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Hoag Clinic dba Hoag Executive Health - 2025-05-05 (2)
SERVICE AGREEMENT BETWEEN THE CITY OF HUNTINGTON BEACH AND HOAG CLINIC dba HOAG EXECUTIVE HEALTH FOR ANNUAL MEDICAL AND WELLNESS EXAMINATION SERVICES THIS AGREEMENT ("Agreement") is made and entered into by and between the CITY OF HUNTINGTON BEACH a municipal corporation of the State of California,hereinafter called the "CITY", and the Hoag Clinic Inc., dba Hoag Executive Health. Hoag Executive Health is a California professional corporation which employs or contracts with licensed California physicians who practice internal medicine or family medicine in Orange County, California hereinafter referred to as "CONTRACTOR". WHEREAS,CITY desires to engage the services of a contractor to provide annual medical examinations,wellness evaluations and Pursuant to document on file in the office of the City Clerk, the provisions of the Huntington Beach Municipal Code, Chapter 3.02, relating to the procurement of service contacts have been complied with; and CONTRACTOR has been selected to perform these services, NOW,THEREFORE,it is agreed by CITY and CONTRACTOR as follows: F 1. SCOPE OF SERVICES CONTRACTOR 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." i CONTRACTOR hereby designates Justine Davis, VP Business Development who shall represent it and be its sole contact and agent in all consultations with CITY during the performance of this Agreement. • 25-16135/374113 1 2. CITY STAFF ASSISTANCE CITY shall assign a staff coordinator to work directly with CONTRACTOR in the 465 performance of this Agreement. ��S 3. TERM: TIME OF PERFORMANCE / Time is of the essence of this Agreement. The services of CONTRACTOR are to commence as soon as practicable after the execution of this Agreement by CITY (the "Commencement Date"). This Agreement shall automatically terminate three (3) years from the Commencement Date, unless extended or sooner terminated as provided therein. All tasks specified in Exhibit"A" shall be completed no later than three(3)years from the Commencement Date of this Agreement. 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 CONTRACTOR. In the event the Commencement Date precedes the Effective Date, CONTRACTOR shall be bound by all terms and conditions as provided herein. 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 a combined total of One Hundred Eight One Thousand Fifty Dollars ($181,050.00) per year. One Hundred Sixty-Six Thousand Fifty Dollars ($166.050.00 for Fire Department not to exceed amount per year) and$15,000 (Fifteen Thousand for Human Resources Department not to exceed amount per year. 25-16135/374113 2 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", CONTRACTOR will undertake such work only after receiving written authorization from CITY. Additional compensation for such extra work shall be allowed only if the prior written approval of CITY is obtained. 6. METHOD OF PAYMENT CONTRACTOR shall be paid pursuant to the terms of Exhibit"B". 7. DISPOSITION OF PLANS,ESTIMATES AND OTHER DOCUMENTS CONTRACTOR 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 CONTRACTOR 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 CONTRACTOR 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 CONTRACTOR's (or CONTRACTOR's subcontractors, if any) • negligent (or alleged negligent) performance of this Agreement or its failure to comply with any of its obligations contained in this Agreement by CONTRACTOR, its officers, agents or employees except such loss or damage which was caused by the sole negligence or willful misconduct of CITY. CONTRACTOR will conduct all defense at its sole cost and expense and 25-16135/374113 3 CITY shall approve selection of CONTRACTOR'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 CONTRACTOR. 9. WORKERS COMPENSATION INSURANCE CONTRACTOR shall carry workers compensation insurance as required by law for the protection of its employees during the progress of the work. Contractor understands that it is an independent contractor and not entitled to any worker's compensation benefits under any City program. 10. GENERAL LIABILITY INSURANCE CONTRACTOR shall obtain and furnish to CITY a comprehensive general liability insurance policy covering the work performed by it hereunder. This policy shall provide coverage for CONTRACTOR's general liability in an amount not less than One Million Dollars ($1,000,000.00)per occurrence and a separate"Additional Insured Endorsement" page listing both the policy number and naming the"City of Huntington Beach, its officers, elected or appointed officials, employees, agents and volunteers"as additional insured on the endorsement. 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 j.. of CITY. 11. CERTIFICATE OF INSURANCE Prior to commencing performance of the work hereunder, CONTRACTOR 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. state that the policy is currently in force;and 25-16135/374113 4 c. 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. CONTRACTOR 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 CONTRACTOR'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. CONTRACTOR shall pay, in a prompt and timely manner, the premiums on the insurance hereinabove required. 12. INDEPENDENT CONTRACTOR { CONTRACTOR 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.CONTRACTOR 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 CONTRACTOR 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. 13. TERMINATION OF AGREEMENT All work required hereunder shall be performed in a good and workmanlike manner. CITY may terminate CONTRACTOR's services hereunder with or without cause, and whether or not the PROJECT is fully complete. CITY may terminate this Agreement with or without cause by giving CONTRACTOR writtennotice("Notice of Termination"),which clearly expresses CITY's intent to terminate the Agreement.Notice of Termination shall become effective no less than thirty (30) calendar days after CONTRACTOR receives such notice. In the event of termination, all 25-16135/374113 5 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 CONTRACTOR. 14. ASSIGNMENT AND DELEGATION This Agreement is a personal service contract and the work hereunder shall not be assigned, delegated or subcontracted by CONTRACTOR to any other person of entity without the prior express-written consent of CITY. If an assignment, delegation or subcontract is approved, all approved assignees,delegates and subcontractors must satisfy the insurance requirements as set forth in this Agreement. 15. CITY EMPLOYEES AND OFFICIALS CONTRACTOR 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,certficates,or other communications hereunder shall be given either by personal delivery to CONTRACTOR'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 below. CITY and CONTRACTOR 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 U.S. certified mail-return receipt requested: 25-16135/374113 • 6 TO CITY: TO CONTRACTOR: City of Huntington Beach Hoag Clinic, dba Hoag Executive Health Attn: Fire Chief Attn: Justin Davis 2000,Main Street 500. Superior Avenue, Suite 200 Huntington Beach, CA 92648 Newport Beach,CA 92663 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 transactions 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 25-16135/374113 7 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 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 CONTRACTOR 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 CONTRACTOR 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. CONTRACTOR 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 CONTRACTOR.. 25-16135/374113 8 24. CONFIDENTIALITY CONTRACTOR recognizes that in the performance of its duties under this Agreement, it must conduct its activities in a manner designed to protect information of a sensitive nature from improper use or disclosure. CONTRACTOR warrants that it will use reasonable efforts consistent with practices customary in the facilities management industry in recruiting,training and supervising employees and in otherwise performing its duties hereunder in order to achieve this result. In the furtherance of this, CONTRACTOR agrees, at the request of the CITY,to require its employees to execute written undertakings to comply with the foregoing confidentiality provision. 25. 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, 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 nonprevailing party. 26. SURVIVAL Terms and conditions of this Agreement,which by their sense and context survive the expiration or termination of this Agreement, shall so survive. 27. GOVERNING LAW + This Agreement shall be governed and construed in accordance with the laws of the State of California. 28. SIGNATORIES j Each undersigned represents and warrants that its signature hereinbelow has the power, authority and right to bind their respective parties to each of the terms of this Agreement,and shall 25-16135/374113 9 indemnify CITY fully for any injuries or damages to CITY in the event that such authority or power is not, in fact,held by the signatory or is withdrawn. CONTRACTOR'S initials 29. 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 supersede all prior understandings and agreements whether oral or in writing between the parties respecting the subject matter hereof. 30. EFFECTIVE DATE' IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by and through their authorized officers. This Agreement shall be effective on the date of its approval by the City Council. This Agreement shall expire when terminated as provided herein. 25-16135/374113 10 (� CONTRACTOR CITY OF HUNTINGTON BEACH, a Hoag Clinic, dba Hoag Executive Health municipal corporation of the State of California By: 6-6e.re, Mayor Print name ITS: (circle one) Chairman/President/ rf�� Vice President City Clerk 5/5/2 AND By: INITIATED AND APPROVED: ITS: (circle one) Secretary/Chief Financial Officer/Asst. Secretary-Treasurer Fire Chie APPROVED AS TO FORM: Cry Attorney 1l•••' REVIEWED AND APPROVED: City Manager 25-16135/374113 1 1 hoag EXHIBIT A / ' ' Executive Health SCOPE OF WORK Scope of Services Hoag Executive Health is confident in our ability to seamlessly implement our proven,world-class physical exam programs in order to fully meet and exceed the Scope of Services for each of the three Medical & Wellness Exam Programs. We are uniquely positioned t) provide participants with access to our renowned clinical staff,while providing an unparalleled health, wellness and educational experience for all participants. Our approach to addressing the components of this program will be as follows: 1• State-of-the-Art Data Collection 2. Thorough and Complete Analysis& Reporting 3. Personalized Data Review and Actionable Plans for Health Improvement Data Collection A key component to the Medical &Wellness Exam Programs is based on what diseases, disorders and early detection tests will be performed. Hoag Executive Health will assess a wide range of distinct categories or systems, to identify and assess participants'disease risk, ability to effectively and safely perform a specific job role and/or to enhance performance and improve health in a number of categories —see below for a detailed list: Annual Firefighter, Police Officer,Safety and Lifeguard Recurring Exam Heart&Circulatory Kidney&Urogenital - Lipid Profile - Urinalysis - EKG/Treadmill Test - Cancer Screen PSA(men 50+) - Blood Oxygen - BUN,Creatinine Panel - CIMT Ultrasound Brain&Nervous Hormonal&Glandular - Reflexes&Sensations - Pre-Diabetes Markers - Hearing - Metabolic Panel - Vision - Metabolic Rate - Strength &Balance - Heavy Metals - Symmetry Lungs&Breathing Blood&Immunity - Pulmonary Function - Blood Composition - Maximal Oxygen Uptake - Immunity - Exercise Heart Rate Ranges - Anemia - X-Ray - Leukemia Muscular&Bone Stomach&Gastrointestinal - Musculoskeletal Assessment - Liver Function Panel - Strength Assessment - Gall Bladder Markers - Postural Screen - Micronutrients - Body Composition - Protein - Functional Mobility Diet and Nutrition Fitness&Exercise - Assess of Current Nutrition(food log) - WFI Assessment - Identifying Health Eating Barriers - Fitness Goals - Resting Metabolic Rate - Assessment of Limitations - Meal Planning - Exercise Prescription/Programming - Nutritional Education hoag .;� Executive Health In addition to the categories by which Hoag Executive Health will assess each Huntington Beach Medical & Wellness Exam participant, below we have outlined the individual components included in each exam. annual Recurring Huntington Beach Medical&Wellness Exam Program Questionnaires Fitness & Nutritional Evaluation Medical History&Health Risk Functional Movement Screen Behavioral Health(PHQ-9) Body Composition Analysis Fitness and Nutritional Assessment Skin Fold Assessment V02 Max(gas exchange) Blood Work Hand Grip Strength CBC Pushup Test MMR,Varicella, Hep B/C Titers Posture Assessment CMP Abdominal Strength hs-CRP Nutritional Assessment&Plan Lipids Fitness Assessment&Plan PSA(over 50) Heavy Metal Panel Urine Heavy Metals Optional Exam Evaluations o Lead CA DMV/DOT Exam if needed or requested o Mercury o Arsenic - Blood Heavy Metals iZeport o Lead Contents o RBC Cholinesterase - Bloodwork TB QuantiFERON - Clinical Data Tetanus Vaccine 10-yrs - Physical Exam Report - Recommendations&Actional Plan Clinical Evaluation - Report provided to participant at conclusion of exam Audiogram Vision Testing - Physicians'clearance statement Vitals PFT(Spirometry) EKG Comprehensive Physical Exam Neurological Exam Musculoskeletal Assessment Hernia Exam Skin Cancer Screen Clinical Breast Exam optional Prostate Exam optional DRE optional Chest x-ray(PA/Lat)) Ultrasound Exam hoag • Executive Health \ , Annual Executive/Management Exam Personalized Physical Components Heart&Circulation Brain&Nerves Blood&Immunity Advanced Lipid Panel Memory 1-esting Blood Composition Inflammation Markers Reflex&Sensations Omega 3-6-9 Distribution Blood Pressure Hearing Screen CBC Complete Blood Count Biometrics Vision Testing White Blood Cells and Differential Carotid Artery Assessment Strength&Balance Red Blood Cell Count and Characteristics Electrocardiogram Cranial Nerve Assessment Blood Composition Stress EKG Cognitive/Memory Testing Anemia Screen,Platelets,Globulin Levels Resting and Stress Echocardiogram Comprehensive Vision Testing Abdominal Aneurysm Screening Lungs&Breathing Hormones&Gland Muscle&Bone Pulmonary Function Thyroid Hormone Testing Movement&Pain Allergies Insulin Resistance Strength Testing Exercise Heart Rate Ranges Metabolic Panel Posture Screen Pulse Oximetry Metabolic Rate Body Composition Maximum Oxygen Consumption(V02 Max) Testosterone Testing Flexibility Assessment PA/Lat X-Ray Stomach&Gastrointestinal Kidney&Urogenital Joint Biometrics Liver Panel Urinalysis Gallbladder Cancer Screen Pap Smear(Women) Micronutrients Cancer Screen PSA(Men) Protein Panel Kidney Function Markers Iron stores Pelvic Exam(optional) Vitamin 89,B12, D Essential Fatty Acids with Omega 3-6-9 distribution hoag Executive Health Annual Lifeguard Skin Cancer Screening Hoag Executive Health developed a one-of-a-kind annual skin cancer screening solution that is actively in place for the Huntington Beach Lifeguard personnel. Below is an outline of the 2 specific solutions for screening and clinical escalation aimed at providing HB Lifeguards with a comprehensive skin cancer screening program. Screening Annual screenings are delivered in the Hoag Corporate Health suite, located at 500 Superior Ave, Suite 200, Newport Beach CA. Hoag Corporate Health provides HBFD with a schedule of 15-min screening slots for each skin cancer screening. Screening details: - Each skin cancer screening will be performed by a board-certified physician - Physicians will utilize a hand-held magnification tool called a dermatoscope to assess any skin lesions - Participants will be asked to remove all makeup, bandages and jewelry Physician Oversight& Review In the event a mole or lesion appears to be cancerous or pre-cancerous, Hoag Executive Health has the ability to send digital images immediately to our program dermatologist Dr.Steven Wang for review. This process eliminates the need to schedule a follow-up dermatology appointment as Dr. Wang is able to review the \ o potential cancer and provide direction as to whether it is benign or if additional in- ► office follow-up or biopsy is recommended. The use of the Hoag Derm-On-Demand capability allows for the most efficient and cost-effective initial specialist referral moil solution. ' hoag (.7„) Executive Health Data Analysis& Presentation Hoag Executive Health sees the interpretation of the complex data and assessments gathered during the Annual Medical &Wellness Exams and Pre-placement exams as one of the key aspects effectively conducting these specialty exams. Ensuring that the results and more importantly, any actionable recommendations is easy for participants to understand and follow will only increase the effectiveness of the data and information that is gathered. Hoag Executive Health physicians have over 65 years of combined executive physical experience amongst them—coupling this with the knowledge of our coaches and exercise physiologists translates into invaluable expertise in creating and presenting realistic health goals, exercise,fitness and nutritional plans for Huntington Beach personnel. Our proposed approach to the Annual Medical & Wellness Exams and Pre-placement exams will utilize a proprietary set of risk calculations that will enable participants and the City to have a clear,tangible understanding of their current health state when compared to a mean of people in their age and activity group and to identify any potential limitations to completing the tasks required for success in the stated roles. Data Review The experience that Hoag Executive Health has, delivering these exact Scope of Services to almost a dozen different agencies throughout Southern California for almost 10 years,allows us to glean from our experiences and best practices developed through delivering thousands of specialty exams. Additionally, it is important to understand that our physicians specialize in this type of clinical delivery—solely practicing preventative, risk identification and Occupational health services...this is what we do. For all of the Wellness exams, each Huntington Beach participant will have dedicated in-person time set aside immediately following the completion of their fitness assessment to review the entirety of their physical report—this will be done with the same exercise physiologist who performed their fitness and nutritional assessment. During this 20-minute follow-up, participants will personally review their physical report, lab work and other assessments. The results and recommendations entailed in each personalized physical report are created in such a way that they are actionable and easy to implement. Our physiologists will answer questions, give further suggestions and provide real-world examples of how to implement the fully customized health plan that was created for the participant. In addition,we will make it easy to share the report and data with each participant's primary care physician by providing a hardcopy of all reports, labs and diagnostics for personal review. Our clinical and lifestyle recommendations focus on behavioral changes and when necessary therapeutic interventions which can be easily enacted by the participants' primary physician. Hoag Executive Health understands that participation in the Annual Medical &Wellness Exam program is only the start to positively impacting the health and well-being of participating firefighters—it is with this in mind that we have created our reporting and follow-up procedures aimed at ensuring positive change is simple to implement. hoag Executive Health t :: 1i Lab Process As it relates to the lab services process for Annual Medical &Wellness Exam participants, Hoag Executive Health is proposing that we utilize a long-standing 3rd party lab partner, LabCorp, to perform the lab panel blood draws. Understanding that there will be significant eligible personnel and that these participants may not all live in Orange County boundaries,we feel as though the most convenient and reliable solution will be to utilize LabCorp and their significant network of draw locations throughout Southern California. The process will be initiated once a participant is scheduled for his/her exam 30 days in advance, at that time they will be entered into the Hoag Executive Health EMR system and an electronic lab requisition will be created and sent to LabCorp.The participant will then simply need to log onto the LabCorp website from a computer, phone or iPad and locate the closest and most convenient LabCorp location to either his/her worksite or home. In addition, Hoag Executive Health will email each participant with a copy of the lab requisition (just in case) as well as a website link that lists all Orange County LabCorp draw sites and instructions for the fasting blood draw. Participants will be asked to ensure they have completed their blood draw within 2-weeks of their scheduled exam to ensure results are obtained prior to their physical. Results are then electronically sent to Hoag Executive Health typically within 3-5 business days from the blood draw. Below is the link and an image of the LabCorp "Find a Location"website along with the contact information for our LabCorp representative—Hoag Executive Health has used LabCorp since our inception 8 years ago and they continue to provide excellent service and reliability : l•aCorp �l0 Account lo9ln .rn.,. Q t.'te ., + • IAdvan•.ed S•.<n Find your nearest lab location and schedule an appointment using the search below. Mat t°Expect test Preparation Appointments must be made at least two bouts m advance.Appointments are not iegutted.and watt-ens are alsowekome. Mom not.not all lab locations offer all seroices. Appointment FARs Schedule a Pah°nly Test< AlMlly Appolntmeni e City --Select State-- • OR ZIP Code i Cancel Appointment,. Insurance Lists A wSesvke • 25 miles • Rate Your Visit https://www.labcorp.comllabs-and-appointments hoag : l Executive Health 'i Sample Exam Schedule for Huntington Beach Medical &Wellness Exams Hoag Executive Health has proposed two schedule blocks for the Huntington Beach Medical &Wellness Exam Program, a morning and afternoon block. Each block consists of 4 exam "slots"those are as follows: Morning Afternoon 9:00am—12:30pm 1:00pm—4:30pm Hoag Executive Health will offer both AM slots and PM slots in our Newport Beach facility—below is a sample exam schedule. Annual Medical and Wellness Exam Time Activity Staff Member 9:00 AM Check In Care Coordinator 9:15 AM Chest X-Ray Care Coordinator Ultrasound Exam 9:45 AM Nurse Testing Body Composition Analysis [RCA] Urine Sample Temperature Medical Assistant Blood Pressure Spirometry EKG Hearing Vision(litmus/Color Vision) CIMT Pulse OX 10:15 AM Physical Comprehensive Physical Exam Review blood work Fitness for Duty Eval OccMed Consult Physician Skin Evaluation Head to Toe Exam Musculoskeletal Exam Hernia Exam[male] Neurological Exam Cancer Screening Immunization Screening 11:00 AM Fitness&Nutrition Evaluation Functional Movement Screen Exercise Physiologist Pushup Test Abdominal Strength Posture Screen Vol Max Test Hand Grip Strength Stress EKG risk stratified 12:00 PM Report Review Exercise Physiologist hoaq hoag ( ,'\ Executive Health "mew Huntington Beach Medical &Wellness Exam Experience Below is a step by step overview of the exam process for Huntington Beach First Responder Personnel 1. Hoag Program Manager works with FD/PD/Marine Safety designee to establish an exam calendar—days of the week and dates that work best for that agency and personnel. a. Hoag Program Manager will create a SharePoint calendar with designated exam dates/times and slots b. FD/PD/Marine Safety designee will populate the exam calendar with participants in either 2,3 or 4 personnel"crews" 2. Each agency will provide a participant list with names, DOB,email address and phone number of eligible exam participants. 3. Participant's will begin the"exam prep" process 4 weeks prior to their assigned exam date 4. Hoag Program Manager will register each participant into Hoag Executive Health's electronic medical record system a. An email will be sent to the participant containing: 1. Medical history and fitness assessment questionnaires 2. Hard copy of the LabCorp lab requisition, lab draw instructions and a link to all LabCorp locations 5. Participant will complete their lab draw and applicable pre-exam questionnaires no less than 1-week prior to his/her annual exam. 6. 3-5 days prior to the scheduled exam date, participants will receive a confirmation email and phone call from the Hoag Program Manager confirming attendance on the scheduled exam date 7. Upon arrival in the office—participants will be checked in and a Hoag support staff member will walk participants to the imaging center to receive their baseline chest x-ray 8. Following completion of the chest x-ray,our staff member will walk the participant back to our office to begin the physical exam 9. The participant will first meet with our clinical support staff to capture all biometric/vital sign data 10. Diagnostic ultrasounds will be performed next,this portion of the exam will take approx..15 minutes 11. Next,the participant will meet with the physician to review all pre-exam questionnaires and conduct a thorough medical health history.Additionally,at this time the fitness for duty evaluation and occupational medicine consultation will be performed 12. Following the physicians consultation,the complete physical examination will be performed 13. Following the completion of the physical exam, participants will transition to a private exercise lab with our exercise physiologist for the fitness and nutritional evaluation—this portion of the exam will take approximately 45 minutes 14. Following the fitness and nutritional assessment,the exercise physiologist will excuse him/herself to retrieve the completed physical exam report in-hand to be reviewed with the participant 15. If there were any medically necessary referrals,our physician would coordinate these with the participant following the report review and prior to their departure. In total,the entire exam process should take no more than 3-3.5 hours for a "crew"of 4 participants or 1.5hrs for an individual participant. hoaa � _.r.�, ... Executi ,,�, . I Exam Scheduling Hoag Executive Health proposes working with the City of Huntington Beach to establish a mutually agreed upon schedule for Annual Medical&Wellness Exams.Once established we have the ability to flex exam delivery to accommodate a wide range of participants,with the understanding that we can administer as many as 24 exams per week while providing both AM and PM exam slots.Our delivery schedule would for an entire 4-member crew to be done and back"on-duty" in approximately 3 hours. Furthermore, no participant will have any more than 30- minutes of down time during the entire exam process. During down time,participants will have a private lounge to wait in that is equipped with a computer,WiFi,television and comfortable amenities.This is an almost identical schedule format to what we put together for the Orange County Fire Authority WEFIT program and we are confident that the logistical plan we've outlined will be time efficient while also allowing more than sufficient time to conduct a meaningful and thorough exam. Hoag Executive Health is proposing that all initial scheduling of Annual Medical&Wellness Exams be done utilizing our secure online SharePoint scheduling system. Hoag Executive Health will create a shared online calendar where the FD/PD/Marine Safety"designee/coordinator"will be able to schedule exams as far as 1 year out and can schedule participants into designated AM or PM time slots at our Newport Beach Hoag Executive Health delivery location.When scheduling a crew or individual participants,each participants name, DOB,email address and phone number will need to be provided in order to secure the slot(s).Once the appointment has been scheduled,an email notification will be sent to the Hoag Executive Health Program Manager to complete the scheduling process, create the applicable lab requisitions and send a hard copy lab req and LabCorp location information to the individual unit participants.Once the participant is scheduled, he/she will receive an email confirming the appointment,as well as a confirmation phone call 3-5 days prior to the exam date. With regards to timing of blood results,our hope would be that all Annual Medical&Wellness Exam participants have their blood draw completed 2-weeks prior to their exam date,this will allow for 3-5 business days for blood processing and we will then review and report results at the conclusion of the physical exam. Ideally,we would like to have crews scheduled no later than 30-45 days prior to an exam date. Based on Hoag Executive Health's experience working with firefighters, police and other emergency responders,we understand that on some occasion's emergency situations will prevent participants from attending a scheduled exam. Likewise,these same circumstances may lead to the need for participants to reschedule their exam on some occasions—we are fully prepared to accommodate these situations and propose the following straight forward protocols. No-Show/Late Cancel (Unexcused) In these instances,we will allow the participant to reschedule his/her Medical&Wellness physical exam preferably within 60-days of the original exam date and we will bill the City of HB for 50%the cost of that designated exam. Late cancel would be considered as any cancelation with less than a 48-hour notice. No-Show/ Emergency Activities(Excused) In these instances,we will allow the participant to reschedule his/her Medical&Wellness physical exam preferably within 60-days of the original exam date and we WILL NOT BILL for the cost of the exam. No-Show/Other(Excused) In these instances,we will allow the participant to reschedule his/her Medical&Wellness physical exam preferably within 60-days of the original exam date and we WILL NOT BILL for the cost of the exam. EXHIBIT B PRICING TABLE Firefighter(NFPA 1582 Compliant),Police Officer,and Lifeguard Cost Recurring Medical Exam Complete medical and health history by a physician(including immunization history) Review of job description Physical exam including: • Vital signs: temperature. BP. pulse.respiration. height.weight, pain scale • Skin. HEENT.Thyroid. lymph nodes. lungs.heart.abdomen. extremities.ranee of motion(back and extremities). grip testing.neuro exam of major cranial peripheral nerves,motor and sensory systems. and reflexes • Hernia exam(umbilical ingui nal) • Physician's medical clearance statement and comments: including clearance for respirator use Resting 12-lead ECG 25-16135/374113 19 of 22 Exercise 12-lead EC'G(treadmill test) Audiogrant Vision testing: Titnnus&Farnsworth Spuometry C'BC with differential CMP Lipid Panel UA(microscopic analysis) Tuberculosis screening Interferon blood test Tetanus Diptheria Vaccine(booster every ten years) Heavy Metal and Specific Exposure Screening An exposure lustory will be obtained and reviewed to assess potential exposures to heavy metals,pesticides. and other potential hazards. Biological specimens(blood or tunnel may be obtained as indicated to evaluate exposures • Urine: Arsenic. mercury. and lead. Baseline for HBFD Hazardous Materials Response Team(HazMat) • Blood. Lead. RBC'cholinesterase. Baseline for HBFD HazMat Team Cancer Screening elements(optional for the employee) • Clinical breast exam • Skin exam • Prostate exam • Digital rectal exam • Mattmrogram For males -40 years of age: PSA X-Ray.Chest(PA&Lateral) Ultrasound Exam Complete abdominal. cardiac scarring_ complete neck ultrasound(including thyroid) Fitness for duty evaluation(per NFPA 1582 for firefighters) • Complete medical. occupational and relevant nt history review by a physician,physical exam,recommendations by exammung physician for additional diagnostic studies or consultations.physician's completion of"Employer Exam Report-winch indicates work status. Occupational Medicine Consultation • Address specific concerns regarding occupational medicine policies or programs. admu ustrattve projects that involve employee health issues. and other matters related to employee health well-being. (Optional-by request)DOT DMV Exam for DOT Medical Examiners Certification: • Exam • Vision • Labs:UA(If different than above) TOTAL EXAM COST: Standard-S1,250 Ha ifat-51,450 25-16135/374113 20 of 22 Lifeguard Annual Screening Cost Skui Cancer Screening S 75 ExecutivelManagement Exam(Class IV) Cost Complete medical and health history by a physician Complete physical examination by physician Spirometry Visual Screening Test Bilateral Comprehensive Metabolic Panel Lipid Panel C-Reactive Protein CBC wrDrff&Platelet Urinalysis w/o scope Audiogram(Pure Tone)Air Chest X-Ray,2 view Glucose in office fasting EKG Complete with Leads<40 and over Treadmill w/Interpretation'over 40 Tonometry(Glaucoma)for patients 35 and over _ __ Stool Test for Blood RPR Pap Smear for Females Consultation with Physician Written Reports of Findings TOTAL EXAM COST: S1,150 Annual Medical&'Wellness Exam For Safety Personnel Cost Medical History&Health Risk Behavioral Health(PHQ-9) Fitness and Nutritional Assessment DOT 5 Panel Drug Screen CBC MMR,Varicella,Hep B%C Titers CMP hs-CRP Lipids PSA(over 50) Heavy Metal Panel • Urine Heavy Metals Lead c Mercury o Arsenic • Blood Heavy Metals o Lead o RBC Cholinesterase 25-16135/374113 21 of 22 TB Screening Tetanus Vaccine Audiogl aan Vision Testing Vitals PFT(Spuometry) EKG Comprehensive Physical Exam Neurological Exam Muscudoskeletal Assessment Henna Exam Skin Cancer Screen C'luucal Breast Exam(optional) Prostate Exam(optional) DRE(optional) Manunogram(optional) Chest x-ray Ultrasound Exam Functional Movement Screen Body Composition Analysis Slum Fold Assessment VO2 Max(gas exchange) Hand Grip Strength Pushup Test Posture Assessment Abdominal Strength Nutritional Assessment& Plan Fitness Assessment&Plan CA DEN DOT Exam(optional) Report should include the following: • Bloodwork • Clinical Data • Physical Exam Report • Recommendations&Actional Plan • Report provided to participant at conclusion of exam • Physicians clearance statement TOTAL.EXAM COST: S1,250 25-16135/374113 22 of 22 ✓c� I DATE(MMIODNYYY) AMR/J) CERTIFICATE OF LIABILITY INSURANCE 8/13/2024 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(ies)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). PRODUCt R CONTACT Jenny Norbeck PHONE FAX NAMc: Alliant Insurance Services,Inc. (AIC,No,ExI): (949)527.9825 tAlc,No: 18100 Von Korman Avenue E-MAIL Ienny.norbeck@alllant.com 101h Floor ADDRESS: Irvine,CA 92612 INSURER(S)AFFORDING COVERAGE NAIC B INSURER A: Hoag Memorial Hospital Self-Insured Program INSURED INSURER B: BETA Risk Management Authority Hoag Memorial Hospital Presbyterian INSURER C: 1 Hoag Drive Newport Beach,CA 92863 _wsuaERo: 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 SH OWN MAY HAVEBEENREDUCED BY PAID CLAIMS. INSRI ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MMIDDIYYYY) (MMIDOIYYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $ 2,000,000 A X PROFESSIONAL LIABILITY Hoag Memorial Hospital HIED EXP(Any one person) $ 2,000,000 X CLAIMS-MADE X Self-Insured Program 07/01/2024 07/1/2025 PERSONAL tL ADV INJURY $ 2,000,000 Retro Date: 10/01/1986 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 2,000,000 POLICY I I JE 4 Li LOG PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: C J $ AUTOMOBILE LIABILITY accident) (Ea aoudenl) $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE ONLY AUTOS (Per accident) UMBRELLA LIAR OCCUR EACH OCCURRENCE $ 5,000,000 XHCL-24-1394 07/01/2024 07/1/2025 $ 5,000,000 B x EXCESS LIAB x CLAIMS-MADE X AGGREGATE DED 1X LRETENTIONS2M -WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN ISTATUTE ER ANY PROPRIETORIPARTNER,EXECUTIVE OFFICER/MEMBER EXCLUDED NIA E.L.EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE•POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more spaCerTstiVrET AS 10 I.014M Evidence of Professional and General Liability Insurance for Hoag Memorial Hospital Ety: MICHAEL E. GATES CITY ATTORNEY CANCELLATION CITY OF HUNTINGTON BEACH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Huntington Beach ACCORDANCE WITH THE POLICY PROVISIONS. 2000 Main Street Huntington Beach, CA 92648 AUTHORIZED REPRESENTATIVE 2/ ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD �CORv® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 09/25/2024 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 poiicy(Ies)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 CONTACT Kelly Grunerud or Brandon Ferguson • Brown&Brown Insurance Services,Inc Imo Nl�o,Ewa: (909)243.8200 I FAX. No): 3633 Inland Empire Blvd, ADDRESS: Brandon.Ferguson Qbbrown.com Suite 890 I INSURER(S)AFFORDING COVERAGE ) NAIC 9 Ontario CA 91764 INSURER A: National Union Fire Insurance Company of Pittsburgh,P 19445 INSURED INSURER B: Hoag Memorial Hospital Presbyterian INSURER C One Hoag Drive INSURER D: PO Box 6100 INSURER : Newport Beach CA 92658 INSURER F COVERAGES CERTIFICATE NUMBER: 23-24 AUTO Only 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 1S SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE Anurs Neel POLICY EFF POLICY EXP LIMITS - INSD woo POLICY NUMBER IMWDD/YYYY) IMMMODIYYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE n OCCUR PREMISES(Ea occurrence) S MED EXP(My one person) $ PERSONAL&ADV INJURY $ GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S POLICY❑�ECT n LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY _ COMBINED SINGLE UNIT $ 1,000,000 (Ea accident)X ANY AUTO BODILY INJURY(Per person) $ a � AWNED — SCHEDULED y CA5630125 03/02/2023 03/02/2024 BODILY INJURY(Per accident) S AUTOS ONLY ..T AUTOS HIRED NON-OWNED PROPERTYD)A IAGE $ AUTOS ONLY _ AUTOS ONLY • (Peraaidenf . . . . S UMBRELLA NAB OCCUR EACH OCCURRENCE $ -� EXCESS LIAB CLAIMS-MADE • AGGREGATE S DED I RETENTION$ $ WORKERS COMPENSATION I FE STATUTE I I ERH AND EMPLOYERS'LIABILITY Y/N • ANY PROPRIETORIPARTNERIEXECUTIVE n NIA EL EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? • (Mandatory In NH) EL DISEASE-EA EMPLOYEE. $ if yes.describe under DESCRIPTION OF OPERATIONS below E.LDISEASE-POLICYLIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule.may be attached If more space Is required) City of Huntington Beach,Its officers,elected or appointed officials,employees,agents and volunteers are additional Insured as respects automobile liability policy where required by written contract,subject to the policy terms and conditions. CERTIFICATE HOLDER. CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Huntington Beach ' ACCORDANCE WITH THE POLICY PROVISIONS. 2000 Main Street AUTHORIZED REPRESENTATIVE Huntington Beach CA 92648 1988 2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD 1 7 ® DATE(MMfODIYYYY) AR o CERTIFICATE OF LIABILITY INSURANCE 09/10/2024 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 CONTACT Leidy Rivera • NAME: The Liberty Company Insurance Brokers PHONE (688)918-3960 I{Arc,No): orc,No.Ext1: LIcU0D79653 "AILADDRESS: leidy.rivera@Iibertycompany.com 5955 De Soto Ave,Ste 250 INSURER(S)AFFORDING COVERAGE NAIGK Woodland Hills CA 91367 INSURER A; Safety National Casualty Corp 16105 INSURED INSURER B: Hoag Memorial Hospital Presbyterian INSURER C: . One Hoag Drive INSURER D: INSURERS: Newport Beach CA 92663 INSURERF: COVERAGES CERTIFICATE NUMBER: 24-25 Workers Comp(CA) 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. 1LTR TYPE OF INSURANCE N UI SD VD� POLICY NUMBER POLICY EFF POLICY EXP (MMIDDlVYYY) (MMATDIYYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S ICLAIMS MADE n OCCUR • • DAMAGE TO RNTE PREMISES(Ea oaure nce) $ ......] MED EXP(Any one person) S. PERSONAL b ADV INJURY . . S • GEM AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ . . POLICY 0 jEpT n LOC PRODUCTS-COMP/OP AGG S OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ _ (Ea accident) ANYAUTO BODILY INJURY(Per person) S — OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTYDAI AGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) ., $ UMBRELLAUAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ QED I I RETENTION$ SIR S 1,000,000 WORKERS COMPENSATION xI S ATUTE I I RA' AND EMPLOYERS'LIABILITY A ANYPROPRIETORIPARTNERIEXECUTNE Ya N!A Y SP4067257 09/0112024 09/0112025 E.L.EACH ACCIDENT s 1,000,000 A OFFICE ry In EXCLUDED? 1,DOO,000 (Mandatory n N NH) - E.L.DISEASE-EA EMPLOYEE $ If Yes,describe under t,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) RE:Medical Wellness Blood Cancer&Ultrasound Screening Whereby required by written contract or agreement,Waiver of Subrogation applies to the workers compensation policy in favor of the certificate holder. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED 1N City of Huntington Beach ACCORDANCE WITH THE POLICY PROVISIONS. Alin Fire Chief • AUTHORIZED REPRESENTATIVE ' _ 2000 Main Street Huntington Beach CA 92648 k1t...IMP--� I C. 0.1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2018103) The ACORD name and logo are registered marks of ACORD, August 13, 2024 Hoag Memorial Hospital Presbyterian 1 Hoag Drive Newport Beach, CA 92663 Re: Hoag Memorial Hospital Presbyterian Professional and Commercial General Liability Insurance Term: July 1, 2024 to July 1, 2025 TO WHOM IT MAY CONCERN: This is to confirm that Hoag Memorial Hospital Presbyterian maintains through BETA Risk Management Authority, excess Professional and General Liability Insurance Coverage. Professional Liability: The Hospital is self-insured for $2 Million with respects to its Hospital Professional, including Hospital General Liability Insurance Coverage. General Liability: The Hospital is self-insured for $2 Million with respects to its General Liability Insurance Coverage for non-hospital operations and exposures. Hoag Memorial Hospital Presbyterian, as a self-insured entity for its Hospital Professional and General Liability exposures can elect to extend Additional Insured coverage to third parties by agreement, up to $2 Million limit. City of Huntington Beach is hereby named Additional Insured as respects General Liability; Waiver of Subrogation and Primary Non-Contributory apply to General Liability. For those Hospital Professional and Hospital General Liability agreements requiring higher than $2 Million, underwriting approval will be necessary. Please contact our office if you have any questions. Sincerely, Via.. / /6 x7I � David Harper SVP, Alliant HealthCare Alliant Insurance Services,Inc.• 18100 Von Karmen Avenue, 10,h Floor.Irvine,CA 92612 ruuvc(949)756-0271 •www.alliantinsw:ance.com BETA Risk Management Authority("BE AltMA") A Public Entity AMENDMENT BLANKET SUPPLEMENTAL MEMBER GENERAL LIABILITY FOR NAMED MEMBER'S CONTRACTS Certificate Number: Amendment No: XHCL-24-I394 X507-0I Issued to: Hoag Memorial I lospital Presbyterian Effective Date:07/01/2024 at 12:01 a.m. Expiration Date:07/01/2025 at 12:01 a.m. Additional Contribution: Per Contract It is understood and agreed that coverage afforded by Section 3 (Excess Bodily Injury and Property Damage Liability)and Section 4(Excess Personal Injury,Advertising Injury and Discrimination Liability)of this Contract is extended to any person or organization for whom the Member or Subsidiary is required by a written agreement to obtain and maintain insurance or other coverage as a Supplemental Member pursuant to Section 7.2,but only for legal liability arising out of the acts,errors or omissions of the Named Member or a Subsidiary solely in the performance of the written agreement between the Named Member or Subsidiary and the Supplemental Member. This Amendment does not extend coverage for the acts,errors or omissions of the Supplemental Member, third parties or their agents or employees. in addition,where required by such written agreement or contract,the coverage extended by this Amendment shall be primary and non-contributory as respects any other insurance policy issued to such Supplemental Member. Otherwise,Section 7.14. APPLICABILITY OF INSURANCE OR OILIER COVERAGE A MEMBER MAY ALSO HAVE,applies.This coverage applies only to the extent of the limits of liability required by such agreement or contract,not to exceed the Limits of Liability in this Contract. ALL OTHER TERMS,CONDITIONS AND EXCLUSIONS REMAIN UNCHANGED. .AgStitt 1)-• Authorized Representative of BETARMA XLICL-X507(07/21) Page I of l Date Issued:July I,2024(Initial) • •BETA Risk Management Authority("BETARMA") A Public Entity AMENDMENT LIMITED BLANKET WAIVER OF SUBROGATION PRIOR TO LOSS Certificate Number:;.,. Amendment No: UiCL-24-1394 • X892-01 Issued to:Hoag Memorial Hospital Presbyterian • Effective Date:07/01/2024 at 12:01 a.m. Expiration Date:07/0'1/2025 at 12;01 a.m. Additional Contribution;Per Contract It is understood and agreed that Section 7.13--Transfer of Rights of Recovery Against Others to BETAIRMA-- does not apply to any Lessors of equipment or premises under Section 3(Excess Bodily Injury and Property Damage Liability)with whom the Named Member or a Subsidiary agreed under a written contract prior to the loss to waive its right to subrogation against the person(s)or organization(s). ALL OTHER TERMS,CONDITIONS AND EXCLUSIONS REMAIN UNCHANGED. iitheic Authorized Representative of BETARMA • • • • XHCL-X892(05/23) Page I oft Date Issued:July 1.2024(Initial) ENDORSEMENT This endorsement, effective 12:01 A.M. 03/02/2024 forms a part of Policy No. 563-01-25 issued to HOAG MEMORIAL HOSPITAL PRESBYTERIAN by NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA. ADDITIONAL INSURED - WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM SCHEDULE ADDITIONAL INSURED: ANY PERSON OR ORGANIZATION FOR WHOM YOU ARE CONTRACTUALLY BOUND TO PROVIDE ADDITIONAL INSURED STATUS BUT ONLY TO THE EXTENT OF SUCH PERSON'S OR ORGANIZATION'S LIABILITY ARISING OUT OF THE USE OF ACOVERED "AUTO". I. SECTION II -LIABILITY COVERAGE,A. Coverage, 1. -Who Is Insured, is amended to add: d. Any person or organization, shown in the schedule above, to whom you become obligated to include as an additional insured under this policy, as a result of any contract or agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy, but only with respect to liability arising out of use of a covered "auto". However,the insurance provided will not exceed the lesser of: (1) The coverage and/or limits of this policy, or (2) The coverage and/or limits required by said contract or agreement. Authorized Representative or Countersignature On States Where Applicable) 87950 (10/05)Includes copyrighted material of Insurance Services Office,Inc.with its permission. Page 1 of 1 41_ , ACRE) CERTIFICATE OF LIABILITY INSURANCE DATE(I�t IAIDD/YYYY) 03/03/2025 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(ies)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 CONTACT Kelly Grunerud or Chao Lee NAIdE: Brown 8 Brown Insurance Services,Inc. PHO NE (612)(612)333-3323 FAX No): 901 Marquette Ave E-MAIL Chao.Lee@bbrown.com ADDRESS: Suite 1800 INSURER(S)AFFORDING COVERAGE NAIC Minneapolis MN 55402 INSURER A: Philadelphia Indemnity Insurance Company 18058 INSURED INSURER B: Hoag Memorial Hospital Presbyterian INSURER C: One Hoag Drive INSURER 0: PO Box 6100 INSURER E: Newport Beach CA 92658 INSURER F: COVERAGES CERTIFICATE NUMBER: 25-26 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. INSR AODL SUBR' POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MMIDD/YYYY) (MM/DDIYYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S DAMAGE TO REN LED CLAIMS-MADE OCCUR PREMISES(Ea occurrence) S MED EXP(Any one person) S PERSONAL 3ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S POLICY JEa f LOC PRODUCTS-COMP/OP AGG 5 OTHER: S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) S A X OWNED -SCHEDULED Y PHPK2707244-000 03/02/2025 03/02/2026 BODILY INJURY(Per accident) S AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE X AUTOS ONLY _AUTOS ONLY (Per accident) S •UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE S DED RETENTION S S WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE NIA E.L.EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S II yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORO tot,Additional Remarks Schedule,may be attached if more space is required) }� City of Huntington Beach,its officers,elected or appointed officials,employees,agents and volunteers aar It V red argstf�cts automobile liability policy where required by written contract,subject to the policy terms and conditions. APPROVED P. C./ �1R�'ll'25�t�11.�12 MICHAEL J.VIGLIOTTA CITY ATTORNEY CITY OF HLIN"CENGTON BEACH RISK Mgt CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Huntington Beach ACCORDANCE WITH THE POLICY PROVISIONS. 2000 Main Street AUTHORIZED REPRESENTATIVE Huntington Beach CA 92648 • ©1988-2015 ACORD CORPORATION, All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 00��v TiaicT0= CITY OF _ - HUNTINGTON BEACH FcOUNTY��e\/,P Lisa Lane Barnes I City Clerk May 5, 2025 Hoag Clinic dba Hoag Executive Health Attn: Justin Davis 500 Superior Ave., Suite 200 Newport Beach, CA 93314 Dear Mr. Davis: Attached for your records is a duplicate original Service Agreement between the City of Huntington Beach and Hoag Clinic dba Hoag Executive Health for Annual Medical and Wellness Examination Services. Sincerely, Lisa Lane Barnes City.Clerk LLB:ds Enclosure Office: (714)536—5405 I 2000 Main Street, Huntington Beach, CA 92648 I www.huntingtonbeachca.gov