HomeMy WebLinkAboutSAXE-CLIFFORD, SUSAN 9INSURANCE NOT ON FILE
WORK MAY NOT PROCEED
&LERK OF COUNCII
C,rPC/ DATE: JUL 10 20
18
AGREEMENT TO PROVIDE PS-YCI#OLOGICAL EVALUATION SERVICES
Q _ vwe 0 FOR THE CITY OF SANTA ANA POLICE DEPARTMENT
N-2018-136
THIS AGREEMENT is made and entered into this 12th day of June, 2018 by and between Susan Saxe
Clifford, Ph.D., a professional corporation ("Consultant"), and the City of Santa Ana, a charter city
and municipal corporation organized and existing under the Constitution and laws of the State of
California ("City").
A. On January 4, 2018, the City issued a Request for Proposal ("RFP") No. 18-001 for the purpose
of retaining a consultant having special skill and knowledge in the field of providing
psychological evaluation and counseling services for the City's Police Department.
B. The City received numerous responses to the RFP. Consultant is one of the three parties
selected by the City. Consultant represents that she is able and willing to provide such services
to the City.
C. In undertaking the performance of this Agreement, Consultant represents that it is
knowledgeable in its field and that any services performed by Consultant under this Agreement
will be performed in compliance with such standards as may reasonably be expected from a
professional consulting firm in the field.
NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms
and conditions hereinafter set forth, the parties agree as follows:
1. SCOPE OF SERVICES
Consultant shall perform during the term of this Agreement, the tasks and obligations including
all labor, materials, tools, equipment, and incidental customary work required to fully and adequately
complete the psychological evaluation services described and set forth in Exhibit A, attached hereto
and incorporated by reference.
2. COMPENSATION
a. City agrees to pay, and Consultant agrees to accept as total payment for its services for
City, the rates and charges identified in Exhibit B. The total sum to be expended under
this Agreement shall not exceed $7,000.
b. Payment by City shall be made within 45 days (forty-five) days following receipt of proper
invoice evidencing work performed, subject to City accounting procedures. Payment need
not be made for work which fails to meet the standards of performance set forth in the
Recitals which may reasonably be expected by City.
This Agreement shall commence on July 1, 2018 and continue for a one (1) year term through
June 30, 2019, unless terminated earlier in accordance with Section 13, below.
4. INDEPENDENT CONTRACTOR
Consultant shall, during the entire term of this Agreement, be construed to be an independent
contractor and not an employee of the City, This Agreement is not intended nor shall it be construed
to create an employer -employee relationship, a joint venture relationship, or to allow the City to
exercise discretion or control over the professional manner in which Consultant performs the services
which are the subject matter of this Agreement; however, the services to be provided by Consultant
shall be provided in a manner consistent with all applicable standards and regulations governing such
services. Consultant shall pay all salaries and wages, employer's social security taxes, unemployment
insurance and similar taxes relating to employees and shall be responsible for all applicable
withholding taxes.
5. INSURANCE
Prior to undertaking performance of work under this Agreement, Consultant shall maintain and
shall require its subcontractors, if any, to obtain and maintain insurance as described below:
a. iCommeeciab Genora][2 Liability Insurance:. Consultant shall maintain commercial
general liability insurance naming the City, its officers, employees, agents, volunteers
and representatives as additional insured(s) and shall include; but not be limited to
protection against claims arising from bodily and personal injury, including death
resulting therefrom and damage to property, resulting from any act or occurrence
arising out of Consultant's operations in the performance of this Agreement, including,
without limitation, acts involving vehicles. The amounts of insurance shall be not less
than the following: single limit coverage applying to bodily and personal injury,
including death resulting therefrom, and property damage, in the total amount of
$1,000,000 per occurrence, with $2,000,000 in the aggregate. Such insurance shall (a)
name the City, its officers, employees, agents, and representatives as additional
insured(s); (b) be primary and not contributory with respect to insurance or self, -
insurance programs maintained by the City; and (c) contain standard separation of
insureds provisions.
b. Business automobile liability insurance, or equivalent form, with a combined single
limit of not less than $ 1,000,000 per occurrence, Such insurance shall include coverage
for owned, hired and non -owned automobiles.
Q. Worker's Compensation: insurance, In accordance with the provisions of Section 3700
of the Labor Code, Consultant, if Consultant has any employees, is required to be
insured against liability for worker's compensation or to undertake self-insurance,
Prior to commencing the performance of the work under this Agreement, Consultant
agrees to obtain and maintain any employer's liability insurance with limits not less
than $1,000,000 per accident.
d. If Consultant is or employs a licensed professional such as an architect or engineer:
Professional liability (errors and emissions) insurance, with a combined single limit of
not less than $1,000,O00 per claim with $2,000,10 in the aggregate.
e. The following requirements apply to tine insurance to be provided by Consultant
pursuant to this section:
i. Consultant shall maintain all insurance required above in full force and effect
for the entire period covered by this Agreement,
ii. Certificates of insurance shall be furnished to the City upon execution of this
Agreement and shall be approved by the City.
iii. Certificates and policies shall state that the policies shall not be canceled or
reduced in coverage or changed in any other material aspect without thirty (30)
days prior written notice to the City.
iv. Where the amounts or coverage provided by the certificates of insurance
provides coverage greater than those listed by this Agreement, the amounts
provided by the certificates of insurance shall be incorporated by reference into
the Agreement.
V. Consultant shall supply City with a fully executed additional insured
endorsement.
f If Consultant fails or refuses to produce or maintain the insurance required by this
section or fails or refuses to furnish the City with required proof that insurance has
been procured and is in force and paid for, the City shall have the right, at the City's
election, to forthwith terminate this Agreement. Such termination shall not affect
Consultant's right to be paid for its time and materials expended prior to notification
of termination. Consultant waives the right to receive compensation and agrees to
indemnify the City for any work pet -formed prior to approval of insurance by the City.
6. IND]EMNIF"ICATION
Consultant agrees to defend, and shall indemnify and hold harmless the City, its officers,
agents, employees, contractors, special counsel, and representatives from liability. (1) for personal
injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for
personal injury, including death, and claims for property damage, which may arise from the negligent
operations ofthe Consultant, its subcontractors, agents, employees, or otherpersons acting on its behalf
which relates to the services described in section I of this Agreement; and (2) from any claim that
personal injury, damages, just compensation, restitution, judicial or equitable relief is due by reason of
the terms of or effncts arising from this Agreement. This indemnity and hold harmless agreement
applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered
or alleged to have been suffered, by reason of the events referred to in this Section or by reason of tine
terms of, or effects, arising from this Agreement. The Consultant further agrees to indemnify, hold
harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to
be selectedbythe City, regarding any action by third party challenging thevalidity of this Agreement,
or asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief
due to personal or property rights arises by reason of the terns of, or effects arising from this
Agreement. City may make all reasonable decisions with respect to its representation in any legal
proceeding. Notwithstanding the foregoing, to the extent Consultant's services are subject to Civil
Code Section 2782,8, the above indemnity shall be limited, to the extent required by Civil Code Section
2782.8, to claims that arise out of, pertain to, or relate to the negligence, recklessness, or willful
misconduct of the Consultant,
RECORDS
Consultant shall keep records and invoices in connection with the work to be performed under
this Agreement. Consultant shall maintain complete and accurate records with respect to the costs
incurred under this Agreement and any services, expenditures, and disbursements charged to the City
for a minimum period of three (3) years, or for any longer period required by law, from the date of
final payment to Consultant under this Agreement. All such records and invoices shall be clearly
identifiable. Consultant shall allow a representative of the City to examine, audit, and make transcripts
or copies of such records and any other documents created pursuant to this Agreement during regular
business hours. Consultant shall allow inspection of all work, data, documents, proceedings, and
activities related to this Agreement for a period of three (3) years from the date of final payment to
Consultant under this Agreement.
S. CONFIDENTIALITY
If Consultant receives from the City information which due to the nature of such information
is reasonably understood to be confidential and/or proprietary, Consultant agrees that it shall not use
or disclose such information except in the performance of this Agreement, and further agrees to
exercise the same degree of care it uses to protect its own information of like importance, but in no
event less than reasonable care. "Confidential Information" shall include all nonpublic information.
Confidential information includes not only written information, but also information transferred orally,
visually, electronically, or by other means, Confidential information disclosed to either party by any
subsidiary and/or agent of the other party is covered by this Agreement. The foregoing obligations of
non-use and nondisclosure shall not apply to any information that (a) has been disclosed in publicly
available sources; (b) is, through no fault of the Consultant disclosed in a publicly available source^, (c)
is in rightful possession of the Consultant without an obligation of confidentiality; (d) is required to be
disclosed by operation of law, or (e) is independently developed by the Consultant without reference
to information disclosed by the City.
9. CONFLICT OF INTEREST CLAUSE
Consultant covenants that it presently has no interests and shall not have interests, direct or
indirect, which would conflict in any manner with performance of services specified under this
Agreement.
10. DISCRIMINATION
Consultant shall not discriminate because of race, color, creed, religion, sex, marital status,
sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by applicable
law, in the recruitment, selection, training, utilization, promotion, termination or other employment
related activities. Consultant affirms that it is an equal opportunity employer and shall comply with all
applicable federal, state and local laws and regulations,
11. EXCLUSIVITY AND AMENDMENT
This Agreement represents the complete and exclusive statement between the City and
Consultant, and supersedes any and all other agreements, oral or written, between the parties. In the
event of a conflict between the terms of this Agreement and any attachments hereto, the terms of this
Agreement shall prevail. This Agreement may not be modified except by written instrument signed
by the City and by an authorized representative of Consultant. The parties agree that any terms or
conditions of any purchase order or other instrument that are inconsistent with, or in addition to, the
terms and conditions hereof, shall not bind or obligate Consultant or the City; Each party to this
Agreement acknowledges that no representations, inducements, promises or agreements, orally or
otherwise, have been made by any party, or anyone acting on behalf of any party, which is not
embodied herein.
12. ASSIGNMENT
Inasmuch as this Agreement is intended to secure the specialized services of Consultant,
Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior
written consent of the City and any such assignment, transfer, delegation or subcontract without the
City's prior written consent shall be considered null and void. Nothing in this Agreement shall be
construed to limit the City's ability to have any of the services which are the subject to this Agreement
performed by City personnel or by other consultants retained by City.
13. TERMINATION
This Agreement may be terminated by the City upon thirty (30) days written notice of
termination. In such event, Consultant shall be entitled to receive and the City shall pay Consultant
compensation for all services performed by Consultant prior to receipt of such notice of termination,
subject to the following conditions:
a. As a condition of such payment, the Executive Director may require Consultant to
deliver to the City all work product(s) completed as of such date, and in such case such
work product shall be the property of the City unless prohibited by law, and Consultant
consents to the City's use thereof for such purposes as the City deems appropriate,
b. Payment need not be made for work which fails to meet the standard of performance
specified in the Recitals of this Agreement.
14. WAIVER
No waiver of breach, failure of any conditions, or any right or remedy contained in or granted
by the provisions of this Agreement shall be effective unless it is in writing and signed by the party
waiving the breach, failure, right or remedy. No waiver of any breach, failure or right, or remedy shall
be deemed a waiver of any other breach, failure, right or remedy, whether or not similar, nor shall any
waiver constitute a continuing waiver unless the writing so specifies,
I $- JURISDICTION -VENUE
This Agreement has been executed and delivered in the State of California and the validity,
interpretation, performance, and enforcement of any of the clauses of this Agreement shall be
determined and governed by the laws of the State of California. Both parties further agree that Orange
County, California, shall be the venue for any action or proceeding that may be brought or arise out of,
in connection with or by reason of this Agreement.
16. PROFESSIONAL LICENSES
Consultant shall, throughout the term of this Agreement, maintain all necessary licenses,
permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder and
required by the laws and regulations of the United States, the State of California, the City of Santa Ana
and all other governmental agencies. Consultant shall notify the City immediately and in writing of
its inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said
inability shall be cause for termination of this Agreement.
17. MISCELLANEOUS PROVISIONS
a. Each undersigned represents and warrants that its signature herein below has the power,
authority and right to bind their respective parties to each of the terms of this
Agreement, acid shall indemnify City fully, including reasonable costs and attorney's
fees, for any injuries or damages to City in the event that such authority or power is
not, in fact, held by the signatory or is withdrawn.
b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set
forth in the bony of this Agreement.
18. NOTICE
Any notice, tender, demand, delivery, or other communication pursuant to this Agreement shall
be in writing and shall be deemed to be properly given if delivered in person or mailed by first class or
certified mail, postage prepaid, or sent by fax or other telegraphic communication in the manner
provided in this Section, to the following persons.
To City:
Clerk of the City Council
City of Santa Ana
20 Civic Center Plaza (M-30)
P.O. Box 1988
Santa Ana, CA 92702-1988
Fax: 714- 647-6956
With courtesy copies to:
Chief of Police
Santa Ana Police Department
20 Civic Center Plaza (M-97)
P.O. Box 1981
Santa Ana, California 92702
Fax:714-245-8090
To Consultant:
Susan Saxe -Clifford, Ph.D.
16530 Ventura Boulevard, Suite 603
Encino, California 91436
SoniaR. Carvalho
City Attorney
City of Santa Ana
20 Civic Center Plaza (M-29)
P.O. Box 1988
Santa Ana, California 92702
Fax: 714- 647-6515
A party may change its address by giving notice in writing to the other party. Thereafter, any
communication shall be addressed and transmitted to the new address. If sent by mail, communication
shall be effective or deemed to have been given three (3) days after it has been deposited in the United
States mail, duly registered or certified, with postage prepaid, and addressed as set forth above. If sent
N-2018-136
by fax, communication shall be effective or deemed to have been given twenty-four (24) hours after
the time set forth on the transmission report issued by the transmitting facsimile machine, addressed
as set forth above. For purposes of calculating these timeframes, weekends, federal, state, County or
City holidays shall be excluded.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year fast
above written.
M�6W
e k of the Council
APPROVED AS TO FORM:
SONIA R. CARVALHO
City Attorney
sy: �
Tamara ogosian
Assistant City Attorney
RECOMMENDED FOR APPROVAL:
ENTIN
Chief of Police
Santa Ana Police Department
CITY OF SANTA ANA
"Il
Raul GodCity Man
CONSULTANT:
Susan Saxe -Clifford, Ph.D.
President
EXHIBIT A
SCOPE OF SERVICES
N-2018-136
SCOPE OF WORK
The City of Santa Ana is seeking a professional and experienced company to pre -employment psychological
evaluation services, peer support training, and crisis counseling. Specific responsibilities include, but are not
limited to:
A. Complete Pre -Employment Psychological Evaluations
Perform a complete pre -employment psychological evaluation for the City's Police Department
applicants. Said psychological evaluation shall comply with the California Peace Officer's Standards
and Training (POST) Psychological Screening Manual, as well as any additional psychological
suitability criteria specified by the City's Police Department.
A complete pre -employment psychological evaluation includes, but is not limited to a clinical
interview, administration of necessary tests, scoring of tests and preparing verbal and written
recommendation for employment.
Consultant shall:
1. Provide the City's Police Department a list of available appointment times for
psychological evaluations; the appointment times must be provided 24 hours prior to
pre -scheduled Commander oral interviews, The psychological evaluations shall be
administered within seven business days of the Commander oral interviews.
2. Provide the City's Police Department with verbal recommendation of the candidate's
psychological suitability for the classifications of Police Officer as well as other
classifications within the Police Department within two (2) working days of said
candidate's clinical interview,
1 Provide the City's Police Department with a written report of the candidate's
psychological suitability for the classification of Police Officer as welt as other
classifications within the Police Department within five (5) working days of the
candidate's clinical interview. This report must be received by the PD within five
working days via US Mail, or may be sent in a pdf document via e-mail.
4. Complete the necessary Police Officer Standards and Training (POST) Continuing
Professional Education (CPE) required for psychologists conducting pre -employment
peace officer evaluations. The initial CPE requirement of six hours must be
completed by April 1, 2018, Evaluators will need to complete 12 hours of POST -
approved CPE every two years, The CPE Tracking System will calculate the required
hours based on the effective date of this requirement (September 1, 2014) and the
date the psychologist began conducting peace officer evaluations,
8. Complete Post -Traumatic Psychological incident Evaluation
Provide City's Police Department employees involved in violent incidents, such as a life -threatening
and/or serious injury or death to any person, complete post -traumatic psychological evaluation.
A complete post -traumatic psychological incident evaluation includes, but Is not limited to, clinical
interview and post -traumatic counseling,
City of Santa Ana — RFP 18-001 for Psychological Services
Page 10
Consultant shall provide:
1, initial psychological service contact with involved officer(s) shall be made
immediately if possible, but no later than forty-eight (48) hours following the incident.
2. A minimum of three (3) follow-up counseling sessions shall follow, if the Consultant
deems those sessions necessary. Such follow-up sessions shall, whenever possible
and practical, be scheduled by Consultant at Consultant's office location, unless
otherwise agreed by involved officer(s).
3. One (1) follow-up session within a period of not less than fourteen (14) days and not
more than thirty (30) days following the traumatic incident with the involved officer(s)
to assess whether additional sessions shall be deemed necessary. Following such
sessions, provide City's Police Department with verbal recommendation as to the
necessity of additional sessions and an assessment of officer(s) recommended duty
status within forty-eight (48) hours. A written psychological assessment of the
officer(s) evaluated shall be submitted within five (5) calendar days to the City's
Police Department upon completion of such follow-up counseling session(s).
4. A verbal recommendation to the City's Police Department for return of said officer(s)
involved in traumatic incidents to full or modified duty status as soon as possible and
In no case later than forty-eight (48) hours following the incident.
5. A written psychological assessment to the City's Police Department of officer($) in
question and a recommendation as to their suitability to return to active duty, full or
modified, and need for follow-up treatment within five (5) days following the post -
traumatic counseling session.
6. At the direction and with consent of City's Police Department, similar post -traumatic
Incident counseling services may be requested for immediate family members of
involved officer(s) adversely impacted by the incident. The goal of such services
shell be to stabilize external factors which might otherwise affect officer(s) return to
duty or recoveryand to determine if referral to other private service providers is
warranted.. Verbal consultation with City's Police Department is recommended but no
written reports of family member counseling sessions are required unless otherwise
indicated or where the fitness for duty of the officer(s) comes into doubt.
C. Review of Fitness for Duty
Review background investigations, clinical interviews, administrative reports and/or other relevant
documents to determine an employee's psychological fitness for duty, when so directed by the City.
Fitness for duty review Includes, but is not limited to, clinical interviews, administration of necessary
tests, scoring of tests, and preparation of verbal and written recommendations for employment.
Consultant shall:
Outline all psychological concerns resulting from that review and submit to City's
Police Department a recommendation concerning further testing and or evaluation
which may be deemed appropriate.
2. Provide City's Police Department with verbal notification as to the above within forty-
Gity of Santa Ana - RFP 18-001 for Psychological Services
Page 11
eight (48) hours, and with a complete written report concerning reviews of fitness for
duty within ten (14) working days following receipt of documents or the last clinical
interview of employee(s) in question.
Note: The City may elect to enter into two agreements to allow for a separate psychologist to
conduct fitness for duties.
D. Crisis Intervention Counseling
Conduct crisis intervention counseling with authorization and approval of City's Police Department
when a Department employee(s) is believed to be suffering from a psychological disorder or emotional
disturbance and unable to perform any or all of the full range of duties of an employee's classification.
Consultant shalt:
1. Obtain authorization from City's Chief of Police or designate prior to conducting crisis
intervention counseling of City's Police Department employee(s). Should intervention be
requested by employee and not Department, consultant agrees to obtain authorization from
City's Chief of Police or designate prior to conducting crisis intervention counseling.
E. Critical Incident Stress Management
The work of law enforcement professionals exposes them to significant incidents that can have a lasting
effect on their mental health and welt -being. The Santa Ana Police Department recognizes the
importance of routine and post -incident debriefings to assist employees in processing events in a
healthy and productive manner while minimizing the risk of post incident stress that can lead to physical
and psychological disorders. Therefore, at the request of the Chief of Police or his/her designee, the
consultant shall:
1: Conduct routine group debriefings with units that are regularly exposed to high levels of
stress (i.e. child abuse Investigators, crime scene investigators, and dispatchers) to ensure
the group's ongoing well-being.
2. Hold a post -critical incident meeting ahead of a formal debriefing to discuss normal
reactions to stress and healthy methods to process stress. When necessary, such
meetings shall be conducted prior to the affected employee's end of watch.
1 Facilitate post -incident group debriefings with affected employees following a critical
incident. Such debriefings should ideally be held within 24-72 hours of the incident but,
given the need to coordinate varying work schedules, shall be conducted as close in time to
the Incident as practical.
F.Consultation services
On -call status is required to respond to criminal incidents such as SWAT call -outs or major
Investigations as requested.
Consultant shall:
Consult with the Department's management regarding psychological profiles and
recommended approach to addressing specific suspects
2. Assist in interpreting intelligence data in reference to criminal incidents and/or suspect.
City of Santa Ana — RFP 18-001 far Psychological Services
Page 12
G. Psychological Training Services
Provide City's Police Department employees with relevant psychological training to assist in the
Providing organizational wellness services. Consultant shall:
Provide training to members of Police Department including, but not limited to, peer
support services, crisis Intervention stress management, and suicide
intervention/prevention training.
City of Santa Ana — RFP 18.001 for Psychological services
Page 13
P'
N-2018-136
CITY OF SANTA ANA
RE4UEST FOR PROPOSALS FOR PSYCHOLOGICAL SERVICES
PROPOSER$ CERTIFICATION ANO PROPOSAL ITEM PRICiNG
Certification - I certify that I have rend, understand and agree to the terms and conditions of this Request for Proposals,
i have examined the Scope of Services (Exhibit A) and am familiar with the services being requested. i understand and
agree that I am responsible for reporting any errors, omissions or discrepancies to the City for clarificatton prior to the
submission of my proposal.
Proposal she([ Include all costs for a three-year psychological Services agreemProposal Item Price - Pricing shall be &II Inclusive and based on the scope of services described in Exhibit A. Cost
ent.
Service
Pricing
Anticipated No.
Subtotal
A,
Pre -employment psychological
$
of Units Per Yr,
TBD
$
evaluatlons
Mgff
B.
Cat ete PostrTraumaitic
$
NiA
Psychological Incident
Evaluation
C.
Review of Fitness for G?uty
$ Per hour
TBD
$
q.
Crisis Intervention Counseling
$ Per hour
u
N/A
E.
Critical Incident Stress
Per hour
N/A
Mana ement
! .
Gcnsuitation 5arvicas
Per hour
N/A
S
G.
Psychological Training Services
$ Per hour
NIA
Tastlmony in court and court
Per hour
TBD
--preparation
Yoe, p
rJne»YearTctal
Three 'Year
$
Total
City of Santa Ana --RF'P 18-001 for Psychological Services
Page 20
'```� u CERTIFICATE OF LIABILITY INSURANCE
DATEIMW2D/YYYTI
Oi/29/2019
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED
ORDER THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BE THE ISSUING
R(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certitcate holder is an ADDITIONAL INSURED, the pollcy(iss) must he ADDITIONAL INSURED provisions be
Or endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies
licies may require an endorsement. A statement
on
this certificate does not confer rights to the certificate holder In lieu of such endorsement(s).
PRODUCER
SCdk�?i'r3Y.fdP
° ER OL HASSAN
NAME_ _
EROL HASSAN
PHONECN. 31054b-6579 rAC No: 310546-6821
3540 HIGHLAND AVE
E-MAIL --'--
-ADDRESS:
' MANHATTAN BEACH, CA 90266
INSUItER(SI AFFORDING COVERAGE
NAIC P
wsuREa A: State Farm General Insurance Company
25151
--
WsuRED
INSURER B: State Farm Fire and Casualty Company
25143
CUFFORD, SUSAN SAXE DR
INSURER C:INSURER
A PROFESSIONAL CORPORATION 16530 VENTURA BLVD
— D:
STE 203
—
INSURER-E:
ENCINOCA 91436
INSURER F:
COVERAGPS rcorm.nw.�... •....'..._
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE
NUMBER:
BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT
OR OTHER
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE
DOCUMENT WITH RESPECT
TO WHICH THIS
POLICIES DESCRIBED HEREIN IS SUBJECT
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN
TO ALL THE TERMS,
REDUCFD BY PAID CLAIMS.
INTN DI —"' —"
TYPE OF INSURANCE AUSV POLICYEFF POLICY EEP
POUCYNV UER MM1DDlYYYY MWID W
UNITS
COMMERCIAL GENERAL LIABILITY
LAIMS-MADE OCCUR
'bhCH—MADETSRENYEE
$ 1,000,000
PREMISES Eeo
3 300,000
--- Y N
MEDEXP(ALr enan)
s 5,000
92-92-2679-2 04/i B/2018 04/18/2019
JGN'LAGGREGATE
PERSONAL B ADV INJURY
S
UMIT"(PLIE""��S PER:GENERAL
JEC
LOCR:
AGGREGATEY
LI
PRODUCTS-COMP/OPAGG
S 2,000,000
BILE LABILITY
COMR NED BINDLE LI 1
ANY AUTO
1'eemlaenq
t
BODILY INJURY (Per Person)
8
OVMEO SCHEDULED
AUTOS ONLV AUTOS
HIRED NON-ONNED
BDUUYINJURY(Peramia.n,)
t
AUTOS ONLY AUTOS ONLY
p �aween-AGE
--'—
S
UMBRELLA LAB
OCCUR
EYCESSUAB
CIAIMS.4IAOE
EACHOCCIIRRENCE
C
AGGREGATE
3
TIED i RETENTIONS
—'
COMPS A
3
B
AND EMPS LIABILITY
ILIT
AND EMPLOVERS'LIABIUTY YIN
ANY PROPRIETORIPARTNER:EAECUTIVE
STATUTE ERtI
E.L. EACH ACCIDENT
--
s 1,000,000
OFFICERAIEMSEREXCWDE09 Y
NIA
N �
92-LH-2103-0
07/01/2018
07/01/2019
IhlYeetltlIPTIO opal
E.L. CISEASE-EA EMPLOYE
g T,OOQOOD
OhSCRiPTiON OF OPERATIONS bHav
EA- DISEASE - POLICY UMIT
i
i 1,000,000
DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD tut, AtlGNanel Remarks Schedule, may be aaacbe0lf mom sW ce Is requirotl7
PsycOlogieal Services
CERTIFICATE HOLDER .....__.. "_._._
CITY OF SANTA ANA
60 CIVIC CENTER PLAZA
SANTA ANA. CA 92702
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS,
WZEDMREPRRE,SENTATIVE
—,,. wname aria Togo are registered marks Of ACORD
All rights
1W1486 132849.12 P&10-2016
/,v'PG%er✓�c /�Otic� frF�TS �EQ S D� �,QF�/'�.i�
�r��. S'D,c'�.t�so�✓
CA Policy No, 92-92-2579-2
CMP-4786.1
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, Page 1 of
CMP-4786.1 ADDITIONAL INSURED — OWNERS, LESSEES, OR CONTRACTORS
(Scheduled)
This endorsement modifies insurance provided under the following:
BUSINESSOWNERS COVERAGE FORM
SCHEDULE
Policy Number: 92-92-2579-2
Named Insured:
CLIFFORD, SUSAN SAXE DR
A PROFESSIONAL CORPORATION
16530 VENTURA BLVD STE 603
ENCINO CA 91436-5017
Name And Address Of Additional Insured Person Or Organization:
THE CITY OF SANTA ANA ITS OFFICERS EMPLOYEES AGENTS VOLUNTEERS AND
REPRESENTATIVES
20 CIVIC CENTER PLAZA
SANTA ANA CA 92701
1. SECTION 11 — WHO IS AN INSURED of
SECTION II — LIABILITY is amended to in-
clude, as an additional insured, any person or
organization shown in the Schedule, but only
with respect to liability for "bodily injury",
"property damage'or "personal and advertis-
ing injury" caused, in whole or in part, by:
a. Ongoing Operations
(1) Your acts or omissions; or
(2) The acts or omissions of those acting
on your behalf;
in the performance of your ongoing opera-
tions for that additional insured; or
b. Products - Completed Operations
"Your work" performed for that additional
insured and included in the "products -
completed operations hazard".
However, Paragraph 1. above is subject to the
following:
a. The insurance afforded to the additional
insured only applies to the extent permit-
ted by law;
b. If coverage provided to the additional in-
sured is required by a contract or agree-
ment, the insurance provided to the
additional insured will not be broader than
that which you are required by the contract
or agreement to provide for such addition-
al insured; and
c. If the contract or agreement between you
and the additional insured is governed by
California Civil Code Section 2782 or
2782.05, the insurance provided to the
additional insured is the lesser of that
which:
(1) Is allowed for the satisfaction of a de-
fense or indemnity obligation by Cali-
fornia Civil Code Section 2782 or
2782.05 for your sole liability; or
(2) You are required by contract or
agreement to provide for such addi-
tional insured.
We have no duty to defend or indemnify the
additional insured under this endorsement un-
til a claim or "suit' is tendered to us.
0, Copyright, State Farm Mutual Automobile Insurance Company, 2013
Includes copyrighted material of Insurance Services office, Inc., with its permission.
CONTINUED
lo4lLrl�7V ;ItJT
s'o�'Fi✓s'ayt/
2. Any insurance provided to the additional in-
sured shall only apply with respect to a claim
made or a "Sint" brought for damages for
which you are provided coverage.
3. With respect to the insurance afforded to the
additional insured, the following is added to
SECTION II — LIMITS OF INSURANCE:
If coverage provided to the additional insured
is required by contract or agreement, the most
we will pay on behalf of the additional insured
will be the lesser of the amount of insurance:
a. Required by the contract or agreement; or
b. Available under the applicable Limits Of
Insurance shown in the Declarations.
This endorsement shall not increase the ap-
plicable Limits Of Insurance shown in the
Declarations.
4. With respect to the insurance afforded to the
additional insured, the following is added to
Paragraph 3. Duties In The Event Of Occur-
rence, Offense, Claim Or Suit of SECTION
11— GENERAL CONDITIONS:
The additional insured must:
a. See to it that we are notified as soon as
of-
fense which may result in a claim. To the
extent possible, notice should include:
(1) How, when and where the "occur-
rence" or offense took place;
(2) The names and addresses of any in-
jured persons and witnesses; and
CMP-4786.1
CMP-4766.1
Page 2 of 2
(3) The nature and location of any injury
or damage arising out of the "occur-
rence" or offense;
b. Tender the defense and indemnity of any
claim or "suit" to us and to all other insur-
ers who may have insurance potentially
available to, the additional insured; and
C. Agree to make available any other insur-
ance the additional insured has for de-
fense or damages for which we would
Provide coverage under SECTION 11 —
LIABILITY.
5. With respect to the insurance afforded the ad-
ditional insured, the following replaces SEC-
TION 11 —LIABILITY of Paragraph 7. Other
Insurance of SECTION I AND SECTION 11 —
COMMON POLICY CONDITIONS:
a. This insurance is primary to and will not
seek contribution from any other insurance
available to the additional insured, provided
that the additional insured is a named in-
sured under such other insurance.
b. Regardless of any agreement between
you and the additional insured, this insur-
ance is excess over any other insurance
whether primary, excess, contingent or on
any other basis for which the additional in-
sured has been added as an additional in-
sured on other policies.
There will be no refund of premium in the event
this endorsement is cancelled.
All other policy provisions apply.
C. Copyright, State Farm Mutual Automobile Insurance company, 2013 1007033 148011 08-21-2014
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
16VI" fie
JQi�En/.fOv✓
Account Number: CA SUSA 1650 Date: 2/23/18 Initials: LPD
CERTIFICATE OF INSURANCE
ALLIED WORLD INSURANCE COMPANY
C/O: American. Professional Agency, Inc.
95 Broadway, Amityville, NY 11701
8OD-421-6694
This is to certify that the insurance policies specified below have been issued by the company
indicated above to the insured named herein and that, subject to their provisions and conditions,
such policies afford the coverages indicated insofar as such coverages apply to the occupation
or business o`. the Named Insured(s) as stated.
THIS CERTIFICATE OF INSURANCE NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS, EXTENDS OR ALTERS
THE COVERAGE(S) AFFORDED BY THE POLICY(IES) LISTED ON THIS CERTIFICATE -
Name and Address of Named Insured:
SUSAN SAXE-CLIFFORD, PH.D.
A PROFESSIONAL CORP.
16530 VENTURA BLVD
STE 603
ENCINO CA 91436
Type of Work Covered: PROFESSIONAL PSYCHOLOGIST
Location of Operations: N/A
(if a. ferent than address listed above)
Claim History:
PPtYnarti ,a-F- 4 - -I - ,
Additional Named lnsureds:
SUSAN SAXE-CLIFFORD, PHD
CATHY GOODMAN, PHD
WILLIAM SMITH, PSY.D.
MEREDITH RIMMER, PH.D.
Coverages
NomberLV Piicy
Effective
Expiration
Limits of
Date
Date
Liability
PROFESSIONAL/
LIAD-T ITY
5011-0137 3/01/18 3/01/1.9 4,000,000
NOTICE OF CANCELLATION WILL ONLY BE GIVEN TO THE FIRST NAMED INSURED, WHO SHALL
ACT ON BEHALF OF ALL INSURE➢S WITH RESPECT TO GIVING OR RECEIVING NOTICE OF
CANCELLATION.
Comments: Defense Reimbursement Prcceedinqs Limit is $150,000.
This Certificate Issued to:
Name: SUSAN SAXE-CLIFFORD, PH.D-
A PROFESSIONAL CORP.
Address: 16530 VENTURA BLVD
STE 603 Aut on
ENCINO CA 91436
APA 00138 00 (06/2014)
---- 1WbR eAic F 1001'161' �� r� ��m IS of 6 2c Fri —ice/
Representative
Account Number: CA SUSA 1650 Date: 2/05/19 Initials: LPD
CERTIFICATE OF INSURANCE
ALLIED WORLD INSURANCE COMPANY
C/O: American Professional Agency, Inc.
95 Broadway, Amityville, NY 11701
800-421-6694
This is to certify that the insurance policies specified below have been issued by the compan
indicated above to the insured named herein and that, subject to their provisions and condition
such policies afford the coverages indicated insofar as such coverages apply to the occupation
or business of the Named Insured(s) as stated.
THIS CERTIFICATE OF INSURANCE NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS, EXTENDS OR ALTERS
THE COVERAGE(S) AFFORDED BY THE POLICY(IES) LISTED ON THIS CERTIFICATE.
Name and Address of Named Insured
SUSAN SAXE-CLIFFORD, PH.D.
A PROFESSIONAL CORP.
16530 VENTURA BLVD
STE 603
ENCINO CA 91436
Type of Work Covered: PROFESSIONAL PSYCHOLOGIST
Location of Operations: N/A
(If different than address listed above)
Claim History:
RPt_rnA1f_i1'c lq. -_ 4 1 no /n' Mn-
Additional Named Insureds-
SUSAN SAXE-CLIFFORD, PHD
CATHY GOODMAN, PHD
WILLIAM SMITH, PSY.D.
MEREDITH RIMMER, PH.D.
Coverages
Policy v
Number
Effective
Date
Expiration
Limits of
Date
Liability
PROFESSIONAL/
2,000,000
LIABILITY-5011-0137 3/O1/19 3/01/20 4,000,000
NOTICE OF CANCELLATION WILL ONLY BE GIVEN TO THE FIRST NAMED INSURED, WHO SHALL
ACT ON BEHALF OF ALL INSUREDS WITH RESPECT TO GIVING OR RECEIVING NOTICE OF
CANCELLATION. _
Comments: Defense Reimbursement Proceedings Limit is $150,000. 3/13 ADDL.INS.BELOF
This Certificate Issued to:
Name: SUSAN SAXE-CLIFFORD, PH.D.
A PROFESSIONAL CORP.
Address: 16530 VENTURA BLVD
STE 603
ENCINO CA 91436
APA 00138 00 (06/2014)
AutXorized Representative
s B/z�Ms