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Item # 22
City of Santa Ana
20 Civic Center Plaza, Santa Ana, CA 92701
Staff Report
December 2, 2025
TOPIC: General Liability and Workers' Compensation Claims Administration Services
AGENDA TITLE
Agreements with AdminSure, Inc. for Third Party General Liability and Workers'
Compensation Claims Administration Services (Specification No. 25-138) (Non -General
Fund)
RECOMMENDED ACTION
1. Authorize the City Manager to execute an agreement with AdminSure, Inc. to
provide third party general liability claims administration services, in an amount not
to exceed $1,537,296, for a term beginning December 2, 2025 and expiring June
30, 2029. (Agreement No. A-2025-XXX).
2. Authorize the City Manager to execute an agreement with AdminSure, Inc. to
provide third party workers' compensation claims administration services, in an
amount not to exceed $2,877,212, for a term beginning December 2, 2025 and
expiring June 30, 2029. (Agreement No. A-2025-XXX).
GOVERNMENT CODE §84308 APPLIES: Yes
DISCUSSION
The City utilizes AdminSure, Inc. to provide the City's self -insured third -party
administration services for general liability and workers' compensation claims
management. AdminSure, Inc. assists the City with services such as, but not limited to,
investigations, correspondence with claimants, assisting with litigation management as
needed, and continuing as our payor agent to issue settlement payments from our City's
escrow banking accounts. AdminSure processes approximately 800 claims per year and
approximately 38,000 payments each year. The City's agreements with AdminSure, Inc.
expired August 31, 2025. Prior to expiration of the AdminSure contracts, staff had been
advised by ICRMA that the City could utilize TPA services through its contract. Staff
subsequently discovered the City would need to continue to maintain direct contracts with
AdminSure to provide claims administration.
Santa Ana Municipal Code, Section 2-807(d), authorizes the City to purchase against
contracts from any public agency utilizing a competitive bid process. The City of Newport
General Liability and Workers' Compensation Claims Administration Services
December 2, 2025
Page 2
Beach contracts with AdminSure, Inc. for third party general liability claims administration
services (C-8179-2) and workers' compensation claims administration services (C-8613-
2) were awarded as a result of open, competitive bidding and meet the City's
requirements.
Staff researched available procurement options and determined that AdminSure, Inc.
meets the City's specifications. By leveraging the procurement power through
piggybackable purchasing, the City of Santa Ana is able to obtain vetted, high quality
services at a reasonable price, and is in accordance with the City's existing Purchasing
Guidelines.
In addition, the City acknowledges that to ensure the continuity of essential general
liability and workers' compensation claims management services, the Consultant may
have provided services prior to these agreements' execution, resulting in outstanding
billings. This agreement is intended to cover services commencing September 1, 2025,
including any unpaid sums owed to the Consultant for services rendered from that date
forward.
ENVIRONMENTAL IMPACT
There is no environmental impact associated with this action.
FISCAL IMPACT
Funding is available in the current FY 2025-26 budget and funding for subsequent fiscal
years will be included in the proposed budgets for City Council consideration.
General Liability
Fiscal
Accounting Unit
Fund
Account Description
Amount
Year
— Account #
Description
2025-26
08009051-62302
Liability &
Liability & Property Ins
$309,180
Property Ins
Fund — Contracted
Fund
Vendor Personnel
S rvcs
2026-27
08009051-62302
Liability &
Liability & Property Ins
$389,568
Property Ins
Fund — Contracted
Fund
Vendor Personnel
S rvcs
2027-28
08009051-62302
Liability &
Liability & Property Ins
$409,044
Property Ins
Fund — Contracted
Fund
Vendor Personnel
S rvcs
2028-29
08009051-62302
Liability &
Liability & Property Ins
$429,504
Property Ins
Fund — Contracted
Fund
Vendor Personnel
S rvcs
Total
$1,537,296
General Liability and Workers' Compensation Claims Administration Services
December 2, 2025
Page 3
Worker's Compensation
Fiscal
Accounting
Fund
Fund Description
Amount
Year
Unit — Account
Description
No.
2025-26
08209054-62302
Workers
Workers
$578,660
Compensation
Compensation Fund
Fund
— Contracted Vendor
Personnel Srvcs.
2026-27
08209054-62302
Workers
Workers
$729,120
Compensation
Compensation Fund
Fund
— Contracted Vendor
Personnel Srvcs.
2027-28
08209054-62302
Workers
Workers
$765,576
Compensation
Compensation Fund
Fund
— Contracted Vendor
Personnel Srvcs.
2028-29
08209054-62302
Workers
Workers
$803,856
Compensation
Compensation Fund
Fund
— Contracted Vendor
Personnel Srvcs.
Total
$2,877,212
EXHIBIT(S)
1. Agreement with AdminSure, Inc. -General Liability
2. Agreement with AdminSure, Inc. -Worker's Compensation
Submitted By: Lori Schnaider, Executive Director — Human Resources Department
Approved By: Alvaro Nunez, City Manager
PROFESSIONAL SERVICES AGREEMENT
FOR THIRD PARTY GENERAL LIABILITY CLAIMS ADNIINISTRATION BETWEEN
THE CITY OF SANTA ANA AND ADMINSURE, INC.
This "Professional Services Agreement Between the City of Santa Ana and Adminsure, Inc.
("Agreement") is made and entered into this 2nd, day of December, 2025, by and between the City of
Santa Ana, California, a California Municipal Corporation (the "City") and Adminsure, a California
corporation ("Consultant). The City and Consultant are sometimes hereinafter referred to individually
as a "Party" or collectively as the "Parties". The Parties enter into this Agreement with reference to the
following:
Recitals
A. City needs a qualified third party to whom to delegate the responsibilities and duties of
administering the City's self -insured general liability coverage program;
B. City desires to engage Consultant to provide Third Party General Liability Claims
Administration services;
C. Consultant recently participated in a Request for Proposal ("RFP") for the same services with
the City of Newport Beach and was selected through this RFP process;
D. The City's purchasing procedures allow the City to piggyback off a successful RFP process
through another government entity for the same services; and
E. Consultant possesses the necessary skills, experiences, training, and certifications to provide
the professional services set forth in this Agreement.
NOW, THEREFORE, in consideration of the performance by the Parties of the covenants and
conditions herein contained, the City and Consultant hereby agree as follows:
Terms and Conditions
Consultant Services.
Consultant agrees to perform any and all work necessary to supervise and administer the general
liability claim program for the City, represent the City in all matters related to the investigation,
adjustment, processing, supervision and resolution of liability claims for money damages asserted by
third parties against the City, and provide to the City during the term of this Agreement all the services
described in the Scope of Services attached hereto as Exhibit A and incorporated herein by reference
(collectively, the "Services").
2. Consultant CoLnpensation and Schedule of Payment.
a. Consultant will accept as payment and City agrees to pay for all services rendered
pursuant to this Agreement, the monthly fees set forth below:
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Dates Covered
Monthly Charges
9/l/2025 — 6/30/2025
$30 918.00
7/1/2026 — 6/30/2027
$32,464.00
7/1/2027 — 6/30/2028
$34,087.00
7/1/2028 — 6/30/2029
$35,792.00
b. The total amount to be expended during the term of this Agreement shall not
exceed one million five hundred thirty-seven thousand two hundred ninety-six dollars and
zero cents ($1,537,296.00).
C. The Parties agree and acknowledge that services rendered since September 1, 2025
are intended to be paid through this Agreement.
d. Payment Schedule. Payment by City shall be made within forty-five (45) days
following receipt of proper invoice evidencing work performed, subject to City accounting procedures.
City and Consultant agree that all payments due and owing under this Agreement shall be made through
Automated Clearing House (ACH) transfers. Consultant agrees to execute the City's standard ACH
Vendor Payment Authorization and provide required documentation. Upon verification of the data
provided, the City will be authorized to deposit payments directly into Consultant's account(s) with
financial institutions. 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.
e. Inspection of Books and Records. Upon request by City, Consultant shall provide
time records and back up data and records verifying project costs and expenses, including out of pocket
third party expenses.
3. Term. The term of this Agreement is for a period of three and a half (3 %z) years,
commencing on December 2, 2025 and terrninating on June 30, 2029.
4. Termination.
a. The City may terminate this Agreement at any time, without cause, with ninety
days' written notice.
b. The City may terminate this Agreement for cause upon providing the Consultant
thirty (30) days written notice if
(i) if the Consultant breaches any provision of this Agreement and does not
cure such breach within ten (10) days after written notice of the breach is given by the City;
(ii) in the event the Consultant's services, in the judgment of City, are
unsatisfactory;
(iii) in the event of the Consultant's failure to prosecute the work with diligence
or within the time limits specified in the contract documents and Consultant fails to cure this breach within
ten (10) days of being advised of the breach;
(iv) failure to procure or maintain insurance as required by this Agreement; or
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(v) in the event of bankruptcy, whether voluntary or involuntary, of Consultant.
c. The Consultant may terminate this Agreement in the event that the City is
delinquent in paying any invoices for a period in excess of sixty (60) days. Termination shall be effective
thirty (30) days after notice is received by mail at the City's office unless the City has remedied said
failure(s) to the satisfaction of the Consultant.
d. If this Agreement is terminated without cause, Consultant shall be paid for the
reasonable value of the Services provided up to the time of such termination or suspension. From and
after Consultant's receipt of notice of termination, Consultant shall use all reasonable efforts to minimize
project costs and expenses, except to the extent the City's notice requested that certain services are
continued.
5. Confidentiality.
If Consultant receives from the City information which due to the nature of such information is
reasonably understood to be confidential and/or proprietary, Consultant 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 Consultant disclosed in a publicly available source; (c) is in
rightful possession of the Consultant without an obligation of confidentiality; (d) is required to be
disclosed by operation of law; or (e) is independently developed by the Consultant without reference to
information disclosed by the City.
Ownership of Records and Work Product.
a. All claim data is owned by the City. All claim electronic files, loss reports, payroll
information, and other documents and materials, and all transactional level electronic data in the requested
format, shall be delivered to the City upon termination of this Agreement.
b. All products of undertaking and completing the Services and Consultant's duties
hereunder including, but not limited to, the study results, reports, drawings, photographs, photo
simulations, maps, plans, renderings, specifications, analyses, surveys, data, computer printouts, programs
and software, and all supporting documentation of such programs prepared in the performance of the
Services shall be the property of City, and shall be delivered to City before final payment and the
completion of performance or any earlier termination under this Agreement.
7. Indemnification.
a. The Consultant agrees to indemnify, defend and hold harmless the City, and/or their
respective officers, members, agents, and employees from any and all loss, liability, claim, demand, cause
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of action or suit, of any and every kind and description, arising or resulting from, or in any way connected
with, Consultant's performance and/or nonperformance of the Services required by this Agreement
including, but not limited to, liability for inaccurate data, loss or dissemination of data, whether intentional
or inadvertent. The Consultant shall, upon demand by the City, as applicable, and at its sole cost and
expense, defend and provide attorneys acceptable to the City, as applicable, to defend the City, and/or
their respective officers, officials, employees and agents from and against any and all loss, liability, claim,
demand, cause of action or suit, of any and every kind and description, arising or resulting from, or in any
way connected with, Consultant's performance and/or non-performance of the Services required by this
Agreement. If the City provides its own defense against any such action or suit, the Consultant shall
reimburse the City for all reasonable attorney fees and other costs incurred by the City.
b. The Consultant agrees to indemnify, defend and hold harmless the City, and/or their
respective officers, members, agents, and employees from any and all loss, liability, claim, demand, cause
of action or suit, of any and every bind and description, arising or resulting from, or in any way connected
with, any fines, fees, penalties or Medicare reimbursements required to be paid as a result of the
Consultant's failure to timely report any Medicare -eligible judgments, awards, or settlements, or for
failure to adequately protect Medicare's conditional or future medical payments.
G. City agrees to defend any demand, claim, or legal action commenced against the
Consultant regarding a matter or incident allegedly caused by or resulting from wrongful or negligent acts
of their respective officers, employees, agents, or others engaged by the City, and to indemnify the
Consultant against any liability, loss, cost, or damage, including attorney's fees, resulting there from.
8. Intellectual Property Indemnification
Consultant 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 Consultant to the City pursuant to this Agreement.
9. Insurance.
Consultant agrees to obtain and maintain through the term of this Agreement insurance
coverages as set forth in the attached Exhibit B and incorporated herein by reference.
10. Non -liability of City Officials, No City representative shall be personally liable to the
Consultant, or any successor in interest of Consultant, in the event of any default or breach by the City, or
for any amount which may become due to the Consultant or any successor, or on any obligation under the
terms of this Agreement.
11. Independent Consultant.
Consultant shall, during the entire term of this Agreement, be construed to be an independent
Consultant 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 Consultant performs the services which are
the subject matter of this Agreement; however, the services to be provided by Consultant shall be
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provided in a manner consistent with all applicable standards and regulations governing such services.
Consultant 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. The
Consultant shall agree to indemnify, defend and hold harmless the City for any action or proceeding
related to Consultant's employees or agents' independent Consultant status.
12. Employment Practices.
Consultant shall not discriminate because of race, color, creed, religion, sex, marital status,
sexual orientation, gender identity, gender expression, gender, medical conditions, genetic information,
or military and veteran status, age, national origin, ancestry, or disability, as defined and prohibited by
applicable law, in the recruitment, selection, teaching, training, utilization, promotion, termination or
other employment related activities or any services provided under this Agreement. Consultant affirms
that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws
and regulations.
13. Conflicts of Interest.
a. Consultant 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.
b. No immediate family members of either the Mayor, City Council Member, or any
appointed City Official, including appointed board and commission members, as defined under the
City's Municipal Code, whose position with the City shall award or influence the award of this
Agreement, or any competing contract or amendment thereof, shall be employed in any capacity by the
Consultant or have any other direct or indirect financial benefit or interest in this Agreement.
C. The section also prohibits the awarding of any agreement, contract, grant, or any
amendment to those awards, to any former full-time employee for one-year from date of employee
separation except for any CalPERS retiree as authorized by City Council resolution
d. The Consultant must comply with all conflict of interest laws, ordinances, and regulations
now in effect or hereafter to be enacted during the term of this Agreement. The Consultant warrants that
it is not now aware of any facts which conflict with the prohibitions defined above. If the Consultant
hereafter becomes aware of any facts that might reasonably be expected to create a conflict of interest, it
must immediately make full written disclosure of such facts to the City. Full written disclosure must
include, but is not limited to, identification of all persons implicated and a complete description of all
relevant circumstances. Failure to comply with the provisions of this paragraph will be a material breach
of this Agreement.
C. Consultant covenants that none of its directors, officers, employees, or agents shall
participate in selecting or administrating any subcontract supported (in whole or in part) by City funds
stemming from the Agreement where the awarding of the subcontract has any direct or indirect financial
benefit or interest to any individual, as defined in subsections (b) and (c) above.
Page 5 of 9
14. Force Majeure.
a. "Force Majeure" means any cause beyond the reasonable control of a party,
including but not limited to act of God, civil or military disruption, fire, strike, flood, riot, war, or inability
due to the aforementioned causes to obtain necessary labor, materials, or facilities.
b. If any Party hereto is delayed or prevented from fulfilling its obligations under this
Agreement by Force Maj cure, said Party will not be liable under this Agreement for such delay or failure,
nor for damages or injuries resulting directly from the inability to perform scheduled work due to Force
Majeure.
C. Consultant shall be granted an automatic extension of time cominensurate with any
delay in performing scheduled work arising from Force Maj cure. Consultant agrees to resume such work
within three (3) days after the Force Majeure has subsided enough to do so.
15. Assignment. Neither Party shall assign or transfer its interest in this Agreement or any part
thereof without the written consent of the other Party.
16. Exclusivity and Amendment.
This Agreement represents the complete and exclusive statement between the City and
Consultant, 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 Consultant. 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 Consultant 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.
17. Waiver of Breach.
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.
18. Notice. Whenever it shall be necessary for either Party to serve notice on the other
respecting this Agreement, such notice shall be served by personal delivery or by certified mail addressed
at the following address, unless and until different addresses may be furnished in writing by either Party
to the other and such notice shall be deemed to have been served within seventy-two (72) hours after the
same has been deposited in a United States Post Office by certified mail or has been delivered personally,
and shall be valid and sufficient service of notice for all purposes;
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If to City: City Clerk
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:
and
Executive Director — Human Resources Agency
City of Santa Ana
20 Civic Center Plaza (M-24)
P.O. Box 1988
Santa Ana, California 92702
Fax 714- 647-6930
City Attorney
City of Santa Ana
20 Civic Center Plaza (M-29)
P.O. Box 1988
Santa Ana, California 92702
Fax 714-647-6515
If to Consultant: AdminSure
Attention; Alithia Vargas -Flores
3380 Shelby Street
Ontario, CA 91764
19, Governing Law and Venue. This Agreement shall be construed and enforced pursuant to
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.
20. Professional Licenses.
Consultant 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. Consultant 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.
21. Attorneys' Fees. Each Party shall also bear its own attorneys' fees and all costs related to
the preparation of this Agreement. In the event any Party to this Agreement brings suit to enforce any
provision of this Agreement, or is required to defend an action relating to any provision of this Agreement,
Page 7 of 9
the non -prevailing Party agrees to pay the prevailing Party such court costs and attorneys' fees as the court
deems just.
22. Advice of Counsel. Each of the Parties acknowledges that it has received or has had the
opportunity to receive independent legal advice from an attorney with respect to the advisability of making
this Agreement and with respect to the advisability of executing this Agreement.
23. No Reliance on Outside Parties. Each of the Parties acknowledges that it has not relied
upon any statement or representation by any other Party or any representative of any other Party, in making
or executing this Agreement, except as expressly stated herein.
24. Authori . 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.
25. Counterparts. This Agreement may be signed in counterparts and compiled into one
agreement to make an original.
26. Amendment. This Agreement cannot be amended or modified except by an instrument in
writing signed by both Parties.
27. Interpretation. Should it be necessary for a court to interpret this Agreement, the Parties
agree that it has been prepared by a joint effort of all Parties. Accordingly, only the fair meaning of the
words shall be used in any interpretation hereof.
28. Severability. The provisions of this Agreement are severable and if one or more provisions
or subcomponents should be determined to be unconstitutional, illegal or judicially unenforceable, in
whole or in part, then, unless such unenforceability would make it impossible to effectuate the original
intent of the Parties, the remaining provisions or subcomponents hereof shall remain binding and
enforceable.
29. Expression of Entire Agreement. This Agreement constitutes a single, integrated written
contract, and as such, expresses the entire Agreement of the Parties with respect to the matters contained
herein and supersedes all prior negotiations, discussions, correspondence and other communications
regarding the terms and conditions hereof.
IN WITNESS WHEREOF, the City, and Consultant hereto have executed this Agreement on the
date first above written.
CONSULTANT
Adminsure, Inc.. [Signatures continue on the next page]
By: *1
Alithia Varga6lFlores
Its: President
Page 8 of 9
ATTEST:
Jennifer L. Hall
City Clerk
APPROVED AS TO FORM:
SONIA R. CARVALHO
City Attorney
By: do-u�.,
8n iu
Laura A. Rossini
Chief Assistant City Attorney
CITY OF SANTA ANA
Alvaro Nunez
City Manager
RECOMMENDED FOR APPROVAL:
r L L_�
Lori Schnaider
Executive Director of Human Resources
Page 9 of 9
EXHIBIT A
SCOPE OF SERVICES
SCOPE OF SERVICES- GENERAL LIABILITY CLAIMS ADMINSTRATION
1. Description of Services. The responsibilities of Consultant are divided into the
following categories: claims administration, litigation management, subrogation and reporting of
claims activities. Consultant agrees to perform these services in accordance with the Best Practices
and Performance Standards for Third Party Administrators.
a. Claims Administration.
(i) Consultant shall provide the City with sufficient qualified personnel,
including at least one senior claims adjuster, to efficiently and effectively meet the responsibilities
as defined below and any other duties incidental, or in addition, to those responsibilities. The
senior claims adjuster shall have a minimum of three years' experience in adjusting liability claims
for public entities. Consultant shall also provide a supervisor/account manager who shall oversee
the servicing of the City's claims. The account manager shall have at least six years' experience
in adjusting liability claims, five of which involved adjusting liability claims for public entities.
No adjuster or supervisor/account manager shall service the City's account without prior approval
by the City.
(ii) The responsibilities of Consultant shall include, but not be limited
to, the following:
(1) Establish and maintain an electronic file for each claim
reported, to include a diary review system by both the examiner and supervisor; statistical data for
each claim should be stored electronically and shall include all data required to comply with federal
and state requirements including Medicare secondary payer laws and regulations;
(2) Provide comprehensive claim investigative services in an
expeditious manner and taking into account the statutory time frame for responding to a
government tort claim;
(3) Periodically, determine potential liability and establish,
review, and update reserves for each reported claims and advise the City of any changes as they
occur;
(4) Notify Independent Cities Risk Management Authority
(ICRMA) Litigation Manager of a claim as required by the ICRMA Liability Program
Memorandum of Coverage (MOC) and coordinate with the City's Risk Management Division,
City Attorney's Office and ICRMA Litigation Manager and any applicable excess insurance
representatives in the defense, settlement, and payment of claims. Prepare and submit information
to the Litigation Manager, and upon request insurance carrier(s), on all claims that fall within the
reporting requirements set forth by the MOC or the insurance carrier(s);
(5) Document sufficiency of reserves, minimally at 90-day
intervals;
(6) Provide the City with a recommendation to accept or deny a
claim within the statutory period in the California Government Tort Claims Act;
(7) Provide immediate notification to the City of offers to settle;
(8) Obtain settlement authority from City, ICRMA (when
required), and the excess carrier where applicable;
(9) Obtain releases and other necessary forms from all
appropriate parties upon settlement of a claim prior to issuing a settlement check;
(10) Upon the City's request, assist with preparation for, and
attend small claims court hearings, court hearings and City Council meetings at no additional
charge to the City;
(I t) Prepare and, where needed, obtain approval for issuance of
checks, drafts, or other documents in the payment of claims with electronic copies sent to the City;
(12) Promptly determine any potential to tender a claim to third
parties and the feasibility of subrogation, and take appropriate steps to subrogate, where such
action is appropriate;
(13) Promptly close each claim as soon as possible, but no later
than 30 days after final check issuance;
(14) Make available time, electronic files, and necessary staff for
meetings with the City and attendance at applicable meetings for settlement authority, claim
resolution strategy, and periodic claim audits;
(15) After collecting member data, Consultant shall determine
whether claimants are Medicare beneficiaries. If claimants are found to be Medicare beneficiaries,
Consultant as part of any settlement with the claimant shall on behalf of the City take all steps
necessary to protect Medicare's interests. This shall include, but is not necessarily limited to,
confirming that all known liens or claims by Medicare shall be satisfied from the settlement, and
making all reasonable efforts to determine whether Medicare will be asserting any future liens or
claims against the City, and if so, to satisfy as part of the settlement any such liens or claims to the
extent they can be determined, through a Medicare Set Aside or other appropriate procedure or
mechanism; and
(16) Maintain complete records of payments from an approved
trust account, established by the Consultant on behalf of the City for the purpose of paying all
claims related costs.
b. Litigation Management.
(i) Consultant shall assist in the implementation and conform to the
procedures of the City Attorney's Office and ICRMA's Litigation Management Program.
(ii) The duties of Consultant shall include, but not be limited to:
(1) Monitor defense counsel and assist in the implementation of
the ICRMA's Litigation Management Guidelines incorporated herein by reference;
(2) Assist defense counsel, at the direction of the City, in
obtaining facts or circumstances of a claim, including assistance in answering interrogatories;
(3) Attend settlement conferences, mediation, and court
appearances when requested;
(4) Supplying and collecting the case analysis and performance
evaluation forms from the defense firms;
(S) Make sure that legal bills have been reviewed by the City
Attorney's Office prior to payment, review legal bills for compliance with the Litigation
Management Guidelines, and use of cost effective processes and bring any concerns to the
attention of the City's Risk Manager and City Attorney's Office;
(6) Providing any and all information, reports, and data to the
City and ICRMA as may be requested from time to time.
(7) Allow access to City files for ICRMA annual audit.
C. Reporting of Claims Activity
(i) Provide a monthly statistical report to the City for each line of
coverage which shows all claims' activity, including claimant name, nature/type/cause of
injury/loss, date of loss, status, loss/expense paid and reserved amounts, with monthly and year-
to-date totals. A guide to any and all abbreviations used in any of the reports shall be provided to
the City and ICRMA. Reports shall include all claims meeting the City's reporting criteria.
(ii) In addition to the monthly statistical report, the Consultant will
provide to the City a monthly payment register showing all payments issued, payee, voucher
number, voucher date, and claimant name, if applicable.
(iii) Upon the request of the City, the Consultant shall also provide
special reports on claims, in detail or summary, sorted or queried by any, or any combination, of
the fields at no additional cost. All reports shall be provided in a Microsoft Excel format or any
other format as requested by the City.
(iv) The Consultant shall also provide reports to the City, as may be
requested from time to time, which accurately identify the types of claims that have been presented
so that the City can identify areas where corrective measures may be adopted to prevent fixture
claims of that nature.
2. Consultant's Obligations. The Consultant shall complete the Services as follows:
a. The Consultant represents that it employs, or will employ, at its own
expense, all personnel required for the satisfactory performance of the Services.
b. The Consultant represents that the Services will be performed by the
Consultant or personnel under its direct supervision, and that all personnel engaged in such work
shall be fully qualified and shall be authorized and permitted under applicable state and local laws
to perform such Services.
C. Consultant shall assign an account manager to ensure the duties under this
Agreement are performed in a timely and professional manner. Said representative shall not be
replaced by the Consultant without prior written notice to the City, nor without written approval
from the City. Any additional personnel used to perform the Services shall be limited to those
initially identified by the Consultant, unless approved in writing by the City.
d. Consultant shall ensure that other personnel, such as management, clerical,
accounting, and data processing, which may be required to satisfactorily provide the services
required by this Agreement, shall be provided by the Consultant within the agreed fee for Services
contained in this Agreement. It is understood that the personnel referred to in this entire Section
need not be dedicated to the exclusive use of the City.
e. Consultant shall furnish, at its own expense, all materials, equipment, and
personnel necessary to carry out the terms of this Agreement. Consultant shall not use City
premises, property including equipment, instruments, or supplies) or personnel for any purpose
other than in the performance of its obligations under this Agreement.
f The Consultant shall provide sufficient office space to ensure that the
City's' claims can be adjusted in an effective and efficient manner. Such office space shall be
equipped with an adequate theft and fire alarm system in an effort to protect the City's records.
g. The Consultant shall work closely with the City and their respective
designated representatives by providing any information, reports, and data to the City as may be
requested from time to time.
h. The Consultant agrees not to release any report, any portion thereof, or any
result of any investigation it may undertake on behalf of the City to any outside person or agency
without the express written consent of the City, except as provided by law or in this Agreement.
Consultant shall notify City immediately of any subpoena or other request for City records made
by a third party.
i. Data Interface. The Consultant shall provide an on-line interface with its
database, accessible from the City's computers. This information will be for use by the City. Such
data shall be in a format which will permit the City to make print copies of the data on its printers.
The data interface will have sufficient firewall and anti -virus software to maintain appropriate
security.
j. Data Reporting. Consultant shall provide City monthly loss information
with the fields and in the format specified.
k. Consultant shall provide reports outlined in this Agreement as specified or
other reports as requested by the City.
1. Consultant shall develop and implement processes and procedures relating
to the protection of electronic data, including a suitable security and off -site back-up system for
all stored data and a written policy with respect to disaster recovery, physical and electronic data
security, and electronic data retention, as required by the standards for Accreditation with
Excellence by the California Association of Joint Powers Authorities. Consultant will notify City
immediately in writing of its discovery of any data breach involving City's data.
In. The Consultant shall comply with all applicable federal, state, and local
laws, ordinances and regulations including but not limited to the Health Insurance Portability and
Accountability Act ("HIPPA."). Consultant shall report immediately to the City, in writing, any
discrepancy or inconsistency it discovers in the laws, ordinances, regulations, orders, and/or
guidelines in relation to the performance of Services under this Agreement.
n. The Consultant, at its sole expense, shall obtain and maintain during the
term of this Agreement, appropriate permits, certificates, and licenses including, but not limited
to, any business license that may be required in connection with the performance of services
under this Agreement.
o. The Consultant shall not subcontract or assign any portion of the Services
without prior written approval of the City.
P. The Consultant shall make no change in the character or extent of the work
required by this Agreement, except as may be authorized in writing by the City. Such supplemental
authorization shall set forth the specific changes of work to be performed and any related
extension of time and/or adjustment of fee to be paid to the City by the Consultant,
q. Consultant shall submit its annual SSAE18 / SAS70 to City within thirty
(30) days of receipt along with any action plans to mitigate any deficiencies noted by the auditor.
r. ConsuItant will cooperate fully with the City, City Attorney's Office, Risk
Manager, ICRMA and any applicable excess carrier.
3. City Obligations. In furtherance of the Services provided by the Consultant, the
City agrees to the following:
a. The City shall provide full information regarding its requirements for the
Agreement, and shall furnish without charge to the Consultant, any and all information available
within the offices of the City and are necessary for the Consultant to provide and perform the tasks
and Services set forth herein.
b. The City shall cooperate with the Consultant in carrying out the work of the
Agreement without undue delay. In this regard, the City, including any representative thereof,
shall examine documents submitted by the Consultant and shall render any necessary decisions
pertaining to such documents or Services as promptly as is practicable.
C. The City will provide to Consultant information regarding its computer
system to the extent necessary for claims processing or litigation management.
Exhibit B
Insurance Requirements
Prior to undertaking performance of work under this Agreement, Consultant shall
maintain and shall require any subcontractors to obtain and maintain insurance as described
below for the entire Term of this Agreement against claims for injuries to persons or damage to
property which may arise from or in connection with services, products and materials supplied to
City. Total cost of such insurance shall be borne by Consultant.
MINIMUM SCOPE AND LIMIT OF INSURANCE
Commercial General Liability (CGL): Insurance Services Office Form CG 00 01
covering CGL on an "occurrence" basis, including products and completed operations,
property damage, bodily injury and personal & advertising injury with limits no less than
$2,000,000 per occurrence and $4,000,000 aggregate. Required policy limits can be met
with primary and umbrella/excess insurance policies.
2. Automobile Liability (AL): Insurance Services Office Form CA 00 01 covering Code 1
(any auto), with limits no less than $1,000,000 combined single limits. In the event
Consultant does not maintain commercial automobile liability insurance, City will accept
evidence of personal automobile insurance, provided that such policy is endorsed for
business use and provides coverage with a minimum limit of $1,000,000. Required policy
limits can be met with primary and umbrella/excess insurance policies.
3. Workers' Compensation (WC): as required by the State of California, with Statutory
Limits, and Employer's Liability Insurance with limit of no less than $1,000,000 per
accident, policy or employee, for bodily injury or disease. Coverage is not required if
Consultant has no employees and signs request to waive such insurance.
4. Professional Liability (PL) /Errors and Omissions(E&O): with limits no less than
$2,000,000 per occurrence or claim, and $4,000,000 aggregate.
5. Cyber Liability (CL): Insurance, with limits not less than $2,000,000 per occurrence or
claim and $2,000,000 aggregate. Coverage shall be sufficiently broad to respond to the
duties and obligations as is undertaken by Consultant in this agreement and shall include,
but not be limited to, claims involving security breach, system failure, data recovery,
business interruption, cyber extortion, social engineering, infringement of intellectual
property, including but not limited to infringement of copyright, trademark, trade dress,
invasion of privacy violations, information theft, and release of private information. The
policy shall provide coverage for breach response costs, regulatory fines and penalties as
well as credit monitoring expenses.
G. Technology Professional Liability -Errors and Omissions Insurance (E&O);
appropriate to the Consultant's profession and work hereunder, with limits not less than
$2,000,000 per occurrence and $2,000,000 aggregate. Coverage shall be sufficiently
broad to respond to the duties and obligations as is undertaken by the Consultant in this
agreement and shall include, but not be limited to, claims involving business interruption,
damage to or destruction of electronic infonnation, and alteration of electronic
information. The policy shall provide coverage for Consultant's failure to provide
professional services and/or products under this Agreement. The Policy shall include, or
be endorsed to include, damage to, alteration of, loss of, or destruction of electronic data
and/or information "property" of Customer in the care, custody, or control of Consultant.
If Consultant maintains broader coverage and/or higher limits than the minimum requirements
for each line of coverage shown above, City requires and shall be entitled to the broader
coverage and/or the higher limits maintained by Consultant. Any available insurance proceeds in
excess of the specified minimum limits of insurance and coverage shall be available to City.
Other Insurance Provisions
The above required insurance policies are to contain or be endorsed to contain the following
provisions:
1. City, its City Council, its officers, officials, employees, agents, and volunteers are to be
covered as additional insureds, under Consultant's CGL and AL policies, with respect to
any liability arising out of work or operations performed by or on behalf of the
Consultant including materials, parts, equipment, and personnel furnished in connection
with such work or operations.
2. Consultant's Insurance company(ies) agrees to waive all rights of subrogation against
City, its City Council, its officers, officials, employees, agents, and volunteers for losses
paid under the terms of Consultant's CGL, AL, and WC policies which arise from work
performed by Consultant under this Agreement.
3. For any claims related to this contract, Consultant's insurance coverage shall be primary
and any insurance maintained by City, its City Council, its officers, officials, employees,
agents, or volunteers shall not contribute with it.
4. A severability of interest provision must apply for all the additional insureds, ensuring
that Consultant's insurance shall apply separately to each insured against whom a claim
is made or suit is brought, except with respect to the insurer's limits of liability.
5. Insurance policies required herein shall provide that coverage shall not be canceled,
suspended, voided, reduced in coverage or in limits, non -renewed by the carrier, or
materially changed except after thirty (30) days prior written notice has been given to
City. Ten (10) days prior written notice shall be provided to City for policy cancellation
or non -renewal due to non-payment of premium.
6. Certificate Holder on each Evidence of Insurance certificate shall be: City of Santa Ana,
Attention: (Luisa Mendoza, Acting Risk Manager), City of Santa Ana, Human
Resources Agency, 20 Civic Center Plaza, P.O. Box 1988, M-24, Santa Ana, CA 92701.
The name and location of project must be included in the Description of Operations
section of each certificate.
Self -Insured Retentions
Self -insured retentions must be declared to and approved by the City. The City may require the
Consultant to purchase coverage with a lower retention or provide proof of ability to pay losses
and related investigations, claim administration, and defense expenses within the retention.
Acceptability of Insurers
Insurance is to be placed with insurers authorized to conduct business in the State of California
with a current A.M. Best rating of no less than ANII, unless otherwise acceptable to City.
Verification of Coverage
Consultant shall furnish City with original. Certificates of Insurance including all required
amendatory endorsements (or copies of the applicable policy language effecting coverage
required by this clause) and a copy of the Declarations and Endorsement Page of the CGL policy
listing all policy endorsements before work begins, However, failure to obtain the required
documents prior to the work beginning shall not waive Consultant's obligation to provide them.
City reserves the right to require complete, certified copies of all required insurance policies,
including endorsements required by these specifications, at any time.
Special Risks or Circumstances
City reserves the right to modify these requirements, including limits, based on the nature of the
risk, prior experience, insurer, coverage, or other special circumstances.
PROFESSIONAL SERVICES AGREEMENT
FOR THIRD PARTY WORKERS' COMPENSATION CLAIMS ADMINISTRATION
BETWEEN
THE CITY OF SANTA ANA AND ADMINSURE, INC.
This "Professional Services Agreement Between the City of Santa Ana and Adminsure, Inc,
("Agreement") is made and entered into this 2nd, day of December, 2025, by and between the City of
Santa Ana, California, a California Municipal Corporation (the "City") and Adminsure, a California
corporation ("Consultant). The City and Consultant are sometimes hereinafter referred to individually
as a "Party" or collectively as the "Parties". The Parties enter into this Agreement with reference to the
following:
Recitals
A. City needs a qualified third party to whom to delegate the responsibilities and duties of
administering the City's self -insured workers' compensation claims program;
B. City desires to engage Consultant to provide Workers' Compensation Claims Administration
services;
C. Consultant recently participated in a Request for Proposal ("RFP") for the same services with
the City of Newport Beach and was selected through this RFP process;
D. The City's purchasing procedures allow the City to piggyback off a successful RFP process
through another government entity for the same services; and
E. Consultant possesses the necessary skills, experiences, training, and certifications to provide
the professional services set forth in this Agreement.
NOW, THEREFORE, in consideration of the performance by the Parties of the covenants and
conditions herein contained, the City and Consultant hereby agree as follows:
Terms and Conditions
Consultant Services.
Consultant agrees to perform any and all work necessary to supervise and administer the
workers' compensation claims program for the City, represent the City in all matters related to the
investigation, adjustment, processing, supervision and resolution of workers' compensation claims filed
against the City, and provide to the City during the term of this Agreement all the services described in
the Scope of Services attached hereto as Exhibit A and incorporated herein by reference (collectively,
the "Services").
2. Consultant Compensation and Schedule of Payment.
a. Consultant will accept as payment and City agrees to pay for all services rendered
pursuant to this Agreement, the monthly fees set forth below:
Page I of 9
Dates Covered
Monthly Char es
9/1/2025
— 6/30/2025
$57,866.00
7/1/2026
— 6/30/2027
$60,760.00
7/l/2027
— 6/30/2028
$63,798.00
7/l/2028
— 6/30/2029
$66,988.00
b. The total amount to be expended during the term of this Agreement shall not exceed
two million eight hundred seventy-seven thousand two hundred and twelve dollars and zero cents
($2,877,212.00).
C. The Parties agree and acknowledge that services rendered since September 1, 2025
are intended to be paid through this Agreement.
d. Payment Schedule. Payment by City shall be made within forty-five (45) days
following receipt of proper invoice evidencing work performed, subject to City accounting procedures.
City and Consultant agree that all payments due and owing under this Agreement shall be made through
Automated Clearing House (ACH) transfers. Consultant agrees to execute the City's standard ACH
Vendor Payment Authorization and provide required documentation. Upon verification of the data
provided, the City will be authorized to deposit payments directly into Consultant's account(s) with
financial institutions, 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.
e. Inspection of Books and Records. Upon request by City, Consultant shall provide
time records and back up data and records verifying project costs and expenses, including out of pocket
third party expenses.
3. Term. The term of this Agreement is for a period of three and a half (3 1/2) years,
commencing on December 2, 2025 and terminating on June 30, 2029.
4. Termination.
a. The City may terminate this Agreement at any time, without cause, with ninety
days' written notice,
b. The City may terminate this Agreement for cause upon providing the Consultant
thirty (30) days written notice if:
(i) if the Consultant breaches any provision of this Agreement and does not
cure such breach within ten (10) days after written notice of the breach is given by the City;
(ii) in the event the Consultant's services, in the judgment of City, are
unsatisfactory;
(iii) in the event of the Consultant's failure to prosecute the work with diligence
or within the time limits specified in the contract documents and Consultant fails to cure this breach within
ten (10) days of being advised of the breach;
(iv) failure to procure or maintain insurance as required by this Agreement; or
Page 2 of 9
(v) in the event of bankruptcy, whether voluntary or involuntary, of Consultant.
C. The Consultant may terminate this Agreement in the event that the City is
delinquent in paying any invoices for a period in excess of sixty (60) days. Termination shall be effective
thirty (30) days after notice is received by mail at the City's office unless the City has remedied said
failure(s) to the satisfaction of the Consultant.
d. If this Agreement is terminated without cause, Consultant shall be paid for the
reasonable value of the Services provided up to the time of such termination or suspension. From and
after Consultant's receipt of notice of termination, Consultant shall use all reasonable efforts to minimize
project costs and expenses, except to the extent the City's notice requested that certain services are
continued.
5. Confidentiality.
If Consultant receives from the City information which due to the nature of such information is
reasonably understood to be confidential and/or proprietary, Consultant 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 Consultant disclosed in a publicly available source; (c) is in
rightful possession of the Consultant without an obligation of confidentiality; (d) is required to be
disclosed by operation of law; or (e) is independently developed by the Consultant without reference to
information disclosed by the City.
6. Ownership of Records and Work Product.
a. All claim data is owned by the City. All claim electronic files, loss reports, payroll
information, and other documents and materials, and all transactional level electronic data in the requested
format, shall be delivered to the City upon termination of this Agreement.
b. All products of undertaking and completing the Services and Consultant's duties
hereunder including, but not limited to, the study results, reports, drawings, photographs, photo
simulations, maps, plans, renderings, specifications, analyses, surveys, data, computer printouts, programs
and software, and all supporting documentation of such programs prepared in the performance of the
Services shall be the property of City, and shall be delivered to City before final payment and the
completion of performance or any earlier termination under this. Agreement.
7. Indemnification.
a. The Consultant agrees to indemnify, defend and hold harmless the City, and/or their
respective officers, members, agents, and employees from any and all loss, liability, claim, demand, cause
Page 3 of 9
of action or suit, of any and every kind and description, arising or resulting from, or in any way connected
with, Consultant's performance and/or non-performance of the Services required by this Agreement
including, but not limited to, liability for inaccurate data, loss or dissemination of data, whether intentional
or inadvertent. The Consultant shall, upon demand by the City, as applicable, and at its sole cost and
expense, defend and provide attorneys acceptable to the City, as applicable, to defend the City, and/or
their respective officers, officials, employees and agents from and against any and all loss, liability, claim,
demand, cause of action or suit, of any and every kind and description, arising or resulting from, or in any
way connected with, Consultant's performance and/or non-performance of the Services required by this
Agreement. If the City provides its own defense against any such action or suit, the Consultant shall
reimburse the City for all reasonable attorney fees and other costs incurred by the City.
b. The Consultant agrees to indemnify, defend and hold harmless the City, and/or their
respective officers, members, agents, and employees from any and all loss, liability, claim, demand, cause
of action or suit, of any and every kind and description, arising or resulting from, or in any way connected
with, any fines, fees, penalties or Medicare reimbursements required to be paid as a result of the
Consultant's failure to timely report any Medicare -eligible judgments, awards, or settlements, or for
failure to adequately protect Medicare's conditional or future medical payments.
C. City agrees to defend any demand, claim, or legal action commenced against the
Consultant regarding a matter or incident allegedly caused by or resulting from wrongfiil or negligent acts
of their respective officers, employees, agents, or others engaged by the City, and to indemnify the
Consultant against any liability, loss, cost, or damage, including attorney's fees, resulting there from.
Intellectual Property Indemnification
Consultant 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 Consultant to the City pursuant to this Agreement.
9. Insurance.
Consultant agrees to obtain and maintain through the term of this Agreement insurance
coverages as set forth in the attached Exhibit B and incorporated herein by reference.
10. Non -liability of City Officials. No City representative shall be personally liable to the
Consultant, or any successor in interest of Consultant, in the event of any default or breach by the City, or
for any amount which may become due to the Consultant or any successor, or on any obligation under the
terms of this Agreement.
11. Independent Consultant.
Consultant shall, during the entire term of this Agreement, be construed to be an independent
Consultant 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 Consultant performs the services which are
the subject matter of this Agreement; however, the services to be provided by Consultant shall be
Page 4of9
provided in a manner consistent with all applicable standards and regulations governing such services.
Consultant 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. The
Consultant shall agree to indemnify, defend and hold harmless the City for any action or proceeding
related to Consultant's employees or agents' independent Consultant status.
12. Employment Practices.
Consultant shall not discriminate because of race, color, creed, religion, sex, marital status,
sexual orientation, gender identity, gender expression, gender, medical conditions, genetic information,
or military and veteran status, age, national origin, ancestry, or disability, as defined and prohibited by
applicable law, in the recruitment, selection, teaching, training, utilization, promotion, termination or
other employment related activities or any services provided under this Agreement. Consultant affirms
that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws
and regulations.
13. Conflicts of Interest.
a. Consultant 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.
b. No immediate family members of either the Mayor, City Council Member, or any
appointed City Official, including appointed board and commission members, as defined under the
City's Municipal Code, whose position with the City shall award or influence the award of this
Agreement, or any competing contract or amendment thereof, shall be employed in any capacity by the
Consultant or have any other direct or indirect financial benefit or interest in this Agreement.
C. The section also prohibits the awarding of any agreement, contract, grant, or any
amendment to those awards, to any former full-time employee for one-year from date of employee
separation except for any CaIPERS retiree as authorized by City Council resolution
d. The Consultant must comply with all conflict of interest laws, ordinances, and regulations
now in effect or hereafter to be enacted during the term of this Agreement. The Consultant warrants that
it is not now aware of any facts which conflict with the prohibitions defined above. If the Consultant
hereafter becomes aware of any facts that might reasonably be expected to create a conflict of interest, it
must immediately make full written disclosure of such facts to the City. Full written disclosure must
include, but is not limited to, identification of all persons implicated and a complete description of all
relevant circumstances. Failure to comply with the provisions of this paragraph will be a material breach
of this Agreement.
e. Consultant covenants that none of its directors, officers, employees, or agents shall
participate in selecting or administrating any subcontract supported (in whole or in part) by City funds
stemming from the Agreement where the awarding of the subcontract has any direct or indirect financial
benefit or interest to any individual, as defined in subsections (b) and (c) above.
Page 5 of 9
14. Force Majeure.
a. "Force Majeure" means any cause beyond the reasonable control of a party,
including but not limited to act of God, civil or military disruption, fire, strike, flood, riot, war, or inability
due to the aforementioned causes to obtain necessary labor, materials, or facilities.
b. If any Party hereto is delayed or prevented from fulfilling its obligations under this
Agreement by Force Maj cure, said Party will not be liable under this Agreement for such delay or failure,
nor for damages or injuries resulting directly from the inability to perform scheduled work due to Force
Majeure.
C. Consultant shall be granted an automatic extension of time commensurate with any
delay in performing scheduled work arising from Force Majeure. Consultant agrees to resume such work
within three (3) days after the Force Maj eure has subsided enough to do so.
15. Assignment. Neither Party shall assign or transfer its interest in this Agreement or any part
thereof without the written consent of the other Party.
16. Exclusivity and Amendment,
This Agreement represents the complete and exclusive statement between the City and
Consultant, 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 Consultant. 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 Consultant 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.
17. Waiver of Breach.
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.
18. Notice. Whenever it shall be necessary for either Party to serve notice on the other
respecting this Agreement, such notice shall be served by personal delivery or by certified mail addressed
at the following address, unless and until different addresses may be furnished in writing by either Party
to the other and such notice shall be deemed to have been served within seventy-two (72) hours after the
same has been deposited in a United States Post Office by certified mail or has been delivered personally,
and shall be valid and sufficient service of notice for all purposes:
Page 6of9
If to City: City Clerk
City of Santa Ana
20 Civic Center Plaza (M-30)
F.O. Box 1988
Santa Ana, CA 92702-1988
Fax 714- 647-6956
With courtesy copies to:
and
Executive Director — Human Resources Agency
City of Santa Ana
20 Civic Center Plaza (M-24)
P.O, Box 1988
Santa Ana, California 92702
Fax 714- 647-6930
City Attorney
City of Santa Ana
20 Civic Center Plaza (M-29)
F.O. Box 1988
Santa Ana, California 92702
Fax 714-647-6515
If to Consultant: Adminsure
Attention: Alithia Vargas -Flores
3380 Shelby Street
Ontario, CA 91764
19. Governing Law and Venue. This Agreement shall be construed and enforced pursuant to
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.
20. Professional Licenses.
Consultant 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. Consultant 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.
21. Attorneys' Fees. Each Party shall also bear its own attorneys' fees and all costs related to
the preparation of this Agreement. In the event any Party to this Agreement brings suit to enforce any
provision of this Agreement, or is required to defend an action relating to any provision of this Agreement,
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the non -prevailing Party agrees to pay the prevailing Party such court costs and attorneys' fees as the court
deems just.
22. Advice of Counsel. Each of the Parties acknowledges that it has received or has had the
opportunity to receive independent legal advice from an attorney with respect to the advisability of making
this Agreement and with respect to the advisability of executing this Agreement.
23. No Reliance on Outside Parties. Each of the Parties acknowledges that it has not relied
upon any statement or representation by any other Party or any representative of any other Party, in making
or executing this Agreement, except as expressly stated herein.
24. Authori . 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.
25. Counterparts. This Agreement may be signed in counterparts and compiled into one
agreement to make an original.
26. Amendment. This Agreement cannot be amended or modified except by an instrument in
writing signed by both Parties.
27. Interpretation. Should it be necessary for a court to interpret this Agreement, the Parties
agree that it has been prepared by a joint effort of all Parties. Accordingly, only the fair meaning of the
words shall be used in any interpretation hereof.
28. Severability. The provisions of this Agreement are severable and if one or more provisions
or subcomponents should be determined to be unconstitutional, illegal or judicially unenforceable, in
whole or in part, then, unless such unenforceability would make it impossible to effectuate the original
intent of the Parties, the remaining provisions or subcomponents hereof shall remain binding and
enforceable.
29. Expression of Entire Agreement. This Agreement constitutes a single, integrated written
contract, and as such, expresses the entire Agreement of the Parties with respect to the matters contained
herein and supersedes all prior negotiations, discussions, correspondence and other communications
regarding the terms and conditions hereof.
IN WITNESS WHEREOF, the City, and Consultant hereto have executed this Agreement on the
date first above written.
CONSULTANT
Adminsure, Inc.. [Signatures continue on the next page]
By: *1
Alithia Varga6lFlores
Its: President
Page 8 of 9
ATTEST:
Jennifer L. Hall
City Clerk
APPROVED AS TO FORM:
SONIA R. CARVALHO
City Attorney
By: Lon. �, . � �-
Laura A. Rossini
Chief Assistant City Attorney
CITY OF SANTA ANA
Alvaro Nunez
City Manager
RECOMMENDED FOR APPROVAL:
Lori Schnaider
Executive Director of Human Resources
Page 9 of 9
Exhibit A
Scope of Services
Scone of Services
Third Party Administration of
Workers' Compensation Claims Program
CLAIMS ADMINISTRATION
The Consultant shall comply with all performance standards of the City's liability pool and any
excess insurers. The Consultant shall also have the authority and responsibility to provide claims
administration services, which include;
A. Establishing an electronic claim file and computer database record upon receipt of an
injury report.
B. Setting and updating reserves.
C. Initiating and maintaining contact with injured workers or their attorneys.
D. Arranging for investigation.
E. Determining compensability.
F. Preparing and issuing benefit notices, if applicable.
G. Arranging for medical treatment and medical services from clinics, facilities,
pharmacies, hospitals, specialists, and other vendors as necessary.
H. Performing all utilization review services through MedReview, communicating
decisions to approve, modify, delay or deny medical treatment in accordance with State
law.
1. Monitoring disability status by reviewing medical reports and contacting doctors for
updates.
J. Auditing and reviewing all medical bills through MedReview and paying all properly
adjusted medical bills in a timely and accurate manner.
K. Paying mileage or medical reimbursements to injured workers.
L. Paying temporary disability compensation when appropriate to do so or advising the
City of the need to adjust payroll records when salary continuation is applicable.
M. Arranging medical exams in conformance with State law to determine whether an
injured worker's medical condition is permanent and stationary (reached Maximum
Medical Improvement/MMI) and what, if any, permanent disability exists.
N. Paying the permanent disability compensation in accordance with the law.
O. Arranging for attorney representation of the City whenever the need arises subject to
final approval of the City.
P. Monitoring attorneys and assisting them in preparing cases.
Q. Auditing and paying legal expenses subject to authorization of payment by the City.
R. Arranging for vocational rehabilitation services when appropriate, monitoring
vocational rehabilitation consultants and assisting them as necessary.
S. Auditing and paying vocational rehabilitation expenses.
T. Attending all hearings that are required by law or where requested by the City.
U. Preparing and issuing Vocational Rehabilitation/Supplemental Job Displacement
Benefits (SJDB) notices.
V. Preparing and issuing the permanent disability compensation notices.
W. Comply with all legal requirements including but not limited to, the California Labor
Code.
X. Pursuing subrogation when there is a viable third parry subject to authorization by the
City.
Y. Notifying the City, the City's liability pool when required by the Memorandum of
Coverage and excess insurers when applicable of all claims which exceed or may
exceed the self-insurance retention; maintaining a liaison among the City, the liability
pool, and their excess insurers on matters affecting the handling of such claims and
arranging for reimbursement to the City of losses in excess of its self-insurance
retention.
Z. Obtaining settlement authority from the City and negotiating settlement on appropriate
claims.
AA. Closing claim files when appropriate to do so.
BB. Participating when necessary in the interactive process or other medical legal
assessments which may affect open claims.
CC. Participating fully in any audit performed by the City or by a third party of the City.
DD. Providing Medicare required reporting.
EE. Providing requested information to the City within twenty-four (24) hours and on
the same day when involving critical issues.
OBLIGATIONS OF THE CITY
The City shall:
A. Submit all reports of work injury to the Consultant in a timely manner not to exceed
two business days of the City's knowledge of the injury.
B. Respond to the Consultant's requests for information and authority within five days of
such requests.
C. Provide information that is accurate and is in a form specified by the Consultant.
D. Grant settlement authority, where the City deems it appropriate to do so, to the
Consultant in advance of WCAB, Rehabilitation, and legal hearings, or be available by
phone or in person during same.
CHECKING ACCOUNT
The City and the Consultant agree that:
A. The City shall establish and maintain a checking account from which all Workers'
Compensation benefits and expenses are to be paid.
B. The Consultant shall prepare checks and issue those checks directly to payees without
delay.
C. The Consultant shall sign checks with a facsimile signature or manually.
D. The Consultant shall secure checks in a locked area accessible to a limited number of
personnel.
E. The Consultant shall keep an accurate statement of all payments made from the account
and will provide information on payments inade from the account when requested by
the City.
F. The City shall maintain an adequate balance in their checking account to meet all
Workers' Compensation obligations without delay.
G. The checking account may be used to pay penalties in which case the Consultant shall
reimburse the City within fifteen (15) working days for any amount of the penalty
which the Consultant caused.
ELECTRONIC DATA PROCESSING
A. The Consultant shall provide the City with electronic data processing services that will
allow for the production of loss experience and transaction reports within ten (10) days
following the close of each calendar month.
B. Notify the City immediately of any unauthorized breach of City's information contained
in Consultant's electronic data system and/or computer system
REGULATORY REPORTING
The Consultant shall prepare all reports required by State and federal regulatory agencies (if any)
in connection with the Program, including the Self -Insurer's Annual Report required by the
Department of Self -Insurance Plans.
RECORDS
The Consultant shall establish and maintain electronic claim files, claim logs, transaction
documents and all other records associated with the Program, These records shall be the property
of the City. Unless this Agreement is cancelled, closed hard files, if any, shall be stored by the
Consultant for five (5) years and shall thereafter become the responsibility of the City. Upon
cancellation of this Agreement, the City shall be responsible for maintaining and storing all data,
records, et cetera. The Consultant shall not dispose of or destroy hard files without the prior,
written authorization of the City.
The City shall allow the Consultant to perform all Bill Review Services through MedReview. Bill
review fees are at $9.00 per bill. Preferred Provider Organization fees shall not exceed 25% of
savings when applicable.
The City shall allow the Consultant to perform all Utilization Review Services through
MedReview. Utilization review fees are incorporated into medical bill review invoices at the rate
of 7% of billed charges. The maximum utilization review fee charged per medical bill is capped
at $750.00. Utilization review by a physician is billed separately in 10-minute increments, at the
rate of $200.00 per hour.
ALLOCATED EXPENSES
The City shall pay for field investigation, defense attorneys, legal costs, remote photocopy,
engineering experts, accident reconstruction experts, process servers, messenger service, court
reporters, vocational rehabilitation consultants, structured settlement consultants, translators, and
any other vendor necessary to administer claim files. Payment of expenses in excess of $150,000
require prior approval of the City before those expenses are paid.
PENALTIES
The Consultant shall be responsible for paying or appealing penalties that are caused by the
Consultant. The Consultant shall not be responsible for penalties that are caused by the City or
any third parties. The Consultant will advise City in writing immediately of any penalties that are
levied against the City for any reason and prior to paying such penalties.
Exhibit B
Insurance Requirements
Prior to undertaking performance of work under this Agreement, Consultant shall
maintain and shall require any subcontractors to obtain and maintain insurance as described
below for the entire Term of this Agreement against claims for injuries to persons or damage to
property which may arise from or in connection with services, products and materials supplied to
City. Total cost of such insurance shall be borne by Consultant.
MINIMUM SCOPE AND LIMIT OF INSURANCE
1. Commercial General Liability (CGL): Insurance Services Office Form CG 00 01
covering CGL on an "occurrence" basis, including products and completed operations,
property damage, bodily injury and personal & advertising injury with limits no less than
$2,000,000 per occurrence and $4,000,000 aggregate. Required policy limits can be met
with primary and umbrella/excess insurance policies.
2. Automobile Liability (AL): Insurance Services Office Form CA 00 01 covering Code 1
(any auto), with limits no less than $1,000,000 combined single limits. In the event
Consultant does not maintain commercial automobile liability insurance, City will accept
evidence of personal automobile insurance, provided that such policy is endorsed for
business use and provides coverage with a minimum limit of $1,000,000. Required policy
limits can be met with primary and umbrella/excess insurance policies.
3. Workers' Compensation (WC): as required by the State of California, with Statutory
Limits, and Employer's Liability Insurance with limit of no less than $1,000,000 per
accident, policy or employee, for bodily injury or disease. Coverage is not required if
Consultant has no employees and signs request to waive such insurance.
4. Professional Liability (PL) /Errors and Omissions(E&O): with limits no less than
$2,000,000 per occurrence or claim, and $4,000,000 aggregate.
Cyber Liability (CL): Insurance, with limits not less than $2,000,000 per occurrence or
claim and $2,000,000 aggregate. Coverage shall be sufficiently broad to respond to the
duties and obligations as is undertaken by Consultant in this agreement and shall include,
but not be limited to, claims involving security breach, system failure, data recovery,
business interruption, cyber extortion, social engineering, infringement of intellectual
property, including but not limited to infringement of copyright, trademark, trade dress,
invasion of privacy violations, information theft, and release of private information. The
policy shall provide coverage for breach response costs, regulatory fines and penalties as
well as credit monitoring expenses.
6. Technology Professional Liability -Errors and Omissions Insurance (E&O):
appropriate to the Consultant's profession and work hereunder, with limits not less than
$2,000,000 per occurrence and $2,000,000 aggregate, Coverage shall be sufficiently
broad to respond to the duties and obligations as is undertaken by the Consultant in this
agreement and shall include, but not be limited to, claims involving business interruption,
damage to or destruction of electronic information, and alteration of electronic
information, The policy shall provide coverage for Consultant's failure to provide
professional services and/or products under this Agreement. The Policy shall include, or
be endorsed to include, damage to, alteration of, loss of, or destruction of electronic data
and/or information "property" of Customer in the care, custody, or control of Consultant.
If Consultant maintains broader coverage and/or higher limits than the minimum requirements
for each line of coverage shown above, City requires and shall be entitled to the broader
coverage and/or the higher limits maintained by Consultant. Any available insurance proceeds in
excess of the specified minimum limits of insurance and coverage shall be available to City.
Other Insurance Provisions
The above required insurance policies are to contain or be endorsed to contain the following
provisions:
1. City, its City Council, its officers, officials, employees, agents, and volunteers are to be
covered as additional insureds, under Consultant's CGL and AL policies, with respect to
any liability arising out of work or operations performed by or on behalf of the
Consultant including materials, parts, equipment, and personnel furnished in connection
with such work or operations.
2. Consultant's Insurance company(ics) agrees to waive all rights of subrogation against
City, its City Council, its officers, officials, employees, agents, and volunteers for losses
paid under the terms of Consultant's CGL, AL, and WC policies which arise from work
performed by Consultant under this Agreement.
3. For any claims related to this contract, Consultant's insurance coverage shall be primary
and any insurance maintained by City, its City Council, its officers, officials, employees,
agents, or volunteers shall not contribute with it.
4. A severability of interest provision must apply for all the additional insureds, ensuring
that Consultant's insurance shall apply separately to each insured against whom a claim
is made or suit is brought, except with respect to the insurer's limits of liability.
5. Insurance policies required herein shall provide that coverage shall not be canceled,
suspended, voided, reduced in coverage or in limits, non -renewed by the carrier, or
materially changed except after thirty (30) days prior written notice has been given to
City. Ten (10) days prior written notice shall be provided to City for policy cancellation
or non -renewal due to non-payment of premium.
6. Certificate Holder on each Evidence of Insurance certificate shall be: City of Santa Ana,
Attention: (Luisa Mendoza, Acting Risk Manager), City of Santa Ana, Human
Resources Agency, 20 Civic Center Plaza, P.O. Box 1988, M-24, Santa Ana, CA 92701.
The name and location of project must be included in the Description of Operations
section of each certificate.
Self -Insured Retentions
Self -insured retentions must be declared to and approved by the City. The City may require the
Consultant to purchase coverage with a lower retention or provide proof of ability to pay losses
and related 'investigations, claim administration, and defense expenses within the retention.
Acceptability of Insurers
Insurance is to be placed with insurers authorized to conduct business in the State of California
with a current A.M. Best rating of no less than ANII, unless otherwise acceptable to City.
Verification of Coverage
Consultant shall furnish City with original Certificates of Insurance including all required
amendatory endorsements (or copies of the applicable policy language effecting coverage
required by this clause) and a copy of the Declarations and Endorsement Page of the CGL policy
listing all policy endorsements before work begins. However, failure to obtain the required
documents prior to the work beginning shall not waive Consultant's obligation to provide them.
City reserves the right to require complete, certified copies of all required insurance policies,
including endorsements required by these specifications, at any time.
Special Risks or Circumstances
City reserves the right to modify these requirements, including limits, based on the nature of the
risk, prior experience, insurer, coverage, or other special circumstances.