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HomeMy WebLinkAboutCALIFORNIA FORENSIC PHLEBOTOMYA-2019.036 INSURANCE NOT ON PILE WORK MAY RQT PROCEED CLERK OF COUNCIL 9 DATE: APR 0 4 2019 0%1?9 L" 6- co M kktj 6-1-' AGREEMENT TO PROVIDE BLOOD DRAWING AND EVIDENCE CUSTODIAN SERVICES THIS AGREEMENT is made and entered into on this Sth day of March, 2019 by and between, California Forensic Phlebotomy ("CFP" or "Contractor"), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California ("City"). RECITALS A. The City desires to retain a Contractor having special skill and knowledge in the field of drawing blood on a routine and continual basis for the Santa Ana Police Department. CPP is the Sole Source blood draw and evidence custodian for all law enforcement agencies in the County of Orange. B. Contractor has previously provided services to the City and its most recent Agreement with the City (A-2017-337) expired on November 20, 2018. C. Contractor represents that Contractor is able and willing to provide such services to the City. D. In undertaking the performance of this Agreement, Contractor represents that it is knowledgeable in its field and that any services performed by Contractor under 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: 1. SCOPE OF SERVICES Contractor shall perform during the term of this Agreement, the tasks and obligations including all labor, materials, tools, equipment, and incidental customary work required to fully and adequately complete the drawing of blood on a routine and continual basis and evidence custodian for the Santa Ana Police Department as set forth in Exhibit A, attached hereto and incorporated herein by reference. 2. COMPENSATION a. The City agrees to pay, and Contractor agrees to accept a rate of $97.46 per draw. The total yearly amount to be expended, during the term of this Agreement, shall not exceed $46,781 per year, The total amount to be expended under the term of this Agreement shall not exceed $155,343, The sum of this amount shall include $140,343 for the base Agreement and a contingency amount of $15,000 for work assigned at the sole discretion of the City. In addition, City will recognize and pay Contractor for services provided during the period from November 20, 2018, to the effective date noted in Section 3 below. b. Payment by City shall be made within forty-five (45) 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 the date first written above and continue for a three (3) year period until March 4, 2022, unless terminated earlier in accordance with Section 15, below. 4. INDEPENDENT CONTRACTOR Contractor shall, daring 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. 3. OWNERSHIP OF MATERIALS This Agreement creates a non-exclusive and perpetual license for City to copy, use, modify, reuse, or sublicense any and all copyrights, designs, and other intellectual property embodied in plans, specifications, studies, drawings, estimates, and other documents or works of authorship fixed in any tangible medium of expression, including but not limited to, physical drawings or data magnetically or otherwise recorded on computer diskettes, which are prepared or caused to be prepared by Contractor under this Agreement ("Documents & Data"). Contractor shall require all subcontractors to agree in writing that City is granted a non-exclusive and perpetual license for any Documents & Data the subcontractor prepares under this Agreement. Contractor represents and warrants that Contractor has the legal right to license any and all Documents & Data. Contractor makes no such representation and warranty in regard to Documents & Data which were provided to Contractor by the City. City shall not be limited in any way in its use of the Documents and Data at any time, provided that any such use not within the purposes intended by this Agreement shall be at City's sole risk. 6. INSURANCE Prior to undertaking performance of work under this Agreement, Contractor shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a, Commercial General Liability Insurance, Contractor shall maintain commercial general liability insurance nanung the City, its officers, employees, agents, volunteers and representatives as additional insured(s) and shall include, but not be limited to protection against claims arising from bodily and personal injury, including death resulting therefrom and damage to property, resulting from any act or occurrence arising out of Contractor's operations in the performance of this Agreement, including, without limitation, acts involving vehicles. The amounts of insurance shall be not less than the following: single limit coverage applying to bodily and personal injury, including death resulting therefrom, and property damage, in the total amount of $1,000,000 per occurrence, with $2,000,000 in the aggregate, Such insurance shall (a) name the City, its officers, employees, agents, and representatives as additional insured(s); (b) be primary and not contributory with respect to insurance or self-insurance programs maintained by the City, and (c) contain standard separation of insureds provisions. b. Business automobile liability insurance, or equivalent form, with a combined single limit of not less than $1,000,000 per occurrence. Such insurance shall include coverage for owned, hired and non -owned automobiles. Q. Worker's Compensation Insurance, In accordance with the provisions of Section 3700 of the Labor Code, Contractor, if Contractor has any employees, 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. d. If Contractor is or employs a licensed professional such as an architect or engineer: Professional liability (errors and omissions) insurance, with a combined single limit of not less than $1,000,000 per claim with $2,000,000 in the aggregate. e. 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 by the City. 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, iv. Where the amounts or coverage provided by the certificates of insurance provides coverage greater than those listed by this Agreement, the amounts provided by the certificates of insurance shall be incorporated by reference into the Agreement. V. Contractor shall supply City with a fully executed additional insured endorsement, f. If Contractor fails or refuses to produce or maintain the insurance required by this section or fails or refuses to furnish the City with required proof that insurance has been procured and is in force and paid for, the City shall have the right, at the City's election, to forthwith terminate this Agreement. Such termination shall not affect Contractor's right to be paid for its time and materials expended prior to notification of termination, Contractor waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. 7. INDEMNIFICATION Contractor agrees to defend, and shall indemnify and hold harmless the City, its officers, agents, employees, contractors, special counsel, and representatives from liability: (1) for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including death, and claims for property damage, which may arise from the negligent operations of the Contractor, its subcontractors, agents, employees, or other persons acting on its behalf which relates to the services described in section 1 of this Agreement; and (2) from any claim that personal injury, damages, just compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects arising from this Agreement, This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason of the events referred to in this Section or by reason of the terms of, or effects, arising from this Agreement. The Contractor further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal or property rights arises by reason of the terms of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. Notwithstanding the foregoing, to the extent Contractor's services are subject to Civil Code Section 2782.8, the above indemnity shall be limited, to the extent required by Civil Code Section 27818, to claims that arise out of, pertain to, or relate to the negligence, recklessness, or willful misconduct of the Contractor. 8. INTELLECTUAL PROPERTY INDEMNIFICATION Contractor shall defend and indemnify the City, its officers, agents, representatives, and employees against any and all liability, including costs, for infringement of any United States' letters patent, trademark, or copyright infringement, including costs, contained in the work product or documents provided by Contractor to the City pursuant to this Agreement. )• 9 DIKfl.l Contractor shall keep records and invoices in connection with the work to be performed under this Agreement. Contractor shall maintain, complete and accurate records with respect to the costs incurred under this Agreement and any services, 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 Contractor under this Agreement. All such records and invoices shall be clearly identifiable. Contractor shall allow a representative of the City to examine, audit, and make transcripts or copies of such records and any other documents created pursuant to this Agreement during regular business hours. Contractor shall allow inspection of all work, data, documents, proceedings, and activities related to this Agreement for a period of three (3) years from the date of final payment to Contractor under this Agreement. 10. 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. 11. 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. 12. NON-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. 13, 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 an authorized representative of 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 or 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 party, which is not embodied herein. 14. 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 subj ect to this Agreement performed by City personnel or by other Contractors retained by City. 15. TERMINATION This Agreement may be terminated by the City 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 all work product(s) completed as of such date, and in such case such work product 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. 16. WAIVER No waiver of breach, failure of any condition, or any right or remedy contained in or granted by the provisions of this Agreement shall be effective unless it is in writing and signed by the party waiving the breach, failure, right or remedy. No waiver of any breach, failure or right, or remedy shall be deemed a waiver of any other breach, failure, right or remedy, whether or not similar, nor shall any waiver constitute a continuing waiver unless the writing so specifies, 17. 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. 1.8. 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. 19. 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 fax or other telegraphic communication in the manner provided in this Section, to the following persons: To City: Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 Fax: 714- 647-6956 With courtesy copies to: Chief of Police City of Santa Ana 20 Civic Center Plaza (M-97) P.O. Box 1988 Santa Ana, California 92702 Fax: 714-245-8007 To Contractor: California Forensics Phlebotomy 27762 Antonio Parkway Suite #L1-647 Ladera Ranch, CA 92694 Attn: Russ Liedholm 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 fax, 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. 20. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature herein below 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. i NormaMitre Acting Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City torney By. Tamara Bogosian Assistant City Attorney RECOMMENDED FOR APPROVAL: �_SJA-rLI NTlht ---- Chief of Police CITY OF SANTA ANA Steven Mendoza Acting City Manager CALIFORNIA FORENSICS PHLEBOTOM INC.: President EXHIBIT A SCOPE OF SERVICES California Forensic Phlebotomy, Inc. www_cal iforn iaforen sicphle botomy. com SCOPE OF WORK 27762 Antonio Parkway, Suite L1-647 Ladera Ranch, CA 92694 24 Hour Technician Response (714) 529-0515 Administration (949) 309-2459 Fax (949) 203-2133 cvc23158@aol.com Contractor to provide employees who shall remain available on an on -call basis at all times, seven (7) days per week, twenty-four (24) hours per day, three hundred sixty five (365) a year, and agree to said employees to conduct tests identified in the City agreement, as requested. Locations for taking of blood samples shall include, but not limited to: Santa Ana Police Department, local hospitals, Orange County Jail field locations in and around the City of Santa Ana. Contractor to provide related employees to appear and conduct requested tests within forty-five (45) minutes of such request. Contractor to provide twenty-four (24) access to a supervisor to remedy any problems or questions that may arise. Contractor to provide medical supplies and equipment necessary to conduct tests at no cost to the City. Contractor to provide transportation for employees at no cost to the City. Contractor's employees, upon request of the City and/or the Orange County District Attorney, shall appear in court or any other designated location, at no additional cost, for the purpose of discussion or testimony concerning collecting of samples. Contractor's said employees agree to appear in court at the time designated by the City and/or the Orange County District Attorney. The City and/or the District Attorney will provide at least two (2) hours' notice to such appearance. In addition to applicable laws, all blood sample collection and subsequent handling shall be conducted in accordance with direction and procedures prescribed by the Orange County Sheriff Department Forensic Sciences Services Division. Only employees of the Contractor, deemed acceptable by the City, hereunder shall perform services; the City will refuse to permit blood samples to be collected by any employee of Contractor considered, by the City in its sole discretion, to be unacceptable. All blood samples shall be refrigerated immediately and deposited by the Contractor at the County of Orange's refrigerated blood locker within (6) hours of withdrawal. Contractor to provide at Contractor's expense, supplies necessary to ensure that blood samples are properly refrigerated as directed by the Orange County Sheriff Department Forensic Science Services Division. CALIFOR-01 LABRO CERTIFICATE OF LIABILITY INSURANCE DA3118/2019 YyYI 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 policy(ios) must have ADDITIONAL INSURED provisions or 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 `-""""'°" ^ w' — — NFP Property & Casualty Insurance, Inc. 1551 North Tustin Avenue Suite 500 Santa Ana, CA 92705 INSURED California Forensic Phlebotomy Inc. 22762 Antonio Pkwy Ste L1-647 Ladera Ranch, CA 92694 (Pe)VFRArFC r`FRTIFICATF NI.IMBER- REVISION NUMBER: 1 447.0011 _ 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 CONTRACTOROTHER DOCUMENTWITH 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. INSR TYPE OF INSURANCE ADDp; yyyp POLICY NUMBER POLICY YFFr POLICY EXPITo LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 2,000,000 CLAIMS -MADE ❑X occuR X SM928506 1111712018 1111712019 DAMAGE TO RENrco J?MACETO n 50,000 X'Prof Llab-Claims Ma qrr MED EXP An onaperson $ 5,000 2000,000 PERSONAL &ADV INJURY $ 3,000,000 GEN'LAGGR-GATE UMITAPPLIES PER: GENERALAGGRECATE $ X POLICY L� JEcT 11 LOC PRODUCTS-COMPtDPAGG $ Included PROF LIAB AGG 3,000,000 OTHE : $ A COMBINED SINGLE LIMIT 1,000,000 AUTOMOBILE LIABILITY Fa acc dent ANY AUTO! SM928506 11/1712018 11/1712019 BODILYINJURySPer erson)_ 5 - OwN1 SCHEDULED AUTOS ONLY AUTOS INJURY Per accident -- AUTE X AtO1TOS ONNE Ix p6p0DILY aoc tlent A(iE $ S ONLY _t„WeOr $ UMBRELLALIAB W OCCUR EACH OCCURRENCE_ $ m EXCESS UAe CLAIMS -MADE AGGREGATE S FORD RETENTION$ __...- B WORKERS COMPENSATION X STATUTE �RH- AND EMPLOYERS' LIABILITY BNU WC0138098 10/1/2018 10/1/2019 YEN 1,000,000 ANY PROPRIETOR/PARTNER/E%EL"IJTIVE E,L EACH ACCInEN7 _T pFFICER/MEMp ER EXCLUDED2 u N/A 1 1,000,000 (Mandatory In NN) E,L DISEASE -EA EMPLOYE If yes, deadbe UmIkr 1,000,000 DESCRIPTION OF OPERATION$ below E.L. DISEASE -POLICY LIMIT DESCRIPTION OF OPERATIONS t LOCATIONS / VEHICLES (ACORD idi, Addlttonai Remarks Schedule, may be attached if more space Is required) The City of Santa Ana, its officers, employees, agents & representatives are named as additional insureds as respects to the General Liability policy limits per endorsement included in the policy. Coverage is Primary and Non -Contributory, as required by written contract. a4gsw 3h,s h" / eF J City of Santa Ana Attn: Purchasing Division 20 Civic Center Plaza Room 429 Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) ©1988.2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD offPOLICY NUMBER: SM928506 NIM[S W EVANSTON INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED ENDORSEMENT - GENERAL LIABILITY (REQUIRED BY CONTRACT) This endorsement modifies insurance provided under the following: SPECIFIED MEDICAL PROFESSIONS GENERAL LIABILITY INSURANCE COVERAGE PART In consideration of the premium paid, it is hereby understood and agreed that the policy is amended as follows: 1. Section The Insured is amended by the addition of the following: Whenever used in this Coverage Part, the unqualified word Insured shall also mean Additional Insured. 2,, Additional Insured means, whenever used in this endorsement, the following: Any organization that the Insured is required to include under the policy as an Additional Insured by a written contract or written agreement in effect during this policy period and executed priorto the 'occurrence of the 'bodily injury' or 'property damage.' 3. Coverage provided to any Additional Insured as defined herein shall apply solely to an Occurrence or offense involving the products, goods, operations or premises covered by this Coverage Part. 4. No coverage shall be afforded to the above Additional Insured for Bodily Injury, Property Damage, Personal Injury or Advertising Injury to any Employee or to any obligation of the Additional Insured to indemnify another because Damages arising out of such injury. 5. In the event that the Limits of Insurance provided by this policy exceed the Limits of Insurance required by the written contract or written agreement, the insurance provide by this endorsement shall be limited to the Limits of Insurance required by the written contract or written agreement. This endorsement shall not increase the Limits of Insurance shown in the Declarations pertaining to the coverage provided herein. 6. Where no coverage shall apply herein for the Named Insured, no coverage or defense shall be afforded to the above Additional Insured. 7. The person or organization is only an additional insured with respect to liability arising out of 'your work' or 'your product.' 8. In accordance with the terms and conditions of the policy and as more fully explained in the policy, as soon as practicable, each additional insured must give the Company prompt notice of any act, error or omission which may result in a claim, forward all legal papers to the Company, cooperate in the defense of any actions, and otherwise comply with all the policy's terms and conditions. Failure to comply with this provision may, at the Company's option, result in the claim or suit being denied All other terms and conditions remain unchanged. ///� Manuscript-1 *r(,48 g/u /7s (Z oFI ) Pagel of 2 9. The Additional Insured and the Named Insured shall be represented by the same lawyer unless such mutual representation is prohibited by law or bay any applicable professional code of conduct. 10. This insurance shall be primary and non-contributory insurance. 3/t»IrcC3aF7) All other terms and conditions remain unchanged. Manuscript-1 Page 2 of 2 CALIFOR-02 LAURAARROYO CERTIFICATE OF LIABILITY INSURANCE DATE(MWODNYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLD8"5/ER.ITHIS 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 pOIICy(ies) must have ADDITIONAL INSURED provisions or be endorsed. f 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 endorsements . ODUCERRIMIACT P Propert & Casualty Services, Inc. 1551 North l astin Avenue Suite 500 Santa Ana, CA 92705 PNONE ac No, E.e : (714 5055550 AIC, Ne:(714) 975-8966 E- INSURERS AFFORDING COVERAGE NAICB INSURED California Forensic Phlebotomy 5753 E. Santa Ana Cyn Rd. Suite G-553 Anaheim Hills, CA 92807 INSURER A: Evanston Insurance COm all INSURERB:StarNet Insurance Com an 35378 40045 INSURER C: INSURER D: INSURER E: COVERAGES NSURER F: - -- � rr.amocn: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED REVISION NUMBER: BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IS SUBJECT TO ALL THE TERMS, INSR ADDL SUBR TR TYPE OF INSURANCE I SD POLICY NUMBER POLICY EFF POLICYEXP A X COMMERCIAL GENERAL LIABILITY lM9RS CLAIMS -MADE OCCUR EACH OCCURRENCE $ 2,000,000 X M928506 11/17/2D18 11117/2019 X Prof Liab- Claims Ma DAMAGETORENTED E 50000 MEDEXP An one rson $ 5,D00 GENLAGGRE ATE LIMIT APPLIES PER' PERSONAL&ADV INJURY $ 2,000,000 X POLICY � P� LOC GENERAL AGGR GATE E 3,000,000 OTHER: PRODUCTS-COMP/OPAGG E Included A PROF LIAB AGG $ 3,000,000 AUTOMOBILE LIABILITY COMBIN�SINGLE LIMB t,000,Q00 ANY AUTO SM928506 11/17/2018 11/17/2019 OWNED SCHEDULED $ BODILY INJURY Per sown AUpT�O�S ONLY AUppTOSWWNNEEDp X AUTOS ONLY X N N TiY BODILY INJURY Peraaitlerd PROPERdY DAMAGE Pe acti em g UMBRELLA LIAB OCCUR $ EXCESS LIAB CLAIMS -MADE EACH OCCURRENCE DED RETENTION$ AGGREGATE $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY X PER OTH- T ANYPROPRIETORIPARTNEWEXECUTIVE YIN OFa��R YI BER EXCLUDEDI ❑ NIA BNUWC0147463 4/1212019 4112/2020 E.L EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE 11000,000 If yes, describe untler DESCRIPTION OF OPERATIONS below E.L DISEASE -POLICY LIMIT $ 1,000,006 DESCRIPTIONOFOPERATIONS/LOCATIONSIVEHICLES (ACORDIGI,AUCIUonal Remarks Schedule, maybeatMehe Vmorespacelsrequlnd) The City of Santa Ana, its officers, employees, agents & representatives are named as additional Insureds as respects to the General Liability policy endorsement Included in the policy. Coverage is Primary and Non -Contributory, as required by written contract. limits per _CERTIFICATE HOLDER City of Santa Ana Attn: Risk Management D 20 Civic Center Plaza, 4th Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 22 1o�Jn THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN J ACCORDANCE WITH THE POLICY PROVISIONS. M. LAMBERt AU IJORD:ED REPRESENTATIVE ACORD 25 (2016/03) _"-- - ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD (ClUJID August 16, 2019 City of Santa Ana CALIFORNIA FORENSIC PHLEBOTOMY Attn: Risk Management Division 20 Civic Center Plaza, 4th Floor Santa Ana, CA 92702 Dear Sirs/Madams, 5753 E. Santa Ana Cyn Rd, Suite G-553 Anaheim Hills, CA 92807 e-mail Nega@californiaforensicphlebotomy.00m 24 Hour Technician Response 714.529.0515 Administration 949.309,2459 Fax 949.203,2133 This letter is to confirm that California Forensic Phlebotomy, Incorporated does not have any company -owned vehicles. The automobile liability policy includes coverage for non - owned autos and hired autos, as the employees use their own vehicles when driving on company business. If you should have any questions, please feel free to contact me. I can be reached at the number below. Sincerely, f> Robert J. Vega' 11 President & Owner California Forensic Phlebotomy, Incorporated (949) 309-2459 x. 4 D & APPROVED INAC{EMENT DIVISION 2019 LAMBERT W\A-- cLavV� 9 os4 A -7 ao1— 03b CALIFOR-02 EV LY OS . Ia O CERTIFICATE OF LIABILITY INSURANCE `� DAM 121111201 YYI 12/11l2019 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 policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. It 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 C TACT NFP Property & Casualty Services, Inc. 1551 North Tustin Avenue Suite 500 OE EX11: (714) 5055550 FAX INC, No:(714) 975-8966 Santa Ana, CA 92705 INSURERISI AFFORDING COVERAGE NAIC 9 INSURER A: Evanston Insurance Company 35378 INSURED wSURERBStarNetInsurance Company 40045 NSURERC:__ California Forensic Phlebotomy 5753 E. Santa Ana Cyn Rd. Suite G-653 Anaheim Hills, CA 92807 INSURER D - INSURER E INSURER F COVERAGES CERTIFICATE NIIMRFR• orvimnM AJUM!?So. 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. INSFt TYPE OF INSURANCE AWL SUER POLICY NUMBER POUCY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LMASIUTY CLAIMS4ADE a OCCUR X SM933591 11117/2019 11/17/2020 EACH OCCURRENCE 2,000,00 DAMAGE TO RENTED 50,000 MEDEXP An . nat S 5,000 PERSONAL &AOV INJURY S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER X POLICY jEgT LOC GENERAL AGGREGATE S 3,000,000 PRODUCTS - COMPIOP AGO s Included OTHER A AUTOMOBILE UA,BIUTY COMBINED SINGLE LIMIT S 11000,000 BODILY INJURY Par eraan $ IXANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOSSWryE SM933591 11/17/2019 11/17/2020 BODILY INJURY Par acadern AUTOS ONLY X AUTOS ONLY P�OPPEERTeYn1l DAMAGE UMBRELLA LIAR OCCUR EACH OCCURRENCE AGGREGATE EXCESS UA8 CLAIMS.MADE DEO RETENTIONS r B ANDEMPLOVERSNNSSATIOITY r�g ANY PROPREIETOFRPARTNER,EXECUTIVE n IMa ISXtdry In NNi, EXCLUDED' LLJJ dearneeorder00 DE MIPTION OFOPERATIONS below NIA BNUWC0147453 411212 �411=0210 )( PER OTH' 1. EACH ACCIDENT 1,000,000 E. L. DISEASE -EA EMPLOYE 00 1,000,gls, E.L. DISEASE - POLICY UNIT S 1,000,000 A E&01Prof Liab SM933591 1111712019 11117/2020 Aggregate 3,000,000 A E&OITrof Llab SM933591 1111712019 11/17/2020 Occurence 11000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I WHWLE5 (ACORD 101, Additla al Renurta ScMduia, mX bX attached r.. XPaca la r•qubedl The City of Santa Ana, its officers, employees, agents & representatives are named IYdditional Insured as respects to General Liability. This Insurance is primary and non-contributory with any other Insurance of the additional insured, so long as a written contract or agreement to such exists prior to a loss, per attached endorsement Manuscript-1. City of Santa Ana Attn: Risk Management D 20 Civic Center Plaza, 4th Santa Ana, CA 92702 ACORD 25 (2016103) IN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ©1988-2015 ACORD CORPORATION. All rights reserved. marks of ACORD SAMANTHA M. LAMBERT 191 POLICY NUMBER: SM933591 MMKEL EVANSTON INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, ADDITIONAL INSURED ENDORSEMENT — GENERAL LIABILITY (REQUIRED BY CONTRACT) This endorsement modifies insurance provided under the following: SPECIFIED MEDICAL PROFESSIONS GENERAL LIABILITY INSURANCE COVERAGE PART In consideration of the premium paid, it is hereby understood and agreed that the policy is amended as follows: 1. Section The Insured is amended by the addition ofthe following: Wheneverused in this Coverage Part, the unqualified word Insured shall also mean Additional Insured. 2. Additional Insured means, whenever used in this endorsement, the following: Any organization that the Insured is required to include under the policy as an Additional Insured by a written contract or written agreement in effect during this policy period and executed prior to the 'occurrence ofthe'bodily injury' or'property damage.' 3. Coverage provided to any Additional Insured as defined herein shall apply solelyto an Occurrence or offense invoNng the products, goods, operations or premises covered by this Coverage Part. 4. No coverage shall be afforded to the above Additional Insured for Bodily Injury, Property Damage, Personal Injury or Advertising Injury to any Employee or to any obligation of the Additional Insured to indemnify another because Damages arising out of such injury. 5. In the event that the Limits of Insurance provided by this policy exceed the Limits of Insurance required by the written contract orwritten agreement, the insurance provide by this endorsement shall be limited to the Limits of Insurance required by the written contract orwritten agreement. This endorsement shall not Increase the Limits of Insurance shown in the Declarations pertaining to the coverage provided herein. 5. Where no coverage shall apply herein for the Named Insured, no coverage or defense shall be afforded to the above Additional Insured. 6. The person or organization is only an additional insured with respectto liability arising out of'yourwork' or'your product.' 7. In accordance with the terms and conditions of the policy and as more fully explained in the policy, as soon as practicable, each additional insured must give the Company promptnolice of any act, error or omission which may result in a claim, forward all legal papers to the Company, cooperate in the defense of any actions, and otherwise comply with all the policy's terms and conditions. Failure to comply with this All other terms and conditions remain unchanged. REVIE_j?i(ED&APPROVED (�y Ris MANAGEMENT DIVISION Manuscript-1 C 18 2019 Page 1 of SAMANTHA M. LAMBERT proasion may, at the Company's option, result in the claim or suit being denied 8. The Additional Insured and the Named Insured shall be represented by the same lawyer unless such mutual representation is prohibited by law or bay any applicable professional code of conduct. 9. This insurance shall be primary and noncontributory insurance. REVIEWED & APPROVED Fy RISK MMANAUMENT DIVISION All other terms and conditions remain unchanged. C 18 2019 Manuscript-1 L)�# M. LAMBERT Page2of2 ill EVANSTON INSURANCE COMPANY POLICY NUMBER: SM933591 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SPECIAL NOTICE OF CANCELLATION In consideration of the premium paid, it is hereby understood and agreed that the policy will not be cancelled until after 30 days written notice has been given by the party effecting such cancellation to the other party and to: City of Santa Ana, Risk Management Division 20 Civic Center Plaza, 4th Floor Santa Ana, CA 92701 Provided the Named Insured is obligated by valid written contract to provide written notice of such cancellation to City of Santa Ana. If such cancellation is due to nonpayment of premium and/or deductible, ten (10) days written notice will be given. REVIEWED & APPROVED Y RISk ANACEMENT EIMSION All other provisions of the policy shall remain unchanged. 18 2019 MEIL 1249 03 16 Page 1 of 1 MA I JA M. LAMBERT I CALIFORNIA FORENSIC PHLEBOTOMY C IF IF) INCORPORATED November 21, 2019 City of Santa Ana Attn: Risk Management Division 20 Civic Center Plaza, 4th Floor Santa Ana, CA 92701 Dear Sirs/Madams, 5753 E. Santa Ana Cyn Rd. Suite G-553 Anaheim Hills, CA 92807 e-mail Nega@caldorniaforensicphlebotomy.mm 24 Hour Technician Response 714.529.0515 Administration 949,309.2459 Fax 949.203.2133 This letter is to confirm that California Forensic Phlebotomy, Incorporated does not have any company -owned vehicles. The automobile liability policy includes coverage for non - owned autos and hired autos, as the employees use their own vehicles when driving on company business. If you should have any questions, please feel free to contact me. I can be reached at the number below. Sincerely, Robert J. Veg President & Owner California Forensic Phlebotomy, Incorporated (949) 309-2459 x. 4 & APPROVED IGEMENT DIVISION 2019 M. LAMBERT ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MMMO/YYYYI 05/30/2018 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 policy(ies) must have ADDITIONAL INSURED provisions or 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 endomement(s). PRODUCER NCONTACT AME: EMPLOYEE KBI Kinter-Buchanan Insurance Agency aCNN E:t. (310)79MID0 ac ee: (310)798E751 License Number: OE40872 I KBinsAgency@gmaii.com ADDRESS: sAg Cy®gmail.com 1014 South PBCIfiC Coast HWV INSURERIS) AFFORDING COVERAGE NAIC N Redondo Beach CA 90277 INsuRERA: Technology Insurance Company 42376 INSURED INSURER a: Kingdom Causes (a Corporation) INSURER C 4508 Atlantic Ave #292 INSURER D : # 292 INSURER E : Long Beach CA 90807 INSURER F: COVERAGES CERTIFICATE NUMBER: cu851011902 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, LTR I TYPE OF INSURANCE INSD WVD POLICYNUMSER P MMID MMID LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S PREMISES Ea acwuenm $ CLAIMSMADEOCCUR MED EXP (Any me person) S PERSONAL S AM INJURY s GEN'L AGGREGATE LIMIT APPLI ES PER GENERALAGGREGATE S PRO POLICY JECT LOC PRODUCTS - COMP,OP AGO E 5 OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea acddent S BODILY INJURY(Per person) S ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Psr auSdentl E HIRED NON -OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per amdent $ E UMBRELLA LIAR OCCUR EACH OCCURRENCE § AGGREGATE E EXCESS LIAR CLAIMS -MADE DELI RETENTIONS $ WORKERS COMPENSATION PER TH- AND EMPLOYERS' LIABILITY YIN STATUTE ER E.LEACHACCIOENT S 1,OOQ000 A ANY PROPRIETORIFARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDEDI Fy NIA TWC3853952 03/01/2020 031011202, (Mandatory in NH) If Yesdescdhe under E.L. DISEASE - EA EMPLOYEE S 1.000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS leelrnv DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addittonal Remarks schedule, may bs attached if more space If required) Evidence of Coverage REVIEWED & APPROVED By RISk MANACIEMENT DIVISION City of Santa Ana 20 Civic Center Plaza Santa Ana CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988.2015 ACORD CORPORATInhi AN rin6f .,.­., A ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD