HomeMy WebLinkAboutNAPHCARE, INC. (3)wbuRANCE NOT ON FILE
WORK MAY NOT PROCEED
,XERK OF COUNCIL
IATE:
OCl 2 2 2021
A-2021-184
Q'.YDIi t2 CMS •Mnnriq�ttt)(�.�T 1
THIS THIRD AMENDMENT to the above -referenced agreement is entered into on
October 1, 2021, by and between NaphCare, Inc., an Alabama corporation ("Contractor"), 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").
RECITALS
A. The parties entered into Agreement No. A-2017-249, dated September 19, 2017, by which
Contractor agreed to provide basic and emergency inmate medical services ("Agreement').
B. On October 1, 2019, the parties entered into a First Amendment to the Agreement (#A-
2017-249-01) to exercise the first option to extend the Agreement until September 30,
2020, and increase the overall compensation.
C. On September 15, 2020, the parties entered into a Second Amendment to the Agreement
(#A-2020-187) to exercise the second option to extend the Agreement until September 30,
2021, and increase the overall compensation. This agreement is current and in effect.
D. The parties wish to exercise the third and final option to extend the term of the Agreement
for one year and to increase the overall compensation for services during the extension.
The Parties therefore agree:
Section 1, TERM, is amended to extend the term of the Agreement for the period from
October 1, 2021 through September 30, 2022.
2. Section 4, COMPENSATION, is amended to increase the overall compensation for the
following:
a. The total amount to be expended during this extension shall not exceed $2,854,746.87.
This amount includes the base amount listed under the Tier 1 listing below, and
includes a contingency amount of $200,000 for services to be provided at the sole
�scretton o e ity and $18,000 to cover parking costs as prove ed under Section 4
of the Agreement. The Total amount to be expended for this Agreement shall not
exceed $ j 3,400,361.15.
Tier 1
Tier 2
(ADP at or above 176)
ADP at or below 175)
Renewal Option — 3`a Extension
10/1/21-9/30/22
$2,636,746.87
$2,323,841,64
A-2021-184
3. Except as modified by this Third Amendment, all terms and conditions of the Agreement,
as amended, shall remain in full force and effect.
IN WITNESS WHEREOF, the parties hereto have executed this Third Amendment to the
Agreement on the date and year first written above.
ATTEST
CITY OF SANTA ANA
DA M Z KRISTINE RIDGE
Clerk of the C uncil City Manager
APPROVED AS TO FORM
SONIA CARVALHO, City Attorney
By:
TAMA BO OSIAN
Senior Assistant City Attorney
FOR APPROVAL
i'
� ALENTIN
c Chief of Police
CONTRACTOR NaphCare, Inc.
By: Bradford T. McLane
Chief Executive Officer
Francine R. Digitally signed by FrancineR.
Villareal
Villareal Date:2022.01.20 13:34:07-08'00'
ACCWV CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDDIYYYY)
01 /18/2022
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(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).
PRODUCER
VIG, LLC., dba/The Vestavia Group
CONTACT NAME: Susan Crain
PNONE . 205-552-0244 ac No): 205-244-8072
E-MAIL
ADDRESS: SUSan.Crafn@V2StaVlagrOUp.COm
2090 Columbiana Road, Suite 2300
INSURERS AFFORDING COVERAGE
NAIC #
INSURERA: Ironshore Insurance Company "A" XV
25445
Birmingham AL 35216
INSURED
INSURER B : Great American Insuance Company"A+"XIV"
16691
INSURER C : The Travelers Indemnity Company "A++" XV
19046
NaphCare, Inc.
INSURER D
2090 Columbiana Road, Suite 4000
INSURER E
Birmingham, AL 35216
INSURER F
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.
INSR
LTR
TYPE OF INSURANCE
ADDL
SUBR
POLICYNUMBER
POLICY EFF
MMIDD
POLICY EXP
MMIDD
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
Y
N
HC7BAB5A62002
12/31/2021
12/31/2022
EACH OCCURRENCE
$ 2,000,000
X I CLAIMS -MADE El OCCUR
DAMAGE To RENTED-
PREM SES (E. occurrence)
$ 50,000
MED EXP (Any one person)
$ 5,000
Retro date: 12/31/2018
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 8,000,000
POLICY PRO-
JECT 7 LOC
PRODUCTS - COMP/OP AGG
$ 1,000,000
$
OTHER:
_R
B
AUTOMOBILE
LIABILITY
Y
N
CAP-1116396
09/30/2021
09/30/2022
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
X
BODILY INJURY (Per person)
_
$ XXXXXXXX
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per accident)
$ XXXXXXXX
PROPERTY DAMAGE
Per accident
$ XXXXXXXX
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
A
X
UMBRELLA LIAB
z
OCCUR
Y
N
HC7BAB5A67002
12/31/2021
12/31/2022
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
$ 5,000,000
EXCESS LIAR
CLAIMS MADE
DIED RETENTION $
$
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANYPROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBEREXCLUDED? y
(Mandatory in NH)
NIA
N
UB-1P248768-21-51-K
UB-1 P250924-21-51-K
09/30/2021
09/30/2022
X I STATUTE I ERH
E.L. EACH ACCIDENT
—
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
--
$ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
A
Professional Liability Claims Made
Y
N
HC7BAB5A62002
12/31/2021
12I31/2022
2,000,000
Retro: 7/01 /2003
8,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
It is understood and agreed The City of Santa Ana, its officers, employees, agents, volunteers and representatives are named as Additional Insured, as respects
their contract with NaphCare, Inc.; the insurance provided by Naphcare, Inc., shall be primary and non-contributory to the insurance carried by the City of Santa
Ana; The City shall receive a (30) thirty day notice of any material modification of policies, as respects their contract with NaphCare, Inc.
CERTIFICATE HOLDER CANCELLATION
City of Santa Ana
Risk Management Division
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
20 Civic Center Plaza
ACCORDANCE WITH THE POLICY PROVISIONS.
Santa Ana, CA 92702-1988
AUTHORIZED REPRESENTATIVE
o" Nye
z
RiskMwaganentDivision
REVIEWED & APPROVED BY.
01988-2015 ACORD C
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
---
Risk Management Analyst
O' I _E
IRONSHORE SPECIALTY INSURANCE COMPANY
175 Berkeley Street
Boston, MA 02116
Toil Free: (877) IRON411
Endorsement # 5
Policy Number: HC7BAB5A62002
Insured Name: NaphCare, Inc.
Effective Date of Endorsement: December 31, 2021
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CITY OF SANTA ANA ENDORSEMENT
LIMITS OF LIABILITY
THIS ENDORSEMENT MODIFIES THE GENERAL LIABILITY COVERAGE PART AND THE PROFESSIONAL LIABILITY COVERAGE
PART OF THE POLICY AS FOLLOWS:
The coverage provided by the policy applies to each insured against whom claim is made or suit is brought subject
to the applicable limit of liability.
ADDITIONAL INSUREDS
THIS ENDORSEMENT MODIFIES THE GENERAL LIABILITY COVERAGE PART AND THE PROFESSIONAL LIABILITY COVERAGE
PART OF THE POLICY AS FOLLOWS:
The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701, its officers, employees, agents,
volunteers and representatives are included as additional insureds under the above -described Coverage Part(s) of
the policy, but only with respect to liability arising solely out of the operations of the policyholder. The coverage
provided by this policy shall be primary and non-contributory, provided that the alleged acts or omissions giving
rise to the liability are otherwise covered by the policy.
SPECIAL NOTICE OF CANCELLATION
The policy is hereby amended as follows:
We will provide thirty (30) days'prior notification to the City of Santa Ana in the event that we cancel or materially
change or alter this policy.
City of Santa Ana
20 Civic Center Plaza
Santa Ana, California 92701
All other terms and conditions of this Policy remain unchanged.
Authorized Representative
MMF.END.171(2.19 ed.)
May 22, 2020
Date
Pa o NSF Risk Management])Msian
z
REVIEWED & APPROVED BY. -
Risk Management Analyst