HomeMy WebLinkAboutPSYCHOLOGICAL CORPORATION, INC., BY: LAWRENCE N. BLUM, PHD - 2007-04-19 1fl0
CONTRACTS SUBMITTAL219PR 24 AM', 10: 53
CITY CLERK'S OFFICE
i � y OF—
To: JOAN FLYNN, City Clerk
PSYCHOLOGICAL CORPORATION, INC. , BY:
Name of Contractor: Lawrence N. Blum, PHD
Purpose of Contract: For Example:Audit Services or Water Quality Testing Huntington Lake—Huntington Central Park
Psychological Services & Training
Amount of Contract: $40,000.00
Copy of contract distributed to: The original insurance certificate/waiver distributed
Initiating Dept. ❑
to Risk Management El
Finance Dept. ❑ ORIGINAL bonds sent to Treasurer El
Date: 23
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qaM4.
City Attorney's Office
G:AttyMisc/Contract Forms/City Clerk Transmittal
PROFESSIONAL SERVICES CONTRACT BETWEEN
THE CITY OF HUNTINGTON BEACH AND
Psychological Corporation, Inc.
FOR
Psychological Services & Training
Table of Contents
1 Scope of Services.....................................................................................................1
2 City Staff Assistance................................................................................................2
3 Term; Time of Performance.....................................................................................2
4 Compensation..............................................:...........................................................2
5 Extra Work...............................................................................................................2
6 Method of Payment..................................................................................................3
7 Disposition of Plans, Estimates and Other Documents ...........................................3
8 Hold Harmless .........................................................................................................3
9 Professional Liability Insurance.............................................................................4
10 Certificate of Insurance............................................................................................5
11 Independent Contractor............................................................................................6
12 Termination of Agreement.......................................................................................6
13 Assignment and Delegation......................................................................................6
14 Copyrights/Patents..........................................:........................................................7
15 City Employees and Officials..................................................................................7
16 Notices.........................................................................................7
17 Consent....................................................................................................................8
18 Modification.............................................................................................................8
19 Section Headings .....................................................................................................8
20 Interpretation of this Agreement..............................................................................8
21 Duplicate Original....................................................................................................9
22 Immigration...............................................................................................................9
23 Legal Services Subcontracting Prohibited................................................................9
24 Attorney's Fees..........................................................................................................10
25 Survival.....................................................................................................................10
26 Governing Law.........................................................................................................10
27 Entirety......................................................................................................................10
PROFESSIONAL SERVICES CONTRACT BETWEEN
THE CITY OF HUNTINGTON BEACH AND
Psychological Corporation, Inc.
FOR
Psychological Services & Training
THIS AGREEMENT ("Agreement") is made and entered into this day of
2T7, by and between the City of Huntington Beach, a municipal
corporation of the State of California, hereinafter referred to as "CITY, and
Psychological Corporation, Inc. a Corporation
hereinafter referred to as "CONSULTANT."
WHEREAS, CITY desires to engage the services of a consultant to
provide psychological servcies & training ; and
Pursuant to documentation on file in the office of the City Clerk, the provisions of
the Huntington Beach Municipal Code, Chapter 3.03, relating to procurement of
professional service contracts have been.complied with; and
CONSULTANT has been selected to perform these services,
NOW, THEREFORE, it is agreed by CITY and CONSULTANT as follows:
1. SCOPE OF SERVICES
CONSULTANT shall provide all services as described in Exhibit "A,"
which is attached hereto and incorporated into this Agreement by this reference. These
services shall sometimes hereinafter be referred to as the "PROJECT."
CONSULTANT hereby designates Lawrence N. B1um,PHD who shall
represent it and be its sole contact and agent in all consultations with CITY during the
performance of this Agreement.
agree/forms/profsery 10/1 510 1-A 1
2. CITY STAFF ASSISTANCE
CITY shall assign a staff coordinator to work directly with CONSULTANT
in the performance of this Agreement.
3. TERM; TIME OF PERFORMANCE
Time is of the essence of this Agreement. The services of CONSULTANT
are to commence as soon as practicable after the execution of this Agreement by CITY(the
three years from
"Commencement Date"). This Agreement shall expire on commencement date , unless
sooner terminated as provided herein. All tasks specified in Exhibit "A" shall be
completed no later than three years from the Commencement Date of this
Agreement. These times may be extended with the written permission of CITY. The time
for performance of the tasks identified in Exhibit "A" are generally to be shown in
Exhibit "A." This schedule may be amended to benefit the PROJECT if mutually agreed
to in writing by CITY and CONSULTANT.
4. COMPENSATION
In consideration of the performance of the services described herein, CITY
agrees to pay CONSULTANT on a time and materials basis at the rates specified in
Exhibit "B," which is attached hereto and incorporated by reference into this Agreement,
a fee, including all costs and expenses, not to exceed
forty thousand Dollars ($ 40,000.00
5. EXTRA WORK
In the event CITY requires additional services not included in Exhibit "A"
or changes in the scope of services described in Exhibit "A," CONSULTANT will
undertake such work only after receiving written authorization from CITY. Additional
agree/fonns/profserv10/15/01-A 2
compensation for such extra work shall be allowed only if the prior written approval of
CITY is obtained.
6. METHOD OF PAYMENT
CONSULTANT shall be paid pursuant to the terms of Exhibit "B."
7. DISPOSITION OF PLANS, ESTIMATES AND OTHER DOCUMENTS
CONSULTANT agrees that title to all materials prepared hereunder,
including, without limitation, all original drawings, designs, reports, both field and office
notices, calculations, computer code, language, data or programs, maps, memoranda,
letters and other documents, shall belong to CITY, and CONSULTANT shall turn these
materials over to CITY upon expiration or termination of this Agreement or upon
PROJECT completion, whichever shall occur first. These materials may be used by CITY
as it sees fit.
8. HOLD HARMLESS
CONSULTANT hereby agrees to protect, defend, indemnify and hold
harmless CITY, its officers, elected or appointed officials, employees, agents and
volunteers from and against any and all claims, damages, losses, expenses, judgments,
demands and defense costs (including, without limitation, costs and fees of litigation of
every nature or liability of any kind or nature) arising out of or in connection with
CONSULTANT's (or CONSULTANT's subcontractors, if any) negligent performance of
this Agreement or its failure to comply with any of its obligations contained in this
Agreement by CONSULTANT, its officers, agents or employees except such loss or
damage which was caused by the sole negligence or willful misconduct of CITY.
CONSULTANT will conduct all defense at its sole cost and expense and CITY shall
agree/forms/profserv10/15/01-A 3
approve selection of CONSULTANT's counsel. This indemnity shall apply to all claims
and liability regardless of whether any insurance policies are applicable. The policy limits
do not act as limitation upon the amount of indemnification to be provided by
CONSULTANT.
9. PROFESSIONAL LIABILITY INSURANCE
CONSULTANT shall obtain and furnish to CITY a professional liability
insurance policy covering the work performed by it hereunder. This policy shall provide
coverage for CONSULTANT's professional liability in an amount not less than One
Million Dollars ($1,000,000.00) per occurrence and in the aggregate. The above-
mentioned insurance shall not contain a self-insured retention, "deductible" or any other
similar form of limitation on the required coverage except with the express written consent
of CITY. A claims-made policy shall be acceptable if the policy further provides that:
A. The policy retroactive date coincides with or precedes the initiation
of the scope of work (including subsequent policies purchased as
renewals or replacements).
B. CONSULTANT shall notify CITY of circumstances or incidents
that might give rise to future claims.
CONSULTANT will make every effort to maintain similar insurance during
the required extended period of coverage following PROJECT completion. If insurance is
terminated for any reason, CONSULTANT agrees to purchase an extended reporting
provision of at least two (2) years to report claims arising from work performed in
connection with this Agreement.
agree/forms/profservl0/15101-A 4
10. CERTIFICATE OF INSURANCE
Prior to commencing performance of the work hereunder, CONSULTANT
shall furnish to CITY a certificate of insurance subject to approval of the City Attorney
evidencing the foregoing insurance coverage as required by this Agreement; the certificate
shall:
A. provide the name and policy number of each carrier and policy;
B. shall state that the policy is currently in force; and
C. shall promise that such policy shall not be suspended, voided or
canceled by either party, reduced in coverage or in limits except
after thirty (30) days' prior written notice; however, ten (10) days'
prior written notice in the event of cancellation for nonpayment of
premium.
CONSULTANT shall maintain the foregoing insurance coverage in force
until the work under this Agreement is fully completed and accepted by CITY.
The requirement for carrying the foregoing insurance coverage shall not
derogate from CONSULTANT's defense, hold harmless and indemnification obligations as
set forth in this Agreement. CITY or its representative shall at all times have the right to
demand the original or a copy of the policy of insurance. CONSULTANT shall pay, in a
prompt and timely manner,the premiums on the insurance hereinabove required.
11. INDEPENDENT CONTRACTOR
CONSULTANT is, and shall be, acting at all times in the performance of
this Agreement as an independent contractor herein and not as an employee of CITY.
CONSULTANT shall secure at its own cost and expense, and be responsible for any and
agree/forms/profsery 10/1510 1-A 5
all payment of all taxes, social security, state disability insurance compensation,
unemployment compensation and other payroll deductions for CONSULTANT and its
officers, agents and employees and all business licenses, if any, in connection with the
PROJECT and/or the services to be performed hereunder.
12. TERMINATION OF AGREEMENT
All work required hereunder shall be performed in a good and workmanlike
manner. CITY may terminate CONSULTANT's services hereunder at any time with or
without cause, and whether or not the PROJECT is fully complete. Any termination of this
Agreement by CITY shall be made in writing, notice of which shall be delivered to
CONSULTANT as provided herein. In the event of termination, all finished and
unfinished documents, exhibits, report, and evidence shall, at the option of CITY, become
its property and shall be promptly delivered to it by CONSULTANT.
13. ASSIGNMENT AND DELEGATION
This Agreement is a personal service contract and the work hereunder shall
not be assigned, delegated or subcontracted by CONSULTANT to any other person or
entity without the prior express written consent of CITY. If an assignment, delegation or
subcontract is approved, all approved assignees, delegates and subconsultants must satisfy
the insurance requirements as set forth in Sections 9 and 10 hereinabove.
14. COPYRIGHTS/PATENTS
CITY shall own all rights to any patent or copyright on any work, item or
material produced as a result of this Agreement.
agree/forms/profsery 10/15/0 1-A 6
15. CITY EMPLOYEES AND OFFICIALS
CONSULTANT shall employ no CITY official nor any regular CITY
employee in the work performed pursuant to this Agreement. No officer or employee of
CITY shall have any financial interest in this Agreement in violation of the applicable
provisions of the California Government Code.
16. NOTICES
Any notices, certificates, or other communications hereunder shall be given
either by personal delivery to CONSULTANT's agent (as designated in Section 1
hereinabove) or to CITY as the situation shall warrant, or by enclosing the same in a sealed
envelope, postage prepaid, and depositing the same in the United States Postal Service, to
the addresses specified below. CITY and CONSULTANT may designate different
addresses to which subsequent notices, certificates or other communications will be sent by
notifying the other party via personal delivery, a reputable overnight carrier or U. S.
certified mail-return receipt requested:
TO CITY: TO CONSULTANT:
City of Huntington Beach Lawrence N. Blum, PHD
ATTN: Mindy James
2000 Main Street 5182 Ratella Avenue, Ste 205
Huntington Beach, CA 92648 Los Alamitos, CA 90720
17. CONSENT
When CITY's consent/approval is required under this Agreement, its
consent/approval for one transaction or event shall not be deemed to be a consent/approval
to any subsequent occurrence of the same or any other transaction or event.
agree/forms/profservl0/15/01-A 7
18. MODIFICATION
No waiver or modification of any language in this Agreement shall be valid
unless in writing and duly executed by both parties.
19. SECTION HEADINGS
The titles, captions, section,paragraph and subject headings, and descriptive
phrases at the beginning of the various sections in this Agreement are merely descriptive
and are included solely for convenience of reference only and are not representative of
matters included or excluded from such provisions, and do not interpret, define, limit or
describe, or construe the intent of the parties or affect the construction or interpretation of
any provision of this Agreement.
20. INTERPRETATION OF THIS AGREEMENT
The language of all parts of this Agreement shall in all cases be construed
as a whole, according to its fair meaning, and not strictly for or against any of the parties.
If any provision of this Agreement is held by an arbitrator or court of competent
jurisdiction to be unenforceable, void, illegal or invalid, such holding shall not invalidate
or affect the remaining covenants and provisions of this Agreement. No covenant or
provision shall be deemed dependent upon any other unless so expressly provided here.
As used in this Agreement, the masculine or neuter gender and singular or plural number
shall be deemed to include the other whenever the context so indicates or requires.
Nothing contained herein shall be construed so as to require the commission of any act
contrary to law, and wherever there is any conflict between any provision contained herein
and any present or future statute, law, ordinance or regulation contrary to which the parties
have no right to contract, then the latter shall prevail, and the provision of this Agreement
agree/forms/profsery 10/15101-A 8
which is hereby affected shall be curtailed and limited only to the extent necessary to bring
it within the requirements of the law.
21. DUPLICATE ORIGINAL
The original of this Agreement and one or more copies hereto have been
prepared and signed in counterparts as duplicate originals, each of which so executed shall,
irrespective of the date of its execution and delivery, be deemed an original. Each
duplicate original shall be deemed an original instrument as against any party who has
signed it.
22. IMMIGRATION
CONSULTANT shall be responsible for full compliance with the
immigration and naturalization laws of the United States and shall, in particular, comply
with the provisions of the United States Code regarding employment verification.
23. LEGAL SERVICES SUBCONTRACTING PROHIBITED
CONSULTANT and CITY agree that CITY is not liable for payment of any
subcontractor work involving legal services, and that such legal services are expressly
outside the scope of services contemplated hereunder. CONSULTANT understands that
pursuant to Huntington Beach City Charter Section 309, the City Attorney is the exclusive
legal counsel for CITY; and CITY shall not be liable for payment of any legal services
expenses incurred by CONSULTANT.
24. ATTORNEY'S FEES
In the event suit is brought by either party to construe, interpret and/or
enforce the terms and/or provisions of this Agreement or to secure the performance hereof,
agree/forms/profservl0/15101-A 9
each party shall bear its own attorney's fees, such that the prevailing party shall not be
entitled to recover its attorney's fees from the non-prevailing party.
25. SURVIVAL
Terms and conditions of this Agreement, which by their sense and context
survive the expiration or termination of this Agreement, shall so survive.
26. GOVERNING LAW
This Agreement shall be governed and construed in accordance with the
laws of the State of California.
27. ENTIRETY
The parties acknowledge and agree that they are entering into this
Agreement freely and voluntarily following extensive arm's length negotiation, and that
each has had the opportunity to consult with legal counsel prior to executing this
Agreement. The parties also acknowledge and agree that no representations, inducements,
promises, agreements or warranties, oral or otherwise, have been made by that party or
anyone acting on that party's behalf, which are not embodied in this Agreement, and that
that party has not executed this Agreement in reliance on any representation, inducement,
promise, agreement, warranty, fact or circumstance not expressly set forth in this
Agreement. This Agreement, and the attached exhibits, contain the entire agreement
between the parties respecting the subject matter of this Agreement, and supercede all prior
understandings and agreements whether oral or in writing between the parties respecting
the subject matter hereof.
agree/forms/profsery 10/15/01-A 10
IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be
executed by and through their authorized offices the day, month and year first above
written.
rNSULTANT,
CITY OF HUNTINGTON BEACH,
a municipal corporation of the State of California
in Birest-eOF-4
By' (Pursuant To C V .03.100)
print name
ITS: (circle one)Chairm /Preside ice President APPROVED AS TO FORM:
� r
AND ' /07
v' City Att ney � 0-1
By:_
A S'. L Ulf REVIEWED AND APPROVED:
print name
ITS: (circle one)Secretary/Chief Financial Officer/Asst.
Secretary—Treasurer—
City Ad mistrator
(only for contrae'ts$ 0,000.00 and over)
i
agree/forms/profservl0/15/01-A I I
EXHIBIT "A"
A. STATEMENT OF WORK: (Narrative of work to be performed)
In an effort to hire quality personnel for the police department to serve the public,
it is essential to properly screen candidates during the hiring process. The City
of Huntington Beach-Police Department promotes a careful complete screening
of all police candidates, which includes a psychological test. Also the police
department uses the services of a professional psychological/psychiatry service
to provide therapy, trauma support, fitness for duty evaluations, consulting, and
debriefing and emergency crisis intervention for police personnel and for high risk
issues. The City has proposed the .use of a contract, trained professional to
assist in these areas. The focus of the service is to provide necessary and
needed services in, order to facilitate the smooth operations and impartial
screening of candidates.
B. CONSULTANT'S DUTIES AND RESPONSIBILITIES
1. The consultant will conduct pre-employment psychological evaluation for
sworn and non-sworn candidates of the Police Department throughout the life
of the contract and provide written reports of the evaluations
2. The consultant will provide training to specific officers in tactical decision-
making. The course is designed to train the trainer in an effort to certify them
so that they may provide training to additional department personnel in the
same subject. The purpose of this training is to provide officers with the skills
to prevent momentary or prolonged shock reactions when they encounter
unanticipated threats.
3. The consultant will provide at least six, eight-hour sessions for "Stress
Exposure Management' to all police department employees. The classes are
designed to provide effective methods to manage work stress.
4. The consultant will participate with the department wellness committee on a
monthly basis to coordinate department wide wellness planning and
encourage physical fitness for physical and mental well-being.
5. The consultant will train and develop the Trauma Support Team. The training
will consist of the "Psychological Debriefing Technique" developed by the
consultant. The training consists of 16 hours of class training for trauma
support personnel with the consultant. The consultant will also attend the
monthly meetings of the trauma support personnel.
6. The consultant will make available therapy sessions for department members
as requested by the department or as recommended by the consultant.
jmp/contracts group/exA/3/13/07
EXHIBIT "A"
7. The consultant will make available emergency crisis intervention as requested
by the department.
8. The consultant will provide debriefing services for department personnel as
requested by the department.
9. The consultant will maintain all appropriate licenses as necessary.
10.The consultant will provide workers compensation insurance of not less as set
forth by City contract provisions.
C. CITY'S DUTIES AND RESPONSIBILITIES:
1. Pay contractor after an invoice is received from the consultant.
2. Review all reports submitted by the consultant.
3. Negotiate rates with the consultant as necessary.
5. Provide overall review of the services.
D. WORK PROGRAM/PROJECT SCHEDULE:
These services will be conducted within the contract period. It is understandable
that some services will continue beyond the contract period if the services are
ongoing. These ongoing services will not have any costs that will be assessed
beyond the contract period.
jmp/contracts group/exA/3/14/07
EXHIBIT "B"
Payment Schedule (Per Unit&Hour)
A. Per Unit& Hourly Rates
I CONSULTANT'S fees for such services shall be based upon administration of work
outlined in the statement of work with the following payment schedule:
W� _7
eai*'
'a
6V ,'Pio'M id- 2 r
Pre-employrnent Evaluations Per candidate $350.00 $350.00 $350.00
Therapy Per hour $150.00 $150.00 $150.00
Fitness for Duty Evaluation Amount $1,250.00 $1,250.00 $1,250.00
Trauma Support Team Training Per hour $250.00 $250.00 $250.00
Consulting/Training Per hour $250.00 $250.00 $250.00
ing Per hour
Debrief $250.00 1 $250.00 $250.00
Emergency Crisis Intervention Per hour $350.00 1 $350.00 $350.00
2. CONSULTANT shall be remitted $75 for cancellation of scheduled therapy
appointments, within 24 hours of the scheduled date and time.
3. CONSULTANT shall be remitted $175 for cancellation of scheduled evaluations
appointments, within 24 hours of the scheduled date and time.
4. CONSULTANT shall be remitted $175 for re-testing of any candidate, if not in
succession of another test with the same candidate within 1-year period.
5. CONSULTANT shall be remitted $350 for re-testing of any candidate, if not in
succession of another test with the same candidate beyond 1-year period.
B. Travel
I. Charges for time during travel are normally not reimbursable and will only be paid
if such time is actually used in performing services for CITY or as otherwise
arranged with CITY.
2. As CITY sometimes uses consultants that are outside of the nearest metropolitan
area, CITY is very conscious of travel costs. Subject to agreement otherwise,
CONSULTANT will be held to charging no fees on travel time to or from
Huntington Beach.
3. Automobile expenses are limited to the IRS standard business mileage rate. All
other travel expenses must be approved in advance by CITY in writing. Requests
for approval shall be submitted at least fourteen (14) days in advance, to allow for
agree/fonns/exB-per unit fee/3/14/07 EXHIBIT B I
Per Unit Payment
EXHIBIT "B"
Payment Schedule (Per Unit&Hour)
reduced transportation fares. Meals are not billable to CITY, without prior written
consent of CITY
C. Billin
1. CONSULTANT shall submit an invoice, as services are provided per unit or hour as
outlined above.
2. CONSULTANT shall submit to CITY an invoice for each monthly payment due. Such
invoice shall:
A) Reference this Agreement;
B) Describe the services performed;
C) Show the total amount of the payment due; and
D) Indicate the specific services and the hours expended, if relevant
E) Indicate the date of services
3. Upon submission of any such invoice, if CITY is satisfied that CONSULTANT is fulfilling
the scope of work as described in Exhibit "A," CITY shall approve the invoice, in which
event payment shall be made within thirty (30) days of receipt of the invoice by CITY.
Such approval shall not be unreasonably withheld. If CITY does not approve an invoice,
CITY shall notify CONSULTANT in writing of the reasons for non-approval and the
schedule of performance set forth in Exhibit "A" may at the option of CITY be suspended
until the parties agree that past performance by CONSULTANT is in, or has been brought
into compliance, or until this Agreement has expired or is terminated as provided herein.
4. CITY will not pay for secretarial time or secretarial overtime. CITY will not pay for
secretarial tasks or tasks that should be subsumed into CONSULTANT's overhead. For
example, time spent for faxing, mailing, arranging for messengers and calendaring are
not acceptable charges.
5. CITY will not pay for word processing charges. This includes per page or hourly
charges.
6. CITY will not pay for billing or discussion of bills. If CITY has questions about billing
or needs additional information on bills, that is not a chargeable event; CONSULTANT
should respond without charging CITY for the time required.
10. Any billings for extra work or additional services authorized in advance and in writing by
CITY shall be invoiced separately to CITY. Such invoice shall contain all of the
information required above, and in addition shall list the work completed and the rate for
such work. CITY shall approve such invoices if the work performed is in accordance with
the extra work or additional services requested, and if CITY is satisfied that the work and
costs incurred is accurate. Such approval shall not be unreasonably withheld. Any dispute
between the parties concerning payment of such an invoice shall be treated as separate and
apart from the ongoing performance of the remainder of this Agreement.
agree/forms/exB-per unit fee/3/14/07 EXHIBIT B 2
Per Unit Payment
MEMORANDUM OF INSURANCE Date Issued:
03/08/2007
Insured: This memorandum is issued as a matter of
information only and confers no rights upon the
LAWRENCE N BLUM PHD INC holder. This memorandum does not amend,
5182 Katella Ave extend or alter the coverages afforded by the
Ste 205 policy and/or certificate listed below.
Los Alamitos,CA 90720-2857
Company Affording Coverage
Producer.-
Trust Risk Management Services, Inc. Ace American Insurance Company
181 W Madison St Ste 2900
Chicago,IL 60602-4643
VED cSTO RM Covered Person (Status) Owner
LAWRENCE N BLUM PHD INC X
5182 Katella Ave
C.TYIFR McGRA H,Ci A�o7�y/ 7 Ste 205 Employee
Q Los Alamitos,CA 90720-2857
This is to certify that the policy and/or certificate listed below has been issued to the insured named
above for the policy and/or certificate period indicated, notwithstanding any requirement, term or
condition of any contract or other document with respect to which this memorandum may be issued or
may pertain. The insurance afforded by the policy and/or certificate described herein is subject to all
terms, exclusions and conditions of such policy and/or certificate. The limits shown may have been
reduced by paid claims.
Policy and/or
Type of Insurance Certificate Effective Date Expiration Date Limits
Number
Professional Liability
Each incident $ 1,000,000
Claims Made 78G22356288 06/01/2006 06/01/2007 Annual aggregate
$ 3,000,000
Retro Date:
Memorandum Holder
SHOULD ANY OF THE ABOVE DESCRI BED POLI Cl ES AND/OR
CERTI FI CATES BE CANCELLED BEFORE THE EXPI RATION DATE
THEREOF,THE ISSUI NG COMPANY WI LL ENDEAVOR TO MAI L 30
DAYS WRITTEN NOTICE TO THE CERTI R CATE HOLDER NAMED
TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL
IMPOSE NO OBLIGATION OR LI ABI LI TY O F ANY KIND UPON THE
COMPANY ITS AGENTS OR REPRESENTATI VES.
Authorized Representative:
PW
MEMORANDUM OF INSURANCE Date Issued:
03/08/2007
Insured: This memorandum is issued as a matter of
information only and confers no rights upon the
LAWRENCE N BLUM PHD INC holder. This memorandum does not amend,
5182 Katella Ave extend or alter the coverages afforded by the
Ste 205 policy and/or certificate listed below.
Los Alamitos,CA 90720-2857
Company Affording Coverage
Producer:
Trust Risk Management Services, Inc. Ace American Insurance Company
181 W Madison St Ste 2900
Chicago, IL 60602-4643
Covered Person (Status) Owner
LAWRENCE N BLUM X
Employee
This is to certify that the policy and/or certificate listed below has been issued to the insured named
above for the policy and/or certificate period indicated, notwithstanding any requirement, term or
condition of any contract or other document with respect to which this memorandum may be issued or
may pertain. The insurance afforded by the policy and/or certificate described herein is subject to all
terms, exclusions and conditions of such policy and/or certificate. The limits shown may have been
reduced by paid claims.
Policy and/or
Type of Insurance Certificate Effective Date Expiration Date Limits
Number
Professional Liability Each incident $ 1,000,000
Claims Made 78G22356288 06/01/2006 06/01/2007
Annual aggregate $ 3,000,000
Retro Date: 02/01/1992
Memorandum Holder
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES AND/OR
CERTI R CATES BE CANCELLED BEFORE THE EXPI RATION DATE
THEREOF,THE ISSUING COMPANY WI LL ENDEAVOR TO MAIL 30
DAYS WRITTEN NOT[CE TO THE CERTI R CATE HOLDER NAMED
TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL
IMPOSE NO OBLI GATI ON OR LI ABI LI TY OF ANY KI ND UPON THE
COMPANY I TS AGENTS OR REPRESENTATI VES.
Authorized Representative:
111_an
PW
CITY OF HUNTINGTON BEACH
Professional Service Contracts
„FB ° Purchasing Certification
1. Date: 3/13/2007
2. Department: Police
3. Requested by: Mindy James
4. Name of consultant: Psychological Corporation, Inc.
S. Attach the written statement of the specification, conditions and other requirements for the requested
services that was provided to solicited consultants in your answer to 11 of this form.
See Exhibit A
6. Amount of the contract: $40,000
7. Are sufficient funds available to fund this contract?' ®Yes ❑ No
8. Is this contract generally described on the list of professional service contracts approved by the City
Council'? ® Yes ❑ No
9. Company number and object code where funds are budgeted: 10070109.69360
10. Is this contract less than $50,000? ® Yes ❑ No
11. Does this contract fall within $50,000 and $100,000? ❑ Yes ® No
12. Is this contract over$100,000? ❑Yes ® No
(Note: Contracts requiring City Council Approval need to be signed by the Mayor and City Clerk. Make
sure the appropriate signature page is attached to contract.)
13. Were formal written proposals requested from at least three available qualified consultants?
®Yes ❑ No el
14. Attach list of consultants from whom proposals were requested (including a contact telephone number).
Lawrence N. Blum, PHD (562) 493-4655, Dr. Susan Saxe-Clifford (818) 788-8005, Dr. Eric Gruver
(714) 544-4434, Affiliated Psychotherapy(562) 324-7307.
15. Attach proposed scope of work.
See Exhibit A ,S
16. Attach proposed payment schedule.
See Exhibit B S
&A-
nt!dU ignature CHAR n ger
Purchasing/Central Se ices
1. If the answer to this question is"No," the contract will require approval from the City Council.
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