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EMPLOYMENT SYSTEMS INC. (ESI) - 1995-10-16
(0 mn � � 3 ; a � bCb ry C - 7 to O Z N�mom o � t O m cn � S LDS � ln � � m `D z Nt y a ID n � Qm roc 3 m N m m coro O -ro � v o G A m Lo n A CD m � �ttta+�'. .. �:L. _ .��SY i�+1r '.!^� ,rr1w �,�• n t:''� J` 1y ������ � ✓- � t:1 i 'F Ki..4i .+ '\ © Q Q O v Council/Agency Meeting Held Deferred/Continued to: t2 01 Approved J Conditionally Approved ❑ Denied City Clerk's Signature Council Meeting Date 10/16/95 Department ID Number FD 95-011 REQUEST FOR COUNCIL ACTION SUBMITTED TO: HONORABLE MAYOR AND CITY COUNCIL MEMBERS SUBMITTED BY: MICHAEL T UBERUAGA, City Administrator PREPARED BY: MICHAEL P DOLDER. Fire Chief SUBJECT: CONTRACT WITH EMPLOYMENT SYSTEMS INCORPORATED FOR AMBULANCE OPERATORIFIRE INTERN Stalennent of Issue. Funding Source. Recommended Action. Alternative Action. Analysis, Envuonmenlal Status,Attachments) Statement of Issue: The City of Huntington Beach executed a one (1 ) year contract with Employment Systems Incorporated (ESI) on October 3. 1994 to lease personnel to staff the Huntington Beach Ambulance Program Renewal of the contract would provide continuation of personnel to staff the ambulance operator/fire intern positions. Funding Source: The Fire Departments Ambulance Program Budget Account (E-AA-FR- 315) identifies a contractual services amount of $528,850 for funding salary and benefits This budget amount is totally offset by transfers from the FireMed fund for ambulance transport costs Recommended Action: By motion approve and authorize the Mayor to execute a contract with ESI in the amount not to exceed $520,000 to provide personnel to the City. Alternative Actiori 1 ) Do not sign this agreement which would prevent staffing of the Huntington Beach Ambulance Program Negotiations with a private provider would need to be initiated for ambulance transport. 2) Staff ambulances with City employees with a commiserate overall cost. Analysis: In 1994 the City entered into its second, one (1 ) year contract with ESI to provide eighteen (18) limited term (3 years) ambulance operator/fire interns. The ambulance operator/fire interns staff three (3) ambulances 24 hours per day. 7 days per week During this last year. ESI met its contractual obligations with the City in a professional and timely manner I . REQUEST FOR COUNCIL ACTION Meeting Date: 10/16/95 SUBJECT: CONTRACT WITH EMPLOYMENT SYSTEMS INCORPORATED FOR AMBULANCE OPERATOR/FIRE INTERN FD 95-011 The ambulance operator/fire intern program with its maximum three (3) year tenure for employees have met all expectations High caliber personnel with a fire service career goal continues to be attracted to the position A second hiring list was established in early 1995 with over 150 personnel assigned. Ten (10) personnel during the last two (2) years have been hired by fire departments including two (2) by the Huntington Beach Fire Department and five (5) others have been selected to attend paramedic school Environmental Status: None Attachment(s): City Clerk's Page 1 Agreement Between the City of Huntington Beach and Employment Systems Incorporated to Supply Personnel to the City 2 Copy of current insurance certificate. F095-011.DOC -2- 10/4/95 8:19 AM RCA ROUTING SHEET INITIATING DEPARTMENT: FIRE SUBJECT: CONTRACT WITH EMPLOYMENT SYSTEMS INCORPORATED FOR AMBULANCE OPERATOR/FIRE INTERN COUNCIL MEETING DATE: October 16, 1995 RCA ATTACHMENTS STATUS Ordinance (w/exhibits & legislative draft if applicable) Not Applicable Resolution (w/exhibits & legislative draft if applicable) Not Applicable Tract Map, Location Map and/or other Exhibits Not Applicable Contract/Agreement (w/exhibits if applicable) (Signed in by the City Attorney) Attached Subleases. Third Party Agreements, etc. (Appoved as to form by City Attorney) Not Applicable Certificates of Insurance (Approved by the City Attorney) Attached Financial Impact Statement (Unbudget. over $5,000) Not Applicable Bonds (If applicable) Not Applicable Staff Report (If applicable) Not Applicable Commission, Board or Committee Report (If applicable) Not Applicable Findings/Conditions for Approval and/or Denial Not Applicable EXPLANATION FOR MISSING ATTACHMENTS REVIEWED RETURNED FORWAtRDED Administrative Staff ( ) ( Y ) Assistant City Administrator (Initial) ( ) y) City Administrator (Initial) ( ) City Clerk ( ) EXPLANATION FOR RETURN OF ITEM: Only)(Below Space For City Clerk's Use AGREEMENT BETWEEN THE CITY OF HUNTINGTON BEACH AND EMPLOYMENT SYSTEMS, INC. TO SUPPLY PERSONNEL TO THE CITY THIS AGREEMENT is made and entered into this 3rd day of October , 1995, by and between the City of Huntington Beach a municipal corporation of the State of California, hereinafter referred to as 'CITY," and EMPLOYMENT SYSTEMS, INC., a California corporation, hereinafter referred to as "ESI." WHEREAS, ESI is a California corporation which provides the services of its employees to government agencies for the purpose of discharging the responsibilities of government agencies; and CITY authorized the implementation of a City Ambulance Program and requires the personal services of certain persons to perform the duties of ambulance operators/fire interns; and Program continuity and economic reasons exist which make it in the best interest of the CITY to discharge certain of its responsibilities through the use of ESI employees; and NOW, THEREFORE, in consideration of the promises, covenants, and warranties hereinafter set forth, the parties hereto mutually agree as follows: 1. DEFINITIONS All terms used in this Agreement shall have the customary meaning afforded such terms unless the same are used in a technical or business context, in which event such terms shall have the technical and/or special meaning normally afforded such terms within the particular trade, industry, or business to which they relate. The following are the definitions of special terms used herein: 1.1 "Current payroll" means the payroll set forth in attached Exhibit A and incorporated by this reference due on a bi-weekly basis. L2 "Employees" means those individual persons who are subject to the terms of this Agreement and whose job type is identiFrred in attached Exhibit B incorporated in this reference. 1.3 "Employee tax forms" means all forms applicable to the payroll which are required by United States, state, and local governments to be provided by an employer to an employee, including US Department of the Treasury, Internal Revenue Service Form W-2 (Wage and Tax Statement) and Form W-4 (Employee's Withholding Allowable Certificate) and Form 1099 (as and if applicable), as well as comparable and/or counterpart forms prescribed by the state and/or local government in which employees are performing services pursuant to this Agreement. 1.4 "Employer tax forms" means all forms required to fully and properly report the payroll to the United States, state and/or local governments, including United States Department of the Treasury, Internal Revenue Service Form 941 (Employer's Quarterly Federal Tax Return for Federal Income Tax Withheld from Wages and for Federal Insurance Contributions Act Taxes), Form 940 (Employer's Annual Federal Unemployment Tax Return), and comparable and/or counterpart forms prescribed by the state and/or local government in which employees are performing services pursuant to this Agreement. 1 1.5 "Payment due date" means any date on or before the last day of each payroll period. 1.6 "Pay period" means the interval between payments to employees specified in attached Exhibit A. 1.7 "Payroll' means the total payroll applicable to all employees and includes the aggregate of net compensation to employees, federal withholding taxes, state and local (if any) withholding taxes, employer and employee costs pursuant to the Federal Insurance Contributions Act, employer costs pursuant to the Federal Unemployment Tax Act, employer costs for state unemployment taxes (if any), employer costs pursuant to the Voluntary Compensation Plan (if any), employer listed service fees (as applicable), employer cost of Workers Compensation insurance , and employer cost of benefit programs listed on Exhibit A (or the cost of employer payments to employees paid in lieu of employee participation these benefit programs). 2. IMPLEMENTATION 2.1 Relationship of Parties. Effective at the commencement of business on the 3rd day of October, 1995, ESI will provide to CITY those of its employees who are identified in attached Exhibit B to CITY and CITY hereby accepts such employees on the terms and conditions provided in this Agreement. 2.2 Term of Agreement. This Agreement and the rights and obligations of CITY and ESI shall commence on the effective time and date specified in paragraph 2.1 and shall expire and terminate at the same time on the corresponding date one year later. CITY may terminate this Agreement by giving thirty (30) days written notice to ESI. 2.3 Employment by CITY of ESI Leased Employees. ESI is aware and has no objection to the CITY at a future date employing directly the leased employees of ESI leased to the CITY. Upon any of these leased employees becoming CITY employees, ESI shall terminate them from their employment and have no further right of compensation from the CITY for that leased employee. 2.4 Specification of Services and Approval of Compensation. CITY shall specify, and by notice to ESI may accept, modify, or reject the services and/or rate of compensation of any and all employees leased to CITY in accordance with this Agreement. In the event of rejection of services and/or rejection of the rate of compensation of any employee leased to CITY, the lease made by this Agreement shall terminate as to such employee, effective upon receipt by ESI of notice thereof. For purposes of business and financial accounting between the parties, this Agreement shall be deemed several as to each employee and shall be deemed prorated on a daily or other periodic basis necessary to give effect to the manifest intentions of the contracting parties. 2.5 Changes and Adjustments of Payroll. CITY and ESI acknowledge the payroll will vary from pay period to pay period by reason of additions, terminations, and changes in compensation rates of employees. It is further acknowledged that the payroll also may vary from pay period to pay period by reason of changes in the rate and/or amount of employee withholding and/or employer payroll contributions and/or costs of employee benefit plans and programs. It is specifically agreed that the amount of all payments coming due and owing from CITY to ESI shall be adjusted (by increase or decrease, as applicable) to the extent necessary to directly reflect such changes on a current basis. All such changes and adjustments in payroll are hereby expressly approved by the parties. 2 2.6 Employer Duties of ESI. ESI shall: 1) pay all wages and other remuneration to its employees who are subject to this Agreement; 2) prepare and file all payroll tax returns and reports; 3) pay all amounts due and owing pursuant to the payroll tax returns and reports which are prepared and filed; 4) prepare, file, and furnish to employees applicable employee tax forms; and 5) prepare and file, with a copy to CITY, applicable employer tax forms. In the event of termination of any employee as provided by paragraph 2.4, ESI shall provide placement assistance to that employee by listing that employee at no charge to the employee in ESI's A/E Connections job listing service. 2.7 Duties of CITY. CITY shall: 1) provide the workplace for all employees subject to this Agreement; 2) maintain the work place in strict accordance with applicable health and working standards and specifications; 3) comply with all safety engineering and governmental health and safety rules, regulations, directives, orders or similar requirements; 4) provide all required safety equipment; 5) for employees located in California, take all actions necessary to establish and implement an injury and illness prevention program as required by the Occupational Injury Program Act, also known as Senate Bill 198, and codified at California Labor Code Section 6401.7; 6) post or provide employee notices required by law; and 7) notify ESI immediately of all employee illnesses, accidents, injuries, and absences; 8) review, approve and forward employee time sheets to ESI; and, 9) provide adequate dormitory and kitchen facilities.. 2.8 Workers' Compensation. Pursuant to California Labor Code Section 1861, ESI acknowledges awareness of Section 3700, et seq. of said code, which requires every employer to be insured against liability for workers compensation; ESI covenants that it will comply with such provisions prior to commencing performance of the work hereunder. ESI shall maintain such workers compensation insurance in an amount of not less than One Hundred Thousand Dollars ($100,000) bodily injury by accident, each occurrence; One Hundred Thousand Dollars ($100,000) bodily injury by disease, each employee, and Two Hundred Fifty Thousand Dollars ($250,000) bodily injury by disease, policy limit, at all times incident hereto, in forms and underwritten by insurance companies satisfactory to CITY. 2.9 Health and Other Benefits ESI maintains various health and other benefits which are available to employees under a cafeteria plan permitting each employee to choose the type of benefits he or she will receive. 3. COMPENSATION 3.1 Eta. CITY agrees to pay a flat rate of One Hundred Fifteen Dollars and Thirty-eight cents ($1 15.38) per employee plus the current payroll, on or before each payment due date. 3.2 Fee Plus Payroll. The total Agreement for Fee Plus Payroll shall not exceed Five Hundred and Twenty Thousand Dollars ($520,000) for a period not to exceed one (1) year. 3.3 Payment Address. All payments due ESI shall he paid to: EMPLOYMENT SYSTEMS, INC. 11590 West Bernardo Court, Suite 211 San Diego, CA 92127 3 3.4 Terms of Compensation. Payment is due fifteen (15) days from date of invoice. ESI will invoice CITY every two (2) weeks, approximately seven (7) days following payroll. Delinquent payments will be subject to a late payment carrying charge computed at a periodic rate of one percent (1%) per month, which is an annual percentage rate of twelve percent (12%), which will be applied to any unpaid balance owed commencing seven (7) days after the payment due date. Additionally, in the event CITY fails to pay any undisputed amounts due ESI within forty-five (45) days after payment due date, then CITY agrees that ESI shall have the right to consider said default a total breach of this Agreement and the duties of ESI under this Agreement may be terminated by ESI without liability to ESI upon ten (10) working days advance written notice. 3.5 Additional Services. CITY may request ESI to perform additional services not covered by this Agreement, such as recruiting services, and ESI shall perform such additional services and will be paid for such additional services when they are mutually agreed to and made part of this Agreement by written amendment. 4. SUPERVISION OF EMPLOYEES ESI shall supervise the daily activities of employees, but employees shall discharge government responsibilities and perform in accordance with the ordinances, resolutions, rules, regulations, and procedures adopted by CITY in its governmental capacity. ESI shall have no control over such government responsibilities and such ordinances, resolutions, rules, regulations, and procedures. 5. INDEMNIFICATION ESI shall indemnify, defend, and hold harmless CITY for the purpose of all required payroll deductions and withholdings, legally required workers' compensation insurance, and health benefits of the employees. However, inasmuch as the employees will discharge governmental responsibilities and perform in accordance with the ordinances, resolutions, rules, regulations, and procedures adopted by CITY in its governmental capacity 1) ESI and its employees to the degree the law will allow shall be entitled to all protection and immunities of government employees, including without limitation, those provided in California Government Code, Title 1, Division 3.6, Claims and Actions against Public Entities and Public Employees; and 2) CITY does release and agree to indemnify, defend and hold harmless the employees, ESI, and ESI's agents, personnel, directors, and officers from, any and all actions, claims, damages or injuries to persons or property, penalties, obligations or liabilities arising out of or related to the services performed by the employees of ESI assigned and working under the control of CITY under this Agreement- In addition, the employees, ESI, and ESI's agents, personnel, directors, and officers shall be additional named insured on CITY's insurance policies or on any self-insurance agreement. If CITY is a member of a Risk Management Agreement (RMA) or similar agreement, CITY will notify the organization responsible for RMA or similar agreement in writing that the employees, ESI, and ESI's agents, personnel, directors, and officers do not have any applicable insurance coverage. 4 6. GENERAL PROVISIONS 6.1 Representation. A CITY representative shall be designated by the CITY and an ESI representative shall be designated by ESI as the primary contact person for each party regarding performance of this Agreement. The following are the designated representatives: EMPLOYMENT SYSTEMS, INC. CITY OF HUNTINGTON BEACH Michelle Friery, Director of Operations Michael P. Dolder, Fire Chief 11590 West Bernardo Court, Suite 211 2000 Main Street San Diego, CA 92127 Huntington Beach, CA 92648 6.2 Assi na ment. This Agreement shall not be assignable by either party without the prior written consent of the other party. 6.3 Audit. CITY shall have the right to audit and inspect ESI's records and accounts covering costs under this Agreement for a period of two (2) years after termination of the Agreement. 6.4 Titles. The titles used in this Agreement are for general reference only and are not pan of the Agreement. 6.5 Severahility. Should any provision of this Agreement be determined to be unenforceable, such determination shall not affect the remaining provisions. 6.6 Extent of Agreement. This Agreement represents the entire and integrated Agreement between CITY and ESI and supersedes all prior negotiations, representations or agreements, either written or oral. This Agreement may be modified or amended only by a subsequent written agreement signed by both parties. 5 IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the date and year first above written. EMPLOYMENT SYSTEMS, INC., a California CITY OF HUNTINGTON BEACH, A corporation municipal corporation of the State of California Z�- �. By: Jo uez, Vice Pres' nt Mayor Oz By: E (- —� ary J. Berryman,. ecretary APPROVED AS TO FORM: ATTES City Attorney e o/3/r /° , City Clerk e, /J= 95 INITIATED AND APPROVED: REVIEWED AND APPROVED Fire Chief t AdmimsfratdK 6 Employment Systems, Inc., Exhibit A Proposal to the City of Huntington Beach for contract staffing of 18 Ambulance Operator Annual Annual Hourly pay rate $5.00 Hours Worked Compensation & Costs Regular hours 1,865 9,325 Overtime hours at time and a half 1,058 7,935 Overtime hours at Doubletime 0 0 Total Hours 2,923 17,260 Number of Employees 18 Total Base Compensation All Employees 167,850 Total Overtime Compensation All Employees 142,830 Total Annual Compensation Per. Employee 310,680 Payroll Takes and Workers Compensation Rare Subject wages FICA (wages up to 61,200 per employee) 6.20% 340,437 21,107 Medicare 1,45% 340,437 4,936 SUI (wages up to 7,000 per employee) 3.90% 126,000 4,914 FUTA (wages up to 7,000 per employee) 0.80% 126.000 1,008 Workers Compensation (excluding OT premium) 9.79% 263.070 25,755 Classification Code (7332) Group Insurance Long term disability (Standard .51% of wages) 0.51% 340,437 1,736 Employee Medical Insurance (Prudential HMO) 114.44 Per mo./per empl 24,719 Employee Dental Insurance (Prudential DMO) 22.01 Per mo./per empl 4,754 Life and AD&D (Cigna .27 per 1000/month) 0.27 12 1,007 Other Benefits 401K Plan - 2.5% Company Match from 1/l/95 6,940 Non Deferred Sick/Vacation/Holiday Pay ' 250 Hrs/Year per empl 22,500 Deferred accrual account 10/93 - 8118/95 1,451 Total His/$ accrued 7,257 ESI Administrative charges $250.00 Per mo./per empl 54,000 Estimated Annual-Cost To Agency 491,313 Non deferred vacation/sick/holiday pay accrual will be all salary cost inclusive with no additional liability to the City, to be charged over 26 bimonthly periods of $865.38. " Deferred vacation/sick/holiday pay accrual will be all salary cost inclusive with no additional liability to the City, to be charged over 10 bimonthly periods of $725.70 Exhibit B AMBULANCE OPERATOR Position Under direct supervision of the Company Commander, respond to both routine and emergency medical aid requests; participate in routine maintenance of apparatus and equipment; attend training sessions; and, do related work as required Examples of Duties Will be regularly dispatched to emergency scenes to assist in rendering aid to injured parties; will perform appropriate field procedures including EMT-1 level skills such as performing vital signs, bandaging, splinting, and assisting paramedics as needed; will drive ambulances and other vehicles as needed; will participate in station and equipment clean-up, training drills, hospital in-services; and, other duties as required. Employee will be required to participate in training deemed appropriate by City. Qualifications Training and Experience: Any combination of experience and education that would likely provide the required knowledge and abilities for the position of ambulance operator. A typical combination would be as follows: graduation from high school; experience in medical emergencies; and, other related knowledge which would indicate success in the position. Knowledge and Abilities: General knowledge of ambulance transportation procedures including first aid, resuscitator and gurney operations. Applicant should be in good physical condition suitable to performing the lifts and tames as required for the position. Special Requirements • Must possess and maintain certification as an Emergency Medical Technician (EMT-1) as defined by the State of California with current CPR card. • Possess an ambulance attendant license from Orange County EMS prior to driving an ambulance. • Must maintain physical fitness requirements as prescribed by the Fire Department. • Possess a valid State of California driver's license, Class C. Desirable Experience • Presently attending or have graduated from a 240 hour fire academy which meets State of California requirements. • Fire Science course work at the college level. 8 I ..d_t :bO S6-£0-01 4 �,auotiis:Q�. CERTIFICAT•OF INSURANCE 0162e {yOEDATE MMOD PRODucER THIS ERTI GATE I ISSUED AS A ATT OF 1 ORM TION o-3NLY A9 5 CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DAV I D BULEN INSURANCE DOES NOT AMEND.EXTEND OR ALTER THE COVERAGE AFFORDED BY THE O BOX 115 POLICIES BELOW. LAKE ELSINORE CA 92531-0115 COMPANIES'AFFORDING COVERAGE COMPANY A C N A INSURANCE COMPANY LETTER COMPANY MSURED B LETTER F..RRYMAN 1, 11F.NIGAR , COMPANY S1 CUNSUL'I'ANITS, INC . 6 LETTER C MPLOYMENT SYSTENIS , INC . COMPANY 6880 W. BERNARDO 0100 LETTER D AN DIEGO , CA 92127-1616 COMPANY E, _ LETTEa COVERAGES -' - - TH19 IS TO CCR'IFY TI IAI IH(POLICILS OF INSURANCE LIS;Ell RFI.OW HAVE BEEN ISSUELI TO THE INSURED NAMED ABOVE FOR THE POLICY P RIOD INDICATGII NOI'NI7115T4NDIfiC AN. HEiJUIRLMENI, iFHM OR O401TION OFgNYCONT CT OR OTHER DOCUMENT WITH gEBPECT POLICY IS CERTfIfICAIE MAY BE ISSVED OR MAY PEPI THE INSURANA AFFORDED BY THE POLICIES DESCRIBED H£REIN IS SUBJECT TO ALL THE TERMS, FXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. VRAI'A OI INSURANCE POUCYEFFECTWE POLICY O(PIRATIOM I POLICY NUMBED IINITb ATE IMMI DATE LIABILITY C 12 817 0 610 12/31/94 12/31/95 ENERAL AGGREGATE { Q .A.L. a'�[ n I 000 PROOUCT9-COMPIOPAOCi, t 1 000 0 I•. v♦ - +P I PERAONAL S ADV INJURY 1 000 00 L _. RDD'C INSURED E °au""E"� ' 1 000 00 -_l' NT. ATTP:CHE REDAMAOEN vamN.) 50 0 MEO.EEP IAPY one penonl { LIABILITYC128170624 12/31/94 12/31/95MBINED BINDLE *OIMIT { 1 0 0 00 EO AViDS LED nu,CBAPPROVED AS TO FOR 9OOKV INJURr GAIL HUTT02{r Cit 0-0tU'Cti J BY.a Depu CI BODILY INJURY IwY-vwviceAuros yA ey PROPEPT DAMAGE g(CEbS i.I"AILIT' C1.28170638 12/31 /94 12/31/95 EACH OCCURRENCE { UMHPI:I IA I"1M AGGREGATE CORM 5, 00000 i IF:R lvA.Y VMBtn.LU .ORKER S COMPENSATION 974TUTORV UMITB AND EACH ACCIDENT IF EMPLOYERS'LIABILITY D19EASE-POLICY UMR { DISEASE-EACH EMPLOYEE OTHER DPSCRWTIOM Of OPEI TIONMIOCATIONONEHICLP.&SPECIAL ITEMS F,RTTFiCATE HOLDER ALONG WITH ITS AGENTS, OFFICIALS AND EMPLOYEES ARE NAMED S ADDITIONAL INSURED IN REGARDS TO GENERAL LIABILITY PER ATTACHED FORM CG2010 . E: ALL PERATIONS CERTIFICATEHOLDER CANCELLATgN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE.' EXPIRATION DATE THEREOF.THE ISSUING COMPANY WILL wmjmn CITY OF HUNTINGTON BEACH MAIL_11) DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE P .O. BOX 190 LEFT, RRl4}I9R4[4PlF7�K9f'K+�1N€R4F9C447�}4 }(y4J4441QR7FR+RR HUNTINGTON BCH CA 92648 }Q1�p {1¢xl{cRa}II{gQ1{jgpEgI{kRX AUTHO R'EPPREESENTATIVE ACDRD2"(7190) •`��� / `'-A'L-`. CACORD CORPORATION 19W l- J~' • PCUCY rJIJ%i6ER: C128170610 COMMERCIAL GENERAL LIACILITy THIS ENDORSFMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B) Th., cr• runt morifies insurance provided under the following: GE t*RAL UABILITY COVERAGE PART. SCHEDULE Name of Person or Organization: CITY OF 11UNTINGTUN BEACH, ITS AGENTS, OFFICIALS AND EMPLOYEES ('f "t� anti + •sctu•ar; et:,ve, infra;rnet;on required to complete this er- rsEment will be shown in the Declarations "- r,. .. _ _ ;n this C•n(!ur cement.) II i, to incluc.e as ;n insured the ; �m�endy ' person or organization shown in the respect to I;;:bility ,arising out of "your work" for ,hat insured by or for you. I CG 20 10 11 85 Copyright, Insurance Services Office. Inc.. 1984