HomeMy WebLinkAboutNEW MEXICO HIGHLANDS UNIVERSITY 1A - 2016City of Sant- A 7
Clerk of the t_,unvd
AGREEMENT TERMINATION FORM
COTC Office Use Only
2120 F ---
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Please complete this form when the attached agreement and all CITY Q
amendments (if any) are no longer in effect. CLERi 'ATA ANA
COUNCILOF
Return form to the Clerk of the Council Office (M-30).
Call 647-6520 if you have any questions. i
The agreement with
No. `(7�OVt5— 005 was completed on V�.J0 and final payment has been made.
(List all amendments. Use space below if needed.)
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Revised 08-23-10
Department: Li 19M.Yky
Phone/Ext.: r�
Signature:
Date:!
�, A- 2015 - 005 -01
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x FIRST AMENDMENT TO CONSULTANT AGREEMENT INCORPORATING INSTITUTE
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� W � 0 =� OF MUSEUM AND LIBRARY SERVICES LEADERSHIP GRANT REQUIREMENTS
r Ll THIS FIRST AMENDMENT TO CONSULTANT AGREEMENT INCORPORATING
cWSTITUTE OF MUSEUM AND LIBRARY SERVICES LEADERSHIP GRANT REQUIREMENTS
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jwjlgreetnent ") is made and entered into this 14rh day of March, 2016, by and between New Mexico
Highlands University (" Consultant") 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
RECITALS
A. On December 1, 2014, the City entered into Agreement #A -2015 -005 with Consultant to retain
Consultant to conduct a serious of community memory workshops throughout New Mexico in
connection with the Memories of Migration Project. These services are being funaded by a grant
received by the City from the Federal Institute of Museum and Library Services.
B. The Agreement provides for reimbursement of meal and beverage expenses and direct payment
by the City to the travel provider for travel costs.
C. The tern of the Agreement is for the period from December 1, 2014 . through September 30,
2017, and the Agreement remains in effect.
D. The parties now wish to amend the Agreement to provide for reimbursement to the Consultant
for travel costs 'instead of direct payment to the travel provider.
The Parties therefore agree:
Article 2.a., Compensation, is amended to read in its entirety:
"Consultant will receive Forty Thousand Six Hundred. Thirty One Dollars ($40,631.00) for
funds to be expended for salaries for AmeriCorp Interns and Teen Historians, and to purchase
equipment required, to collect and archive community rnemory information. The City shall also
pay reasonable travel costs (limited to transportation, airfaro and lodging, if any) for Consultant
to perform. its services pursuant to this Agreement. Travel costs shall be reimbursed in a total
amount not to exceed $3,400.44, upon receipt of proper documentation and subject to City
ac000ming procedures. Such amount shall be included in the above - stated compensation.."
1 Except as modified by this First Amendment, the terms and conditions of the Agreement
remain unchanged and in full force and effect.
IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to the
Agreement the date and year first written above.
CITY OF SANTA ANA
David, avazos
City Manager
CONSULTANT
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Namen �f„j " A ,a Title:
Page
Page oft
ATTEST
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Maria D. Huizar
Clerk of Council
APPROVED AS TO FORM
J M. Funk
Assistant City Attorney
Pale 2 of 2
EVIDENCE OF COVERAGE
MEMORANDUM NUMBER:RMD- EOC -FY16 (0130)
This Evidence of Coverage is used as a matter of information only and confers no rights upon the Certificate Holder. This Evidence
of Coverage does not amend, extend, or alter the coverage afforded by the Tort Claims Act or the referenced insurance potic(ies) for the type(s)
of coverage listed below.
CERTIFICATE HOLDER INFORMATION
INSURED: STATE OF NEW MEXICO LOSS PAYEE: TO WHOM IT MAY CONCERN
and
NEW MEXICO HIGHLANDS UNIVERSITY
(AGENCY CODE U5700)
Coverage Period:
12:01 AM 7/1/2015 to 12:01 AM 6/30/2016
This is to certify that the Insured has the coverage's listed below for the period indicated. Notwithstanding any requirement, term
or condition of any contract or other document with respect to which this Evidence of Coverage may be used or may pertain, the
coverage's indicated in this Evidence of Coverage are subject to all terms, exclusions, and conditions of the Certificates of Coverage
and other insurance policy(s) to which this Evidence of Coverage pertains. Property and Liability Certificates of Coverage may be
obtained at: http: / /www.gencralservices. state. nm. us / riskmanagement /certiricatessuretybonds.aspx
Type of Coverage
Limit of Liability /Coverage
A) Liability 6`0$15,000,01
.00 Aggregate Limit
i. General Liability syQ
ii. Automobile Liability 2�\�
iii. Law Enforcement
iv. Civil Rights
B) Workers Compensation ....................... \>lv
utory Limit
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C) Property .................. ...............................
$550,000,000.00 Limit
i. Auto Physical Damage .......... ...............................
Actual Cash Value (ACV)
Boiler & Machinery ..... ...............................
$100,000,000.00 Limit
Fine Arts ................. ...............................
$300,000,000.00
Per 66 -5 -207, NMSA 1978, - A motor vehicle owned by the United States Government, any state, or political subdivision of
the state, is exempt from the Mandatory Financial Responsibility Act.
Per 66- 6- 15(E), NNISA 1978, - A vehicle or trailer owned by and used in the service of the State of New Mexico or any county
or municipality thereof need not be registered but must continually display plates furnished by the Transportation Services
Division of the General Services Department.
Should any of the above coverage's for the Covered Party be changed or withdrawn prior to the expiration date issued above, the State
of New Mexico will notify the Certificate Holder, but failure of such notification shall impose no obligation or liability of any kind
upon the State of New Mexico, its agents, or representatives, If you have any questions, contact:
Authorized Representative:
Date Issued:
6 -30 -2015
A.J. Forte, Director, Risk Management Division , GSD
SUSANA MARTINEZ
GOVERNOR
ED BURCKLE
CABINET SECRETARY
AJ FORTE
DIRECTOR
RISK MANAGEMENT
TO:
,�Y'E STgT�
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State of New Mexico
General Services Department
Letter of Administration
Issuing Certificates of Coverage
Fiscal Year 2016 Beginning July 1, 2015
ADMINISTMTIVE SERVICES DIVISION
(505) 827 -200D
FACILITIES MANAGEMENT DIVISION
)827 -2141
STATE PURCHASING DIVISION
(505) 827 -0472
RISK MANAGEMENT DIVISION
(505) 827 -0442
STATE PRINTING & GRAPHIC SERVICES BUREAU
(SOS) 476 -1950
TRANSPORTATION SERVICES DIVISION
(505) 827 -1958
All Public Entities Covered by the Risk Management Division under the
Tort Claims Act and the Insurance on Public Buildings Act
FROM: A.J. Forte, Director
Risk Management Division (RMD) e(j��
State of New Mexico, General Services Department (GSD) �e FNe� LL)
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SUBJECT: Letter of Administration Issuing Certificates of Coverage
Description of and Type, Extent and Nature of
aa,
RMD Administered Insurance and Self Insurance Programs�`A
PLEASE TAKE NOTICE:
As authorized by Rule 1.6.5.8 of the New Mexico Administrative Code ( "Certificates of
Coverage "), this Letter of Administration issues the Property and Liability Certificates of
Coverage. The type, extent, and nature of the coverages extended under these Certificates of
Coverage are set out in Rule 1.6.5 of the New Mexico Administrative Code, which is fully
incorporated herein by reference.
The Certificates of Coverage provide property and liability coverage to the extent required by the
Insurance on Public Buildings Act (NMSA 1978, § 19 -5 -1 et seq.) and the New Mexico Tort
Claims Act (NMSA 1978, § 41 -4 -1 et seq.). These Certificates of Coverage supersede and
replace any and all prior certificates of coverage. The Certificates of Coverage are effective as
of July 1, 2015.
If any legal documents relating to a claim are presented to or served upon your agency or
university, E -Mail to pae.claimsTi'state.nmms or fax to (505) 827 -2969 IMMEDIATELY to
the attention of RMD's Property and Casualty Bureau. RMD will notify you as to
availability of coverage and provide any special instructions.
I
I. NEW MEXICO TORT CLAIMS ACT MAXIMUM LIMITS (General Liability)
Medical and Medically-Related Expense Per Occurrence $300,000.00
Bodily Injury Each Person (excludes medical expenses) $400,000.00
Bodily InjuKy Each Occurrence (excludes medical expenses) $750,000.00
Property Damage Per Occurrence $200,000.00
IL APPLICABLE DEDUCTIBLES (Per Occurrence)
Property Real (Buildings) and Personal (Contents) $2500.00
Theft (All Property and Vehicles ) $5000.00
Personal Property of Others In Your Care $2500.00
Vehicles Owned, Hired, and Non -Owned $2500.00
Fine Arts $50,000.00
Boiler Mechanical Breakdown) $2500.00
As to the State of New Mexico Property Certificate of Coverage, specifically described
coverages, exclusions, and dispute processes contained therein are the following: purpose
and nature of the certificate, property covered, perils covered, coverage limits and
deductibles, extensions of coverage, property excluded, perils excluded, valuation,
payments to loss payee, duties of the governmental entity after a loss, coverage dispute,
valuation dispute, other coverages, subrogation, and other conditions. If applicable the
Property Certificate of Coverage also contains terms of: business interruption extra
expense, tuition fees, and fine arts coverage. The exact terms and conditions of coverage
are fully described in complete detail in the State of New Mexico Property Certificate of
Coverage and those terms and conditions are controlling.
Specifically described coverages, exclusions, and dispute processes contained in the State of
New Mexico Liability Certificate of Coverage are the following: purpose and nature of the
certificate, coverage defined, covered party, exclusions, conditions, and definitions (used in
the certificate). The exact terms and conditions of coverage are fully described in complete
detail in the State of New Mexico Liability Certificate of Coverage and those terms and
conditions are controlling.
Administrative FY16
a,� C
This is an overview only of coverages. Refer to the Certificate of Coverage(s) for detailed
terms and conditions.
A. AIRCRAFT / DRONES
RMD has secured aircraft policies for those agencies which have an exposure. This
policy covers liability, medical, airfields /landing strips, and hull coverages. Aircraft
traveling to Mexico must be pre - insured by the State before entering into Mexican
airspace. RMD must be notified thirty days before the proposed trip.
B. AUTOMOBLIE
1. State Owned Vehicles
Coverage includes all State Agencies and Universities up to the limits required by
the Tort Claims Act. In order to drive any licensed motor vehicle, an employee must
be in compliance with state motor vehicle laws i.e., being licensed to drive in the
State of New Mexico and being able to show financial responsibility (by having
vehicle insurance as shown by a current and valid Evidence of Coverage) certificate
issued by RMD. In addition, the employee must be in compliance with the State
Motor Vehicle GSD rule 90 -202 (or its successor) if applicable and any other
additional requirements of the employer, if any.
2. Employee Vehicles
The State will provide secondary coverage up to the Tort Claims limit as described
in the New Mexico Tort Claims Act but this will be excess of the employees' own
vehicle coverage. The employee's personal automobile liability, collision and
comprehensive policies are primary, including applicable deductibles to be paid by
the employee. The State will only provide secondary coverage for remaining
financial exposure, if any, up to the Tort Claims limit. RMD recommends agency
confirms employee vehicle liability insurance.
In the case of physical damage to an employee vehicle, the only claims to be
submitted to RMD are losses exceeding the agency's vehicle deductible. Please
submit documentation from the employee's supervisor certifying the employee was
in the course and scope of duties at the time of the accident /incident. The agency
will be responsible for the applicable deductible.
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Administrative FY16
Rental Cars
Liability coverage for rental vehicles is self - insured paid out of the Public Liability
Fund administered by RMD. The State will provide coverage where the State or
employee is responsible due to the Tort Claims Act and when the State is legally
responsible. Physical damage for rental cars is covered under the Property
Certificate of Coverage, subject to the applicable vehicle deductible.
4. Automobile — Uninsured, Underinsured, and Medical
RMD does not provide uninsured, underinsured or medical payments coverage.
5. Automobile liability Coverage (Mexico)
This coverage is provided through a Mexican Auto Insurance Policy purchased by
RMD to provide coverage for agencies and universities traveling into Mexico via
automobile on authorized state business. Automobile travel into Mexico must be
reported to Risk Management prior to the trip. A maximum of eight vehicles at one
time is allowed. Proof of insurance is required by requesting an "Evidence of
Coverage" certificate from the Risk Management Property & Casualty Bureau.
Claims made when no `Evidence of Coverage" certificate has been issued will be
DENIED.
C. GENERAL LIABILITY
Coverage is provided through a combination of self - insurance under the Public
Liability Fund administered by RMD and insurance policies purchased by RMD for
all State Agencies and Universities tip to the limits of the Tort Claims Act (NMSA
1978, § 41 -4 -1 et seq.).
D. MEDICAL MALPRACTICE LIABILITY
This coverage relates to all authorized medical exposures whether hospital, clinic,
infirmary, emergency medical services (including ambulance operations and
treatment provided by emergency medical technicians) or doctors, nurses, dentists,
pharmacists, technicians or other Medical Professionals.
E. LAW ENFORCEMENT OFFICERS' LIABILITY
This covers exposures relating to police, jailers, matrons, etc. for negligent acts in
the course and scope of employment.
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Administrative FY16
F. FOREIGN JURISDICTION EXCESS LIABILITY
RMD carries excess liability coverage for claims arising out of occurrences in
foreign jurisdictions that would not come under New Mexico's Tort Claims Act
such as claims for accidents that happen in other states or countries.
G. CIVIL RIGHTS LIABILITY COVERAGE
This coverage does not include defense of criminal proceedings or payment of any
type of lost wages, salaries or legal fees as damages or settlements.
H. PROPERTY COVERAGE — Subject to applicable deductible and exclusions
1. Basic Coverage
This covers State owned buildings, State owned contents, State owned
miscellaneous items, and property of others in your care subject to the Insurance
on Public Buildings Act, (NMSA 1978, § 19 -5 -1 et seq.), NOTE: RMD must be
notified in writing of any new or newly acquired buildings to affect coverage. In
addition, RMD must be informed of any buildings that have been vacated,
demolished or disposed o£ Buildings vacant for more than six months are not
insured by our excess property insurance carriers.
2. Buildings Under Construction Coverage
RMD must be notified of any new construction of State owned buildings in
excess of $500,000 prior to the initiation date of the contract.
3. Fine Arts
This covers paintings, etching, drawings, (including their frames, glasses, and
shadow boxes), rare books, manuscripts, rugs, tapestries, statuary and other
verified works of art or rarity of historic value or artistic merit. This coverage is
insured through insurance policies purchased by RMD. This standalone coverage
is subject to a $50,000.00 deductible and is not covered by Public Property
Reserve Fund.
4. Boiler (mechanical breakdown)
Boilers are covered tinder a combination of self- insurance under the Public
Property Reserve Fund administered by RMD and boiler insurance policies
purchased by RMD. Our arrangements with the boiler insurance policy
underwriters require the insuring company to make boiler inspections at all
insured locations.
Administrative FY16 lV6
I. SURETY BONDS
The State provides coverage for all State agencies and their employees for bonded losses
up to $500,000.00, subject to the applicable deductible. This coverage is self - insured
through RMD and sloes not include employee theft or mysterious disappearance of
agency personal property.
J. HEALTH CARE STUDENT COVERAGE
RMD extends coverage under the Public Liability Fund for health care liability to
students currently enrolled in a health care instruction program through a governmental
entity.
K. COVERED COMMUNITY LAND GRANTS and SPECIAL DISTRICTS
Coverage for Community Land Grants and Special Districts is contingent upon
prompt payment of the premium assessment determined by the Director of the
Risk Management Division.
a. Community Land Grants: The General Services Department, Risk
Management Division is authorized under Section 41 -4 -30 of the Tort
Claims Act to issue a Certificate of Coverage to community land grants
that are governed as a political subdivision of the State of New Mexico
pursuant to 1978 NMSA, Chapter 49, Article 1. Coverage is extended
per the terms and conditions of NMAC 1.6.6.1 et. seq.
b. Special Districts: Special Districts organized pursuant to NMSA § 73 -2-
1 et.seq.; § 73 -9 -1 et.seq.;and § 73 -20 -1 et.seq, may apply to RMD for
coverage as provided by enabling statutes.
L. ADDITIONAL INSURED
RMD will not identify anyone or any business as an additional insured or will RMD
indemnify, hold harmless, or defend any 3`d party individual or business under RMD
coverages.
M. EVIDENCE OF COVERAGE
Upon written request, RMD will issue an Evidence of Coverage certificate to any State
Agency to show proof of insurance for liability and /or property coverage.
N. CLAIMS (How to file)
General Liability, Auto Liability, Property Coverage, Civil Rights, Medical Malpractice,
Law Enforcement Officers Liability, Fine Arts, AirWO'Boiler, E -Mail to:
pae. cla imsr'sta tem m.0 s vlAe�
Administrative FY16 j \ar