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HomeMy WebLinkAboutBENTON, BETSY 4 -2013INSURANCE ON FILE WORK MAY PROCEEo N- 2013 -023 UN1'R, INSURANCE EXPIRES CLERK OF COUNCIL PROFESSIONAL SERVICES AGREEMENT DATE R 1 0 2013 0. KA (2y THIS AGREEMENT made and entered into this ` day of Z' 20A by and between Betsy Benton (hereinafter "Contractor "), and the City of S nta Ana, a charter city 72Cand municipal corporation organized and existing under the Constitution and laws of the State of er California (hereinafter "City "). RECITALS A. The City desires to retain a Contractor having special skill and knowledge in the field of arbitration and mediation to provide professional administrative hearing services. B. Contractor represents that Contractor is able and willing to provide such services to the City. C. In undertaking the performance of this Agreement, Contractor represents that she is knowledgeable in the field and that any services performed by Contractor render 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: SCOPE OF SERVICES Contractor will provide professional Administrative Hearing services for the City of Santa. Ana Community Preservation Department and Public Works Department, as set forth Exhibit A. Said hearings may include Vehicle Abatement, Administrative Citation Appeals, and Alternative Public Nuisance Abatement. Administrative Hearing officer services may be utilized by other agencies within the City of Santa Ana. 2. COMPENSATION a. City agrees to pay, and Contractor agrees to accept as total payment for its services, the rates and charges identified in Exhibit A. The total sum to be expended for Administrative Hearing Services provided by all contracted Hearing Officers shall not exceed $10,000.00 during the term of this Agreement. b. Payment by City shall be made within thirty (30) 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 commence on January 1, 2013 and terminate on December 31, 2013, unless terminated earlier in accordance with Section 12, below. 'The term of this Agreement may be extended upon a writing executed by the Executive Director of the Planning and Building Agency, the Executive Director of the Public Works Agency and the City Attorney and Contractor. 4. INDEPENDENT CONTRACTOR Contractor 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 Contractor performs the services which are the subject matter of this Agreement; however, the services to be provided by Contractor shall be provided in a manner consistent with all applicable standards and regulations governing such services. Contractor shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 5. INSURANCE Prior to undertaking performance of work under this Agreement, Contractor shall maintain and shall require its subcontractors, if any, to obtain and maintain: a. Worker's Compensation Insurance. In accordance with the provisions of Section 3300 of the Labor Code, Contractor, if Contractor has any employees, Contractor 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, Contractor agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. b. Professional liability (errors and omissions) insurance, with a combined single limit of not less than $1,000,000 per claim. c. The following requirements apply to the insurance to be provided by Contractor pursuant to this section: (i) Contractor 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 in form by the City Attorney. (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. 6. INDEMNIFICATION Contractor agrees to and shall indemnify and hold harmless the City, its officers, agents, employees, consultants, special counsel, and representatives from liability for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including health, and claims for property damage, which may arise from the operations of the Contractor or its contractors, subcontractors, agents, employees, or other persons acting on their behalf which relates to the provision of services described in Section 1 of this Agreement. CONFIDENTIALITY If Contractor receives from the City information which due to the nature of such information is reasonably understood to be confidential and /or proprietary, Contractor 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 Contractor disclosed in a publicly available source; (c) is in rightful possession of the Contractor without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Contractor without reference to information disclosed by the City. S. CONFLICT OF INTEREST CLAUSE Contractor 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. 9. 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 telefacsimile or other telegraphic communication in the manner provided in this Section, to the following persons: To City: Clerk of the Council City of Santa Ana 20 Civic Center Plaza (M -30) P.O. Box 1988 Santa Ana, CA 92702 -1988 telefacsimile (714) 647 -6956 With courtesy copies to: and Executive Director of Planning and Building City of Santa Ana 20 Civic Center Plaza (M -20) P.O. Box 1988 Santa Ana, California 92702 telefacsimile (714) 973 -1461 City Attorney City of Santa Ana 20 Civic Center Plaza (M -29) P.O. Box 1988 Santa Ana, California 92702 telefacsimile (714) 647 -6515 To Contractor: Betsy Benton 2750 Artesia Blvd. 4465 Redondo Beach, CA 90278 A party may change its address by giving notice in writing to the other party. 'Thereafter, any communication shall be addressed and transmitted to the new address. If sent by mail, communication shall be effective or deemed to have been given three (3) days after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed as set forth above. If sent by telefacsimile, 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 time frames, weekends, federal, state, County or City holidays shall be excluded. 10. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Contractor, 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 Contractor. 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 Contractor nor 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 partywhich are not embodied herein. 11. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Contractor, Contractor 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 contractors retained by City. 12. TERMINATION This Agreement may be terminated by either party upon thirty (30) days written notice of termination. In such event, Contractor shall be entitled to receive and the City shall pay Contractor compensation for all services performed by Contractor 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 Contractor to deliver to the City written Findings and Determination for any case in which Contractor has served as a hearing officer, and in such case such Findings and Determination shall be the property of the City unless prohibited by law, and Contractor consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work which fails to meet the standard of performance specified in the Recitals of this Agreement. 13. DISCRIMINATION Contractor 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. Contractor affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 14. JURISDICTION - VENUE This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 15. PROFESSIONAL LICENSES Contractor shall, throughout the term of this Agreement, maintain all necessary licenses, permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States, the State of California, the City of Santa Ana and all other governmental agencies. Contractor shall notify. the City immediately and in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. 16. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature hereinbelow 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. // IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: MARIA D. HUIZAR Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City Altft'�x () By: r Ryan ffo( Assistant RECOMMENDED FOR APPROVAL: Q(i�� J Y M. TREVINO Executive Director Planning & Building Agency RAUL GODINEZ II P. . Executive Director Public Works Agency CITY F S A ANA K Vin-O'Rourke Interim City Manager CONTRACTOR I��GII�I117_1 SCOPE OF SERVICES I. Background In order to provide effective and expeditious hearings to individuals cited for violation of the Santa Ana Municipal Code, the City would like to develop a list of Hearing Officers to conduct administrative hearings regarding alleged violations of the City's Municipal Code. In an effort to streamline the hearing process, the City proposes to establish a list of qualified hearing officers than can be assigned as needed on a rotating basis. Contractor shall conduct Administrative Hearings for the City of Santa Ana. Primarily the Contractor will hear administrative citation appeals, alternative nuisance abatement proceedings and vehicle abatement proceedings associated with action of the City's Planning and Building Agency. Contractor may be asked to provide administrative hearings for other City Agencies. The Hearing Officer will be charged with making a just determination as to whether a municipal code was violated, whether the property owner is still in violation, and will also make determinations as to whether the process for the abatement of a nuisance, including inoperative vehicles, will move forward. Hearings will be held in accordance with the City of Santa Ana Municipal Code sections 1- 21.8, 16 -119, 17 -105, 17 -108, and 17 -135. II. General Information It is the intent of the City to establish a list of qualified Hearing Officers. The actual number of hearing officers to be utilized will depend on the total number of qualified candidates established by the proposal process, and the number of hearings to be provided. A. When appropriate, the City will provide forms and information in its possession relevant to the conduct of a fair hearing, including but not limited to Notices of Violation, Administrative Citations, and Vehicle Abatement Notices. B. The Hearing Officer shall be responsible for the review of documents provided by the City prior to the hearing. C. All documents and other products used or developed during preparation for a hearing will become the property of the City. • Contractor shall preside over the City's administrative hearings. Contractor will be required to independently evaluate the facts of each case and make a determination as to the merits of that case based upon the information presented at the hearing and the Santa Ana Municipal Code. The Hearing Officer must be experienced and knowledgeable in administrative hearing procedures. The Hearing Officer shall be responsive and maintain excellent working relationships with property owners, residents, business representatives, and City staff. Contractor's service will include preparation of finding of facts, hearing dispositions, billing statements, and other documents as necessary. Job Requirements for Administrative Hearing Officers A. A hearing officer must be independent and impartial. In this regard, a hearing officer may not: 1. Be an employee of the City of Santa Ana or any public agency that is involved in testifying at a hearing; be a member of any board of commission of the City of Santa Ana; 2. Have a personal or professional interest that would conflict with his or her objectivity in the hearing; B. All hearings will be conducted at Santa Ana City Hall, at dates and times to be determined by the City. C. A hearing officer must possess the necessary support and equipment to perform his /her duties as a hearing officer. At a minimum, the hearing officer must have and maintain in good working order (1) a telephone (monitored during business hours by a secretary, answering service or answering machine or system); (2) a facsimile machine; (3) a personal computer, with internet service, running Windows and Microsoft Office compatible software; and (4) an electronic mail address. D. A hearing officer must possess standards of neutrality and confidentiality. E. A hearing officer must organize and maintain individual case files along with detailed records of activity on each case, such as research, drafting of orders, decisions, and correspondence. F. A hearing officer must comply with all legal and contractual timelines, including but not limited to: 1. Rendering a final written decision, including findings of fact disposing of all issues raised by the parties in a hearing not later than the 10`h day following the date of the hearing; 2. Mailing the final written decision to the appellant, with a copy to the City, on the date the decision is rendered; 3. Returning individual case files to the City within 30 days of rendering a final decision. The files which must be organized and maintained by the hearing officer are the property of the City of Santa Ana and must be maintained in accordance with the Agency's record retention schedule. It is therefore imperative that the files are returned to the Agency within 30 days of the date of the issuance of the final decision. 4. Upon notification that the agency has received a request for a document pursuant to the public information act, the relevant document must be provided to the City immediately. G. The hearing officer shall prepare and submit to the Planning and Building Agency by the fifth of each month a standard invoice detailing the activities and expenses by case. An invoice template will be provided. Payment for services and reimbursement of expenses by the City to the hearing officer are further conditioned upon: 1. The reasonableness of the amount of time spent by the hearing officer on the case(s) for which the hearing officer is seeking payment /reimbursement; 2. The hearing officer's timely submission of reasonable and acceptable documentation supporting all expenses being claimed by the hearing officer; and 3. The hearing officer's prompt return to the City of all file materials relating to closed cases, 4. Contractor's services will be billed to the nearest quarter hour. H. Providing hearing officer services to other clients is not barred so long as the hearing officer does not decline the request for hearing services more than two consecutive times; specifically, the hearing officer must: 1. Maintain the ability to respond to requests for hearings and prehearing motions within 24 hours; 2. Meet all applicable time lines; and 3. Demonstrate that such outside practice does not conflict with contractual work with the City of Santa Ana. I. Comply with the decision format requirements set by the City pursuant to the rules governing a hearing officer's decision as per SAMC 1 -21.8, 16 -119, 17 -105, 17 -108, and 17 -135. The decisions of the hearing officer must include formal findings of fact, and meet in all respects the minimum requirements applicable to the decisions of executive agencies conducting contested cases. J. There is no guarantee as to the number of cases that will be assigned to a hearing officer. The City anticipates that it will establish a list of qualified hearing officers and assign hearings all on a given date based on a rotation of the names on the list. COMPENSATION City agrees to pay and Contractor agrees to accept as total compensation for all services and costs, a rate of $100.00 per hour, to the nearest quarter hour, for all hearing officer services provided to City. Said services include review of the materials provided by City, holding of the hearing and providing findings and determination. City will not pay costs associated with providing hearings including City validating parking receipts for the time that hearing officer is performing services for City and travel time to and from the hearing site. AC"R®® CERTIFICATE OF LIABILITY INSURANCE lzj2(4 %ZO12) 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 pollcy(les) must 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 COMPLETE EQUITY MARKETS INC 1190 Flex Court Lake Zurich, IL 60047 CONTACT NAME: a"ENO ExI: (847) 541 -0900 FAX A/C, Ne,(847)541 -0444 E-MAI ADDRESS.� INSURERI6) AFFORDING COVERAGE NAICp INSURER A: Underwriters at Lloyds London INSURED Betsy Benton INSURER B: INSURER C' 2750 Artesia Boulevard #465 INSURER D: Redondo Beach, CA 90278 INSURERE - 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 I�TR TYPE OF INSURANCE AINSR IWO POLICY NUMBER MMIDD;Ym 901D/YYY'I LIMITS GENERAL LIABILITY EACH OCCURRENCE $ PREMISES BE occurrence $ COMMERCIAL GENERAL LIABILITY CLAIMS -MACE CI OCCUR MEDEXP(Anyonepea.n) $ PERSONAL &ADV INJURY $ GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER: POLICY PRo LOC PRODUCTS - COMPIOP AGG $ P R E TO FM M IS AUTOMOBILE LIABILITY O B NE SINGLE LIMIT (Ed $ BODILY INJURY (Per person) $ ANYAUTO� ALL OWNED SCHEDULED AUTOS AUTOS ( q (7 BODILY INJURY (Pereccitlznq $ .NON -OWNED HIRED AUTOS AUTOS ■ YA M YaM ps�acoldarnlDAMAGE 5 -- UMBRELLA LIAB _ OCCUR 1 EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE /1 LED RETENTIONS I $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERVE%ECUTIVE ❑ OFFICER/MEMBER EXCLUDED] NIA _ WC STATU- OTH- TORY LIMITS ER E. L. EACHACCIDENT $ E.L, DISEASE - EA EMPLOYEE S IManddIII, in NR If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMB S $1,000,000 Each Claim A Professional 716120 01/01/1301/01/14 $1,000,000 Aggregate Liability DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Ailanh ACORD 101, Atltlilionel Remarks Schodd., If more space is required) Please see pages 2 -4 for additional information. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. For Informational Purposes OnlyP AUTHORIZED REPRESENTATIVE���Y,r���//��,,,�, ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD25(2010 /05) The ACORD name and logo are registered marks of ACORD 2 Certificate of Insurance BETSY BENTON Policy Number: 716120 Subject to all policy terms conditions, exclusions and endorsements SURPLUS LINES NOTICE TO POLICYHOLDER - PLEASE SEE ATTACHED i �i A i i Lawrence T.P. Molloy binder5'138 NOTICE: 1. THE INSURANCE POLICY THAT YOU HAVE PURCHASED IS BEING ISSUED BY AN INSURER THAT IS NOT LICENSED BY THE STATE OF CALIFORNIA. THESE COMPANIES ARE CALLED " NONADMITTED" OR "SURPLUS LINE" INSURERS. 2. THE INSURER IS NOT SUBJECT TO THE FINANCIAL SOLVENCY REGULATION AND ENFORCEMENT THAT APPLY TO CALIFORNIA LICENSED INSURERS. 3. THE INSURER DOES NOT PARTICIPATE IN ANY OF THE INSURANCE GUARANTEE FUNDS CREATED BY CALIFORNIA LAW. THEREFORE, THESE FUNDS WILL NOT PAY YOUR CLAIMS OR PROTECT YOUR ASSETS IF THE INSURER BECOMES INSOLVENT AND IS UNABLE TO MAKE PAYMENTS AS PROMISED. 4. THE INSURER SHOULD BE LICENSED EITHER AS A FOREIGN INSURER IN ANOTHER STATE IN THE UNITED STATES OR AS A NON - UNITED STATES (ALIEN) INSURER. YOU SHOULD ASK QUESTIONS OF YOUR INSURANCE AGENT, BROKER, OR "SURPLUS LINE" BROKER OR CONTACT THE CALIFORNIA DEPARTMENT OF INSURANCE AT THE FOLLOWING TOLL -FREE TELEPHONE NUMBER: 1- 800 -927 -4357. ASK WHETHER OR NOT THE INSURER IS LICENSED AS A FOREIGN OR NON - UNITED STATES (ALIEN) INSURER AND FOR ADDITIONAL INFORMATION ABOUT THE INSURER. YOU MAY ALSO CONTACT THE NAIL'S INTERNET WEB SITE AT WWW.NAIC.ORG. 5. FOREIGN INSURERS SHOULD BE LICENSED BY A STATE IN THE UNITED STATES AND YOU MAY CONTACT THAT STATE'S DEPARTMENT OF INSURANCE TO OBTAIN MORE INFORMATION ABOUT THAT INSURER. 6. FOR NON- UNITED STATES (ALIEN) INSURERS, THE INSURER SHOULD BE LICENSED BY A COUNTRY OUTSIDE OF THE UNITED STATES AND SHOULD BE ON THE NAIC'S INTERNATIONAL INSURERS DEPARTMENT QID) LISTING OF APPROVED NONADMITTED NON - UNITED STATES INSURERS. ASK YOUR AGENT, BROKER OR "SURPLUS LINE" BROKER TO OBTAIN MORE INFORMATION ABOUT THAT INSURER. binders'138 7. CALIFORNIA MAINTAINS A LIST OF APPROVED SURPLUS LINE INSURERS. ASK YOUR AGENT OR BROKER IF THE INSURER IS ON THAT LIST, OR VIEW THAT LIST AT THE INTERNET WEB SITE OF THE CALIFORNIA DEPARTMENT OF INSURANCE: WWW.INSURANCE.CA.GOV. 8. IF YOU, AS THE APPLICANT, REQUIRED THAT THE INSURANCE POLICY YOU HAVE PURCHASED BE BOUND IMMEDIATELY, EITHER BECAUSE EXISTING COVERAGE WAS GOING TO LAPSE WITHIN TWO BUSINESS DAYS OR BECAUSE YOU WERE REQUIRED TO HAVE COVERAGE WITHIN TWO BUSINESS DAYS, AND YOU DID NOT RECEIVE THIS DISCLOSURE FORM AND A REQUEST FOR YOUR SIGNATURE UNTIL AFTER COVERAGE BECAME EFFECTIVE, YOU HAVE THE RIGHT TO CANCEL THIS POLICY WITHIN FIVE DAYS OF RECEIVING THIS DISCLOSURE. IF YOU CANCEL COVERAGE, THE PREMIUM WILL BE PRORATED AND ANY BROKER'S FEE CHARGED FOR THIS INSURANCE WILL BE RETURNED TO YOU. D -2 (Effective July 21, 2011) binders -138 ENDORSEMENT NO.: 853228 TRANSACTION NO.: N/A PREVIOUS ENDORSEMENT NO.: 716120 AUTHORIZATION NO.: (UMR) B1294CP103613 CUSTOMER NO.: 10021992 Endorsement to Master Certificate No. CEM 14 -13 DECLARATIONS ARBITRATORS, HEARING OFFICERS AND MEDIATORS PROFESSIONAL LIABILITY INSURANCE issued to the NATIONAL ASSOCIATION OF SALARIED PROFESSIONALS PURCHASING GROUP, INC. and SPECIFIED MEMBERS EVIDENCE OF INSURANCE affected with certain UNDERWRITERS AT LLOYD'S, LONDON PARTICIPATION HEREON: 100% ..- - - - - -- Specified BETSY BENTON Member 2750 Artesia Boulevard #465 Redondo Beach CA 90278 LIMITS OF LIABILITY: Coverage A - Professional Liability and Personal Injury Coverage Each claim: $110001000,00 Aggregate: $1,000,0)0,00 Coverage B - Defense Cost Coverage Each claim: $1,000,000.00 Aggregate: $1,000,000,00 Aggregate Limit of Liability Maximum insurance available for Coverages A and B combined $2,000,000.00 Deductible - each claim including Cost of Defense: $1,000.00 Retroactive Date: NONE PREMIUM (Including endorsements): $468.00 pp VE AS TO FORM Purchasing Group Tax for CA @ 3% $14.04 � I R N .HODGE TOTAL LLOYD'S PREMIUM (Including Texas): $482.04 ---ass istant itv Atternev PERIOD OF INSURANCE: From January 1, 201412:01 a.m. to January 1, 201512:01 a.m., at the Specified Member's address, above. Special Conditions: See attached Summary page In consideration of the premium paid and in reliance upon the statements in the application attached hereto, the above specified member is an Assured under the Master Certificate ( "Cartificate'9 issued to the National Association of Salaried Professionals Purchasing Group, Inc. of Illinois by Underwriters at Lloyd's, London (not incorporated) for the Period of Insurance and Limits of Liability specified above. All other terms, conditions, and exclusions rs the of Certificate are unchanged. This certifies that the attached Cortificate is a true copy of the original document issued to the Association, which is hereby issued to the Specified Member. Dated: December 16, 2013 LII 14.1 Dec (01113) medforms*g66 (PO) FILE COPY UNDERWRITERS AT LLOYD'S, LONDON Complete Equity Markets, Inc. dba Complete Equity Markets Insurance Agency, Inc. (CASL#OD44077) By Lawrence T.P. Molloy