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HomeMy WebLinkAboutREACH EMPLOYEE ASSISTANCE, INC. 1D - 2009f~ ~ ±.+R;a RaiCE t~N F1LE ~.~~~ ri4 I^;URANCE EXPIRr=5 ++ ~, GIERK OF COU C!L ~ n~T~ , ~ ' . ;. FOURTH AMENDMENT TO AGREEMENT ~_~~ THIS FOURTH AMENDMENT TO AGREEMENT is entered into on May 29, 2009, by ~ ~, and between REACH Employee Assistance, Inc., a California corporation ("Consultant") and the N ~ City of Santa Ana, a charter city and municipal corporation of the State of California ("City"). ~ ~ RECITALS: A. The parties entered into Agreement #2002-208, dated November 18, 2002, (hereinafter "said Agreement") by which Consultant has provided employee assistance program services. B. Said Agreement was amended by the parties on October 3, 2005, on September 18, 2006 and on September 17, 2007. Each amendment extended the term of said Agreement. C. On August 18, 2008, the City Council of the City of Santa Ana accepted Consultant's offer to extend the terms and conditions of said Agreement and authorized a renewal of the agreement for an additional one-year period. D. In accordance with the terms and conditions of said Agreement, the parties wish to renew said Agreement for an additional one-year period and add compensation to pay for services during the extended term of said Agreement. WHEREFORE, in consideration of the covenants contained in said Agreement, and subject to all the terms and conditions of said Agreement, except those amended in this Fourth Amendment to Consultant Agreement, the parties agree as follows: 1. Section 2.a, COMPENSATION, shall be deleted in its entirety and replaced with the following: "Commencing January 1, 2009, City agrees to pay and Consultant agrees to accept as total payment for its services, a fee of $1.85 per employee per month, with an agreed employee count of 1,550.00. The total compensation to be expended pursuant to said Agreement shall not exceed $34,410, annually, during the term of said Agreement. 2. Section 3, TERM, shall be deleted in its entirety and replaced with the following: "The term of said Agreement shall commence on January 1, 2003 and terminate on December 31, 2009, unless terminated earlier in accordance with Section 12 of said Agreement. City shall have the option to extend the term of said Agreement for up to two additional one-year terms, at the rate set forth in Section 1, above." A-2002-208-04 3. Except as herein amended, all terms and conditions of said Agreement shall remain in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this Fourth Amendment to Consultant Agreement on the date and year first written above. ATTEST: ~~~ ~ - / PATRICIA E. HEALY Clerk of the Council CITY OF SANTA ANA '~ Lam. DAVID N. REA City Manager APPROVED AS TO FORM: JOSEPH W.FLETCHER City Attorney Laura Shee y Assistant City Attorney REACH EMPLOYEE ~ ASSISTANCE / ,P (Name) ~ d r`eu s D ~ • ~+ 7F7" (Title) G (; ~,` e . / '~, %t c~'~'~ 2 ACORD CERTIFICATE OF LIABILITY INSURANCE ° HN EA DATE (MMIDD/YY1'Y) C 3 R 06/03/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Van Wagner Group Div. Sterling HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P . O. Box 9017 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Woodbury NY 11797 Phone: 516-487-0300 Fax:516-487-0372 INSURERS AFFORDING COVERAGE NAIC# INSURED wsuRERa Ace American Ins. Co. 22667 INSURER B. Reach Employee Assistance, Inc Marcus Dayhoff wsuRERc 101 East Lincoln Ave. , Ste 230 Anaheim CA 92805- wsuRERD INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOIJIREMENT, TEP,M OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAV PERT:4'N, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICES AGGREGATE LIMITS SHOWN NAYHAVE BEEN REDUCED BY PAID GLAIMS- LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE (MM/DDIVY) DATE (MM/DDIYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 , 000 , 000 A X ~=OIdMERCIA,LGENERALLIABILITY 149446 02/17/09 02/17/10 PREMISES (Eaoccurence) $ 100,000 CL41MS MADE ~ OCCUR MED EXP (Any one perscny $ rj , OQO PERSONAL&ADVINJURY $1,000~OQO GENERAL AGGREGATE $ 3, O D 0, 0 0 0 ~cN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS -COMP/OP AGG $ 1 , 000 , 000 I X POLh;'r PRO- LOC JECT AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT $ ~ ANV AU-O (Ea accident) :4LL OWNED AUTOS BODILY INJURY SCHEGULE~ AUTOS (Per person} $ HIRED AUTOS BODILY INJURY NON-OWNEG PUTOS (Per accident) $ PROPERTY DAMAGE _ (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ~, A.NY ?.LTO OTHER THAN EA ACC $ Fi o 1V1 AUTO ONLY: AGC $ EXCESS/UMBRELLA LIABILITY ~i'g~O ~ EACH OCCURRENCE $ OCCUR ~ CLAIMS MADE ~~ ~ ! ~ ~~ AGGREGATE $ r ~~`' r $ DEDUCTIBLE ~ J[1C'LU7 ]ti Laul e I R T T n } ~tLOIII l $ 10fJ $ EtJ E t Y l WORKERS COMPENSATION AND ' - TORY LIMITS ER EMPLOYERS LIABILITY ANY PROPRfETOR/FARTNERlEXECtJTIVE E.L. EAGHACCIDENT $ OFFICERIMEMBER EXCLUDED? If d rib d E.L. DISEASE - EA EMPLOYEE $ yes, esc e un er SPECIAL PROVISIONS Gelow El. DISEASE- POLICY LIMIT $ OTHER A Professional Liab 149446 02/17/09 02/17/10 Each Occ. 1,000,000 Aggregate 3,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS /VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT I SP CIAL PROVISIONS All Client Companies are included as additional insureds but only as respects to the operations performed by the named insured. CERTIFICATE HOLDER CANCELLATION City of Santa Ana Personnel Dpt. 20 Civic Center Plaza M-34 Santa Ana CA 92702 ac~Rn ~~ r~nnirnui SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. n nnnen i+neennwTinu ~nnn CERTHOLDER COPY STATE P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 COMPENSATION IN S U R A N C E U N ~ CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 03-01-2009 GROUP: POLICY NUMBER: 1555105-2009 CERTIFICATE ID: 11 CERTIFICATE EXPIRES: 03-01-2010 03-01-2009/03-01-2010 CITY OF SANTA ANA BENEFITS DEPT 20 CIVIC CENTER PLAZA SANTA ANA CA 92702 SP 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 Hamad 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. ~~ THORIZED REPRESENTATi PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #1600 - MARCUS D DAYHOFF, PRESIDENT CEO - EXCLUDED. ENDORSEMENT #1600 - LETICIA A DAYHOFF, SECRETARY TREASURER - EXCLUDED. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 03-01-2000 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. APPRO V E AS TO FORM Laura Stitt Sheedy Assistant City Attorney EMPLOYER REACH EMPLOYEE ASSISTANCE, INC gp 101 E LINCOLN AVE STE 230 ANAHEIM CA 92805 SP M0408 IREV.2-osl - PRINTED 02-17-2009 MEMORANDUM ~Ii ~aucation 1st To: City Attorney's Office Date: March 3, 2009 From: Patricia Mayberry, Benefits & Compensation Manager Subject: Workers' Compensation Insurance Policy Agreement A-2002-208-03 Attached is the above updated insurance policy for R.E.A.C.H., the City's employee assistance program (EAP). Once approved, please forward to the Clerk's Office. Thank you. Patricia Mayb ry ,''~ N Benefits & Compensation Manager >~ 647-6932 ~ x~• c: Clerk of the Council ' ro Finance -Accounting -Connie Gee m a~ ~o ' CERTHOLDER COPY ,• . STATE P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 COMPENSATION ~ IN SUFtANCE F U N ~ CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 03-01-2009 GROUP: POLICY NUMBER: 1555105-2009 CERTIFICATE ID: 11 CERTIFICATE EXPIRES: 03-01-2010 03-01-2009/03-01-2010 CITY OF SANTA ANA SP BENEFITS DEPT 20 CIVIC CENTER PLAZA SANTA ANA CA. 92702 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. THORIZED REPRESENTATI PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #1600 - MARCUS D DAYHOFF, PRESIDENT CEO - EXCLUDED. ENDORSEMENT #1600 - LETICIA A DAYHOFF, SECRETARY TREASURER - EXCLUDED. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 03-01-2000 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. APPRO V ~ AS TO FORM Laura SLlit Sheedy Assistant City Attorney EMPLOYER REACH EMPLOYEE ASSISTANCE, INC SP 101 E LINCOLN AVE STE 230 ANAHEIM CA 92805 SP M0408 1Rev.2-o51 - PRINTED 02-17-2009 ~~R~ CERTIFICATE OF LIABILITY INSURANCE O LA HZ DATE (MM/DDIYYW( R C 3 03/11/10 HIS CERTIFICATE IS 9SUED AS A M T ER OF INF RM TION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Van Wagner Group Div. Sterling HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P . O. Box 9017 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Woodbury NY 11797 Phone: 516-487-0300 Fax:516-487-0372 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: ACE: American Ins. Co. 22667 Re h E l i INSURER B ac mp oyee Ass stance, IAC Marcus Dayhoff INSURER C: 101 East Lincoln Ave. , Ste 230 Anaheim CA 92805- INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEp 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 TFiE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE tMMlDD/YYYY) DATE (MMIDDIYYYY( LIMITS GENERAL LIABILnY EACH OCCURRENCE $ 1, OOO , OOO A X COMMERCIAL GENERAL LIABILITY 149446 02/17/10 02/17/11 PREMISES(Eao~rence) $ 100,000 CLAIMS MADE ~ OCCUR MED EXP (Any one person) $ 5 , 000 PERSONAL 6 ADV INJUf@Y $ 1 , OQQ ~ QQQ GENERAL AGGREGATE $ 3,000,000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ 1 , OO O , OOO }{ POLICY PE0. LOC AUT OMOBILE LIABILRY COMBINED SINGLELIMIT ANY AUTO IEa accident) $ ALL OWNED AUTOS O ~ ~ BODILY INJURY SCHEDULED AUTOS " ~ (Per person) $ HIRED AUTOS D1 l N URY NON-OWNED AUTOS `S~ `1 BO 8 c d n $ O i~~' ~`~ DAMAGE 4 S~ (Pe~acaden $ GARAGE LIABILITY og !'~~ AUTO ONLY - EA ACCIDENT $ ANY AUTO O ~~ EA ACC F iA N $ ' AUTO ON L Y' AGG $ EXCESS !UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ^ CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N TORY IMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE r~ OFFICER/MEMBER EXCLUDED? E.L. EACH ACCIDENT $ u (Mandatory In NH) If r es describe und E.L. DISEASE - EA EMPLOYEE $ y , e SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ A OTHER Professional Liab 149446 02/17/10 02/17/11 Each Occ. 1,000,000 Ag negate 3,000,000 DESCRIPTION OF OPERATIONS I LOCAT10N51 VEHICLES 1 EXCLUSIONS ADDED Y ENDORSEMENT f - P CIAL PROVISIONS All Client Companies are included as additional insureds but only as respects to the operations performed by the named insured. CERTIFICATE HOLDER CANCELLATION City of Santa Ana Personnel Dpt. 20 Civic Center Plaza M-34 Santa Ana CA 92702 ACORD 25 (2009101} SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR RePRESENTATIVES. AUTHORIZED REPRESENTATIVE ©1988-2009 All rlahts reserved. The ACORD name and logo are registered marks of ACORD ADDITIONAL INSUREDS) ENDORSEMENT Named Insured Endorsement Number Reach Employee 1 Assistance, Inc. Policy Symbol Policy Number Policy Period Effective Date of Endorsement AHM 149446 02/17/10 to 02/17/11 02/17/10 Issued by (Name of Insurance Company) ACE American Insurance Compan THIS ENDORSEMENT CHANGES YOUR POLICY. PLEASE READ IT CAREFULLY. It is agreed that the natural persons or organization(s) listed by name as an Additional Insured in the Schedule below shall be considered "Insured(s)" under the Who Is An Insured provision of the applicable Coverage Part(s) indicated below, but solely with respect to such Additional Insured's liability arising solely out of: if Professional Liability coverage is indicated for such Additional Insured, "healthcare professional services" performed by you or on your behalf for such Additional Insured; or 2. if General Liability coverage is indicated for such Additional Insured, "bodily injury", "property damage" or "personal or advertising injury" caused by an "occurrence" or offense that was caused solely by: i. you or your "employees" acting on your behalf; and ii. within the scope of your duties to and performed on behalf of such Additional Insured. Schedule Additional Insured: Address: Additional Premium Applicable Coverage Part ® GENERAL LIABILITY COVERAGE PART City of Santa Ana 20 Civic Center INCLUDED Personnel Dept. Plaza M-34 ®PROFESSIONAL LIABILITY COVERAGE PART ^ GENERAL LIABILITY COVERAGE PART ^ PROFESSIONAL LIABILITY COVERAGE PART ^ GENERAL LIABILITY COVERAGE PART ^ PROFESSIONAL LIABILITY COVERAGE PART ^ GENERAL LIABILITY COVERAGE PART ^ PROFESSIONAL LIABILITY COVERAGE PART All other terms, conditions and exclusions of this policy remain unchanged. Authorized Agent PF-12934d (05/07) ACE USA, Copyright 2005, 2006, 2007 Page 1 of 1 CERTHOLDER COPY P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 03-01-2010 CITY OF SANTA ANA SP BENEFITS DEPT 20 CIVIC CENTER PLAZA SANTA ANA CA 92702 GROUP: POLICY NUMBER: 1555105-2010 CERTIFICATE ID: 11 CERTIFICATE EXPIRES: 03-01-2011 03-01-2010/03-01-2011 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. THORIZED REPRESENTATI PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT k1600 - MARCUS D DAYHOFF, PRESIDENT CEO - EXCLUDED. ENDORSEMENT Jl1600 - LETICIA A DAYHOFF, SECRETARY TREASURER - EXCLUDED. ENDORSEMENT If2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 03-01-2000 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER REACH EMPLOYEE ASSISTANCE, INC SP 101 E LINCOLN AVE STE 230 ANAHEIM CA 92805 SP M0408 (REV.2-osl PRINTED 02-17-2010