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Home My WebLink AboutNAPHCARE, INC.4iNSURANCE ON FILE U WORKMAYNT"ROCEED�� CLERK OF COUNCIL Q'� ® DATE: I -.A filc.f �ttJt i 9 FIRST AMENDMENT WITH NAPHCARE, INC. 4 2� TO PROVIDE INMATE MEDICAL SERVICES A-2017.249.01 1 HIS Y1K51 ANILNllMbN 1 to the above-reterencea agreement is enterea into on vctoner 1, 2019, by and between t1Qare, Inc., an Alabama corporation ("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 parties entered into Agreement No. A-2017-249, dated September 19, 2017, by which Contractor agreed to provide basic and emergency inmate medical services ("Agreement"). The Agreement's term is scheduled to expire on September 30, 2019, and is currently in effect. B. The parties wish to exercise its first option to extend the term of the Agreement for one year and to increase the overall compensation to pay for services during the extension. The Parties therefore agree: 1. Section 1, TERM, is amended to extend the term of the Agreement for the period from October 1, 2019 through September 30, 2020, 2. Section 4, COMPENSATION, is amended to increase the overall compensation per the following: a. Tier 1 RFP Staffing-176 ADP and Up in Exhibit B shall be deleted in its entirety and replaced with Tier 1 RFP Staffing-176 ADP and Up attached hereto which increases the required Psychiatrist hours from four to eight hours. b. Compensation for the renewal option year shall be adjusted by $35,822.18, which is the amount required to increase the Psychiatrist hours from four (4) to eight (8) hours. Compensation for renewal option year one beginning October 1, 2019, through September 30, 2020, shall be as follows: Tier I Tier 2 (ADP at or above 176) (ADP at or below 175) Renewal Option Year One $2,517,709.56 $2,218,930.61 (10/01/19-09/30/20) c. The total amount to be expended during this extension shall not exceed $2,717,709.56. This amount includes the base amount listed under the Tier 1 listing above, and includes a contingency amount of $200,000, for services to be provided at the sole discretion of the City. The total amount to be expended for this Agreement shall not exceed $7,709,196.34. #7433v1 A•2017.249.01 3. Except as modified by this First Amendment, all terms and conditions of the Agreement shall remain in fall force and effect. IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to the Agreement on the date and year first written above. ATTEST CITY OF SANPA ANA Clerk of tile counc I y rCity Manager APPROVED AS TO FORM SON . Z. CARVALHO. City Attorney NAPHCARE, INC. �1 By: TA:\4ARA BOGOSIAN I�}c James S. McLane Assistant City Attorney Title: Chief Executive Officer A.E Dr, PPROVA #7433v1 Nfan Cues V4cd Tixurs Frf Sat Sun tiatirs' FTis Position'Citle DaySixlft H alth Sexvices Administrator 8.04 8.00 8.D0 8.00 8.00 40 1.000 Admin. Assistant/ Medical Records Clerk $.00 8.00 8.00 8,00 8,00 40 1.000 Medical Director/Ph sician On Call 24 hours Dail PA / NP 8.00 8.00 8,00 8.00 8.00 40 1.000 RN Chax e -Intake/Siekcall 12. 00 12.00 12.00 12.00 12.00 12,00 12.00 84 2,100 LVN-MedPass 24,00 24.04 24.00 24.00 24.00 24.00 24.00 168 4.200 Ps chiatrist 4.00 4.00 8 0.200 Ps ch RN / SocialY orker 12.00 12,00 I2.00 12.00 12.00 12.00 12,00 84 2.lOD Dentist -- - 4.00 4' 4,1t50" Dental Assistant 4,00 4 0.100 - L\{giXt yJj4llt i RN Charge -Intake/Sickeall 12.OD I2.00 12.00 1200 I2.00 12.00 2.00 84 2.100 LVN . Med Pass 24.00 24A0 24.00 24.00 24.D0 24.00 24.00 168 4.200 -I oral v x,P's 18.100 ACORO® CERTIFICATE OF LIABILITY INSURANCE 16#./ DATE(MNVDD/YYYY) 1 10/24/2019 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(les) 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 endorsements . PRODUCER CONTACT - NAME: Susan Crain VIG, LLC., dba7The Vestavia Group PxawE , 205-552-0241 205-244-6072 2090 Columbiana Road. Suite 2300 EMAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC0 INSURERA: lronShoreSpecieftyinsuranoe A XV 14375 Binnin ham AL 35216 INSURED INSURER B: Great American Insurance A+XIV 16691 INSURER C : The Travelers Insurance Company A++XV 19046 NaphCare, Inc. INSURER D 2090 Columbiana Road, Suite 40DO INSURER E : INSURER F: Birmingham AL 35216 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED 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. INSR LTR TYPE OF INSURANCEJim ADOLSUBIR J= POUCYNUMBER POLICY EFF SV POLICY EXP M LIMITS COMMERCIALGENERALLIAaIUTY EACH OCCURRENCE $ 1,000,000 A X CLAIMS -MADE OCCUR Y N 003886500 12/312018 1251/2019 DAMAGE TOR PR MIS S Ee P. $ 50,000 MED EXP (Any one parson) 3 5,000 PERSONAL& ADVINJURY $ 1,000,000 GENE AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 5,000,000 POLICY ❑ jE�T LOC PRODUCTS - COMPIOP AGG S 1,000,000 $ OTHER AUTOMOBILE LIABILITY COMOIN90 SINGLE LIMIT Ea accident S 1,000,000 B X ANY AUTO Y N CAP1116382 09/30/201g 091302020 BODILY INJURY (Per parson) S XXXXXXX OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) S XXXXXXX HIRED NON-0WNEO AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Perecddenl $ XXXX)= S UMBRELLA OAS OCCUR Not Applicable XXXXXXXX XXXXXXXX EACH OCCURRENCE S %OOLIOCf AGGREGATE S XXXKKXX EXCESS LIAR CLAMS -MADE DED RETENTION S S C WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANYPROPRIETORIPARTNERIE%ECUTIVE OFFICERIMEMBEREXCLUDED9 a (Mandatory In NH) NIA N UB-1P248768-19-51-K UB-1P250924-19-51-R 09/302019 09l3012020 PER O H- x srnr r ER E.L. EACH ACCIDENT S 1.000.000 E.L. DISEASE - EA EMPLOYEE s 1,000.000 R yes. describe under DESCRIPTION OF OPERATIONS bob E.L DISEASE - POLICY LIMIT S I,000,000 A Professional Liability Y N 0388610/1 12/312/118 12/31/2019 Each Med. Incident 1,000,000 Claims Made Ann. Aggregate 5,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101. Additional Remarks Schedule,may lea attached if more apace Is requlrad) It is understood and agreed the City of Santa Ana, officers, employees, agents, volunteers and representatives are named as additional insured as respects their Contract with NaphCare, Inc.; the insurance carded by NaphCare, Inc., shall be primary and non-contributory to insurance carried by the City of Santa Ana; if policies are changed or materially modified a thirty (30) day Written notice will be provided to the City of Santa Ana as respects their Contract with NaphCare, Inc. REVIEWED & APPROVED By RISk MANAGEMENT DIVISION CERTIFICATE HOLDER nnr n .. GANGELLATION City of Santa Ana S NY ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Risk Management Division 9 FRANCINE R. N DATE THEREOF, NOTICE WILL BE DELIVERED IN V W TH THE POLICY PROVISIONS. 20 Civic Center Plaza, 4th Floor AUTHORIZED REPRESENTATIVE Santa Ana, CA 92702 urL C'A.a,-k) 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD LARGE GROUP COMBINED LIABILITY POLICY BLANKET ADDITIONAL INSURED ENDORSEMENT POLICYHOLDER: NaphCare, Inc. ENDORSEMENT EFFECTIVE DATE: December 31, 2018 POLICY NUMBER: 003886500 The policy is hereby amended as follows: Each ofganization contracting with the policyholder for the provision of professional services is included as an additional insured under the policy, but only with respect to vicarious liability arising solely and entirely out of the rendering of or failure to render professional services directly by an insured professional and provided that the alleged acts or omissions giving rise to the liability are otherwise covered by the policy. Each additional insured described in this endorsement shall not have its own insurance coverage, but shall share in the coverage of the insured whose acts or omissions gave rise to the liability of the additional insured. REVIEWED & APPROVED By Risk MANAGEMENT DIVISION 4CT 28 2019 FA lNNE R. VILLAREAL Large Group Combined Liability Policy Page 1 of i Blanket Additional Insured Endorsement Francine R. Digitally signed by FrancineR. Villareal Villareal Date:2022.01.20 13:34:07-08'00' ACCWV CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 01 /18/2022 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 endorsement(s). PRODUCER VIG, LLC., dba/The Vestavia Group CONTACT NAME: Susan Crain PNONE . 205-552-0244 ac No): 205-244-8072 E-MAIL ADDRESS: SUSan.Crafn@V2StaVlagrOUp.COm 2090 Columbiana Road, Suite 2300 INSURERS AFFORDING COVERAGE NAIC # INSURERA: Ironshore Insurance Company "A" XV 25445 Birmingham AL 35216 INSURED INSURER B : Great American Insuance Company"A+"XIV" 16691 INSURER C : The Travelers Indemnity Company "A++" XV 19046 NaphCare, Inc. INSURER D 2090 Columbiana Road, Suite 4000 INSURER E Birmingham, AL 35216 INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICYNUMBER POLICY EFF MMIDD POLICY EXP MMIDD LIMITS A X COMMERCIAL GENERAL LIABILITY Y N HC7BAB5A62002 12/31/2021 12/31/2022 EACH OCCURRENCE $ 2,000,000 X I CLAIMS -MADE El OCCUR DAMAGE To RENTED- PREM SES (E. occurrence) $ 50,000 MED EXP (Any one person) $ 5,000 Retro date: 12/31/2018 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 8,000,000 POLICY PRO- JECT 7 LOC PRODUCTS - COMP/OP AGG $ 1,000,000 $ OTHER: _R B AUTOMOBILE LIABILITY Y N CAP-1116396 09/30/2021 09/30/2022 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) _ $ XXXXXXXX ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ XXXXXXXX PROPERTY DAMAGE Per accident $ XXXXXXXX HIRED NON -OWNED AUTOS ONLY AUTOS ONLY A X UMBRELLA LIAB z OCCUR Y N HC7BAB5A67002 12/31/2021 12/31/2022 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 EXCESS LIAR CLAIMS MADE DIED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? y (Mandatory in NH) NIA N UB-1P248768-21-51-K UB-1 P250924-21-51-K 09/30/2021 09/30/2022 X I STATUTE I ERH E.L. EACH ACCIDENT — $ 1,000,000 E.L. DISEASE - EA EMPLOYEE -- $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 A Professional Liability Claims Made Y N HC7BAB5A62002 12/31/2021 12I31/2022 2,000,000 Retro: 7/01 /2003 8,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) It is understood and agreed The City of Santa Ana, its officers, employees, agents, volunteers and representatives are named as Additional Insured, as respects their contract with NaphCare, Inc.; the insurance provided by Naphcare, Inc., shall be primary and non-contributory to the insurance carried by the City of Santa Ana; The City shall receive a (30) thirty day notice of any material modification of policies, as respects their contract with NaphCare, Inc. CERTIFICATE HOLDER CANCELLATION City of Santa Ana Risk Management Division SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 Civic Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana, CA 92702-1988 AUTHORIZED REPRESENTATIVE o" Nye z RiskMwaganentDivision REVIEWED & APPROVED BY. 01988-2015 ACORD C ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD --- Risk Management Analyst O' I _E IRONSHORE SPECIALTY INSURANCE COMPANY 175 Berkeley Street Boston, MA 02116 Toil Free: (877) IRON411 Endorsement # 5 Policy Number: HC7BAB5A62002 Insured Name: NaphCare, Inc. Effective Date of Endorsement: December 31, 2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CITY OF SANTA ANA ENDORSEMENT LIMITS OF LIABILITY THIS ENDORSEMENT MODIFIES THE GENERAL LIABILITY COVERAGE PART AND THE PROFESSIONAL LIABILITY COVERAGE PART OF THE POLICY AS FOLLOWS: The coverage provided by the policy applies to each insured against whom claim is made or suit is brought subject to the applicable limit of liability. ADDITIONAL INSUREDS THIS ENDORSEMENT MODIFIES THE GENERAL LIABILITY COVERAGE PART AND THE PROFESSIONAL LIABILITY COVERAGE PART OF THE POLICY AS FOLLOWS: The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701, its officers, employees, agents, volunteers and representatives are included as additional insureds under the above -described Coverage Part(s) of the policy, but only with respect to liability arising solely out of the operations of the policyholder. The coverage provided by this policy shall be primary and non-contributory, provided that the alleged acts or omissions giving rise to the liability are otherwise covered by the policy. SPECIAL NOTICE OF CANCELLATION The policy is hereby amended as follows: We will provide thirty (30) days'prior notification to the City of Santa Ana in the event that we cancel or materially change or alter this policy. City of Santa Ana 20 Civic Center Plaza Santa Ana, California 92701 All other terms and conditions of this Policy remain unchanged. Authorized Representative MMF.END.171(2.19 ed.) May 22, 2020 Date Pa o NSF Risk Management])Msian z REVIEWED & APPROVED BY. - Risk Management Analyst