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HomeMy WebLinkAboutCOUNSELING TEAM INTERNATIONAL, THE (NANCY K. BHOHL, INC.)INSURANCE NOT ON FILE N-2418-146 WORK MAY NOT PROCEED LERK OF COUNCIL DAIS: `n 17 AGREEMENT TO PROVIDE PSYCHOLOGICAL EVALUATION SERVICES FOR THE CITY OF SANTA ANA POLICE DEPARTMENT THIS AGREEMENT is made and entered into this 12th day of June, 2018 by and between Nancy K. Bob], Inc., a California corporation dba Tlae Coun el ng Team,Int�,mational,(,"`Consultant"), and tlic City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California C'City"). RECITALS 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 it 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: I. SCOPE OP 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 -S 12,138:' 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. 3. TERM This Agreement shall commerce on July 1, 2018 and continue for a one (1) year term through June 30,2014, 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 underthis Agreement, Consultant shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General 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. C. Worker's Compensation Insurance. In accordance with the provisions of Section 3700 oftI* 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 omissions) insurance, with a combined single limit of not less than $1,000,000 per claim with $2,000,000 in the aggregate. e. The following requirements apply to the insurance to be provided by Consultant pursuant to this section: L 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. 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 performed prior to approval of insurance by the City. 6. INDEMNIFICATION 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 of the Consultant, its subcontractors, agents, employees, or other persons 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 effects 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 the 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 selected by the City, regarding any action by a third party challenging the validity 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 terms 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 fi•om the date of final payment to Consultant under this Agreement. 8. 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 del iver 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. K 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 condition, 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. 15. 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 detennined 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 maybe 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 ofthe 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 ofthis 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, and 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 body 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: Sonia R. 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 Nancy K. Bohl, Inc. dba "The Counseling Team International 1881 Business Center Drive, Ste. I I San Bernardino, CA 92408 Fax: 909-384-0734 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 N-2018-146 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 asset forth above. If sent 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 first above written. ATTEST: V R x Maria D. Huizar L Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney Tamara Bogos�an Assistant City Attorney RECOMMENDED FOR APPROVAL: -- ID VALENTIN Chief of Police Santa Ana Police Department CITY OF SANTA ANA Raul Godinez II City Manager CONSULTANT: EXHIBIT A SCOPE OF SERVICES and COMPENSATION N-2018-146 EXHIBIT A 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. & Provide the City's Police Department with a written report of the candidate's psychological suitability for the classification of Police Officer as well 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. B. 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(s) 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 shall be to stabilize external factors which might otherwise affect officer(s) return to duty or recovery and 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 - City 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 (10) 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 shall: 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 well-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 (Le. 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. 3. 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 for 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 L7 D E D U 11 N-2018-146 < \ EXHIBIT B �(� CITY OF SANTA ANA REQUEST FOR PROPOSALS FOR PSYCHOLOGICAL SERVICES PROPOSERS CERTIFICATION AND PROPOSAL ITEM PRICING Certification - I certify that I have read, 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 clarification prior to the submission of my proposal. Proposal Item Price - Pricing shall be all inclusive and based on the scope of services described in Exhibit A. Cost proposal shall Include all costs for a three-year psychological services agreement. I City of Santa Ana — RFP 13-001 for Psychological Services IPage 20 VZ a% mm Service Pricing Anticipated No. Subtotal of Units Per Yr. A. Pre-employment psychologicalM $300 Per applicant TBD evaluations g. Complete Post -Traumatic — $175 Per hour TBD Psychological Incident Evaluation C, __67 Review of Fitness for Duty $ Per hour N/A _ Crisis Intervention Counseling $95 Per hour TBD E. Critical Incident Stress $175Per hour _ TBD Mana ement F. Consultation Services Per hour TBD C. Psychological Training Services $87.saPer hour TBD Testimony in court and court $ Per hour N/A* $ NIA _pLepgration Three�Year � I City of Santa Ana — RFP 13-001 for Psychological Services IPage 20 VZ a% '`' CERTIFICATE OF LIABILITY INSURANCE DATE/10/20YYYY) � I�''®� D5/10/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTHT`ATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed, If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s), PRDDUCER S%a#t^Farm SKALA INSURANCE AGENCY INC 4214 N SIERRA WAY 0 MAL SAN BERNARDINO, CA 92407 CONTACT NAME: PHONE909-883-8961 Are FA ___.._..._.._..._........._.._.........,,,_.._. Na ; 6MAllg ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC It INSURER A : State Farm General Insurance Company 25151 INSURED NANCY K ROHL INC DBA THE COUNSELING TEAM INTERNATIONAL AND DBA THE ORGANIZATIONAL NETWORK INSURER 8: State Farm Mutual Automobile Insurance Company 25178 INSURER C: INSURER D: INSURER E: INSURER F; n=Vial UIN IYUIVIOMM: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRI:rR L'TR TYPE Or INSURANCE -ADDL , SUER POLICY NUMBER POLFCY EFF MMIDDIYYYY4 PflUCY EXP MMIODfYYYY i -----"--'--" LIMITS COMMERCIAL GENERAL LIABILITYI CLAIMS -MADE OCCUR ;:CUI?EACHOREt-0CH g 1,000,000 t{UNGFTiTiER—tIII PREMISES.Eaoccurrence!. S 300000 IF\I HIRED AUTO MED EXP (An one porson't '> 5,000 A _... ._.............. Y Y 92LB14261 & 92YD04220 05/10/2018 07/12/2019 ENOL I PCRSONAL&rOVINJiRY _ 3 ` GEN'L AGGREGATE LIMIT APPLIES PER: r� '� GENERAL AGGREGATE ----....---..._..... ' 2,000,00D ' PRC. POLICYt� L:,:, PRODUCTS • COMP!OP AGG$ JEGT OTHER: ..__.. i AUTOMOBILE LIABILITY (I 4414187F2475 05/10/2018 12/24/2018 Wncc UE "t, SINGLE LJMV' S B ANY AnTO OWSVE: SCHEDULED I I BODILYINJURY(Per persal) _ y 1.000,000 - BODILY IN -JURY (Per accident) S 1,000,000 'UTOSGNLY ALTOS HIRED NON-O`1NNED AJrCS OI.iL'v AUrg50NLY 1 PROPERTY DAMAGE rarci•' ns- $ 1,000,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS LIAR • AGGREGATE — $ OED Pr`I ft?!uN S ! 5 WORKERS COMPENSATIO ,, i AND EMPLOYERS LIABILITY -) _ SiT UTE SRH 1, r N E ANY PROPRIETORtPAf2TNER!'cX£CLifIVE O°EECERiMtEh4IsER E -Xi LUD O7 f N ! A E L F:'tCti AC(:IDENT ._ y )IMandac5,nin NH) i !1 yes, describa undrr E.L.. DISEASE • EA EMPLgvEe ; E DISEASE . POLICY LIMIT .. 1 CESOR)P`IO'0 OF OPE'RAVOIJS belesv Illj I —.-$ DESCRIPTION OF OPERATIONS i LOCATIONS ! VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space Is required) Business Office Policy Property Locations: 1881 Business Center Dr, San Bernardino, CA 92408 39755 Murrieta Hot Springs Rd, Ste D160, Murrieta, CA 92563 j 1545 Anacape Rd Ste 7C, Victorvilie, CA 92392 135 S State College Blvd Ste 200, Brea, CA 92821 ' a' 444 Camino Del Rio Ste 2015,San Diego, CA 92108 7220 Avenida Encinas Ste 125, Carlsbad, CA 92011 74075 El Paseo Ste A9, Palm Desert, CA 92260 t 232 W Harrison Ste D, Claremont, CA 91711 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN SANTA ANA POLICE DEPARTMENT ACCORDANCE WITH THE POLICY PROVISIONS. 60 CIVIC CENTER PLAZA SANTA ANA, CA 92702 A IZE REPRESENTA © 1988-201 OR C R I . A Ig reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of A n s�/� 1001486 132849.12 03-16-2015 y,�f Aw L�,> CERTHOLDER COPY P.O. BOX 8192, PLEASANTON, CA 94588 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 08-12-2018 SANTA ANA POLICY DEPARTMENT ATTN: TAYLOR GEIL-CHIEFS OFFICE M-97 60 CIVIC CENTER PLZ SANTA ANA CA 92701-4060 SP GROUP: POLICY NUMBER: 0702761-2018 CERTIFICATE ID: 3 CERTIFICATE EXPIRES: 08-12-2019 08-12-2O18/61F--1-2---2C19 This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. Authorized Representative President and CEO EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #0015 ENTITLED ADDITIONAL INSURED EMPLOYER EFFECTIVE 2015-08-12 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. NAME OF ADDITIONAL INSURED: SANTA ANA POLICY DEPARTMENT ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 08-12-2011 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER NANCY K BOHL INC A: THE COUNSELING TEAM SP INTERNATIONAL 1881 BUS CTR DR ST SAN BERNADINO CA 92408 r M0408 (REV.7-2014) PRINTED : 07-17-2018 SP Certificate of Insurance(ProofofCoverage) Date Issued. 08121/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORIMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT"AIVH:ND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE PULiCIES BELOW. Insured Name and Mailing Address* Santa Ana Police Department Program Administrator Nancy K. Bohl Inc. dba The Counseling Team International POLICY PROVISIONS. Administered By: Nancy K Bohl [ X YesllYo J **If CPH and Associates 1881 Business Center Drive 911 711 S. Dearborn, Suite 205 'an Bernardino, CA 92108 lieu of such endorsement(s). Chicago, IL 60605 P.312-987-9823 F.312-987-0902 ''Additional insured locations are often requested by individual business owners who have more than one info(Elenhins.coin office. Your coverage is portable, meaning that you are covered at any location for practice corder the Underwritten By: occupation(s) listed on yourpolicy. Philadelphia Indemnity Insurance Company Coverage Policv #: 025826 Effective Date: 08/31/2017 Expiration Date: 08(31!2018 THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQITIREIVIENT, TERIYI OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT BY THE POLICIES DESCRIBED IIERE11N IS SUBJECT TO ALL THF. TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LINIITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits of Liability EACH OCCURRENCE AGGREGATE Coverage Part (Per individual claim) (Total amount per policyyyear) — $1.000,000 $5,000,000 Professional Liability Commercial General Liability N/A N/A Includes: General Liability, Fire & Water Legal Liability and Personal Liability NIA N/A Property Coverage $1.0001000 $5,000,000 Supplemental Liability Unlimited Unlimited Defense Expense Coverage $35,000 $35,000 State Licensing Board Investigation Defense Coverage $15,000 $15,000 Assault Coverage $10,000 $35,000 D;position Expense Benefit $5.000/person $50,000 Medical Expense Coverage $15,000 $15,000 First Aid Coverage Description.;Special Provisions: Certificate Holder Cancellation Santa Ana Police Department 60 Civic Center Plaza SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Santa Ana, CA 92702 EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Holder has also been added to the policy as an additional insured:** [ X YesllYo J **If ' the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder is Authorized Representative lieu of such endorsement(s). C. Philip Hodson DISCLAIMER:The Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend, or alter the coverage afforded by the policies listed thereon. j0s'v� VV -70 � 4�e THIS ENDORSEMENT CHANGED THE POLICY. PLEASE READ IT CAREFULLY Additional Insured Endorsement This endorsement modifies insurance provided under the following: ALLIED HEALTHCARE PROVIDERS PROFESSIONAL AND SUPPLEMENTAL LIABILITY POLICY In consideration of the premium paid, this policy is amended as follows Santa Ana Police Department is hereby added as an Additional Insured, solely for Damages arising out of a Professional Incident covered under this policy. The Professional Incident must arise out of services provided by the Insured, under contract with Santa Ana Police Department. Additional Insured Name and Mailing Address: Santa Ana Police Department 60 Civic Center Plaza Santa Ana, CA , 92702 All other terms and conditions of this policy remain unchanged. This endorsement is part of your policy and takes effect on the effective date of your Policy, unless another effective date is shown below. Policy: 025826 Effective on and after: 08/31/2017 Issued to: Nancy K. Bohl Inc. dba The Counseling Team International Expiration date: 08/31/2018 PI-PHCP-05 (03/01) By: Robert O'Leary, Authorized Representative ow � ale CF tIl 45 SUPPLEMENTAL INSURANCE CHECKLIST �o TO: CLERK OF THE COUNCIL OFFICE s FROM: CONTRACT ADMINISTRATOR: CMDR. MATHEW SORENSON EXT.: 8051 NAME OF CONSULTANT I PARTY: Nancy K Bohl. Inc. - The Counseling Team International AGREEMENT NUMBER (IF APPLICABLE): N-2018-146 Please review the insurance section of the agreement to ensure all necessary certificates of insurance are submitted to the Clerk's Office. Please provide ALL documents listed to fully execute the agreement and avoid payment delay to the vendor. Please check all boxes below that apply to your agreement. BUSINESS AUTOMOBILE LIABILITY ' -49N=OWPtE& 'cltIjUE C=I) ❑ HIRED ❑ QWNE-D 6 ❑ GENERAL LIABILITY ✓ ❑ PROFESSIONAL LIABILITY ✓I ❑ WORKER'S COMPENSATION ✓ ❑ REVISED: 9/19/2018 4CO & CERTIFICATE OF LIABILITY INSURANCE `,..i ODI eA 1122V2019 ov2v2D1s THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or he endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certiflcate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT State Farm SKALA INSURANCE AGENCY INC FF PHONE N 909-883-8861 NI Na ® 4214 N SIERRA WAY ALss; _ INSURERLS) AFFORDING COVERAGE NAI:# SAN BERNARDINO, CA 92407 INSURER A: Slate Farm General Insurance Company 25151 -INSURED INSURER a: State Farm Mutual Automobile Insurance Company 25178 INSURER C: NANCY K KOHL INC INSURERo: DBA THE COUNSELING TEAM INTERNATIONAL IRU" E: AND DBA THE ORGANIZATIONAL NETWORK is u;;:,- MEDEXP n one eradnl 6 5,000 COVERAGES COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILT�R TYPE OF INSURANCE POLICYNUMBER MPGUCYEFF POUCYEXP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE E 1.000,000 CLAIMS -MADE ® OCCUR P IIa1VOWAOlEq p�VvrtJa 1y S 3001000 MEDEXP n one eradnl 6 5,000 HIRED AUTO ENOL 'ERSONALIAO"IIIRY E A Y Y 92LB14261 &92YD04220 05/10r2018 07112/2019 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE E 2,000,000 POLICY a PE�a LOC PRODUCTS-COMPAIPAGG E E OTH : AUTOMOBILE UARIUDY 4414187F2475 12/2412016 06/24/2019 OMBINEDSINGLEtuar S BODILY INJURY (Per person) 5 1,000,000 ANY AUTO R OWNED$DHEDDLED AUTOS ONLY CK AUTOS BODILY INJURY(Paraccidsrd) E 1,000,000 PROPERTY DA MADE E 1,000,000 Per Er HIRED NON4 MEO AUTOS ONLY AUTOS ONLY UMBREUA LMeOCCUR EACH OCCURRENCE $ AGGREGATE S EXCESS UAB CLAIM54dADE DEC RETENTION 5 5 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE ❑ OFFICERIMEMSER EXCLUDED? NIA PER H- TAT T ER EL EACH ACCIDENT E E- L. DISEASE- EA EMPLOYEIIJ $ (Mandatary in son - It Yes, de9Cdba llMer DESCRIPTION OF OPERATIONEI EL. DISEASE -POLICY LIMIT $ DESCRIPnONOFOPERATIONS/LOCATIONS/VEHICLES (AGGRO 101, Addaidnal Rmnarka Schetlule, may be attached it more span is mqulredl Business Office Policy Property Locations: 1881 Business Center Dr, San Bernardino, CA 92408 39755 MUNI Hot Springs Rd, Ste D160, Murrieta, CA 92563 1545 Anacapa Rd Ste 7C, Vlctorvllle, CA 92392 135 S State College Blvd Ste 200, Brea, CA 92821 444 Camino Del Rio Ste 2015,San Diego, CA 92108 7220 Avenida Encinas Ste 125, Carlsbad, CA 92011 74075 EI Paseo Ste AB, Palm Desert, CA 92260 232 W Harrison Ste D, Claremont, CA 91711 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE E EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, DRDANCE WITH THE POLICY PROVISIONS. AGENTS, VOLUNTEERS & REPRESENTATIVES- --- 20 CIVIC CENTER PLZ A"41 SANTA ANA, CA 92701.4058 /. / ©19 015 ACORD CO OI T AIN is reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 1001488 132849.12 03 -16 -MB /.vfay/1�i✓�r' /�iE�rS f?Fc� f' o� �/I�Fi'-2L�✓j +�?A`F �roj� l'l7diP. J'o.e'F.uJ'D?n/ THIS ENDORSEMENT CHANGED THE POLICY. PLEASE READ IT CAREFULLY Additional Insured Endorsement This endorsement modifies insurance provided under the following: ALLIED HEALTHCARE PROVIDERS PROFESSIONAL AND SUPPLEMENTAL LIABILITY POLICY In consideration of the premium paid, this policy is amended as follows: City of Santa Ana, Its Officers, Employees, Agents, Volunteers & Representatives is hereby added as an Additional Insured, solely for Damages arising out of a Professional Incident covered under this policy. The Professional Incident must arise out of services provided by the Insured, under contract with City of Santa Ana, Its Officers, Employees, Agents, Volunteers & Representatives. Additional Insured Name and Mailing Address: City of Santa Ana, Its Officers, Employees, Agents, Volunteers & Representatives 60 Civic Center Plaza Santa Ana, CA, 92702 All other terms and conditions of this policy remain unchanged. This endorsement is part of your policy and takes effect on the effective date of your Policy, unless another effective date is shown below. Policy #: 025826 Endorsement #: PI-PHCP-05 (03/01) Effective on or after: 01/25/2019 Issued to: Nancy K. Bohl Inc. dba The Counseling Team International Expiration date: 08/31/2019 /.0 i fe, le,? I & %SO L / e, ®`IL'F%,S l` C:61 . r PI-PHCP-05 (03/01) pl--�9�Rt F? Zvi "2Pf?'"2"w �'thrs2 fb.PFi✓J'aa✓ CP H ® PHILADELPHIA INSURANCE COMPANIES S ASSOCIATES Certificate of Liability Insurance Date Issued: 01/25/2019 Underwritten by: Philadelphia Indemnity Insurance Company - One Bala Plaza, Suite 100 Bala Cynwyd, PA 19004 NAIC if: 18058 Administered by: CPH & Associates 711 S. Dearborn St. Ste 205 Chicago, IL 60605 - P 800.875.1911 F 312.987.0902 - info@cphins.com DISCLAIMER: This certificate is issued as a matter of information only and confers no rights upon the certificate holder. The Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend, or alter the coverage afforded by the policies listed thereon. Insured: Nancy K. Bohl Inc. dba The Counseling Team International Nancy BON 1881 Business Center Dr. #11 San Bernardino, CA 92408 Policy Number: 025826 Policy Term: 08/31/2018 to 08/31/2019 Covered Locations Professional Liability: Portable coverage, not location specific Coverage Type Per Incident Aggregate (Occurrence Form) (Per individual claim) (Total amount per year) Professional Liability $ 1,000,000 $ 5,000,000 Supplemental Liability $ 1,000,000 $ 5,000,000 Licensing Board Defense $ 35,000 $ 35,000 Commercial General NIA N/A Liability N/A N/A Fire/Water Legal Liability Business Personal Property N/A N/A Vicarious Sexual $ 1,000,000 $ 1,000,000 Misconduct Comments/Special Descriptions: Certificate Holder City of Santa Ana, Its Officers,Employees, Agents, Volunteers & Representatives 60 Civic Center Plaza Santa Ana, CA 92702 ® Certificate Holder has been added as an additional insured If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). Notice of Cancellation will only be provided to the first named insured in accordance with policy provisions, who shall act on behalf of all additional insureds with respect to giving notice of cancellation. Authorized Representative C. Philip Hodson /l-,d1le' �a z / c y /�llil=& rS Dl ZfYY CERTHOLDER COPY P.O. BOX 8192, PLEASANTON, CA 94588 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 08-12-2018 SANTA ANA POLICY DEPARTMENT ATTN: TAYLOR GEIL-CHIEFS OFFICE M-97 60 CIVIC CENTER PLZ SANTA ANA CA 92701-4060 SP GROUP: POLICY NUMBER: 0702761-2018 CERTIFICATE ID: 3 CERTIFICATE EXPIRES: 08-12-2019 08-12-2018/0 - 2-2019 This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance affordeedd by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. Authorized Representative President and CEO EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #0015 ENTITLED ADDITIONAL INSURED EMPLOYER EFFECTIVE 2015-08-12 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. NAME OF ADDITIONAL INSURED: SANTA ANA POLICY DEPARTMENT ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 08-12-2011 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER NANCY K BOHL INC A: THE COUNSELING TEAM SP INTERNATIONAL 1881 BUS CTR DR ST SAN BERNADINO CA 92408 (REV.7-2014) /vf�ieo�✓tr hcGcTS /1�6QT d� Ro2E2i ��/j M0408 RINTED : 07- -2018 SP 1vn h✓uro�✓