HomeMy Public PortalAboutC-20-052 - Cooperative Personnel Services, Executive Recruitment for Director of Community Services and Parks & RecreationCITY OF CARSON CONTRACfSERVICESAGREEMENTFOR EXECUTIVE RECRUITMENT THIS PROFESSIONAL SERVICES AGREEMENT (herein '"Agreement") is made and entered into this 18th day of May, 2020, by and between the CITY OF CARSON, a California municipal corporation ("City") and COOPERATIVE PERSONNEL SERVICES, dba CPS HR CONSUL TING. a California Joint Powers Authority (herein "'Consultant"). City and Consultant are sometimes hereinafter individually referred to as "'Party" and hereinafter collectively referred to as the "Parties.,, NOW, THEREFORE, the parties hereto agree as foJlows: l. SERVIC~ OF CONSULT ANT 1.1 Scope of Services. In compliance with aJI of the terms and conditions of this Agreement, the Consultant shaJI 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 it has the experience and ability to perform aU work and services required hereunder and that it shall diligently perform such work and services in a 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. Pennits. Fees and Assessments. Consultant shall obtain at its so)e cost and expense such licenses, pennits, and approvals as may be required by law for the performance of the services required by the Agreement. 1.4 Special Requirements. Additional tenns and conditions of this Agreement, if any, which are made a part hereof are set forth in the ..,.Special Requirements" attached hereto as Exhibit "B"' and incorporated herein by this reference. In the event of a conflict between the provisions of Exhibit "B" and any other provisions of this Agreement, the provisions of Exhibit "B" shall govern. 2. 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 "C" and incorporated herein by this reference, but not exceeding the maximum contract amount of Twenty Three Thousand Dollars ($23,000) ("Contract Sum"). 2.2 Invoices. E.ach month Consultant shall furnish to City an originaJ invoice for all work perfonned and expenses incurred during the preceding month in a form approved by City's Director of Finance. By submitting an invoice for payment under this Agreement, Consultant is certifying compliance with all provisions of the Agreement. The invoice shall detail charges for all necessary and actual expenses by the following categories: labor (by sub-OI007 Oll(W~701? I
category), trave~ material~ equipment, supplies, and sub-contractor contracts. Sub-contractor charges shall also be detailed by such categories. Consultant shall not invoice City for any duplicate services perfonned by more than one person. ' City shall independently review each invoice submitted by the Consultant to determine whether the work performed and expenses incurred are in compliance with the provisions of this Agreement. Except as to any charges for work perfonned or expenses incurred by Consultant which are disputed by City, City will use its best efforts to cause Consultant to be paid within forty five (45) days of receipt of Consultant's correct and undisputed invoice; however, Consultant acknowledges and agrees that due to City warrant run procedures, the City cannot guarantee that payment will occur within this time period. In the event any charges or expenses are disputed by City, the original invoice shall be returned by City to Consultant for correction and resubmission. Review and payment by the City of any invoice provided by the Consultant shall not constitute a waiver of any rights or remedies provided herein or any applicable Jaw. 2.3 Additional Services. City shall have the right at any time during the perfonnance of the services, ,vithout invalidating this Agreemen~ to order extra work beyond that specified in the Scope of Services or make changes by altering, adding to or deducting from said work. No such extra work may be undertaken unless a written order is first given by the Contract Officer to the Consultant, incorporating therein any adjustment in (i) the Contract Sum for the actual cost of the extra work, and/or (ii) the time to perfonn this Agreement., which said adjustments are subject to the written approval of the Consultant Any increase in compensation of up to ten percent ( I OOA) of the Contract Sum but not exceeding a total contract amount of Five Thousand Dollars ($5,000) or in the time to perfonn of up to ninety (90) days may be approved by the Contract Officer. Any greater increases, taken either separately or cumulatively, must be approved by the City ~ouncil. No claim for an increase in the Contract Sum or time for perfonnance shall be valid unless the procedures established in this Section are followed. 3. PERFORMANCE SCHEDULE Agreement 3.1 • Time of Essence. Time is of the essence in the performance of this 3.2 Schedule of Performance. Consultant shall commence the services pursuant to this Agreement upon receipt of a written notice to proceed and shall perform all services within the time period(s) established in the "Schedule of Performance" attached hereto as Exhibit "D" and incorporated herein by this reference. When requested by the Consultant, ex.tensions to the time period(s) specified. in the Schedule of Performance may be approved in writing by the Contract Officer but not exceeding thirty (30) days cumulatively. 3.3 Force Majeure. The time period(s) specified in the Schedule of Perfonnance for perfonnance of the services rendered pursuant to this Agreement shall be extended because of any delays due to unforeseeable causes beyond the control and without the fault or negligence of the Consultant, including, but not restricted to, acts of God or of the public enemy, unusually severe weather, fires, earthquakes, floods, epidemics, quarantine restrictions, riots, strikes, freight embargoes, wars, litigation, and/or acts of any governmental agency, including the City, if the Consultant shat) within ten (10) days of the commencement of such delay notify the Contract Officer in writing of the causes of the delay. The Contract Officer shall
ascertain the facts and the extent of delay. and extend the time for performing the services for the period of the enforced delay when and if in the judgment of the Contract Officer such delay is justified. The Contract Officer's detennination shall be final and conclusive upon the parties to this Agreement In no event shall Consultant be entitled to recover damages against the City for any delay in the performance of this Agreement, however caused, Consultant's sole remedy being extension of the Agreement pursuant to this Section. 3.4 Term. Unless earlier tenninated in accordance with Article 7 of this Agreement, this Agreement shall continue in full force and effect until completion of the services but not exceeding one (I) year from the date hereof, except as otherwise provided in the Schedule of Perfonnance (Exhibit "D"). 4. COORDINATION OF WORK 4.1 Representative of ConsultanL Frank Roias is hereby designated as being the representative of Consultant authorized to act on its behalf with respect to the work and services specified herein and make all decisions in connection therewith. All personnel of Consultant and any authorized agents shall be under the exclusive direction of the representative of Consultant. Consullant shall utilize only competent personnel to perform services pursuant to this Agreement Consultant shall make every reasonable effort to maintain the stability and continuity of Consultant's staff and subcontractors, and shall keep City infonned of any changes. 4.2 Contract Officer. Faye Moseley. Director of Human Resources and Risk Management 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 to make aJI decisions in connection therewith ("Contract Officer"). 4.3 Prohibition Against Subcontracting or Assignment. Consultant shall not contract with any entity to perfonn 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. 4.4 Independent Consultant Neither the City nor any of its employees shall have any control over lhe manner, mode or means by which Consultant, its agents or employees, perfoam the services required herein, except as otherwise set forth. Consultant shall perform all services required herein as an independent contractor of City with 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, or that it is a member of a joint enterprise with City. S. INSURANCE AND INDEMNIFICATION 5.1 Insurance Coverages. The Consultant shall procure and maintain, al its sole cost and expense, in a fonn and content satisfactory to City~ during the entire tenn of this Agreement including any extension thereof, the following policies of insurance which shall cover all elected and appointed officers, employees and agents of City:
(a) Commercial General Liability Insurance (Occurrence Fonn CGOOOJ or equivalent}. A policy of comprehensive general liability insurance written on a per occurrence basis for bodily injury, personal injury and property damage. The policy of insurance shall be in an amount not less than $1,000,000.00 per occurrence or if a general aggregate limit is used, either the general aggregate limit shall apply separately to this contract/Jocation, or the general aggregate limit shall be twice the occurrence limit (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 the Consu1tant 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. (c) Automotive Insurance (Form CA 0001 (Ed 1/87) including "any auton and endorsement CA 0025 or equivalent). A policy of comprehensive automobile liability insurance written on a per occurrence for bodily injury and property damage in an amount not less than either (i) bodily injury liability limits of SI 00,000 per person and $300,000 per occurrence and property damage liability limits of $150,000 per occurrence or (ii) combined single limit liability of $1,000,000. Said policy shall include coverage for owned, non-owned, leased, hired cars, and any other automobile. (d) Professional Liability. Professional liability insurance appropriate to the Consultant's profession. This coverage may be written on a "claims made" basis, and must include coverage for contractual liability. The professional liability insurance required by this Agreement must be endorsed to be applicable to claims based upon, arising out of or related to services performed under this Agreement. The insurance must be maintained for at least 5 consecutive years foJlowing the completion of Consultant's services or the tennination of th.is Agreement During this additional 5-year period, Consultant shall annually and upon request of the City submit written evidence of this continuous coverage. (e) Additional Insurance. Policies of such other insurance, as may be required in the Special Requirements in Exhibit "B". (t) Subcontractors. Consultant shall include all subcontractors as insureds lUlder its policies or shall furnish separate certificates and certified endorsements for each subcontraclor. Al I coverages for subcontractors shal 1 be subject to all of the requirements stated herein. 5.2 General Insurance Requirements. All of the above policies of insurance shall be primary insurance and shall name the City, its elected and appointed officers, employees and agents as additional insureds and any insurance maintained by City or its officers, employees or agents may apply in excess of, and not contribute with Consultant's insurance. The insurer is deemed hereof to waive aJI rights of subrogation and contribution it may have against the City, its officers, employees and agents and their respective insurers. The insurance policy must specify that where the primary insured does not satisfy the self-insured retention, any additional insured may satisfy the self-insured
retention. All of said policies of insurance shall provide that said insurance may not be amended or cancelled by the insurer or any party hereto without providing thirty (30) days prior written notice by certified mail return receipt requested to the City. In the event any of said policies of insurance are cancelled, the Consultant shall, prior to the canceJlation date, submit new evidence of insurance in conformance with this Section 5.1 to the Contract Officer. No work or services under this Agreement shall commence until the Consultant has provided the City with Certificates of Insurance, additional insured endorsement forms or appropriate insurance binders evidencing the above insurance coverages and said Certificates of Insurance or binders are approved by the City. City reserves the right to inspect complete, certified copies of and endorsement to all required insurance policies at any time. Any failure to comply with the reporting or other provisions of the policies inc:luding breaches or warranties shall not affect coverage provided to City. The insurance required by this Agreement shall be satisfactory only if issued by companies quaJified to do business in California, rated "A" or better in the most recent edition of Best Rating Guide, 1be 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 City's Risk Manager or other designee of the City due to Wlique circumstances. 5.3 Indemnification. To the full extent permitted by law, Consultant agrees to indemnify, defend and hold hann1ess the City, its officers, employees and agents ("Indemnified Parties") against, and will hold and save them and each of them hannless from, any and all actions, either judicial, administrative. arbitration or regulatory claims. damages to persons or property, losses, costs, penalties, obligations, errors, omissions or liabilities whether actual or threatened (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 work. operations or activities provided herein of Consultant, its officers, employees, agents, subcontractors, invitees, or any individual or entity for which Consultant is legally liable ("indemnitors"), or arising from Consultant's or indemnitors' reckless or willful misconduct, or arising from Consultanfs or indemnitors' negligent perfonnance of or failure to perform any term, provision, covenant or condition of this Agreement, except claims or liabilities occurring as a result of City's sole negligence or willful acts or omissions. The indemnity obligation shall be binding on successors and assigns of Consultant and shall survive tennination of this Agreement. 6. RECORDS, REPORTS, AND RELEASE OF INFORMATION 6.1 Records. Consultant shall keep, and require subcontractors to keep, such ledgers., books of accounts? invoices, vouchers, canceled checks, reports, studies or other documents relating to the disbursements charged to City and services performed hereunder (the "books and records"), as shall be necessary to perform the services required by this Agreement and enable the Contract Officer to evaluate the perfonnance of such setvices and shall keep such records for a period of three years following completion of the services hereunder. The Contract Officer shall have full and free access to such books and records at all times during nonnaJ business hours of City, including the right to inspect, copy, audit and make records and transcripts from such records.
6.2 Reports. Consultant shaJJ periodically prepare and submit to the Contract Officer such reports concerning the perfonnance of the services required by this Agreement or as the Contract Officer shall require. 6.3 Confidentiality and Release oflnfonnation. (a) All infonnation gained or work product produced by Consultant in perfonnance of this Agreement shall be considered confidential, unless such information is in the public domain or already known to Consultant. Consultant shall not release or disclose any such infonnation or work product to persons or entities other than the City without prior written authorization from the Contract Officer. (b) Consultant shall not, without prior written authorization from the Contract Officer or unless requested by the City Attorney, voluntarily provide documents, declaration~ letters of support, testimony at depositions, response to interrogatories or other information concerning the work perfonned under this Agreement Response to a subpoena or court order shall not be considered "voluntary'! provided Consultant gives the City notice of such court order or subpoena. (c) If Consultant provides any information or work product in violation of this Agreement, then the City shall have the right to reimbursement and indemnity from Consultant for any damages, costs and fees, including attorney's fees, caused by or incurred as a result of Consultant's conduct. (d) Consultant shall promptly notify the City should Consultant be served with any summons, complaint, subpoena, notice of deposition, request for docwnents, interrogatories, request for admissions or other discovery request, court order or subpoena from any party regarding this Agreement and the work performed thereunder. The City retains the right, but has no obligation, to represent Consultant or be present at any deposition. hearing or similar proceeding. Consultant agrees to cooperate fully with the City and to provide the City with the opportunity lo review any response to discovery requests provided by Consultant. 6.4 Ownership of Documents. All studies, surveys, data, notes, computer files, reports, records, drawings, specifications, maps, designs, photographs, documents and other materials (the .. documents and materials") prepared by Consultant in the performance of this Agreement shall be the property of the City and shall be delivered to the City upon request of the Contract Officer or upon the termination of this Agreement. and Consultant shall have no claim for further employment or additional compensation as a result of the exercise by the City of its full rights of ownership use, reuse, or assignment of the documents and materials hereunder. Moreover, Consultant with respect to any documents and materials that may qualify as "works made for hire" as defined in 17 U.S.C. § IOI~ such documents and materials are hereby deemed "works made for hire" for the City. 7. ENFORCEMENT OF AGREEMENT AND TERMINATION 7.1 California Law. This Agreement shall be interprete~ construed and governed both as to validity and to performance of the parties in accordance with the laws of the State of California. Legal actions concerning any dispute, claim or matter arising out of or in
relation to this Agreement shall be instituted in the Superior Court of the County of Los Angeles, State of California. In the event of litigation in a U.S. District Court, venue shall lie exclusively in the Central District of California, in the County of Los Angeles, State of California 7.2 Disputes: Default. In the event that Consultant is in default under the terms of this Agreement, the City shall not have any obligation or duty to continue compensating Consultant for any work perfonned after the date of default. Instead, the City may give notice to Consultant of the default and the reasons for the default The notice shall include the timeframe in which Consultant may cure the default This timeframe is presumptively thirty (30) days, but may be extended, if circumstances wammt. During the period of time that Consultant is in default, the City shall hold all invoices and shall, when the default is cured. proceed with payment on the invoices. If Consultant does not cure the default. the City may take necessary steps to terminate this Agreement under this AnicJe. 7.3 Legal Action. In addition to any other rights or remedies, either party may take legal action, in law or in equity, to cure, correct or remedy any default, to recover damages for any default, to compel specific performance of this Agreement, to obtain declaratory or injunctive relief, or to obtain any other remedy consistent with the purposes of this Agreement. Notwithstanding any contrary provision herein, Consultant shall file a statutory claim pursuant to Government Code Sections 905 et. seq. and 910 et. seq., in order to pursue any legal action under this Agreement Except with respect to rights and remedies expressly declared to be exclusive in this Agreement, the rights and remedies of the parties are cumulative and the exercise by either party of one or more of such rights or remedies shall not preclude the exercise by it, at the same or different times, of any other rights or remedies for the same default or any other default by the other party. 7.4 Tennination Prior to Expiration of Tenn. This Section shall govern any termination of this Contract except as specificaJly provided in the folJowing Section for termination for cause. The City reserves the right to tenninate this Contract at any time, with or without cause, upon thirty (30) days' written notice to Consultant, except that where termination is due to the fault of the Consultant, the period of notice may be such shorter time as may be determined by the Contract Officer. In addition, the Consultant reserves the right to tenninate this Contract at any time, with or without cause, upon sixty (60) days' written notice to City, except that where termination is due to the fault of the City, the period of notice may be such shorter time as the Consultant may determine. Upon receipt of any notice of termination, Consultant shall immediately cease aJI services hereunder except such as may be specifically approved by the Contract Officer. Except where the Consultant has initiated termination, the Consultant shall be entitled to compensation for all services rendered prior to the effective date of the notice of termination and for any services authorized by the Contract Officer thereafter in accordance with the Schedule of Compensation or such as may be approved by the Contract Officer. In the event the Consultant has initiated termination, the Consultant shall be entitled to compensation only for the reasonable value of the work product actually produced hereunder, but not exceeding the compensation provided therefore in the Schedule of Compensation Exhibit "C". In the event of tennination without cause pursuant to this Section, the terminating party need not provide the non-terminating party with the opportunity to cure pursuant to Section 7.2.
7.5 Tennination for Default of Consultant If tennination is due to the failure of the Consultant to fulfill its obligations under this Agreement, City may, after compliance with the provisions of Section 7.2, take over the work and prosecute the same to completion by contract or otherwise, and the Consultant shall be liable to the extent that the total cost for completion of the services required. hereunder exceeds the compensation herein stipulated (provided that the City shall use reasonable efforts to mitigate such damages), and City may withhold any payments to the Consultant for the purpose of set-off or partial payment of the amounts owed the City as previously stated. 8. MISCELLANEOUS 8.1 Covenant Against 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, gender, sexual orientation, marital status, national origin, ancestry, or other protected class in the performance of this Agreement. Consultant shall take affinnative action to ensure that applicants are employed and that employees are treated during employment without regard lo their race, color, creed, religion, se~ gender, sexual orientation. marital status, national origin, ancestry, or other protected class 8.2 Non-liabilitv of City Officers and Employees. No officer or employee of the City shaJI 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. 8.3 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 personalJy 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 (with her/his name and City title), City of Carson, 701 East Carson, Carson, California 90745 and in the case of the Consultant, to 1he person(s) at the address designated on the execution page of this Agreement. Either party may change its address by notifying the other party of the change of address in writing. Notice shall be deemed communicated at the time personally delivered or in seventy-two (72) hours from the time of mailing if mailed as provided in this Section. 8.4 Integration: Amendment. It is understood that there are no oral agreements between lhe parties hereto affecting this Agreement and this Agreement supersedes and cancels any and all previous negotiations, arrangements, agreements and understandings, if any, between lhe 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. 8.5 SeverabiJity. 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 lhe remaining portions of this Agreement which are hereby declared as severable and shall be interpreted to cany 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.
8.6 Waiver. No delay or omission in the exercise of any right or remedy by non-<lefaulting 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 UMecessary 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. 8.7 Attomevs' 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 any be granted, whether legal or equitable, shall be entitled to reasonable attorney's fees, whether or not the matter proceeds to judgment. 8.8 Interpretation. TI1e terms of this Agreement shall be construed in accordance with the meaning of the language used and shall not be construed for or againsf"either party by reason of the authorship of this Agreement or any other rule of construction which might otherwise apply. 8.9 Countemarts. This Agreement may be executed in counterparts, each of which shall be deemed to be an original, and such counterparts shall constitute one and the same instrument 8.10 Warranty & Representation of Non.Collusion. No official, officer, or employee of City has any financial interest. direct or indirect, in this Agreement,. nor shall any official, officer, or employee of City participate in any decision relating to this Agreement which may affect his/her financial interest or the financial interest of any corporation. partnership, or association in which {s)he is directly or indirectly interested, or in violation of any corporation, partnership, or association in which (s)he is directly or indirectly interested, or in violation of wty State or municipal statute or regulation. The determination of "financial interest" shall be consistent with State law and shall not include interests found to be "remote" or "noninterests" pursuant to Government Code Sections I 091 or I 091.5. Consultant warrants and represents that it has not paid or given, and will not pay or give, to any third party including, but not limited to, any City official, officer, or employee. any money, consideration, or other thing of value as a result or consequence of obtaining or being awarded any agreement. Consultant further warrants and represents that (s)he/it has not engaged in any act(s), omission(s), or other conduct or collusion that would result in the payment of any money, consideration, or other thing of value to any third party including, but not limited to, any City official, officer, or employee, as a result of consequence of obtaining or being awarded any agreement. Consultant is aware of and understands that any such act(s), omission(s) or other conduct resulting in such payment of money, consideration~ or other thing of value will render this Agreement void and of no force or effect. Consultant's Authorized Initials~
8. J J 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. This Agreement shall be binding upon the heirs, executors, administrators, successors and assigns of the parties. [Signatures on the following page.]
Donesia Gause-Aldana. City Clerkr APPROVED AS TO FORM: ALESHIRE & WYNDER. LLP e7 I, ----6.u.i:-r 7( r~ Sunny K. Soltani, City Attorney [eqgJ CITY: CONSULT ANT: COOPERATIVE PERSONNEL SERVICES, dba CPS HR CONSUL TlNG, a California Joint Powers Authority By: ~lf\J~ ~k~ Name: Sandy MacDonald-Hopp 1 Title: ChiefFinancinl Officer By: n/a • CPS HR is a JPA not n corporation Name: Tille: Address: 2450 Del Paso Road, Suite 120 Sacramento, CA 9S834 916-471-3358 Two corporate officer signatures rrqulred when Consultant is o corpon11ion, wllh one., signa111r~ r4!quired from mch or the roUowlng groups: I) Chairmon of lhe Board. President or any Vice Prcslden1; and l) Seorrctnry, any .Asslslonl Scr:relJll')". Chier Fioancisl Offkcr or any Assistant Trc.sunr. CONSULT ANT'S SIC.NATURES SHALL BE DULY NOTARIZED, AND APPROPRIATE AlTESTATIONS SHALL BE
INCLUDED AS MAY BE REQUIRED BY THE BYLAWS, ARTICLES OF INCORPORATION, OR OTHER RULES OR REGULATIONS APPLICABLE TO CONSULTANT'S BUSINESS ENTITY. CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT A notary public or other officer completing this cenificate verifies only the identity of the individual who signed the documenr to which this certificate is attached. and not the uuthfufness, accuracy or validity of that document. ST ATE OF CALIFORNIA COUNTY OF LOS ANGELES On • 2020 before me, , per.;onally appeared • proved to me on the basis of satisfactory evidence to be the person(s) whose names{s) is/are subscribed to the within instrument and acknowledged to me that he/shei1hey executed the same in his/her/their authorized capacity(ies), and that by his/her/their signarurc(s) on the instrument the pcrson(s), or the entity upon behalf of which the person(s) acted, executed the instrument r certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and corrccL WITNESS my hand and official seal. Signature:-----·---------OPTIONAL Though the data below is not required by raw, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this fonn. D D D D D 0 D CAPACITY CLAIMED BV SIGNER INDIVIDUAL CORPORA TE OFFICER TITLE{S) PARTNER(S) 0 LIMITED D GENERAL A lTORNEY-IN•F ACT TRUSTEE(S) GUARDIAN/CONSER VA TOR OTHER·----~~--~-~ SIGNER JS REPR£S[NTING: (NAME OF PERSON(S) OR ENTITY(IES)) DESCRIPTION OF A IT ACHED DOCUMENT -------------TITLE OR TYPE OF DOCUMENT NUMBER OF PAGES DA TE Of DOCUMENT SIG,NER(S) OTHER THAN NAMED ABOVE
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is anached, and not the truthfulness.. accuracy or validity of that docwnent. ST A TE OF CALIFORNIA COUNTY OF LOS ANGELES On , 2020 before me. • personally appeared • proved to me on the basis of satisfactory evidence to be the person(s) whose names(s) is'are subscribed to the within instrument and acknowledged to me that he/she/they executed the snme in his/her/their authorized capacity(ies). and that by his/her/their signature(s) on the instrument the person(s). or the entity upon behalf of which the person(s) acted, executed the instrument t certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature:--------------OPTIONAL Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form CAPACITY CLAIMED BY SIGNER 0 INDIVIDUAL 0 CORPORA TE OFFICER D D D D D TITLE(S} PARTNER(S) 0 LIMITED D GENERAL A TTORNEY-IN-f ACT TRUSTEE(S) GUARDIAN CONSERVATOR OTiiER~~~~---~·~-~ SIGNER IS REPRESENTlNG: (NAME OF PERSON(S) OR ENTITY(IES)) DESCRIPTION OF ATTACHED DOCUMENT TITLE OR TYPE OF DOCUMENT . ---NUMBER OF PAGES DATE OF DOCUMENT SIGNER(S) OTHER THAN NAMED ABOVE
EXHIBIT "A" SCOPE OF SERVICES I. Consultant will provide executive recruitment services for the City of Carson for the position of Director of Community Services/Parks & Recreation. A. Consultant will work with the Contract Officer to familiarize themselves with the City•s expectation for a new Director of Community Services/Parks & Recreation. Consultant will learn the values and culture of the organization. as well as, understand the current issues, challenges and opportunities that face the City. Consultant will be clear on the City's expectations regarding the knowledge, skills and abilities sought in the ideal candidate and will work with the City to identify expectations regarding compensation and other items necessary to complete the successful appointment of the ideal candidate. The profile developed at this stage will drive subsequent recruitment efforts. B. After gaining an understanding of the City of Carson•s needs., Consultant will design an effective advertising campaign appropriate for the Director of Community Services. Parks & Recreation. C.onsultant will focus on professional journals that are specifically suited to the Director of C.ommunity Services, Parks & Recreation search. Consultant will also develop a professional recruitment brochure on the City's behalf that will discuss the community, organization, position and compensation in detail. Once completed, Consultant will mail the profile to an extensive audience (sufficient mailings at the sole reasonable determination of the Contract Officer), making them aware of the opportunity with the City of Carson. C. After cross-referencing the profile of the ideal candidate with Consultant's database and contacts in the field, Consultant will conduct an aggressive outreach effort, including making personal phone calls to prospective applicants, designed to identify and recruit outstanding candidates. Consultant recognizes that the best candidate is often not looking for a new job yet often is the person Consultant will actively seek to convince to become a candidate. Consultant expressly understands that aggressively marketing the Director of Community Services, Parks & Recreation position to prospective candidates will increase the likelihood of the success of the search. D. Following the closing date for the recruitment, Consultant will screen the resumes received. Consultant will use the criteria established in Task B as a basis upon which to nanow the field of candidates. E. Consultant will conduct personal interviews with the top IO to 12 candidates with the goal of detennining which candidates have the greatest potential to succeed in the City of Carson. During the interviews, Consultant will explore each candidate's background and experience as it relates to the Director of Community Services, Parks & Recreation position. In addition, Consultant will discuss the candidate's motivation for applying for the position and make an assessment of his/her knowledge, skillst and abilities to perform the functions of the position. Consultant will devote specific attention to establishing the likelihood of the candidate's acceptance of the position if an offer of employment is made.
F. Following the interviews, Consultant will conduct a review of published articles for each recommended candidate. Consultant will review various sources including but not limited to Lexis-Nexis TM, a newspaper/magazine search engine, Google and social media. This will alert Consultant to any further detailed inquiries that may need to be made regarding particular candidates, and Consultant will promptly make such detailed inquiries. G. Based on the infonnation gathered through meetings with the City, personal interviews \vith candidates, and any further infonnation detennined pursuant to any detailed inquiries, Consultant will prepare a detailed written report on each candidate that focuses on the results of Consultant•s interviews and public records searches. Consultant will make specific recommendations. but the final determination of those to be considered will be made by the City. H. Consultant will assist the City in developing an interview process that objectively assesses the qualifications of each candidate. Consultant \viii adopt an approach that fits the City's needs (in the sole reasonable detennination of the Contract Officer), whether it is a traditional interview, multiple interview panel and/or or assessment center process. Consultant wiJI provide the City with suggested interview questions and rating forms and will be present at the intenriew/assessment center to facilitate the process. Consultant will facilitate the discussion so as to bring about a consensus regarding the final candidates. Consultant wilt work closely with Contract Officer to coordinate and schedule interviews and candidate travel. City's goal is to ensure that each candidate has a very positive experience, as a candidate's impression of the City will affect their interest in the position. I. Consultant wilt conduct credit, criminal, civil litigation, and motor vehicle record checks for the top one to three candidates based on the final interviews. In additio11t those candidates will be the subjects of detailed, confidential reference checks. In order to gain an accurate and honest appraisal of the candidates• strengths and weaknesses, Consultant will talk candidly with people who have direct knowledge of their work and management style. Consultant will ask candidates to forward the names of their supervisors, subordinates and peers for the past several years. Additionally, Consultant ,vill speak confidentially to individuals who Consultant knows have insight into a candidate's abilities, but who may not be on their preferred list of contacts. At this stage in the recruitment, Consultant will also verify candidates' degrees. J. Consultant recognizes the critical importance of successful negotiations and can se,ve as the City's representative during this process (as the sole reasonable discretion of the Contract Officer). Consultant knows what other organizations have done to put deals together with great candidates and will be available to advise the City regarding current approaches to difficult issues such as housing and relocation, if applicable. Consultant will represent the City•s interests and advise the City regarding salary, benefits. and employment agreements \vith the goal of putting together a deal, which results in the appointment of City~ s chosen candidate. Consultant will endeavor and make best efforts to assist the City in turning any difficult aspect of the recruitment into one that is viewed positively by both City and the candidate. K. Throughout the recruitment Consultant will provide the Contract Officer with updates on the status of the search upon request by the Contract Officer, and such updates will be in writing upon request by Contract Officer. Consultant will also take care of all administrative
details on City's behalf, as determined in the sole reasonable discretion of the Contract Officer. Candidates will receive personal letters. prepared by Consultant and approved by Contract Officer, advising them of their status at each critical point in the recruitment. In addition, Consultant will respond to inquiries from candidates and the City about the status of their candidacy within 24 homs. Evecy administrative detail will receive Consultants• full and complete professional attention. II. As part of the Services, Consultant will prepare and deliver the following tangible work products to the City: A. Advertising campaign details (sources, date of placement) B. Recruitment brochure (PDF and hard copy) C. Full Candidate list following application closing date D. Recommended Finalists book(s) E. Interview book(s) F. Results of reference and background checks III. In addition to the requirements of Section 6.2, during performance or the Services, Consultant will keep the Contract Officer updated or the status of performance by delivering the following status reports and tangible work products: A. Task B: Consultant will periodically infonn City (at interval agreed upon by City and Consultant) regarding number/quality of applicants B. Tasks C-0: Consultant will inform City regarding results of candidate screening and plans for preliminary interviews C. Task E-F: Consultant will meet with City regarding results of preliminary interviews and public records searches and determine final candidate pool D. Task G-H: Consultant will deliver detailed reports, interview questions and rating forms as provided in Tasks H-1 E. Task I: Consultant will provide City with results of references and background checks F. Task K: Consultant will deliver updates as provided in Task K IV. All work product is subject to review and acceptance by the City, and must be revised by the Consultant without additional charge to the City until found satisfactory and accepted by City. V. Consultant will utilize the following personnel to accomplish Che Services: A. Frank Rojas-Senior Executive Recruiter/Project Manager
EXHIBIT "B" SPECIAL REQUIREMENTS (Superseding Contract Boilerplate) I. Section 2.2, Invoices, shall be amended as follows (new text is identified in bold & italics, deleted text in stFilie tht=eugh): "2.2 Invojces. Each month Consultant shaJl furnish to City an original invoice for all work performed and expenses incurred during the preceding month in a form approved by tl1e Contract Officer City's Direeter ef FiB&Ree. By submitting an invoice for payment under this Agreement, Consultant is certifying compliance with aJI provisions of the Agreement. The invoice shaU detail charges for all necessary and actual expenses by the following categories: labor (by sub-category), professional services (by task), travel. materials, equipment, supplies, and sub-contractor contracts, If applicable. Sub-contractor charges shall aJ.so be detailed by such categories. Consultant shall not invoice City for any duplicate services perfonned by more than one person. City shall independently review each invoice submitted by the Consultant to determine whether the work performed and expenses incurred are in compliance with the provisions of this AgreemenL Except as to any charges for work perfonned or expenses incurred by Consultant which are disputed by City, City wilJ use its best efforts to cause Consultant to be paid within forty five (45) days of receipt of Consultant's correct and undisputed invoice; however, Consultant acknowledges and agrees that due to City warrant run procedures, the City cannot guarantee that payment wilJ occur within this time period. In the event any charges or expenses are disputed by City. the original invoice shall be returned by City to Consultant for correction and resubmission. Review and payment by the City of any invoice provided by the Consultant shall not constitute a waiver of any rights or remedies provided herein or any applicable law."
EXHIBIT"'C" SCHEDULE OF COMPENSATION I. Consultant shall perform the following Services at the following rates: The consulting fee for conducting the Director of Community Services, Parks & Recreation recruitment on behalf of the City of Carson is $17,000 plus expenses. Services provided for in the fee consist of all steps and services provided for in this Agreement including meetings on site. The City of Carson will be responsible for reimbursing expenses Consultant incurs on the City's behalf with the express understanding that such expenses shall not exceed $6~000. Reimbursable expenses include such items as the cost of recruiter travel, if applicable; clerical support; brochure design and printing; express mail delivery; placement of ads/advertising; credit, criminal and civil background checks for one candidate; education verification; and public records searches. Postage, printing, photocopying, and telephone charges are allocated costs and included in the expense estimate. TASK RA TE SUB-BUDGET Task A Flat Rate $2,500 Task B Flat Rate $1,000 Task C Flat Rate $2,500 Task D Flat Rate $1,000 Task E Flat Rate $2,500 Task F Flat Rate $1,500 Task G Flat Rate $2,000 Task H Flat Rate $2,000 Task J Flat Rate $1,000 Task J-K Flat Rate $1,000 II. A retention of ten percent (10%) shall be held from each payment as a contract retention to be paid as a part of the final payment upon satisfactory completion of services. Ill. Within the budgeted amounts for each Task, and with the approval of the Contract Officer, funds may be shifted from one Task sub budget to another so long as the
Contract Sum is not exceeded per Section 2.1, unless Additional Services are approved per Section 2.3. JV. The City will compensate Consultant for the Services performed upon submission or a valid invoice at the completion of each task. Each invoice is to include, as applicable: A. Line items for all the work perfonned., the number of hours worked, and the hourly rate. B. Line items for all materials and equipment properly charged to the Services. C. Line items for all other approved reimbursable expenses claimed, with supporting documentation. D. Line items for all approved subcontractor labor, supplies, equipment, materials, and travel properly charged to the ~ervices. V. The total compensation for the Services shall not exceed $23,000, as provided in Section 2.1 of this Agreement.
EXIDBIT"D"' SCHEDULE OF PERFORMANCE I. Consultant shall perform all services timely in accordance with the following schedule as agreed upon by Contract Officer on behalf of City: Task: Week Contract Start Date: I week from contract start date Initial Meeting(s): 2 weeks from contract start date Consultant develops recruitment brochure: 3 weeks from contract start date City approves brochure: 4 weeks from contract start date Job advertising and candidate sourcing: 8 weeks from contract start date Consultant reviews application packets: 9 weeks from contract start date Consultant conducts screening process: IO weeks from contract start date City approves candidates: 12 weeks from contract start date City's interview pane) convenes: J 3 weeks from contract start date Reference/Background Checks: 14 weeks from contract start date Second Interviews by City, if necessary: 15 weeks from contract start date Offer of Employment: 16 weeks from contract start date II. Consultant sbaU deliver the tangible work products identified io Exhibit "A," Sections II and Ill, promptly to the City upon completion as well as upon request from Contract Officer. III. The Contract Officer may approve extensions for performance of the Services in accordance with Section 3.2.
1.._c9,RY CERTIFICATE OF LIABILITY INSURANCE I DA TE pilll/l)IJl'(YY 6/2Sl2019 nus C&RTIACATE 18 IS&UGD A8 A MATTER OF INl'ORMATION QNLY AND CONFERS NO RJOHTS UPON THE C&RTIFICATii HOLDER. Tlt18 CERTlfJCATii DOE& NOT AFFIRMATM!l.Y OR NEGATIVELY AMEND, EXTEND OR AL'TER THE OOVERAO! AFFORDED BY TH& POLICIES BELOW. THIS CERTIP'JCATE OF fNBURANCli OOliS NOT CONSTITUTE A CONTRACT BaT'Wli&N THE ISSUING INSURER(&), AIJTNORIZ!O R&PRIIEHTATIVE OR PRODUCER, AND THE C&fmf'ICATi HOLD&R. IMPORTANT: If 1M oertlftoata holder Is an ADDmONAL INSURED, Ult! polloy(les) must have ADDITIONAL INSURED pt'O¥fslons CH tM en4CH'Md. If SU8ROOATION 18 WAMD, 1ubJeot lo Ille terms and condltloM of Ult! polkly, a.rt.In polloles may rwqulra an andorMment. A statllmont on tNs o•ltlflaa1e doet not oonfer rlal,b to ttl• Hrtifloabt holdar In Heu ot 1uch ondorserntntts). PRODUCU ~~ Rebecca Foste< Edgewood Partners Insurance Center ~ ·-· 916-576-1524 Ir~ ~-~ 91e,.sa3-1s13 Ucense 1IOEl29370 POEm 13647 ~~.. Rehilcca.Fo1talflealcbrokara.com Seaamento CA 95853 .. lll•""'"Affa.tDUlO COVl!ll40E NNCI 111suiu1u: Vallav Fon» Insurance Co .20508 INSUAEI) COOPPER$ 111u1•.-R •, The Contfneni.11n11u11.nce Comnan11 35280 Cooperatlve Personnel services IIIIIUIIER C ' Uovde of London 85202 OBA: CPS HR Consultln~ 2450 Del Paso Rd., Sta 20 INSURER o, American Caaualtv Com1>11nv of R11dtna PA 20427 Sacramanto CA 95834 d/lUR£A f:• 1Ht1t1U• ~ : COVERAGES CERTIFICATE NUMBER: 192.040999 REVJBJON NUMBER; ms IS TO CERTIFY THAT TNE POLICIES OF IN6UAANCE UST£0 BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POt.lCY PEl'IOO INDICAT£0. N01WTHSTANOING AAY RliOUIREMENT, T£RM OR CONDmON OF ANY C(lt(fflACT OR OTHER DOCUMENT v.tTit RESPECT TO 1MilCH TlflS CERTIFICATE MAY ee ISSUED OR MAY PERTAIN. THE INBUAAHCE AFFORDED BY THE POLICIES DE6CRl8.ED HER!:IN IS SUBJECT TO All THE TERMS. EXCLUSIONS ANO CONDITIONS OF SUCH POLICIES llMITS SHO'MI MAY HAVE 8EEN REOUCSD BY PAID Ct.AIMS. "!'~ TTl'~ OF INIUIWI" •-•n , __ lll<'>lll:y IIUlllll'D . """"'r 1a.rr ~To:&J" 1.1111111 A X COMlll!RCW. IMINDAl. LIAllVJY 8072380517 71112019 7/112020 EAai OCCVAAENCE S 1000000 ..._ 0 CVJl,IS.MAOE 0 OCCUR =~'fc':cn11;u ....... ~ , ,.000000 ..._ I--MEOElCPINw ane-• $1$000 ,__ Pl:JISO~ l M:JII INJUR't' S 1000000 RH\. /IOGREG,\Tl! UMIT N'PLIES P(lt OEHEJW. .-OOAE°"ff ll.000,000 POU!:'I' D ~ [K] LOC PAOOUC'TB. COMPIOP AGO 12.000000 s OTWER: 8 AllrDMOIIUUUIUTI' !I0723V0548 71112(119 T/1/l020 ,r .• ........;._~ .. c;;~ IJMII 11.000000 .._ AH'i NJTO 8001L V IHAIRY (Ptf ,-.oni s ..._ OWNED ~ SCHEDULED BODILY IHNRY(Pencallf1U S .._ IWTOSOHl.'1' x MITOS X tllftED NO~EO ra'~~';"'"""""" l .__ MITOSOHLV .__ J,JJTOS ONL 'I' s b X UUl!lllUA LWI ~OCC4JR 6072lV0551 7/tf201t 71112.020 EAai OCCURRENCE S&000.000 .__ EllCl!U LIA.I C\M,18-MAOE AGGREGATE l&.000.000 nr" I X I IIETI,folll()M S • • n """ ' D INOIUWaJ COlll'EJIU. '10H 6072390534 711/2019 711/2020 X I Bf; l\ITTI I l~i\ .. .,, __ ..,._ ........ 0 .111 D DIPt.OY!Jltl' UAIIILffY VIII &om90520 71112019 7/1/2020 SI 000.000 AMY!'RDf'IIIETCM'AffTNERIEJlfCUT!W D U. E,t,Ctl At.CU>EHT OFf'QMIEloll!EREXCl.laO'I HIA S 1 OOOQOD t...,.._,IIINHI E.1.. D15EASE • IEA EMPLDVE£ ~m~~E:RATl""'abllow E L PtSEAIE -PO\. ICY LAUT s 1 000000 C tfflllll ' Clffllalanl W180C!l100501 1/1121119 711/2020 ~i= ss.oc:oooo ci-1 ~ D• 10i1311118U S50, DESCIIIPnoN o, CflEJIATIONa I LOCAnoNI I WMIC!i.l !ACORD 101. MIi-i 4'--1<a ..,,..,. .. -, ""..,..... K-llflK• •,.,....,, Re· All ConuedsM'ritlen ~nt1ment.1 ~ the Certfflcale Holder and lhe lnaunKl Additional Insured· The City of Canion, 115 eledecl 11nd ~olnter Dfflcel'W, ~loyen and ~ta. WJ,en required ~rttten contnlct, add Ilion al lowl9d 1tatllt wllh prtmary aiverage and waiver of subrogation apply lo nera Liability Automobtta 1111)1, all per ll'le ad eridD™HMnts.. CERTIFICATE HoLD!R C~ofC&BOn 70 E Carson Street Carson CA 90745 I ACORD ti (2011103) CANCEU.A TION Jipft'D~ SMOUU> ANY OF TKI: ABOVE DESCIUBEO POUCIES SE CANCEU.E.D BEFORE ffiE. EXPIRATIQN DATE THEREOF, Nonce W1U BE DeUVERE.D IN ACCORDANCE wmt THE POLICY PROVISlOMS. Ru-AU1ffCIIIIZUI IIS'fl!IIIITA TM! s-,s-2.-0 ~~ . rf ts rasorved. C> 1H8 2015 ACORD CORPORATION. All gh Th• ACORD name ancl 10110 Int nt;ls1lu•d marks of ACORD
CERTIFICATE OF LIABILITY INSURANCE THIS camFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIACATE HOLDER. THIS CERnf'JCATE DOES NOT AFF1RIIA11\l'ELV OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFOffDEO BY THE POlJaES BELOW. THIS CERTIFICATE Of INSURANCE DOES NOT COHSm'UTE A CONTRACT BETW!D,I THE ISSUING INSURER(SJ, AUTHORIZED REPRESENTATIVE OR PRODUCER, Mm THE CERTIRCATE HOLDER. IMPORTANT: 1f ~ ctrtlflcate hold&r Is an ADDmONAL INSURED, tt11 polh:y(1es) mfJSt have ADDITIONAL INSURED provisions ar be endorsed.. tf SUBROGATION IS WAIVED, subjld to Ula tenns and conditions of ttll policy, certain PoDcles ,nav 111qu)re an endorsenu,nt. A statanwnt on this cartlff~ does not conw rt to die Clttiftcate holder In lleu of web emtorse~f{S). INSURED Cooperative Personnel Services OBA· CPS HR Consulling 2450 Del Paso Rd • Ste 220 Sacramento CA 95834 COVERAGES INSUltEll F : CERTIFICATE NUMBER· 1924340999 20508 ofRead!n .PA 21).427 REVISION NUMBER: Tii!S IS TO CERTIFY ™AT lliE POLICIES OF INSURANCE USTEO Ba.OVi HAVE B££N lSSUED TO THE INSUR£0 NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTAMDING ANY REQUIREMSNT, TERM OR CONDITION Of ANY CONTRACT OR OTH£R DOCUMENT WITH RESPECT TO WHICH THIS CERTIFJCATE MAY BE ISSUED OR MAY PERTAIN, THE INSUAANCE Af'ForuiED 8Y TifE POLICJES DESCRIBED HEREIN IS SUBJECT TO AU. THE TERMS EXCLUSIONS AND CONOJnONS OF SUCH POUC:U;S LIMITS SHOWN MAY KAVE BEEN REDUCED BY PAID CLAIMS 6ll!l 1'1'Pl!Of'll1$UIWfCE 1-rnl'"""'l l'QUCYNUM!Et I ,mJCY!JIF I PDIJCYPJI' I UMl'B A f llEIU:W.GEHaw.UARm ,. 6072390517 7/tl.2019 711/2020 I EACHOCCURRENCE $1.000.0CIO ~r.'15.w.o!: 0 OCCVR PAEMlr~'t~, s 1.000.000 I MEDE)(f"{IWCN-) S15.000 P£RSOIW. &AOVINJIJR'I' S 1.000 000 I I 6D72390551 I 71112019 I 8 ·~ UlilllMl.l.AUAa = oca,,R I I 11112020 EACHOCCURReHCe is& ooo ooo EXCE?i$UAB LJ Cl.AIMS-MADE AGGREGATE i s5 COG.000 DEO ! XI RETENTIONS••~~~ s C Emn& Olan.ins Oeim.s Madel'Rsto Ollla 10llll19119 YIN D NIA 6072390534 6072390520 Wt80C51905(U 7/1/2019 7/1/2019 7/112020 tX I STATUTE I I ~H· Ctftft Gan.,,_._ 7/112020 EL EACHACCIDEHT S 1 000.000 EI. DISEAS£ • EA EMPLOY££ S 1 000,000 £L CISEASE -POLICY IJMIT S 1.000.0DO I 711/2019 I 1,112020 Ol!:$CRFTIOH OIF OPEIIATICJl5 I LOCAllOHS I Y!ltlCU!S CACORD tDI, M4111oea1 ~ ~ ~ .. -11--la '"'*"I Re: All Contrads/Wrillen Agreemenls between the Ceftilicate Holder and the Insured Ad~lional lnslftd The City of Can;on. its eleeted and appointed officers, employees and agents Wien reqLired by written contract. additional insured status with primary coverage and waiver of subrogation apply to General Liabllity and Aulomotllle Llabllily, all per tt1e altaClled endorsemen1s CERTIFICA Te HOLDER CANCBJ.ATION SH0Ul.O ANY Of THE ABOVE DESCRIBEO POUCIES 8E C:ANCEUEO BEJ=ORE 1HE EXPfMTIQN DATE THEREOF, NOTICE W1U. 8E DELIVERED IN ACCORDANCE WITH THE POIJC't PROVISIONS. City of Carson 701 E Carson Street AUTHOIU2ED~TIW Carson CA 90745 ~~ ' 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 {2016'03) Tbe ACORD name and logo an, n,glstentd marks of ACORD
C'NA CNA PARAMOUNT General Liability Extension Endorsement 1. ADDITIOHAL INSUREDS a. WHO JS AN INSURED is amended to include as an Insured any person or organization described in paragiaphs A. through K. below whom a Named lnsurad is required to add as an additional insured on this Coverage Pa.rt tmder a written contrad or written agreement. provided such conttacl or agreement (1t is a.,rrentfy in effect or becomes effective during the term of this Cowerage Part and (2) was executed prior to: (a) the bodily Injury or property damage; or {b) the offense that caused the personal and advertising inja.ay, for which such additional insured seeks coverage. b. However, subject always to the tenns and concfdions of this policy, including the rnnits of insurance, the Insurer will not provide such additional insured wiUt (1) a higher fimit of insurance than requintd by such contract or agreement; or (2) a,verage broader than required by such contract or agreement. and in no event broader than that desaibed by the applicable paragraph A. through K. below. Any coverage granted by this endorsement shall apply only to the extent permissible by law. A. Controlling Interest Any person or organization with a controlling interest in a Named Insured, but only with respect to such person or organization's 6abinty for bodily Injury, property dampge or personal and advertising injury arising out of: 1. such person or organization's financial control of a Named Insured; or 2. premises such person or organization owns, maintains or controls while a Named Insured leases or occupies such premises; provided that the coverage granted by this paragraph does not apply to struclural alterations, new oonstruction or demolition operations performed by, on behalf of. or for such additional insured. B. Co-owner of fnsunMf Premises A co-owner of a premises co-owned by a Hamed Insured and covered under this insurance but only with respect to such CG-ONnars raabBity Jor bodily injury, property damage or personal and advertising injury as co-owner of such premises. C. Grantor of Franchise Any person or organization that has granted a franchise to a Named tnsurad, but only with respect to such person or organization's flabilily for bodily injury, property damage or personal and advertising injury as grantor of a francruse to the Named Insured. 0. Lessor of Equipment Any person or organization l'rom whom a Named lnsun,d leases equipment, but only with respect to iabiity for bodily injury, property damage or personal and advertising injury caused, in whole or in part, by the Named lnsured"s maintenance, operation or use of such equipment, provided that the occumtnee giving rise to such bodBy Injury. property damage or the offense giVing rise to such personal and advertising Injury takes place prior to the termination of such lease. CNA74879XX (1-15) Page2 of13 VlU.LEY FORGE INSURANCE COMPANY Insured Name: COOPERATIVB PBRSONNBL SBRVIC'BS Poftcy No: 6072390517 Endorsement No: 4 Effective Date: 01/01/2019 •
z I I C'NA E. Lessor of Land CNA PARAMOUNT General Liability Extension Endorsement Any person or organization from whom a Named Insured leases land but only with respect ta liability for bodily lnjwy. property damage or personal and advertising injury arising out of the ownerahip, maintenance or use of such land, provided that the occunvn~ giving rise lo such bodily injury or property damage. or the offense giving rise to such personal and advertising injury, takes place prior to the tennination of such lease. The coverage granted by this paragraph does not apply to structural alterations, nev., construction or demolition operations performed by. on behalf of, or for such adcfrtional insured. F. Lessor of Premises An owner or lessor of premises leased to the Named rnsured, or such owner or lessor's rea) estate manager, but only wilh respeci to fa.ability for bodily injury, property damage or personal and adwrtising injury arising out of the ownership, maintenance or use of such part of the premises leased to the Named lnsuM, and provided that the oceurrence giving rise to sueh bodily injury, property damage or the offense giving rise to such personal and advertising Injury takes place prior to the termination of such lease. The coverage granted by this paragraph does not apply to structural alterations, new construction or demolition operations performed by, on behalr of, or for sueh additional insured. G. Mortgagee. Assignee or Receiver A mortgagee, assignee or receiver of premises but only with respect to such mortgagee, assignee or receiver's liability for bodily injury. property damage or personal and advertising injury arising out of the Named lnsured's ownership, maintenance, or use of a premises by a Named Insured. The coverage granted by this paragraph does not apply to structural alterations, new c:onstnJdion or demo6tion operations performed by, on behalf of. or for such additional insured. H. State or GovemmentaJ Agency or Subdivision or _Political Subdivisions -Pennits A state or governmental agency or subdivision or political subdivision that has issued a pennit or authorization, but only With respect to such state or governmental agency or subdivision or pofltical subdivision's fiability for bodily injuty, property damage or personal and advertising Injury arising out of: 1. the following hazards in connection with premises a Named Insured owns, rents. or controls and to which this insurance applies: a. the existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings. canopies, celfar entrances, coal holes, driveways, manholes. marquees. hoistaway openings, sidewalk vaults, street banners, or decorations and similar exposures; or b. the construction, eredion, or removal of elevators: or e. the ownership, maintenance or use of any elevators covered by this insurance; or 2. the pennitted or authorized operations performed by a Named Insured or on a Named lnsured's behalf. The coverage granted by this paragraph does not apply to: a. Bodlly injury, property damage or personal and advertising injury arising out of operations penormed for the state or governmental agency or subdivision or polttical subdivision; or b. Bodily injury or property damage induded within the products-completed operations hazard With respect to this provision's requirement that additional insured status must be requested under a written contract or agreement, the Insurer will treat as a written contract any governmental permit that requires the Named Insured to add the governmental entity as an additional insured. CNA74879X.X (1·15) Page 3of 13 VALLEY FORGE INSORANCB COMPANY Insured Name: COOPERATIVE PERSONNEL SERVICES Policy No: 60723 9051 7 Endorsement No: 4 Effective Date: 07/01/2019
C'NA CNA PARAMOUNT General Liability Extension Endorsement L Trade Sllow Event lessor 1. With reaped to a Named lnsured's partic:ipation in a trade show event as an exhibitor. presenter or displayer. any person or organization whom the Named Insured is required to indude as an additional insured, but only with respect to such pen;on or organization's liability for bodily Injury, property damage or personal and advertising injury caused by: · a. 1he Named lnsuntd's acts or omissions; or b. the acts or omissions of those acting on the Named lnsurad's behalf, in the performance of the Named lnsured's ongoing operations at the trade show event premises during the trade show event. 2. The cover.age granted by this paragraph does not apply to bodily injury or property damage included wflhln the products-completed operations hazard. J. Vendor Nrf person or o,ganization but only with respect to such person or organization's iabJlly for bodily Injury or property damage arising out of your products which are distributed or sold in the regular course of such person or organization•s business. provided that: 1. The coverage granted by this paragraph does not apply to: a. boclDy Injury or property damage for which such person or organization is obligated to pay damages by reason of the assumption of liability in a contract or agreement unless such fiabifity exists in the absence of the contract or agreement; b. any express warranty unauthorized by the Named Insured; c. any physical or chemical change in any product made intentionaly by such person or organization; d. repackaging, except when unpadced sorely for lhe purp0$e of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container. e. any faiwe to make any inspections. adjustments, tests or S8fVicing that such person or organization has agreed to make or nonnaHy undertakes Co make in the usual course of business, in mnnec:tion with the distribution or sale of the products; f. demonstration, installation, servicing or repair operations, except such operations pelfonned at the such per.son or o,ganization's premises in connection with the sate of a product; g. products which, after distribution or sale by the Named Insured, have been tabefed or relabefed or used as a mntainer, part or ingredient of any other thing or substance by or for such person or organization; or h. bodily injury or property damage arising out of the sole negligence of such person or organization ror its own ads or omissions or those of its employees or anyone else acting on ils behalf. However, this exclusion does not apply Co: (1) the exceptions contained in Subparagraphs d. orf. above; or (2) such inspections, adjustments, tests or servicing as such person or organization has agreed with the Named Insured lo make or normally undertakes to make in the usual course of business. in connedion wiltl the distri>ution or sale of the producis. 2. This Paragraph J. does not apply lo any insured person or organization, from whom the Named Insured has acqufred such produds, nor to any ingredient. part or container, entering into. accompanying or containing such products. CNA74879XX (1-15) Page4of13 VALLEY FORGB INSURAHCB COMPANY Insured Name: COOPERATIVE PBRSONNBI, SERVICES Policy No: 6072390517 EndoBement No: 4 Effective Date: 07/01/2019
C'NA 3. This Paragraph J. also does not apply: CNA PARAMOUNT General Liability Extension Endorsement a. to any vendor spec:ifically scheduled as an additional insured by endorsement to this Coverage Part; b. to any of your products for which cove.rage is excluded by endorsement to this Coverage Part; nor c. if bodily injury or property damage included within the produc&s-completed oper.ations hazard is excluded by endorsement to this Coverage Part K. Other Person Or Organization Any person or organization who is not an adcfltional insured under Paragraphs A. through J. above. Such additional insured is an Insured solely for bodily Injury, property damage or personal and advertising injury for which such additional insured is tiable because of the Named IRSUred's acts or omissions. The coverage granted by this paragraph does not apply to any pen.on or mganizalion: 1. for bodily injury, pn,pe,ty damage, or personal and advertising injury arising out of the rendering or failure to render any professional service; 2. for bodily injury or property damage included within the products-completed operations hazard; nor 3. who is specifically scheduted as an additional insured on another endorsement to this Coverage Part 2. ADDmONAL INSURED -PRIMARY ANO NON-CONTRIBUTORY TO ADDITIONAL INSURED•$ INSURANCE A. The Other Insurance Condition in the COMMERCIAL GENERAL UASIUTY CONDITIONS S~on is amended to add the following paragraph: If the Named Insured has agreed in wrning in a conltad or agreement that this insurance is primary and non-contributo,y relative to an additional insured's own insurance, then this insurance is primary, and the Insurer will not seek contribution from that other insurance. For the purpose of this Provision 2., the additional insured's own insurance means Insurance on which Che additional insured is a named insured. B. Wth respect to pBfSOns or organizations that qualify as additional insureds pursuant to paragraph 1.K. of this endorsement, the following sentence is added lo the paragraph above: Otherwise, and notwithstanding anything to the contrary ersewhere in this Condition, the insurance provided lo such person or organization is excess of any olhe, insurance available co such person or organization. 3. BODILY INJURY -EXPANDED DEFINITJON Under DEFINmONS the definition of bodily Injury Is defeted and replaced by the folfowing: Bodily injury means physical injury, sickness or disease sustained by a pe,son. including death, humiliation, shock. mental anguish or mental injury sustained by that person at any time which results as a consequence of the physical injury, sickneu or disease. 4. BROAD KNOWLEDGE OF OCCURRENCE/ NOTICE OF OCCURRENCE Under CONDfTIONS, the condition entitted Duties in The Event of Occurrence, Offense, Clalm or Sult is amended to add the following: A. BROAD KNOWLEDGE OF OCCURRENCE The Named In.sured must give the Insurer or the Insurer's authorized representative notice of an occurrence, offense or clabn only when the occurrence. offense or claim is known to a natural person Named Insured, to a partner, executive officer, manager or member of a Named Insured, or to an employee designated by any of the above to give such notice. 8. NOTICE OF OCCURRENCE CNA74879XX (1-15) Page5of13 VALLEY FORGE INSURANCE COMPANY Insured Name: COOPERATIVE PERSONNEL SERVICES Policy No: 607239051 7 Endorsement No: 4 Effective Date: 07/01/2019
.. a I I -II = ---CNA CNA PARAMOUNT General Liability Extension Endorsement not be deemed to be damages for personal and advertislng injury and will not reduce the limits of insurance. D. This PERSONAL AND ADVERTISING INJURY • LIMITED CONTRACTUAL LIABILITY Ptovision does not apply if Coverage B -Personal and Advertising Injury Uability is excluded by another endofsement attached to this Coverage Part 17. PROPERTY DAMAGE-B.EVATORS A. Under COVERAGES, Coverage A -BodUy lnjmy and Pn>perly Damage UabDlty. the paragraph entitled Exclusions is amended such that the Damage to Your Product Exdusion and subparagraphs (3). (4) and (6) of lhe Damage to Property Excilsion do not apply to property damage that R1Su1ts from the use of elevators. B. Solely for the purpose of the coverage provided by this PROPERTY DAMAGE -ELEVATORS Provision, the Other lnswance conditions is amended to add lhe following paragraph: This insurance is excess over any of the other insurance, whether primary. excess, contingent or on any other ~ that is Properly insurance covering property of olhers damagedjrom the use of elevato,s. 1LSUPPLEMENTARYPAYMENTS The section entitled SUPPLEMENTARY PAYMENTS -COVERAGES A AND ~ is amended as follows: A. Paragraph 1.b. is amended to delete the $250 &mi &f'IOwn for Che-cost of bail bonds and replace it with a $5,000. fmit: and B. Paragraph 1.d. is amended to delete lhe lmit of $250 shown for daily loss of earnings and replace it wtth a $1.000. limit. 19. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS If tfle Hamed Insured unintentionally fails to disclose al existing hazards at the inception dale of the Named lnsuntd's Coverage Part. the Insurer will not deny coverage under lhis Covetage Part because of Stich failure. 20. WAIVER OF SUBROGATION· BLANKET Under CONDITIONS, the Transfet' Of Rights Of Recovery Against Othens To Us Condition is amended to add the following; The lnsuTer waives any right of recovery the Insurer may have against any person or organization because of payments the Insurer makes for injury or damage arising out of: 1. the Named rnsurecrs ongoing operalions; or 2. your work included in the products-completed operations hazard. However. this waiver applies onty when the Named Insured has agreed in writing to waive such rights of recove,y in a written contract o, written agreement, and only if such conlrad or agreement: 1. is in effect or becomes effective during the term of this Coverage Part: and Z. was executed prior to the bodily injury, property damage or personal and adva.rtiaing injury giving rise to the datm. AH other tenns and concfttions of Che Policy remain unchanged. This endorsement, which forms a part of and is for attachment to Che Policy issued by the designated Insurers, 1akes effect on the effective date of said Policy at the hour staled in said Policy, unless another effective date is shown below, and expires concurrenUy with said Poficv. CNA74879XX (1•15) Page 13 of13 VALLEY FORGE INSURANCE COMPANY 11\SU!'ed Name: COOPBRATIVE PERSONNEL SERVICES PoficyNo: 6072390S17 Endorsement No: 4 Effective Date: 07/01/2019
Policy #60n390S48 C'#A CNA83700XX (Ed. 10-15) EXTENDED COVERAGE -BA PLUS -FOR HIRED AND NON-OWNED AUTOS It is understood and agreed that this endorsement amends the BUSINESS AUTO COVERAGE FORM as follows. If any other endorsement attached to this policy amends any provision also amended by this endorsement. then that other endorsement contrors with fl?Sped to such provision, and the changes made by this endorsement to such provision do not apply. TABLE OF CONTENTS I. AMENDMENTS TO LIABILITY COVERAGE A. Who Is An Insured 1. Majority Owned Corporations 2. Newly Acquired Organizations 3. Additional Insureds Required By Written Contracts 4. Employee.Hired Autos B. Increased Loss of Earnings AHowance C. Fellow Employee Coverage II. AMENDMENTS TO PHYSICAL DAMAGE COVERAGE A. Increased loss of Use Expense B. Broadened Electronic Equipment Coverage ID. AMENDMENTS TO BUSINESS AUTO CONDmONs A. Knowledge of Accident or Loss e. Knowledge of Documents C. Waiver of Subrogation D. Unintentional failure To Disclose Hazards E. Primary and Non.contributory When Required By Contract IV. AMENDMENTS TO DEFINITIONS A. Broadened Bodily Injury I. AMENDMENTS TO LIABILITY COVERAGE A. Amendments to Who Is An Insured Under SECTION II -COVERED AUTOS LIABILITY COVERAGE, the paragraph entitled Who Is An rnsured is amended to add the following: 1. Majority owned Corporations Any incorporated entity in which you own a majority of the voting stock on the inception date of this Coverage Fonn is an '"insured", but only if such entity is not an "insured'' under any other liability "policy" that provides "auto" coverage. 2. Newly Acquired Organizations Any organization you newly acquire or form during the policy period, other lhan a fimited liabt1ity company, partnership or joint venture, and in which you maintain majority ownership interest is an "insured", but only if such organization is not an "insured" under any other liability "policy" that provides "auto" coverage. The insurance afforded by this provision: CNA83700XX (Ed. 10.15) Page 1 of3 Copyright. CNA All Rights Reserved
a. Is effective on the date of acquisition or formation of the organization, and applies unti: (1) The end ofthepolicyperiodofthis Coverage Form; or (2) The next anniversary of this Coverage Fonn·s inception date, whichever is earlier; and CNA83700XX (Ed.10-15) b. Does not apply to "bodily Injury" or "property damage" caused by an •accidenf' that occurred before you acquired or formed the organization. 3. Additional Insureds Required By Written Contract Any person or organization that you are required by written contract lo make an additional insured under this Insurance is an "'insured". but only with l8Sp8Ct to that person or organization's legal liability for acts or omissions of a person who qualifies as an ... insured" for Liability Coverage under Section II -Who Is An Insured of this Coverage Form. 4. Employee-Hired Autos Any "employee• of yours is an "insured" white operating with your permission an •auto" hired or rented under a contract in that ·~pfoyee·s· name, wh~e performing duties related to the COl'!duct of your business. With respect to provisions A.1. and A.2. above, "policy" includes those policies that were in foree on the inception date of this Coverage Form, but: I. Which are n~ longer in force; or ii. Whose rmits have been exhausted. B. Increased Loss of Earnings Allowance Under SECTION ti -COVERED AUTOS LIABILITY COVERAGE, the paragraph entitled Coverage Extensions is amended under Supplementary Payment subparagraph (4) to delete U,e $250 a day limit for loss of earnings and replace it with a S500 a day limit. c. Fellow Employee Coverage Under SECTION II -COVERED AUTOS LIABILITY COVERAGE, the paragraph entilled Exclusions is amended to defete the exclusion entifled Fenow Employee. ti. AMENDMENTS TO PHYSICAL DAMAGE COVERAGE A. Increased Loss of Use Expense Under SECTION Ill -PHYSICAL DAMAGE COVERAGE, the paragraph entitled Coverage Extensions is amended under Loss of Use Expenses ID delete the maximum of $600, and replace it with a maximum of $800. B. Broadened Electronic Equipment Coverage Under SECTION 111-PHYSICAL DAMAGE COVERAGE, the paragraph entitled Exclusions is amended to delete paragraphs 5.a through 5.d. in their entirety, and replace them with the foUowing: S. Exclusions 4.c. and 4.d. above do not apply to "loss" lo any electronic equipment that at the time of "loss" is: a. Pennanently installed in or upon a coveted "auto•, nor to such equipment's antennas or other accessories used with such equipment A $100 deducbble applies to this J)l'(MSfon. and supef'Sedes any otherwise app~cable deductible; or b. Designed to be operated solely by use of the power from the "auto's· electrical system and is: (1) Removabte from a housing unit which is pennanentfy installed in or upon the covered "auto·; (2) An integraf part of the same unit housing any electronic equipment described in paragraphs a. or b.(1) above; or (3} Necessary for the nonnal operation of the covered ·auto· or the monitoring of the covered "auto's., operating system. CNA63700XX (Ed. 10-15) Page2of3
C'#A Ill. AMENDMENTS TO BUSINESS AUTO CONDITIONS A. Knowledge of Accident or Loss CNA83700XX (Ed.10-15} Under BUSINESS AUTO CONDmONS, the Loss Condition entitled Duties In the Event of Accident. Claims, Suit, or Loss is amended to add the following subparagraph a.(4): (4) If your "employees" know of an "accident" or "loss", this will not mean that you have such knowledge until such "accident"' or "foss" is known to a natural person Named Insured, to a partner, executive officer, manager or member of a Named rnsured, or to an "employee" designated by any of the above to be your insurance manager. e. Knowledge of Documents Under BUSINESS AUTO CONOmONS. the Loss Condition entitled Duties In the Event of Accident, Claims, Suit. or Loss is amended to add the following subparagraph b.(6): (6) If your •employees" know of documents concerning a claim or "suit", this wi11 not mean that you have such knowledge until such documents are known to a natural person Named Insured, to a partner, executive officer, manager or member of a Named Insured, or to an "employee" designated by any of the above to be your insurance manager. C. Waiver of Subrogation Under BUSINESS AUTO CONDmONS, the loss Condition entitled Transfer Of Rights Of Recovery Against Others To Us is amended to add the foUowing: We waive any right of recovery we may have, because of payments we make for injury or damage, against any person or organization for whom or which you are required by written contract or agreement to obtain this waiver from us. This injury or damage must arise out of your activities under a contract with that person or organization. You must agree to that requirement prior to an "accident" or "loss." D. Unintentional failure To Disclose Hazards Under BUSINESS AUTO CONDmONS, ttie General Condition entitled Concealment. Misrepresentation or Fraud is amended to add the following: Your failure to disclose all hazards existing on the inception date of this Coverage Fonn shaU not prejudice you with respect to the coverage provided by this insurance, provided such failure or omission is not intentional. E. Primary and Non-Contributory When Required By Contract Under BUSINESS AUTO CONDITIONS, the General Condition entitled Other Insurance is amended to add the foRowing: Notwithstanding provisions 5.a. through 5.d. above, the coverage provided by this Coverage Form shall be on a prim8fy and non-contributory basis when required lo be so by a written contract entered into prior to "accident" 0t "loss." IV. AMENDMENTS TO DEFINmONs A. Broadened Bodffy Injury Under DEFINITIONS, the definition of "bodily injury" is deleted and replaced by the following: ''Bodily injury" means physical injury. sickness or disease sustained by a person, including death, mental anguish or mental injury sustained by that person which results as a consequence of the physii;al injury, sickness or disease. An other terms and conditions of the Policy remain unchanged. CNA83700XX (Ed. 10-15) Page 3 of 3 Copyright, CNA AU Rights Reseived
CNA Workers Compensation And Employers Liability Insurance Policy Endorsement This endorsement changes the policy to which it is attached. ft is agreed that Part One -Workers' Compmsatlon Insurance G. Recovery From Others and Part Two · Employers• liahirity Insurance H. Recovery From Others are amended by adding the following; We will not enforce our right to recover against persons or organizations. {This agreement applies only to the extent that you perform work under a written contnlct that requires you to obtain this agreement from us.) PREMIUM CHARGE • Refer to the Schedule of Operations The charge will be an amount to which you and we agree that is a percentage of the total standard premium for California exposure. The amount is 2%. All other terms and conditions of the policy remain unchanged. 1ms endorsement. which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below. and expires concurrentlv with said policy unless another expiration date is shown below. No:G-1~1C!0·8111·1997) . -.• rsement Elfectiva Date: Endorsement Expiration Oata: Endorsement No: 2; Page: 1 of 1 Underwriting Company: Ame,ican Casualty Company of Reading, Pennsytvania, 151 N Franklin St. Oiicago, IL 60606 Policy No: WC 6072390520 Policy Effective Date: 07/01/2019 . -·------·-·---------------0 Copyright CNA All Rights Reserved.
CNA Workers Compensation And Employers liability Insurance Policy Endorsement We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Any person or organization for which the employer has agreed by written contract, executed prior to Joss, may execute a waiver of subrogation. However, for purposes of work performed by the employer in Missouri, this waiver of subrogation does not apply to any construction group of classifications as designated by the waiver of right to recover from others (subrogation) rule in our manuat. Schedule Any Person or Organization on whose behalf you are required to obtain this waiver of our right to recover from under a w.ritten contract or agreement. The premium charge for the endorsement is reflected in the Schedule of Operations. Alf other terms and conditions of the policy remain unchanged. This endorsement, which forms a part of and is for attachment to the policy issued bv the designated Insurers, takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below. form No: WC 00 03 13 (04-19841 EndorsGment Effective Date: Endorsement No: 4: Page: 1 ol 1 Endorsement E•pitation Date: Underwriting Comp.any: American Casualty Company of Reading, Pennsylvania. 151 N Frai,lclin St. Chicago, IL 60606 Copyright 1983 National Council on Compensation Insurance. Policy No: WC 6072390534 Policy Effective Dale 07i01!2019
Workers Compensation And Employers Liability Insurance Policy Endorsement This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3.A. of the Information Page. We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedute, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule where you are required by a written contract to obtain this waiver from us. This endorsement shatl not operate directly or inditectfy to benefit anyone not named in the Schedule. The premiwn for this endorsement is shown in the Schedule. Schedule 1. 0 Specific Waiver Name of person or organization (Kl Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2. Operations: All Texas Operations 3. Premh.m: The premium charge for this endorsement shall be 2% percent of the premium developed cm payroll in connection with work performed for the above personfs) or organizationls) arising out of the operations described. 4. Advance Premium: Refer to Schedule ol Operations All other terms and conditions of the policy remain unchanged. This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date! is shoWTI below, and expires concurrently with said policy unless another expiration date is shown below. Form No: WC42 03048(06-2014J ·---;~No.;.,~·6072390954 Endorsement No: 89: Page 1 or 1 Endorsement Eflective Da111: &,do,sement Expiration Date· Policy Bfectiw Oa111· 07/01-/-2019 I Underwnt,ng Coo,pany: Amfflean Casualty Company ol Reading, Pennsylvania. I 51 N Franklin St, Chic8Qo, IL 60606 ·-.. ~~~~~ -~~~~~~ ~~~· o Copyright 2014 Nalional Council on Compensation lnsuranco, tne. All Righi$ ReselVtld.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT· CALIFORNIA Polley Number: 57 WEC AC2M9V Endorsement Number: Effective Date: 11/10/19 Effective hour is the same as staled on the Information Page of the policy. Named Insured and Address: RALPH ANDERSEN & ASSOCrATES 5800 STANFORD RANCH RO STE 410 ROCKLIN CA 95765 We have the righl to recover our payments from anyone liable for an injury covered by this policy We win not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent lhat you perfonn work under a written contract that requires you to obtain this agreement from us ) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule The additional premium for this endorsement shall be 2 % of the California worlc:ess' compensation premium othetWise due on such remuneration. SCHEDULE Person or Organization Job Description Any person or organization from whom you are required by wntten contract or agreement to obtain this waiver of rights from us Countersigned by --~--------A~:-ut':"l'horiz--:-.-ed-r:R:-ep-rese--n..,..ta~tiv,-e-Form WC 04 03 06 (1) Printed in U.S A. Process Date: 10/01/19 Policy Expiration Date: 11/10/20
BUSINESS UABIUTY COVERAGE FORM b. Donates hi$ or her work; c. Acts at the direction of and within the scope of duties determined by you; and d. Is not paid a fee, salary or other compensation by you or anyone else for their work perfonned for you. 24. "'Your product": a. Means: (1) Any goods or products. olher than real property. manufactured, sold, handled, distributed or disposed of by: (a) You; (b) Olhe,s trading under your name; or (c) A person or organization whose business or assets you have acquired;and (2) Containers (other than vehicles), materiafs, parts or equipment furnished in connection with such goods or products. b. Includes: (1) Warranties or representations made at any time YJith respect to the fitness, quality. durability, performance or use of "your product"; and Page24of24 POUCY NUMBER 57 SBA BL2394 (2) The providing of or failure to provide warnings or instructions. c. Does not include vending machines or other properly rented to or located for the ue of othe,s but not sold. 25. "Your wort(': a. Means: (1) Work or operations perfonned by you or on your behalf; and (2) Materials, parts or equipment furnished in connection with such work or operations. b. Includes: (1) Warranties or representations made at any lime with respect to the fitness, quality, durabifity, performance or use of "your work"; and (2) The providing of or failure to provide warnings or instructions. Form SS 00 08 04 05
POU CY NUMBER 57 SBA BL2394 c. The wrongful eviction from, wrongful entry into, or invasion of the right ct private occupancy of a room. dwelling or premises that the person occupies. committed by or on behalf of its owner. landlord or lessor; d. Oral, written or electronic publication of material that slanders or libels a person or organization or disparages a person's or organization's goods, produds or services; e. Oral, written or electronic publication of material that violates a person's right of privacy; f. Copying, in your "advertisement". a person's or organization's "advertising idea" or style of "advertisemenf'; g. rnfringement of copyright, slogan, or title of any literary or artistic work. in your "advenisement"; or h. Discrimination or humifiation that results in injury to the feelings or reputation of a natural person. 18. "PoDutants" means any solid, liquid, gaseous or themtal irritant a eontaminan~ inciuding smoke. vapor, soot. fumes, acids, al<alis, chemicals and waste. waste includes materials 1o be recycled. reconditioned or raclaimed. 19. -Products-completed operations hazard", a. Includes all "bodily injury'' and "property damage" occurring away from premises you own or rent and arising out of "your product" or "your work" except: (1) Products that are stal in your physical possession; or (2) Work that has not yet been completed or abandoned. However, "your wotk" will be deemed to be completed at the earliest of the following times: (a) When all of the work called for in your contract has been completed. (b) Vllhen all of the work to be done at the job site has been completed if your contract calls for work at more than one job site. (c) When that part of the work done at a job site has been put to its intended use by any person or organization other than another contractor or subcontractor working on the same project. Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM Work that may need service. maintenance, correction, repair or replacement, but which is otherwise compJele, will be treated as completed. The "bodily injury' or .. property damage" must occur away from premises you own or rent, unless your business includes the selling, handling or distribution of "your product" for consumption on premises you own or rent b. Does not include "bodily injury" or "property damage" arising out of: {1) The transportation of property, unless the injury or damage arises out of a condition in or on a vehicle not owned or operated by you, and that condition was created by the "loading or unloading" of lhat vehicle by any insured; or (2) The existence of tools. uninstalled equipment or abandoned or unused materials. 20. "Property damage .. means: a. Physical injury to tangible property, including atl resulting loss of use of that property. All such loss of use shaU be deemed to occur at the time of the physical injury that caused it; or b. Loss of use of tangible property that is not physically injured. Afl such loss of use shall be deemed to occur at the time of "oe<:orrence" that caused it. As used in this definition, "electronic data" is not tangible property. 21. "Suit" means a civil proceeding in which damages because of "bodily injury", "property damage" or "personal and advertising injury'" to which this insurance applies are alleged. "Suit" includes: a. An arbitration proceeding in which such damages are claimed and to which the insured must submit or does submit with our consent: or b. Any other aHemative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent 22. 'Temporary worker" means a person who is furnished lo you to substitute for a permanent "en,:,loyee" on leave or to meet seasonal or short-term workload conditions. 23. "Volunteer worker" means a person who: a. Is not your "employee": Page23of24
BUSINESS LIABILITY COVERAGE FORM (1) That .indemnifies an an::hiled, engineer or surveyor for injury or damage arising out of: (a) Preparing, approving or faffing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change on:letS, designs or drawings and specifications; or (b) Giving directions or instructions. or faling to give them, if that is the primary cause of the injury or damage;ar (2) Under which the insured. if an architect, engineer or surveyor, assumes tiabiity for an injury or damage arising out of the insured's rendering or failure to render professional services, including 1bose isled in (1) above and supervisory, inspection, architectural or engineering activities. 13. "Leased worker" means a person leased to you by a labor leasing finn under an agreement between you and the labor leasing firm, to perfonn duties related to the conduct of your business. "leased worl(e(' does not include a i.emporary woiker". 14 ... Loading or unloading"' means lhe handling of property: a. After It is moved from the pface where it is accepted for movement into or onto an aircraft, waten:raft or •auto·; b. \Nhtle it is in or on an aitcraft. watercraft or "auto"; or c. \IVhile it Is being -moved from an aircraft. watercraft or "auto" to the place where it is finaOy delivered; but "loading or unloading" does not include the movement of property by means of a mechanical device, other than a hand truck, that is net attached to the aircraft. watercraft or •a.rte,". 15. "Mobile equipment" means any of the folowing types of lend veh~les, including any attached machinery or equipment a. Buldozers, farm machinery, fofklifts and other vehicles designed for use principally off public roads; b. Vehides maintained for use solely on or next to premises you own or rent; c. Vehicles that travel on Cl'a\Nfer treads; d. Vehicles, whether self-propelled or not, on INtlich are permanently fflOW'lted: Page 22of 24 POLICY NUMBER 57 SBA BL2394 (f) Power cranes, shovels, loaders. diggers or drills; or (2) Road construction or resurfacing equipment such as graders, saape,$ or rollers; e. Vehicles not described in a.. b .. c., or d. above that are not self-propelled and are maintained primarily to pl'OYide mobility to pennanenUy attached equipment of the following types: (1) Air compressors, pumps and generators. including spraying, welding, building cleaning, geophysical exploration. lighting and well servicing equipment or (2) Cherry pid<ers and similar devices used 1o raise or lower workers; f. Vehicles not described in a., b •• c., or d. above maintained primarily for purposes other than the transportation of petsOOS or cargo. However. self-propelled vehicles with lhe following types of pem1anenlly attached equipment are not "mobite eqtq>menf' but will be considered ·autos": C1) Equipment, of at least 1.000 pounds gross vehicle weight, designed priman1y for: (a) Snow removal; (b) Road maintenance, but not construction or resurfacing; or (c) Street deaning; (2) Cheny pickers and similar devices mounted on automobile or truck chassis and used to raise or lowef" WOfkers: and {3} Air compressors, pumps and genefcllors, including spraying. welding, building cleaning, geophysical exploration, fighting and well servicing equipment 16. "Occurrence" means an accident, i'ldl.l(ing continuous or repeated exposure to slbstanlialtJ the same general harmful conditions. 17. "Persona! and advertising injury" means injury. including consequential "bodily injury•. arising out of one or more of the following offenses: a. False arrest, detention or imprisonment: b. Malicious prosecution; · Form SS 00 08 04 05
POLICY NUMBER 57 SBA BL2394 a. The United States of America (including its territories and possessions), Puerto Rico and Canada; b. International waters or airspace. but only ff the injury or damage OCCUIS in the course of travel or transportation between any places included in a. above; c. All other parts of the world if the injury or damage arises out of: (1) Goods or products made or sold by you in lhe territory described in a above; (2) The activities of a person whose home is in the territory desaibed in a above, but is away for a short time on your business; or (3) "Personal and advertising injury'' offenses that take place through lhe lnlemet or similar electronic means of communication provided the insured's responsibility to pay damages is determined in the United States of America (including its territories and possessions}, Puerto Rico or Canada, in a "suit" on the merits according to the substantive law in such territory, or in a settlement we agree to. 7. "Electronic data .. means information, facts or programs: a. Stored as or on. b. Created or used on; or c. Transmitted to or from computer software, induding systems and appWcations software, hard or floppy disks, CO-ROMS. tapes. drives. cells, data processing devices or any other media which are used with electronicaljy controlled equipment. B. ..Employee· includes a ·1easect worter". "Employee" does not include a "temporary worker''. 9. "Executive officer" means a person holding any of the officer positions created by your charter. constitution, by·laws ar any other similar goveming documenl 10. "Hosl1le fire" means one whictl becomes uncontrollable or breaks out from where it was intended lo be. 11. impaired property" means tangible property. other than "your producr or Myour work", that cannot be used or 1s less useful because: a. tt incorporates ''your product" or "your work" Ulat is known or U,ooghl to be defective. deficient, inadequate or dangerous: or Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM b. You have faiJed to futfill the terms of a contract or agreement if such property can be restored to use by: a. The repair, replacement, adjustment or removal of "your product" or )tour wort". or b. Your fulfilling the terms of the contract or agreement. 12. "Insured contract" means: a. A contract for a lease of premises. However. that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning or explosion to premises while rented to you or temporarity occupied by you with pennission of the owner is subject to tile Damage To Premises Rented To You limit described in Section D. -Liability and Medical Expenses Limits of Insurance. b. A sidetrack agreement; c. Any easement or license agreement, including an easement or license agreement in connection with construction or demolition operations on or within 50 feet of a railroad; d. Any obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a rrunicipafily: e. An elevator maintenance agreement; or f. That part of any other contract or agreement pertaining to your business (including an indemnification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury" or "property damage" to a third per5on or organization, provided the "bodily injury" or •property damage" is caused, in whole or in part. by you or by those acting on your behalf. Tort liability means a liability that woukl be imposed by law in the absence of any contract or agreement. Paragraph f. includes lhat part of any contract or agreement that indemnifies a railroad for "bodily injury" or "property damage" arising out of construction or demolition operations within 50 feet of any railroad property and affecting any railroad bridge or trestle, tracks, road-beds, tunnel, underpass or crossing. However, Paragraph f. does not include that part or any contract or agreement Page21 of24
BUSlNESS UABIUTY COVERAGE FORM This insurance doe$ not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. 9. Addltlonal Insured -Owners, Lessees Or Contractors -Scheduled Person Or Organization a. WHO IS AN INSURED under Section C. is amended to include as an additional insured the person(s) or organization(s) shown in the Declarations as an Additional Insured -Owner, Lessees Or Contradors, but only with respect to liability for "bodily injury'". "'property ctamage• or "personal and advertising injury"' caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (1) In the performance of your ongoing operations for lhe additional lnsured(s); or (2} fn connection with '"your work" perlormed for that additional insured and included within the '"products-completed aperations hazard'', but only If this Coverage Part provides coverage for "bodily injury" or "property damage" included within the "produds-completed operations hazard". b. Vllith respect to the insurance afforded to these additional insureds. this insurance does not apply to "bodily injury". "property damage" or "personal an advertising injury" arising out of the rendering of. or the failure to render. any professional architectural, engineering or suNeying services, including: (1) The preparing. appl'OVing, or fanure to prepare or approve, maps, shop drawings, opinions. reports, surveys, field orders, change orders, designs or drawings and specifications: or (2) Supervisory, inspection, architedural or engineering activities. 10. Additional Insured -Co-Owner Of Insured Premises WHO IS AN INSURED under Seclion C. is amended to include as an additional insured the pen.on(s} or Organiz:ation(s) shown in the Declarations as an Additional fnsured -Co-ONner Of Insured Premises, but only with raspect to their liability as co-owner of the premises shown m the Declarations. Page20of24 • POU CY NUMBER S7 SBA BL2394 The limits of insurance that apply to additional insureds are desaibed in Section D. -Limits Of lnsura.nce. How this insurance applies when other insurance is available lo an additional insured is described in the Other Insurance Condition in Section E. -Liabifity And Meaacal Expenses General Conditions. G. LIABILITY AND MEDICAL EXPENSES DEFINmONS 1. '"Advedfsemenr means the widespread public dissemination of information or images that has the purpose of inducing the sale of goods, products or services through: a. (1) Radio; (2) T etevision; (3) Billboard; (4) Magazine; {5) Newspaper. b. The Internet, but only that part of a web site that is about goods, products or services for the pu,poses of inducing lhe sate of goods. products or services; or c. Any other publication that is given widespread public distribution. However. "advertisemenr does not loclude: a. The design, printed material, information or images contained in. on or upon lhe packaging or labeling of any goods or produds;or b. An interactive conven;ation between or among persons through a computer network. 2. "Advertising idea'" means any idea for an "advertisemenr. 3. "Asbestos hazard" means an exposure or threat of exposure to the actual or aDeged properties of asbestos and includes the mere presence of asbestos in any form. 4. "Auto" means a land motor vehicle. trailer or semi-trailer designed for travel on public roads, induding any attached machinery er equipment. But .. auto"' does not include "mobile equipment". s. ·eodily fnjl.lfY" means physicai: a. Injury; b. Sickness; or c. Disease sustained by a person and. if arising out of the above, mental anguish or dealh at any time. 6. "Coverage territofy'" means: Form SS 00 08 04 05