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PSYCHOLOGICAL CORPORATION, INC. - 2005-02-04
SU ity\ Contracts Submittal to City Clerks Office \ Hunt / 'Beuh• / To: City Clerk 1. Name of Contractor: Psychology,Inc. Amendment No. 1 2. Purpose of Contract: For Example:Audit Services or Water Quality Testing Huntington Lake—Huntington CentrAgtark= Psychological Services and Training ' rQ 3. Amount of Contract: $19,500 M0 Copy of contract distributed to: The ORIGINAL insurance certificate/waiver sent to Risk " Management , n Initiating Dept._ V City Treasurer ORIGINAL bonds sent to Treasurer �a CITY CLERK' I E O Y: ls(ame/Exh-n—sit:W ' City Attorney's Office . Date: 8/22/05 r t£� Y U i g:/Attymisc/forms/city clerk contract transmittal.doc s. w AMENDMENT NO. 1 TO AGREEMENT BETWEEN THE CITY OF HUNTINGTON BEACH AND PSYCHOLOGICAL CORPORATION FOR PSYCHOLOGICAL SERVICES AND TRAINING THIS AMENDMENT is made and entered into by and between the CITY OF HUNTINGTON BEACH, a California municipal corporation,hereinafter referred to as"CITY", and PSYCHOLOGICAL CORPORATION, INC., a California corporation, hereinafter referred to as "CONSULTANT." WHEREAS, CITY and CONSULTANT are parties to that certain agreement, dated February 4, 2005, entitled"Professional Services Contract Between the City of Huntington Beach and Psychological Corporation, Inc. for Psychological Services and Training"which agreement shall hereinafter be referred to as the"Original Agreement;" and Since the execution of the Original Agreement, CITY and CONSULTANT wish to amend Paragraph 4 thereof, NOW, THEREFORE, it is agreed by CITY and CONSULTANT as follows: 1. Paragraph 4 is hereby amended to read as follows: 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 Nineteen Thousand Five Hundred Dollars ($19,500.00). 2. REAFFIRMATION Except as specifically modified herein, all other terms and conditions of the Original Agreement shall remain in full force and effect. IN WITNESS WHEREOF,the parties hereto have caused this Agreement to be executed by and through their authorized officer on-T .H.. - 1 ,200 15-7 05agree/psych amend 1 PSYCHOLOGICAL CORPORATION, INC. CITY OF HUNTINGTON BEACH, a municipal corporation of the State of California By: Lawrence Blum,PhD,President AND Police Chief S , 1 ( - o<— By: Paula S. Blum, cretary-Treasurer PROVED AS TO FORM: i City Attorney •� '1 tiG l n' REVIEWED ANDAPPROVED: City mi 'strator 05agreelpsych amend 2 FROM FAX NO. :562493BB97 Aug. 09 2005 02:47PM P1 RUNTINCxT(A 7:3EM.111)(R I.CE 101P.A RTM ENT 9AX).Nfain street T'l antinl trnxt Botu,lr, CA 9r�),648 It 714-41'(it1-88,11 August 1, 2005 Lawrence N. Blum,Ph.D.Inc. Psychological Corporation Incorporated 5182 Katella Avenue,Suite 205 Los Alamitos,CA 90720 Dear Mr. Lawrence; The Police Department of the City of Huntington Beach has Marl a positi ve working relationship with your company for many years. We are very appreciative of the professional,courteous and thorough Service your company has provided to us over the years. We would like to continue this working relationship in the future. Enc;l.osed you will .find an addendum to your current addendum with the City of Huntington Beach. This addendum allows us to increase your annual compensation from $12,000 to W,500. 'would be happy to discuss any questions you may have or make any mutually agreed upon changes to facilitate this addendum. Again, I would like to thank you for your excellent service in the past and to make myself available to ease a smooth transition for this addendum. Please note that this addendum.is valid until the terns ofyour contract expires or is otherwise modified. In.order to complete this process I will need the signed addendum return to n1c. If you have;any questions or I maybe of any further assistance,please contact meat 714-536- 5425 or via e-mail at mjamc§fa)hbpd.gr . P.S. Can you fax a copy of your current'Professional Liability renewal to me'? My fax number is (714)374-1594. Thank youl HUN GTON BEACH POLICE DEPAXI MENT Mindy James Department Analyst,Senior FROM FAX NO. :5624936897 Rug. 08 2005 02:48PM P2 H WGMN BEACH POLIC-1 DEPARTMENT En SCHEDUC.E PRE-EMPLOYMF,NT EVALUATIONS $ 245.00 V APPOINTMENTS MISSED EVALUATION ,A, P 1.NTMENTS 125.00 TWRAPY 125.00 MISSED THERAPY APPOINTMENTS 125.00 FITNESS FOR DUTY EVALUATION 1,250.00 TRAUMA SJPPO)t17 TEAM IRAIhNG 200.00 PER.HOUR CONSULTING/TRAINING 250.00 PER HOIJR DEBRIEFING 250.00 PER HOUR EMERGENCY CRISIS INTERVENTION 250.00 PER HOUR (RAVEL, SUPPLIES AND MELEAGE ARE NOT CHARGED THE CONSULTANT WILL COVER THOSE COSTS oar+K'ii�llt•.WI3�PDF13P�G4t�:utit.t: �nizuos INSURANCE AND INDEMNIFICATION WAIVER MODIFICATION REQUEST 1. Requested by: Christi Mendoza, Risk Management ! 2. Date: August 15, 2005a , . � 3. Name of contractor/permittee: Lawrence N. Blum, PhD. Inc. 4. Description of work to be performed: Professional services to Police Department to include pre-employrment evaluations, therapy, fitness-for-duty evaluations, trauma support team training, consulting/training, debriefing, emergency crisis intervention. 5. Value and length of contract: Not-to-exceed $19,500; annual, ongoing 6. Waiver/modification request: Cancellation clause wording/professional &general liability 7. Reason for request and why it should be granted: Unable to comply with the city's insurance cancellation clause wording requirement 8. Identify the risks to the City in approving this waiver/modification: None. ©_t -7—Ce.�) � Department Head Signature c Date: APPROVALS Approvals must be obtained in the order listed on this form. Two approvals are required for a request to be granted. Approva!,#Gm jhe City Administrator's Office is only required if Risk Management Ad th City Attorney's Orrice dis9gree. 1. Risk Management Approved ❑ Denied Signature ate : proved . i Attorney's Office❑ De O , (� �e� — SignaiLM Da e 3. City Administrator's Office ❑ Approved ❑ Denied Signature Date If approved,the completed waivertmodifrcation request is to be submitted to the City Attorney's Office along with the contract for approval Once the contract has been approved, this form is to be filed with the Risk Management Division of Administrative Services Lockton Affinity 8/8/2005 9: 19 AM PAGE 1/002 Fax Server r ................' �..... .............: : ;r r . a . ::: :'. . idxli `6" =tisi i3 !.6s. iivsoivi l bt ?F3 ..::fF tli?Z4lF...Fife&i17333. 1 .=:;•Eccic......'r:. ................... ........... .... ........ ... ................. ................... .......... ..... ........ .... ................. eisss. f .. $ait6s£ iEidalt Date:August 8,2005 To:Christine Mendoza City of Huntington Beach/Risk Management Receiver's Fax:(562)493-8897 Receiver's Phone:(562)493-4655 Sender:TRMS Department:Trust-Sponsored Professional liability Program Sender's Fax:1.877.251.5111 Sender's Phone:1.677.637.9700 J'v10'�r k 1 Re:Trust-Sponsored Professional Liability Program Message: As per your request,enclosed is a memorandum(certificate)of insurance to verify Dr.Lawrence Blum's coverage through the Trust-Sponsored Professional Liability Insurance Program. Please rote that we are unable to honor your request to amend the cancellation clause. I MEMORANDUM OF INSURANCE Date Issued: 08/08/2005 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 X LAWRENCE N BLUM PHD INC 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 06/01/2005 06/01/2006 Annual aggregate $3,000,000 Retro Date: 02/01/1992 Memorandum Holder SHOULD ANY OF THE ABOVE DESCRIBED POLL G ES AND/OR City of Huntington Beach CERTI Fl CATES BE CANCELLED BEFORE THE EXPI RATION DATE THEREOF,THE I SSUI NG COMPANY WI LL ENDEAVOR TO MAI L 30 Attn:Christine Mendoza DAYS WRI TTEN NOTI CE TO THE CERTI R CATE HOLDER NAMED 2000 Main St TO THE LEFT, Huntington Beach,CA 92648 1 MPOSE NO OBLI GATI ON OR LI ABI LI TY OF ANY KI ND UPON THE COMPANY ITS AGENTS OR REPRESENTATIVES. Authorized Representative: PW ACORD DATE(MMVDDlYYYY) CERTIFICATE OF LIABILITY INSURANCE oe 09 OS PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Grosslight Insurance, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 1333 Westwood Blvd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW- Los Angeles CA 90024 Phonec310-473-9611 Fax_31D-312-4993 INSURERS AFFORDING COVERAGE HAIG0 INSURED INSURER A: Safeco Insurance Companies 4 24740 INSURER B: Lawrence N. Blum, PHD Inc. INSURER¢ 5182 Rat lla Ave. #2b5 INSURER D: Los Alamitos CA 96720 --- INSURER E: 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 RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LE POLICY EXPIRATION TR NSR TYPE OF INSURANCE POLICY NUMBER DATPOLE MMlrFFUD(YY DATE MMtDDM/ UMITs GENERAL LIABILITY EACH OCCURRENCE $1,QOO OOO A X X COMMERCIAL GENERAL LIABILITY 02BP1831632 04/30/05 04/30/06 ME.ISEstEaoc .' ) S 300,000 CLAIMS MADE D OCCUR MED EXP(Any one person) $10,000 PERSONAL&AMINJURY S11000 000 GENERAL AGGREGATE. s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2 00O 000 17 POLICY I J- LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT s ANY AUTO (Ea accdenl) ALL OWNED AUTOS BODILY INJURY s SCHEDULED AUTOS (Per P—) HIRED AUTOS BODILY INJURY S I NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE S (Per noddelH) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANY AUTO OTHER THAN EA ACC t AUTO ONLY: AGG S EXCESS/UMBRELLA UABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE S �— S DEDUCTIBLE $ RETENTION S $ WORKERS COMPENSATION AND TQRY LBAITS ER EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ If Pes,describe unde S ECIAL PROVISIONS bebw r E.L.DISEASE-POLICY LIMIT 3 S OTHER I DESCRIPTION OF OPERATIONS I LOCATIONS r VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS The City of Huntington Beach, its agents, officers and employees are additional insureds but only as respect to liability arising out of the operation of the named insured, but only to the extent covered by the insurance company. *10 Days notice of cancellation for non payment of premium. CERTIFICATE HOLDER CANCELLATION HUNT I-2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EVIRA DATE THEREOF,THE ISSUING INSURER WILL=MWMGK=MA1L *3O DAYs WRITTEN City of Huntington Beach NOTICE TO THE CERTIFICATE HOLDER HAMEDTO THE LEFT,BUi� SMALL Police Department 2000 Main Street IMPOSE NO OBLIGATION OR LIABIU OF ANY KIND UPON THE INSURER rT8 AGENTS OR Huntington Beach CA 92648 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Gil Grossli ht ACORD 25(2001108) 1 r0 ACORDOZORPORATION I C THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ fT CAREFULLY. S A F E C Gt' LIABILITY PLUS ENDORSEMENT CO 72 3610 01 COMMERCIAL GENERAL 1.101LITY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY CDVERACE PART SCHEDULE Name of Person or Organization: The City of Huntington Beach, its agents, officers and employees ADDITIONAL INSURED - 6Y WRITTEN CONTRACT, (z) Your ongoing operations for fttat insured, AGREEMENT OR PERMIT,OR SCHEDULE whether the work is performed by you or for The foibwMg paragraph Is added to WHO IS AN INSURED you; (Section fiy (3) The mainterianCe, operation or use by you of equipment leased to you by such person 6 Any person or organization shown in the Schedule or or organization, subject to the lolbwing for whom you are required by written contract, additional provisions: agreement or permit to provide insurance is an (a) This insurance does not apply to any Insurer!,subject to the following additional provisions: 'occurrence" which tells place after L The comae, agreement or permit roust be in 111e egnipmeol tease expires; effect during the policy period shown In the (b) This insruance does not appt to Declarations,and must have been eKeclrted prior "Bodily injury" or "property damage" to Vie "bodily injury," "orooeny darnaoe," arising out of Uri sole negligence of "personal and advertising injury_" such person or organization: b. The person or organization added as an insured (4) Permits issued by any state or political by this endorsement is an insured only to the subdivision with mapect. to ope%Wna R extent you are held liable due to: pertormed by you or on your behalf,subject (1) The ownership, maintenance or use of that to the following additional provision; part of promises you own, rent, lease or This hsurance does r10t apply la "bodsy occupy, subject to the following additional bi(ury," "property damage," "personal and provisions: advertising kt)urlf' arising out of operations (a) This Insurance does not apply to any performed for the stale or munk Ipalslr "occurrence" which takes place after c The insurance with respect to any archkect, you Cease to be a tenant in any engineer,or surveyor added as an ina red by this premises leased to or Ferried to you; endorsement does not apply to "bodily fniury," (b) This insurance does not apply to any "property damage," "personal and advertising structural alterations, new construction bilr"y" artS(rry vul ur the rende►ing Df or On or demolition operations performed by failure to render any profess►onal services by or or on behalf of the person or tot you,incfudfrtg: organization added as an insured; kskrdce GopFi�,rat Matorial or 6nWpiesServices Olncs,Ina.,With its Permission. CaWighl,lnsurwme Services oaks,Inc.,2001 Pape 1 of 3 Gaa�SJ4leti�l-0EQ�16t CO 76 3510 01 COMMERCIAL GENERAL LIABILITY (1) The preparing, approving, or (ailing to (4) Liability assumed under any "insured prepare or approve maps, drawings, contract" for the ownership, maintenance or opinions, reports, surveys, change orders, use of aircraft or watercraft;or designs or specifications;and (5) "Bodily injury" or "property damage" (2) Supervisory, inspection or engineering arising out of the operation of any of the services. equipment listed in paragraph E(2) or f.(3) d. This insurance does not apply to "bodily inlur)r• of the definition of"mobile equipment." or "property damage" included within the (6) An aircraft you do not own provided 4 is not "products-completed operations hazard." operated by any insured. A person's or organization's status as an insured TEt(AftTS'PROPERTY DAMAGE LIABILITY under this endorsement ends when your operations for that insured are completed. When a Damage to Premises Rented to you Limit is shown No coverage will be provided N, in the absence in the Declarations, Exclusion J.of Coverage A.Section I Is of this endorsement, no liability would be replaced by the following: imposed by law on you.Coverage shall be limited ), Damage To Prop" to the extent of your negligence or tault according to the applicable principles of comparative fault. (Property damage"to: (1) Property you own, rent, or occupy,including any NON-OWNED WATERCRAFT AND NO"WNED AIRCRAFT costs or expenses incurred by you,or any other LIABILITY person. organization or entry, for repair, Exclusion g, of COVERAGE A (Section 1) Is replaced by the replacement, enhancement, restoration or following: maintenanrxt of such pmprrty for any reason, including prevention of Injury to a person or 9. "Bodily injury" or"property damage" arising out damage to anther's property; of the ownership, maintenance, use or (2) Premises you sell, give away or abandon, if the entrustment to others of any aircraft, "auto" or "property damage" arises out of any part of watercraft owned or operated by or rented or those premises; loaned to any insured. Use includes operation (3) Property loaned to you; and"loading or unloading." (4) Personal property in the care, custody or control This exclusion applies even if the claims against of the insured.- any insured allege negligence or other (s) That particular part of real property on which you wrongdoing in ine supervision, hiring, or any contractors or subcontractors working employment, training or monitoring of others by directly or indirectly on your behalf are that insured, if the "occurrence which caused Performing operations, it the"property damage" the "bodily injury" or "property damage" arises out of those operations,or involved the ownership, maintenance, use or (6) That particular part of any property that must be restored, repaired or replaced because "your entrustment to others of any aircraft, "auto" or work" was incorrectty performed on A. watercraft that is nwnerl nr operated by or rented or loaned to any insured. Paragraphs (1), (3) and (4) of this exclusion do not This exclusion does not apply to: apply to "property damage" (other than damage by fire) to premises, including the Contents of such (1) A watercraft while ashore on promises you premises, rented 10 you.A separate limit of insurance own or rent; applies to Damage To Premises Rented To You as (2) A watercraft you do not own that is: described in Section III -Limits Of Insurance. (a) Less than 52 feet tong;and Paragraph (2) of this exclusion does not apply if the (b) Not being used to carry persons or premises are "your work" and were never occupied, property for a charge; rented or held for rental by you. (3) Parking an "auto" on, or on the ways next Paragraphs (3), (4), (5) aria (0) of this exclul510ri do to, premises you own or rent, provkfed the not apply to liability assumed under a sidetrack auto' is not owned by or rented or loaned agreement. to you or the insured: Includes Copyrighted Material of insurance services oince,Inc.,with It Potm'ssion. Copyright,Insurance Services Office,Inc.,2001 Page 2 of 3 GaC-ar+awTOai-0iKgCui , CO 76 35 1B 01 COMMERCIAL GENERAL LIABILITY Paragraph (6) of this exclusion does not apply to EXTENDED"PROPERTY DAMAGE" "property damage" included in the Exclusion a. of COVERAGE A. (Section 1) is amended to "products-completed operaf*ns hazard-" read: Paragraph 6.of Section III is replaced by the following: a. "Bodily injury' or "property damage" expected or 5. Subject to 5. above, the Damage fo Property lima is intended from the standpoint of the insured This the most we will pay under Coverage A for damages exclusion does not apply to "bodily Injury" or because of"property damage" to any one premises, "property damage" resulting from the use d reasonable force to protect e while rented to you,or in the case of damage by fire, rsons or property. while rented to you or temporarily occupied by you INCREASED MEDICAL EXPENSE LIAUT with permission of the owner. Zhe medical ex psrtse limit is amended t0=10 000. The Tenants' Property Damage to Premises Rented to You KNOWLEDGE OF OCCURRENCE IYna is the higher of$200,000 or the amount shown In the The following is added to Paragraph 2.Duties In The Event Declarations as Damage to Premises Rented to You Limit. Dt Occurrence, Offense, Claim Or Suit of COMMERCIAL WHO IS AN INSURED - MANAGERS GENERAL LIABILITY CONDITIONS(Section IV): The following is added to Paragraph 2.a. of WHO IS AN Knowledge of an "occurrence," claim or "suit" by your INSl1RFn(Spmlon It): agent, tPrvant or employee shall not In Itselt constili to Paragraph (1) does not apply to executive officers, or to knowledge of the named insured unless an officer of the managers at the supervisory levei or above. named insured has rmelved such nonce from the agent, SUPPLEMENTARY PAYMENTS - COVERAGES A AND B servant or employee. - BAIL BONDS UNINTENTIONAL FAILURE TO DISCLOSE ALL HAZARDS Paragraph 1.b. of SUPPLEMENTARY PAYMENTS The following is added to Paragraph Ill. Representations of COVERAGES A AND B Is replaced by the following: COMMERCIAL GENERAL LMILITY CONDITIONS (Section IV). b. Up to$2.000 for cost of ball bonds required because If you uninientlonally fail to disclose any hazards existing of arcirlents or traft krw vinlatinns arising curt of the at the inception date of your policy, we will not deny use of any vehicle to which the Bodily Injury Liability coverage under this Coverage Form because of such►allure. Coverage applies. Vde do not have to furnish these However, this pravisioa does not affect our rift to cofieet bonds. additional premium or exercise our rtpht of cancellation or EMPLOYEES AS INSUREDS-HEALTH CARE SERVICES non-renewal. Provision 2.a.(1)d. of WHO 15 AN INSURED (Section 11) is LIBERALIZATION CLAUSE deleted,unless excluded by separate endorsement. The following paragraph is adM to COMMERCIAL = EXTENDED COVERAGE FOR NEWLY ACQUIRED GENERAL LIABILITY CONDITIONS(Section IV): ORGANIZATIONS 10. It a revision to this Coverage Part. which would Provision 4.a. of WHO IS AN INSURED (Section 11) is provide more coverage with no additional premium, replaced by the following: becomes effective during the poky period in the state IL Coverage under this provision is afforded only Shown in the Declarations, your policy will until the end of the policy period. automatically provide this additional Coverage on the effective date of the revision. Includes Copyrighted Material of Insuram Services offim Inc-with is permission. copyriold.Irwrarn Services Ocoee,teC..Zoo4 Page 3 or 3 09Waramar alitaa113" 08/06/2005 11:50 NO.417 P003 . s SP POLICYHOLDER COPY STATE P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 COMPENSATION IN SURAN CE FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 08-08-2005 GROUP: POLICY NUMBER: 1016063-2005 CERTIFICATE D. 15 CERTIFICATE EXPIRES:04-01-2006 04-01-2005/04-01-2006 THE CITY OF HUNTINGTON BEACH SP 2000 MAIN STREET HUNTINGTON BEACH CA 92648 This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon30 days advance written notice to the employer, We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement term Or condition Of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is Subject to all the terms, exclusions, and conditions, of such policy. AUTHORIZED REPRESENTATNE PRESIDENT EMPLOYER'S LIABILITY LIMIT INCUJCING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT M1600 - LAWRENCE N. BLUM PRESIDENT - EXCLUDED. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 04-01-1993 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. i I I EMPLOYER LAWRENCE N. BLUM, PH.D., INC. (A PROF, CORP.) 5192 KATELLA AVE STE 205 LOS ALAMITOS CA 90720 (TDG,CN) tREV.2-051 PRINTED 08-08-2005 Su ity Contracts SubmittalAo City Clerk's Hunt Beach- U i D L_r',U i To: City Clerk 1. Name of Contractor: Psychology, Inc. 2. Purpose of Contract: For Example.Audit Services or Water Quality Testing Huntington Lake—Huntington Central park Psychological Services and Training 3. Amount of Contract: $12,000 Copy of contract distributed to: The ORIGINAL insurance certificate/waiver sent to Risk Management Initiating Dept, City Treasurer ORIGINAL bonds sent to Treasurer CITY CLERK'S OFFICE USE ONLY: Ndne/Extlion City Attomey's Office Date: 65 g:/Attyrnisclforms/city clerk contract transmittal.doo PROFESSIONAL SERVICES CONTRACT BETWEEN THE CITY OF HUNTINGTON BEACH AND FOR THIS AGREEMENT ("Agreement") is made and entered into this 4 day of , 20k�,-by and between the City of Huntington Beach, a municipal corporation of the State of California. hereinafter referred to as "CITY, and cj--�ol� 1 /s a � 0�'��6� CorO hereinafter referred to as "CONSULTANT." WHEREAS, CITY desires to engage the services of a consultant to Ae i c4j Gg.S and Pursuant to documentation on file in the office of the City Cleric, 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 all represent it and be its sole contact and agent in all consultations with CITY during the performance of this Agreement. agraelfornslprofscrvi4115/Oi 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 "Commencement Date"). This Agreement shall expire on 30)01001 unless sooner terminated as provided herein. All tasks specified in Exhibit "A" shall be completed no Later than 30) Wl 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. In 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, a fee, including all costs and expenses, not to exceed eof) — roe--- Dollars ($ Jaj ()QD . 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/forms/profsery 1011510 1 2 compensation for such extra work shall be allowed only if the prior written approval of CITY is obtained. b. METHOD OF PAYMENT CONSULTANT shall be paid pursuant to the terms of Exhibit "B," which is attached hereto and incorporated by reference into this Agreement. 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. CITY agree/forms/profsery 10/15/01 3 E shall be reimbursed by CONSULTANT for all costs and attorney's fees incurred by CITY in enforcing this obligation. CONSULTANT will conduct all defense at its sole cost and expense and CITY shall 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) 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 agreelformslprofservl0115101 4 provision of at least two (2) years to report claims arising from work performed in connection with this Agreement. 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 parry, 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 indemnification and defense 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. agrce/forms/profsery 10/15/01 5 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 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. agrcclf6rmslprofscrv10115/01 6 j 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. 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 I 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 ATTN: 2000 Main Street ✓� Huntington Beach, CA 92648 24 agrcc/forms/pro fscry 10/t 5101 7 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. 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. agrce/forms/ptofserv10115/01 8 a 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 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. agrcdformslpro fsery 10/15101 9 24. ATTORNEY'S FEES Except as expressly set forth in Section 8 of this Agreement, 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, 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 am-i'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 other-wise, 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 par-ties respecting the subject matter of this Agreement, and supercede all prior agrn/forms/profsery 10115/01 10 understandings and agreements whether oral or in writing between the parties respecting the subject matter hereof. 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. CONSULTANT, CITY OF HUNTINGTON BEACH, �-r— - a municipal corporation of the State of California J Director of atico By (Pursuant To HHBMC§3.03.100) "?'J tC'rJ WP print name ITS: (circle one)Chairma Presiden Vice President APPROVED AS TO FORM: AND City Attorne By: t4t!( LU�1 _ REVIEWED AND APPROVED: print name ITS: (circle one)Secretary/Chief Financial Officer/Asst. er� Treasurer City,Administrator (onfv for contracts•pver$50,000.00) I � r a8rceiforms/profscrv10/15101 11 3 t 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, 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/12/21/04 l i 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/12/21104 E 1 EXHIBIT "B" Payment Schedule (Per Unit &Hour) A. Per Unit &Hourly Rates 1. CONSULTANT'S fees for such services shall be based upon administration of work outlined in the statement of work with the following payment schedule- - Pre-employment Evaluations $245 per candidate Therapy $125 per hour Fitness for Duty Evaluation $1,250 Trauma Support Team Training $200 per hour Consulting/Training $250 per hour Debriefing $250 per hour Emergency Crisis Intervention $250 per hour 2. CONSULTANT shall be remitted $125 for cancellation of scheduled evaluations or missed therapy appointments,within 24 hours of the scheduled date and time. 3. CONSULTANT shall be remitted $245 for re-testing of any candidate, if not in succession of another test with the same candidate. B. Travel 1. 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 reduced transportation fares. Meals are not billable to CITY, without prior written consent of CITY agree/forms/exB-per unit fee/12/21/04 EXHIBIT B 1 Per Unit Payment EXHIBIT "B" Payment Schedule (Per Unit &Hour) C. Billing 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 fillfilling 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. S. 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?]2/21104 EXHIBIT B 2 Per Unit Payment Lockton Companies 1/4rLUUZ� 'J:4* VIN 1JA1.h Z/UUZ rax iDerver MEMORANDUM OF INSURANCE Date Issued: 01/04/2005 Insured: This memorandum is issued as a matter cf LAWRENCE N BL UM PHD INC information only and confers no rights upon the 51821<ateiiaAve holder. This memorandum does not amend, Ste205 extend or alter the coverages afforded by the _ Los Alamitos,CA90720-2857 Certificate listed below. Producer: Company Affording Coverage Chicago Insurance Company Near North Insurance Brokerage in Association with Trust Risk Management Services 875 N Michigar, Ave Covered Person (Status) Owner Ste 1900 LAWRENCE N BLUM Chicago, IL 60611-1803 X Em p ioy ee This is to certify that the Certificate fisted below has been issued to the insured named above fo• the Chicago insurance Company policy period indicated, rotwithstanding any requirement, term or condition of any contract or other document with respect to which this APPROVED ASTCFORM memorandum may be issued or may pertain, the insurance afforded by the Certificate described herein is subject to all terms, exclusions and conditions of 3ENNIFC(GTH Gity�fAt# 111 such Certificate The limits shown may have been reduced by paid claims. Certificate/Pal:cy Effective Expiration Type of Insurance (Number Date Date Limits Professional. Liability Each incident $ 1,00C.000 Claims Made 45P-2010973 06MI/20^4 06/01!2005 Annual aggregate $ 3,000;00U Retro Date: 02l01/1992 Mem orandu rn Holder SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE [SSUING COMPANY WILL FBC-ArIF9r A MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TC THE LEFT, I _ Authorized Representative: 5u ity PROFESSIONAL SERVICE CONTRACTS Hunhn �Beach:m PURCHASING CERTIFICATION i 1. Requested by: Shana Bawa 2. Date: January 9, 2004 3. Name of consultant: Psychological Corporation, Incorporated 4. Description of work to be performed: Psychological Services 5. Amount of the contract: $12,000.00 6. Are sufficient funds available to fund this contract?' ® Yes, ❑ No 7. Company number and object code where funds are budgeted: 10070109.69360 8. Is this contract generally described on the list of professional service contracts approved by the City Council'? ® Yes, ❑ No 9. Is this contract within $25,000 or 25% (whichever is less) of the amount stated on the list of professional service contracts approved by the City Council?' ® Yes, ❑ No 10. Were (at least) informal written proposals requested of three consultants? ® Yes, ❑ No 11. Attach list of consultants from whom proposals were requested (including a contact telephone number). 12. Attach proposed scope of work. 13. Attach proposed payment schedule. 3 0 'R HAR41A�MXDRIL, Manager Purchasing/Central Services t If the answer to any these questions is"No,"the contract will require approval from the City Council. Purchasing Certification-Pschologist.dot 1/10/2005 2:43 PM i Bids for Psychological Services Dr. Susan Saxe-Clifford Psychiatrist 17323 Ventura Encino, CA 818-788-8005 Rate: $350 per hour Dr. Eric Gruver Psychiatrist 17772 17th Street, #106 Tustin, CA 714-544-4434 Rate: $400 per hour Affiliated Psychotherapy Psychiatrist rate 17315 Studebaker Road, #300 Cerritos, CA 562-324--7307 Rate: $175 In office-general therapy Does not do candidate evaluation