HomeMy WebLinkAbout0487.093~ 'I i
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September 23, 1993
THE HONORABLE CITY COUNCIL
Palo Allo, California
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Worker's Compensation Clab", Admjnistrgtjoo Sgykt . Award or Contract
Members of the Council;
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!be City of Palo Nlo conttacts for worker's compensation ctJirns adrf1inist:ration services. This
report recommetds BP!'I'Oval of a new contract witll Athens Administrators. effective
November 1, 1993. This agreement is for a one-year term. with options to renew fOI an
additional two years. for • lOW tern not 10 e<eeed thcee years.
Since April 18, 1986. the City bas contracled wilh G=nfIeld-Tbompscn Associ.,es for worker's
compensation claims adrninislralion. In May of 1992, Foundation Health Corporalion acquired
GreenfIeld-ThompsOn A.5sociales (GTA) and Associaled Claims Management, Inc.(ACMI}. The
combined companies comprise one of the largest worker's compensation admlnistratcm: in
California, operating and.r Ihe name of AssociaJed Claims Management Inc. As. result of this
merger, ACMI and GrA combiDed operations under Ihe :wne of ACMI, as our current
administrator.
'The service levels experienced by the Cjry with GTA have diminished since the m:rgcr with
ACMI. Fre.quent attempts to resolve customer .service issues wirh ACMI have not been
successful. This has been iargely due to ACMI's increased client base and the large strucwre
of their organization.. We simply have not been able 10 gel the cost effective and personalized
service we once received.
Proposals were solicited in June 1993 from seven companies to provide this service. Six fonnal
proposals: were receiVed. All of the proposals were reviewed, and three firms meeting lhe City~s
criteria were interviewed: ACMl. Innovative Care Systems and Athens Adminiso-arors. Their
annual quoted service fees fDr were as follows:
CMR:487:93
Associated Claims Management Inc (ACMI)
Innovative Care Systems (IeS)
Athens Administrators
$120,000
$111,000
$105,000
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Site visits mo1 clien:: references W~ ~!~') :.on;;!"i.:LcU wirh L."UlovaUve Care Systems and Athens
!-u!(jilt~i;;trators, Athens Administ.rators ~"UrrentIy services other public entities, has an excellent
reputation for customer Sl..TVice in the industry and also had the lowest submitted fees for their
services. Based on this process, Athens Administrators. was seletred to pro'Wide claims
administration servi<=.
Appl"O\'3.I of the attached agrecmeu[ is not a. project (or purposes of the California Environmental
Qu.aIDy Act. Therefore, no environmental assessment is necessary.
BrgrnmendatJon:
Staff recornmeo:ls that Council: 1) Approve and authoriu !he City Manager to execute the
attached contract with Athens Administrators for daiJru. administration services, and 2) authorize
the Manager to renew the ccntratt for up [0 two addirional years and [0 execute any documents
necessary In eff<ct II>ose renewals,
RiBlI Manager :h cl2 ______ t. ____
J';;yc. ROUNDS
Director, Human Resources
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Assistant City 'Manager
CMR487:93
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B&lW&&d THE CITY OF PALO ALTO
AND ATHJD:S AI:KINISnATOl<S
FOR IfOUUS' C(lIOBllSATION ADJU>n:9'fAArION SRRVlCES
THIS AGREEMENT is made and eni:".ered into this ___ day of
=---==..."-'-:,.,,.,'-====0-' 1993. by and between the CITY OF PALO ALTO,
a municipal corporation of California, hel:einafter referred to as
"CITY,· and ATHENS ADMINISTRATORS (Taxpayer Identification Number
). a wholly-owned subsidiary of J~~es c.
Jenkins Insurance Services, Inc_ • with offices at 2552 Stanwell
Driv-e, Concord, CA 94522, hereinafter reflS'rred to as "CONTRA.CI'OR";
WIT NESS ~,
WHEREAS, CITY desires to contract for certain worke~5'
compensation administrative services; and
WHEREAS ~ CITY desires to engage CONTRACTOR to provide
these services by reason of its qualificati~ns and experience for
perfonr.ing sl.lch 8ervices~ and. CONTRACTOR has offered to provide the
r~~ired services on the terms and in the manner 9~t forth herein;
NO~i'j THERBFORE, io consideration of r:heir mutual
covenants. the parties hereto agree as follows:
~CTION 1 -DEFINITIONS
Ll CITY
The term "CITY-shall mean t.he City of Palo Al to ..
Cal i f ornia .
The term ·City Manager'll shall mean the dulj.· appointed
City Manager of the City of Pttlo ~to. California, or his or her
designated representative.
1.3 !:.LTY CLERK
The term ~City Clerk" shall mean the duly appOinted City
Clerk of the City of palo Alto. California, or his or her
designated representative.
1 .4 RISK MNjAGER
The tenr. "Risk Manager" shall mean the duly appointed
Risk Manager of the City of Palo Alt.o, Cali£ornia, or his or her
designated representative.
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Tne t~rrn QProject" shall mean the services described in
Exhibit ·A-. entitled "Scope of Ser<-ri rf"o$, -at.t",-ched (jer-eto and made
.;::. Pi"i.i-t i.1~reof by this reference.
SEcrION 2
2.1 CIn
PROJECT CQ9RDIlj.ATION
The City Manager shall be representative of CITY for all
purposes under this Agre~ent. Jay Rounds. the Director of Human
Resources. is designated as the proj ect Manager for the City
Manager~ and he shall supervise the progress and execution of this
Agreement. and shall be assisted by Randall Rafoth, the Risk
Manager~
2 . 2 CCNTRACTQ.&
CONTRACTOR shall assign a single proj ect Director to r..ave
overall respollBibility for the progress and exeo::ution of this
Agreement for CONTRAC"TOR. Peter J. Brown, the President of
CONT'R.ACTOR, hereby is designated as the Proj eet Director for
CONTRACTOR. Should cirr=ttmstances O~ condi tions subsequent to the
execution of this Agreement require a substitute Project Director
for any reason, the Project Director designee shall be subject to
the prior written approval of the Project Manager.
SECTION:) -DGTIBS Q£ __ CONTRACTQR
3.1 £l1&Y.lCES TO BE FURNI~R
CONTRACTOR shall provide all specified services as set
forth in Exhibit A.
3.2 LAWS TO BE CBSERVED
CONTRACTOR shall:
3..2.1 Pro(:ure all permits and licenses, pay all
charges and fees, and give all notices ~hich may be necessary ana
incident to the due and lawful prosecution of the services to be
performed by CONTRACTOR under ~his Agreement,
3.2.2 Keep icself fully informed of all existing
and future federal. state, and local laws. Drdinances~ regulations,
orders, and decrees which may affect those enga.ged or employed
under this Agreement, any materials used in COl'.'TRACTOR' s
performance under this Agreement, cr the performance of the
services under this Agreement;
3.2.3 At all times observe and comply with, and
cause all of its subcontractors and employees, if any, to observe
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and comply with, the leaws, Qrdinances, regulations, orders and
decrees mentioned above; and
3.2.4 lnunediately report: to the .Froj~ct Manager
in writing a~y diacrep~ncy or inccnsistency it discevers in the
laws, ordiz::.ances, regulations; or.:iers r and decrees mentioned above
in relation to any plans, drawlngs, spec~ficatiGns or p~ovisicn5 of
this Agreement.
3 • 3 RE r B It S E Qf. .:sE PORTS l+.Ntl INFQRMA T 1 ON
Any reports; information, data or other material given
to, or prepared or assembl~d by, CONTRACTOR or its subco~tractcrs.
if any, under chis Agreement shall be the property of ern and
shall not be made available to any individual or organization by
CONTRACTOR or it.s subcontractors, if any, withc·ut the prior .... ritten
approval of the City Manager.
3.4. COPIES QP REPORTS AND INFORMA.'tIO.H
If CITY requests additional copies of any repc";'::ts,
drawings, data or any other material which CONTRACTOR is required
to furnish in limited ~~antities as part ot the s~rvices und~r this
Agreew~nt. CONTRACTOR shall provide such additional copies as are
requested and CITY shall compensate CONTRACTOR for tha costs of
duplicating of such copies at CONTRACTOR's cost,
3.5 QUALIF~ATIQNS OF 90NTRACTOR
CONTRACTOR represents that it has the expertise and
professional qualifications tQ furnish the services described under
this Agreement. As evidence thereof, CONTRACTOR warrants that one
or more members of employees of the firm are 1 icensed by the State
of California and that the services to bp. provided under ttlis
Agreement will be performed by them or ~nder their supervision.
3.6 COl-1PLIANCE WITH AD';
CCNTRACTOR states that it. is aware of the requirements of
the federal Americans: with DiSabilities Act af 1990, and the
Government Code and the Health and Safety Code of the State of
California, relating to access to public buildings and
acconmodations for disabled persons I and relating to facilities for
disabled persons. CONTRACTOR shall comply with or ensure by its
advice that compliance with such provisions ..-ill be effected
pursuant to the terms of this Agreement.
SE'(."1'IQN 4 -COMPENSATION
Por the full perfarmance of the administrative $e~Fices
described herein by COlfT,RACTOR for the first year of the term of
this Agreeme'!"'.t~ CITY sr..all pay CONTRACTOR a total sum not to exceed
One Hundred and Five Thousand Dollars ($105,000), payable within
thirty (30) days of submission by CONTRACTOR of its itemized
billings in triplicate, in accordance with the attached Fee
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schedule marked Exhibit ·S-and incorporated 'herein by this
reference. For the complete electronic claims da.ta conversion
requiret under Exhibit A hereof, CITY shall also pay CONTRACTOR a
total one (I}-time fee not to exceed Four Thousand Five Hundred
DollC'{rs ($4/~DO) I as set. fortn in Exr.ibit B. In the even.t t-his
AgreemeGt is renewed for any additional one·year-te~~, CITY shall
pay CONTRACTOR One Hundred Five Thousand Dollars ($105,000) fOl"
each additional year, sUbject to a fee increase as set forth in
Exhibit B.
This Agr~ement shall commence on November 1. 1993, and
shall continue for ene 'Ii year. This Agreement may be renewed on
an a~~ual basis. for a tctal term not to exceed thr~e (3) years, to
expire no later than October 3L 1996. Ea~n annual renewal hereof
shall be subject teo the Cir.y Council's cont:inued ap.nual
appropriation of sufficient fur~ds for this Agreement and the mutual
agreement between the parties to rene"" the Agree..Y!lent for an
additional year. Such annu31 renewal shall be evidenced by the
delivery to CITY by CONTRACTOR of a notice of a~ual renewal at
l~ast thirty {30) days prior to the end of each year of the term of
the Agreement.
SECTION 6 -EXTENS IQ~ OF TERM
In the event. that the services called fo=-under this
Agreement are Dot completed within the time specified 3bove, the
City Manager shall have the opt,ion to extend the-time for
completioD. This paragraph dDes not preclude the reCCNf;:ry Df
damages for delay by either party.
SECTION 7 -TERMINATION OR SUSPENSIQN OF AGREEMENT
7.1 RIGHT TO SUSPEND OR TERMI~
Notwitbstanding Section 5 hereOf, the City Manager ma.y
suspend this Agre.e...'1'.ent. in whole or in part. or terminate this
Agreement! with or wit,hout: cause, by giving sixty (60) days' prior
written notice thereDf to CONTRACTOR. Upon receipt of such notice:,
CONTRACTOR shall immediately discontinue its perfcr-munce under this
Agreement_
CONl?ACTOR may ter.minate this Agreement or suspend work
on the Project by giving sixty (60} d.ays' prior written notice
thereof to CITY. hut only in the event of substantial failure of
perfo~ance by CITY or in the event CITY abandons or indefinitely
postpones tne Proje~t.
7.2 PAYMENT
Upon Buch suspension cr Lermina~ion by CITY. CONTRACT~R
shall be paid for all services actually rendered to CITY to the
date of such suspension or terminatiDn; provided, however, if this
Agreement is suspended or terminated for fault of CONTRACrOR, CITY
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shall be obligated to compensate CONTRACTOR only for that cor-tiol":
of COf\il'TRACTOR' s ser\lices 'Whic!"~ are of benet it to CiTY, as such
determination may be made by the City Manager in the reasonable
exercise of his or her discretion.
Upon s;"!ch suspension or ter:mination, CONTRACTOR shall
tUl,.'n over to the City Manager immediately any and all copies of
studies, drawings, computations, and other data, whether or not
completed. prepared by CONTRACTOR or its subcontractors, if any, or
given t.o COtl'TRACl'OR or its subcontractors, if any. in connection
with this Agreement. Such materials shall become the permanent
property of CITY.
7. '* FTNAL ___ ~CCQUNTiNG
Upon any canc~llation or termination of tnis Agreement,
CONTRACTOR shall make a final accounting of all fees payable co
CONTRACTOR hereunder and a final accoun~ing of any funds be~o~9ing
to CITY then in the possession of CONTRACTOR, and any balance due
either party shall be paid to the party enti~led thereto no later
tr-.Lan fort.y-five (45) days following such cancellation or
termination, unless necessary for the final administration ~f any
outst~~ding claims. It shall be underotood that ~ll claim files.
open and closed, are and remain the exclusive property of CI1:i and
CITY shall retain the right and option to remove from CONTRACTOR
sald claim files upon any cancellation or termination of this
Agreement.
SECTION 8 -INDEPENDENT ~-,..mN1'
Failure of CITY to agree with CONTRACTOR's indepEnden~
findings, conclusions, or recommendations, if the s~me are called
tor under this A;reement. on the basis of differences in matters of
judgment. sha.ll not be construed as faj lu.re on t:..ne part of
COh~R to meet the requirements of this Agre~~ent.
SECTION 9 -ASSIGNMENT' PER:2QAAL SERVI~.\1l3CON'TRACTORS
AND EMPLOYEES
9.1 MSIGNMENT
Both parties shall give Lheir personal attention to the
faithful performance of this Agreement and shall not assignr
transfer. convey, or otherwise dispose of this Agreement or any
right, title or interest in or to the same or any par-t thereof
without the prior written consent of the other party, and then only
subject to such terms and conditions as the other party may
require. A consent to one assignment shall not be deemed to be a
consent to any subsequent assignments~ Any assignment "Without such
approval shall be void and, at the optia~ of the other party, shall
terminate this Agreement and any license or privilege granted
herein~ This Agreement-a!;d any interest herein shall not be
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assignable by operation of law without the prior written consent of
the other party.
9.:2 PF.J(sONAL SBRVICJ;:-"s'
It is agreed that this Agreement is for the personal
services of CONTRACTOR and cannot be performed by any other perscu
or organization.
9. J SlJBCONTAACTOkS j RMPLOYEES
CONTRACTOR shall be responsible for employing or engagin9"
all persons nece~sary to perform the servir:es of CONI'RACTOR
hereunder. .No subcontz'accor of CONTRACTOR .... ill be recognized by
CITY as s~ch; rather~ all suDcontractoLs are deem~d to be employees
of CONTRACTOR~ and it agrees to be responsible for their
performance. CONTRACl'OR shall give its personal attention to the
fulfillment of the provisions of this Agreement by all of its
employees and Bubcontractors~ if any, and shall keep the work under
its control. If any employee or subcontractor of CONTRACTOR fails
or refuses ~o carry out the prOVisions of this Agreement or appears
to be incompetent or to act in a disorderly or improper maili~er, the
employee or subcontractor shall be discharged immediately fram the
work under this AgreR~nt on demand of the Project Manager.
All notices hereunder shall be given in 'Writ.ing and
mailed~ postage prepaid~ by certified mail, addressed as follows;
To CITY: Office of the City Clerk
Post Office Box 10250
Palo ~to~ CA 94303
To CONTRACTOR: Attention of the Project Director
at the address of CONTRACTOR recited above
SECTION 11 -INTEREST OF _~O~
In accepting this Agreement, CONTR..llCTOR covenants that it
present.ly has no interest, and shall not acquire any interest r
direct or indirect, financial or otherwise, which would conflict in
any manner or degree with the perfo~~ce of the services
hereunder. CONTRACTOR further covenants that, in the performance
of this Agreement ~ no subcontractor or person having such an
interest shall be emplcyed. CONTRACTOR certifies that no one who
has or will have any financial interest under this Agree..ment is an
officer or employee of CITY. It is expressly agreed that in the
performance of the professional services required under this
Agreement. CONTRACTOR~ and any of its subcontractors or employees,
shall at all times be considered independent contractors and not
agents or employees of CITY.
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SE("TION 12 -!NDEM!!ITI
co:rrI'RACTOR agrees to protect, indemnify I defend and hold
harmless CITY, its Council members. officers, agents and employees
from any -3.nd all dernands, claims, or liability of any nature,
including death or injury to any pe:rs,::m, property damage or any
other loss, caused bv or arising out of CONTRACTOR'S, its
officers'; agents', subcontractors' or employees' negligent acts,
error-a, or omissions, or .... illtul misconduct, or conduct for which
the law may impose strict liability on CONTRACTOR in the
perfonnance of or failure to perfor:m its cbl-igations under this
Agreement: .
_SECTION.-l_~ -WORKERS I COMPENSATION
CONTRACTOR, by executing this .~greemei~t~ certifies that
it. is aware of: t.he prQvisl.o!1S of the Labor ('code of the State of
California which re-quire every employer to be insured against.
liability for ~Q:rkers' compensa.tion or tv undertake self-insurance
in accordance with the orovisions of that Code. and certifies that
it. will comply 'With -suct~ provisions before commencing the
performance of the work of this Agreement.
S$CTION 14 -INSURANCE
CONTRACTOR, at its sole cost and expense, shall obtain
and ~aintain, in full force and effect throughout the entire term
of this Agreen~nt. the insurance coverage described in Bxhibit "CD,
attacbed hereto and made a part hereof by this reference. insuring
not only CONTRACTOR and its subcontractors, if any, but also, with
the exception of workers· compensation. employer'S liability, and
professioIlal liability insurance, naming as additional insureds
CITY, its Council members. officers. agents and employees, and each
of them, concerning this Agreement and the Project.
All inFiurance covsrage required hereunder shall be
provided throug~ carriers with a Best rating of A:X or higher that
are admitted to do business in the State of California. Any and
all subcontractors of CONTRACTOR under this Agreement shall obtain
and maintain, in full force and effecc throughout the ter.m of this
~~greementr identical insurance c ov-e rage , with CITY named as
additional insured under such policies as required above.
14 . 2 EVIDENCE QFQ.«-~
Certificates of such insurance l preferably on the forms
provided by CITY. shall be filed with CITY concurrently with the
execution of this Agreement. The certificates shall be subject to
the approval of the Risk Manager and shall contain an endorsement
stating that the i.nsurance is primary coverage and will not be
cancelled or altered by the insurer except after filing with the
City Clerk thirty (30} days' prior written notice of such
cancellation or alteration. and that the City of Palo Alto is named
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as an additional insured except in policies of worke>rs'
compensation, employer's liability.. and professional liability
insurance. Curren~ certificates of such insurance shall b€ kept on
file at all times ~uring the term of this Agreement with the City
Clerk: .
14.3 NQ LIMIT OF LIABILITY
The procuring of such requi:red pol icy or policies of
ins'.lrance shall not be construed to limit ('ONTRACTOR's liability
hereunder nor to fulfill the inde~ification provision and
requirements of this Agreement under Section 1.3 hereof.
Notwithstanding said po1icy or policies of insur;;,nce, CONTRACTOR
shall be obligated for the full and total amount of ar..y damage.
injury, or loss caused b~f the service3 performed under this
AgreemEnt, including after the Agreement has terminated or expired+
SECTION _1.~" -AUVITS
CONTRACTOR agrees to per.m!.t CITY to audit. at any
reasonable time during the term of this Agreement and for three (3)
years thereafter, CONTRACTOR's records pertaining to matters
covered by this Agreement. CONTRACTOR further agrees to maintain
such rec0rds for at least three (3) years after the ter.m of this
Agreement.
SECTION 1.6 _ + AGREEMENT BINDING
The terms; covenants, and conditions of t~is Agreement
shall apply to~ and ahall bind, the heirs~ successors, executors.
administrators, ae6igns~ and subcontractors of both parties.
SECTION 17 -WAIVERS
The waiver by either party of any breach or violation of
any term, covenant, or condition of this Agreement, or of any
provisions of any ordinance or law. shall not be deB~ed to be a
waiver of any other term. covenant, condition, ordinance. or law or
of any subsequent breach or violation of the same or of any other
term. covenant, condition; ordinan,ce, or law. The subsequent
acceptance by either party of any fee or other money which may
become dlle hereunder shall not be deemed to be a waiver of any
preceding breach or violation by the other party oE any term,
covenant, or condition of this Agreement or of any applicable law
or ordinance.
SECTION 18 -COSTS AND ATTQ~J~_Y.$' FEES
The prevailing party in any act-ien brought to enforce the
terms of this Agreement or ariSing out of this Agreement may
recover its reasonable costs and attorneys' fees expended in
connect ion with such an action from the ether party.
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~ECTIQN 19 . NO IMPLIBD WAIVER
No payment, part.ial payment, acceptance, or partial
acceptar.ce by CITY shall operate as a waiver aTI the part of CITY ot
any of its rights under this Agreement.
SECTION 2Q -l\;,lliDISCRIMINATION; PBWtLTY
20.1 DL:rY OF QONTRACTOR
Po discrimination shall be made in the employment of
persor .. s unde;-this Agreemant. because of the age, race. color,
national origin. ancestry, religion, di~ability, sex~al preferecce
or sex of such person. If the value of this Agreemen.t is. or may
be, Five Thousand Dollars {$S,OaO} or more, CONTRACTOR agrees to
meet all requirementS' of the Palo Alto Municipal Code p€I·taining t::.
nondiscrimination in ~mployment, including completing the
"Compliance Report--Nondiscrimination Provisions of City of Palo
Alto Contract~r on the form furnished by CITY, attached hereto as
Exhibit -0" and made a part hereof by this reference.
CO~~CTOR agrees that each agreement for services from
independent providers shall contain a provision substantially as
fullows :
·provider sh~11 provide CONTRACTOR with a
certificate stating that he (or she) is
currently in campI iance wi th all Federal and
State of California laws covering
nondiscrimination in employment; that he (or
she) will pursue an affirmative course of
action as required by the Affirmative Acticn
Guidelines of the City of Palo ~to; and that
he (or she} will not discriminate in the
employment of any person under th!o contract
because of the age, race, color. national
origin, ancestry~ religion, disability, s~xual
preference or sex of such person.~
If CO~R is found in violation of the
nondiscrimination provisions of the State of California Fair
Employment Practices Act or similar provisions of f~deral law cr
executive order in the performance of this Agreement, it shall
thereby he found in material breach of this Agreement. Thereupon,
CITY shall have the power to cancel or suspend this Agreement, in
whole or in part. or to deduct from the a"'Clount payable to
CONTRACTOR the sum of Twenty-Five Dollars ($25) for each person for
ea.-::h calendar day during which such person was discriminated
against. as damages for breach of contract, or both. Only a
finding of the State of California Fai r Employment Practices
Commission or the equivalent federal agency or officer shall
cor~titute evidence of a v1olation of contract under this section.
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If CONTRACTOR is Eou~d in violation of the
ncndiscriminati0z:. prov~s:ions of this Agreemen'C or the applicable
affirmative aCCl.on guidelines p"=!z"taining to this Agreement,
CONTRACTOR shall be found in ma~arial breach of this Agreement.
Thereupon, CITY shall have th€ power to cancel or suspend this
Agreement, in 'Whole or in part. or to deduct from the amO'.Jnt
payable to CONTRACTOR th-e sum of bo Hundred Fifty Dollars (S.250)
for each calendar d.s.y during which CON':'RACTOR is found to r..a.ve been
in such nOD~ompliance as damages for breach of contract, or both.
SECTION ,1 AGREEMENT CONTAINS ALI! UNDERSTANpINGS;
Tnis document represents the entire and integrated
agreement between CITY and CONTRACTOR and supersedes all prior
negotiations, represeLtations i and agreernents~ either writter. or
oral. This document may be amended only by writte.n in.strument~
signed by both CITY and CO~~CTOR.
5kC'TION 22 -GOVERNING LAW
This Agreement shall be governed by the laws of the State
of California.
IN WI'TNESS WHEREOF. the parties hereto have executed this
Agr~ement the day GU~d year first above written.
CITY OF PALO ALTO ATHENS • ~NISTRATORS
By' ~/~
Its: ;.,..tatpX..,L City Manager
APPROVED AS TO FORM,
Senior Asst. City ActorT~ey
APPROVF.I),
Assistant City Manager
Director ot Finance
Risk Manager
APPROVED AS TO CONTENT!
Director of Human Resources
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Attachments:
EXHIBIT "All!
EXHIBIT liS II :
EXHIBIT "C II !
EXHIBIT "D.III:
SCOPE OF SERVICES
FBE SCHEDULB
INSURANCE
NONDISCRIMINATION COMFLIANCE FORM
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EXIUBIT A: SCOPE OF SERVICES
WORKER'S COMPENSATION PROGRAM ADMINlSTRATIOJli
l. INTRODUCTION..
The City of Palo Alto ("City") is permissibly self-insured for Werker', Compensation
in the State of California through a combination of ",If-insurance (CertifICate 17104) and excess
coverage. UDder this scope of service" Athens Administrators ("Athens") ,hall admini.'ter the
Worker's Compensotion Program of the City of Palo Alto related to such obligatiof15, in
accordance with !be terms of this Agniement.
The intent of this scope of services is to insure that Lie City and Athens agree on the
service levels outlined in this agreement. in an tffort to maintain tt'le highest cWlomer service
staDdards to !be benefit of !be City', employees.
!!. GENERAL SERVICES OF ATHENS
AtbeDs A&rees:
A. To e-AlIJllinc, on behalf of tbe City. all reports of industrial injury or illness
relatiI!g 10 City employees and reponed to Atbens;
B. To engage !he services of person(') or firm(s) otber than Athens, upon approyal
from (be City, for senrices relati.."lg to I:he inv~tigation and defense of cl.a.im. ....
subject 10 !he oonditioos set fonb in this Agreemen' at tbe expense of tbe City;
C. To determine, on behalf of !be City. wbaJ benefits. if any, should be paid or
rendered und:r the applicable Worker's Compensation Laws in each reporttxf
claim;
D. To pay compensalion. medical expenses, "Alloca.ed Loss Expenses.' and o!her
benefits as prescnlled by law out of funds provided by tbe City;
E. To maintain a claim ftJe on each reported claim which shaIl be available [0 the
City at all times for inspection and 10 co.>duct. at a time and frequency 10 be
determined by the City. claim ftle reviews wim the City at a location to be
determined by tbe Cily;
F. To consult with and advise the City on a.ny matter arising in conjunction with the
business of tbe City whicb involves the subject matter of this Agreement;
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G. To provide all necessary forms a..'1d supplies for the eff-clenr: operation of the
Worker's Compensation Program, including customized cbecks bearing llJe City
name and =l, and to prepare.nd ftle all legally required fonns and documents;
F. To insure that 00 claims examincr handling City claims for the CIty, shall at an)'
lime be assigned a caseload in excess of two-hundred (200) open indemnity
c:aims;
G. To provide the City with computer-generated 105s rum, case logs, check registers,
risk mmagemeru reports and any other claim related repo!TS reyuested by the
Cily, at a frequ<ncy to be determined by the Cil)';
H. To utilize iI third pan}' vendor, upon the approval of the Cuy, [0 review and cost
CDotrol, all medical, OOspital and drug bills ,,'Xi to assist the City with designating
industtial medlca1 c1inrc.<; and hospitals which will provide the City with a
prefelTed provider (pPO) disCDu.'U at fees less than the Industrial Fees Schedule
(IFS), and to provide an ilemized list of all medical savings resulting from this
program, at a frequellJ:y to be detennined by lhe City.
1. To subscnbe to and pay on behalf of the City, enrollment in the Index
Bureau System on behalf of the City, for worker's compensation claims in
California and to report to the Index Bureau ea<:b and every Indemnity claim filed;
1. To provide ton-free "800" telephone numbers for employees of the City to coDUct
AtlJens regarding questions or concerns regarding claims information; and
K. To provide a complete and detailed electronic conversion of all claims data,
including all claims data from the City's previous administrator utilizing the David
Corporation CmnpPlus computer system.
m. SPECIAL CLAIMS HANDLING SERVICES;
Athens av-ro proTide tbe fGDowing Special Clai!ll'i Handling Servicts;
A. To attempt to contact all injured worke" within twenty-four (24) boor.;, and in
any event no later than forry",igbt (48) OOurs following the dare Athens receives
a claim from the City, Follow-up pOOne e<>ntac! shall be truide with the injured
worker every two (2) weeks thereafter pi'Ovided the injured worker remains off
work. and is unrepresented oy counsel. AIl telepho~ contacts must be
documented in the claim me;
2
B. To confer witlJ the City's Risk Manager regarding questions, reports, or iSS".Jes
concerning claims and to assist City departtnent managers and supervisors
regarding questiow, concerns, or issues involving employee claims;
C. To promptly furnish the Risk Manager with all required material papers,
which consist of but shall DO{ be limited to:
Applications and Other Legal DocumenlS
Narrative Medical Reports
Leiters from Defense Cou1l5C1
Vocatiooal Rehabilitation Reports
Private investigation R..-ports and Summaries
Benefil Notices
Delay andIor Denial of Claim Notice.;
D, To automatically assign for follow-up investigation, to be completed within seven
(7) <Illy. of assigrooen' unless otherwise approved, the following types of claims:
Heart or Stroke Relared Clann.
SrresslPsycblalric Clann.
Time Loss Claims Greater !han Fourteen (14) <Illy,
Late Reponed Claims
Back Claims Involving Lost Time
OJl1lUlative Trauma Disorder (ern) Claims and Repetitive Motion
Injuries (RMI);
E. To establish Indemnity or Lost Time Claim. within five (5) da'j' upon
receipt of the Employers' First Report of Injury (Form SOlO) from the Ciry.
The defrnidon of an "Zndemnity Claim" sball be 3!l industrial mjury or illness
claim fo" which any of the following benefits are claiTTJed:
I. Temporary Disabiliry
2. Permanent Disability
3. Life Pensjon
4. Death;
F. To close Medical Only Claims within twelve (12) months from the date of
injury; c:w-,ceptioll5 to this requirement shall be reported to the City~
G. To submit for appro\lal and c103-ute with.in fIve (5) days of receipt of written
notice, all lIIIIlispured Advisory Rating,;
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H.
I.
To immertiately notify the Risk Manager, by providing a copy of • Reserve
Computatbn Sheet, of any reserve changes over Ten-T'housand Dollom
($10,000.00);
To revi:w and obtain approval by Risk Manager of any c!3Un denials;
1. To retain a claim settlement authority of five-Thollsand Dollars ($5000 00) on
each claim;
K. To conduct supervisory reviews documented in writing every six (6) months of
all claim rues open for longer rhac six (6) months aW those whicb carry 3D
incurred value of Ten-Thoosand Dollars (SIO,OOO.OO) O[ more;
L. To confer with the Risk: Manager when the fonowing conditions arise:
To approve of a Vccatiow.) Rehabilitation Plan
To refer 2 claim fo a law fmn or attorney
To approve surveUlances, subrosas., or other investigations
To obtain settlement authorilJl over five-Thousand DoDar' ($5000.00)
M. To provide the City with a check register and • claim' and expense repon !hal
balm:es with the monthly loss exp<'.ricnce report. These reports will be
sellI ,., later IIwl te~ (10) day. following the end of each month to the Risk
Manager.
IV, SPECIAL CLAIMS HANDLING SERVICES OF THE CITY:
The CIty agrees to provide !be following special claims handling serviees:
A. To promptly .report to Athens all incidents of employee industrtal injuries or
illness;
B. To promptly forwaDd to Athens all applications, reports, ootices, or aoy IegaJ
~ pertalning In claims administnltion;
c. To make available to Athens funds for the payment of benefits for serviccs to
employees with industrial injuries or illnesses;
D. To P"Y all "Allocated Lms Expenses· defm.:d as: all losses incurred in the
adjustment, handling, settlement, or resistance of claims, including litigation
expenses:
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E. To pay AtbeJ'l.5 aU service fees as prescribed and included in Sec[LOn 5 hereof and
under Exhibit B -Fee Schooule;
\', ADDmQNAL TERMS:
Penalties iInposOO by the Wodcer'. Compensation Appeals Board (WCAB), the o"partment of
lndustrial R.e!.ations, the Division of Worter~s Compensation, The Federal GoYcmrnent, or any
judicial forum or quasi-judicial forum in the State of C.Hlomia, arising oul of the denial of
claims shall be the responsibility of t ... City if imposed as a "",-ull of acliQ!l, !:Lite. loy Athens
al the express direc,ion of the City.
Poualties imposed as a resalt of impl'Ol"'< denial of claims shaIl be the responsibility of Athens
if no formal request fo< denial was obtained by the Ri,k Manager.
Penalties Deposed as a result of the failure by either party under this Agreement to comply with
the administrative rules, regulations am the l..al!<-.-r Code of the State of Califami., shall be the
responsibility of the culpable party.
Athens sbaI1 provi<le the City with • quarterly lICOJunting of all penalties paid by Athens 00
bebalf of the City, including a listing of each penalty payment 2nd the specific claim me to
which the penalty payment was charged. Penaltieli shall be paid OUt of the City' 5 bellClit accrunt
am Athens shall then reimburse the City within thirty days of the issuance of the pell2lry and
fines report, for Ihose pen<ies and fires which are the respon.;ibiliry of Athens under the terms
am conditions of this Agreement.
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EXHIBIT D: FEE SCHEDULE
WORKER'S COMPENSATION PROGRAM ADMINISTRATION
A.'lNJJAL FEE
In accordance with the terms and coooiuo.QS set forth in the Agreemenr: between the City
of p..o]o Alto ("City") and Albens AdminiSlrlllors ("Athens") under Sec,io" 4 -Compensation,
the City shaD compensate Athens based on the fonowing fee schedule:
A. An ltDIlIIalizf<! fee of one-hundred the thoU5aOO dollars ($105,000.00)
sh.aIl be paid 10 Albens in twelve (12) monlhly billings of eight thousand seven
bundred fifty dollars ($8750.00) per month;
B. MonIhIy biilings sball be payable wiL'lin thirty (30) days of receipt of a properly
supported invoice provided by Athens mailed 10 the City of Palo Afto. Attn: Risk
MAnager. 250 Hamilton Avenae. Palo AlIa. CA 94301;
C. Administration fees paid under Se<;'ion I (A) hereof includos paymeru to Atilens
for serv;cing of all new claims reported 10 Athens during the lenn of this
Agn:ement and all "tail" claims resulting from the takeover from the City',
cummt Administrator for Worker's Compensation.
D. Any additional goods andIor ",rvices for whicb additional fees are allocated on
• pereenttge per savings basis wiU be negotialed with tile CilJl out,ide the scope
of the idministrativ. fees set fonh in this Agreement.
1L. ANNUAL FEE ADJUSTMENT
The Ienn of this Agreement shall be for one year (I). commencing November I. 1993,
subject to up 10 two (2) amruall"cnewaIs as provided under Secrion 5 net'e{)f. for a maximum
tota! term of three (3) years hereof lerminating no laler than Oclober 31. 1996. In the everu this
Agre.emem is extended beYQnd the initial one-yf"ar (1) ienn. Arhens sha1! receive a fee increase,
for eacb subsequent year of me agreement. equa110 the Consumer Price Index -Urnon Workers
(CPI-U) inr.Iease. ifany. for San Francisco. Oakland. and San Jose. for the previous one·year
period, or an increase in the administrative fee equal to ltotal of five pen;.,.'"11! (5%), whichever
is less.
IlL ADDITIONAL FEES
For the complete and de!aiJed electronic claims data conversion 10 be
co!lduaed by Athens bereunder, utilizing the David Corporation CompPlus
computer system •• one·time (I) maximum fee of fOUT lllou5aOO five bundred
dolIan ($4 .500. 00) sball also be paid to Athens hereunder upon completion
of tbe conversion and installation of the David System.
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EXHIBIT C ::>
A.
e.
C.
D.
f. ..
••
H.
-INSUBANCE REQUlREMENTS -LonG Form SECTION 00650'"
Insurance Requirements for Contraetors
CONTRACTOR:
PflOJECT MANAGER:
CONTRACT NAME:
GENERAL TERMS "-NO INSTRUCTIONS
ODIIT'I'IAtTQM;TQ Ttil Cln-Of ~ AL"I'C, AT THlIIIIIOU ~ ......... ! OIT_ AoICIM_T_ ~ ~ 'nil flMII OF r'tl[ ':OIom'JIo(:T ~Toq;
\MU. If 1IIfOI.IIifI:!IJo '1'0 ~ 1'1 tiElflfflC~1'"I ~ fHf lIII~f AND _~ 'flojl eH" AS All AUOIII~ IM"-"'£C. #IU IM~CI CO'WMAOf
IIIfQ4JNlI OUU' ... ""'O\N)IU) ~ Cfl#llllill!lM~ A.m ""~ Of IIt. ....... 0fI.~ .. ~T N'It ,o,oN;1ne;110 tlO ...... Ml .... ll\.[ .,.,.,uo.-c.#IUKIftI\"
ntt C'DI1'I~7t Of _er IIIIiST II CQMIIUlUI AIIIO P!etfl'fD I" M AI1!HOIIIZUI /l8'§MNrI'l1lVi! Of' 1)<1 C~"1W'r ~a ~f. RI. ... "OfIIImI
-mE CfTY. NtO ~ n1H(aT\' U'O'II' eotmu.cT'fWIU. .11:OIOI"P"ftI c~ .... ~CT"IN_Cf
RETOON THE COMPLETED CERTIFICATE TO THE CITY OF PALO ALTO. PURCfiASING & CONTRACT
ADMINISTRATKlN, 25{l fiAM'LTON AVEfJUE. PALO ALTO 94301.
TYPf OF COVlRAGE
~ ~. G ....... Uebirrty:
INCLU04NG:
• PERSOHAL INJURY
• MOAD F~M PftOPEltTY DAMAGE
• BUr.~K!T CON'T'A~CT\JAL .-
..::......-,.. Automobio Ueblity:
lNQ.uo,NG:
• .... 'NED
• HIMO
• N~cwnt£D
o Prof __ UobiIity:
INCLUDING:
• ElI.RORS "NO 0Mt$~C*S.
• MALPRACTICE Itt ~j
•
AI!"QUIAEMENT
8OOl(. y ltUUAY
PROPERTY DAMAGE
BOOfLY INJUR.Y 6. f'fI:QnRn'
DAMAGoECDMmNED
&oOIl y IE.-ch P,'.orll
IOQlb Y IN.JU!Ity p .... ~
f'f\OI'QUY pAMA,G E
BOOfly IkJURY" PROPEP.TY
OAMAGE'COMBtNfD
AU DAMAGES
.',000.000
'l,OOO,COO
.1000 OOD
11 009 ooq
'1,000,000
.',000,000
.',000,000
'1.000,000
1M Ctot of '.0 AIttJ, itI ~ ... nu .ncr .mpIOyHI .,. named .. .tditio,... i,.,...ec!, but o~ .. tQ wol1< pwfOfrMd IIT'6e1
COftUaot, 6_ COW~ ~ 't::: ::. ~ of ,..., Aha, lIe·, ..... M!">rim¥V eo ... ~u., WlthOLlI 0f/"8! ~t City', '''tint iMuI'~
1IOd....,. Cln-ineuranoe wrried ~ thIo Cfty beinu "'CIKI' i ......... nc, oriy.
WheN ttw wl'dllnvol_ "_"'IiI, ~'","" llIolJV'B1l"Q, (t~ or OIM' und~oond "'DIi:., tI">I j)Qiey in<:lll_ ""truction or wi, .. ,
con6uitJ, pipfl, meiM, 0. ~ ........ , ~.~ DO" lroy lIPPI'''''' irl eO~CbO" tfwflMItI tJ.1<"l'" &.. .... lrfec:. of ttIe groynd whether
IIWTWd by thi.4 p~ 11K 1fw CIty of ,.Il10 "rto.
WhffiI the w!Uk in~ ,.eanoIinv. eoa..p.-. co......,~ '-,.rcwkled i., tM amounu «JDVIIo.
TIM pcliey IndW.. • "s.wr.bUity of Int.'H(" 1KO .... 0fI.
o-..c1IiiHS 0_ '5,000 muI1 IN incieatld _ arB IUtljee'I tQ ~o...-.l.
"..-pojoteI. .. 0Il'00Ile4 Of ~ durinQ! tt. period oJ c.a"'I~" .tat4d MI.(\.. ill. IIYch.. me.n.Mf .. to. .u.,::t thI Cenilleetc,
thirty (30) ct.y. ",ritt.., 1IOOoe ...... "*'-d 10 tbI City or ""0 AIt<>: Cc.".so;t Admini'U-6tion, P.O. Boll: 111250, H30J
1M hbi6ity inMIt-. poicy inc:Ww I contrac'RMIliiItICIi,'f endO''''nc,"1 p'~i"lr i,*,""C8 (;0\'8""" fO!" CO"'!IIICtor'lI ... ement
III ~ 11M City,
ttre eo_ntp IIIfIl.6e6 ........ thtI poaco. ... Nt~[ ,0" IIII"/nI Qf lM poIicietl d"",Nllsd ~n.-.d ~t. 0lil of lhII p'owRio .. ~
fer Mrti.,.
DATf:_~ ____ ' COHT~ACT ItDMI"'~TM TOFl.-,Ko.~"'-'»~Zl~>4~· "',,,6~,",,7,,:::=====-_
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EXHIBIT 0 o
SECTION 00410
CERTJFICA TJON OF NONDfSCRIMINA TJON
C'rttfiG'ltjon of Nondiscrimination: As sl.;ppiiers of goods or services to the City of
Pafo Aha, the firm and indrviduals listed below certifies that they do not discriminate
in emptoyment with reoards to age, race, calor, religion. nattonal origin, ancestry.
disability~ or sexual preference; that they are in compli6nce with arl Federal, State and
kK:al directives and 9xecutrve orders regarding nondiscrimination in employment; and
that they agree to demonstrate positively and aggressively the principle of equal
opportunity in employment.
The Bidder!Proposer agrees specificarlv:
'.0 To establish or observe employment policies which amrmatively promote
opportunities for minority persons at all job levels.
2.0 To communfcate this policy to all persons concerned. including all
emplovees, outside recruiting services., especially those serving minority
communities. and' to the mtnority commun;ties e1 1arge.
3.0 To take affirmative action steps to hire minority employees within the
organization.
4.0 To be knowledgeable of the local, state, and federal laws and regulations
concerning affirmative action policies and prov:de opportunities for
employees.
F~m: ________________________________________________ _
Title of Officer Signing: _____________________ __
Signature ___________________________ _
DMe _____________________________________ _
Please inc'ude any additional information aVoilable regardIng equal opportunity
employment programs now jn effect within your company.
END OF SECTION
CITY of PALO At. TO, Pt.IorHfiscr~minaticn 15/931 SECTION 0041 Q.. t