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HomeMy WebLinkAbout1I OCRCITY COUNCIL STAFF REPORT DATE: January 27, 2022 CONSENT CALENDAR SUBJECT: APPROVE AMENDMENT NO. 1 TO AGREEMENT NO. 8436 WITH BRUCE BOWER INVESTIGATIONS FOR BACKGROUND SERVICES FROM: Justin Clifton, City Manager BY: Police Department SUMMARY: In 2019, the City entered into a services agreement with Bruce Bower Investigations (A8436) for processing pre-employment backgrounds meeting the standards of the California Commission on POST (Peace Officer Standards and Training) for public safety related positions. This agreement has provided the City with the necessary expertise and assistance in completing pre-employment backgrounds for police officers, dispatchers, and other safety-related positions. The proposed Amendment No. 1 will extend the services agreement for a period of 36 months, from January 1, 2022 through December 31, 2024. RECOMMENDATION: 1. Approve Amendment No. 1 to Agreement No. 8436 with Bruce Bower Investigations for background services. 2.Authorize the City Manager to execute all necessary documents. BUSINESS PRINCIPAL DISCLOSURE: Bruce Bower is a Sole Proprietor doing business as Bruce Bower Investigations. His Public Integrity Disclosure Form is included as Attachment 1. STAFF ANALYSIS: The California Commission on Peace Officer Standards and Training (POST) requires that specific pre-employment background guidelines be followed when hiring for certain safety positions, such as police officers and dispatchers. The contracting services agreement with Bruce Bower Investigations provides the City with the necessary expertise and assistance in providing pre-employment backgrounds, on an as-needed basis. Because there is a regular need for background investigations for public safety- Item 1I - 1 related positions, it is necessary to have a dependable, readily available resource with the ability to complete these background investigations for all existing vacancies and applicants in a timely manner. Bruce Bower Investigations has a proven record of efficiently completing pre-employment backgrounds and Staff recommends a 36-month amendment to the agreement approved by the City in 2019. The 2019 agreement (A8436) approved by the City is included as Attachment 2. Section 4.5 of the agreement, also referenced in the amendment, allows for a 30-day termination clause, with or without cause, providing the necessary flexibility of a shorter term is necessary. The amendment, included as Attachment 3, will ensure continued POST compliance with background investigations and the flexibility of having an available resource as the need for hiring of police officers and other safety personnel continues. ENVIRONMENTAL IMPACT: The requested City Council action is not a “Project” as defined by the California Environmental Quality Act (CEQA). Pursuant to Section 15378(a), a “Project” means the whole of an action, which has a potential for resulting in either a direct physical change in the environment, or a reasonably foreseeable indirect physical change in the environment. According to Section 15378(b), a Project does not include: (5) Organizational or administrative activities of governments that will not result in direct or indirect physical changes in the environment. FISCAL IMPACT Costs of each background, per the schedule of services, range from $925 to $1025 plus expenses and are scheduled at the direction of the City. The annual costs vary depending on the number of positions and applicants processed. During FY 20/21, the actual costs for background investigations were $17,945.36. FY 21/22 to date, costs for background investigations have reached $31,624.76. Costs will not exceed department budgeted amounts for contractual services. REVIEWED BY: Department Director: Andrew G. Mills City Manager: Justin Clifton ATTACHMENTS: 1)Public Integrity Disclosure 2)Agreement for Contract Services 3)Amendment No. 1 to Agreement for Contract Services Item 1I - 2 ATTACHMENT 1 PUBLIC INTEGRITY DISCLOSURE Item 1I - 3 PUBLIC INTEGRITY DISCLOSURE APPLICANT DISCLOSURE FORM 1.Name of Entity 2.Address of Entity (Principal Place of Business)lb l/0x 6 13.Local or Californ a Address (if different than #2) 4.State where Entity is Registered with Secretary of State If other than California, is the Entity also registered in California? D Yes D No 5.Type of Entity Sole liot'Mmfl--□Corporation D Limited Liability Company D Partnership D Trust �Other (please specify) 6.Officers, Directors, Members, Managers, Trustees, Other Fiduciaries (please specify) Note: If any response is not a natural person, please identify all officers, directors, members, managers and other fiduciaries for the member, manager, trust, or other entity _7lr<u_---"(£-=,--'t=:...,_o_�_(ft--______ D Officer D Director D Member D Manager [name] D General Partner D Limited Partner ji?JOther fJW� ______________ D Officer D Director D Member D Manager [name] D General Partner D Limited Partner D Other __________ _ ______________ D Officer D Director D Member D Manager [name] D General Partner D Limited Partner D Other __________ _ Item 1I - 4 7.Owners/Investors with a 5% beneficial interest in the Applicant Entity or a related entity EXAMPLE JANE DOE 50%, ABC COMPANY, Inc. [name of owner/investor] A. �c.£ flD()J(!ll_ [name of owner/investor] B. [name of owner/investor] C. [name of owner/investor] D. [name of owner/investor] E. [percentage of beneficial interest in entity and name of entity] /Ov � [percentage of beneficial interest in entity and name of entity] [percentage of beneficial interest in entity and name of entity] [percentage of beneficial interest in entity and name of entity] [percentage of beneficial interest in entity and name of entity] [name of owner/investor] [percentage of beneficial interest in entity and name of entity] I DECLARE UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF CALIFORNIA THAT THE FOREGOING IS TRUE AND CORRECT. Signature of Disclosing Party, Printed Name, Title Date -a a �() ,/" I u, Z--'?.- Item 1I - 5 ATTACHMENT 2CONTRACT SERVICES AGREEMENT - APPROVED 2019Item 1I - 6 CONTRACT SERVICES AGREEMENT Background Investigation Services by Bruce Bower Investigations THIS AGREEMENT FOR CONTRACT SERVICES ("Agreement") is made and entered into on January 1, 2020, by and between the City of Palm Springs, a California charter city and municipal corporation ("City"), and Bruce Bower Investigations a background and personnel investigations firm, ("Contractor"). City and Contractor are individually referred to as "Party" and are collectively referred to as the "Parties". RECITALS A.City requires the services of a background and personnel investigations firm in theprocessing of backgrounds for applicants for safety related positions in meeting the standards of the California Commission on POST (Peace Officer Standards and Training) and other applicant backgrounds as necessary to fill positions efficiently as possible, ("Project"). B.Contractor has submitted to City a proposal to provide background l investigati onservices, to City under the terms of this Agreement. C.Based on its experience, education, training, and reputation, Contractor isqualified and desires to provide the necessary services to City for the Project. D.City desires to retain the services of Contractor for the Project.In consideration of these promises and mutual agreements, City agrees as follows: AGREEMENT 1.CONTRACTOR SERVICES1.1 Scope of Services. In compliance with all terms and conditions of this Agreement, Contractor shall provide background investigation services to City as described in the Scope of Services/Work attached to this Agreement as Exhibit "A" and incorporated by reference (the "services" or "work"). Exhibit "A" includes the agreed upon schedule of performance and the schedule of fees. Contractor warrants that all services and work shall be performed in a competent, professional, and satisfactory manner consistent with prevailing industry standards. In the event of any inconsistency between the terms contained in the Scope of Services/Work and the terms set forth in this Agreement, the terms set forth in this Agreement shall govern. 1.2 Compliance with Law. Contractor services rendered under this Agreement shall comply with all applicable federal, state, and local laws, statutes and ordinances and all lawful orders, rules, and regulations. 1.3 Licenses and Permits. Contractor shall obtain at its sole cost and expense such licenses, permits, and approvals as may be required by law for the performance of the services required by this Agreement. Revised: 1/31/18 720599.1 3 Item 1I - 7 1.4 Familiarity with Work. By executing this Agreement, Contractor warrants that it has carefully considered how the work should be performed and fully understands the facilities, difficulties, and restrictions attending performance of the work under this Agreement. 2.TIME FOR COMPLETIONThe time for completion of the services to be performed by Contractor is an essentialcondition of this Agreement. Contractor shall prosecute regularly and diligently the work of this Agreement according to the agreed upon schedule of performance set forth in Exhibit "A." Contractor shall not be accountable for delays in the progress of its work caused by any condition beyond its control and without the fault or negligence of Contractor. Delays shall not entitle Contractor to any additional compensation regardless of the party responsible for the delay. 3.COMPENSATION OF CONTRACTOR3.1 Compensation of Contractor. Contractor shall be compensated and reimbursed for the services rendered under this Agreement in accordance with the schedule of fees set forth in Exhibit "A". 3.2 Method of Payment. In any month in which Contractor wishes to receive payment, Contractor shall submit to City an invoice for services rendered prior to the date of the invoice, no later than the first working day of such month, in the form approved by City's finance director. Payments shall be based on the rates set forth in Exhibit "A" for authorized services performed. City shall pay Contractor for all expenses stated in the invoice that are approved by City and consistent with this Agreement, within thirty (30) days of receipt of Contractor's invoice. 3.3 Changes. In the event any change or changes in the Scope of Services/Work is requested by City, Parties shall execute a written amendment to this Agreement, specifying all proposed amendments, including, but not limited to, any additional fees. An amendment may be entered into: A.To provide for revisions or modifications to documents, work product, orwork, when required by the enactment or revision of any subsequent law; or B.To provide for additional services not included in this Agreement or notcustomarily furnished in accordance with generally accepted practice in Contractor's profession. 3.4 Appropriations. This Agreement is subject to, and contingent upon, funds being appropriated by the City Council of City for each fiscal year. If such appropriations are not made, this Agreement shall automatically terminate without penalty to City. 4.PERFORMANCE SCHEDULE4.1 Time of Essence. Time is of the essence in the performance of this Agreement. 2 Revised: 1/31/18 720599.1 4 Item 1I - 8 4.2 Schedule of Performance. All services rendered under this Agreement shall be performed under the agreed upon schedule of performance set forth in Exhibit "A." Any time period extension must be approved in writing by the Contract Officer. 4.3 Force Maieure. The time for performance of services to be rendered under this Agreement may be extended because of any delays due to unforeseeable causes beyond the control and without the fault or negligence of Contractor, if Contractor notifies the Contract Officer within ten (10) days of the commencement of such condition. Unforeseeable causes include, but are not limited to, acts of God or of a public enemy, acts of the government, fires, earthquakes, floods, epidemic, quarantine restrictions, riots, strikes, freight embargoes, and unusually severe weather. After Contractor notification, the Contract Officer shall investigate the facts and the extent of any necessary delay and extend the time for performing the services for the period of the enforced delay when and if, in the Contract Officer's judgment, such delay is justified. The Contract Officer's determination shall be final and conclusive upon the parties to this Agreement. 4.4 Term. Unless earlier terminated in accordance with Section 4.5 of this Agreement, this Agreement shall continue in full force and effect for a period of 24 months, commencing on January 1, 2020, and ending on December 31, 2021, unless extended by mutual written agreement of the parties. 4.5 Termination Prior to Expiration of Term. City may terminate this Agreement at any time, with or without cause, upon thirty (30) days written notice to Contractor. Where termination is due to the fault of Contractor and constitutes an immediate danger to health, safety, and general welfare, the period of notice shall be such shorter time as may be determined by the City. Upon receipt of the notice of termination, Contractor shall immediately cease all services except such as may be specifically approved by the Contract Officer. Contractor shall be entitled to compensation for all services rendered prior to receipt of the notice of termination and for any services authorized by the Contract Officer after such notice. Contractor may terminate this Agreement, with or without cause, upon thirty (30) days written notice to City. S.COORDINATION OF WORK5.1 Representative of Contractor. The following principal of Contractor is designated as being the principal and representative of Contractor authorized to act and make all decisions in its behalf with respect to the specified services and work: Bruce Bower, Owner/Qualified Manager. It is expressly understood that the experience, knowledge, education, capability, and reputation of the foregoing principal is a substantial inducement for City to enter into this Agreement. Therefore, the foregoing principal shall be responsible during the term of this Agreement for directing all activities of Contractor and devoting sufficient time to personally supervise the services under this Agreement. The foregoing principal may not be changed by Contractor without prior written approval of the Contract Officer. 5.2 Contract Officer. The Contract Officer shall be the City Manager, the Director of Human Resources and/or designee ("Contract Officer"). Contractor shall be responsible for keeping the Contract Officer fully informed of the progress of the performance of the services. 3 Revised: 1/31/18 720599.1 5 Item 1I - 9 Contractor shall refer any decisions that must be made by City to the Contract Officer. Unless otherwise specified, any approval of City shall mean the approval of the Contract Officer. 5.3 Prohibition Against Subcontracting or Assignment. The experience, knowledge, education, capability, and reputation of Contractor, its principals and employees, were a substantial inducement for City to enter into this Agreement. Therefore, Contractor shall not contract with any other individual or entity to perform any services required under this Agreement without the City's express written approval. In addition, neither this Agreement nor any interest may be assigned or transferred, voluntarily or by operation of law, without the prior written approval of City. 5.4 Independent Contractor. Neither City nor any of its employees shall have any control over the manner, mode, or means by which Contractor, its agents or employees, perform the services required, except as otherwise specified. Contractor shall perform all required services as an independent contractor of City and shall not be an employee of City and shall remain at all times as to City a wholly independent contractor with only such obligations as are consistent with that role; however, City shall have the right to review Contractor's work product, result, and advice. Contractor shall not at any time or in any manner represent that it or any of its agents or employees are agents or employees of City. 5.5 Personnel. Contractor agrees to assign the following individuals to perform the services in this Agreement. Contractor shall not alter the assignment of the following personnel without the prior written approval of the Contract Officer. Acting through the City Manager, the City shall have the unrestricted right to order the removal of any personnel assigned by Contractor by providing written notice to Contractor. Name: Bruce Bower 6.INSURANCE Title: Owner/Qualified Manager of Bruce Bower Investigations Contractor shall procure and maintain, at its sole cost and expense, policies of insuranceas set forth in the attached Exhibit "B", incorporated herein by reference. 7.INDEMNIFICATION.7.1 Indemnification. To the fullest extent permitted by law, Contractor shall defend (at Contractor's sole cost and expense), indemnify, protect, and hold harmless City, its elected officials, officers, employees, agents, and volunteers ( collectively the "Indemnified Parties"), from and against any and all liabilities, actions, suits, claims, demands, losses, costs, judgments, arbitration awards, settlements, damages, demands, orders, penalties, and expenses including legal costs and attorney fees ( collectively "Claims"), including but not limited to Claims arising from injuries to or death of persons (Contractor's employees included), for damage to property, including property owned by City, from any violation of any federal, state, or local law or ordinance, and from errors and omissions committed by Contractor, its officers, employees, representatives, and agents, that arise out of or relate to Contractor's performance 4 Revised: 1/31/18 720599.1 6 Item 1I - 10 under this Agreement. This indemnification clause excludes Claims arising from the sole negligence or willful misconduct of the City, its elected officials, officers, employees, agents, and volunteers. Under no circumstances shall the insurance requirements and limits set forth in this Agreement be construed to limit Contractor's indemnification obligation or other liability under this Agreement. Contractor's indemnification obligation shall survive the expiration or earlier termination of this Agreement until all actions against the Indemnified Parties for such matters indemnified are fully and finally barred by the applicable statute of limitations or, if an action is timely filed, until such action is final. This provision is intended for the benefit of third party Indemnified Parties not otherwise a party to this Agreement. 7 .2 Desien Professional Services Indemnification and Reimbursement. If the Agreement is determined to be a "design professional services agreement" and Contractor is a "design professional" under California Civil Code Section 2782.8, then: A.To the fullest extent permitted by law, Contractor shall indemnify, defend( at Contractor's sole cost and expense), protect and hold harmless City and its elected officials, officers, employees, agents and volunteers and all other public agencies whose approval of the project is required, (individually "Indemnified Party"; collectively "Indemnified Parties") against any and all liabilities, claims, judgments, arbitration awards, settlements, costs, demands, orders and penalties ( collectively "Claims"), including but not limited to Claims arising from injuries or death of persons (Contractor's employees included) and damage to property, which Claims arise out of, pertain to, or are related to the negligence, recklessness or willful misconduct of Contractor, its agents, employees, or subcontractors, or arise from Contractor's negligent, reckless or willful performance of or failure to perform any term, provision, covenant or condition of this Agreement ("Indemnified Claims"), but Contractor's liability for Indemnified Claims shall be reduced to the extent such Claims arise from the negligence, recklessness or willful misconduct of the City and its elected officials, officers, employees, agents and volunteers. B.The Contractor shall require all non-design-professional sub-contractors,used or sub-contracted by Contractor to perform the Services or Work required under this Agreement, to execute an Indemnification Agreement adopting the indemnity provisions in sub­section 7 .1 in favor of the Indemnified Parties. In addition, Contractor shall require all non­design-professional sub-contractors, used or sub-contracted by Contractor to perform the Services or Work required under this Agreement, to obtain insurance that is consistent with the Insurance provisions as set forth in this Agreement, as well as any other insurance that may be required by Contract Officer. 8.RECORDS AND REPORTS8.1 Reports. Contractor shall periodically prepare and submit to the Contract Officer reports concerning the performance of the services required by this Agreement, or as the Contract Officer shall require. 8.2 Records. Contractor shall keep complete, accurate, and detailed accounts of all time, costs, expenses, and expenditures pertaining in any way to this Agreement. Contractor shall keep such books and records as shall be necessary to properly perform the services required 5 Revised: 1 /31118 720599.1 7 Item 1I - 11 by this Agreement and enable the Contract Officer to evaluate the perfonnance of such services. The Contract Officer shall have full and free access to such books and records at all reasonable times, including the right to inspect, copy, audit, and make records and transcripts from such records. 8.3 Ownership of Documents. All draw_ings, specifications, reports, records, documents, and other materials prepared by Contractor in the performance of this Agreement shall be the property of City. Contractor shall deliver all above-referenced documents to City upon request of the Contract Officer or upon the termination of this Agreement. Contractor shall have no claim for further employment or additional compensation as a result of the exercise by City of its full rights or ownership of the documents and materials. Contractor may retain copies of such documents for Contractor's own use. Contractor shall have an unrestricted right to use the concepts embodied in such documents. 8.4 Release of Documents. All drawings, specifications, reports, records, documents, and other materials prepared by Contractor in the performance of services under this Agreement shall not be released publicly without the prior written approval of the Contract Officer. 8.S Cost Records. Contractor shall maintain all books, documents, papers, employee time sheets, accounting records, and other evidence pertaining to costs incurred while performing under this Agreement. Contractor shall make such materials available at its offices at all reasonable times during the term of this Agreement and for three (3) years from the date of final payment for inspection by City and copies shall be promptly furnished to City upon request. 9.ENFORCEMENT OF AGREEMENT9.1 California Law. This Agreement shall be construed and interpreted both as to validity and to performance of the parties in accordance with the laws of the State of California. Legal actions concerning any dispute, claim, or matter arising out of or in relation to this Agreement shall be instituted in the Superior Court of the County of Riverside, State of California, or any other appropriate court in such county, and Contractor covenants and agrees to submit to the personal jurisdiction of such court in the event of such action. 9.2 Interpretation. This Agreement shall be construed as a whole according to its fair language and common meaning to achieve the objectives and purposes of the Parties. The terms of this Agreement are contractual and the result of negotiation between the Parties. Accordingly, any rule of construction of contracts (including, without limitation, California Civil Code Section 1654) that ambiguities are to be construed against the drafting party, shall not be employed in the interpretation of this Agreement. The caption headings of the various sections and paragraphs of this Agreement are for convenience and identification purposes only and shall not be deemed to limit, expand, or define the contents of the respective sections or paragraphs. 9.3 Waiver. No delay or omission in the exercise of any right or remedy of a non-defaulting party on any default shall impair such right or remedy or be construed as a waiver. No consent or approval of City shall be deemed to waive or render unnecessary City's consent to or approval of any subsequent act of Contractor. Any waiver by either party of any default must 6 Revised: 1/31/18 720599.1 8 Item 1I - 12 be in writing. No such waiver shall be a waiver of any other default concerning the same or any other provision of this Agreement. 9.4 Rights and Remedies are Cumulative. Except with respect to rights and remedies expressly declared to be exclusive in this Agreement, the rights and remedies of the parties are cumulative. The exercise by either party of one or more of such rights or remedies shall not preclude the exercise by it, at the same or different times, of any other rights or remedies for the same default or any other default by the other party. 9.5 Legal Action. In addition to any other rights or remedies, either party may take legal action, in law or in equity, to cure, correct, or remedy any default, to recover damages for any default, to compel specific performance of this Agreement, to obtain injunctive relief, a declaratory judgment, or any other remedy consistent with the purposes of this Agreement. 10.CITY OFFICERS AND EMPLOYEES: NON-DISCRIMINATION10.1 Non-Liability of City Officers and Employees. No officer or employee of City shall be personally liable to the Contractor, or any successor-in-interest, in the event of any default or breach by City or for any amount which may become due to the Contractor or its successor, or for breach of any obligation of the terms of this Agreement. 10.2 Conflict of Interest. Contractor acknowledges that no officer or employee of the City has or shall have any direct or indirect financial interest in this Agreement nor shall Contractor enter into any agreement of any kind with any such officer or employee during the term of this Agreement and for one year thereafter. Contractor warrants that Contractor has not paid or given, and will not pay or give, any third party any money or other consideration in exchange for obtaining this Agreement. 10.3 Covenant Against Discrimination. In connection with its performance under this Agreement, Contractor shall not discriminate against any employee or applicant for employment because of actual or perceived race, religion, color, sex, age, marital status, ancestry, national origin ( i.e., place of origin, immigration status, cultural or linguistic characteristics, or ethnicity), sexual orientation, gender identity, gender expression, physical or mental disability, or medical condition ( each a "prohibited basis"). Contractor shall ensure that applicants are employed, and that employees are treated during their employment, without regard to any prohibited basis. As a condition precedent to City's lawful capacity to enter this Agreement, and in executing this Agreement, Contractor certifies that its actions and omissions hereunder shall not incorporate any discrimination arising from or related to any prohibited basis in any Contractor activity, including but not limited to the following: employment, upgrading, demotion or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship; and further, that Contractor is in full compliance with the provisions of Palm Springs Municipal Code Section 7.09.040, including without limitation the provision of benefits, relating to non-discrimination in city contracting. 11.MISCELLANEOUS PROVISIONS720599.1 7 Revised: 1 /31 /18 9 Item 1I - 13 11.1 Notice. Any notice, demand, request, consent, approval, or communication that either party desires, or is required to give to the other party or any other person shall be in writing and either served personally or sent by pre-paid, first-class mail to the address set forth below. Notice shall be deemed communicated seventy-two (72) hours from the time of mailing if mailed as provided in this Section. Either party may change its address by notifying the other party of the change of address in writing. To City: To Contractor: City of Palm Springs Attention: City Manager/ City Clerk 3200 E. Tahquitz Canyon Way Palm Springs, California 92262 Bruce Bower, Owner/Qualified Manager Bruce Bower Investigations, CA PI #26864 P.O. Box 6914 La Quinta, CA 92248-6914 Phone:760-574-2734 11.2 Integrated Agreement. This Agreement contains all of the agreements of the parties and supersedes all other written agreements. 11.3 Amendment. No amendments or other modifications of this Agreement shall be binding unless through written agreement by all Parties. 11.4 Severability. Whenever possible, each provision of this Agreement shall be interpreted in such a manner as to be effective and valid under applicable law. In the event that any one or more of the phrases, sentences, clauses, paragraphs, or sections contained in this Agreement shall be declared invalid or unenforceable by valid judgment or decree of a court of competent jurisdiction, such invalidity or unenforceability shall not affect any of the remaining phrases, sentences, clauses, paragraphs, or sections of this Agreement, which shall be interpreted to carry out the intent of the parties. 11.5 Successors in Interest. This Agreement shall be binding upon and inure to the benefit of the Parties' successors and assignees. 11.6 Third Party Beneficiary. Except as may be expressly provided for in this Agreement, nothing contained in this Agreement is intended to confer, nor shall this Agreement be construed as conferring, any rights, including, without limitation, any rights as a third-party beneficiary or otherwise, upon any entity or person not a party to this Agreement. 11. 7 Recitals. The above-referenced Recitals are hereby incorporated into theAgreement as though fully set forth in this Agreement and each Party acknowledges and agrees that such Party is bound, for purposes of this Agreement, by the same. 8 Revised: 1/31/18 720599.l 10 Item 1I - 14 11.8 Authority. The persons executing this Agreement on behalf of the Parties warrant that they are duly authorized to execute this Agreement on behalf of Parties and that by so executing this Agreement the Parties are formally bound to the provisions of this Agreement. IN WITNESS WHEREOF, the Parties have executed this Agreement as of the dates stated below. Date:� APPROVED AS TO FORM: 8 ��7 3� etirC:i3auing6, City Attorney Date: �Lt-#-Lw'o__._-z_,_/-=z=o=--1-1-1-9 __ _ 720599.1 "CITY" City of Palm Springs ATTEST "CONTRACTOR" Bruce Bower Bruce Bower Investigations By: �/�Q�:A,,,�/2�.......__=--­. Bruce Bower APPROVED BY CITY COUNCL t11g .tv r2-'i-1r 9 Revised: 1/31/18 11 Item 1I - 15 'Br.c ~~ David H. Ready, PhD City Manager 720599.1 . � l. (. t • ... • ..... ( j. -.. j. l ! :t: CIVIL CODE§ 11• n,eeeac,sus11'1<: :C <,< <nc:ee0e;:,,mma0,ereeee:E1ss«ur,< C10A<zo0e:1>ea-oaoras,eeee A IIOIIIIW pdlliD G Oita all'ila rm ... lliuu 1li3 Cllftl'mla waifm adJ ---d .. idmal ....... claaunal1Dwfldltli:a califi:labadal. and natdlB�m:lnCJ •l:ailll)taftlalclacunft. 8bd&afCcdflw11ia ) Cauntyaf '-"'!°%\0¢ ) On "\oJW1'1 bafant me. --�--___ \'€_4¥ _ _,. ___ N __ OTPr........;P._y_P __ v __ & __ lA __ v ______ _i." Hantlnat Nsme111111 Tif»ol,,.Oftblt' pmaana0y appa.nd 9NG€ ALAN Bow,:& Name(sl al__,,, _,., plMld 1D me an the lmia of &di ! dmy evidance 1D be the panwwtG vAm fllDIIIIM iallll'e eubl:aibad to tha within in3lnanant and m:lnN1edgad ID me 1hat ..,..._, 9IPCldad the aame in �capaa1w:,sl "llldthlltby�anthainallurnanthpa� o, theadfty upan blhal of .tlich 118 pe.www41f aclad. exeadat the inBtrunall I cartiJy under PENALlY OF PBUURY wider the tin of the 81:ata af QdifGnia that the bagui:Jig paragraph ia true and canact. 1············1• J.KELLY : ' ..,. Notary Public • California : f .. · Riverside County J ,r ·. .. Commission #2275231 -◄,, •' My Comm. Expires Feb 11, 2023 Oeacriptian of Allzacttad Documanl Tdla 01 Type af Daan8nt __________ Dacunaal 0sta: ______ _ Nlmbar af Pagaia: --- 8igrl8l(a) Ollar Than Named Abova: ----------­ � Qaimad by &ignal(a) �atama: _________ _ □ Cu.pa;al& Officar -lillat¢ _____ _□ Pmtns -□ Umitad □ Ganand□ lndivilkd □Allmnay al Fact□Tnmlaa □ 8Lardan w Cu.aaauatm□Ohr. ___________ _SignarbRapawww64 _______ _ �Nsma: _________ _ □Cu.pandaOfficer-TillaC$ ____ _□ Partner -□ Umitad □ GarlMII□ lndivilta1 □ Allmnay al Fact□Tnmtae □GmrdmlarCmmawdar□Olhtr. ------------Signer b Rapwasantiv; _______ _ .<o .. u .... u.ca.u�<=-CCWeece == a cc ec:o.o .. --.. :a:cx.u.u .. eeueue ==•= u ao.o.:::x.:cc 10 Revised: 1/31/18 12 Item 1I - 16 I I I j .. I I I I • • I I I • I • I I I I ~ ~-------t --------------Ol'JJOIVAl.-------------- 11to&rgll Illa Ndiall o ciptillla.C. ~ fhfs lnl'omldial, can dldw albnflDn ol fll9 documenl or ~ All.lffa:lu••d olflia mm fD an""'"'"""""~ 720599.1 EXHIBIT "A" CONTRACTOR'S SCOPE OF SERVICES/WORK Including, Schedule of Fees And Schedule of Performance 11 Revised: 1/31/18 13 Item 1I - 17 SCOPE OF SERVICES -PALM SPRINGS POLICE DEPARTMENT Level I backgrounds <Peace Officer, Public Safety Dispatcher, CSO, Code Compliance, and Jail Transport positions): $1,025.00 per individual background investigation, plus any costs required to complete the background ( fees charged by others to obtain official transcripts, Law Enforcement Agency Checks, etc.). These fees are unusual but do occur rarely. Mileage will be charged at the current year IRS rate for any required travel outside the Coachella Valley. For required travel outside the Southern California area, an hourly rate of $40.00 will be charged for travel time in addition to the mileage rate. All travel outside the Southern California area will be approved by the Palm Springs Police Department before any costs are incurred. Level Il backgrounds (All other full-time employee positions): $925.00 per individual background investigation, plus the associated fees outlined above. Level III backgrounds (Volunteers): $400.00 per individual background investigation. No additional fees are anticipated. Level IV backgrounds (Cannabis): $200.00 per individual owner background investigation. No additional fees are anticipated. Partially Completed Backgrounds: $240.00 minimum fee. This fee applies to backgrounds where the applicant for an employment (paid or volunteer) position fails to progress beyond the initial background interview stage. If the background progresses past the initial background interview but is not completed, then the fee is based on the total number of hours committed to the partially completed investigation. The hourly rate is unchanged at $40.00 per hour. Service Details: All backgrounds will be completed in a thorough and accurate manner in accordance with POST requirements. The fees stated above do not include the costs associated with any other processes required by the City of Palm Springs for its hiring process (i.e., LiveScan, Polygraph, Medical or Psychological testing). Those fees are the sole responsibility of the City of Palm Springs. Bruce Bower Investigations will be responsible for all costs associated with printing and compiling the final investigations document for submission to the City of Palm Springs Police Department. The scope of investigation for Level I and Level II investigations would include the following: 14 Item 1I - 18 For all Sworn and Police Department Non-Sworn (Records staff, Police aides, Police Community Service Officers, Evidence staff, Dispatchers, Police secretarial), the following is conducted: -Personal History Statement review-Pre-Investigative Questionnaire review-Coordination of Polygraph examination-Polygraph results review and evaluation-Required Documents list-False Statement Advisement-Lateral Officer Advisement-Live Scan (utilizing City equipment/resources)-Local and Nationwide Criminal Search-State and Nationwide Sexual Offender Search-Education verification-Credit Bureau Report analysis-Citizenship Verification-Military Service Verification-Local Agency Checks-Dissolution of Marriage Verification-Marriage Verification-Employment Reference Contact and Employment Verification-Personal Reference Contact-Driving Record Verification and Analysis-Local County Superior Court Search and AnalysisAdditional services for Sworn Peace Officer, Public Safety Dispatcher, Community Service Officer, Jail Transport Officer, and Code Compliance Officer positions ONLY: All of the above, plus: -Residence Verification-Residence Check-Neighborhood Canvasing and Neighbor InterviewsThe scope of investigation for Level III investigations would include the following: -Initial background interview that would cover the applicant's Personal History Statement andsigning of required background documents (including notarized release)-Completion of Live Scan-Employer contact for past 7 years-Family contact-Personal reference contact-Local database checks (state and nationwide sexual offender, and nationwide criminal)-Selective Service verification-CA OMV record verification and insurance verification 15 Item 1I - 19 - Detailed report and document submission and conclusion of the background investigation The scope of investigation for Level IV investigations would include the following: -Live Scan completion and evaluation -Local database checks (state and nationwide sexual offender, and nationwide criminal) -Lien and Judgement search -Search for adverse business practice judgments 16 Item 1I - 20 720599.1 EXHIBIT "B" INSURANCE PROVISIONS Including Verification of Coverage, Sufficiency of Insurers, Errors and Omissions Coverage, Minimum Scope of Insurance, Deductibles and Self-Insured Retentions, and Severability of Interests (Separation of Insureds) 12 Revised: 1/31/18 17 Item 1I - 21 INSURANCE 1. Procurement and Maintenance of Insurance. Contractor shall procure and maintain public liability and property damage insurance against all claims for injuries against persons or damages to property resulting from Contractor's performance under this Agreement. Contractor shall procure and maintain all insurance at its sole cost and expense, in a fonn and content satisfactory to the City, and submit concurrently with its execution of this Agreement. Contractor shall also carry workers' compensation insurance in accordance with California workers' compensation laws. Such insurance shall be kept in full force and effect during the term of this Agreement, including any extensions. Such insurance shall not be cancelable without thirty (30) days advance written notice to City of any proposed cancellation. Certificates of insurance evidencing the foregoing and designating the City, its elected officials, officers, employees, agents, and volunteers as additional named insureds by original endorsement shall be delivered to and approved by City prior to commencement of services. The procuring of such insurance and the delivery of policies, certificates, and endorsements evidencing the same shall not be construed as a limitation of Contractor's obligation to indemnify City, its elected officials, officers, agents, employees, and volunteers. 2.Minimum Scope of Insurance. The minimum amount of insurance requiredunder this Agreement shall be as follows: 1.Comprehensive general liability and personal injury with limits of at leastone million dollars ($1,000,000.00) combined single limit coverage per occurrence and two million dollars ($2,000,000) general aggregate; 2.Automobile liability insurance with limits of at least one million dollars($1,000,000.00) per occurrence; 3.Professional liability ( errors and omissions) insurance with limits of atleast one million dollars ($1,000,000.00) per occurrence and two million dollars ($2,000,000) annual aggregate is: ____ required ____ is not required; 4.Workers' Compensation insurance in the statutory amount as required bythe State of California and Employer's Liability Insurance with limits of at least one million dollars $1 million per occurrence. If Contractor has no employees, Contractor shall complete the City's Request for Waiver of Workers' Compensation Insurance Requirement form. 3.Primary Insurance. For any claims related to this Agreement, Contractor'sinsurance coverage shall be primary with respect to the City and its respective elected officials, officers, employees, agents, and volunteers. Any insurance or self-insurance maintained by City and its respective elected officials, officers, employees, agents, and volunteers shall be in excess of Contractor's insurance and shall not contribute with it. For Workers' Compensation and Employer's Liability Insurance only, the insurer shall waive all rights of subrogation and 13 Revised: 1/31/18 720599.1 18 Item 1I - 22 contribution it may have against City, its elected officials, officers, employees, agents, and volunteers. 4.Errors and Omissions Coverage. If Errors & Omissions Insurance is required,and if Contractor provides claims made professional liability insurance, Contractor shall also agree in writing either (1) to purchase tail insurance in the amount required by this Agreement to cover claims made within three years of the completion of Contractor's services under this Agreement, or (2) to maintain professional liability insurance coverage with the same carrier in the amount required by this Agreement for at least three years after completion of Contractor's services under this Agreement. Contractor shall also be required to provide evidence to City of the purchase of the required tail insurance or continuation of the professional liability policy. S.Sufficiency of Insurers. Insurance required in this Agreement shall be providedby authorized insurers in good standing with the State of California. Coverage shall be provided by insurers admitted in the State of California with an A.M. Best's Key Rating of B++, Class VII, or better, unless otherwise acceptable to the City. 6.Verification of Coverage. Contractor shall furnish City with both certificates ofinsurance and endorsements, including additional insured endorsements, effecting all of the coverages required by this Agreement. The certificates and endorsements are to be signed by a person authorized by that insurer to bind coverage on its behalf. All proof of insurance is to be received and approved by the City before work commences. City reserves the right to require Contractor's insurers to provide complete, certified copies of all required insurance policies at any time. Additional insured endorsements are not required for Errors and Omissions and Workers' Compensation policies. Verification of Insurance coverage may be provided by: (1) an approved General and/or Auto Liability Endorsement Form for the City of Palm Springs or (2) an acceptable Certificate of Liability Insurance Coverage with an approved Additional Insured Endorsement with the following endorsements stated on the certificate: 1."The City of Palm Springs, its officials, employees, and agents are named as an additional insured ... " ("as respects City of Palm Springs Contract No._" or ''for any and all work performed with the City" may be included in this statement). 2."This insurance is primary and non-contributory over any insurance or self- insurance the City may have ... " (" as respects City of Palm Springs Contract No._" or ''for any and all work performed with the City" may be included in this statement). 3."Should any of the above described policies be canceled before the expiration date thereof, the issuing company will mail 30 days written notice to the Certificate Holder named." Language such as, "endeavor to" mail and "but failure to mail such notice shall impose no obligation or liability of any kind upon the company, its agents or representative" is not acceptable and must be crossed out. 14 Revised: 1/31/18 720599.1 19 Item 1I - 23 4.Both the Workers' Compensation and Employers' Liability policies shall containthe insurer's waiver of subrogation in favor of City, its elected officials, officers, employees, agents, and volunteers. In addition to the endorsements listed above, the City of Palm Springs shall be named the certificate holder on the policies. All certificates of insurance and endorsements are to be received and approved by the City before work commences. All certificates of insurance must be authorized by a person with authority to bind coverage, whether that is the authorized agent/broker or insurance underwriter. Failure to obtain the required documents prior to the commencement of work shall not waive the Contractor's obligation to provide them. 7.Deductibles and Self-Insured Retentions. Any deductibles or self-insuredretentions must be declared to and approved by the City prior to commencing any work or services under this Agreement. At the option of the City, either ( 1) the insurer shall reduce or eliminate such deductibles or self-insured retentions with respect to the City, its elected officials, officers, employees, agents, and volunteers; or (2) Contractor shall procure a bond guaranteeing payment of losses and related investigations, claim administration, and defense expenses. Certificates of Insurance must include evidence of the amount of any deductible or self-insured retention under the policy. Contractor guarantees payment of all deductibles and self-insured retentions. 8.Severability of Interests (Separation of Insureds). This insurance appliesseparately to each insured against whom claim is made or suit is brought except with respect to the limits of the insurer's liability. 15 Revised: 1/31/18 720599.1 20 Item 1I - 24 OPID: MN ACORD-CERTIFICATE OF LIABILITY INSURANCE I DA TE (1111/DDM'VV) � CM/29/2019 THIS CERTIFICATE IS ISSUED AS A MATIER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSfflUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certlfleate holder Is an ADDmONAL INSURED, the potlcy(lea) must be endoraed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the pollcy, certain pollcles may require an endorsement. A statement on this certificate does not confer rig hts to the certificate holder In Heu of such endorsementlsl. PRODUCER Alliance Mgt. & Insurance Serv 355 Via Vera Cruz #7 CA Arlant/Broker Uc# 0737966San arcoa CA 92078 Michelle A. Nowell INSURED Bruce Bower Investigations Bruce A Bower POBox6914 La Quinta, CA 92248 COVERAGES CERTIFICATE NUMBER: : T Michelle A Nowell � �wt\• 760-471-7116 l�: mnowell@amlscorp.comc .. -··---=--=-BOWER-2 INSURER(&) AFFORDING COVERAGE INSURER A: Acceptance Casualty Ins Comp INSURER 8: INSURERC: INSURERD: INSURER E: lNSURERF: I r�. Nol: 780-471-9378 NAIC# 10349 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS ANO CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. •�,: TYPEOFINSURANCE ,,,,. _ _,.. POUCYNUMBER POLIC Y��-�111.TiDP-=�-------U -MITS-------·-t GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY =1 CLAIMS-MADE 00 OCCUR -X Errors & Omis sion --GE N'L AGGREGATE LIMIT APPLIES PER: rx7 POLICY n ��� nLOC AUTOMOBILE UABILJTY ANYAUTO ALL OWNED AUTOS -SCHEDULED AUTOS -HIRED AUTOS -NON-OWNED AUTOS - UMBRELLA LIAS EXCESSUAB _ DEDUCTIBLE RETENTION S H OCCUR CLAIMS-MADE WORKERS COMPENSATION AND EMPLOYERS' UABIUTY y I N X ANY PROPRfETORIPARTNERJEXECUTIVE □ OFFICER/MEMBER EXCLUDED? N / A (Mandatory In NH) grsc:== ��RATIONS below X CP00980712 04/08/2019 04/08/2020 tonal lnsuta res to worft rrorme the ve ed tnsu d. .PiCRIPTION OF q,ERJ\TIONS I LOC� I VEHlCLEJ (A1tac:h ACORD 101, Addlttonal Remarlls Sdledule, If more space Is required) c I of Palm tiPrl:rr1s, Its officials, enu,10 rQeS, an a tnts are named as ,g . �yeraaeM• p?ma!� non-coniufory, 1,ly tf!fce :rm.ncellatronan WJIIVtr Of ,ubroga\ron'applles. 1nveat1gat1on, A -CERTIFICATE HOLDER CANCELLATION EACH OCCURRENCE $ 1,000,00Cl PWeMisesY&�nce> $ 100,00Cl MED EXP (Any one penon) $ 5,00Cl PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 5,000,000 PRODUCTS· COMP/OP AGG $ 1,000,000 $ COMBINED SINGLE LIMIT $ (Ea acc:iclent) BOOIL V INJURY (Per person) s BOOIL Y INJURY (Per accident) s ------------PROPERTY DAMAGE $ (PER ACCIDENT) $ s EACH OCCURRENCE $ AGGREGATE $ s IT�i�TATIJ. I flt lJUIT� W---L-!iill...+----------E.L. EACH ACCIDENT $ E.L. DISEASE -EA EMPLOYEE S E.L. DISEASE -POLICY LIMIT s SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEUEO BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Palm Springs ACCORDANCE WITH THE POLICY PROVISIONS. 3200 E. Tahqultz Canyon Way Palm Springs, CA 92262 AUTHORIZED REPRESENTATIVE �(}� I © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD 21 Item 1I - 25 I '--· --.l I I ·- -•r A - I I I -- I I I ,_ s .__ - . POLICY NUMBER: CP00960712 COMMERCIAL GENERAL LIABILITY CIGL 79 0318 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations City of Palm Springs, its officials, employees, and agents. Blanket as required by valid written contract. It is agreed that Forms CG2404 (05-09) Waiver of Transfer of Rights of Recovery Against Others to Us and CIGL30 (01-14) Primary and Non-Contributing Insurance Endorsement apply to this additional insured and that, as respects this coverage, thirty (30) days notice of cancellation, except as respects non-payment of premium, for which ten (10) days notice will apply, or other regulatory requirements that may apply, will be given as respects this additional insured. Additional Information: Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A.Section II -Who Is An Insured is amended to include as an additional insured the person or organizationshown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal andadvertising injury" arising out of: 1.Your acts or omissions; or 2.The acts or omissions of those acting on your behalf; in the performance of your operations for the additional insured at the location shown in the Schedule. How�ver: a.The insurance afforded to such additional insured only applies to the extent permitted by law; b.If coverage provided to the additional insured is required by a contract or agreement, the insurance CIGL 79 0318 Includes copyrighted material of Insurance Services Office, Inc. Page 1 of 2 22 Item 1I - 26 afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured; and c.Regardless of the date of occurrence or when the injury or damage first occurs or is first discovered, aperson's or organization's status as an additional insured under this endorsement ends upon the earliestof: (1)The completion or termination of the contract or agreement between you and the additional insuredfor the location shown in the Schedule; (2)The date you cease actively performing operations for the additional insured at the location shown inthe Schedule; or (3)The expiration or termination date of the policy or this endorsement. B.With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to liability or damages for "bodily injury'\ "property damage", or ''personal andadvertising injury": 1.Caused by, arising from, or included in the "products-completed operations hazard"; 2.Arising out of the additional insured's sole negligence; 3.Arising out of work or operations performed by you that were completed prior to the effective date of thisendorsement; or 4.Which continues or progressively deteriorates after you cease actively performing operations for theadditional insured at the location shown in the Schedule, even if the injury or damage first occurred, or isalleged to have first occurred, during the course of your operations for the additional injured. C.Solely for purposes of this endorsement, the following definition is deleted in its entirety and replaced by thefollowing: 1.'"'Products-completed operations hazard": a.Includes all "bodily injury" and "property damage" occurring away from premises you own or rent andarising out of "your product" or "your work" except: (1)Products that are still in your physical possession; or (2)Work that has not yet been completed or abandoned. However, "your work" will be deemedcompleted at the earliest of the following times: (a)When all of the work called for in your contract has been completed; (b)When all of the work to be done at the location shown in the Schedule has been completed ifyour contract calls for work at more than one location; or (c)When that part of the work done at the location shown in the Schedule has been put to itsintended use by any person or organization other than another contractor or subcontractorworking on the same project. Work that may need service, maintenance, correction, repair or replacement, but which is otherwise complete, will be treated as completed. D.With respect to the insurance afforded to these additional insureds, the following is added to Section Ill -Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay onbehalf of the additional insured is the amount of insurance: 1.Required by the contract or agreement; or 2.Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CIGL 79 03 18 Includes copyrighted material of Insurance Services Office, Inc. Page 2 of 2 23 Item 1I - 27 EMPLOYERS ASSURANCE CO. A Stock Company BOWER BRUCE (AN INDIVIDUAL) OBA BRUCE BOWER INVE STIGAilONS POBOX6914 LA QUINTA CA 92248 Customer# Additional Locations: carrier# 36870 FEIN# 364725913 Worbra' Compenaatlon and Employers Liability Insurance Polley RISK EXCHANGE INS SVCS INC VENTURE POBOX192 CUMBERLAND.RI 02864 Tele hone: 8773227399 Risk ID# Entity of InsuredINDIVIDUAL 0000969 2.The Policy Period is from04/25/2019 to 04/25/2020 12:01 a.m. Standard Time at the lnsured's mailing address. 3.A. Workers Compensation Insurance: Part ONE of the policy applies to the Workers Compensation Law of the stateslisted here: CA B.Employers Liability Insurance: Part TWO of the policy applies to work in each state listed in Item 3A.The limits of our liability under Part TWO are: Bodily Injury by Accident $ 1,000,000 each accident Bodily Injury by Disease $ 1,000,000 policy limit Bodily Injury by Disease $ 1,000,000 each employee C.Other States Insurance: Part THREE of the policy applies to the states, if any, listed here: All states except HI, ND, OH, WA, WY and states listed in item 3.A. D.This policy includes these endorsements and schedules: See attached schedule. 4.The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates, and Rating Plans.All Information required below is subject to verification and change by audit. SEE EXTENSION OF INFORMATION PAGE Minimum Premium $ 750 Expense Constant $ Premium Discount $ Assessments and Taxes $ Total Estimated AnnualPremlum s □This is a Three Year Fixed Rate Policy Premium Adjustment Period: Iii Annual; D Semiannual; D Quarterly; D Monthly #P£t-Countersigned this Day of Issued Date: 03/19/2019 Issuing Office EMPLOYERS ASSURANCE co. 500 NORTH BRAND BLVD., SUITE 700 GLENDALE, CA 91203-3916 Issued Date 03/19/2019WC990630 (5198 Ed.) INSURED COPY Page 1 of 4 Authorized Representative 160 1,024 24 Item 1I - 28 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC040306(Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We willnot enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perfonn work under a written contract that requires you to obtain thisagreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees whileengaged in the work described in the Schedule. The additional premium for this endorsement shall be ___o._ %of the California workers' compensationpremium otherwise due on such remuneration. Person or Organization CITY OF PALM SPRINGS CHARTER CITY & MUNICIPAL CORP 3200 E TAHQUITZ CANYON WAYPALM SPRINGS CA 92262 Schedule Job Description The charge for this endorsement Is $ 250 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The Information below Is required only when this endorsement la Issued aubaequent to preparation of the policy.) This endorsement, effective 04/25/2019 Policy No. EIG 2348769 03 at 12:01 AM standard time, forms a part of Of the EMPLOYERS ASSURANCE CO. Carrier Code 00919 Issued to BOWER BRUCE (AN INDIVIDUAL)Endorsement No. Premium //(/ /J �Countersigned at _________ on _____ By: ____ /f ___ �_· ______ Authorized Representative WC040306 (Ed. 4-84) @ 1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved. 25 Item 1I - 29 CITY OF PALM SPRINGS, CA CONFLICT OF INTEREST AND NON-DISCRIMINATION CERTIFICATION Conflict of Interest. Contractor acknowledges that no officer or employee of the City has or shall have any direct or indirect financial interest in this Agreement nor shall Contractor enter into any agreement of any kind with any such officer or employee during the tenn of this Agreement and for one year thereafter. Contractor warrants that Contractor has not paid or given, and will not pay or give, any third party any money or other consideration in exchange for obtaining this Agreement. Covenant Against Discrimination. In connection with its performance under this Agreement, Contractor shall not discriminate against any employee or applicant for employment because of actual or perceived race, religion, color, sex, age, marital status, ancestry, national origin ( i.e., place of origin, immigration status, cultural or linguistic characteristics, or ethnicity), sexual orientation, gender identity, gender expression, physical or mental disability, or medical condition ( each a "prohibited basis"). Contractor shall ensure that applicants are employed, and that employees are treated during their employment, without regard to any prohibited basis. As a condition precedent to City's lawful capacity to enter this Agreement, and in executing this Agreement, Contractor certifies that its actions and omissions hereunder shall not incorporate any discrimination arising from or related to any prohibited basis in any Contractor activity, including but not limited to the following: employment, upgrading, demotion or transfer; recruitment or recruitment advertising; layoff or tennination; rates of pay or other forms of compensation; and selection for training, including apprenticeship; and further, that Contractor is in full compliance with the provisions of Palm Springs Municipal Code Section 7.09.040, including without limitation the provision of benefits, relating to non-discrimination in city contracting. NAME OF CONTRACTOR/VENDOR: .1?/(l,<(1,1[: � If""Ve!'[J64{7DI'!{ NAME and TITLE of Authorized Representative: (Print) ?Muw A-, &Wt;; ,e 6wB«ft5;WtJIIR tl1MJ4<-<fil Signa � e of Authorized Representative: (Sign) _,.,___� a (Date) lt/�r-? 26 Item 1I - 30 ---------------------------------------------=- flit.I - �1Bte t-ann Mutual AUtomobile Insurance Company 900 Old River Road Blllceistleld, CA 93311 AT2 006508 0009 A-1498 A BOWER, BRUCE & ANITA 79291 SPALDING DR BERMUDA DUNES CA 92203-1237 I I I 11111111 11111111,," 11111111111 ul I 11111 11, I I I• I 111 •I 11 II,,,, 1 Polley Number: 362 9989-813-55 Policy Period: August 13, 2019 to February 13, 2020 Vehlcle:- 2015 HONDA ACCORD Principal Driver: BRUCE BOWER Your auto insurance rates are Impacted by the mileage your vehicle is driven. To ensure we've priced our insurance 9Qverage accurately based on the number of miles you -dnvi,wifobla� valid b(jometerreaaings for this vehiclethrough a third party provider and/or from you. Annual mileage was determined using this data and applied. Please contact your State Farm agent with questions. Your policy has the Guaranteed Renewal Endorsement. Policy Number: 362 9989-813-55 Prepared July 8, 2019 1004583 017890 &State Farm ® AUTO RENEWAL PREMIUM PAID: $464.80 DO NOT PAY. Your premium Is bl/led through the Stall Fann Payment Pl•n State Farm Payment Plan Number: 0353957012 Your State Farm Agent JOHN FORD Office: 760-564-0011 Address: 79440 CORPORA TE_ CTR DR STE 104 LA QUINTA, CA 92253-7243 ff}OU hM a new ordlfarent car, have added snydMrs, orh1N8 moved, plessecx,ntactyoursgem. Thank you for choosing State Farm. When you provide a check as payment, you authorize us either to use information from your check to make a u one-time electronic fund transfer from your account or to prooess1heipayma,t ascroheok-tf!SrilsaotioR.-When we. use information from your check to make an eleob'onlc fund transfer, funds may be withdrawn from your account as soon as the same day we receive your payment, and you will not receive your meek back from your financial institution. Page number 1 of 5 1435e2 202 01-15-.1>18 It's What You Know. ·Your auto insurance premium is $464.80. Did you know you may qualify for a discount? Call State Farm• Agent JOHN FORD at 760-564-0011 to see how much you can save! •Not all discounts are available in every state, and discount amounts may vary by state.TP22 27 Item 1I - 31 &StateFarm g VEHICLE INFORMATION Review your policy Information carefully. If anything is incorrect, or if th·ere are any changes to your vehicle information, please let us know right away. Vehicle Deacrtptlon Vehicle Identification Number (VIN) Who principally drives this vehicle? How la this vehicle normally used? 2015 HONDA ACCORD ,. . ..... 1 HGCR2F59FA203088 BRUCE BOWER. a married male, v.tio will To W�rk, School or Pleasure. have 44 years of driving experience 'as' of August 13, 2019. Other Ho·usehold Vehlcle(s) Your premium may be influenced.by other State-Farm pohctes that currently insure the following .vehiole(s) in your household: 2007 FORD EXPED EL 2014FORO EXPED EL The premium on the expiring policy term was based on over 7,500 miles per year. The premium on the renewal policy term was based on 13,900 miles per year. The premium for this renewal was determined using an annual mileage this vehicle is expected to be driven that was developed from information we obtained or was provided by you. The national average Is more than 121 000 miles driven annually according to the U.S. Department of Transportation. Please oontact us if you expect your annual mileage to change over the next year. DRIVER INFORMATION Assigned Drtver(s) The following driver(s) are assigned to the vehicle(s) on this policy. Premium Adjustment Each year, we review our medical payments and personal injury protection coverages claim experience to determine the vehiclJ safety discount that is applied to each make and model. In addition, we review the oomprehensive, collision, bodily injury and property damage claim experience annually to determine which makes and models have earned decreases or Increases from State Farm,.s standard rates. If any changes result from our reviews, adjustments are reflec� in the rates shown on this renewal notice. Name Driving Experience as of Marital August 13, 2019 Gender Status BRUCE BOWER 44years Other Household Drlver(s) In addition to the Principal Driver(s) and Assigned Driver(s), your premium may be influenced by the ,. �-�five1i '19,n below and oth� indivi4uals permitted to ·drive four vehicle. This list does not extend or expand coverage beyond that contained in this automobilepolicy. The drivers listed below are the drivers reported to us that most frequenUy drive other vehicles in your household. AIMEE BOWER ANITA BOWER Policy Number: 382 9989-813-55 Prepared July 8, 2019 Male Married Page number 2 of 5 28 Item 1I - 32 f-��-Principal Driver & Assigned Drivers For each automobile, the Principal Driver is the individual who most frequenUy drives It. Each driver is designated as an Assigned Driver on the household automobile that they most ftequenUy drive. Your &State Farm� premium may be influenced by the information shown for these drivers. w COVERAGE AND LIMITS See your policy for en explanation otthese coverages. A Liability Bodily Injury 100._000/300,000 Property Damage 100,000 C Medical Payments 25,000 D 250 Deductible C9f1lPT9hensive G 250 Deductible Collision u Uninsured Motor Vehicle Bodily Injury 100,000fJOO,O00 U1 If any coverage you carry J&-ohaAged to give broader protection with no additional premium charge, we will give DI SC OUNTS These adjustments hsve slreBdy been sppfled to your premium. Multiple Line Multicar Vehicle Safety Driving Safety Record Other Available Dlscount{s) You may be eligible for additional disoounts See the enolosed insert for more information. Mature Driver SURCHARGES ANO DISCOUNTS Driving Safety Record Rating Plan Your driving safety record, along with other rating factors, determines �at you pay for Liability, Medical Payments, Policy Number: 362 9989-813-55 Prepared July 8, 2019 017891 $186.02 $28.64 $48.06 $161.95 $38.51 $1.62 you the broader protection .without issuing. a new policy 1 starting on the date we adopt the broader protection. ✓ ✓ ✓ ✓ ✓ (continue<! on next page) Page number 3 of 5 29 Item 1I - 33 Comprehensive, Collision, and Uninsured Motor Vehicle Coverages. Policyholders with no accidents and convictions pay less than those with accidents and convictions. The Driving Safety Reoord Rate Level that is assigned to your policy moves up, down, or stays the same every policy renewal, depending upon your driving record. For every 12 months since the renewal following the occurrence of a chargeable accident or the conviction of a minor violation, the initial assigned Driver Reoord.Level for that chargeable accident or conviction shall be lowered by 1 level. For each 12 month period since the conviction of a major violation, the Initial assigned Driver Record Level for that conviction shall be lowered by 2 levels. The Rate Level is Increased if there are subsequent chargeable accidents or convictions. Definition of Chargeable Accidents Chargeable accidents for new business are those which resulte� In �fly injury or de�th or in payment(s) by an insurer due to damage to any property in the amount of more than $1000. For aooidents occurring prior to December 11, 2011, an accident shall be chargeable provided It resulted in death or In payment(s) by an insurer ADDITIONAL INFORMATION If any information on this renewal notice is incomplete or inaccurate; or if you want to confirm the information we have in our records, please contact your agent. For additional Annual Mileage &State Farm ® due to damage to any property in the amount of more than $750. For applicants withqut prior insurance at the time of the accident, an accident shall be chargeable provided it resulteq ir_t damage to any property in the amount of more than $1000 (more than $750 if the accident occurred prior to December 11, 2011 ). Chargeable accidents for renewal business are those which resulted in bodily injury or death or State Farm olc3im payments totaling more than $1000 (more than $750 for accidents occurring prior to December 11, 2011) under property damage liability coverage and collision coverage combined. For more information about the rating plan, please contact your State Farm agent. Your Multiple Line Discount has increased. For additional information, please oontact your agent. Superior Driver Rate Level information regarding disoounts or coverages, see your State Farm agent or visit statefarm.com®. We want to tell you about a change to how your premium will be calculated. Beginning with this renewal, we will obtain odometer readings annually through a third party vendor to determine your annual mileage. This eliminates the need for customer-provided odometer readings. When applicable, this new process replaced any previous mileage-based rating on your pof ioy. If you have questions, please contact your State Farm agent Important Notice Regarding Your Premium State Farm works hard to offer you the best combination of price, service, and protection. The amount you pay for automobile insurance is determined by many factors Including: •The coverage you have •Where you live •The kind of oar you drive •How the car is used •Who drives the car Any premium adjustment is reflected on this Auto Renewal. If you have any questions, please contact your agent. Buying a new car? Remember to contact your agent! When you buy an additional oar or one that replaces a car already on your policy, you need to report the change to your agent promptly. Even though the dealership you purchased the oar from may offer to notify your agent or insurance company, you, as the named insured, are responsible for reporting all changes to your auto policy. By contacting your agent, you oan help: {continued on next page) Policy Number: 362 9989-813-55 Paga number 4 of 5 Prepared July 8, 2019 30 Item 1I - 34 1. 2. 3. Name of Entity PUBLIC INTEGRITY DISCLOSURE APPLICANT DISCLOSURE FORM Address of Entity (Principle Place of Business) t? () 6 4.State where Entity is Registered with Secretary of State Nf>J f<e61 Si2:=�� -�D)i$ /.t..o/'/<.112!7)� 5.Type of Entity D Corporation D Limited Liability Company D Partnership O Trust @ Oth er (P, ase specify).s. �/'4 /L. 6.Officers, Directors, Members, Managers, Trustees, Other Fiduciaries (please specify)Note: ff any response Is not a natural person, please Identify all officers, directors,members, managers and other fiduciaries for the member, manager, trust or other entity _3,_{<u ____ t_,'.h: ___ -___ & _____ �---=�..._· ________ D Officer O Director D Member O Manager(name] (name] D General Partner D Limited Partner � Other (»W1:-x,/dv1WIJJ � cer D Director D Member D Manager 0 General Partner D Limited Partner □Other ___________ _ ________________ 0 Officer D Director D Member D Manager (Revised 09 13 18) D General Partner D Limited Partner □Other ___________ _ CITY OF PALM SPRINGS - PUBLIC INTEGRITY DISCLOSURE APPLICANT DISCLOSURE FORM Page 1 of 2 31 Item 1I - 35 If other than Califomia is the Enti No /.,(l'iame] 7.Owners/Investors with a 5% beneficial interest in the Applicant Entity or a related entity EXAMPLE JANE DOE [name of owner/investor] A. [name of owner/investor) B. [name of owner/investor] C. D. E. 50%, ABC COMPANY, Inc. [percentage of beneficial inter st in entity and name of en · ] [percent e of beneficial interest in entity nd name of entity) [percentage of beneficial interest in entity and name of entity) (percentage of beneficial interest in entity and name of enti ] [percentage of beneficial interest in entity and name of entity] [name of owner/investor] (percentage of beneficial Interest in entity and name of entity] I DECLARE UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF CALIFORNIA THAT THE FOREGOING IS TRUE AND CORRECT. Signature of Disclosing Party, Printed Name, Title Date (Revised 09 13.18) CITY OF PALM SPRINGS -PUBLIC INTEGRITY DISCLOSURE FORM APPLICANT DISCLOSURE FORM Page 2 of 2 32Item 1I - 36 e ATTACHMENT 3 AMENDMENT NO. 1 TO AGREEMENT FOR CONTRACT SERVICE AGREEMENT – APPROVED 2019 Item 1I - 37 AMENDMENT NO. 1 TO AGREEMENT FOR CONTRACT SERVICES BETWEEN CITY OF PALM SPRINGS AND BRUCE BOWER INVESTIGATIONS This Amendment No. 1 (“Amendment”) to that certain Agreement for Contract Services between the City of Palm Springs and Bruce Bower Investigations (the “Agreement”) is made and entered into this ___ day of ____________, 2022, by and between the City of Palm Springs, a California charter city and municipal corporation (“City”), and Bruce Bower Investigations, a sole proprietorship (“Contractor”). City and Contractor are individually referred to as “Party” and are collectively referred to as the “Parties”. RECITALS A.The City and Contractor previously entered into the Agreement for background and personnel investigation services, the term of which was set to expire on December 31, 2021. B.Section 4.4 of the Agreement authorizes the Parties to extend the term by mutual written agreement. C.The City and Contractor mutually desire to extend the term of the Agreement. NOW, THEREFORE, in consideration of the mutual covenants and promises in this Amendment, the Parties hereto agree to bind themselves as follows: AGREEMENT 1. Extension of Term. Section 4.4 of the Agreement is hereby amended to read: “4.4 Term. Unless earlier terminated in accordance with Section 4.5 of this Agreement, this Agreement shall continue in full force and effect for a period of 36 months commencing on January 1, 2022, and ending on December 31, 2024, unless extended by mutual agreement of the parties.” 2.Applicability. This Amendment is attached to and made a part of the Agreement. In the event of any contradiction or inconsistency between the terms and provisions of this Amendment and the terms and provisions of the Agreement to which it is attached, the terms and provisions of this Amendment shall control and be interpreted in such a manner as to override any provision of the Agreement that would prevent the spirit and letter of the terms and provisions of this Amendment from being given full force and effect. All defined terms not specifically defined in this Amendment shall be given the same meaning as the defined terms in the Agreement. All other terms and conditions contained in the Agreement shall remain unchanged. Item 1I - 38 3.Joint Authorship. This Amendment has been entered into as an act of free will, without duress, and no presumption of authorship shall attach to same, and any ambiguity in the terms and conditions of this Agreement shall not be attributed to one Party over the other. 4. Authority. The persons executing this Amendment on behalf of the Parties warrant that they are duly authorized to execute this Amendment on behalf of Parties and that by so executing this Amendment the Parties are formally bound to the provisions of this Amendment. [SIGNATURES ON THE FOLLOWING PAGES] Item 1I - 39 IN WITNESS WHEREOF, the Parties have executed this Amendment as of the date first written above. CITY OF PALM SPRINGS, a California Charter City Bruce Bower Investigations, a Sole Proprietorship Justin Clifton, City Manager Bruce Bower, Owner/Qualified Manager ATTEST: Anthony J. Mejia, City Clerk APPROVED AS TO FORM: By: Jeffrey S. Ballinger, City Attorney Date: Item 1I - 40 OP ID: MN ACORD" CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYY) � 04/20/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER �2�t�cT Michelle A Nowell Alliance Mgt. & Insurance Serv 355 Via Vera Cruz #7 ri:JgNJo Ext\: 760-471-7116 I r.e� N ol: 760-471-9378 CA AriWent/Broker Lie# 0737966 San arcos, CA 92078 Michelle A. Nowell INSURED Bruce Bower InvestigationsBruce A Bower PO Box 6914 La Quinta, CA 92248 COVERAGES CERTIFICATE NUMBER- it1tJ�ss: mnowell@amiscorp.com �������:ID#: BOWER-2 INSURER(S) AFFORDING COVERAGE INSURER A : Peleus Insurance Company IN SURER B: INSURER C: INSURER D: IN SURER E: IN SURER F: REVISION NUMBER- NAIC# 34118 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 TYPE OF INSURANCE ,<UU'-�u"" POLICY EFF POLICY EXP LTR ,..,.,., "'"'" POLICY N UMBER IMM/DD/YYYYI IMM/DD/YYYYI GENERAL LIABILITY A X COMMERCIAL GENERAL LIABILITY X X PKV0000431 04/08/2021 04/08/2022 -=:J CLAIMS-MADE 00 OCCUR -X Errors & Omission GEN'L AGGREGATE LIMIT APPLIES PER: m POLICY n r,rR-r n LOC AUTOMOBILE LIABILITY t--ANY AUTO -ALL OWNED AUTOS -SCHEDULED AUTOS t--HIRED AUTOS t--NON-OWNED AUTOS t-- UMBRELLA LIAB H OCCUR t--EXCESS LIAB CLAIMS-MADE DEDUCTIBLE t--RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE □ OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Ci �. of Pf I.m S�rinjs, its officials, emfl�tees, and a�tnts are named a� Itona msu ed s res ects to wor rformed b e ab9ve na ed insured.f��iR,oyeragf t grimafroand nqn-confri utory, 30-0ay Notice of �ancellation r.n .aIv�r � rogat on applies. nvestIgatIon, -- CERTIFICATE HOLDER CANCELLATION LIMITS EACH OCCURRENCE $ 1,000,000 U1'M1''->t: 1?tt:N I t:U PREMISES Ea occurrence} $ 100,000 MED EXP (Any one person} $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 5,000,000 PRODUCTS -COMP/OP AGG $ 1,000,000 $ COMBINED SINGLE LIMIT $ (Ea accident) BODILY INJURY (Per person} $ BODIL y INJURY (Per accident} $ PROPERTY DAMAGE (PER ACCIDENT) $ $ EACH OCCURRENCE $ AGGREGATE $ $ $ ,T�f STATU-I RY LIMITS IOTH-ER E.L. EACH ACCIDENT $ E.L. DISEASE -EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Palm Springs ACCORDANCE WITH THE POLICY PROVISIONS. 3200 E. Tahquitz Canyon Way AUTHORIZED REPRESENTATIVE Palm Springs, CA 92262 �o.� I © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD Item 1I - 41 h I ~ l:MPLIJYER!i® I I Workers' Compensation and Employers Liability Insurance Policy EM PLOVERS ASSURANCE CO. Policy Number Policy Period From To A Stock Company EIG 2348769 05 04/25/2021 04/25/2022 I 12:01A.M. Standard Time at the address of the Insured as stated herein Transaction RENEWAL DECLARATIONS NCCI Carrier # 36870 WCIRB CARRIER# 00919 PRIOR POLICY NUMBER EIG234876904 1.Named Insured and Address Agent BOWER BRUCE (AN INDIVIDUAL) VENTURE AGENCY HOLDINGS INC 0002822 OBA BRUCE BOWER INVESTIGATIONS 30555 SOUTHFIELD RD STE 305 PO BOX 6914 SOUTHFIELD, Ml 48076 LA QUINTA CA 92248 Telephone: 2482060900 Customer# I Carrier# I FEIN# I Risk ID# I Entity of Insured 36870 364725913 INDIVIDUAL Additional Locations: 2.The Policy Period is from 04/25/2021 to 04/25/2022 12:01 a.m. Standard Time at the lnsured's mailing address. 3. A. Workers Compensation Insurance: Part ONE of the policy applies to the Workers Compensation Law of the states listed here: CA B. Employers Liability Insurance: Part TWO of the policy applies to work in each state listed in Item 3A. The limits of our liability under Part TWO are: Bodily Injury by Accident $ Bodily Injury by Disease $ Bodily Injury by Disease $ 1,000,000 1,000,000 1,000,000 each accident policy limit each employee C.Other States Insurance: Part THREE of the policy applies to the states, if any, listed here: All states except ND, OH, WA, WY and states listed in item 3.A. D.This policy includes these endorsements and schedules: See attached schedule. 4.The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates, and Rating Plans. All information required below is subject to verification and change by audit. SEE EXTENSION OF INFORMATION PAGE Minimum Premium $ 650 Assessments and Truces $ O This is a Three Year Fixed Rate Policy Expense Constant Premium Discount Total Estimated AnnualPremium Premium Adjustment Period: Ix) Annual; 0 Semiannual; 0 Quarterly; 0 Monthly Countersigned this Day of JfJJY $ $ $ Issued Date: 03/16/2021 Authorized Representative Issuing Office EMPLOYERS ASSURANCE CO. 500 NORTH BRAND BLVD., SUITE 700 GLENDALE, CA 91203-3916 Issued Date 03/16/2021 WC990630 (5/98 Ed.) INSURED COPY Page 1 of 4 160 930 Item 1I - 42 . I IEMPLIJYER!T WORKERS' COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY Policy Number: EIG 2348769 05 EMPLOYERS ASSURANCE CO. A Stock Company 500 NORTH BRAND BLVD., SUITE 700 GLENDALE, CA 91203-3916 Named Insured: BOWER BRUCE (AN INDIVIDUAL) Agent: VENTURE AGENCY HOLDINGS INC EXTENSION OF INFORMATION PAGE CLASSIFICATION OF OPERATIONS Code No. California Classification Description Rating Period: 04/25/2021 through 04/25/2022 Site 00001 7721 DETECTIVE OR PRIVATE INVESTIGATIVE AGENCIES 8810 CLERICAL OFFICE EMPLOYEES-N.O.C. Site 00001 Total Total of Sites for Rating Period Rating Period Total Rating Period: 04/25/2021 through 04/25/2022 0930 0900 0936 0935 0937 0938 0939 0940 0943 9741 WAIVER OF SUBROGATION EXPENSE CONSTANT STATE W.C. FRAUD ASSESSMENT STATE W.C. ADMINISTRATIVE ASSESSMENT CA INSURANCE GUARANTY CA UNINSURED EMPLOYERS FUND CA SUBSEQUENT INJURY FUND OSHF ASSESSMENT LABOR ENFORCEMENT & COMPLIANCE CATASTROPHE PREMIUM 9740 TERRORISM PREMIUM Rating Period Total State Total Policy Total Issued Date 03/16/2021 WC990630 (5/98 Ed.) INSURED COPY Page 2 of 4 Premium Basis Total Est. Annual Rate Per $100 of Remuneration Remuneration 7,500 24,000 895 895 895 895 895 895 895 31,500 31,500 5.210000 0.330000 0.004734 0.022646 0.000775 0.006579 0.002584 0.002272 0.020000 0.030000 $ $ $ $ $ $ 0002822 Estimated Annual Premium 391.00 79.00 470.00 470.00 470.00 250.00 160.00 4.00 20.00 1.00 6.00 2.00 2.00 6.00 9.00 460.00 930.00 930.00 "' z r-0 0 .c: (.) .., Item 1I - 43 l:MPLIJYERIT EMPLOYERS ASSURANCE CO. A Stock Company 500 NORTH BRAND BLVD., SUITE 700 GLENDALE, CA 91203-3916 State CA BOWER BRUCE (AN INDIVIDUAL) 79291 SPALDING DRIVE BERMUDA DUNES CA 92203 Issued Date: 03/16/2021 WC990410 (7/06 Ed.) 1 WORKERS' COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY Policy Number: EIG 2348769 05 Named Insured: BOWER BRUCE (AN INDIVIDUAL) Agent: VENTURE AGENCY HOLDINGS INC SITE LOCATION SCHEDULE INSURED COPY Page 3 of 4 0002822 Item 1I - 44 ~ i . ' t t l:MPLIJVER!T EMPLOYERS ASSURANCE CO. A Stock Company 500 NORTH BRAND BLVD., SUITE 700 GLENDALE, CA 91203-3916 State Form Nbr. CA wcooooooc CA WC000406A CA WC000419 CA WC000421E CA WC000422C CA WC040301D CA WC040306 CA WC040310 CA WC040360B CA WC040421 CA WC040422 CA WC040601A CA WC990405A Issued Date: 03/16/2021 WC990633 (5/98 Ed.) Ed. Date (1/15) (7 /95) (1/01) (1/21) (1/21) (2/18) (4/84) (1/95) (1/15) (1/08) (1/12) (12/93) (3/07) WORKERS' COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY Policy Number: EIG 2348769 05 Named Insured: BOWER BRUCE (AN INDIVIDUAL) Agent: VENTURE AGENCY HOLDINGS INC ENDORS8v1 ENT SCHEDULE Description WC/EL INS. POLICY FORM BOOKLET PREMIUM DISCOUNT ENDORSEMENT PREMIUM DUE DATE ENDORSEMENT CATASTROPHE PREMIUM ENDORSE TERRORISM RISK INSURANCE PROG CA POLICY AMENDATORY END CA WAIVER OUR RIGHT TO RECOVER DUTY TO DEFEND CA ELL AMENDATORY ENDORSEMENT OPTIONAL PREM INCREASE ENDT SHORT RATE PENALTY CANCELLATION ENDORSEMENT INSTALLMENT PAYMENT ENDORSE INSURED COPY Page 4 of 4 0002822 C C C � c C " 0 C C C r C Item 1I - 45_,.,n ", nl.: ai,:;. f:T,N~::1t-rh007 N'B RB WORKERS COMPBIISATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS e.lDORSEMBIIT-CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be __Q_% of the California workers' compensation premium otherwise due on such remuneration. Person or Organization CITY OF PALM SPRINGS 3200 E TAHQUITZ CANYON WAY CHARTER CITY AND MUNICIPAL COR PALM SPRINGS CA 92262 The charge for this endorsement is$ 250 Schedule Job Description This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective 04/25/2021 Policy No. EIG 2348769 05 at 12:01 AM standard time, forms a part of Of the EMPLOYERS ASSURANCE CO. Issued to BOWER BRUCE (AN INDIVIDUAL) Premium Carrier Code 00919 Countersigned at ___________ on _____ _ By: WC 04 03 06 Endorsement No. ,f/!Jll Authorized Representative (Ed. 4-84) 0 1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved. 0 .c () j..) Item 1I - 46~«.1.n•-M-00001%-0025-0006077 GLNBa 07 NB RB J� � �::,._q"'"' •o f-­cn o State Farm Mutual Automobile Insurance Company PO Box 853919 Richardson, TX 75085-3919 AT2 012296 0009 A-1498 A BOWER, BRUCE & ANITA 79291 SPALDING DR BERMUDA DUNES CA 92203-1237 111• II I I 11 I 11111 I II I I II 11 I 111 • 11 11111 • 111I111111 1 1 1 11111 I111 1 1 11 I Policy Number: 362 9989-813-55A Policy Period: August 13, 2021 to February 13, 2022 Vehicle: 2021 GMC CANYON Principal Driver: BRUCE BOWER Your auto insurance rates are impacted by the mileage your vehicle is driven. To ensure we've priced our insurance coverage accurately based on the number of miles you drive, we tried to obtain valid mileage information for this vehicle through a third party provider. We were unable to obtain odometer readings and have applied an average annual mileage using information from a third party provider and some of your vehicle and policy characteristics. Please contact your State Farm agent with questions. Policy Number: 362 9989-813-55A Prepared July 7, 2021 1004583 StateFarm e AUTO RENEWAL PREMIUM PAID: $520.49 DO NOT PAY. Your premium is billed through the State Farm Payment Plan State Farm Payment Plan Number: 0353957012 Your State Farm Agent JOHN FORD Office: 760-564-0011 Address: 79440 CORPORATE CTR DR STE 104 LA QUINTA, CA 92253-7243 If ;ou have a new or different car, have added any drnters, or have moved, please contact ;our agent Thank you for choosing State Farm. Your policy has the Guaranteed Renewal Endorsement. When you provide a check as payment, you authorize us either to use information from your check to make a one-time electronic fund transfer from your account or to process the payment as a check transaction. When we use information from your check to make an electronic fund transfer, funds may be withdrawn from your account as soon as the same day we receive your payment, and you will not receive your check back from your financial institution. Page number 1 of 5 143562 202 01-15-2018 Thanks for being part of our neighborhood. You mean a lot to us. If you need anything, call State Farm ® Agent John Ford at 760-564-0011. LJ TP31 Item 1I - 47 K� � Principal Driver & Assigned Drivers For each automobile, the Principal Driver is the individual who most frequently drives it. Each driver is designated as an Assigned Driver on the household automobile that they most frequently drive. Your StateFarm e premium may be influenced by the information shown for these drivers. LJ �� [;:; � .:. o COVERAGE AND LIMITS See your policy for an explanation of these coverages. (1)1:l A Liability Bodily Injury 100,000/300,000 Property Damage 100,000 C Medical Payments 25,000 D 250 Deductible Comprehensive G 250 Deductible Collision u Uninsured Motor Vehicle Bodily Injury 100,000/300,000 U1 Uninsured Motor Vehicle Property Damage Total Premium If any coverage you carry is changed to give broader protection with no additional premium charge, we will give DISCOUNTS These adjustments have already been applied to your premium. Multiple Line Multicar Vehicle Safety Driving Safety Record California Good Driver Loyalty Total Discounts Other Available Discount(s) You may be eligible for additional discounts See the enclosed insert for more information. Mature Driver SURCHARGES AND DISCOUNTS Driving Safety Record Rating Plan Your driving safety record, along with other rating factors, determines what you pay for Liability, Medical Payments, Policy Number: 362 9989-B13-55A Prepared July 7, 2021 $163.34 $20.99 $62.67 $234.85 $37.08 f' $1.56 $520.49 you the broader protection without issuing a new policy, starting on the date we adopt the broader protection. ✓ ✓ ✓ ✓ ✓ ✓ $2,071.45 (continued on next page) Page number 3 of 5 Item 1I - 48 State Farm· Disclaimer: This message is provided for informational purposes only and does not grant any insurance coverage. The terms and conditions of coverage are set forth in your State Farm Car Policy booklet, the most recently issued Declarations Page, and any applicable endorsements. Policy Number: 362 9989-B13-55A Prepared July 7, 2021 Page number 5 of 5 LJ Item 1I - 49