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HomeMy WebLinkAboutStaff Report 3.BM CITY OF PETALUMA, CALIFORNIA November 5. 2007 AGENDA BILL Agenda Title: Meeting Date: Resolution Authorizing the City Manager to Sign an Agreement with November 5 2007 Wittman Enterprises LLC to Provide Billing Services for Ambulance and Emergency Response Services Meeting Time: ® 3:00 PM ❑ 7:00 PM Category: ❑ Presentation ® Consent Calendar ❑ Public Hearing ❑ Unfinished Business ❑ New Business Department: irec Contut Perso Phone Number: Fire Department hris n C"Si/A e 707-778-4492 Cost of Proposal: Account Number: Not to Exceed $400,000 over 3 years 5199-54111 Amount Budgeted: Name of Fund: $400,000 Ambulance Fund Attachments to Agenda Packet Item: Resolution Professional Services Agreement Certificate of Insurance Summary Statement: Wittman,EnterprisesLLC began providing billing services to the City for the ambulance activity July 8, 2003 pursuant to a one-year contract. On June 30, 2004, a 3 year addendum was signed. The proposed new agreement is at a rate of 6% of collections, minus refunds. The previous 3 year contract rate was 6.3%. Staff is recommending that the newly negotiated contract be approved for a period of 3 years with a rate not to exceed $400,000 during the period of the contract. Recommended City Council Action/Suggested Motion: Approve resolution authorizing City Manager to enter into a new agreement with Wittman Enterprises, LLC. Reviewed by Admin. Svcs. Dir: Reviewed by City Attorney: Approved biA MyManager: OY Date: a ccs Date: Date: Rev. # Date Last Revised: Filers:/agenda/11/19/07 Wittman CITY OF PETALUMA, CALIFORNIA NOVEMBER 5, 2007 AGENDA REPORT FOR Resolution Authorizing the City Manager to Sign an Agreement with Wittman Enterprises LLC to Provide Billing Services for Ambulance and Emergency Response Services 1. EXECUTIVE SUMMARY: Wittman Enterprises LLC began providing billing services to the City for the ambulance activity July 8, 2003 pursuant to a one-year contract. On June 30, 2004, a 3 year addendum was signed. The proposed new agreement is at a rate of 6% of collections, minus refunds. The previous 3 year contract rate was 6.3%. Staff is recommending that the newly negotiated contract be approved for a period of 3 years with a rate not to exceed $400,000 during the period of the contract. 2. BACKGROUND: When the 3 year addendum was signed to extend the original contract dated July 8, 2003, it was determined that Wittman Enterprises, LLC was the most cost-effective contractor. Staff continues to believe that the contractor will continue to provide the required service. Staff also negotiated the new contract to be at a rate of 6% of collections, minus refunds, which is less than the previous rate of 6.3%. 3. ALTERNATIVES: Re -bid the contract, or return the collection function in-house. 4. FINANCIAL IMPACTS: Billing services are paid out of the Ambulance fund and are contingent on the amount collected. The new contract amount will not exceed $400,000 total for the 3 year period. 5. CONCLUSION: The City should enter into a new contract with Wittman Enterprises, LLC. 6. OUTCOMES OR PERFORMANCE MEASUREMENTS THAT WILL IDENTIFY SUCCESS OR COMPLETION' Continuous Ambulance service billing through FY 2010. %. RECOMMENDATION: Approve resolution. S:/agenda/I1-19-07 Wittman RESOLUTION AUTHORIZING THE CITY MANAGER TO SIGN AN AGREEMENT WITH WITTMAN ENTERPRISES LLC TO PROVIDE BILLING SERVICES FOR AMBULANCE AND EMERGENCY RESPONSE SERVICES WHEREAS, the Administrative Services Department, in conjunction with the Fire Department, has previously determined that it would be cost effective for the City to contract out the task of Ambulance service billings; and WHEREAS, Wittman Enterprises, LLC has satisfactorily been providing this service for the past four years. NOW, THEREFORE BE IT RESOLVED, that the City Council hereby authorizes the City Manager to sign a Professional Services Agreement with Wittman Enterprises, LLC to provide billing services for ambulance and emergency response services through August 31, 2010. PROFESSIONAL SERVICES AGREEMENT Wittman Enterprises, LLC (Title of Project) FY 07-08 Fund # 5199 Exp. Acct. # 54111 Project # Amount $ 40$ 0,000 For multi-year contracts or contracts with multiple accounts: FY Fund # Exp. Acct. # Project # Amount $. FY Fund # Exp. Acct. # Project # Amount $. FY Fund # Exp. Acct. # Project # Amount $, FY Fund # Exp. Acct. # Project # Amount $, THIS PROFESSIONAL SERVICES AGREEMENT ("Agreement") is entered into and effective as of , 20 ("Effective Date"), by and between the City of Petaluma, a municipal corporation and a charter city ("City") and Wittman Enterprises, LLC„ a Limited Liability Corporation ("Consultant") (collectively, the "Parties"). WHEREAS, the Parties enter into this Agreement for the purpose of Consultant providing professional services to City under the terms and conditions set forth herein. THEREFORE, in consideration of the mutual covenants contained in this Agreement, the Parties agree as follows: 1. Services. Consultant shall provide billing services to the City of Petaluma for ambulance and emergency response services as described in and in accordance with the schedule set forth in Exhibit "A" attached hereto and incorporated herein ("Services"). 2. Compensation, Business Tax Certificate. A. For the full performance of the Services described herein, City shall compensate Consultant under the terms set forth in Exhibit "A" and in an amount not to exceed $400,000 for the full term of this contract. B. Consultant shall submit detailed monthly invoices reflecting all services performed during the preceding month, and including a revised schedule for performance and additional documentation requested by City, as applicable. C. Consultant shall be compensated for services in addition to those described in Exhibit A, only if Consultant and City execute a written amendment to this Agreement describing the additional services to be performed and the compensation to be paid for such services. In no case shall the total compensation under this Agreement exceed $400,000 per the term of the contract without prior written authorization of the City Manager. Further, no compensation for a section or work program component attached with a specific budget shall be exceeded without prior written authorization of the City Manager. D. Notwithstanding any provision herein, Consultant shall not be paid any compensation until such time as Consultant has on file with the City Finance Department current information requested on the "Vendor Information" form PROFESSIONAL SERVICES AGREEMENT (City) May 2006 available from City, and has obtained a currently valid Petaluma business tax certificate. E. City's obligation to pay compensation to Consultant as provided herein is contingent upon Consultant's performance of the Services pursuant to the terms and conditions of this Agreement and any amendments thereto. Term. The term of this Agreement commences on the Effective Date, and terminates on August 31, 2010, unless sooner terminated in accordance with Section 4. Upon termination, any and all of City's documents or materials provided to Consultant and any and all of the documents or materials prepared for City or relating to the performance of the Services, shall be delivered to the City as soon as possible, but not later than fourteen (14) days after termination of the Agreement. 4. Termination. City may terminate this Agreement without cause upon ten (10) days' written notice. City may immediately terminate or suspend this Agreement for cause. Cause for immediate termination or suspension shall include, but not be limited to, any breach of this Agreement by Consultant or Consultant's bankruptcy. or insolvency. Upon receipt of notice of termination or suspension for cause, Consultant shall immediately stop all work in progress under this Agreement. In the event of early termination of this Agreement by City, Consultant shall be entitled to payment for all Services performed to the date of termination to the extent such Services were performed to the satisfaction of City in accordance with the terms and conditions of this Agreement. If City terminates this Agreement for cause, Consultant shall be liable to City for any excess cost City incurs for completion of the Services. 5. Consultant's Representation; Independent Contractor. Consultant represents that Consultant possesses distinct professional skills in performing the Services. City has relied upon said representation as a material inducement to enter into this Agreement. Consultant shall, therefore, provide properly skilled professional and technical personnel to perform all Services under this Agreement. It is expressly understood that Consultant and its agents and employees, shall act in an independent capacity and as an independent contractor and not as officers, employees or agents of City. This Agreement shall not be construed as an agreement for employment. 6. Facilities and Equipment. Consultant shall, at its sole cost and expense, furnish all facilities and equipment that may be required for furnishing Services pursuant to this Agreement. City shall furnish to Consultant no facilities or equipment, unless the City otherwise agrees in writing to provide the same. 7. Licenses, Permits, Etc. Consultant shall, at Consultant's sole cost and expense, keep in effect at all times during the 'term of this Agreement any licenses, permits or other such approvals which are legally required for performing the Services. 8. Time. Consultant shall devote such time to the performance of the Services as may be reasonably necessary for satisfactory performance of Consultant's obligations pursuant to this Agreement. 'PROFESSIONAL SERVICES AGREEMENT (City)•v May 2006 9. Inspection. Consultant shall provide the City every reasonable opportunity to ascertain that the Services are being performed in accordance with the requirements and intentions of this Agreement. All work done and materials furnished, if any, shall be subject to inspection and approval by the City. The inspection of such work shall not relieve Consultant of any of its obligations pursuant to this Agreement. 10. Progress Reports. Upon the City's request, Consultant shall provide, in a form acceptable to City, written progress reports of all oral and written observations, opinions, recommendations, analyses, progress and conclusions related to Consultant's performance of the Services. 11. Confidentiality. In the course of Consultant's employment, Consultant may have access to trade secrets and confidential information, disclosure of which is protected or limited by law. Consultant shall not directly or indirectly disclose or use any such confidential information, except as required for the performance of the Services. 12. Conflict of Interest. Consultant represents that it presently has no interest, and covenants that it shall not acquire any interest, direct or indirect, financial or otherwise, which would conflict in any manner or degree with the performance of the Services hereunder. Consultant further covenants that, in the performance of this Agreement, it shall not employ any subcontractor or person having such a conflict of interest. Consultant represents that no one who has or will have any financial interest under the Agreement is an officer or employee of City. If such conflict of interest arises during this Agreement or any extension, Consultant will immediately advise City and City may, at its sole discretion, immediately terminate this Agreement. 13. Consultant No Agent. Except as City may specify in writing, Consultant shall have no authority, express or implied, to act on behalf of City in any capacity whatsoever as an agent. Consultant shall have no authority, express or implied, pursuant to this Agreement to bind City to any obligation whatsoever. 14. Standard of Performance. Consultant shall perform all the Services in a manner consistent with the standards of Consultant's profession. All instruments of service of whatsoever nature, which Consultant delivers to City pursuant to this Agreement, shall be prepared in a substantial, first class and workmanlike manner and conform to the standards of Consultant's profession. All such instruments of service shall become the sole and exclusive property of City upon delivery of the same. 15. Assignment/Transfer. No assignment or transfer in whole or in part of this Agreement shall be made without the prior written consent of City. 16. Subcontractors. Consultant shall directly perform all Services, and shall not subcontract any portion of performance of the Services without the prior written consent of City. Any such subcontractors shall be required to comply, to the full extent applicable, with the terms and conditions of this Agreement, including but not limited to, procuring and maintaining insurance coverage as required herein and which shall name City as an additional insured. PROFESSIONAL SERVICES AGREEMENT (City) May 2006 17. Compliance With All Laws. Consultant shall fully comply with all applicable local, state and federal rules, laws, regulations and ordinances pertaining to the performance of the Services required hereunder. To the extent that any other government agency or entity provides compensation for any Services, Consultant shall comply with all rules and regulations applicable to such fiscal assistance. 18. Discrimination. During the performance of this Agreement, Consultant shall not discriminate against any employee or applicant for employment because of race, religion, creed, color, national origin, ancestry, gender, sexual orientation, age or physical or mental disability in violation of any applicable law. 19. Notice. Except as otherwise specified in this Agreement, all notices to be sent pursuant to this Agreement shall be made in writing, and sent to the Parties at their respective addresses specified below or to such other address as a Party may designate by written notice delivered to the other Party in accordance with this Section. All such notices shall be sent by: (i) personal delivery, in which case notice is effective upon delivery; (ii) certified or registered mail, return receipt requested, in which case notice shall be deemed delivered on receipt if delivery is confirmed by a return receipt; (iii) nationally recognized overnight courier, with charges prepaid or charged to the sender's account, in which case notice is effective on delivery if delivery is confirmed by the delivery service; or (iv) facsimile transmission, .in which case notice shall be deemed delivered upon transmittal, provided that (a) a duplicate copy of the notice is promptly delivered by first-class or certified mail or by overnight delivery, or (b) a transmission report is generated reflecting the accurate transmission thereof. Any notice given by facsimile shall be considered to have been received on the next business day if it is received after 5:00 p.m. recipient's time or on a nonbusiness day. City: City Clerk City of Petaluma Post Office Box 61 Petaluma, California 94953 Telephone: (707) 778-4360 Facsimile: (707) 778-4554 And: Dan Epperson. EMS Manager 198 D Street Petaluma California 94952 Telephone: (707) 778-4492 Facsimile: (707) 762-4547 PROFESSIONAL SERVICES AGREEMENT (City) May 2006 Consultant: Wittman Enterprises, LLC P.O. Box 269110 Sacramento California 95826-9110 Telephone: (800)906-6552 Facsimile: (916) 266-2200 20. Ownership of Documents. All original papers, documents or computer material on disk or microfilm, and copies thereof, produced as a result of this Agreement, shall be the property of City and may not be used by Consultant without the written consent of City. Copies of such documents or papers shall not be disclosed to others without the written consent of the City Manager or his or her designated representative. 21. Indemnification. Consultant shall indemnify, defend with counsel acceptable to City, and hold harmless City and its officers, officials, employees, agents and volunteers from and against any and all liability, loss, damage, claims, expenses, and costs (including, without limitation, attorney's fees and costs and fees of litigation) (collectively, "Liability") of every nature arising out of or in connection with Consultant's performance of the Services or its failure to comply with any of its obligations contained in this Agreement, except such Liability caused by the sole negligence or willful misconduct of City. Notwithstanding the foregoing, to the extent that this Agreement is a "construction contract" within the definition of Civil Code Section 2783, as may be amended from time to time, such indemnity shall not include Liability for the active negligence of City. 22. Insurance. Consultant shall comply with the "Insurance Requirements for Consultants" in Exhibit B-2, attached :hereto and incorporated herein by reference. [Indicate attached exhibit, e.g., "B-1 "or "B-2."] 23. Amendment. This Agreement may be amended only by a written instrument executed by both Parties. 24. Litigation. If litigation ensues which pertains to the subject matter of Consultant's services hereunder, Consultant, upon request from City, agrees to testify therein at a reasonable and customary fee. 25. Construction. This Agreement is the product of negotiation and compromise on the part of both Parties and that the Parties agree that, notwithstanding Civil Code section 1654, any uncertainty in the Agreement shall not be construed against the drafter of the Agreement. 26. Governing Law; Venue. This Agreement shall be enforced and interpreted under the laws of the State of California and the City of Petaluma. Any action arising from or brought in connection with this Agreement shall be venued in a court of competent jurisdiction in the County of Sonoma, State of California. PROFESSIONAL SERVICES AGREEMENT (City) May 2006 27. Non -Waiver. The City's failure to enforce any provision of this Agreement or the waiver thereof in a particular instance shall not be construed as a general waiver of any part of such provision. The provision shall remain in full force and effect. 28. Severability. If any term or portion of this Agreement is held to be invalid, illegal, or otherwise unenforceable by a court of competent jurisdiction, the remaining provisions of this Agreement shall continue in full force and effect. 29. No Third Party. Beneficiaries. The Parties do not intend to create, and nothing in this Agreement shall be construed to create any benefit or right in any third party. 30. Mediation. The Parties agree to make a good faith attempt to resolve any dispute arising out of this Agreement through mediation prior to commencing litigation. The Parties shall mutually agree upon the mediator and shall divide the costs of mediation equally. 31. Consultant's Books and Records. A. Consultant shall maintain any and all ledgers, books of accounts, invoices, vouchers, canceled checks, and other records or documents evidencing or relating to charges for services, or expenditures and disbursements charged to the City for a minimum period of three (3) years or for any longer period required by law, from the date of final payment to Consultant pursuant to this Agreement. B. Consultant shall maintain all documents and records which demonstrate performance under this Agreement for a minimum period of three (3) years or for any longer period required by law, from the date of termination or completion of this Agreement. C. Any records or documents required to be maintained pursuant to this Agreement shall be made available for inspection or audit, at any time during regular business hours, upon written request by the City Manager, City Attorney, City Finance Director, or a designated representative of these officers. Copies of such documents shall be provided to the City for inspection at Petaluma City Hall when it is practical to do so. Otherwise, unless an alternative is mutually agreed upon, the records shall be available at Consultant's address indicated for receipt of notices in this Agreement. D. Where City has reason to believe that such records or documents may be lost or discarded due to dissolution, disbandment or termination of Consultant's business, City may, by written request by any of the above-named officers, require that custody of the records be given to the City and that the records and documents be maintained in Petaluma City Hall. Access to such records and documents shall be granted to any party authorized by Consultant, Consultant's representatives, or Consultant's successor in interest. 32. Headings. The headings used in this Agreement are for convenience only and are not intended to affect the interpretation or construction of any provisions herein. PROFESSIONAL SERVICES AGREEMENT (City) May 2006 33. Survival. All obligations arising prior to the termination of this Agreement and all provisions of this Agreement allocating liability between City and Consultant shall survive the termination of this Agreement. 34. Entire Agreement. This Agreement, including the exhibits attached hereto and incorporated herein, constitutes the entire agreement between the Parties with respect to the Services, and supersedes all prior agreements or understandings, oral or written, between the Parties in this regard. . IN WITNESS WHEREOF, the parties hereto have executed this document the day, month and year first above written. CITY OF PETALUMA City Manager ATTEST: City Clerk APPROVED AS TO FORM: City Attorney APPROVED: Department Director APPROVED: Risk Manager APPROVED: Administrative Services Director file name: Wittman CONSULTANT By Name Title Address City State Zip Taxpayer I.D. Number Petaluma Business Tax Certificate Number PROFESSIONAL SERVICES AGREEMENT (City) May 2006 EU INSURANCE REQUIREMENTS Consultant and any subcontractor shall not commence work under this Agreement until Consultant shall have obtained all insurance required under this paragraph and such insurance shall have been approved by the City Attorney as to form and carrier and the City Manager as to sufficiency, nor shall Consultant allow any contractor or subcontractor to commence work on this contract or subcontract until all similar insurance required of the Consultant and/or subcontractor shall have been so obtained and approved. All requirements herein provided shall appear either in the body of the insurance policies or as endorsements and shall specifically bind the insurance carrier. Consultant shall procure and maintain for the duration of the contract all necessary insurance against claims for injuries to persons or damages to property which may arise from or in connection with the performance of the work hereunder by the Consultant, the Consultant's agents, representatives, employees or subcontractors. A. Minimum Scope of Insurance Coverage shall be at least as broad as: 1. Insurance Services Office Commercial General Liability coverage: a. Personal injury; b. Contractual liability. 2. Insurance Services Office form covering Automobile Liability, code 1 (any auto). 3. Workers' Compensation insurance as required by the State of California and Employer's Liability Insurance. 4. Professional Liability insurance. 5. Such other insurance coverages and limits as may be required by the City prior to execution of this agreement. B. Minimum Limits of Insurance Consultant shall maintain limits no less than: 1. General Liability: $2,000,000 per occurrence for bodily injury, personal injury and property damage. If Commercial General Liability Insurance or other form with a general aggregate liability is used, either the general aggregate limit shall apply separately to this project/location or the general aggregate limit shall be twice the required occurrence limit. 2. Automobile Liability: $1,000,000 per accident for bodily injury and property damage. 3. Employer's Liability: Bodily Injury by Accident - $1,000,000 each accident. Bodily Injury by Disease - $1,000,000 policy limit. Bodily Injury by Disease - $1,000,000 each employee. 4. Professional Liability insurance: $1,000,000. 5. Such other insurance coverages and limits as may be required by the City prior to execution of this agreement. INSURANCE REQUIREMENTS - CITY March 2003 C. Deductibles and Self -Insured Retentions Any deductibles or self-insured retentions must be declared to and approved by the City. At the option of the City, either: the insurer shall reduce or eliminate such deductibles or self- insured retentions as respects the City, its officers, officials, employees, and volunteers; or the Consultant shall procure a bond guaranteeing payment of losses and related investigations, claim administration and defense expenses. D. Other Insurance Provisions The required general liability and automobile policies are to contain, or be endorsed to contain the following provisions: 1. The City, its officers, officials, employees, agents and volunteers are to be covered as insureds as respects: liability arising out of activities performed by or on behalf of the Consultant; products and completed operations of the Consultant; premises owned, occupied or used by the Consultant; or automobiles owned, leased, hired or borrowed by the Consultant. The coverage shall contain no special limitations on the scope of protection afforded to the City, its officers, officials, employees, agents or volunteers. 2. For any claims related to this project, the Consultant's insurance coverage shall be primary insurance as respects the City, its officers, officials, employees, agents and volunteers. Any insurance or self-insurance maintained by the City, its officers, officials, employees, agents or volunteers shall be excess of the Consultant's insurance and shall not contribute with it. 3. Any failure to comply with reporting or other provisions of the policies including breaches of warranties shall not affect coverage provided to the City, its officers, officials, employees, agents or volunteers. 4. The Consultant's insurance shall apply separately to each insured against whom claim is made or suit is brought except, with respect to the limits of the insurer's liability. 5. Each insurance policy required by this clause shall be endorsed to state that coverage shall not be suspended, voided, canceled by either party, reduced in coverage or in limits except after thirty (30) days' prior written notice by certified mail, return receipt requested, has been given to the City. E. Acceptability of Insurers Insurance is to be placed with insurers with a current A.M. Best's rating of no less than A: VII. F. Verification of Coverage Consultant shall furnish the City with original endorsements effecting coverage required by this clause. The endorsements are to be signed by a person authorized by that insurer to bind coverage on its behalf. The endorsements are to be on forms provided by the City. All endorsements are to be received and approved by the City before work commences. As an alternative to the City's forms, the Consultant's insurer may provide complete, certified copies of all required insurance policies, including endorsements effecting the coverage required by the City. INSURANCE REQUIREMENTS - CITY March 2003 WITTMAN ENTERPRISES, LLC 21 Blue Sky Court, Sacramento, CA 95828 (916)381-6552 (800) 906-6552 City of Petaluma Scope of Work 1. Private Billing Wittman Enterprises to prepare all invoices and follow-up mailings. Initial invoicing with both English and Spanish instructions will be on 8Xl I billings and will be placed in envelopes, sealed and mailed, postage prepaid. Initial invoicing occurs within three (3) days of receipt of transport tickets. Toll Free 800 telephone number provided to patients. An initial telephone call will also be made at this time to elicit any insurance information from the patient or patient's family. If we receive no answer on this call, Wittman's will send an inquiry letter in addition to the initial invoice. The standard bill schedule is as follows: Private Bill Schedule 1, Invoice Immediately 2. Statement 30 days 3. Past Due 20 days 4. Final Demand 10 days 11. Medicare Medi -Cal Medi -Medi Wittman Enterprises, LLC to prepare all invoices and electronically convey to Medicare and Medi - Cal fiscal intermediaries. All secondary and coinsurance billing transferred to the appropriate secondary pay source and promptly billed to that source. Ill. Workers' Compensation and Private Insurance Wittman Enterprises, LLC to bill private insurance, supplemental insurance, secondary insurance and Workers' Compensation billed according to specific requirements. Electronic billing of insurance companies is performed where appropriate. Any correspondence for additional information or follow up necessary to secure insurance payments will be performed by Wittman Enterprises, LLC. IV. Delinquent Claim L-landling Patients with claims aging over 45 days will be contacted by telephone for payment arrangements, Telephone follow up will continue until payment in full is received or account is dismissed by the City of Petaluma to an outside collection agency. Wittman Enterprises, LLC will utilize installment billing as allowed by the City of Petaluma in cases of financial hardship. V. Receipts Processing Wittman Enterprises, LLC will receive direct payment, posting and depositing cash receipts within one (l) day of receipt. Bank deposit receipt will be faxed to the City of Petaluma. Wittman Enterprises, LLC shall have no access to the proceeds of the receipts. All funds are under the exclusive control of the City of Petaluma. VI. Reports Monthly,. Wittman Enterprises, LLC will perform accurate month end close procedures that will result in the following reports: Monthly Ticket Survey Monthly Sales Journal Monthly Cash Receipts Journal Monthly Receivables Aging Management Summary Statistical Reports customized to client needs VII. Provider Responsibilities • Submit necessary transport information, including pay source information and patient condition, to Wittman Enterprises, LLC for billing purposes. • Forward to Wittman Enterprises, LLC all necessary information relating to patient transports services, payments and patient eligibility. • Notify Wittman Enterprises, LLC of any accounts that require special attention. • Obtain signature of patient or guardian. • Provide patient's Social Security Number Vill. Source Documents Wittman Enterprises will retain all source documents including attachments for six (6) years, When service contracted is terminated, all source documents are returned to the City JX, Fees A. Percentage of Net Collections 6.0 % Collections minus refunds B, Monthly reports Included INSURANCE REQUIREMENTS Consultant and any subcontractor shall not commence work under this Agreement until Consultant shall have obtained all insurance required under this paragraph and such insurance shall have been approved by the General Counsel as to form and carrier and the Executive Director as to sufficiency, nor shall Consultant allow any contractor or subcontractor to commence work on this contract or subcontract until all similar insurance required of the Consultant and/or subcontractor shall have been so obtained and approved. All requirements herein provided shall appear either in the body of the insurance policies or as endorsements and shall specifically bind the insurance carrier. Consultant shall procure and maintain for the duration -of the contract all necessary insurance against claims for injuries to persons or damages to property which may arise from or in connection with the performance of the work hereunder by the Consultant, the Consultant's agents, representatives, employees or subcontractors. A. Minimum Scope of Insurance Coverage shall be at least as broad as: 1, Insurance Services Office Commercial General Liability coverage: a. Personal injury; b. Contractual liability. 2. Insurance Services Office forrn covering Automobile Liability, code I (any auto). 3. Workers' Compensation insurance as required by the State of California and Employer's Liability Insurance. 4. Professional Liability insurance. 5. Such other insurance coverages and limits as may be required by the PCDC prior to execution of this agreement. B. Minimum Limits of Insurance Consultant shall maintain limits no less than: 1. General Liability: $2,000,000 per occurrence for bodily injury, personal injury and property damage. If Commercial General Liability Insurance or other form with a general aggregate liability is used, either the general aggregate limit shall apply separately to this project/location or the general aggregate limit shall be twice the required occurrence limit. 2. Automobile Liability: $1,000,000 per accident for bodily injury and property damage. 3. Employer's Liability: Bodily Injury by Accident- $1,000,000 each accident. Bodily Injury by Disease - $1,000,000 policy limit. Bodily Injury by Disease - $1,000,000 each employee. 4. Professional Liability insurance: $1,000,000. 5. Such other insurance coverages and limits as may be required by the PCDC prior to execution of this agreement. INSURANCE REQUIREMENTS - PCDC Mauch 2003 C. Deductibles and Self -Insured Retentions Any deductibles or -self-insured retentions must- be declared to and approved by the PCDC. At the option of the PCDC, either: the insurer shalt reduce or eliminate such deductibles or self-insured retentions as respects the PCDC, its officers, officials, employees, and volunteers; or the Consultant shall procure a bond guaranteeing payment of losses and related investigations, claim administration and defense expenses. D. Other Insurance Provisions The required general liability and automobile policies are to contain, or be endorsed to contain the following provisions: 1. The PCDC, its officers, officials, employees, agents and volunteers are to be covered as insureds as respects: liability arising out of activities performed by or on behalf of the Consultant; products and completed operations of the Consultant; premises owned, occupied or used by the Consultant; or automobiles owned, leased, hired or borrowed by the Consultant. The coverage shall contain no special limitations on the scope of protection afforded to the PCDC, its officers, Officials, employees, agents or volunteers. 2. For any claims related to this project, the Consultant's insurance coverage shall be primary insurance as respects the PCDC, its officers, officials, employees, agents and volunteers, Any insurance or self-insurance maintained by the PCDC, its officers, officials, employees, agents or volunteers shall be excess of the Consultant's insurance and shall not contribute with it. 3. Any failure to comply with reporting or other provisions of the policies including breaches of warranties shall not affect coverage provided to the ,PCDC, its officers, officials, employees, agents or volunteers. 4. The Consultant's insurance shall apply separately to each insured against whom claim is made or suit is brought except, .with respect to the limits of the insurer's liability, 5. Each insurance policy required by this clause shall be endorsed to state that coverage shall not be suspended, voided, canceled by either party, reduced in coverage or in limits except after thirty (30) days' prior written notice by certified mail, return receipt requested, has been given to the PCDC. B. Acceptability of Insurers Insurance is to be placed with insurers with a current A.M. Best's rating of no less than ANII. F. Verification of Cove, -age Consultant shall furnish the PCDC with original endorsements effecting coverage required by this clause. The endorsements are to be signed by a person authorized by that insurer to bind coverage on its behalf. The endorsements are to be on forms provided by the PCDC. All endorsements are to be received and approved by the PCDC before work commences. As an alternative to the PCDC's fon-ns, the Consultant's insurer may provide complete, certified copies of all required insurance policies, including endorsements effecting the coverage required by the PCDC. INSURANCE RCQUIRENIHNTS - PCDC March 2003 YYl 1 I CN I __U'1 IVI41'I ACORD CERTIFICATE OF LIABILITY INSURANCE FDATE (MkUDPNYYY) 7/6/2007 PRODUCER (916) 231-1741 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Wells Fargo of California Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE CA DOI LIC #0352275 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1'7 C b ___ I 0.,q o ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. b lerock Dnve, Suite 100 Rai. r Cordova, CA 95670 INSURED Wittman Enterprises, Lic P. O. Box 269110 Sacramento, CA 96826-9110 rMVF:R6r.Pfi INSURERS AFFORDING COVERAGE NAIL # INSURER A: Hartford Casualty Insurance Company INSURER B: D. E: 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, I(JSR LTR DIY N POLICY NUMBER POLICYEFPECTIVE IMM19prm POLICY6EXMnATTON 126n J' LIMITS GENERAL LIABILITY EACH OCCURRENCE S x,DDO,DD i A X X COMWRCIALGENERALLIABILITY 57SBAAT6490 7/1/2007 7!1!2008 PREMISES Eaoccurence $ 300,00 MED EXP (Any one prison) S 10,00; CLAIMS MADE � OCCUR PERSONAL 8 ADV INJURY S 2,000,001 GENERAL AGGREGATE $ 4,000,001 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COM1PrOP AGG S 4,000,00, X POLICY PROJEC- LOC AUTOMOBILE LIABILITY A ANY AUTO 57SBAAT6490 7/1/2007 71112008 COMBINED SINGLE LIMIT Me acc+denq 2,00p 00� `� ' ALL OWNED AUTOS BODILY INJURY $ SCHEOULEO AUTOS (Per pomn) X HIRED AUTOS X BODILY INJURY S NON-OWNEDAUTOS (Peraccidenl) PROPERTY DAMAGE (Paracdeenq $ -•is GARAGE LIABILITY AUTO ONLY- EA ACCIDENT S ANY AUTO OTHER THAN EA ACC 5 5 AUTO ONLY; AGG EXCESSIUMBRELLA LIABR.TTY EACH OCCURRENCE S 1 r000r0O AI OCCUR EICLAIMSMADE 57SBAAT6490 7/1/2007 7/112008 AGGREGATE $ 1,OQO,QO S DEDUCTIBLE S X RETENTION 5 10,000 a WORKERS COMPENSATION AND OC STATRY U• IJ - EMPLOYERS' LIABILITY R E.L. EACH ACCIDENT S ANY PROPRIETORMARTNERIEXECURVE OFFICERIMEMBER EXCLUDE07 NII yyap, da.albe undLt SPECIAL PROVISIONS E.L. DISEASE . EA EMPLOYEE S balaw E.L. DISEASE -POLICY LIMIT b OTHER _.___.... .�-.. _. _. _. _.-._.._. .-.._.......-....w�,.............-...�..�....... .......... ... �......o.,F...cn, r arca.in� rnuv mrun� :ertificate holder is Included as additional insured par SS 04 49 05 93 attached- Subject to 10 day notice of cancellation for non-payment of premium. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 13EFORE THE EXPIRATION City of Petaluma Ambulance Attn: Ron Blanwule CATETHEREOF, THE ISSUINGINSURER WILLXiI)QX)DMAIL 30 DAYS WRITTEIT 1304 Soulhpint Blvd, #250 NOTICE TO THE CERTIFICATI= HOLDER NAMED TO THE LEFT, B Petaluma, CA 94954- X�E�TiLFEXTXtNiXlXlfiaC7lsXTiT2STXfiCIKIXt3fi#�'dpLy'�aTXTXXIiU(X XIMex E1159Ct41tlC AUTHORIZED REPRESENTATIVE h-- IMPORTANT If the certificate holder is an ADDITIONAL. INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or after the coverage afforded by the policies listed thereon. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY ADDITIONAL INSURED— DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: BUSINESS LIABILITY COVERAGE FORM SCHEDULE Name of Person or Organization: CITY OF PETALUMA AMBULANCE 1304 SOUTHPOINT BLVD., #250 PEiALUMA, CA 94954 Who is an insured in the BUSINESS LIABILITY COVEAGE FORM is amended to included as an insured the person or organization shown in the Declarations, but only with respect to liability arising out of the operation of the named insured. For Losses covered under the BUSINESS LIABILILTY COVERAGE of this policy this insurance is primary to other valid and collectible insurance, which is available to the person or organization shown in the Declarations as an Additional Insured. SS 04 49 05 93 Printed in U.S.A. (NS) Copyright, Hartford Fire Insurance Company, 1993 DATE(hlis{iDDlYYYY) tITzOPID OA 10 �ACORD CERTIFICATE CE LIABILITY( INSURANCE 06/29/07 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Tntercare Insuraixe Solutions HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 3 010 Lava Ridge Ct Ste 110 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Rc-eville CA 95661I f e.916-677-2100 Fax:916-677-2473 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Republic Indemnity Ins Co INSURER B: Wittman Enterprises LLC Jean Kohlmeister INSURER C: 21 Blue Sky Court Suite A INSURER O: Sacramento CA 95828 - INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, 140TWITHSTANDING ANY REJUIREMENT, 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 DESCRIDED HEREIN IS SUBJECTTO ALL THETERI.IS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IRS LTR NS TYPE OF INSURANCE POLICY NUMBER '-fIV DATE MMIDDJYY P G PIRA D DATE jMMrQD/YY LIMIrS GENERAL LIABILITY EACH OCCURRENCE S COMMERCIAL GENERAL LIABILITY ENTEQ- PREMISES IIE occurence S CLAIMS MADE EI OCCUR }.IED EXP (Any one person1 $ PERSONAL & ADV INJURY $ GENERALAGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP AGG S POLICY E LOC AUTOMOBILE UAJ31L1)Y ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Par person) 5 AU OWNED AUTOS SCHEDULED AUTOS 130DILYINJURY (Par accldenl) 3 HIRED AUTOS NDN-DVINED AUTOS PROPERTY DAMAGE jPor accident) S GARAGE LIABILITY AUTO ONLY - E11 ACCIDENT $ OTHER TI JAN EA ACC 3 ANY AUTO S AUTO ONLY: AGG DCCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE 3 T ~` S DEDUCTIBLE $ RETENTION S A WORKERS COMPENSATION AND ENIPLOYERS'LIABIUTY ANY PROPRIETOR/PARTNEMFXECUTIVE 16620403 07/01/07 07/01/08 TORY LIMITS I I ER E.L.EACHACCiDENT $ 1000000 E.L, DISEASE, En EMPLOYEE $ 10 0 0 0 0 0 OFFICER/MEMBER EXCLUDED? 11 yes, describe undar- SPECIAL PROVISIONS bolow E.L. DISEASE - POLICY LIMIT I S 10 0 0 0 0 0 OTTIER DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES IEXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION rj+.I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOI DATE TIiEREOF,'R{E ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL City of Petaluma Ambulance IMPOSE NO OBLIGATION OR LIABILITY OF hIYKINDUPONTHEINSURER,ITSAGENTSOR Attn: Ilan Hlanwuio 1304 Southpint Blvd. 11-250 REPRESENTATIVES. Petaluma CA 94954 AUTHORIZED REPRESENTATIVE Kristen Kvtonen' v - A!`rlbh orr IOnnd Inas �. „ ., ..._...�,� .-..........-..�.,.,, TE �2�RD,� CERTIFICATE OF LIABILITY DA oA7/10/200 �1 A' PRODUCER (916) 231.1741 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Wells Fargo of California Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR CA DOI UC 40352275 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 11017 Cobblerock Drive, Suite 100 Rr o Cordova, CA 95670 INSURED Wittman Enterprises, Lic P. 0. Box 269110 Sacramento, CA 9582G-9110 INSURERS AFFORDING COVERAGE NAIC # INSURER A; Executive Risk Indemnity, Inc. INSURER B: INSURER C: INSURER D: INSURER G 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 ocn_ n -r _ t MAITO cunrnut nAeV uavF RPF'N RPM tr.Pn RY PAIn CLAIKAS- INS`€i O'._ T TYPE OF 511RANCE POLICY NUMBER POLFCY EFFECTIVE POLICY EXPIRATION LIMITS ^--- GENERAL LIAB1UTY EACH OCCURRENCE $ PREMISES n 0=1 once $ X COMMERCIAL GENERAL LIABILITY MED EXP (Any ona parson) $ CLAIMS MADE r—] OCCUR PERSONAL a ACV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER; PRODUCTS - COMPIOP AGO $ POLICY PRO Fj LOC AUTOMOBILE LIABILITY ANY AUTO» COMBINED SINGLE LIMIT (Ea acc)dont) S - -- ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Par parson) $ HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (PoraccldnnQ t - PROPERTY DAMAGE (Part Jdanl) S GARAGE LIABILITY AUTO ONLY. EA ACCIDENT $ OTHER THAN F -A ACG $ ANY AUTO S AUTO ONLY; AGG EXCESSJUNRRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR El CLAIMS )RADE r _ S S DEDUCTIBLE $ RETENTION S WC S7ATU- DTH• WORKERS COMPENSATION ANO T I 1 TS ER E.L. EACH ACCIDENT 5 EMPLOYERV LIABILITY ANY PROPRIETOWPARTNER0MCUTrVE OFFICERMAEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYE $ E L. DISEASE •POLICY LIMIT S 1( yps, do'cliba under SPECIAL PROVISIONS bolaw OTHER A Errors & Omissions 81716616 7/112007 7/1/2008 $7,540 Deductible S1,000'DU DESCTUPTION OF OPERATIONS I LOCATIONS J VEHICLE$ I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Surbjeetto 10 day notice of Cancellation for non-paymP.nt of premium. City of Petaluma Ambulance Attn: Ron Blanwuie 1304 Southpint Blvd, #250 - Petaluma, CA 94954 - SHOULD ANY OFTHE ABOVE DESCRIBED POLICIES DE CANCELLED BEFORE THE EXPIRATION DATE THEREDF. THE ISSUING INSURER WILLXLyLXU){*MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, B XI)i i a�xx�c�x��x�fJ�actxwl AUTHORIZED REPRESENTATIVE If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies fisted thereon.