now 100% employee
owned. Our organization now has approximately 200 employees and 21 service offices
located across the United States.
Carl Warren & Company administers liability claims services to many private entities, and a
large number of public entities, including cities, school districts, counties, risk -sharing pools
and special districts.
Following the arrival of a new CEO in February of 2004, Carl Warren & Company instituted
a dynamic corporate re -structuring that has resulted in a renewed vigor and a sharp focus
on quality and customer service. We have enumerated the core values that guide our
conduct. We are convinced that these factors will positively impact the working
relationship between The City of Carson and Carl Warren & Company and that our
partnership will continue well into the future.
Carl Warren & Company Value Statement
Customer Satisfaction:
* Customer service is our business.
• We see ourselves as the "gold standard" of customer service. We will do
whatever it takes to understand and exceed customer expectations.
• We will provide professional service and advice on time and at a competitive
price.
Integrity and Communication:
• We will always be honest, trustworthy and operate in an ethical fashion.
• Our communication will be open, timely, constructive and insightful.
Excellence:
We will aggressively pursue best practices in providing professional services and
advice.
• We will foster the values of caring, attention to detail, flexibility and creativity.
• We will take risks when appropriate.
• We will anticipate the needs of our customers and employee -owners.
Teamwork:
0 We value the individual strengths of every employee -owner and as such, every
employee owner has an equal accountability for the success of the organization.
0 We value the differences in perspective, opinion, background and culture which
make us better as a team and as a company.
* We will treat everyone we contact with fairness, dignity, and respect without
regard to title, status or individual beliefs.
0 We have fun.
Leadership:
• We will support learning and growth through positive leadership.
• We accept personal accountability and responsibility and are not afraid to
challenge the status quo.
• We will recognize the efforts of our colleagues at all levels of the company.
• We will be actively involved in the communities in which we live, work and to
whom we provide services.
In September of 2005, Carl Warren & Company was awarded the California / Western
States Chapter ESOP Company of the Year in recognition of its values and employee
pride, service and ownership. Further, Carl Warren & Company is one of only six PERI-
qualifled TPAs in the entire country! (see attachment #1)
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SERVICE OFFICE
Carl Warren & Company would administer the City of Carson program from its Home Office
located at 770 S. Placentia Ave., Placentia, CA, a mere 26 miles from the Carson City Hall.
Our adjusters are available and accessible 24 hours a day, 7 days a week. We provide after
hours contact information so that our adjusters can be easily reached in the event of an
emergency.
All of the adjusters managing City of Carson files will be based there as will the files
themselves.
SERVICE OFFICE STRUCTURE
Claims Analysts and Specialists:
The claims analysts and specialists will complete a thorough investigation into each claim
that is received. The specific items that are completed by the claims analysts and specialists
are outlined in the Scope of Work section of this proposal. This includes but is not limited to
investigation, reporting, negotiation, performing litigation management functions, and
reserving. The claims analysts and specialists will also be responsible for obtaining the
services of outside vendors when necessary, assuring excellence in their services and
processing the invoices of these outside vendors.
Client Relationship Manager:
Our Client Relationship Manager, Mr. Me Reed is the liaison between the City of Carson and
the claims and support staffs. He will receive and review new claims from the City and
assign them to the appropriate claims person. He reviews incoming mail and outgoing
reports before they are sent to the City. He will maintain the in-house settlement authority
as may be granted by the City. He coordinates claims audits. The Client Relationship
Manager is responsible for ensuring that all aspects of the City's account run smoothly,
including home office coordination and support.
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LAI
EXECUTIVE MANAGEMENT
KEVIN D. SOVEREIGN, ASSISTANT VICE PRESIDENT
PUBLIC ENTITY SERVICE AND RETENTION LEADER
San Bernardino Valley College
California State University
Western State University College of Law
20 years claims adjusting experience
Program Manager, New Mexico Public Schools Insurance Authority
(89 school districts)
Past President, New Mexico Claims Association (2 terms)
Carl Warren & Company employee since 1988
LARRY HUNT, EXECUTIVE VICE PRESIDENT
PUBLIC ENTITY CLIENT GROUP LEADER
Bachelor of Science, Weber State University
Safeco Insurance Claims School Graduate
Associate in Risk Management Degree
Certified Instructor — California Department of Insurance
Former President of the California Association of Independent Insurance Adjusters
Carl Warren & Company employee since 1976
CARYNSIEBERT
PRESIDENT AND CEO
ID, New York Law School
Safeco Claims School Designer
Former Claims Director Coregis, ERC, Safeco
Former Director, Board of Governors, National Insurance Crime Bureau
Contributing Author — EPLI:Safeguarding Your Future
Speaker at PRIMA and PARMA
E
ARRAY OF RESOURCES
A wide variety of ancillary services that support the day to day operations of our branch
claims offices are provided by our home office located in Placentia, CA as well as other
branch offices. Those ancillary services include Human Resources and Finance, Information
Technology and executive management. In addition to those services, we have established
"'Centers of Excellence" that are responsible for such tasks as trust account management,
check issuance and database management.
We also provide ongoing training for our Support staff personnel so that they can keep
abreast with the latest technological advances available. This enables us to continue to
provide the highest quality work product possible while improving efficiency and
responsiveness to client needs.
Additional resources which we provide to our claims management staff include state of the
art online Index Bureau access, property damage estimating programs, and ongoing support
from professional interaction with other claims professionals through support of insurance
industry associations such as PARMA, PRIMA, CASBO, the California Association of
Independent Insurance Adjusters (Carl Warren & Company was a founding member) and
many other state and local claims associations and insurance industry groups. Several of our
employee -owners have served in leadership capacities in these organizations and we are
now a PERI -qualified TPA.
5
RAI
CLAIMS MANAGEMENT PHILOSOPHY
Carl Warren's claim handling philosophy has been and will continue to fully comply with
that of the City of Carson.
Quite simply, our company philosophy in managing claims is; ""Pay what you owe, when
you owe it, attempt to avoid litigation whenever possible. Do not spend $2.00 on
subrogation to recover $1.00." Most importantly, we believe it is imperative "to treat
people the way that we would want to be treated."
We believe that the most effective claims management occurs when there is a strong
foundation laid. A prompt, thorough investigation is required while being mindful that the
extent of the investigation must be appropriate for the nature of the claim, the extent of
the damages and the liability exposure presented.
We believe that reserving should be conservative, taking into consideration many aspects,
including jurisdiction, severity of injury and degree of liability / responsibility. Reserves
must be reviewed and timely adjustments made.
Our service to many public entities has proven that prompt contact with claimants, timely,
aggressive evaluation of claims and open communication with all parties will, in the long
run, avoid prolonged, costly litigation.
Attached as item #2 you will find our claims handling protocol (and we have a 186 page
set of claims handling guidelines).
Wow—
PUBLIC ENTITY EXPERTISE
EXTENSIVE EXPERIENCE WITH PUBLIC ENTITIES
Companywide, Carl Warren & Company administers claims for more than 175 cities and
more than 350 public entities. We are the claims administrators for approximately 25% of
the public entities in California.
Our adjusters and supervisors are well -versed in the Government Code, as well as the
applicable defenses and remedies available to public entities. This experience and
expertise is a necessary element in the successful management of claims.
A representative sample of the governmental entity accounts that are administered by Carl
Warren & Company are:
0 California Joint Powers Insurance Authority (107 member cities)
• City of Azusa
City of El Monte
• City of Beverly Hills
City of Santa Clarita
• City of Chino
City of San Fernando
• City of Gardena
City of San Gabriel
• City of South Gate
City of Monterey Park
• City of La Habra
City of Whittier
• City of Palmdale
City of Hesperia
• City of Palm Springs
City of Inglewood
• Los Angeles Unified School District
• New Mexico Public Schools Insurance Authority (89 member districts)
• Los Angeles Community College District
• Santa Monica Community College District
• Maine School Board Management Association
VA
CLAIMS STAFF
EDUCATION AND EXPERIENCE
MIKE REED -CLIENT RELATIONSHIP MANAGER
CRM for City of Carson account between the years of 1988 and 1993 / 1999 to present
Bachelor of Science, Business Administration — University of California at Berkeley
Associate Degree — Orange Coast College
28 years claims adjusting experience
Nationwide Insurance — Multi -Line Adjuster — All Personal Lines and some Commercial
Carl Warren Employee -Owner since 1983
GORDON H. ELIASON — CLIENT RELATIONSHIP MANAGER
Brigham Young University, Provo, Utah 1986 Bachelor of Arts, Family Living 1987-1988
Travelers Insurance Co., Brea, California Claims Representative
General Liability Claims Account Manager for Cities of Costa Mesa, Newport Beach,
Huntington Beach, and Laguna Hills.
Managing and adjusting claims for City of Costa Mesa since 1993.
Managing and adjusting claims for City of Newport Beach since 2000.
Managing or adjusting claims for City of Huntington Beach since 1988.
Managing and adjusting claims for City of Laguna Hills since 1997.
E.,
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SETrL EMENT OF CLAIMSIA UTHORITY
Most of our clients prefer to provide Carl Warren & Company with limited settlement
authority. That authority rests with the CRM who reviews each matter before granting the
adjuster authority within his level. Our client is then is advised within 30 days of any
settlement made within Carl Warren & Company's settlement authority.
Requests for authority above the Carl Warren & Company level would be directed to the
City"s Risk Manager. All requests for authority would be presented in writing, accompanied
by all of the necessary information that is needed for the Risk Manager to make an
informed decision.
rRUSTAccouNr
Carl Warren & Company manages Trust Accounts for many of its clients who find it to be
more convenient and efficient in managing their programs. Trust Account funds are used
to pay loss expenses, settlements and judgments. All trust account finds are maintained in
accordance with the accounting principals set forth in SAS 70.
L.UrGA TrON MA NA GEMEN T
When a new lawsuit is served upon a member, a request will be sent to the City's Risk
Manager to assign defense counsel. The request will be sent with an updated report,
outlining all relevant information on the matter, including settlement potential and any new
information that is available.
Legal bills will be reviewed and processed on a monthly basis. The adjuster will check the
bills for accuracy and compliance with the Litigation Guidelines. Any corrections to the bills
will be clearly noted and copies will be sent to the City of Hesperia.
Carl Warren & Company assists the defense attorney as the case progresses. This may
include locating witnesses, obtaining documents and information or providing input in the
litigation plan. The defense attorney submits a request to undertake discovery with their
initial report. The adjuster will review,the reports and approve only those discovery items
that will move the case closer to conclusion.
EXCESS CA RRIER REI -A 7TONSHIPS
Carl Warren & Company is familiar with the reporting requirements of excess carriers and
we incorporate those requirements into our claims handling procedures. When it appears
that a claim should be reported to the carrier, Carl Warren will place the excess carrier on
notice of the loss as necessitated by their reporting requirements.
9
CLATM FUES
MEE7:rNGS
Carl Warren & Company's staff will attend meetings with
the City's staff or attorney firms, as requested. It is our
belief that meeting to review large losses and discussing
trends is beneficial for all concerned. Carl Warren &
Company can prepare data in a variety of formats for your
use in your own meetings.
Carl Warren & Company will maintain a claim file for each claim, incident or request for
investigation that is submitted to Carl Warren & Company for file creation. The files will be
available for review by the City's staff, financial auditors and claims auditors, upon
reasonable notice.
COST SAVINGS MEASURES
Carl Warren & Company is always conscious of the City's need to contain costs and save
money wherever possible, without sacrificing quality. Carl Warren & Company will make
recommendations for cost savings approaches/activities for the City when requested.
10
Our primary cost savings approaches include careful review of coverage, litigation
management, vendor selection and reasonable inventories.
IDENTTFTCA TION OF HAZ4 RDS
Our claims analysts and specialists pay careful attention to their surroundings, watching for
any hazards or potential problem areas. When something like this is found, it is reported
to the Risk Manager, so that appropriate action can be taken to reduce or eliminate the
problem. The prevention of future claims saves the City of Carson both investigative and
settlement dollars.
EFFicrENr cums HANDaNG mocwuREs
Rather than taking a "'cookie -cutter" approach to claims handling, each claim is individually
reviewed and a determination is made as to what specific investigation is needed. Minor
claims with little exposure do not require as extensive an investigation as more complicated
claims with greater exposure. By focusing our investigative efforts where they are most
needed, Carl Warren provides the best service to its clients and reduces its adjusting
expense.
EXPERIENCE
One of Carl Warren"s most effective cost containment elements for the City of Carson is
experience. From handling similar claims, our adjusters are familiar with the codes and
immunities that can be applied to protect the city. This streamlines the adjusters' efforts
and reduces the City's costs. Often times, a claimant attorney will choose not to advance a
claim into litigation, after being advised and confirming for themselves that their cause of
action will be barred.
Experience also helps to reduce settlement costs. Having handled similar claims for other
municipalities, our adjusters know the value of sometimes very unusual claims. In addition
to this, as an adjuster gains more experience in the field, they become better negotiators.
Carl Warren's adjusters all have many years of claims experience. This has helped them to
obtain the confidence and knowledge to be tough but fair negotiators.
LEGAL COST CONTArNfifENT PROCEDURES AND STRA TEGrES
Our well -investigated and documented files provide the defense attorney with a solid
background on the case, and save many hours of time that the attorney would have spent
obtaining this information. We encourage utilization of Alternative Dispute Resolution (ADR)
as another means to reduce litigation costs.
11
Z I LII\V
Once the matter has entered litigation, Carl Warren & Company does not abandon the file.
Instead, we help the defense attorneys develop a litigation plan, and we assist the defense
attorneys by undertaking any additional investigation that they deem necessary. This not
only allows the attorney to focus his/her time and energy on the litigation process, but it
will save the City of Carson money, since it is much more cost effective to have an analyst
or specialist investigating a case than to have an attorney investigating the case.
Litigation costs are also contained by a careful review of the legal bills prior to payment.
Billing guidelines are provided to all of the defense attorneys. They are then uniformly
applied. Every bill is reviewed for accuracy and adherence to the guidelines prior to being
submitted for payment.
Perhaps the best way to save on litigation costs is to keep a file out of litigation. Upon
service of a lawsuit, Carl Warren & Company carefully evaluates the status of the case, the
plaintiffs settlement demand/position and potential of resolving the case prior to answering
the Complaint. We work closely with the City's Risk Manager to attempt to resolve cases
that have liability issues whenever possible, rather than to send the case into litigation.
RISK MANAGEMENT INFORMATION SYSTEMS
mycarlwarren.com
Our current information system was developed in-house and has modified over the
past 12 years to meet the various needs of our diverse client base. Our risk
management information system provides each client with an enormous degree of
flexibility, not only in determining what and how their data is captured, but also in
providing the type of output they require.
Our in house Information Systems Department has the capability to customize
reporting to suit client needs. We can also feed your data to PERI if you so desire.
Our system was designed with each unique clients needs in mind. Five different lines
of coverage are supported. One can actually be specified by the client for their
individual needs. All cause codes are client specific. Fourteen different expense
categories are reported from legal expenses to expert witnesses. Reporting can be
done on a monthly, quarterly or semi-annually basis. To a degree, we are able to
accommodate client requests for special supplemental fields that might be unique to
their needs.
12
21
Our current system has the capability for varied "ad hoc" reporting. Each of our
reports can also be generated by entity, location or department. A claims register
report can even be generated for member entity or department within that entity.
A variety of reports also exist on a per -request basis, such as Stratification Reports,
Loss Development Triangles and Prior Period Comparison Reports. Subrogation
Registries and Recovery Registries are also available.
All information is inputted via terminal at the branch office and the data is
automatically archived from the existing data on a daily basis. Every morning, the
branch personnel insert a new back-up tape into a DAT drive, which creates a back up
of all the data on the branch server. The nightly tapes are recycled on a weekly basis
except for the Thursday evening tape, which is forwarded to the Home Office in
Orange, California. These weekly tapes are retained for a period of five weeks. On the
first working day of each month the IS personnel at the branch send the back up tape
from the last working day of the previous month to the Home Office and that tape is
retained for a period of one year.
The tapes which are sent to the Home Office on Thursday nights are picked up by an
offsite vendor who stores five generations of the weekly tapes for each of the branch
offices and the same offsite vendor stores 12 monthly tapes for each branch.
On a monthly basis, the IS Department archives all of the client data from a pre-closing
loss run tape and combines it into an "'All Branches Loss Run Tape" for that particular
month and this tape is kept on permanent file for future reference.
In addition to the Risk Management Information System, Carl Warren & Company has
its own Microsoft NT wide area network system running at 100 megabits. This system
allows rapid communication between all of our branch offices as well as the support
services provided by our home office. This system is primarily utilized for transmitting
data. It is fully firewalled for security purposes and years ago was proven to be fully
Y2K compliant. Now we even have a SAS70 Type II Report.
Also, Carl Warren & Company has the ability to fully manage Trust Account funds and
to produce checks at its local branch offices. Security is also a key element of this
aspect of our system. A separate password is required in order to access the check
writing module of the system. Our system enables us to create checks from blank
paper instead of using check stock. Checks are produced utilizing a Laser 3et Printer
and the latest lock ' out / encryption security protection technology. This omits the need
for securing actual check stock on site. Check numbers can not be duplicated within
the system and if checks need to be reprinted, new check numbers are issued and
prior check numbers are voided. Absolutely no handwritten checks are permitted for
any reason.
13
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L14
The system also incorporates "*flags" to prevent duplicate bill payments.
WEBSITE
Carl Warren's website can be viewed at www.carlwarren.com.
Our website provides an overview of company, information about our clients, our services,
our management team, the location of our branch offices and "'breaking news" about our
company. Our website includes testimonials from clients and articles about our community
volunteerism and charitable works.
MAI
LIS
MYCARLWARREN.COM
There is no doubt that a loss run report is an invaluable risk management tool. However
loss run print outs can be bulky, cumbersome and often do not reflect the most current'
information on the claim. Carl Warren & Company is pleased to provide mycarlwarren.com
to our valued clients. This interactive website allows the client to obtain up to the minute
information about their account.
The Los Angeles Unified School District and the New Mexico Public Schools Insurance
Authority were among the first of our clientsto test this new system. Each of the
authorized City of Carson representatives can be provided with their own access code.
With their access code, the mycarlwarren system can be accessed from any internet-
enabled computer at any location. This enables the City to have access to data 24 hours a
day, 7 days a week. Therefore, authorized representatives can access the system from
their homes or when traveling. No special programming or equipment is necessary for the
City to be able to enjoy the benefits provided by this system.
Standard and customized reports can easily be accessed, saved and subscribed to by the
client. A subscribed to report is automatically generated and sent to the client's e-mail
address at the designated time. The reports can be scheduled to arrive at the client's
preference — quarterly, monthly, weekly — whatever best suits the client's needs.
This system is constantly being upgraded to provide Carl Warren & Company's clients with
a tool that we feel is unparalleled within the industry.
Attachment #3 includes some sample data reports from the mycarlwarren system and
security informatio
15
! L14
PRICING
Carl Warren & Company proposes to furnish the services requested subject to a
first year, annual price, not to exceed $63,500-- based upon an anticipated
annual volume of 90 claims." Our Time and Expense pricing structure is as
follows:
Services
Telephone
Mileage
Photocopies
Stenographic
Photographs
Cassettes
Duplicated Photos
Office Expense
Set up fee
Data Processing
Index Bureau
1099 Issuance
Administrative Fee
$52.00 per hour (year one)
$53.00 per hour (year two if locked in now)
$54.00 per hour (year three if locked in now)
8% of Services
.49 per mile
.25 per page
$4.50 per page
$2.25 each
$2.00 each
$1.25 each
18% of Services
One hour of Service Time
$30.00 per suffix (i.e. per line entry)
$15.00 each
$10.00 each
$225.00 monthly billed quarterly
As a long standing client of Carl Warren & Company, we will waive the
mycarlwarren annual fee of $1,000.00.
Claims in excess of 90 per year would be billed at the rates quoted above.
Pricing includes ongoing management of all open claims.
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partne . r . s I ............... List of PERI -Qualified Third Party Administrators*
rV I IM I r, Ic
Risk,Manap�ment Resource
PERI -Qualified TPAs are listed below along with the city where they are
headquartered.
Last Updated Februaty Z 2006
Carl Warren & Company
Placentia, CA
CompManagement, Inc.
Dvbfin, Ohio
Gallagher Bassett SeMces, Inc.
Itasca, Illinois
George Hills Company, Inc.
Pancho Cordova, Califorrija
Hewitt, Coleman & Associates, Inc.
Greenville, South CaroJina
Ward North America
Tustin, California
"A
Again, thank you for your participation in the Data Exchange program. If you have
any questions about the program, please contact Pamela Marino at (703) 352-1846.
S incere.17,
PUBLIC ENTM RISK
c
INSTITUTEVrard Hoetmer
11350 RANDOM HILLS RD, xecutive Director
SUITE 210
FAIRFAX, VA 22030 Enclosure
TEL 703.352.1846
FAX 703.352.6339
www.riskinstitute.org
ptjBLIC ENTJT�,
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February 2, 2006
BOARD OF DIRECTORS
Caryn Siebert
SAM MALES
President
CHAIRMAN
Carl Warren & Company
RENO, NV
770 S - Placentia Avenue
Placentia, CA 92870
YVONNE LEUNG
VICE CHAIRMAN
Dear Caryn:
LINCOLN, NE
CALVERT WRAY
On behalf of the Public Entity Risk Institute (PERI), I would like to extend our
ATLANTA, GA
appreciation to Carl Warren & Company for your participation in the PERI Data
Exchange.
DAVID MORA
SALINAS, CA
The PERI -Qualified Third Party Administrator Program recognizes third
party
administrators who are cooperating with PERI by
GARY BINGER
providing data on behalf of their
interested clients.
OAKLAND, CA
Therefore, I am pleased to recognize Carl Warren & Company as a PERI -Qualified
Third Party Administrator for Liability Data. Enclosed you will find a certificate of
GERARD J. HOETMER
EXECUTIVE
recognition. This certificate will be renewed on an annual basis provided Carl Warren
DIRECTOR
& Company continues to meet the program criteria.
Your organization is now included on the list of PERI -Qualified Third Party
Administrators which is posted on our web site at www.riskinstitute.or--.
As a PERI -Qualified Third Party Administrator,
you are welcome and encouraged to
mention this recognition in your marketing materials. Additionally,
you are authorized
to use the PERI -Qualified Third Par-ty Administrator logo in your marketing
materials
and on your website.
Again, thank you for your participation in the Data Exchange program. If you have
any questions about the program, please contact Pamela Marino at (703) 352-1846.
S incere.17,
PUBLIC ENTM RISK
c
INSTITUTEVrard Hoetmer
11350 RANDOM HILLS RD, xecutive Director
SUITE 210
FAIRFAX, VA 22030 Enclosure
TEL 703.352.1846
FAX 703.352.6339
www.riskinstitute.org
General Claims Management
Receipt of Claims and Processing
Claims Reporting
As always, new claims may be reported electronically by email, through our web site,
telephone -using a toll free number of by fax. We also provide an 800 number and cell
phone number for 24 hours contact in case of an emergency.
Claims Processing
When a claim is received it will be processed using our established Liability Claim
Standards:
I Within 24 hours of receipt of the first report, a file will be created, reserved and
assigned the proper code numbers and necessary data will be entered into the
information system.
2. The initial reserve will take into consideration all potential payments related to the
loss including liability and allocated expenses. There after any reserve revision and
all payments will be clearly explained in the file notes.
3. All payments, reserve revisions and file closings will be reviewed on every diary
date and adjusted when file material warrants it.
4. We will submit all bodily injury (BI) claims to the Index System.
5. When a claim has been resolved, we will prepare a closing report to the City and
promptly close the file.
Response to Claims
Carl Warren & Company shall, on the City of Carson's behalf, take the following action on
all claims covered by the circumstances described below:
Deny, as untimely, all claims that have not been filed with the statutory required
time.
2. Deny all claims on or before the date when denial is required or permitted by
law, if, in the exercise of reasonable, prudent judgment and after review of all
pertinent information, there is no basis of liability against the City of Carson or
its employees.
3. Deny claims after reasonable efforts to obtain necessary additional information
clarifying or substantiating issues of liability or damage, from the claimant or
departments are successful.
4. For each claim not submitted in accordance with the legal statutory filing
requirements, Carl Warren & Company shall, on the City of Carson's behalf,
notify the claimant or third party of the -specific insufficiency. Carl Warren &
Company shall deny all claims where claimant or third party has failed to remedy
the noted insufficiencies.
z %upon
5. Carl Warren & Company shall, on the City of Carson's behalf, reject all
"Applications for Leave to Present Late Claim", unless the untimeliness of filing
a claim clearly falls within Government Code Sections 911.4 and 911.6. In these
cases, Carl Warren & Company shall advise and obtain the City of Carson's
written approval to accept a late claim.
6. Carl Warren & Company shall forward petitions for relief from the requirements
of Government Code Sections 911.4 or 911.6 to the City of Carson and shall
assist in opposing the petitions filed as directed.
Investigation Procedures
I Contact with any injured claimant will be made within 24 hours of receipt of the
first report.
2. Within 24 hours of receipt of the first report, contact will be made with the client
where there is a need for further initial clarification concerning the claim.
3. Initial statements and/or inspections will be taken within 72 hours of receipt of
the claim.
4. Within twenty (20) days of receipt of the first report, there should be an
investigation of facts of accident and injury"' sufficient to make a liability
determination and send the initial claims report to the City of Carson. If there
is a potential to tender the claim to a third party, we will request authority to do
so in the initial report.
5. We will provide written reports to the City of Carson keeping you informed of any
major claim developments such as medical status, settlement demands,
scheduling of settlement conferences, hearings and trials.
6. Any claim with a total incurred value of $50,000 or more will be reported every
90 days until the claim is resolved or through completion of the discovery phase
of the litigation process.
7. We will seek approval from the City of Carson prior to hiring independent experts
deemed necessary to properly conduct fraud investiaations or direct sub-rosa
services when needed.
8. Contact will be maintained with any claimant on a regular basis to ensure
accurate reserving and claimant rapport.
9. We will request a medical authorization and a loss of earnings authorization
from the claimant on any bodily injury file where settlement is being considered.
10. All medical bills submitted by the claimant for payment will be reviewed for
causal relationship to the accident.
11. Subrogation/contribution possibilities will be promptly recognized and
investigated, preserving required evidence, and utilizing experts where needed
and approved by the City of Carson.
12. Where warranted, settlement will be aggressively pursued and all negotiations
will be properly documented in the file notes and handled internally by the
claims adjuster assigned the file unless there is a documented basis to handle it in
another manner.
13. When liability has been deterTnined and the settlement value is within our
authority we will immediately start negotiations to settle the claim without
litigation. If the value of the claim exceeds our authority, we will prepare an
Evaluation/Authority Request form which will provide a clear analysis of the
claim and our authority request.
14. When a settlement amount is agreed upon, we will prepare and send all releases,
agreements, W -9's and other payment instruments to the claimant and/or the
claimant's representative.
File Documentation
All notes to file are available for the City of Carson's review 24/7/365 in our information
system, mycarlwarren.com. The file notes will include the following:
I Direction given to the claims adjuster at the discretion of supervisory
personnel
2.) Documentation regarding all telephone conversations, discussions, and
meetings held on the case.
3.) Documentation as to coverage issues, liability, dam"ages, injuries and our
plan of action.
4.) An electronic diary schedule which is used to maintain files on diary.
Claims will be reviewed every 30 days unless a longer schedule is approved
by the City of Carson after a discussion of the file.
5.) Documentation regarding all statements and claimants, client employees,
witnesses, doctors and other investigation efforts.
6.) File notes regarding all efforts to conclude the claim, offers of settlement.
7.) All correspondence or other documents related to the file which will be
date-stamped on the day received and shall be documented in the file within
48 hours.
The City of Carson will continue to h4ve access to an extranet environment to perform
intuitive reporting and ad-hoc analyses on risk and loss prevention data. You are able to
link to individual claims information, find a particular payment and read the adjuster's
notes related to the payment.
Reserving Practices
Carl Warren & Company's information system identified as mycarlwarren.com
tracks data on each claim to include loss reserve, expense reserve, and loss
payment reserve also provides calculation tracking including initial reserve
established and all subsequent changes.
2.) Case reserves are established within 24 hours of receipt of the claim. Reserves
are established on a case by case basis, not on a statistical basis. The liability
exposure, expense and anticipated life of the claim are all factors taken into
consideration when reserving a file. The file is reserved at full value with a
component of comparative fault factored in where appropriate. Reserves are
reviewed and evaluated each time the file is handled by the adjuster and
reviewed by the account manager.
3.) The adjuster will review the reserve every time any work is done on the file and/or
when new information is received that would change evaluation of the claim. The
reserve will be adjusted to reflect the proper value of the claim whether it is too
high or too low. The file will be reviewed every 30 days or as approved by the City
of Carson and the file documented to reflect the review and substantiate any
adjustments in the reserve within 24 hours of the change.
4.) The reserve caption on written reports will provide the City with an analysis of
why the reserve is proper.
5.) The claims manager will review the reserves before approving a written report
to the City.
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L31
RFP NO. P07-02
City of Carson
Request for Proposal No. P07-02
Liability Third -Party Claim Administration Services
City of Carson
701 E. Carson Street
Carson, CA 90745
Dear Purchasing Manager:
In accordance with your request for proposal for providing liability third-partY claim administration
services, as described by city of Carson Request for Proposal No. P07-02 and the attached
documents, we are pleased to offer the city of Carson the required service for the prices contained
below, for a period of three years with two one-year options:
1 .
Administrative Fee
$
2.
Telephone
$ A
3.
4.
Photographs
Mileage
$ I -J de! V-
$
5.
Photocopy
$
$
L L^) Po. v-, v-eA�
FIRM NAME
0 P L
ADDRESS
BY:
PRINT
( 8M) �5 -72 — & C1 CIVIC",
TELEPHONE NO. ,
Loa c(f--- A�-+ o4 CA
Ct 2- a :7-0
TITLE: Cov- ksay—'Af��_�
DATE:
7
RFP NO. P07-02
CITY OF CARSON
RFP NO. P07-02
AFFIDAVIT OF NON -COLLUSION
The undersigned, as proposer, declares that this proposal is made without collusion with any
other person, firm or corporation and that the only person or parties interested as principals are
named herein. Having carefully examined the Notice Inviting Proposals, the Specifications, and the
Terms and Conditions, we do hereby propose and agree, in the event of acceptance hereof, to enter
into the required agreement with the city of Carson.
-4,
Dated this 6 day Of �� AJI'C� 2007,
I certify (or declare) under penalty of pe�ury
that the foregoing is true and correct.
(-Av, L b,),� r- rej -+�n
N
OF COMPANY
SIGNATURE
.CQ!!� 4 () V- 00�_te'
TITLE V
8
Z9,_M"
BIDDER QUESTIONNfAIRE
TO THE BIDDER:
The following questionnaire is a part of the complete bid and must be submitted as such. The
information provided therein will be used solely for evaluating the qualifications of the Bidder and
their omanizations to carry out satisfactorily the terms and conditions of the contract. This
questionnaire must be filled out accurately, completely and submitted with the bid. Any errors,
omissions or fraudulent infori-nation may be considered as a basis for the rejection of the bid and
may be gTounds for the cancellation of any subsequent agreement executed as a result of the bid or
bids involved.
BIDDER'S FACILITY (attach listing if more than one (1) location)
Name: - Carl Warren & Company
Address: 770 S. Placentia Avenue
Placentia, CA 92870
Name of Facility Manager Mike gppd/Tom Boylan
0
Telephone: 714-572-5200 FaxNumber: 714_q61_R1m
Web Site: www. carlwarren . rom
EXPERIENCE AND REFERENCES
Provide a minimum of three (3) references from your organization's client list that have
contracted with your firm to provide liability claim administration in the last 5 years.
.1,
FIRM'S NAME Cnunt3� nf Los -
ADDRESS: 3333 Wilshire Blvd. . Los Angeles-LJ1A.
CONTACT PERSON: John St ex-iX-t- TELEPHONE:, 213-351--6421
CONTRACT WAS IN EFFECT DURING WHAT PERIOD? 1989 -Present .
2. FIRM'S NAME: -California Joint Powers Ins. Authori y
. mfiffrXZu- 1 - I . I_
CONTACT PERSON: Jon Shull TELEPHONE: 562-463--8700
A "&�
CONTRACT WAS IN EFFECT DURING WHAT PERIOD? 1980 -Present
3. FIRM'S NAME:
ADDRESS:
New Mexico Public Schools Authority
410 Old Taos Hiehway. Santa Fe, NM 87501
CONTACT PERSON: Sammy Quiintana TELEPHONE: 800-9,819-9736
CONTRACT WAS IN EFFECT DURING WHAT PERIOD? 19 9 5 - P r e s e n t
rx
"A
PROPOSER QUESTIONNAIRE
RFP NO. P07-02
TO THE PROPOSER:
RFP NO. P07-02
The following questionnaire is a part of the complete RFP and must be submitted as such. The
information provided herein will be used solely for evaluating the qualifications of the proposer and
their organization to carry out satisfactorily the terms and conditions of the contract:
PROPOSER'S FACILITY (attach listing if more than one location)
Name: see, 4-ffiAC-1--ee�t
Address:
Name of Facility Manager:
Telephone: Fax Number:
Web Site:
11. EXPERIENCE AND REFERENCES
Provide a minimum of three (3) references from your organization's client list that have
contracted with your firm to providp liability claim administr4tion in the last 3 years.
1. FIRM'S NAME: C I t\-[ 15F A-) 007T-Reeqzc�
ADDRESS:
CONTACT PERSON: LA%we,-� -7p �-Ie ELEPHONE: (q trot)
2. FIRM'S NAME: L"',4V AkL—
ADDRESS: J41 Z 2�-f
-C-A. q2714'
Lf 8,Z , q
CONTACT PERSON: kJ0EFQAqtW 0 TELEPHONE:
3. FIRM'S NAME:
ADDRESS:
-r�tev-104�L- S-'�kooLs
CONTACT PERSON: L.&Y', N kS
C -L �.AeA,-jft�. rA-,
TELEPHONE:
82 -
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RFP NO. P07-02
INSURANCE REQUIREMENTS
GENERAL COMPREHENSIVE LIABILITY
ADDITIONAL INSURED ENDORSEMENT
NAME OF ADDRESS OF INSURED:
General description of agreement(s) and/or activity(ie�) insured:
Notwithstanding any inconsistent statement in the policy to which this endorsement is attached or in
any endorsement now or hereafter attached thereto, it is agreed as follows:
The Owner, consisting of the following described public entity:
[X] N The City of Carson, California
and its or their elected officials, officers, agents and employees are insured
thereunder in relation to those activities described generally above with', regard to
operations performed by or on behalf of the named insured.
2. Such insurance shall be primary, and not contributing with any other insurance
maintained by the Owner.
3. The policy to which this endorsement is attached shall apply separately to each
insured auainst whom claim is made or suit is brought except with respect to the
limits of the company's liability.
4. The policy to which this endorsement is attached shall not be subject to cancellation,
change in coverage, reduction of limits or non -renewal except after written notice to
Risk Manac ' ement, city of Carson, by certified mail, return receipt requested, not less
than thirty (30) days prior to the effective date thereto.
CANCELLATION NOTICE AND ENDORSEMENT TO BE SENT TO:
Risk Management
City of Carson
P.O. Box 6234
Carson, CA 90749
(310) 952-1700
Except as stated above and not in conflict with this endorsement, nothing contained herein shall be
0
held to waive, alter or extend any of the limits, agreements, or exclusions of the policy to which this
endorsement is attached.
Endorsement Effective Policy No.
No. Date A,
444
RFP NO. P07-02
TYPE OF COVERAGES TO WHICH POLICY PERIOD LIMITS OF
THIS ENDORSEMENT ATTACHES FROM TO LIABILITY
Scheduled items or locations are to be identified on an attached sheet.
The followinc, inclusions relate to the above coverages includes:
C,
Premises & Operations
Contractual Liability
Independent Contractors
Products/Completed Operations
Broad Form Property Damage
Broad Form Liability Endorsement
Explosion Hazard
Collapse
Underground Hazard
Personal Injury
A deductible or self-insured retention (strike out one) of
coverage.
DEDUCTIBLE APPLIES PER CLAIM
PER OCCURRENCE
INSURANCE COMPANY
ADDRESS:
applies to
(print name) hereby declare under penalty of perjury,
under the laws of the State of Califomia, that I have the authority to bind the above-named
insurance company to this endorsement and by my execution hereof, do so bind said company.
Signature of Authorized Representative (Original Signature only; No
C)
facsimile signature or initialed signature accepted)
Executed at on
Phone No.:
)20
RFP NO. P07-02
AUTOMOBILE LIABILITY
ADDITIONAL INSURED ENDORSEMENT
NAME OF ADDRESS OF INSURED:
General description of agreement(s) and/or activity(ies) insured:
Notwithstanding any inconsistent statement in the policy to which this endorsement is attached or in
any endorsement now or hereafter attached thereto, it is agreed as follows:
The Owner, consisting of the following described public entity:
[ I N The City of Carson, California
and its or their elected officials, officers, agents and employees are insureds
thereunder in relation to those activities described generally above with re gard to
operations perfon-ned by or on behalf of the named insured.
2. Such insurance shall be primary, and not contributing with any other insurance
maintained by the Owner.
3. The policy to which this endorsement is attached shall apply separately to each
insured against whom claim is made or suit is brought except with respect to the
C,
limits of the company's liability.
4. The policy to which this endorsement is attached shall not be subject to cancellation,
change in coverage, reduction of limits or non -renewal except after written notice to
Risk Manaoement, City of Carson, by certified mail, return receipt requested, not
ID
less than thirty (30) days prior to the effective date thereto.
CANCELLATION NOTICE AND ENDORSEMENT TO BE SENT TO:
Risk Manaaement
City Of Carson
P.O. Box 6234
Carson, CA 90749
(310) 952-1700
Except as stated above and not in conflict with this endorsement, nothing contained herein shall be
held to waive, alter or extend any of the limits, agreements, or exclusions of the policy to which this
endorsement is attached.
Endorsement Effective Policy No.
No. Date
A v- o( o �F_ CbV14n,-Q
1L2;pqqlb&
RFP NO. P07-02
TYPE OF COVERAGES TO WHICH POLICY PERIOD LIMITS OF
THIS ENDORSEMENT ATTACHES FROM TO LIA.BILITY
Scheduled items or locations are to be identified on an attached sheet.
The following are covered by the policy:
Owned Automobiles Owned, Nonowned and Hired Automobiles
Nonowned Automobiles
Hired Automobiles
A deductible or self-insured retention (strike out one) of applies to
coverage.
DEDUCTEBLE APPLIES PER CLAIM , PER OCCURRENCE
INSURANCE COMPANY
ADDRESS:
(print name) hereby declare under penalty of peijury,
under the laws of the State of California, that I have the authority to bind the above-named
insurance company to this endorsement and by my execution hereof, do so bind said company.
Signature of Author-ized Representative (Original Signature only; No
facsimile signature or initialed signature accepted)
Executed at I -on 20
Phone No.:
L 3
41'
RFP NO. P07-02
WORKERS'COMPENSATION/EMPLOYERS LIABILITY
SPECIAL CANCELLATION NOTICE ENDORSEMENT
NAME AND ADDRESS OF INSURED:
General description of agreement(s) and/or activity(ies) insured:
This policy shall not be subject to cancellation except after notice in writing shall have been sent not
less than thirty (30) days prior to the effective date thereof by certified mail, return receipt
requested, addressed to Risk Manacrement, City of Carson, P.O. Box 6234, Carson, CA 90749.
The company agrees to waive all rights of subrogation against the Owner, consisting..of the
followine, described public entity:
[ ] N The City of Carson, California
and its or their elected officials, officers, agents and employees.
1)
Except as stated above and not in conflict with this endorsement, nothing contained herein shall be
held to waive, alter or extend any of the limits, agreements, or exclusions of the policy to which this
endorsement is attached.
Endorsement Effective Policy No.
No. Date
TYPE OF COVERAGES TO WHICH POLICY PERIOD LIMITS OF
THIS ENDORSEMENT ATTACHES FROM TO LIABILITY
Workers' Compensation
Employers Liability
Statutory
D (J I deep ��PJ"J
V -C
C c) C
14
,
The following are included in the above coverages:
Broad Form All States Endorsement
Voluntary Compensation Endorsement
RFP NO. P07-02
INSURANCE COMPANY
ADDRESS:
(print name) hereby declare under penalty of*pedury,
under the laws of the State of California, that I have the authority to bind the above-named
insurance company to this endorsement and by my execution hereof, do so bind said company.
Signature of Authorized Representative (Original Signature only; No
facsimile signature or initialed signature accepted)
Executed at __ - I on 20
Phone No.:
RFP NO. P07-02
EXCESS LIABILITY INSURANCE
ADDITIONAL INSURED ENDORSEMENT
NAME AND ADDRESS OF INSLTRED:
General description of agreement(s) and/or activity(ies) insured:
Notwithstanding any inconsistent statement in the policy to which this endorsement is attached or in
Z:)
any endorsement now or hereafter attached thereto, it is agreed as follows:
1. The Owner, consisting of the following described public entity:
0 1�
[ ] 0 The City of Carson, California
and its or their elected officials, officers, agents and employees are insureds
thereunder in relation to those activities described generally above with regard to
operations performed by or on behalf of the named insured.
2. Such insurance shall be primary, and not contributing with any other insurance
maintained by the Owner.
3. The policy to which this endorsement is attached shall apply separately to each
insured against whom claim is made or suit is brought except with respect to the
limits of the company's liability.
4. The policy to which this endorsement is attached shall not be subject to cancellation,
change in coverage, reduction of limits or non -renewal except after written notice to
Risk Management, city of Carson, by certified mail, return receipt requested, not less
than thirty (30) days prior to the effective date thereto.
CANCELLATION NOTICE AND ENDORSEMENT TO BE SENT TO:
Risk Management
City Of Carson
P.O. Box 6234
Carson, CA 90749
(310) 952-1700
Except as stated above and not in conflict with this endorsement, nothing contained herein shall be
held to waive, alter or extend any of the limits, agreements, or exclusions of the policy to which this
endorsement is attached.
Endorsement Effective Policy N
No. Date 0 e-
16
RFP NO. P07-02
TYPE OF COVERAGES TO WHICH POLICY PERIOD LIMITS OF
THIS ENDORSEMENT ATTACHES FROM TO LIABILITY
Excess Liability AMOUNT EXCESS OF
Following Form
Umbrella Liability
Other
Applicable underlying coverages
Insurance Compan Policy No. Amount
The followina inclusions, exclusions, extensions
'D or specific provisions relate to the above
coverages:
0
A deductible or self-insured retention (strike out one) of $ applies to
coverages not included in underlying policies.
DEDUCT113LE APPLIES PER CLAIM—, PER OCCURRENCE
INSURANCE COMPANY
ADDRESS:
1, , (print name) hereby declare under penalty of pedury,
under the laws of the State of California, that I have the authority to bind the above-named
insurance company to this endorsement and by my execution hereof, do so bind said company.
Signature of Authorized Representative (Original Sip—atureonly; No
facsimile signature or initialed signature accepted)
Executed at on - � 20.
Phone No.:
17 51
651
Representative Dec Pages are attached.
Upon being selected as the Third party Administrator for this account, Carl
Warren & Company will work with its insurance carriers to obtain the
required endorsements.
1. General Liability
Chubb
$2M limit
2. Automobile Liability
Chubb
$1M limit
3. Worker's Compensation
Everest National Insurance Company
$1M limit
4. Errors & Omissions
Chubb
$3M limit
5. Excess Insurance / Umbrella
ACE
$3M
EXHIBIT NO. 2
Liabilitv Insurance
Declarations
Named Insured and Mailing Address
CARL WARREN & COMPANY
770 S. PLACENTIA AVENUE
PLACENTIA, CA 92870
Chubb Group of Insurance Companies
15 Mountain View Road
Warren, NJ 07059
Policy Number 3584-39-79 WUC
EffectiveDate MAY4,2007
Issued by the stock insurance company
indicated below, herein called the company.
FEDERAL INSURANCE
COMPANY
Producer No. 0009356 Incorporated under the laws of
INDIANA
Producer MCGRIFF, SE11BELS & WILLIAMS INSURANCE SVCS INC.
19100 VON KARMAN, #900
IRVINE, CA 92614-0000
Policy Period
From: MAY 4, 2007 To: MAY 4,2008
12:01 A.M. standard time at the Named Insured's mailing address shown above.
Liability Coverage Limit Of Insurance
GENERAL LIABILITY
GENERAL AGGREGATE LIMIT $ 2,000,000
PRODUCTS/COMPLETED OPERATIONS S 2,000,000
AGGREGATE LIMIT
EACH OCCURRENCE LIMIT S 2,000,000
ADVERTISING INJURY AND S 2,000,000
PERSONAL INJURY AGGREGATE LIMIT
DAMAGE TO PREMISES $ 2,000,000
RENTED TO YOU LIMIT
MEDICAL EXPENSES LIMIT 10,000
Liability Insurance Issue Date: MAY 10, 2007 continued
FOrM 80-a2-0010 (Ed. 4-94) Declarations
Page 1
IEChubb Group of Insurance CompanLes
15 Mountain View Road Warren, NJ 07059
Item 1. Named Insured and Mailing Address
CARL WARREN & ��O�MPANy
770 S. PLACENTIA AVENUE
PLACENTIA CA 92870
COMMON POLICY DECLARATION
FEDERAL INSURANCE CoMpANy
Incorporated under the laws of Indiana
Policy Number
(07)7353-56-17
Agent Name and Address
MCGRIFF, SEIBELS & WILLIAMS INSURANCE
Svcs INC.
19100 VON KARMAN, #900
IRVINE CA 92614
Agent No. 093 56 - 0 0 0
Item 2. Policy Period From: 05-04-2007 To: 05-04-2008
at 12:01 AM., Standard Time at your mailing address shown above.
Item 3. Business Description: INSURANCE AGENTS, & BROKERS
Form of Business: CORPORATION
Item 4. In return for the payment of the premium, and subject to all the terms of this policy, we agree with you to
provide the insurance as stated in this policy.
This policy consists of the following coverage parts for which a premium is indicated. Where no premium is shown,
there is no coverage. This premium may be subject to adjustment.
E Coverage Part (s) Premium
COMMERCIAL BUSINESS AUTO COVERAGE PART $ 1,884.00
Item 5. Forms and Endorsements Total Policy Premium $ 1,884.00
Forms(s) and Endorsement(s) made a part of this policy at time of issue:
See Schedule of Forrns and Endorsements
Countersigned:
Date:
By:
Authc)rized Representative
TO THE EXTENT THAT ITEM TWO OF THE BUSINESS AUTO, TRUCKERS, OR GARAGE DECLARATIONS SHOW
SYMBOLS WHICH DESCRIBE 'ANY AUTO"OR 'HIRED AUTOS ONLY"AS COVERED FOR PHYSICAL DAMAGE
COLLISION COVERAGE, SUCH COVERAGE SHALL ALSO APPLY TO RENTAL VEHICLES.
COVERAGE PART(S), I
THIS COMMON POLICY DECLARATION AND THE SUPPLEMENTAL DECLARATION(S), TOGETHER WITH THE COMMON POLICY CONDIT ONS,
16-02-0207 (Ed- 1-01) COVERAGE FORM(S) AND FORMS AND ENDORSEMENTS, IF ANY, COMPLETE THE ABOVE NUMBERED POLICY.
U
ITEM ONE
Named Insured
CARL WARREN & COMPANY
A
BUSINESS AUTO COVERAGE
Policy Number
(07)7353-56-17
Agent Name
MUUXIFF, SEIBELS & WILLIAMS—I—NSURANCE—
SVCS INC.
Effective Date: 05-04-2007
12:01 A.M., Standard Tim
AnpntKjn nQ4rr,_r)r)r)
ITEM TWO —SCHEDULE OF COV81UGEtAND C6WRItO AUTOS
This policy provides only those coverages where a charge is shown in the premium column below. Each of these
Coverages will apply only to those "autos" shown as covered "autos". "Autos" are shown as covered "autos"for a particular
coverage by the entry of one or more of the symbols from the Covered Autos Section of the Business Auto Coverage
Form next to the name of the coverag .
Coverages
Covered
Autos**
Limit
The most we will pay for any
Premium
one accident or loss
Liability
819
$1,000,000
$ 1,644
Personal Injury Protection`
Separately stated in each P.I.P. endorsement
minu Ded.
Added Personal Injury
-
Separately stated in each added P.I.P.
Protecfion****
endorsement.
Property Protection Insurance
Separately stated in the P.P.I. end orsement
rMichigan only)
minus Ded. for each
accident.
Auto Medical Payments
Uninsured Motorists
Underinsured Motorists (When not
included in LIM Coverage)
SEE SCHEDULE ded. for each cov-
P
Comprehensive Coverage
8
Actual
ered auto, but no deductible
$ 90
H D
cash
applies to loss caused by fire or
Y A
value or
lightning.*****
cost of
Specified Causes of Loss
$25 ded. for each covered auto for
S m
repair,
I A
Coverage
which-
loss caused by mischief or
ever is
vandalism.
C G
less
SEE SCHEDULE ded. for each cov-
* * * * *
$ 1501
A E
Collision Coverage
8
minus
ered auto.
L
Towing and Labor (Not
for each disablement of a
available in California)
private passenger "auto".
Forms and Endorsements applying to this coverage part and made a Tax/ Surcharge/ Fee
part of this policy at time of issue:
SEE SCHEDULE OF FORMS AND ENDORSEMENTS Premium for Endorsements
*Estimated Total Premium $ 11884.00
This --policy may be subject to final audit.
Entry of one or more of the symbols from the COVERED AUTOS Section of the Business Auto Coverage Form
shows which autos are covered autos.
Or equivalent No -Fault Coverage
Or equivalent added No -Fault coverage
See ITEM FOUR for Hired or Borrowed "Autos".
This policy declaration and the supplemental declaration(s), together with the common policy conditions, coverage parts,
coverage form(s) and forms and endorsements, if any, complete the above numbered policy.
16-02-0214 (Ed. 1-01)
Page I of 3
R"Q11K1=QQ Airrn r%
r-GLARA11 IONS tContinued)
Policv Number: (0717151-8;A-17
ITEM THREE - SCHEDULE OF COVERED AUTOS'YOU OWN
SEE SCHEDULE OF COVERED AUTOS YOU OWN
ITEM FOUR - SCHEDULE OF HIRED OR BORROWED COVERED'AUTO COVERAGE AND-Pk9MIUM§
LIABILITY COVERAGE - RATING BASIS, COST OF HIRE
State
Estimated Cost of Hire
for Each Stat -
Rate Per Each $ 100 Cost
of Hire
Factor (if Liability Coverage
is Primary)
Premium
CA
$ 1,500
$ 3.073
$ 107
F-1
Total Premium $ 107
Cost of hire means the total amount you incur for the hire of "autos" you don't own (not including "autos* you borrow or
rent from your partners or employees or their family members). Cost of hire does not include charges for services
performed by motor carriers of property or passengers.
PHYSICAL DAMAGE COVERAGE CA
Coverages
Limit of Insurance
The Most We Will Pay
Deductible
Estimated
Annual Cost
of Hire
Rate Per
Each $100
Annual Cost
of Hire
Premium
Comprehensive
Actual
cash
value,
or cost
of
repair
whichever is less, minus $ 1, o o o
ded. for each covered auto, but no de-
ductible applies to loss caused by fire or
lightning.
$ 1,500
$ 90
Specified
Causes of Loss
whichever is less, minus $25 ded. for
each covered auto for loss caused by
mischief or vandalism.
Collision
whichever is less, minus $ 1, 000
ded. for each covered auto.
$ 1,500
$ 150
Total Premium
$
16-02-0214 (Ed. 1 -01)
Page 2 of
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY
INFORMATION PAGE REVISION NO.
This is a 3 Year Fixed Rate Policy
Evare" Ne" I I
—ranoo continny
NCCI Company Code No. 28312 New 0 Revision Policy No. CA20MO824(y7l
I FKI Renewal: — 0 Reissue: El Rewrite of Prior Policy No. CmWioeMl
Page 1 Issue Date 034M _LAcct. No.
P-1. Term I Ywr
I Pay Term I Yr. I St. CA I Co. I Town I SG I % Adj.
Adjustment Date: AUDITED I THIS INFOR14ATION PAGE, WITH POLICY PROVISIONS AND ENDORSEMENTS, IF ANY,
Anniv. Rate Date: I COMPLETES THIS POLICY.
I. NAMED INSURED AND MAILING ADDRESS
CARL WARREN AND COMPANY., CARL
$ 7Z304
PRODUCER C1142 BRANCH CODE 023
WARREN AND COMPANY OF NEVADA
MCCIRIFF, SEIBELS & VWWAMS INS saMCES, INC.
WO & PLACENTIA AVE
MINIMUM PREMIUM
19100 VON KARMEN AVENUE
PLACENTIA CA 9M
SUME 900
IRVINE CA 92612
Insured is: CC] Individual [I Partnership El
Corporation, or (0 Other: ESOP
Other workplaces not shown above:
See Location Schedule
Insured's Identification number(s):
See Schedule
2. The policy period is from 03-01-2007 to 03-01-2008 at 12-M A.M. Standard Time at the insured's mailing address.
Each Old Installment $ Increase $
Decrease $
Each New Installment $
3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here:
AR AZ CA 00 CT Fl. IL NM NV TX
B - Employers Liability Insurance: Part Two of the policy applies to the work in each state listed in Item 3.A.
The Limits of our Liability under Part Two are: Bodily Injury by Accident 1,000,000 each Accident
Bodily Injury by Disease 1,000,000 policy limit
Bodily Injury by Disease 1,000,000 each employee
C. Other States Insurance: All states except North Dakota, Ohio, Washington, West Virginia, Wyoming and -s—tates designated in Item 3A of the
Information Page.
D. This policy includes these endorsements and schedules:
See Schedule of Forms and Endorsements
4. The premium for this policy will be determined by our Manual of Rules, Classifications, Rates and Rating Plans. All information required on following
Classification Schedule is subject to verification and change by audit. See Extension Schedule Attached,
$ 7Z304
TOTAL ESTIMATED ANNUAL POLICY PREMIUM
If indicated, interim adjustments of
premium shall be made:
El Semi -Annually
Quarterly
Monthly
ADJUSTMENT PREMIUM DUE (Addl., or Return Premium - A minus
figure means Return Premium)
$ 110W
MINIMUM PREMIUM
DEPOSIT PREMIUM
I Servicing Office:
Agent or Producer
WC 00 00 01 A
Countersigned by Resident Licensed Agent
14SURED COPY
Date
/0\
Chubb -Group of Insurance Companies
15 Mountain View Road CHUBB PROE&OSM
OMLSOE3 Warren, New Jersey 07059
.. DECLARATIONS
EXECUTIVE RISK INDEMNITY-�INC.
A stock insurance company, incorporated under
the laws of Delaware, herein called the Company
Policy Number 6802-6616
NOTICE: THIS IS A CLAIMS MADE AND REPORTED POLICY, WHICH APPLIES ONLY TO "CLAIMS" FIRST
MADE AND REPORTED IN WRITING DURING THE 'POLICY PERIOD,- OR ANY EXTENDED REPORTING
PERIOD. THE LIMIT OF LIABILITY TO PAY DAMAGES OR SETTLEMENTS WILL BE REDUCED AND MAY
BE EXHAUSTED BY "DEFENSE COSTS,- AND -DEFENSE COSTS' WILL BE APPLIED AGAINST THE
RETENTION AMOUNT. THE COVERAGE AFFORDED UNDER THIS POLICY DIFFERS IN SOME RESPECTS
FROM THAT AFFORDED UNDER OTHER POLICIES. READ THE ENTIRE POLICY CAREFULLY.
ITEM 1.
ITEM 2.
ITEM 3.
ITEM 4.
ITEM 5.
ITEM 6.
ITEM 7.
PARENT ORGANIZATION -NAME AND ADDRESS:
Cad Warren & Company
770 South Placenta Avenue
Placenta, CA 92870
POLICY PERIOD:
(A) Inception Date: May 4, 2007
(13) Expiration Date: May 4. 2008
at 12:01 a.m. both dates at the Address in ITEM 1.
LIMITS OF LIABILITY (inclusive of Defense Costs):
(A) $3,000,000.00 maximum limit of liability each Claim or Related Claims, but not to exceed
(13) $3,000,000.00 maximum aggregate limit of liability under this Policy for all Claims.
RETENTION AMOUNT. $25,000.00 each Claim or Related Claims.
EXTENDED REPORTING PERIOD:
(A) Additional Period
365 day
INSURED SERVICES:
Appraisal Services
Claims Adjusting
Claims Administration Services
Consulting & Training
(13) Additional Premium
100% of Annual Premium
PRIOR ACTS DATE: May 04,1985, at 12:01 a.m. at the Address in ITEM 1.
C33192 (Ed. 7/2003)
Page 1 of 14
Catalog No. 14-02-8622
...... . ---
Chubb Group of Insurance Companies
15 Mountain View Road CHUBB PROE&OW
CMLM13 Warren, New Jersey 07059
IFTEM 8. PREMIUM: $45,000.00
These Declarations, the completed signed Application and this Policy with Endorsements shall constitute
the contract between the insured and the Company.
In witness whereat the Company issuing this Policy has caused this Policy to be signed by its authorized officers, but
it shall not be valid unless also signed by a duly authorized representaffve of the Company.
EXECUTIVE RISK INDEMNITY INC.
4.11
Secretary President
04/30/07
Date
C33192 (Ed. 7/2003)
Page 2 of 14
— a�
Authorized Representative U
Catalog No. 14-02-8622
Z Illinois Union insurance
Company
F1 Westchester Surplus Lines
Insurance Company
Excess Liability
Insurance
Policy Declarations
This policy is issued by the stock insurance company listed above (herein "Insuret").
UNLESS OTHERWISE PROVIDED IN THE FOLLOWED POLICY, THIS POLICY IS A CLAIMS
MADE POLICY WHICH COVERS ONLY CLAIMS FIRST MADE AGAINST THE INSUREDS
DURING THE POLICY PERIOD. PLEASE READ THIS POLICY CAREFULLY.
Policy No. XEO G21675155 003
Item I Insured Company
Principal Address:
Carl Warren & Company
770 South Placentia Avenue
Placentia, CA 92780
Item 2. Coverages Provided: Excess Liability Insurance Policy
Item 3. Followed Policy: Excess Technology Liability
Insurer: Chubb Pro Executive Risk Indemnity
Policy number 6802-6616
Item 4. Policy Period
From 12:01 A.M. 05/04/2007 To 12:01 A.M. 05/04/2008
(Local time at the address shown in Item 1 -)
Item 5. Aggregate Limit of Liability:
$3,000,000
for all Loss under all Coverages combined.
Item 6. Premium:
$21,997
Discovery Period Premium: 100% of the Policy Period Premium
Item 7. NOTICE TO INSURER
A. Notice of Claim, Wrongful Act or Loss:
ACE USA, Professional Risk
Attention: Claims Unit
140 Broadway, 40th Floor
New York, NY 10005
B. All other notices:
ACE USA, Professional Risk
Attention: Chief Underwriting Officer
140 Broadway, 40th Floor
New York, NY 10005
Ft e -m8. Schedule of Underlying Policies:
Policy
Insurer Numbe
Chubb Pro Executive Risk Indemnity 6802-6616
Primary or Policy
Limits Excess Period
$3,000,000 Primary 05/04/07-
05/04/08
THESE DECLARATIONS, TOGETHER WITH THE COMPLETED AND SIGNED APPLICATION
AND THE POLICY FORM ATTACHED HERETO, CONSTITUTE THE INSURANCE POLICY.
Autho�zed Agent
Date:06/0612007
MO/DAYNR.
L41
ACORL),
CERTIFICATE OF INSURANCE
ISSUE DAT
06/06/2007 E
PRODUCER
This certificate is issued as a matter of information only and confers no rights
MSW Insurance Services, Inc.
19100 Von Kerman Ave. Suite 900
upon the Certificate Holder. This Certificate does not amend, extend or alter the
coverage afforded by the policies below.
COMPANIES AFFORDING COVERAGE
Irvine, CA 92612
License #OE55346
Company Federal Insurance Company
A
INSURED
Company Executive Risk Indemnity Inc.
Carl Warren & Company
B
770 S. Placentia Ave
Placentia, CA 92870
Company Illinois Union Insurance Co
C
Company
D
Company
E
This is to certify that the policies of insurance described herein have been issued to the Insured named herein for the policy period indicated. Notwithstanding
any requirement, term or condition of 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, conditions and exclusions of such policies. Limits shown may have been reduced by paid claims.
CO
TYPE OF INSURANCE
POLICY NUMBER
EFFECTIVE
LIMITS OF LIABILITY
LT
EXPIRATION
A
GENERAL LIABILITY
35843979
05/0412007
EACH OCCURRENCE $ 2,000,000
0 Commercial General Uability
0 Claims Made [M Occurrence
0 Owners'and ContractorsTrotection
0
05/04/2008
FIRE DAMAGE $ 2,000,000
MEDICAL EXPENSE $ 10,000
PERS. AND ADVERTISING INJURY $ 2,000,000
GENERAL AGGREGATE $ 2,000,000
El
—A
General Aggregate Urnit applies per:
0 policy 0 project D Location
PRODUCTS AND COMP OPER. AGG. 2.000,000
AUTOMOBILE LIABILITY
73535617
05/04/2007
COMBINED SINGLE LIMIT $ 1,000,000-
11 Any Automobile
0 Ali Owned Automobiles
Scheduled Automobiles
Hired Automobiles
05/04/2008
BODILY INJURY (Per aerson) $
BODILY INJURY (Per accident) $
PROPERTY DAMAGE (Per accident) $
COMPREHENSIVE $1000 deductible
Non -owned Automobiles
COLLISION $1000 deductible
10
WORKERS'COMPENSATION
AND EMPLOYERS'LIABILITY
WC Statutory Limit her F
EL EACH ACCIDENT $
EL DISEASE (Each emolovee) $
EL DISEASE (Policy Limit) $
EXCESS LIABILITY
EACH OCCURRENCE I$
00ccurrence 11ClaimsMade
AGGREGATE Is
B
ERRORS AND OMISSIONS
6802-6616
05104/2007
$ 3,000,000
G21675155003
05104/2008
$ 3,000,000
C
$
$
City of Carson is an Additional Insured as
respects to the General Liability coverage as required by writen contract subject to policy terms, conditions, and
exclusions.
CERTIFICATE HOLDER
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO
MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF
ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
Authorized Representative
City of Carson
PO Box 6234
Carson, CA 90749
Page 1 of 1 ificate to #
U�S HOUs
I All�.
-P RE S L N TIAV
-R
k
Certificate of Congressionaf
Recognition
ftesentedto
Cad Warren (i� Company
- :,
W01
in rcrognition of bring nanub
0
t4r 21105 California anb
Wrstern `&tates �iSMIJ
TonyanLi of t4r Vrar-
Datedthis 8h day of 'Fe6ruary, 2006
A,,
,;,,A ryx��
9fonora6fe GarY G- 9wider
42-d CongressionalDistrict
EXHIBIT NO. 3