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Forensic Nurse Specialists, Inc. - 2022-10-01 (3)
• • • AGREEMENT FOR FORENSIC EXAMINATION SERVICES by FORENSIC NURSE SPECIALISTS,INC, This Agreement for Forensic Examination Services is made and entered into as of the 1st day of October, 2022 (the "Effective Date"), by and between FORENSIC NURSE SPECIALISTS, INC., a California corporation doing business as FORENSIC NURSE SPECIALISTS,INC("FNS"),a privately owned minority(woman) professional corporation, and the CI'l'Y OF I•IUN•l'INGTON BEACH, a California Municipal Corporation• ("City"), on behalf of the Huntington.. Beach Police Department ("Department"),with respect to the following; WHEREAS, Department requires the collection of forensic evidence with respect • to victims of sexual assault and other forms of interpersonal violence; •WHEREAS, this is a.mandatory expense as failure to provide a victim of sexual assault with an examination by a qualified healthcare professional would be a violation of the California Penal Code; . • WHEREAS, Department does not have the capability to collect the aforesaid forensic evidence internally; • . WHEREAS, ENS has specialized training •and expertise in the forensic • • examination services and Department desires to contract such services from FNS;and WHEREAS, FNS is the sole source providing this service in Orange County and there are no specific registries that utilizes forensic nurses solely for the purpose of exams, • NOW, 'THEREFORE, in consideration of the mutual promises, covenants, and conditions contained herein,the parties hereto agree as follows: • • 1. Services. INNS agrees to provide the following services (collectively, the "Services")to the Department: • 1.1. Examination. INS agrees to provide the I7eptutment approved • forensic-medical exams 24 hours per day,7 days per week(i.e. continuously)to sexual assault and other types of victims with a • • one hour response to a mutually agreed upon examination location. The exam is.to include digital imaging of injuries and physical findings.The examination will be conducted by forensic nurses who arc trained and competent in the California State Protocol established by CALMS(California Office of Emergency Services). 1.2. Evidence. All evidence collected during the examination will be packaged,labeled and sealed according to the state and local crime • lab requirements and submitted to the on-site evidence storage • refrigerator with appropriate chain of custody documentation. • Evidence for mobile exams(off site)or courtesy cases will be relinquished at the conclusion of that examination to the authorizing Department.Digital photographs will be available upon request.by Department investigators. 1.3. Equipment and Supplies. FNS will provide all equipment and supplies to conduct all services listed in Exhibit A. 1.4. Testimony. PNS agrees to provide competent court testimony as requested by the Department(upon receipt of subpoena). • 2. Compensation. In exchange for the Services to be provided by INNS pursuant to Section 1 above,Department, through City, shall compensate INS according Exhibit.A•"FEE SCHE.DU E--2022",Services can be added at any time per Department request and at negotiated rates. 2,1. Rate Adjustment, Department acknowledges and agrees that PNS is entitled to adjust the rates set forth in this Section 2, Exhibit A.All fee adjustments are subject to prior written mutual agreement of the parties. INS shall use reasonable efforts to give Department at least sixty (60) days advance•written notice of any increase or adjustment to rates. 3, Payment. MS shall invoice Department monthly for all Services performed in each previous month,Department shall remit payment to PNS within forty- . five(45)days of receipt of an invoice,unless Department reasonably disputes the validity or veracity of the information on the invoice, Department shall provide PNS with notice of any such disputed information or amount within thirty (30) days of receipt of an invoice, 4, 'Perm. This Agreement shall be for a term of one year, commencing on the Effective Date and expiring on the first anniversary thereof(the"Initial Term").This • Agreement shall be renewable only upon the mutual written agreement. of both parties hereto(each, a"Renewal Term" and together with the Initial Term, the"Term"). 4.1. 7.erinuiation. Either party may terminate this Agreement without cause at •any time during the term of this Agreement by providing the other party at least thirty (30)days prior written notice of termination. 5. Indemnification. The parties each shall indemnify, defend, and hold the other party harmless from and against any and all claims, liability, loss, damages, costs, and expenses (including reasonable attorneys' fees) caused, or alleged to be caused, by the negligence or wrongful acts or omissions of such indemnifying party or its • • employees, officers or agents. The provisions of this Section 5 shall survive the • expiration or termination of this Agreement. • 6. Insurance. ENS shall procure and maintain at its own expense the following insurance: 6.1. Commercial General Liability Insurance in an amount not less than • $'1;000,000 per each occurrence and $2,000,000 general aggregate (claims made • • • .anti modified occurrence policies are not acceptable.) Insurance companies must be approved by the CITY, admitted and licensed in California, and have a I3est's • Guide Rating of A-,Class VII or better,as approved by the CITY. 6.2. Workers Compensation Insurance as required by the Calilbmia ]..abor - Code and employer's'liability insurance in an amount.not Less than $1,000,000. This •policy shall be endorsed to state that the insurer waives its right of subrogation against the City, its boards and 'commissions, and its officials, . • employees;and agents. 6.3. Professional liability or errors or omissions insurance in an amount not less than.$1,000,000 per claim. • 7.. Confidentiality of Patient Information. None of the parties shall disclose any confidential patient health information to any third party, except where permitted or required by law or where the patient expressly approves such disclosure, ENS and the Department shall comply with all federal and sta(c laws and regulations regarding the confidentiality of such information, including without limitation the.Health•Insurance portability and Accountability Act(FIIPAA)of. 1996. 8. Non-Discrimination. By signing this Agreement,ENS certifies that it does not discriminate in hiring or treatment on the basis of race, color, creed, religion, sex, sexual orientation, ago, mental status, national origin, ancestry, physical handicap, medical condition,or any other classification protected by State or Federal law. 9. Non-Exclusivity. This Agreement is not exclusive, and nothing herein shall preclude either.party from contracting with .any other person or entity for any purpose. • . 10. Notices. Any notices required or desired to be given under this Agrccmcnt.shall be in writing and personally delivered or deposited.in the US Postal Service,first class. IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the date first written above. FORENSIC NURSE SPECIALISTS, CITY OF HUNTINGTON BEACH INC,(FNS)a professional Corporation "DEPARTMENT" in the State of�,California ���� ��Q� � I3y:fl0 �'; �C litl G�� By (...r."" Name: Melinda Wheeler Name: %►'`; v il ''ro" Title: President Title: C.A":. • Receive and File trif41, 94ini744,144d City Clerk s fty..al ;OVEIr StO.t; RM .;t;;l4A54.h',OA'Rer Carl ATTOF NeY HUIVINOTQ10lACH EXHIBIT A- FEE SCHEDULE—2022-2023 Service Definition Rate • Sexual Assault Forensic Evidence collection,clothing, DNA reference $1000.00 Exam samples,blood and urine toxicology,digital photography,medical-forensic (All ages, reported or non- documentation using state mandated reported cases to law forms, healthcare treatment for STI enforcement) prevention, HIV prevention and pregnancy prevention provided at the time of the exam, 7.1.21-CALOES REIMBURSES EACH POLICE AGENCY$1127.00 PER EXAM Mobile Trauma Exam A forensic exam conducted at any Orange $1200.00 County hospital in the ER or ICU when a patient Is severely Injured and admitted to that other hospital for on-going medical care.(Requests for Mobile exams in nursing homes and psychiatric facilities will be conducted on a case-by-case basis.) Dry Run Department calls out the on-call forensic $300.00 nurse to perform a case and through no fault of FNS, the victim changes their mind, refuses to permit the examination,does not want the examination,or does not permit forensic nurse to conduct the examination. Domestic Violence/ A forensic exam focused on body injury and $500.00 Strangulation Exam(DALE) assessment with specific written and photographic documentation on strangulation injury. Testimony Expert witness testimony by the forensic $400.00/day nurse upon receipt of subpoena form the in court on • District Attorney's office the stand ' AC CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDIYYYY) ��D 05iO3/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES.NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME CT Deb Puglia Aon Affinity Insurance Services, Inc. PHONE 1-888-288-3534 FAX 1100 Virginia Drive,Suite 250 MANo.Ext): INC.No): IL Fort Washington,PA 19034-3278 ADDRESS: customer.service@hpsocover.com INSURER(S)AFFORDING COVERAGE NAIL q INSURER A:American Casualty Company of Reading,PA 20427 INSURED INSURER B: Forensic Nursing Specialist Inc DBA Forensic Nurse 10413 Los Alamitos Boulevard INSURER C Los Alamitos,CA,90720 . INSURER 0: • INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ITR TYPE OF INSURANCE ADDL INSD WVD POLICY NUMBER (BR MMIDDIYYYYI (MM/DDIIYYY XYPY) LIMITS COMMERCIAL GENERAL LIABILITY 0732542425 03/03/2023 03/03/2024 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE n OCCUR PREMISES(Ea occurrence) $ General Liability-Occurrence MED EXP(Any one person) $ A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 X POLICY !EC7 LOG PRODUCTS-COMP/OP AGO $ OTHER: • $ AIITOMOB)LELIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ • HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _AUTOS ONLY (Per accident) $ • UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED RETENTIONS S WORKERS COMPENSATION AND EMPLOYERS'LIABILITY PER - ERH ANYPROPRIETORIPARTNERIEXECUTIVE YIN - EL.EACH ACCIDENT $ OFF ICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-BA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Professional Liability 0732542425 03/03i2023 03/03/2024 Liability(Each claim):$1,000,000 A • Liability(Aggregate):$6,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space le required) APPRO ED RPR itAIC EL E.OATES CITY ATTORNEY CERTIFICATE HOLDER CANCELLATION CITY OF HUNTINGTON REACH The City of Huntington Beach SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 2000 Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Huntington Beach,CA,92648 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE � (ilii (JJJ///7J✓/CC.UJVYt4 IL 1988-2015ACORD CORPORATION. All rights reserved. ACORD 26(2016/03) The ACORD name and logo are registered marks of ACORD ' C� /YY DATE(MWDDYY) ' ,,.�- CERTIFICATE OF LIABILITY INSURANCE 5/4/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder In Ileu of such endorsement(s). PRODUCER CONTACT Malinda Wheeler Pie Insurance Services N/ME: 1755 Blake Street PHONE M FAX 5th Floor INC,No.Ext): I (A/C.No): Denver, Co 80202 Email FNS1S4ALIWDA@ GMAIL.COM Address: 00001 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A SIRIUSPOINT AMERICA INSURANCE COMPANY 38776 INSURED INSURER B: Forensic Nurse Specialists Inc. INSURER C: 10412 Los Alamitos Blvd INSURERD• Los Alamitos, CA 90720-2112 INSURER E: INSURER F: _ COVERAGES CERTIFICATE N UMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF MY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED SY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LI MITS SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS. INS TYPE OF INSURANCE ADDL SUl3R POUCY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSRD WVD (MM/DD/YY) (MMIDDIYY) COMMERCIAL GENERAL LIABIUTY EACH OCCURRENCE r$ CLAIMS-MADE❑OCCUR DAMAGETORI2JTED $ PRFM MPS/Fa nano rrenrnl MED.EXP(My one person) $ — PERSONAL&ADV INJURY $ GEN'-L AGGREGATE UMIT.APPLIES PER: GENERAL AGGREGATE $ RPOUCY ❑PROJECT LOC _PRODUCTS-COMP/OP AGG. $ • OTHER $ AUTOMOBILE UABIUTY COMBINED SINGLE OMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED —,SCHEDULED•AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ — —. HIRED NON•OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) $ UMBRELLA'LIAB OCCUR EACH OCCURRENCE $ EXC ESS LIAR CLAIMS.MADE AGGREGATE $ DED I 'RETENTION $ $ ' WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY Y!N STATUTE ER A ANY PROPRIErORIPARTNER/ ECUTIVE 0 N/A MC19880-02 10/2/2022 10/2/2023 EL EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) EL DISEASE-EACH EMPLOYEE $ 1,000,000 If yes,describe ender OEWRIPTICN OFF OPERATICNS below EL DISEASE-POUCY OMIT $ 1,000,000 DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) OUTPATIENT FORENSIC NURSING ,CERTIFICATE HOLDER CANCELLATION THE CITY OF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE HUNTINGTON BEACH THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 2000 MAIN ST AUTHORIZED REPRESENTATIVE Zi HUNTINGTON BEACH, CA 92648-2702 �s'r f ©1988-2015 ACORD CORPORATION.AII rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD