Loading...
HomeMy WebLinkAboutWELLDYNE/RX WEST INC. 1 -2007A-2007-278 INSURANCE ON FILE WORK MAY PROCEED UNTIL INSURANCE EXPIRES AGREEMENT WITH WELLDYNE/Rx WEST, INC. 7-01-o8 W c- FOR PROFESSIONAL SERVICES CLERK OF COUNCIL "SHARPS PROGRAM" DATE: 11 -31 -O 7 D: PWA (-)-) 0xvMI t iv, li5 This Agreement is entered into this 3r4 day of-Dece,,,,,ka,v , 2007 ("Effective Date' by and between WellDyne/RxWest, (hereinafter referred to as "CONSULTANT") and the City of Santa Ana, a municipal corporation (hereinafter referred to as the "CITY"). RECITALS A. The City has determined that it is in the best interest of its citizens to implement a program to ensure used medical needles ("sharps') are collected and disposed of in safe and sanitary collection containers. B. The City's franchise waste hauler, Waste Management, has introduced a complete disposal system ("Sharps Disposal by Mail") designed for individuals injecting their medication at home. C. CITY has determined that it will participate in the Sharps Disposal by Mail System and that it requires professional services in order to administer the program. D. CONSULTANT represents that it is fully qualified to provide professional data collection and billing services to the CITY in relation to the medical sharps disposal program- E. CONSULTANT is willing to accept responsibility for performing the services set forth in this Agreement for the compensation and in accordance with the provisions of its agreement with Sharps Compliance, hic. NOW THEREFORE, in consideration of performance by the parties of the promises, covenants, and conditions herein contained, CITY hereby engages CONSULTANT and CONSULTANT hereby agrees to perform the services set forth in this Agreement. 1. CONSULTANT'S SERVICES CONSULTANT shall on a monthly basis obtain an accounting of the number of Sharps Disposal By Mail Containers (hereinafter `Sharps Container") distributed by participating pharmacies located in the City of Santa Ana, California, to residents of the City, as further detailed in Exhibit A, attached hereto. CONSULTANT will provide to CITY, on a month -in - arrears basis, an accounting of the number of Sharps Containers distributed to said residents by participating pharmacies. The accounting shall include for each participating pharmacy, the total number of Sharps Containers issued to participating residents and the number of second, third or more Sharps Containers issued to an individual participant during the prior one year period. Individual participants will not be identified in the report issued to the City. Page 1 The accounting shall reflect the total Sharps Containers Disposal fees which are subject to reimbursement by CITY based upon the specified information at the rates set forth in Section 4 herein. CITY shall, within 30 days of the receipt of said accounting, forward payment to CONSULTANT who shall, within 15 days of receipt of CITY's payment, be responsible for reimbursing the participating pharmacy, in amounts set forth in Section 4, below. 2. CITY'S RESPONSIBILITY CITY shall provide CONSULTANT with all pertinent data, documents and other requested information in City's possession as is reasonably available for the proper performance of CONSULTANT's services. 3. TERM The Agreement and the obligation of each Party to perform shall commence on January 1, 2008, and shall terminate, if not terminated earlier pursuant to the Agreement, on December 31, 2008. The term of this Agreement may be extended upon a writing executed by the Executive Director of the Public Works Agency and the City Attorney. 4. COMPENSATION CITY shall deliver to CONSULTANT, subject to CONSULTANT's submittal of the information required by Section 1, moneys calculated at the following rate: A. $21.16 for the first Sharps container obtained by each individual participant during the one year period. B. $16.16 for the second Sharps container obtained by each individual participant during the one year period. C. $16.16 for the third Sharps container obtained by each individual participant during the one year period. D. $0.00 for any additional Sharps containers obtained by an individual participant during a one year period. CONSULTANT shall be compensated for its services pursuant to the agreement between CONSULTANT and Sharps Compliance, Inc. City will not be responsible for compensating CONSULTANT for its services. Total compensation to be paid for reimbursements under this Agreement shall not exceed $60,000, during the term of this Agreement. 5. STANDARD OF PERFORMANCE CONSULTANT shall perform all work to the highest professional standards and in a manner reasonably satisfactory to CITY. Page 2 6. OWNERSHIP OF DOCUMENTS All reports, documents or other written material developed by CONSULTANT in the performance of this Agreement shall be and remain the property of CITY without restriction or limitation upon its use or dissemination by CITY. Such material shall not be the subject of a copyright application by CONSULTANT. CITY may use or reuse any such materials on any project other than the Project for which they were prepared in the City's sole discretion and without notice or compensation to CONSULTANT. 7. INDEPENDENT CONTRACTOR CONSULTANT is, and shall at all times remain as to CITY, a wholly independent contractor. CONSULTANT shall have no power to incur any debt, obligation, or liability on behalf of CITY or otherwise act on behalf of CITY as an agent. Neither CITY nor any of its agents shall have control over the conduct of CONSULTANT or any of CONSULTANT's employees, except as set forth in this Agreement. CONSULTANT shall not, at any time, or in any manner, represent that it or any of its agents or employees are in any manner employees of CITY. CONSULTANT agrees to pay all required taxes on amounts paid to CONSULTANT under this Agreement, and to indemnify and hold CITY harmless from any and all taxes, assessments, penalties, and interest asserted against CITY by reason of the independent contractor relationship created by this Agreement. CONSULTANT shall fully comply with the workers' compensation laws regarding CONSULTANT and CONSULTANT's employees. CONSULTANT father agrees to indemnify and hold CITY harmless from any failure of CONSULTANT to comply with applicable workers' compensation laws. CITY shall have the right to offset against the amount of any fees due to CONSULTANT under this Agreement any amount due to CITY from CONSULTANT as a result of CONSULTANT's failure to promptly pay to CITY any reimbursement or indemnification arising under this Section. 8. CONFIDENTIALITY All data, documents, discussion, or other information developed or received by CONSULTANT or provided for performance of this Agreement are deemed confidential and shall not be disclosed by CONSULTANT without prior written authorization by CITY. CITY shall grant such authorization if disclosure is required by law. All CITY data shall be returned upon written request to CITY upon the termination of this Agreement. CONSULTANT's covenant under this section shall survive the termination of this Agreement. 9. CONFLICT OF INTEREST CONSULTANT and its officers, employees, associates and subconsultants, if any, will comply with all conflict of interest statutes of the State of California applicable to CONSULTANT's services under this agreement, including, but not limited to, the Political Reform Act (Government Code Sections 81000, et seq.) and Government Code Section 1090. During the term of this Agreement, CONSULTANT and its officers, employees, associates and subconsultants shall not, without the prior written approval of the City Representative, perform work for another person or entity for whom CONSULTANT is not currently performing work Page 3 that would require CONSULTANT or one of its officers, employees, associates or subconsultants to abstain from a decision under this Agreement pursuant to a conflict of interest statute. 10. INDEMNIFICATION CONSULTANT shall defend, indemnify and save harmless CITY, its elected and appointed officials, officers, agents and employees, from all liability from loss, damage or injury to persons or property, or from any violation of civil rights or private property rights, including but not limited to trespass and waste, including the payment by CONSULTANT of any and all legal costs and attorneys' fees, in any manner arising out of the acts and/or omissions of CONSULTANT pursuant to this Agreement, including, but not limited to, all consequential damages, to the maximum extent permitted by law. 11. INSURANCE The CONSULTANT shall not commence work under this contract until it has obtained all insurance required hereunder in a company or companies acceptable to CITY, nor shall the CONSULTANT allow any subcontractor to commence work on its subcontract until all insurance required of the subcontractor has been obtained. The CONSULTANT shall take out and maintain at all times during the life of this contract the following policies of insurance: Workers' Compensation limits as required by the Labor Code of the State of California and Employee's Liability limits of One Million Dollars ($1,000,000.00) per accident. 12. COOPERATION In the event any claim or action is brought against CITY relating to CONSULTANT's performance or services rendered under this. Agreement, CONSULTANT shall render any reasonable assistance and cooperation which CITY might require. 13. RECORDS AND INSPECTIONS CONSULTANT shall maintain full and accurate records with respect to all matters covered under this Agreement. CITY shall have access, without charge, during normal business hours to such records, and the right to examine and audit the same and to make transcripts therefrom, and to inspect all program data, documents, proceedings, and activities. 14. CITY NOT OBLIGATED TO THIRD PARTIES CITY shall not be obligated or liable under this Agreement to any party other than CONSULTANT. Page 4 15. PERSONNEL, EQUIPMENT AND MATERIALS CONSULTANT represents that it has, or will secure at its own expense, all personnel, equipment and materials required to perform the services required under this Agreement. All of the services required under this Agreement will be performed by CONSULTANT or under its supervision, and all personnel engaged in the work shall be qualified to perform such services. CONSULTANT shall obtain the prior written approval of CITY to assign personnel to perform work under this Agreement. 16. TERMINATION OF AGREEMENT CITY shall have the right to terminate this Agreement for any reason on five (5) calendar days written notice to CONSULTANT. CONSULTANT shall have the right to terminate this Agreement for any reason on sixty (60) calendar days written notice to CITY. 17. FORCE MAJEURE CONSULTANT shall not be liable for any failure to perform if acceptable evidence has been submitted to CITY that failure to perform the Agreement was due to causes beyond the control and without the fault or negligence of the CONSULTANT. Examples of such causes include acts of God, civil disturbances, fire, war, or floods, but do not include labor -related incidents, such as strikes or work stoppages. 18. NOTICES Any notices, bills, invoices, or reports required by this Agreement shall be conclusively deemed received on (a) the day of delivery if delivered by hand during CITY's regular business hours; or (b) on the third business day following deposit in the United States mail, postage prepaid, to the addresses heretofore below, or to such other addresses as the parties may, from time to time, designate in writing pursuant to the provisions of this section. 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 telefacsimile (714) 647-6956 With courtesy copy to: City of Santa Ana Public Works Agency 20 Civic Center Plaza M-21 P.O. Box 1988 Santa Ana, CA 9270 To CONSULTANT: We1lDyne/RxWest Page 5 7472 South Tucson Way, Suite 100 Centennial, Colorado 80112 Attention: SNhAMW R2NosKY L1P OPEKhaox �% � i 19. NON-DISCRIMINATION AND EQUAL EMPLOYMENT OPPORTUNITY In the performance of this Agreement, CONSULTANT shall not discriminate against any employee, subcontractor, or applicant for employment because of race, color, creed, religion, sex, marital status, national origin, ancestry, age, physical or mental handicap, medical condition, or sexual orientation. CONSULTANT will take affirmative action to ensure that subcontractors and applicants are employed, and that employees are treated during employment without regard to their race, color, creed, religion, sex, marital status, national origin, ancestry, age, physical or mental handicap, medical condition, or sexual orientation. 20. ASSIGNABILITY; SUBCONTRACTING CONSULTANT shall not assign or transfer any interest in this Agreement nor the performance of any of CONSULTANT's obligations hereunder, including the performance of any of CONSULTANT's obligations by any subcontractors, without the prior written consent of CITY, and any attempt by CONSULTANT to subcontract any work or assign this Agreement or any rights, duties, or obligations arising hereunder shall be void and of no effect. 21. COMPLIANCE WITH LAWS CONSULTANT shall comply with all applicable federal, state, county and local laws, ordinances, codes and regulations. 22. NON -WAIVER OF TERMS, RIGHTS AND REMEDIES Waiver by either party of any one or more of the conditions of performance under this Agreement shall not be a waiver of any other condition of performance under this Agreement. In no event shall the making by CITY of any payment to CONSULTANT constitute or be construed as a waiver by CITY of any breach of covenant, or any default which may then exist on the part of CONSULTANT, and the making of any such payment by CITY shall in no way impair or prejudice any right or remedy available to CITY with regard to such breach or default. 23. REMEDIES CUMULATIVE Each right, power and remedy provided for herein or now or hereafter existing at law, in equity, by statute, or otherwise shall be cumulative and shall be in addition to every other right, power, or remedy provided for herein or now or hereafter existing at law, in equity, by statute, or otherwise, and the exercise, the commencement of the exercise, or the forbearance of the exercise by any party of any one or more of such rights, powers or remedies shall not preclude the simultaneous or later exercise by such party of any or all of such other rights, powers or remedies. Page 6 24. EXHIBITS; PRECEDENCE All documents referenced as exhibits in this Agreement are hereby incorporated in this Agreement. In the event of any material discrepancy between the express provisions of this Agreement and the provisions of any document incorporated herein by reference, the provisions of this Agreement shall prevail. 25. ENTIRE AGREEMENT This Agreement, and any other documents incorporated herein by specific reference, represent the entire and integrated agreement between CONSULTANT and CITY. This Agreement supersedes any and all other agreements, either oral or in writing, between the parties with respect to the subject matter herein. Each party to this Agreement acknowledges and agrees that no representations by any party which are not embodied herein and no other agreement, statement or promise not contained in this Agreement shall be valid and binding. Any modification of this Agreement will be effective only if it is in writing signed by the parties. 27. GOVERNING LAW; VENUE This Agreement shall be governed by and construed in accordance with the laws of the State of California. Any legal action brought for any purpose that arises, directly or indirectly, from this Agreement and the performance or failure to perform under the Agreement shall be brought in the Superior Court in the County of Orange, California. 28. SEVERABILITY Wherever possible, each provision of this Agreement shall be interpreted in such a manner as to be valid under applicable law. If any provision of this Agreement, or the application of it to any person or circumstances, is determined by a court of competent jurisdiction to be unenforceable, such provision shall be severed from and shall not affect the remainder of the Agreement. 29. CAPTIONS The captions used in this Agreement are solely for reference and the convenience of the parties. Said captions are not a part of the Agreement and in no way bind, limit, or describe the scope or intent of any provision, and shall have no effect upon the construction or interpretation of any provision herein. 30. EXECUTION This Agreement may be executed in any number of counterparts, each of which shall be deemed an original, but all of which when taken together shall constitute one and the same instrument. Page 7 31. SIGNATURES CONSULTANT affirms that the signatures and titles set forth hereinafter in the execution of this Agreement represent all individuals, firm members, partners, joint venturers, and/or corporate officers having principal interest herein and is sufficient to bind the corporation. IN WITNESS WHEREOF, the parties have executed this Agreement as of the date fast written above. CITY OF SANTA ANA A Municipal Corporation WELLDYNE/RxWEST David N. Ream Name: a tTq k0,U TR e tit c b rcy City Manager Title: V n• CNCP-A ncnJs Sind &o T' ATTEST: Patricia E. Healy Clerk of the Council � RECOMMENDED FOR APPROVAL `/ 1� 6� ^ James iv Ross Executive Director —Public Works Agency APPROVED AS TO FORM: JOSEPH W.FLETCHER City Attorney By, La a Sheedy Assistant City Attorne Susan 61 Senior Vi President of Operations Page 8 A City resident obtains his/her first Sharps Disposal by Mail container from a participating pharmacy at no cost to the resident. The resident will be required to pay $5.00 for a second or third container during the one year period. Sharps Disposal Containers in excess of three (3) per year will be fully paid by the resident. The City, and/or resident's co -pay will reimburse the pharmacy for the cost of up to three containers per year. • The Sharps Disposal by Mail System® includes a specially designed sharps container; a government approved exterior shipping box and instructions for use. • Used sharps are placed inside the container for safe storage. • When full, the container is closed, bagged and sealed inside its original packaging that includes a postage pre -paid mailing box. • Residents return the postage pre -paid box to their mail carrier or nearest post office. • The box is delivered to the processing center where both the sharps container and its packaging are destroyed. • The receipt and complete destruction of the container and it contents are documented. This system offers self -injectors convenience (available at their local pharmacy), confidentiality (protected by HIPPA Patient Privacy Act), and affordability. These benefits assure better compliance and diversion of used and contaminated syringes, making our communities safer. Consultant works with participating Pharmacies to account for the number of sharps containers acquired by Santa Ana residents. Consultant provides the report to the City, which will reimburse the pharmacy, through Consultant, for the cost of the sharps containers provided to Santa Ana residents. Page 9 . .,__. _... _.._.. _ .. .�. Dal, Page 2 012 ACORD Il' 9 �E�' �+ f+y ' �til� P I. ! ("��y'I7 Ii T)+a'"Ji DATE IMMIDDIYY) ICI � ' .,'i'� ..' 'HaoucER 6J� 1212712007 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Sarlal N A17833 AON RISK SERVICES, INC. OF FLORIDA ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1001 6RICKELL BAY DRIVE, SUITE 01100 ALTER ER, H12 COVERAGTHIS ECATE AFFOR13ED BY THE POLICIEEXTEND BELOW. MIAMI, FL 33131 4937 COMPANIES AFFORDING COVERAGE PHONE: 600443.6130 FAX: ODO-522.7514 COMPANY A NEW HAMPSHIRE INSURANCE COMPANY NSURED COMPANY ADP TOTALSOURCE MI XXX, INC. g 10200 SUNSET DRIVE MIAMI, FL 33173 COMPANY 'ALTERNATE EMPLOYER: C WELL DYNE, INC. COMPANY ; ` (., udi lU. 'q TIao S 4it3u6 71; ISTOOEfEFYTHATTHEPOUCIEOF INSURANCE LISTED BELOWHAVE BEEN ISSUED TO�THE INAURFO NAAAEDABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHFR DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED B Y THE POLICIES DESCRIBED HEREIN IS SVBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, -0 TYPE OF IN6VRANCE POLICYEFFECTIVE PQLICYENPBNTQN .TR POLICY NUMBER GATE (MMIDOIYt) GATE FAMIDOMI LIMITS GENERAL LIABILITY GENERAL AGGREGATE S COWCRCIALGFN'ERALLASaRY �7CLAWSMADE GI OCCUR PRODUCTG-COMPICPAGG I O PERSONAL a ADV PJJURY S OWNER'S A CONTRACTOR B PROT EACH OCCURRENCE S FeEDAMAGE(Anyonr/,el I6 AUTOMOBILE LIABILITY M�EXP IAnV 0,0 pti mn) A ANY AUTO GOMDN= SINGLE LIMIT is I1-7 ALL OWNED AUTOS NSCHEDULED AUTOS PPeOd ei on) S —I HIREDAUTOS NON-OWNEDAUTOS I PP.ya:oe.N arae'd."'j If PROPERtt DAMAGE I 6 GARAGE LIABBATY ANY AUTO AUTO ONLY. EA ACOIOENT 4 0THEaTHAN AUTOONLY ( CACHACCOC-NT 6 AGGREGATE i EXCESS LIABILITY UMBRELLA FORM EACHOCCARINCE 6 nGGREGATE f OTHER 11-AN UYSRELLA FORM S WORRERT COMPENSATION AND EMPLOYERS' LIABILDY wC 1P+Fm CO WC'IDO550 FL 07/01/2007 07/01/2009 wr •.iiAiiu onR. X iOR'%DMR9 FR EL EACH ACCIDENT S 1,000,D 0 + TIE PROPRI[2%*I we; I0e0f] eB w'CI!um OC EL DISEASE POLKYLIMT s 1,000,000 rM',\'FRGAkECN,vE NCL WC P, lads' •R TRER9 ARc CALL 'eL DISEASE •EA EMPLOYEE S 1,DDD,DDO O OTHER E90RPTIDN OF pPERArON61LOCATIpNBNF_HICLPSISPF.CUL ITlNS aL LEASED EMPLOYEES WORKING FOR THE ABOVE NAMED CLIENT COMPANY. PAID UNDER ADP TOTAL SOURCE, INC'S PAYROLL, WILL BE COVERED UNDER THE ROVE STATED POLICY. *THE ABOVE NAMED CLIENT IS AN ALTERNATE EMPLOYER UNDER THIS POLICY. Hr IIrf,1; I. 1 •L�" a�II � v '� A ,I ��5. 'd. SHOULD ANVOF TNO ABOVE DESCRIBED POLICIES BE CANCELLED SEFORE THE WELL DYNE, INC. EWIRATION OATS I4QREOF, THE ISSUING COMPANY YAILL ENDEAVOR TO MAIL 7472 STUSCON WAY ENGLEWOOD, CO 80112 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAICURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR UASILITY OF ANY HIND UPON THE COMPANY, ITS AGENTS ER REPROWNYATNE3. AUTHORISE REPR2SENTAYag AON RISK SERVlCCS, INC. OF FLORIDA dN'N �I ai�;,�f—)u DATE (MMIDDfM ACORD, CERTIFICATE OF LIABILITY INSURANCE 06/2&2008 Is SUE OF PRODUCER Serial# A77446 THE CFORMATION ERTIFICA E ERTIFICATE ONLYCANDERTIFICAT NO RIGHTS UPON CON NO OR AON RISK SERVICES, INC. OF FLORIDA A�TEND TER THE COVEERAGE CAFFORDED BY THE POLICIES BELOW. 1001 BRICKELL BAY DRIVE, SUITE #110D COMPANIES AFFORDING COVERAGE MIAMI, FL 33131-4937 PHONE: 800-743.8130 FAX: 800-522-7514 CAM^" NEW HAMPSHIRE INSURANCE COMPANY A INSURED n n "�(✓n7�a76 ADP TOTALSOURCE, INC /� 10200 SUNSET DRIVE COMPAW MIAMI, FL 33173 C `ALTERNATE EMPLOYER: WELL DYNE, INC. MANY D .. a -. ... _:. TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED CONTRACT OR OTHER WITH RESPECT WHICH THIS OR CONDITION OF ANY Y THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLDOCUMENT REQUIREMENT,THE E TERMS, INDICERTIF SAµ TH G BE ISSUED OR MAY INSUARANCE AFFORDED B LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, POLICY EFFECTIVE P p�,MLIMITS CD TYPE OF INSURANCE POLICY NUMBER DATE (MMMDlfy) LTR GENERAL LIABILITY GENERAL AGGREGATE PRODUCTS -COMPfOP AGG f f COMMERCIAL GENERAL LIABILITY PERSONM-&ADNIWURV f CLAIMS MADE OCCUR EACH OCCURRENCE S OWNERS S CONTRACTOR'S PROT FIRE DAMAGE (Myanefra) f_ MED EV Wy we Wmn) AUTOMOBILE LIABILITY COMBINED SINGLE LIMB f ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS (Ispor URY f NON-OWNEDAUTOS PROPERTY DAMAGE $ GARAGE LIA0ILITY AUTO ONLY - EAACCIDENT f OTHERTHANAIITOOM-Y: EACH ACCIDENT f ANY AUTO AGGREGATE $ EACH OCCURRENCE f EXCESS LIASILITY AGGREGATE f UMBRELLA FORM f OTHER TMNN UMBRELLA FORM WOOKa B COMPENSATION AND WC 5881064 CO 07/01/2008 07/01/2009 X TDRY!' ER EL EACH ACCIDENT f 1,000,000 A I EMPLOYERLAmuTY 10000 ELDISEASE.POLICYLRAT WETiOPRETM INCL pARTIEASF%Ecurm ELDISEASE-FA EMPLOYEE s 1,DOO,000 OFF ms ARE: EACL OTHER DESCRIPTION OF OPBIATIONSAOCA ICUESISPECLMLITEMS FOR THE ABOVE NAMED CLIENT COMPANY, PAID UNDER ADP TOTAL SOURCE ING'S PAYROLL, WILL BE COVERED UNDER ALL EMPLOYEES WORKING THE ABOVE STATED POLICY 'THE ABOVE NAMED CLIENT IS AN ALTERNATE EMPLOYER UNDER THIS POLICY .. SHOULD My OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MA WELL DYNE, INC 30 DAYS WRDTEN NOTICE TO THE CERTIFICATE HOLDER NAMEDTO THE LEFT' 7472 S TUSCON WAY — FNWRE TO MAIL SUCH NOTICE SMALL IMPOSE NO OBL'GATXN OR LTABBJTY ENGLEWDOD, CO 80112 BUT aP My NND UPON THE COMPANY. ITS AGENTS OR REPRESEWATNES. AUTHORIZED REPRO ENTATNE AON RISK SERVICES, INC. OF FLORIDA r �► ,aco CERTIFICATE OF LIABILITY INSURANCE 6/20F DATE M/DDI12 � 6/20/20 PRODUCER (303) 534-7325 FAX: (303) 623-7325 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Peak 360, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER T lq$-,,,r�-FRTIFICATE DOES NOT AMEND, EXTEND OR 1600 Emerson St. ,n , ALE COI/ RAGE AFFORDED BY THE POLICIES BELOW. Denver CO 80218 INSURERS AFFQRpING COVERAGE NAIC # INSURED C INSURER k HO$414,iI\d Insurance Co of NY WellDyne, Inc.; WellDyneRX; CF Pharmacy Svc wsuRERe:Contirl 'fatal Insurance (CNA) 7472 S. Tucson Way pINsuRERc: The Hartford 00914 ©� a-7 1 INSURER D: ' Centennal CO 80112 V INSURER 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 OFSUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADD' NSR TYPE OF INSURANCE POLICY NUMBER EFFECTIVE POLICY /YY DATE MMIDDYY POLICY EXPIRATION DATE MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 A CLAIMS MADE [A] OCCUR L-0925-11 12/7/2011 12/7/2012 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 ! i GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 3,000,000 X POLICY !77 PRO- LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ B X ALL OWNED AUTOS SCHEDULED AUTOS 4026985883 12/7/2011 12/7/2012 BODILY INJURY (Per accident) $ X X HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ -e-� GARAGE LIABILITY ANY AUTO 1 / AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ $ AUTO ONLY: AGG EXCESS I UMBRELLA LIABILITY X OCCUR CLAIMS MADE , i.,t. i EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 $ $ A DEDUCTIBLE -0251-11 12/7/2011 12/7/2012 EXCESS OVER CNA ONLY $ X RETENTION $ 10,000 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) 34WEJI3046 6/1/2012 6/1/2013 I WRYTATU- OTRH- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1 000,000 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT I $ 1,000,000 A OTHER PROF LIABILITY L-0925-11 12/7/2011 12/7/2012 EACH OCCURRENCE $ 1,000,000 ANNUAL AGGREGATE $ 3,000,000 C TPA E&O LIABILITY iPG0257328 12/7/2011 1 12/7/2012 1,000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION ckindig@santa-ana.org SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF SANTA ANA DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN CHRI STY KIND IG NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 20 CIVIC CENTER PLAZA SANTA ANA, CA 92701 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE _ Gary Friedman/GARY ACORD 25 (200910l) © 1988-2009 ACORD CORPORATION. All rights reserved. INS025 (200901) The ACORD name and logo are registered marks of ACORD fT► iZ673_i_ k'I 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 This Certificate of Insurance 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 listed thereon. ACORD 25 (2009/01) INS025 (200901) Digitally signed Ac"Mor CERTIFICATE OF LIABILA W E DATE (MMIDDIYYYY) �.,.,,� /l4 3 n 11Q2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS WRIGHTS UPON TF c -FxRTIFICATE H LDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGF AF,Qex*tQPOLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A ZITRACT BETWEEN THE ' UING Ii:`zURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy es) A DI D provisions c: be en orsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may rer,uire an en(yeP q,,:4tten�tt7► �J 7.lJo.`} �J lJ D this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).CONTACT PRODUCER Lockton Companies _ NAME, PHONE FAX A/C No): 8110 E Union Avenue Suite 100 Denver CO 80237 E-MAIL ADDRESS: (303) 414-6000 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Arch Specialty Insurance Company 21199 INSURED WellDyneRX, LLC 1477414 500 Eagles Landing Drive INSURER B : Zurich American Insurance Company 16535 INSURER C : ACE American Insurance Company 22667 INSURER D : Berkley Insurance Company 32603 Lakeland, FL 33810 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 14516082 REVISION NUMBER: XXXxxS x 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 INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY N N FLP006017705 2/16/2022 2/16/2023 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE 1XI OCCUR DAMAGE T PREM SESOEa occurrDence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY n PRO - POLICY F-1 LOC PRODUCTS - COMP/OP AGG $ 3,000,000 $ OTHER: A AUTOMOBILE LIABILITY N N FLP006017705 2/16/2022 2/16/2023 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ XXX)CS XX ANY AUTO OWNED SCHEDULED AUTOS ONLYNAUTOS BODILY INJURY (Per accident) $ XXX�CSCSCS� Xr PROPERTY DAMAGE Per accident $XXXXXXX HIRED NON -OWNED AUTOS ONLYAUTOS ONLY $ XXXyCS xx A X UMBRELLA LIAB X OCCUR N N FLP006017705 2/16/2022 2/16/2023 EACH OCCURRENCE $ 10,000,000 A EXCESS LIAB CLAIMS -MADE Prof. Liab. RetroDate: 2/16/20 X AGGREGATE $ 10,000,000 DED RETENTION $ $ XXXXX� B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A N WC014390905 2/16/2022 2/16/2023 EROTH- X STATUTE ER 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 Pharmacy Prof. Liab. N 2/16/2022 2/16/2023 $1M/$3M Retro Date: 2/16/2020 C PBM E&O Liab. =FLPOR046017705 2508130002 2/16/2022 2/16/2023 Limit: $3M/Ret $250K D Crime 500242325 2/16/2022 2/16/2023 Limit: $2M per Occ. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Per Agreement Master Agreement A-2007-278 and current agreement A-20180-131-01 with the City of Santa Ana, Proof of Worlcers' Compensation Coverage. 14516082 City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana CA 92701 ACORD 25 (2016103) 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,— Risk M8118gement DMskrn +� �m REVIEWED & APPROVED BY: @ 1 s88-2o ACo The ACORD name and logo are registered marks of ACORD r Risk Management Specialist off IN Miscellaneous Attachment: M577149 Master ID: 1477414, Certificate ID: 14516082 Excess Liability Schedule Carrier Policy Number Limit Lloyd's of London MCFAL1000459 $25,000,000 Lloyd's of London B0180PC2209645 $30,000,000 m Risk Management DlMsian REVIEWED & APPROVED BY: r Risk Management Specialist