HomeMy WebLinkAboutVALLEY OAK SYSTEMS (AON) - 2005
iNSURANCE O,~ FILE
WORK M/, Y PilOCEED
UNTIL If,SURANCE EXPIRES
7 - ;)Jr-uCj
CLERK OF COUNCIL
OATE:5 - ~r--o':'
A-200S-0n
THIRD AMENDMENT TO V ALLEY OAK SYSTEMS
SOFTWARE LICENSE, SERVICE, AND MAlNTENANCE AGREEMENT
THIS THIRD AMENDMENT, made and entered into this 1t1'--'day of April, 2005, by and between,
V ALLEY OAK SYSTEMS (hereafter "VOS") and the City of Santa Ana, a charter city and municipal
corporation duly organized and existing under the Constitution and laws of the State of California
("City"), collectively referred to herein as "the Parties".
RE~!IA1S.
A. The Parties entered into that certain agreement entitled "VALLEY OAK SYSTEMS
SOFTWARE LICENSE, SERVICE, AND MAINTENANCE AGREEMENT ", hereinafter
referred to as "said Agreement", for installation, training and maintenance of the City of Santa
Ana Personnel Services Agency workers' compensation and liability claims computer program;
B. On April 7, 2003, the Parties amended said Agreement to provide additional training, updates
and upgrades and other services under the terms of said Agreement.
C. The Parties hereto now desire to amend said Agreement to provide continuous service under
the terms of said Agreement.
WHEREFORE, in consideration of the mutual and respective covenants and promises hereinafter
contained and made, and subject to all of the terms and conditions of said Agreement as hereby amended,
the parties hereto do hereby agree as follows:
1. Section 2, of said Agreement, pertaining to Exhibits is hereby amended to add Exhibit E, entitled
"iVOS Upgrade/Services Understanding" and Exhibit F, entitled "Proposal for Migration from VOS
Portal to iVOS and/or ASP at the City of Santa Ana" dated August 27,2004, as attached hereto and
incorporated into said Agreement by reference.
2. Except as hereinabove modified, the terms and conditions of said Agreement remain unchanged and
in full force and effect.
IN WITNESS WHEREOF, the parties hereto have executed this Amendment to said Agreement the date
and year first above written.
ATTEST:
. .
TRICIA E. HEALY
Clerk of the Council
(Signatures Continued)
APPROVED AS TO FORM:
JOSEPH W. FLETCHER
City Attorney
By. .". I".' ~/~, j ~-f{ -
.. L. )~~- /
Michael Vigliotta
Deputy City Attorney
APPROVED AS TO CONTENT:
Valley Oak Systems, Inc.
,
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'Robert Faulhaber
President
Tax ill #: 68-0331363
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- .-
EXHIBIT E
IVOS UPGRADE/SERVICES UNDERSTANDING
1. Current & Past Maintenance Fees Overcharge
The original agreement states, "... the renewal rate for this Maintenance Agreement shall either
be the same as the current year's rate or at an increase not to exceed the United States Consumer
Price Index (CPI)."
The City has been overcharged for maintenance fees over the past several years. See table
below.
Fee That Should
Invoice Have Been
# Support Range CPI Charged Fee Charged Overcharge Total Overcharge
1651 10/01/1999 09/30/2000 $ 14,400.00 $ 14,400.00 $ $
1783 10/01/2000 09/30/2001 3,4 $ 14.890.00 $ 14,900.00 $ 10.00 $ 10.00
2091 10/01/2001 09/30/2002 2.8 $ 15,307.00 $ 15,645.00 $ :138.00 $ 348.00
2596 10/01/2002 09/30/2003 1.6 $ 15,552.00 $ 16,802.25 $ 1,250.25 $ 1,598.25
3289 10/01/2003 09/30/2004 2.3 $ 15,910.00 $ 17 ,642.50 $ 1,732.50 $ 3,330.75
4514 10/01/2004 09/30/2005 3.5 $ 16,467.00 $ 18,525.00 $ 2,058.00 $ 5,388.75
2. Revised iVOS Maintenance Fee
The 2nd agreement amendment states, "The fee increase for the addition of the iVaS application
for the first year will be $8,401.13."
Considering that the current maintenance fee should be at $16,467, the first year's ivas
maintenance fee will be $24,868.13.
vas will provide City a credit for our cumulative overcharges of $5,388.75 on the next invoice.
3. VOS to Carry-forward Custom Reports
vas will be responsible for carrying forward the Portal customizations & custom reports into
iVaS. The original agreement Exhibit A & C identify customizations & custom reports include
the following:
Check Printing - custom design
Check Reconciliation Interface File
Bill Review Interface (existing format)
Custom Report - Attorney Totals
Custom Report - Claims by Claimant Type
Custom Report - Claim Summary Contact (Claim Contact)
Custom Report - Claim Summary Contact Payment (Claim Contact Paid)
Custom Report - Claim Summary Contact Financial
The agreement states, "... VOS agrees to provide periodic updates and upgrades to the products
listed in 2a" in reference to software maintenance. Item 2a refers to Exhibits A & C (see above).
Check Printing Report
City prints workers comp checks to a Troy laser printer (HP 4000 OEM). VOS will re-develop
the check printing report in iVOS using the current format. The 3'd -party softfont for the MICR
font (instead of the Troy hardware MICR font) is acceptable; VOS can provide the MICR
softfont if desired. The courtesy amount field, however, should continue to use the Troy LCF
Convenience softfont. The City can provide VOS this font if needed.
Check Reconciliation Interface File Report
VOS will develop the City's Check Reconciliation Interface File report in iVOS using the
current format.
Bill Review Interface
The existing Portal Bill Review Interface needs to work in iVOS using the same format as
currently defined in Portal.
Other Custom Reports
Some of the 5 "Custom Reports" above are no longer working in Portal (after upgrades & such)
and some exist under a different name.
VOS will work with one of the City's key reports users to understand the report requirements &
develop replacement / similar reports in iVOS.
4. iVOS Implementation Services
The City will engage VOS for the services identified on page 8 of Exhibit F "Proposal for
Migration from VOS Portal to iVOS and/or ASP at the City of Santa Ana", including the optional
Infrastructure Setup and Configuration and iVOS Installation and Configuration services. Project
Management time will be billed for the actual time spent, up to $15,000.
S. VOS to Develop Document Image Deletion Functionality
VOS agrees to provide the Document Imaging Module with this upgrade at no charge.
VOS agrees to build functionality in iVOS during the next 2 years to allow a manager user the
ability to configure the automatic deletion of document images (but not the original record) from
the system.
iVOS will provide the ability to run a batch deletion process with the following user defined
selection criteria:
. number of years (user-defined)
. document type (i.e.: bills, correspondence, EOBs, etc.)
. claim status (i.e.: Closed)
. document date (i.e.: Bill Date)
The system will allow the user, with proper permission (Manager), the ability to manually or
automatically execute the batch deletion. The results of the user-defined selection will be
displayed in a report for review prior to deletion.
6. iVOS Bill Review Services
The City shall utilize VOS' iVOS Bill Review Services for review of the City's pharmacy bills
for a trial period of six (6) months. At the end of 6 months, if the City is not satisfied with the
iVOS Bill Review Services, the City can discontinue services. Ifthe City agrees to continue
using the iVOS Bill Review Services, said services shall renew and automatically continue for
one-year terms, unless either party terminates. The period of Bill Review Services shall
commence on May I, 2005 or when iVOS upgrade installation is completed.
IVOS Review Services includes review and payment recommendations on medical treatment,
hospital, surgery center, pharmacy and miscellaneous bills based on compliance with the
applicable fee schedules or usual and customary databases. VOS will provide access to the
Preferred Provider Organizations (PPO) networks that have negotiated contract rates with
hospitals and providers and will maintain appropriate PPO and state mandated fee schedules.
The City will provide VOS with identified bills and related reports for re-pricing and will update
and maintain the vendor file. The City will pay VOS within thirty (30) days for the service fees
agreed upon.
In the event that Bill Review Services as set forth above are terminated, the City shall pay all
fees and commitments, incurred by VOS up to the termination date. Either party may terminate
this portion of the agreement upon written thirty (30) days written notice.
The fee for said services shall be billed at a $2 set up fee per bill with a $1 per line charge for bill
review. There will be an additional fee of 20% of savings for PPO discounts below fee schedule
and 25% of savings on negotiated settlements for treatment bills in dispute. No charges will be
incurred for duplicate reviews (Full and Partial) or for additional bill reconsiderations. VOS
will provide WCAB appearances at no additional charge.
7. Confidential Information
Each party may, in confidence, discloses to the other party non-public information concerning
such party's volume of business, methods, systems, clients, fees, practices, plans, and contract
terms, and other confidential or commercially valuable proprietary information (collectively,
"Confidential Information"). Each party acknowledges that the disclosing party shall, at all
times, be and remain the owner of all Confidential Information disclosed by such party. The
party to whom Confidential Information is disclosed may use such Confidential Information only
in furtherance of the purposes and obligations. The party to whom any Confidential Information
is disclosed shall use its best efforts, consistent with the manner in which it protects its own
Confidential Information, to preserve the confidentiality of any such Confidential Information,
which such party knows or reasonably should know that the other party deems to be Confidential
Information. Neither party shall use for its own benefit or disclose to third parties any
Confidential Information of the other party without such other party's written consent.
EXHIBIT F
Proposal
For
Migration
from
vas Portal
to
:iVOS1\f
and/or
ASP
At
City of Santa Ana
August 27, 2004
Va y Oak
SYSTEMS
~
Valley Oak Systems, Inc.
Bishop Ranch 8
5000 Executive Parkway, Suite 340
San Ramon. CA 94583
www.valleyoak.com
(925) 242-4600
,
v.ney o.k
'T,"M'
Proposal to City of Santa Ana
Table of Contents
EXECUTIVE OVERVIEW ..........................................................................................................................3
APPLlCA nON SERVICE PROVIDER (VOS TO HOST SOFTW ARE)...................................................4
REMOTE ACCESS... ..... .............. ......................... ..... .......................... .... ........ ........ ...................... ........ ........4
SYSTEM INFRASTRUCTURE................ .... .... .... ................ ........... ................. ............................. ......... ...........4
SERVICES ................. .................. .... ....................... ............ ............ .................. ................ ..................... ......4
INCLUDED SERVICES FOR TRANSITION TO IVOS.............................................................................6
OTHER RECOMMENDED SERVICES......................................................................................................6
PROJECT MANAGEMENT!IMPLEMENT A nON SUPPORT...... ..................... ......... .................... .......... ..............6
TRAINING ........ ........ ..... ............................ ....... .................... ...... ........ ............................. .......... ......... .........6
OPTIONAL SERVICES ......... ..... ........: ........ ................................... ..................... ...................... ..................... 7
Infrastructure Setup and Configuration ................................................................................................. 7
NOS Installation and Configuration........ .................. ......... ................... .............. ...... ...... .......... ........... 7
CLIENT RESPONSIBILITIES ............ ....................... ................ .............. ..................... ........... .......... ...............7
Interface or Additional Module ............................................................................................................. 7
Custom Reports..... .... .............. ............. .......... .................. ................ .............. ........... ..... .......... .............7
PRICING....................................................................................................................................................... 8
MIGRA nON TO IVOS MODEL.....................................................................................................................8
Annual Maintenance Fees ...c...... ...................... ......... ................. ..... ............... ............... .... ....................8
PROJECT MANAGEMENT ............................................................................................................................8
Optional Services (City of Santa Ana may choose to perform these tasks):..........................................8
Training ........................... ................... ........... .................. .................. ................... .......... .......... ............. 8
MIGRA nON TO IVOS ASP MODEL ............................................................................................................ 9
Annual Maintenance Fee....... ........ .................. ................. .................. ........... ...... ......... ........... ..............9
ASP Monthly Fee .... ........ ............... ............. .............. ............ .................. ......... ................. ........... ......... 9
Project managementllmplementalion support ..... ........... ................... .......... .................... ............... ....... 9
Data Conversion................................................ .._.................................................................................9
HARDWARE AND SOFTWARE REQUIREMENTS ..............................................................................10
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9/3/2004
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Proposal to City of Santa Ana
Executive Overview
This document is meant to provide information regarding migration of the VOS Portal system
currently being used by the City of Santa Ana (The City) to our iVOS application. In addition to
iVOS, this document will provide information regarding our ASP deployment.
iVOS is a browser-based J2EE compliant Claim Administration System designed to handle
multiple lines of insurance. VOS has an established product and is recognized as one of the
"best-of-breed" solutions in the market today. The iVOS system is highly configurable and can
be customized to meet most organizational needs. iVOS has been designed to:
)> Take advantage ofthe efficiencies gained by using truly browser-based technology
enabling an unparalleled integration into the Windows desktop
)> Require no middle-ware (i.e. Citrix)
)> Eliminate the need to distribute software to individual desktops
)> Maintain platform independence
)> Be installed on your network or hosted on ours (ASP solution)
)> Provide immediate access to the information you need for controlling costs, anytime,
from anywhere
iVOS enables the City to increase the efficiency and effectiveness of the entire claims
administration process by taking advantage of the capabilities of what we think is the most
advanced claims administration system available. Additionally, the integration of the system into
the City's processes enables the organization to:
)> Increase customer service levels and response times by being able to query, open, and
edit multiple claimant files for multiple accounts simultaneously.
)> Increase the productivity of claims personnel through various automated processes such
as letter generation, diary notifications, and workflow business rules.
)> Provide an easy to use reporting capability with over 80 standard reports; ad hoc
reporting, and data export to various file formats that will enable all users to make
business decisions based on quality data.
In addition to providing a new technical platfonn, iVOS also provides many functional
improvements to VOS Portal. Key new additions include:
)> Totally integrated Ad Hoc Report Designer (full supported by VOS support) means
No More InfoMaker
)> New "Claim Mail" - e-mail functionality at the claim file level
)> hnproved Document Imaging
)> Simplified security configuration
)> Expanded Sticky Notes available throughout system
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9/3/2004
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Proposal to City of Santa Ana
Aoolication Service Provider (VOS to Host Software)
In addition to iVOS, VOS is providing information about our ASP model along with it benefits.
The benefits associated with our ASP are:
. VOS hosts the software and database at vas
. The City will access the software via the Internet and or other communication line
. vas eliminates the need for City to support a database server and physical database
for your claims system operation
. VOS takes on the responsibility to provide and maintain the server and database
platform
. One point of contact for support of both infrastructure and software
. Technical expertise (No DBA services required)
. Constant IT oversight and managemeot
. Reduce'or eliminate IT Staff
. Data located offsite
. Replication of servers
Below is an outline of the services that will be included in the ASP service provided by vas if
the City chooses to implemeot iVOS using this model.
Remote Access
~ Access via the Internet
~ System is available Sam - 6pm Monday through Saturday
(System will be available outside of the hours noted above but will be subject to
potential unavailability for vas maintenance procedures.
~ Customer support is available Sam Eastern- 6pm Pacific Monday through Friday
System Infrastructure
~ Hardware
~ Database
~ Operating System
~ Ancillary Software (excluding e-mail, fax, etc.)
Services
In addition to the standard system support, VOS will provide the System Administration
support normally provided by in-house techoical staff. Services are available during normal
support hours. Other procedures such as check geoeration, correspondeoce modification,
and refereoce table maintenance will be the responsibility of Clieot Personnel. Examples of
services provided by VOS are listed below as well as examples of tasks to be performed by
Client.
Services provided by VOS
~ Database administration tasks - such as killing runaway jobs, monitoring logs.
backups, testing backups, monitoring performance/capacities etc.)
Service provided to client at an additional cost:
~ Running standard monthly reporting history periods for value-as-of reporting.
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9/3/2004
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Proposal to City of Santa Ana
~ Security maintenance -adding new users, changing existing user profiles, resetting
passwords etc.
~ Data corrections to client databases at client request
~ Reference table changes - changes that cannot be done via iVOS
~ Enhancements
Additional services will be provided upon request at VOS' current hourly rates.
Services provided by Client
~ E-mail services
~ Internet services
~ Desktop/Printer/Scanner support
~ Desktop software (e.g. MS Office)
~ V ims protection
~ Network infrastructure and connectivity to ISP
~ User access/password approvals
~ Enhancement change request approvals
~ Production maintenance approvals
~ Reference table changes - changes made via iVOS
~ Running custom interfaces - such as Bill Review, state EDI data transfers, Bank
~ Check generation
~ Correspondence maintenance
~ Policy maintenance
VOS also bas a long-term commitment to our clients. Our development methodology has
enabled us to effectively and efficiently support our clients. As part of an on-going support
relationship we provide our clients with a very high level of service and support as well as annual
updates (both technical and functional) to the system. We pride ourselves on the fact that VOS
has never lOst a client and we work very had to maintain that distinction.
VOS is well qualified to provide an outstanding solution for the City. VOS has developed an
excellent reputation in the industry that is supported by our clients. We are very enthusiastic
ahout the opportunity to develop a mutually beneficial business relationship with the City . We
would like to view this proposal as a basis to develop that relationship. With the capabilities of
the system and combined efforts ofhoth of our tearns, we believe a tremendous solution can be
implemented.
We believe that there are two key points with respect to our existing vas Portal clients
migrating to the iVOS application:
o No data conversion Is required
o No additional license fees are required
However, there are costs associated with implementing iVOS and the ASP deployment for
existing VOS Portal clients. The costs involve and increase in your current Annual
Maintenance Fee (not applicable with the ASP), Project Management, Training and
Implementation Support. Specific estimated costs are listed in the Cost section of this document.
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9/3/2004
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v.JleyOok
,...,..,
Proposal to City of Santa Ana
Included Services for Transition to iVOS
The services listed below will be provided are no additional cost for our current clients:
>- 4 hour consultation with a Valley Oak implementation manager to discuss iVOS its
infrastructure requirements, features and functionality. The objective of this is to jointly
decide which components of the migration will be completed by the client and to identify
areas where assistance will be required from Valley Oak. This allows the correct
scheduling and resource allocation to occur in order to meet our client's business
requirements.
>- Handover to support to ensure that any custom configurations or system setup is know to
facilitate ongoing support
Other Recommended Services
These services are recommended to obtain the maximum business benefit from your iVOS
implementation.
Project ManagementlImplementation Support
Moving to an iVOS environment has many implications for existing and new users. Valley Oak
offers services to review the existing VOS Portal implementation and to advise,on how iVOS
could be implemented taking advantage of the new features, security system, reporter and report
designer. Our Project Management services also provide for a smooth transition for VOS Portal
toiVOS.
Training
Migration to iVOS - System Administration 1 Day
Selected Power Users will learn all essential functions for managing and securing Users in iVOS
Claims and Reporter. All levels of security will be discussed including adding/copying new
Users, creating Roles and Groups, configuring field and column security and configuring iVOS
Scheduler.
Migration to iVOS - User Intermediate 1 Day
Current Portal Users will be introduced to iVOS by learning the differences between iVOS and
Portal. Users will leam ofiVOS' New Look and New Features such as Sticky Notes, Email, and
Payment Search
Migration to iVOS - iVOS Reporter
Current Reporter Users will be introduced to iVOS Reporter. Users will
functionality of iVOS Reporter, including new look GUI and features.
1 Day
leam design and
Migration to iVOS - iVOS Report Designer 1 Day
Client selected iVOS Users willleam VOS' custom report designer which allows the generation
of adhoc reports using an intuitive drag and drop interface.
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9/3/2004
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ValJeyOak
........
Proposal to City of Santa Ana
Ootional Services
Infrastructure Setup and Configuration
iVOS is a browser based application and for many of our customers this is the internet
application which they have deployed. Therefore Valley Oak offers support services to advise
and/or perform the setup and configuration of the technical infrastructure required to run iVOS,
namely installation and configuration of the application server. Duration is dependant on the
complexity and size of the iVOS implementation.
iVOS Installation and Configuration
Many of the standard Valley Oak features such as Security and Business Rules are implemented
with a new User Interface and some changes to functionality. Some of our Clients prefer Valley
Oak to advise and/or perform the iVOS setup in terms of users, groups and roles, business rules,
the iVOS scheduler and claim mail. The extent of Valley Oak involvement in this process i~
normally ascertained during the NOS requirements analysis workshop.
Client Resoonsibilities
Interface or Additional Module
It will be necessary to run test files on existing system interfaces to ensure continuity of
operation within the iVOS environment.
Custom Reports
These will be supported within the iVOS environment; however clients should begin to deploy
custom reports using the new iVOS report designer.
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9/3/2004
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Proposal to City of Santa Ana
Pricinl!
Migration to iVOS Model
c'l
Annual Maintenance Fees b ,
The City of Santa Ana will experience an increase from your current fee of $18,525 to
S27,728.
:'1-';; 0/0
Proiect Manal!ement
(5 -.10 Days @ $1,500/day) S7,500 - S15,OOO
Optional Services (City of Santa Ana may choose to perform these tasks):
. Infrastructure Setup and Configuration (I day@ $1,500 per day)
. iVaS Installation and Configuration (1 day@ $1,500 per day)
$1,500
$1,500
Traininl!
The cost for training has been calculated based on the assumption of vas providing training
for up to 10 users. Actual Fees are based on $1,500/day/trainer.
. Migration to iVOS - User Intermediate
(I dayS@ $1,500 per day)
$1,500
. Migration to iVOS - iVaS Reporter
(I day@ $1,500 per day)
. Migration to iVOS - iVOS Report Designer
(1 day@$1,500 per day)
. Migration to iVOS - System Administration
(I day@ $1,500 per day)
Total:
$1,500
$1,500
$1,500
$6,000
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9/3/2004
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Proposal to City of Santa Ana
Migration to iVOS ASP Model
Annual Maintenance Fee
Annual Maintenance fee remains at current rate.
ASP Monthly Fee $2,750/mo
Fee is based on Nl. concurrent users.
Proiect manal!ementJImplementation support $7,500 - $15.000
Services to support the migration from the current systems to the ASP
model. We estimate five to ten (5) days for all necessary services. Actual
implementation cost will be invoiced @ $1,500/day.
Data Conversion
Conversion of data from the City's current VOS Portal systems to the iVOS $4,500
ASP system. Includes merging the data from the separate City of Santa Ana
Databases into one and retaining their distinct reference tables via the use of
the Client Code in iVOS.
Pricing quoted is confidential to Valley Oak Systems and exclusive to City of Santa Ana.
Pricing is valid for 60 days from the date of this Proposal, assumes mutually agreeable
contract documentation, and may be extended in writing at the discretion of Valley Oak
Systems, Inc.
All pricing is exclusive of travel related expenses, which are billed to City of Santa Ana
on a monthly basis as incurred.
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913/2004
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Proposal to City of Santa Ana
Hardware and Software Requirements
iVOS Requirements:
Database Server Hardware and Software Requirements
Requirements based on database selected.
Databases Supported:
. Oracle 9i or later
. MS SQL Server 2000 with Service Pack 3 or later
. Sybase Adaptive Server Enterprise 12 or later
e For Intel-based solutions, vas recommends a minimum ofa IGHz
processor with 512MB ofRAM.
e Disk space requirements depend upon the amount of historical data,
annual claims volume, and optional modules selected such as Document
Imaging.
Web Application Server Hardware and Software Requirements
. Server: Platform independent with dual I GHz processor system and 1GB of RAM per 50
users
.
J2EE I.3/J2SE 1.4 compliant application server
Desktop Hardware and Software Requirements
. 800MHz processor
. 256MB RAM for Windows 98 and 512MB RAM for Windows NT, Windows 2000, or
Windows XP
. Adobe Acrobat Reader 5.0 or later, Microsoft Word and Excel (2000 and later)
. Browser: Internet Explorer 6.0 (Service Pack 2 or later)
Internet Connection
.
Download speed: 1.5Mb/see
Upload speed: 384Kb/sec
.
Remote Connectivity Hardware and Software Requirements
. Network access and PCAnywhere software
PriDters
. Check Printers - HP LaserJet family that have MICR toner carnidges available
(optional)
. LetterlReport Printer - Laser printer (HP preferred) with 2 bin capability, DeskJet
printers are not supported
Page 10
9/3/2004
DATE (MMIDD1YYYY)
07/09/2004
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
"nVE
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDIN'
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
'r'l~ ~g,~~ TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION
~NERAL LIABILITY 3582 -10-16 PLE 07/28/2004 07/28/2005 EACH OCCURRENCE
X COMMERCiAl GENERAL LIABILITY DAMAGE TO RENTED
I CLAIMS MADE [IJ OCCUR
E.L. EACH ACCIDENT $
~L. DISEA~ EA EMPLOY~~ $
E.L. DISEASE - POLICY LIMIT $
$3,000,000
$50,000 Deductible
~.
CERTIFICATE OF LIABILITY INSURANCE
PRODUCER (650)341-4484
Business Professional
1519 South B Street
San Mateo, CA 94402
FAX (650)341-4465
Ins. Assoc. Inc.
.
INSURERS AFFORDING COVERAGE
INSURER A:. Federal Insurance
INSURERB Granite State Ins. CO
INSURER C.
INSURER 0
INSURER E
'NSURED Valley Oak Systems Inc.
5000 Executive Pkwy., Suite 340
San Ramon, CA 94583
.~
$
$
$
$
$
PRODUCTS - COMP/OP AGG S
MED EXP (Anyone person)
PERSONAL & PIN INJURY
GENERAL AGGREGATE
A
GEN'L AGGREGATE LIMIT APPLIES PER:
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~TOMOBlLE LIABILITY
_ ANY AUTO
~ ALL OWNED AUTOS
SCHEDULED AUTOS
f.-cc
~ HIRED AUTOS
~ NON-OWNED AUTOS
I-
PROPERTY DAMAGE
(Per aCCident)
07/28/2005
7499-64-69 07/28/2004
COMBINED SINGLE LIMIT
(Eaaccident)
BODILY INJURY
(Per person)
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OTHER THAN
AUTO ONLY
07/28/2005
7983-41-70 07/28/2004
EACH OCCURRENCE
AGGREGATE
EXCLUDES PROFESSIONAL
LIABILITY
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
8 ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICERlMEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
DO~~essional liability
A
CA
PA/Fl
MI/MD
we 311-14-75
WC 311-12-24
WC 311-12-23
10/16/2003
10/16/2004 X I wc STATU,-r IOJb"
3582-10-16 07/28/2004 07/28/2005
(EXCLUDED FROM EXCESS
LIABILITY POLICY)
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT J SPECIAL PROVISIONS
he City of Santa Ana, its officers, agents & employees are named as
nsured's operations.
~dditional Insured applies to General Liability policy only
I
UMITS
EA Ace
AGG
NAIC#
I,OOO,OOC
300,00<
10,OOC
I,OOO,OOC
2,OOO,OOC
2,OOO,OOC
.
I,OOO,OOC
$
.
$
3,OOO,OOC
3,OOO,OOC
I,OOO,OOc
I,OOO,OOC
I,OOO,OOC
Additional Insured with regards to
'10 day notice of cancellation for non payment of premium shall apply
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
....lL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
City of Santa Ana
20 Civic Center Plaza
Santa Ana, CA 92702
Debbie Uland SANDEE
OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVe$.
AUTHORIZED REPRESENTAllVE
COL,,~ -
@ACOROCORPORATION 1988
ACORD 25 (2001/08)
- I
-r.AC1JBa. CERTIFICATE OF LIABILITY INSURANCE DATE (MMlDDIYYYY)
07/26/2005
PRODUCER (650)341-4484 FAX (650)341 4465 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Business Professional Ins. Assoc. Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1519 South B Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
San Mateo, CA 9440Z
INSURERS AFFORDING COVERAGE NAIC#
INSURED Valley Oak Systems Inc. /t~ 1919- M3 INSURER A: Federal Insurance/Chubb Ins.
5000 Executive Pkwy., Suite 340 fl- ;i{tJ;! - 035 INSURER B: Granite State Ins. Co
San Ramon, CA 94583 Ih.< 003- ok. 9 INSURER c:
4 - .:2.ro5- 0 7.2- INSURER 0-
INSURER E:
"nV"RA''''''
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
II~":- ~p.,<~ TYPE OF INSURANCE POLICY NUMBER PPH.g,v EFFECTIVE POLICY EXPIRATION LIMITS
~NERAL UABILlTY 3582-10-16 PLE 07/Z8/Z005 07/28/2006 EACH OCCURRENCE S 1,000,000
-.! ~ERCIAL GENERAL LIABILITY DAMAGE TO RENTED S 1,000,000
_ CLAIMS MADE [!] OCCUR MED EX? (Ivry one person) S 10,OO(
A PERSONAl & ADV INJURY S 1,000,001
GENERAL AGGREGATE S Z,OOO,OOl
~~ AGGREGATE LIMIT APnS PER: PROOUCTS-COM~OPAGG S 1,OOO,OO(
(nPRO.
POLICY JECT LOC
~OMOB1LE LIABILITY 7499-64-69 07/28/2005 07/28/2006 COMBINED SINGLE LIMIT
(Eaaecidenl) S 1,OOO,Ooc
7 ANY AUTO
ALL OWNED AUTOS BoalL Y INJURY
e.::- (Per person} S
A 7 SCHEDULED AUTOS
HIRED AUTOS BODILY INJURY
i (Perao::ident) S
~ NON-OWNED AUTOS
- PROPERTY DAMAGE S
(Per accident)
;=rDE LlABIUTY AUTO ONLY. EA ACCIDENT S
ANY AUTO OTHER THAN EAACC S
AUTO ONLY. AGG S
5~SSJUMBRELLA lIABIUTY 7983-41-70 07/Z8/2005 07/28/Z006 EACH OCCURRENCE S 3,000,000
OCCUR 0 CLAIMS MADE AGGREGATE S 3,000,000
A EXCLUDES PROFESSIONAL s
Fxi DEDUCTIBLE LIABILITY S
X RETENTION S 10, OOC s
WORKERS COMPENSAnON AND CA we 9543237 10/16/Z004 10/16/Z005 X I T"X~~m~~ I IOJ~'
EMPLOYERS' UABIUTY PAlFL WC 9543236 1,OOO,OOC
B ANY PROPRIETDRlPARTNERlEXECUTlVE E.L. EACH ACCIDENT S
OFFICERlMEMBER EXCLUDED? MI/MO WC 9543235 E.L. DISEASE. EA EMPLOYEE S 1,OOO,OOC
~~~~~s~'bV~s,'ONS below E.L. OlSEASE . POLICY LIMIT S 1,OOO,OOC
OnlY. . Liabil ity 3582-10-16 07/Z8/2005 07/Z8/2006 $3,000,000
A ro esslonal (EXCLUDED FROM EXCESS $50,000 Deductible
LIABILITY POLICY)
IJtESCRlPnON OF ~PERATlONS I LOCAnONS' VEHICLES' EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS are named as Additional Insureds
he City 0 Santa Ana, its officers, agents, employees, and volunteers
On respects to insureds business operations.
~dditional Insured applies to General Liability policy only
~10 day notice of cancellation for non payment of premium shall apply.
City of Santa Ana
Jeff Stevens- Risk Mgr.
20 Civic Center Plaza
Santa Ana, CA 9Z701
1"P,PRO, VED,AS 'TO
, , I
" I_,,-=-
I \" ' '
ichJd Vig;\lolta
Deputy Cilv'\\lOrncy
SHOULD ANY OF THE ABOVE DESCRJBED POLICIES BE CANCELLED BEFORE THE
EXPIRAnON DATE THEREOF, THE ISSUING INSURER WILL ~ MAlL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOlDER NAMED TO THE LEFT,
7~~1II(1lIOOiltl@OOty..V"~XX
Jll(JIIOOIlOOI~_llllll__ltl."XXXXXXXX
AUTHORIZED REPRESENTATIVE
le
1 and SANDEE
~~
ACORO 25 (2001/08)
@ACORDCORPORATION 1988
~ ~
COMMERCIAL GENERAL LIABILITY
Valley Oak Systems Inc.
Policy Number 3582-10-16-PLE
Federallnsurance/Chubb
ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS
(FORM B)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization:
The City of Santa Ana, Its Officers, Agents, Employees, and Volunteers.
(If no entry appears above. information required to complete this endorsement will be shown in the
Declarations as applicable to this endorsement.)
WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown
in the Schedule. but only with respect to liability arising out of your ongoing operations performed for that
insured.
SUCH INSURANCE AS IS AFFORDED BY THE GENERAL LIABILITY POLICY
IS PRIMARY INSURANCE AND NO OTHER INSURANCE OF THE ADDITIONAL INSURED
WILL BE CALLED UPON TO CONTRIBUTE TO A LOSS.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
CO 2010 1093
, TQ FORM
APl'W..o\(ED (\Si 'i ,I
, i," l" - JL_,
I '1' f ----r .~
'\! \, ~ '" / \,." I,
~~~,.~'\ ~/i-g,li0tta
. . C;ty t\ttorney
Dcrll\\ " '
j\'CORQ. CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDOlVvyYt
11/03/2005
PROD~CER (650)341-4484 FAX (650)341-4465 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Business Professional Ins. Assoc. Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1519 South B Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
San Mateo, CA 94402
INSURERS AFFORDING COVERAGE NAIC#
INSURED Valley Oak Systems Inc. ~(''1Il'' -00"3 INSURER A: Federal Insurance/Chubb Ins.
5000 Executive Pkwy., Suite 340 A- 'UXI~ ~ogS INSURER B: Granite State Ins. Co
San Ramon, CA 94583 ^ - '2.~ .0lD'! INSURER c:
INSURER 0:
It, - WJS . 012.. INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REOUIREMENT, 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 AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I,N~~ ~~~~ TYPE OF INSURANCE POL.ICY NUMBER P~,.U..5:Y EFFECTIVE POUCY EXPIRATION L.IMITS
CA WC 184-37-90 10/16/2005
MI WC 184-40-07
ALL OTHER STATES -
WC 184-34-39
3582-10-16 07/28/2005 07/28/2006
(EXCLUDED FROM EXCESS
LIABILITY POLICY)
f,-DLESCRIPTlON OF OPERA TlONS I LOCA nONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROViSIONS
he City of Santa Ana, its officers, agents, employees, and volunteers
n respects to insureds business operations.
GENERAL LIABILITY
'x COMMERCIAL GENERAL LIABILITY
l CLAIMS MADE m OCCUR
A
f--
f--
GEN'l AGGREGATE LIMIT APPLIES PER
hi ,nPRO.'n
POLICY JEer LOC
AUTOMOBILE LIABILITY
-
X ANY AUTO
ALL OWNED AUTOS
-
A SCHEDULED AUTOS
X HIRED AUTOS
X NON-OWNED AUTOS
f--
I---
RRAGE LIABILITY
ANY AUTO
:JESS/UMBRELLA LIABILITY
OCCUR 0 CLAIMS MADE
A
~ DEDUCTIBLE
X RETENTION , IO,OOC
WORKERS COMPENSATION AND
E~PLQV~R_S' I.lABILlTY
B ANY PROPRIETORIPARTNERlEXECUTIVE
OFFICERIMEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
OT"""
Protessional Liability
A
3582-10-16 PLE 07/28/2005 07/28/2006 EACH OCCURRENCE ,
DAMAGE TO RENTED $
MEO EXP (Anyone person) S
PERSONAL & ADV INJURY $
GENERAL AGGREGATE $
PRODUCTS - COMPIOP AGG $
7499-64-69 07/28/2005
07/28/2006
COMBINED SINGLE LIMIT
(Eaaccident)
BODILY INJURY
{Per person)
BODlL Y INJURY
(Peraccidenl)
PROPERTY DAMAGE
(Per accident}
AUTO ONLY - EA ACC1DENT $
,
OTHER THAN
AUTO QNL Y:
EA ACC
7983-41-70 07/28/2005 07/28/2006 EACH OCCURRENCE
AGGREGATE
AGG $
,
,
,
,
.
EXCLUDES PROFESSIONAL
LIABILITY
10/16/2006 X I wc STATU. \ \OJ);"
E.L EACH .A.CCIDENT
E.L. DISEASE - EA EMPLOYEE $
E.L. DISEASE - POLICY LIMIT $
1,000,000
1,000,000
10,000
l,OOO,OOC
2,000,000
1,000,000
,
1,000,000
,
.
.
3,000,000
3,000,000
,
1,000,000
1,000,000
1,000,000
$3,000,000
$50,000 Deductible
are named as Additional Insureds
~dditional Insured applies to General Liability policy only
'10 day notice of cancellation for non payment of premium shall apply.
CERTIFICATE HOLD"R
,..
4TlnN
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
~ROV ED AS 'CO ~-\ ,- EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
~ ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
0--t!4./ I A BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
_ iStltt SI,c6i.." .... OF ANY KINO UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
fa .) AUTHORIZED REPRESENTAl1VE
1t City Aller'" Debbie Unland/SANDEE COL"I :-..:::,
@ACORD CORPORATION 1988
City of Santa Ana
. Jeff Stevens- Risk Mgr.
20 Civic Center Plaza
Santa Ana, CA 92701
ACORD 25 (2001108)
COMMERCIAL GENERAL LIABILITY
Valley Oak Systems Inc.
Policy Number 3582-10-16-PLE
Federallnsurance/Chubb
ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS
(FORM B)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization:
The City of Santa Ana, its Officers, Agents, Employees, and Volunteers.
(If no entry appears above, information required to complete this endorsement will be shown in the
Declarations as applicable to this endorsement)
WHO IS AN INSURED (Section 11) is amended to include as an insured the person or organization shown
in the Schedule, but only with respect 10 liability arising out of your ongoing operations performed for that
insured.
SUCH INSURANCE AS IS AFFORDED BY THE GENERAL LIABILITY POLICY
IS PRIMARY INSURANCE AND NO OTHER INSURANCE OF THE ADDITIONAL INSURED
WILL BE CALLED UPON TO CONTRIBUTE TO A LOSS.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
CG2010 1093
\PPRU',I,"u AS TO FORM
--~~[~
'\",:'r:-,lanl City AtLOC1CY