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HomeMy WebLinkAbout04942 - HEARING AID HEALTH CARE DOCUMENT TRACKING Page: 1 Report: One Document Detail April 24, 2006 Condition: Document NumberA4942, Document# Description Approval Date Expiration Date Closed Date A4942 Employee Hearing Evaluations 08/01/2004 06/01/2005 Company Name: Hearing Aid Health Care Address: Service: In File xRef: HUMAN RESOURCES Ins. Status: No Certificate on file. Document Tracking Items, Due Completed Tracking Amount Amount Code Item Description Date Date Date Added Paid 08-2704 to CC for sign 8-16-04 to CM for Signature END OFREPORT* * * * ' * At g� Hearing Aid Health Care Employee Heating Evaluations AGREEMENT #4942 CITY OF PALM SPRINGS CM signed 8-16-04 CONTRACT SERVICES AGREEMENT FOR Employee Hearing Evaluations THIS CONTRACT SERVICES AGREEMENT (herein "Agreement') is made and entered into this f day of :+-iSs+ 2004, by and between the CITY OF PALM SPRINGS, a municipal corporation (herein "City") and Hearing Aid Health Care, (herein "Contractor"). NOW, THEREFORE, the parties hereto agree as follows: 1.0 SERVICES OF CONTRACTOR 1.1 Scope of Services. In compliance with all of the terms and conditions of this Agreement, the Contractor shall perform the work or services set forth in the "Scope of Services" attached hereto as Exhibit "A" and incorporated herein by reference. Contractor warrants that all work and services set forth in the Scope of Services will be performed in a competent, professional and satisfactory manner. 1.2 Compliance With Law. All work and services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, and regulations of the City and any Federal, State or local governmental agency of competent jurisdiction. 1.3 Licenses, Permits, Fees and Assessments. 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. 2.0 COMPENSATION 2.1 Contract Sum. For the services rendered pursuant to this Agreement, Contractor shall be compensated in accordance with the "Schedule of Compensation" attached hereto as Exhibit "B" and incorporated herein by this reference, but not exceeding the maximum contract amount of Twenty Four Thousand Nine Hundred Dollars ($24,900.00) ("Contract Sum"). 2.2 Method of Payment. Provided that Contractor is not in default under the terms of this Agreement, Contractor shall be paid as outlined Exhibit "B" Schedule of Compensation. 3.0 COORDINATION OF WORK 3.1 Representative of Contractor. Jeanette Hait, Manager, is hereby designated as being the principal and representative of Contractor authorized to act in its behalf with respect to the work and services specified herein and make all decisions in connection therewith. 3.2 Contract Officer. Sue Mills, PHR is hereby designated as being the representative the City authorized to act in its behalf with respect to the work and services specified herein and make all decisions in connection therewith ("Contract Officer). The City C:\Documents and Settings\DLR\Local Settings\Temp\Hearing Aid Health Care.wpd -1- Manager of City shall have the right to designate another Contract Officer by providing written notice to Contractor. 3.3 Prohibition Against Subcontracting or Assignment. Contractor shall not contract with any entity to perform in whole or in part the work or services required hereunder without the express written approval of the City. Neither this Agreement nor any interest herein may be assigned or transferred, voluntarily or by operation of law, without the prior written approval of City. Any such prohibited assignment or transfer shall be void. 3.4 Independent Contractor. Neither the 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 herein, except as otherwise set forth. Contractor shall perform all services required herein as an independent contractor of City and shall remain under only such obligations as are consistent with that role. 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. 4.0 INSURANCE AND INDEMNIFICATION 4.1 Insurance. The Contractor shall procure and maintain, at its sole cost and expense, in a form and content satisfactory to City, during the entire term of this Agreement including any extension thereof, the following policies of insurance: (a) Commercial General Liability Insurance. A policy of commercial general liability insurance written on a per occurrence basis with a combined single limit of a least $1,000,000 bodily injury and property damage including coverages for contractual liability, personal injury, independent contractors, broadform property damage, products and completed operations. The General Liability Policy shall name the City of Palm Springs, its officers, employees, and agents, as additional insured in accordance with standard ISO additional insured endorsement form CG2010(1185) or equivalent language. (b) Worker's Compensation Insurance. A policy of worker's compensation insurance in such amount as will fully comply with the laws of the State of California and which will include $1,000,000 employer's liability. (c) Business Automobile Insurance. A policy of business automobile liability insurance written on a per occurrence basis with a single limit liability in the amount of $1,000,000 bodily injury and property damage, Said policy shall include coverage for owned, non-owned, leased and hired cars. (d) Additional Insurance. Policies of such other insurance, including professional liability insurance in a minimal amount of $1,000,000 if contract has professional liability exposure, as may be required in Exhibit"C". All of the above policies of insurance shall be primary insurance. The insurer shall waive all rights of subrogation and contribution it may have against the City, its officers, employees and agents, and their respective insurers. In the event any of said policies of insurance are canceled, the Contractor shall, prior to the cancellation date, submit new evidence of insurance in conformance with this Section 4.1 to the Contract Officer. No work or services under this Agreement shall commence until the Contractor has provided the City with C:\Documents and Settings\DLR\Local Settings\Temp\Hearing Aid Health Care.wpd -2- Certificates of Insurance or appropriate insurance binders evidencing the above insurance coverages and said Certificates of Insurance or binders are approved by the City. The contractor agrees that the provisions of this Section 4.1 shall not be construed as limiting in any way the extent to which the Contractor may be held responsible for the payment of damages to any persons or property resulting from the Contractor's activities or the activities of any person or person for which the Contractor is otherwise responsible. In the event the Contractor subcontracts any portion of the work in compliance with Section 3.3 of this Agreement the contract between the Contractor and such subcontractor shall require the subcontractor to maintain the same polices of insurance that the Contractor is required to maintain pursuant to this Section. 4.2 Indemnification. Contractor agrees to indemnify the City, its officers, agents and employees against, and will hold and save them and each of them harmless from, any and all actions, suits, claims, damages to persons or property, losses, costs, penalties, obligations, errors, omissions or liabilities, (herein "claims or liabilities") that may be asserted or claimed by any person, firm or entity arising out of or in connection with the negligent performance of the work, operations or activities of Contractor, its agents, employees, subcontractors, or invitees, provided for herein, or arising from the negligent acts or omissions of Contractor hereunder, or arising from Contractor's negligent performance of or failure to perform any term, provision, covenant or condition of this Agreement, whether or not there is concurrent passive or active negligence on the part of the City, its officers, agents or employees but excluding such claims or liabilities arising from the sole negligence or willful misconduct of the City, its officers, agents or employees, who are directly responsible to the City, and in connection therewith: (a) Contractor will defend any action or actions filed in connection with any of said claims or liabilities and will pay all costs and expenses, including legal costs and attorneys' fees incurred in connection therewith; (b) Contractor will promptly pay any judgment rendered against the City, its officers, agents or employees for any such claims or liabilities arising out of or in connection with the negligent performance of or failure to perform such work, operations or activities of Contractor hereunder; and Contractor agrees to save and hold the City, its officers, agents, and employees harmless therefrom; (c) In the event the City, its officers, agents or employees is made a party to any action or proceeding filed or prosecuted against Contractor for such damages or other claims arising out of or in connection with the negligent performance of or failure to perform the work, operation or activities of Contractor hereunder, Contractor agrees to pay to the City, its officers, agents or employees, any and all costs and expenses incurred by the City, its officers, agents or employees in such action or proceeding, including but not limited to, legal costs and attorneys' fees. 5.0 TERM 5.1 Term. Unless earlier terminated in accordance with Section 5.2 below, this Agreement shall continue in full force until June 30, 2005. 5.2 Termination Prior to Expiration of Term. Either party may terminate C:\Documents and Settings\DLR\Local Settings\Temp\Hearing Aid Health Care.wpd -3- this Agreement at any time, with or without cause, upon thirty (30) days' written notice to the other party. Upon receipt of the notice of termination, the Contractor shall immediately cease all work or services hereunder except as may be specifically approved by the Contract Officer. In the event of termination by the City, Contractor shall be entitled to compensation for all services rendered prior to the effectiveness of the notice of termination and for such additional services specifically authorized by the Contract Officer and City shall be entitled to reimbursement for any compensation paid in excess of the services rendered. 6.0 MISCELLANEOUS 6.1 Covenant Against Discrimination. Contractor covenants that, by and for itself, its heirs, executors, assigns and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, or ancestry in the performance of this Agreement. Contractor shall take affirmative action to ensure that applicants are employed and that employees are treated during employment without regard to their race, color, creed, religion, sex, marital status, national origin or ancestry. 6.2 Non-liability of City Officers and Employees. No officer or employee of the City shall be personally liable to the Contractor, or any successor in interest, in the event of any default or breach by the City or for any amount which may become due to the Contractor or to its successor, or for breach of any obligation of the terms of this Agreement. 6.3 Conflict of Interest. No officer or employee of the City shall have any financial interest, direct or indirect, in this Agreement nor shall any such officer or employee participate in any decision relating to the Agreement which effects his financial interest or the financial interest of any corporation, partnership or association in which he is, directly or indirectly, interested, in violation of any State statute or regulation. The Contractor warrants that it has not paid or given and will not pay or give any third party any money or other consideration for obtaining this Agreement. 6.4 Notice. Any notice, demand, request, document, consent, approval, or communication 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 prepaid, first-class mail, in the case of the City, to the City Manager and to the attention of the Contract Officer, CITY OF PALM SPRINGS, P.O. Box 2743, Palm Springs, California 92263, and in the case of the Contractor, to the person at the address designated on the execution page of this Agreement. 6.5 Interpretation. The terms of this Agreement shall be construed in accordance with the meaning of the language used and shall not be construed for or against either party by reason of the authorship of this Agreement or any other rule of construction which might otherwise apply. 6.6 Integration; Amendment. It is understood that there are no oral agreements between the parties hereto affecting this Agreement and this Agreement supersedes and cancels any and all previous negotiations, arrangements, agreements and understandings, if any, between the parties, and none shall be used to interpret this Agreement. This Agreement may be amended at any time by the mutual consent of the parties by an instrument in writing. C:\Documents and Settings\DLR\Local Settings\Temp\Hearing Aid Health Care.wpd 6.7 Severability. In the event that part of this Agreement shall be declared invalid or unenforceable by a valid judgment or decree of a court of competent jurisdiction, such invalidity or unenforceability shall not affect any of the remaining portions of this Agreement which are hereby declared as severable and shall be interpreted to carry out the intent of the parties hereunder unless the invalid provision is so material that its invalidity deprives either party of the basic benefit of their bargain or renders this Agreement meaningless. 6.8 Waiver. No delay or omission in the exercise of any right or remedy by a nondefaulting party on any default shall impair such right or remedy or be construed as a waiver. A party's consent to or approval of any act by the other party requiring the party's consent or approval shall not be deemed to waive or render unnecessary the other party's consent to or approval of any subsequent act. Any waiver by either party of any default must be in writing and shall not be a waiver of any other default concerning the same or any other provision of this Agreement. 6.9 Attorneys' Fees. If either party to this Agreement is required to initiate or defend or made a party to any action or proceeding in any way connected with this Agreement, the prevailing party in such action or proceeding, in addition to any other relief which may be granted, whether legal or equitable, shall be entitled to reasonable attorney's fees, whether or not the matter proceeds to judgment. 6.10 Corporate Authority. The persons executing this Agreement on behalf of the parties hereto warrant that (i) such party is duly organized and existing, (ii) they are duly authorized to execute and deliver this Agreement on behalf of said party, (iii) by so executing this Agreement, such party is formally bound to the provisions of this Agreement, and (iv) the entering into this Agreement does not violate any provision of any other Agreement to which said party is bound. SIGNATURES ON NEXT PAGE C:\Documents and Settings\DMLocal Settings\Temp\Hearing Aid Health Care.wpd EXHIBIT "A" SCOPE OF SERVICES Contractor shall perform a variety of employee hearing evaluation services on an as-needed basis to support the activities of the City's Human Resources Department. C:\Documents and Settings\DLR\Local Settings\Temp\Hearing Aid Health Care.wpd SCHEDULE B SCHEDULE OF COMPENSATION Total compensation for services and expenses provided hereunder shall not exceed $24,900.00. Personnel: Per Screening $25.00 C:\Documents and SettingsOMLocal Settings\Temp\Hearing Aid Health Care.wpd EXHIBIT "C" SPECIAL CONDITIONS Section 4.1 (c), 'Business Automobile Insurance' is eliminated. Section 4.1 (d), "Additional Insurance" - A policy of medical professional liability insurance written on an occurrence or claims made basis with limits of a minimum of $1,000,000 is required. C:\Documents and Settings\DLR\Local Settings\Temp\Hearing Aid Health Care.wpd AUG. 2, 2004- 4, 29PfM-1SU 0fILLINGHAM N0, 134 P, 1/1- / 'ab y'MR5111mA N) `PR04UD,aR Ta�0 rFPTPR,-A`oL='C3 ISSUE5,%S a,-WA`e7rR OF nmFO2c.76i 0m Fsu 7 illingliza" las. ',�'csc ixnu. amLV AFf©O'owEu.ys up Ricm4.7s po;o l st-Z=S:m:etl?k'E'U';^.R Lsbcase '=13465 IiOiDER,THIS CRTIRC;ATfE EICIES 00T1>,iNM-IID,LiG!' ND OR f�f 2 M 00 pGobc o A oDd: 4i26'S AC4 LZ Y TRH;rOVEP.EIGL AWC3B•;®'EDv 13Y YHL POLIMS I37a C W. P ?imm: �)51-279-13'Sa VISURERS ArrOFcGENG:COVERAGE MG?C iJ INSURER A: KMCC3 A`.`_"u'Od.�c,Z,SCI C®5FIf0 E3cP Inc 6nk: rsElning Heal�fl C�ze INSURER c• AMID �oyE'as.ee A,Z.E.-fitNY ID Monterey _v=aU2 INSURER D COVMACES 7NEPOLICIES aG IRISIRfi,IC.EI.S>FE64�F.P.DL�?4L4VEDrEN IJ31JEUTOT:"EE 1N.$UREB HAMEDAGOVF POP..TNEPGLIDYPE.JOD INDICf.TED NDSWlT1STpM1l@(.."i ANY REQUIREMENT,TCR:A OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITI=I R@SPSCT To NMICH 71113 CERTIMCATE M,AV BE ISSUEQ Or MA(PERTAIN,THE INSURANCEAFGORD€D 6R'TKR POVOIK 008CRISED HEREIN 15 SUOJECT TO ALLY HE TEH143.!ACLU$IQWl AND CONDITIONS OF SUCH POLIbIES.AGGREGATE UNITS SHOV6`1 MAY HAVE BEEN REDUCED BY PAID CLAIMS. QL G Ft='b"II ,Ir'ID I4 e TG iUSR _tira_srlSulu-',taC•E 630'ytee NUMeaF. C14t'E 6,^.efC SrfJ1 DOTE MUMM..Y _ LIN'An CNNEo. LLYSAILITY EACH OCCURRENCE Ir22.000000 ' HiII`._. mw SU S 11 COMMERC1A.LGENER1L LIl,®IL15'I L'E„v;d LZO�d^G [1f p�[7 F;�Dfl G�/b2/OS ' r-RErovs's Ea araranoE sw`5000 CLAIMS MADE OCCUR ,MUD EMP(Any DnE p...n) S500D p X k-un 0'mn6 'J _?uta PERSOUAL S ADv INJURY z3.0000©0 UEhIF,RAL AGGREGATE '200000c) 'Itlygl OWL AGGREGATE LIMIT APPLIES PER' I I PRODUCTS;-COMPIOP AGG S2000000 POLICY JcCa LCC AUTt➢IMMLL MACJLik l COMOBIN0 8INGLE LMM6 ANYAUTO IEo D.Om l ALL OWNED AUTOS :N li °ODIC? JUF.Y N SCHEDUUEDAUTOS K'P.mn) 0 NIRED AUTON DODILh NIJJRV NON-OWNED AUTQS (Perecv:eonl) b I PP.CPENF3 mAM?.GF (vGP ut2,odi) C _ A ��- GARAC. LIAd9UY AUTO ONLV-CAACCI)FIJY $ ---_ ANVAUTO OTHEATHAN 5A ACC 5 0 AUTO ONLY' AGO .� 9 E=J(cESSIUP.DRELL161MAOILITV EACH ODCURCiENtE I OCCUR u CLAIMS MADE AGGREGATE S 9 OEOUCTIDLE ° RETENTION L VIODMRSOGrImEwMI ION AND WLS u. 14 — P'MCPA]@i'UADIL1YY �YCPV LTtr31 J EF'_I_.._ ANY EXC ArtDPil�(AR LUELUc1:EGVYIVC E L.EACH AC9OEH"T 5 OFPICERLIiCMIp[P,E(CLUDEa%9 E.L OISCASC•EA Et<JPL©YEE 3 p� I/ Ob AOscrlpb Under - --'I V y SNEUIIAL FRtlVIR90N5 Fale. EL OfSE_,A56-P061CY LIMIT 6 ! OTr1GR j .u.. z s 17 �.s Prop EaZdabT6RO�a�i462 4.3/U®/C74 C5�/®5Z4� S7� se1 ,"t2�b®� DEaCR9P ' _ T0ON CN OF QPG-F1AyTIOP99I LOCAYIONSI Vi;IdlC6r 5TF�5(LP,'U ION59DDEm•OV IDBR'sEr!IGN7ISPES!:�9.P410'!I SIQNs '- La9n._.is4Am+.c^ lh.11dnB' is RFGtC c P.s a d'ditTtM1d`ga2 insured �.'4"1 T`o-yjpcC'Ls to 'zee=--i[T.,c3 tests arfcraoat by t&ae I-71=2ed for city Qmplo ees. Endo smleesvl�: to foll6q.A. bm 9`etT df2.a�`49TG9YnFS� P_�,e»2,G`L;a C I GE'rRTIFICAT c RdsiLCMEP Ga?C9'CL2L:y?fiG"ud _ CA-1,&!SCO j OROULD ANY OF TNEAZOV€3E,5=59D POISCE B=CNN ELLEO 5E^a'.,E T 190 I(I DAYE7HE!�-(.ED:,THE ISSUING INSUP.EN WILL ENDRAVOR t,RP1e iL y�) DAYS WrITFNN NOTICE S°_—HDcffRHFICAYRNOL^^ ":S'@O'TOTHE LErT.i3UT P=!LURE TO DO SD s'f-3 rt6 C.n tea oil PrxZ D 'springs I _*.R O IFD$E 7eLIG LLON O�CPAE WO AfJl 6Yilr/ UHVHS INSURER-MAGL=P,u6R 5 ®© r 'ZZ Ez, a -2 ©Ya E>)31r raly2 cp--iasrs Cfll JD'292 4iTu bP1 (, k AACLORD 25(7.01108) LIBERTY aMSURANCE COMPANY, A .V.Vo Atidifdary Pr®fsaeio As CERTIFICATE OF COVERAGE .' Ceu-fflce}e Number AUD UNI48650e935e7 l -U era 1. Named L®sured and Address: (plumber, Strect, City, County, Mate; �lP� Bearing Aid Healthcare ft 44650 Monterey Avenue Pz na Desert CA 92260 Item 2. Policy Period: (Monaih,Day, Year)As Endorsed to Master Policyg UM-41 =00 -------$i2ali0�- —tp ---- uf2S/Oil---- — ----- -- - -- 12:01 A.M., standard time, at the address ofthe named'inured as stated herein. Tlie nai ned insured is: \ Individual Partnershi Co oratioan }® ❑ p � xqs ®.loiant Venture ©Ctlner � Iteerrtn 3. Insurance is worded only for the coverages that are indicated below by insertion of a limit of liability. The limit of our liability against each coverage shall be stated herein, subject to all the terms of the policy. COVERAGES LIMITS OF LUBELITY B. Professional Liability 000,000 Each Medical Incidennt 63,000,000 Ag e ate Item A. Certificate Premium $1,218.00 Assn Fees Included 8/12/03 Issue Dote Couraters'gned by THIS IS A CERTIFICATE OF COVERAGE 31NI1DE R THE MASTER rOL KY MSU ED 70 THE NATIONAL ASSOCIA71ON OF, AUD17 011Y PROFESSIONALS AND ALL MEMBERS OF THE ASSOCIATION. ACTUAL POLICY WORDING CAN 3i E 03T'AINED FROM ASSOCIATION HEADQUAR7 RS. \ P.O. Bwo ®30 Nl evTort 4IIa. 99156 1-800-397-8559 CLAIMS MADE POLICY Claims must be reported promptly,within the policy period, for coverage to apply. IN WITNESS WHEREOF, the parties have executed and entered into this Agreement as of the date first written above. CITY OF PALM SPRINGS ATTEST:....,. a municipal al r , City Clerk City Manager Ke'Vkvred and, � a by CONTRACTOR: Hearing Aid Health Care Check one:_Inpi�ti� _e $hfp,_��I�o5�Cy4at 555 So Sunrise Way,#116 a Ut� + ft' �U, tivL),i11N,�6Yb�. Palm Springs, CA 92264 Corporations require two notarized signatures: One from each of the following' A. CFiarrman ofGR^arn Pr�,ygnY, br agy tine, President:fND'B.Secretary,Assistant Secr/etary,,0easurer,Assistant Treasurer,or Chief Financial Officer). By: a�-kr"'YJ .- P,�'M<,�1�,,�r'l i .`�H,.�-,A�e� ..`t, By: �v!�tviL./�a'Ld) .�,�-C' ,�iclj� =,gyp?.- � Signature(notarized) -�� Signature (notarized) Name: 'fr-tC ':L V-V 't% Name: 4L- Title: �tl C((u_gj- I Title: V 1Ce d�'%'sp�'6-'��'-. �� Address: 4-q'(oTb Address: �.O4X'Cs�'i. L° 0 State of UJ-n a r� rl State o(11 County of�,;; , 1N �5_�1:Flss� , //�� l County of({ ,OF�2 �i"I On�'� / On ��/ ore m personallyappeare /I'?` :,Lv (t,07, Oar personally appeare _�,,,- t Dom' lc sir`x F personally known to me (or-proved-to-me-on-the-basia�f personally known tu),me (or-proved-to-me-on-the-basis-of satisfaoiory-eviderrcerto be the person(sf whose name-) _satisfactory eyideece) to be the persoo(s=r whose nam&, is/arra`subscribed to the within instrument and acknowledged is/are subscribed to the within instrument and acknowledged to me that he/sb�the�'-executed the same in his/bor/th it to me that�M6Lshe/thl executed the same in is/hed)thrjr authorized capaa4y(ye's)-and that by his/heL/tl�err signa[urels� authorized capacitygps), and that by_his/her/th6ir-aignatur€w on the instrument t perso�s�), or the entity upon behalf of on the instrument the perso`(o,',, or the entity upon behalf of which the persons)-acted,executed the instrument. which the person(¢).acted,executer the instrument. WITNESS my hand and p[ficial seal. WITNESS my hand and�offcia-seal. Notary SignatureL_&/1 / /k %' '� 'Z,7, Notary Signatur / , f��L Notary Seal: Notary Seal: z CoCmAmRst n#VA�9Oa©� }C�tI Cm..�:>� CoCmAmriCssLlo Ma y>®AD4NCVEVS iCLoM.DANTE ; Notary Public-Califomto NOVary¢ubo-Caf9fo� ®rSSw Rivside County Riverside Couniv � W COMM.Expires Aug 16.2007 L OMY Comm,Expires Aug 16,2=V n 4� Cd`��Gl�'vGAa=r C:\Documents and Settings\DLR\Local Settings\Temp\Hearing Aid Health Care.wpd AUG, 13, 2004_ 1 ;09PM.—ISU WILLINGHAM N0, 848 P, "116(MM DBM YO ACORD CERTIFICATE OF LIABILITY INSURANCE HEARZ 1 Go 13 04 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION xSV Willingham Ins. Svcs. Inc. ONLY AND CONFERS NO BIGHTS UPON THE CERTIFICATE License #OC13465 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 2469 Pomona Road #101 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Corona CA 92800-6983 Phone: 951-278-1368 Fax:951-278-0664 INSURERS AFFORDING COVERAGE NAIC ° INSURED INSURERA; AMCO Insurance COm as HIS and Associates Inc. INSURERS; DBA: Hearing HealtA Care services INSURER C: 44650 Montere Avenue 7NSVRER D: Palm Desert C 92260 INSURER E ::: 9d COVERAGES 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 W$PRCTTO WHICH THIS OERTIFICATE 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NB TYPEOFINSURANCE POLICY NUMBER DATE MMI'81 POLICY DATB MMIOOI LIMITS GENERAL LIABILITY EACH OCCURRENCE S1000000 A X X COMMERCIAL GENERAL LIABILITY EDR7830690404 04/08/04 04/08/05 PREMISESEsOxurenn 5300000 CLAIMS MADE OCCUR MED EXP(Are,Ono pmrion) 15000 X Non Owned Auto PERSONAL BADVINJURY $1000000 GENERALAGGREGATE S 2000000 GEHL AGGREGATE LIMIT APPLIES PER PRODUCTS-=P/DPAGG 92000000 POLICY 7 jELOrT X L00 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANYAUTO (Es accident ALL OVMED AUTOS BODILYINJURY9 SCHEDULED AUTOS (Par paramon) HIRED AUTOS BODILY INJURY NON.OWNEDAUToS (Pefdxldcnl) S TYDAMAGE(Par= 6 (Par accidanQ GARAGELIABILITY ALTO ONLY.EA ACCIDENT G ANYAVTO OTHERTHAN EAACC S AUTO ONLY, AGG B EXCESSIUMBRBLLA LIABILITY EACHOCCURRENCE S OCCUR CLAIMS MADE AGGREGATE U DEDUCTIBLE a RETENTION ^s S WORKERS COMPENSATION AND I TORY LIMITS I I ER EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERJEKEGUTIVE E.L.E'AOH ACCIDENT 5 OFFICERIMEMBER EXCLUDED? EL,DISEASE-E EMPLOYEE S SPEdIdAL PROVIribe SONS belew E,L DISEASE-POLICY¢IMIT $ OTHER A Bus Pars Prop BPR7830690404 04/08/04 04/OB/05 Special 126000 Replacement Cost Ded 500 DESCRIPTION OF OPERATIONS I LOCATIONS IVEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Certificate holder is named as additional insured with respects to hearing tcst5 performed by the insured for city employees per PB 6004 attached. ill CERTIFICATE HOLDER CANCELLATION PA.LM52o SHOULD ANY OF THE ABOVE DESCRLSED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURERWILL ENDEAVORTO MAIL 10 DAYS WRITTEN NOTICE W THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL City of Palm Springs IMROSENOODUGATION R LIABILITY OFANYKINO UPON THE INSURER,ITS AGENTS ON Department Of Human Resources 5200 E Tahquitz Canyon Way REPRESENTATIVE Palm Springs CA 92262 AUTHORUMD REPR VB Tom Curth ACORD 26(2001108) Al ACORDE91RPORATIOR 1092 RUG. 13, 2004 1 : 09PM ISU WILLINVAM N0, 648 P. 2 BUSINESSOWNERS PR600108W THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - SERVICES PERFORMED ON PREMISES OF ADDITIONAL INSURED This endorsement modifies insurance provided underthe following: PREMIER BUSINESSOWNERS LIABILITY COVERAGE FORM SCHEDULE Name of Person or Organization: pity of Palm Springs A. The following is added to Section 11.WHO IS AN B. ADDITIONAL EXCLUSION INSURED: This insurance,including our duty to defend The person or organization designated in the "suits",does not apply to"bodily injury", "property Schedule of this endorsement is also an insured, damage"or"personal and advertising injury" but only with respect to their liability for"bodily arising out of any active negligence of the person injury'or"property damage"arising out of acts or or organization designated in the Schedule of services normal and usual to your business this endorsement. described in the Declarations,performed byyou or on your behalf for the person or organization designated in the Schedule of this endorsement on premises owned, leased, maintained or used by such person or organization. All terms and conditions of this policy apply unless modified by this endorsement. PH 60 04 08 03 Pace i of'I PaoDucER THIS OERTWICAYE IS ISSUED ASA P/ATIER OF IN70PWAS➢OX � Dl4i sY£i.2d Lasu=a9nco F�2f3SiF'-^..i. ©NL°7Ai.,7d CorcFERS 40;UGHTS:UPON :CMTEMCAIM Of "DIMI .MTMIS CEXTEF7CEATC DOES m0T6AC,T£lma.e4%Twn 0r 136 E. South Ste 2300 t�TEEd7E8E CTSTfE4AGE E4EFQARDED BTJTEdE P+d+s9C9Ea®SD_Di�i. Salt LaI>:e City ZiT Bl:l . L°racnee GOIl-325=5®00 gaa::P30Il-532^^eG®� tBSu79RFL1n0 A77zXmIll es cavEII&AGE N-fUc SI BJ59➢R9 OJSUNSRA: $➢ST lch Amerieaa Ins Co. 16555 Tril,Tet Acunieltio n Covp. dba nslucai� TriHet 22, Dyer Group, Inc. FtsRI,*.�c: attn. 1U.-L':: Caatx02. Department 2100 Bala TMM ds0 Blvd. casEB D: San Leandro CA 94577 _ LNDEe+�Re COVERAGES THE POLICIES OF INSURANCELISTEDBELOWNAYEBEEN ISSUED TOTHEMLSURED NALIEDABOVEFORTHE POLOYPEJNOD WDICATEO.NDTWOlHSTA .lPM ANYREOUIREMENT.TFAMORCONDOIIW OFANYCONLRICTOROTIIERDOCUMWWRHRESPECTTOWHIG77H[SCERUFIGTEMAYBEISSIEODR MAYPERTAN.THE fOEORPIJCEAFFONDEO D'PiRE POLICI6 O[SCRIB®kFEREGi L55UBSE:T70 J1^.L.R:'c9Ei.l1a'.EY?AUSIOBiSPIVBCOtSWTfS'NSOFSL"Cii d-'OLICIFS.nGflREG'aTELIk1fiS5£110'.'JC3D'..9YCCILLB'..EPu FSF9L�'EA C.V p,V3DQlliL^^5. �� � �] LTR GR TYPE OFINSBIPANCE PODGY fCAgD81 OAIE 1.5➢�FfY� PDAYEV InnWP CJ'MI GENERAL LIABILITY EACH OCCURRENCE'J$ CDL4:EdCIAi CETIU LLAEEMY ..( PEREOfsnLGADV[N➢uRw :, G995IALAGGREGAYE B S GENTA.GGREGATELIMRAPFLIESPEC PRODUCTS-C"JOP ASS S pDLICV JEGOiT L'CC AUT0:90ELELIA0161SP COMWPED59NGLELIPAIY nNYA7nT0 Q�c-c"enB9 5 ALLOWNEDAUTOS ODDILY101my SCHEDULEDAUTOS (Pn(pcmm) WTEDAUMS HODILV ULTRY PSONDW;dE®d1HH05 QPLi cc'.+,^.1) i 1 PROPERTY DAMAGE i GARAGELIM11-my AIJIOUYLY-EAACobWT $ - M?4PllSO OTHERYIAN E:AC.CC j Amosmy: AUG G IXCESSnY"DREILALPADILnY EACHOWIJBIRENCE ^y OCCUR FI CVMf MADE AGGRO-GATE $ J DFDVEWLE s Rr=w'ENY[®.a c WORKERS COYPEMABON AND °K T YLMAIi'B ER a EwF]Pr1c PFRlm0P°F RTc lECUBJE we 45-75-915-00 07/01/04 07/01/05 EL.EACNACCIDENT $1000000 OFFICERMEVSERE( LUDED? E.L.OSERSE-FA kZ9J'60 51000000 s `r1AL`�e.bQovle o`ssD.[o-, E.�Duc-��r pDilGvosz^.>P Z2800090 . Dm�a i DESCRIPTIONOF OPERANONS I LOCATIONS I VEHICLES lIXCLUSIONS ADDED BY ENDORSER@LITISPECIAL FROWSJOUS p- Hearing Aid Healthcare is named as the alternate ernplovew,as per the terms and conditions of the p©1imy. CER"SaM ATE HOLDER CeAMCEF I A-MIM �P^.nYaY17H SwOOU'�ID LUAYmFri'9GA©6VeFiclCYiilOC-O PD1tSCES OEOGIC]GEh1.EmE�CitC-3'16E Ef[PIAdl2cflh W1Lv"'EYu uiEDr•YNle9'eSUIPYO RiSVREP.4tiW.EC@OEAYOR'S'O @MAY 30 ES2Vat"L;97TQ'.1 P:DT[CETOYHECERTIRCATEItOLOER NALEDY07HEf.EFT,EDTE41S11➢RE ee"D DO^_-IDSNgLC City of FalR¢ Springs IMPOSE N00BUGATmMOR LIABILITY OFANY IOND UPDMTRE INRUREB,D S AGE-M OR PVPCE?E:7TATPVF:. . P . F9DEPC:EEERTATPfE ' P ACORD 25(2001100) (DAG ➢e)C0 nor.-ATIOM`S^,a Search Results -Page - - AM Best Online Ratings and Analysis Page 1 of 1 August 13,2304 ptf irt,yi,w, zjr- � �'"fir l ie BEST nnr'best.cram .c Ranng=.fi%Ana rsis �.�1•£Y$l'1=,'kY�".�1t=i7N L.�eia;- ..-. .M News Publmaucne t Pre duc:c-&Sar•vic, A Insurance k_aourc== Search Results Page 1 of An_ur 42, Bast 2 Rated or Unrated companies found, results sorted by Company Name (ascending) Criteria Used: Company Name: Company names starting with Zurich American Rating To refine your search, please use our Advanced Search or view our Online Help for more it a E A K LH f0- Ratings ( Company Information View results starting with: ABCDEFGHIJKLMNOPQRSTUVW )<YZ Best's AMB# M Industry Company Name � Rating Domicile Enter Company Marne or A1d.Beet Nuribar 02563 P Zurich...American Insurance A United States: Nei Company Find1, ___.. - __ ___. _ .___ — _ —_..._.._ ._— _ _s: 03565 P Zurich American Insurance A United States: Illin 1Vore"search opumn Company of IL CONTACT Us 1'lhere in the /'YI'odd Is ry A.M.BEST? Finn cur locoiions Ratings as of 08/13/2004 08:54 AM E.S.T. 147rat do Industry: P = Property/Casualty(non-life) L = Life/Health you think lend usvour cnmmems View the Guide to Best's Financial Strength Ratings for an in-depth explanation of Best's System and Procedures. Accessing the pages on ambest.com constitutes the user's agreement toour Important Notice: Best's Ratings reflect our opinion based on a comprehensive terms of uses, P g p Information collected qualitative evaluation of a company's balance sheet strength, operating performance and via this web site is These ratings are not a warranty of an insurer's current or future ability to meet its contra, protected by our View our entire„notice for a complete details. privacy statement, Comments or concerns should be directed to Companies interested in placing a Best's Security Icons on their web site to promo' our customer service group;For other strength may register online. matters refer to our contact us page. 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Best Company, Inc,ALL RIGHTS RESERVED No part of this report may be distributed in any electronic form or by any means,or stored in a database or retrieval syst written permission of the A.M.Best Company.Refer to our terms of„use for additional details. hitp://www3.ambest.conVratings/RatingsSearch.asp 8/13/2004 CONTRACT ABSTRACT Contract Company Name: Hearing Aid Health Care Company Contact: Jeannette Hait Summary of Services: Employee Hearing Evaluations Contract Price: $24,900.00 Funding Source: Risk Management Accounts Contract Term: 7/1/04 - 6/30/05 Contract Administration Lead Department: Human Resources Contract Administrator: Sue Mills Contract Approvals Council/ Community Redevelopment Agency Approval Date: Minute Order/ Resolution Number: Agreement No: Contract Compliance Exhibits: Signatures: Insurance: Bonds: Contract prepared by: Submitted on: By