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HomeMy WebLinkAboutC-1544 - Administer City's legally uninsured Workmen's Compensation Insurance ProgramCITY OF NEWPORT BEACH CALIFORNIA DATE July 7, 1975 TO: FINANCE DIRECTOR FROM: City Clerk SUBJECT: Contract No. 1544 City Hall 3300 W, Newport Bivd. Area Code 714 673 -2110 Authorized by Resolution No. 8531 , adopted on June 23 1975 Effective date of Contract July 1, 1975 Contract with 1 Fred S. James B Co. Pmount of Contract man ,agneemeat V -City ftem July 7, 1975 Bill Brown, S7TC Amendment to Worimen Is Cc Vwwation ProWam Pgreammt C-1S44 Enclosed are two executed copies of subject agreement. Plea" U*mmnit cne to Fried S. Jams Company. he City Council authorized this amendment on June 23, The by the adoption of Resolution No. 8531. Laura Lagios City Clark L.L: swk enc. Al �' =� <�. l �Y� ... � ....' ... ... .0.�:'�i:a. SPEED LETTER© FRFV. S. JAMES & Co. OF CALIFORNIA TO FROM InsurQttG OkEPJ' and consultants Since 185s Laura Lagios, City Clerk 9495 WILSHIRE BOULEVARD City of Newport Beach LOS ANGELES. CALIFORNIA 90010 TELEPHONE 885 -0545 SUBJECT ENO. B 9 10 FOLD MESSAGE DATE June 30 19 75 Enclosed please find duly executed "AMENDMENT TO AGREEMENT." Thank you. c.c. Bill Brown Safety & Training Coordinator sl REPLY DATE 19 r ENO, 10 FOLD SIGNED 'WW A -WAY" FORM 44-02r s Y.Rn AI 474 RETAIN Wt{ITE,_ MucoM ,oM.c'ewkMMi ®..•i �• nlMne iM n ... COPY, RETURN KINK COPY PURCHASE ORDER UUi rulIJClCSa_ 7UU lU . NIA "92660 10 .. ... __B DATE DEPARN[ _. Amendment to s Com fign Program per _ contract 10 s54Q.4D::. Contract 1544 Resolution.. 8.531 - I IMPORTANT = . .. CITY OF'NEWPORT BEACH r - A 0214520M 1f}s�Q� The Articles covered by this Purchase Order or Contract must con- form with the Safety. Orders at the State of California, Divisidn . of Industrial Safety. Show as a separate item any retail sales tax, use tax or Federal 'tax applicable to'thispurchase. !!! .. This order subject to California sales tax.. .D. W. MEANS All allowable transportation charges must be prepaid and shown as a separate. item on the invoice. Do not include Federal transporta- PURCHASING AGENT i. tion tax. - - DEPARN[ _. __ ,l .i, � ,a �« � .. �:_ : >.�= -_-�: -. _� �_,� E June 26, 1975 41111 Bill Brown, Safety & TrainingtooAdMIMmor ?amendment to Workman's Violation Insurance Agreement C-1544 JYMNA are the original and two copies of subject amendment to agreement with Fred K James & Company. Please transmit to Fred S. James for signature and return the original to us for inclusion in our files. Aura Lagios City Cileri4c s;wdk enc. AMENDMENT TO AGREEMENT THIS AMENDMENT TO AGREEMENT is made and entered into this 157- day of a ul q 1975, by and between the CITY OF NEWPORT BEACH, a municipal corporation, hereinafter referred to as "City ", and FRED S. JAMES & COMPANY, insurance brokers and consultants, hereinafter referred to as "Consultant ". W I T N E S S E T H WHEREAS, on July 1, 1973 City and Consultant entered into an agreement whereby Consultant undertook the administration of City's legally uninsured Workmen's Compensation Program; and NOW, THEREFORE, in consideration of the foregoing, the City and Consultant amend said agreement dated July 1, 1973, in the following particulars: 1. Paragraph I of the subject agreement is amended to read as follows: "The term of this contract shall extend for one year beginning July 1, 1975, and shall renew itself for subsequent one -year periods thereafter. Either party may at any time terminate this agree- ment by serving a written notice of intention to terminate on the other party sixty (60) days prior to the effective date of termination." 2. Paragraph II of the subject agreement is amended to read as follows: "For furnishing the services specified herein City agrees to pay Consultant the following sums on a quarterly basis: $5,000.00 for services necessary to administer the City's self- insurance program; $2,500.00 for safety services." In addition, City shall pay the actual cost of legal services incurred in the administration of this program up to a maximum of $3,000.00. Any legal costs in excess of that amount shall be the responsibility of Consultant. 3. Any provisions of the subject agreement dated July 1, 1973, which are not specifically referred to in this amended agreement shall remain in full force and effect for the duration of this agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the day and date first above written. ATTEST: City Clerk CITY OF NEWPORT BEACH (City) i e =:_`-� By / %�U• /��l�W� . ,q41 Mayor R -vx Mayor FRED S. JAMES & COMPANY (Consultant) m 0 I ^ RESOLUTION NO. 8 5 3 1 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF NEWPORT BEACH AUTHORIZING THE EXECUTION OF AN AMENDMENT TO AN AGREEMENT BETWEEN THE CITY OF NEWPORT BEACH AND FRED S. JAMES & CO., PERTAINING TO THE CITY'S LEGALLY UNINSURED WORKMEN'S COMPENSATION PROGRAM WHEREAS, there has been presented to the City Council of the City of Newport Beach a certain amendment to an agreement between the City of Newport Beach and Fred S. James & Co., pertaining to the City's legally uninsured Workmen's Compensation Program; and WHEREAS, the City Council has considered the terms and conditions of said amendment to agreement and found them to be fair and equitable, and in the best interests of the City; NOW, THEREFORE, BE IT RESOLVED by the City Council of the City of Newport Beach that said amendment to agreement above described is approved, and the Mayor and City Clerk are hereby authorized and directed to execute the same on behalf of the City of Newport Beach. ADOPTED this 23rd day of June , 1975. Mayor ATTEST: City Clerk DDO /bc 6/19/75 0 TO: FINANCE DIRECTOR FROM: City Clerk SUBJECT: Contract No. 1544 t R CITY OF NEWPORT BEACH CALIFORNIA City Hall 3300 W. Newport Blvd. Area Code 714 673 -2110 Authorized by Resolution No. A337 , adopted on Atigust 12 ig74 Effective date of Contract Aiipgt 14, 1994 Contract with Fred S. James & Co. Amount of Contract Sc+n nontran City . e c A&Wnt 15, 1974 Fred S. James 9 Co. 8435 Wilshire Boulevard. Suite ICs Angeles, CA 90010 Attention: Andrew J. IYnk, Administrator Self- Sns:u+ m Services Subject Amendwrt to Workmen's Compensation Agreement C-1S44 Enclosed is a fully wa arted copy of subject Amendment. Ihis agreement was approved by the City Council on August 12 by the adoption of Resolution No. 8337. IAura Lagics, W City clerk M. -M c OW. oc: city Attorney Pbraoeaxl Department 0 0 F3?,E D. S. JAM E S & CO. OF CALIFORNIA Insurance Brokers and Consultants Since 1858 3435 WILSHIRE BLVD. • LOS ANGELES 90010 • (413) 385 -0545 July 29, 1974 Mr. David R. Baade Assistant City Attorney City of Newport Beach City Hall 3300 Newport Boulevard Newport Beach, California Dear Mr. Baade: \'y�je.�. i JUL ^1 1974a -1 _ Attached are the executed copies of the Amendment to the Agreement entered into on July 1, 1973 between the City of Newport Beach and Fred. S. James & Co. I understand that when the Agreement is approved by the City Council you will return a fully executed copy to this office. Thank you very much. Very truly yours, drew J. Fin Administrator Self- Insurance Services AJ F: Aoy enc BOSTON • NEW YORK • PHILADELPHIA • HARRISBURG • PITTSBURGH • CHICAGO • OKLAHOMA CITY - DALLAS - TUCSON • FRESNO • SAN FRANCISCO • PORTLAND • SPOKANE • SEATTLE • LONDON INTERNATIONAL SERVICE THROUGH ASSOCIATES IN MAJOR CITIES THROUGHOUT THE WORLD r � AMENDMENT TO AGREEMENT THIS AMENDMENT TO AGREEMENT is made and entered into this Iq y day of A ljg y cr— , 1974, by and between the CITY OF NEWPORT BEACH, a municipal corporation, hereinafter referred to as "CITY ", and FRED S. JAMES & COMPANY, insurance brokers and consultants, hereinafter referred to as "CONSULTANT ". W I T N E S S E T H: WHEREAS, on July 1, 1973, CITY and CONSULTANT entered into an agreement whereby CONSULTANT undertook the administration of CITY's legally uninsured Workmen's Compensation Program; and agreement. WHEREAS, the parties hereto desire to amend said NOW, THEREFORE, in consideration of the foregoing, the CITY and CONSULTANT amend said agreement dated July 1, 1973, in the following particulars: 1. Paragraph I of the subject agreement is amended to read as follows: "The term of this contract shall extend for one year beginning July 1, 1974, and shall renew itself for subsequent one -year periods thereafter. Either party may at any time terminate this agreement by serving a written notice of intention to terminate on the other party sixty (60) days prior to the effective date of termination." 2. Paragraph II of the subject agreement is amended to read as follows: "For furnishing the services specified herein CITY agrees to pay CONSULTANT the following sums on a quarterly basis: $5,000.00 for services necessary to administer the CITY's self- insurance program; -1- 0 0 $2,500.00 for safety services." In addition, CITY shall pay the actual cost of legal services incurred in the administratjon of this program up to a maximum of $3,000.00. Any legal costs in excess of that amount shall be the responsibility of CONSULTANT. 3. Any provisions of the subject agreement dated July 1, 1973, which are not specifically referred to in this amended agreement shall remain in full force and effect for the duration of this agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the d to _`L PC ATTEST: /FOR"-% APPROVED AS TO FORM Assistant City Attorney -2- to first above written. OF NEWPORT BEACH 14PIN By: By: CITY CONSULTANT 0 AU 1974 RESOLUTION NO. 8 33 By the CITY COUNCIL QTY r* aY RGACH A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF NEWPORT BEACH AUTHORIZING THE EXECUTION OF AN AMENDMENT TO AN AGREEMENT BETWEEN THE CITY OF NEWPORT BEACH AND FRED S. JAMES & CO., PERTAINING TO THE CITY'S LEGALLY UNINSURED WORKMEN'S COMPENSATION PROGRAM WHEREAS, there has been presented to the City Council of the City of Newport Beach a certain amendment to an agreement between the City of Newport Beach and Fred S. James & Co., pertaining to the City's legally uninsured Workmen's Compensation Program; and WHEREAS, the City Council has considered the terms and conditions of said amendment to agreement and found them to be fair and equitable, and in the best interests of the City; NOW, THEREFORE, BE IT RESOLVED by the City Council of the City of Newport Beach that said amendment to agreement above described is approved, and the Mayor and City Clerk are hereby authorized and directed to execute the same on behalf of the City of Newport Beach. ADOPTED this 12th day of August, 1974. Mayor ATTEST: City Clerk DDO:mh 8/8/74 CITY OF NEWPORT BEACH CALIFORNIA City Hall 3300 W. Newport Blvd. Area Code 714 673 -2110 DA'L'E July 31, 1973 TO: FINANCE DIRECTOR FROM: City Clerk SUBJECT: Contract No. 1544 Description of Contract Uninswed Workmen's CalWeation Ocnsultlnt Authorized by Resolution No. 8028 adopted on 6 -25 -73 Effective date of Contract Contract with Address July 1, 1973 Fred S. James 5 Caq)any P. 0. Box 76902 Los Angeles, CA 90010 Amount of Contract see ccntmat city fte a 9 City Clerk July 12, 1973 City A ttorney Attn: Dave Aaade City Clerk Enclosed is one executed copy of the uninsured workmen's compensation consultant agreement with Fred S. James Company and one executed copy of the State Compensation Insurance Fund Policy Agreement, Y� LL:dg Encl. � 9 City Clerk A G R E E M E N T 0 THIS Agreement is made and entered into this lyLT day of V of r , 1973, by and between the CITY OF NEWPORT BEACH, a municipal corporation, hereinafter referred to as "CITY ", and FRED S. JAMES & COMPANY, insurance brokers and consultants, hereinafter referred to as "CONSULTANT ". W I T N E S S E T H WHEREAS, CITY has determined that the public interest requires that it maintain a legally uninsured workmen's compen- sation program; and WHEREAS, CONSULTANT is qualified to undertake the administration of said program; NOW, THEREFORE, THE CITY and CONSULTANT do hereby agree as follows: I The term of this contract shall be for one year beginning July 1, 1973, and shall renew itself for subsequent one -year periods thereafter. Either party may at any time terminate this agreement by serving a written notice of inten- tion to terminate on the other party sixty (60) days prior to the effective date of termination. II For furnishing the services specified herein, CITY agrees to pay CONSULTANT the sum of Eight Thousand Five Hundred Dollars ($8,500.00) each year. This amount represents One Thousand Dollars ($1,000.00) for legal services, Two Thousand Five Hundred Dollars ($2,500.00) for safety services and Five Thousand Dollars ($5,000.00) for other services necessary to • i administer the CITY's self- insurance program. Payments will be made on a quarterly basis. III CONSULTANTS shall perform the following services: A. DEVELOPMENT OF PROGRAM 1. Review with key personnel of CITY the need for modification of procedures, practices and coor- dination to meet State requirements and CITY needs. 2. Participation in the orientation of CITY personnel involved directly and indirectly in the processing of industrial cases. 3. Provide information on changes or proposed changes in legislation, rules and regulations affecting the CITY's responsibility as a self - insured employer. B. LITIGATION AND SUBROGATION 1. Recommend legal counsel for the defense of litigated claims and assist counsel in the prepar- ation of the cases and in the negotiation of com- promise and release settlements. CONSULTANT shall attempt to recommend the most suitable counsel for each individual case so that maximum flexibility in the utilization of legal resources shall be assured. 2. Monitor all cases for potential subrogation recoveries, prepare correspondence to effect collec- tion and assist legal counsel where litigation is required to effect recovery. 3. Advise the CITY on a regular basis of developments in cases which are in litigation. -2- 0 4. Assume all costs involved in the legal defense of work related claims incurred during the term of this Agreement. C. CLAIMS ADMINISTRATION 1. Review and process all industrial injury cases in accordance with the requirements of the Department of Industrial Relations for reporting and notification. 2. Determine compensability of injuries and illness in accordance with State Workmen's Compen- sation laws. 3. Determine eligibility for and authorize payment of temporary disability compensation in coordinationeath medical advice and rehabilitation efforts. 4. Determine the extent and degree of permanent disability utilizing whenever necessary and desir- able advisory ratings of the permanent disability rating bureau. 5. Recommend permanent disability compensation and death benefits in accordance with advisory ratings, orders of the Workmen's Compensation Appeals Board or compromise and release. agreements. 6. Maintain on each case current estimates of the cost of all anticipated benefits. 7. Investigate wherever necessary and appro- priate questionable cases and the status of dis- abled employees in order to assist in the adjustment and litigation of cases. B. Issue documentation and audit trail to enable the CITY to issue payments. -3- 0 D. MEDICAL CONTROL 1. Develop and recommend a panel of physicians for the first treatment of employees and recommend a panel of medical specialists for treatment re- quiring long -term or speciality care. 2. Monitor treatment programs for injured or ill employees, including review of all doctors, first reports of work injury. 3. Maintain close liaison with treating physicians. 4. Provide guidance in the evaluation of physical capacity of injured employees to return to work. 5. Assist in the development of medical standards and health requirements for all jobs and incorporate such standards and requirements in a program of pre - employment and periodic examination. E. EMPLOYEE SERVICE 1. Provide information and guidance to injured employees regarding the benefits they will receive in accordance with CITY's policy. 2. Assist in solving employee non -legal problems arising out of industrial injury cases. 3. Assist injured employees, CITY personnel staff and other agencies to provide rehabilitation, retraining or reassignment of employees with physical or performance limitations arising out of industrial injuries. 4. When requested by CITY, consult with employee groups on problem cases. 5. Develop policies and procedures to insure that the return to work by or reassignment of injured employees is consistent with the findings of the Workmen's Compensation Appeals Board. 0 F. PREVENTIVE SERVICE 1. Review with the aid of CONSULTANT'S Loss Control Personnel current employees safety activities, evaluate current accident control needs and make recommendations as to appropriate action and priorities. 2. Compile and publish statistical data on the cost of industrial accidents and injuries both as a measure of individual locations, achievement of safety objectives and as a guide for direction of future efforts. Review each month the data reports with CITY personnel to assist in identifying problems. 3. Assist in the implementation and evaluation of comprehensive programs of safety, including promotion, training, evaluation of performance, identification and elimination of hazards, accident investigation and evaluation. 4. Conduct on a selective basis special studies aimed at analyzing, diagnosing and making recommen- dations for the solution of major problems in accident protection, or the conduct of the program. 5. Assist as required in the development, conduct and evaluation of the effectiveness of training programs and other instructional means in industrial and vehicular accident prevention, reporting and investigation. G. REPORTING SYSTEMS CONTROL 1. Utilize computer programs to provide CITY with continuing information on cash flow, incurred costs, the progress of individual claims and effectiveness of safety and other cost control programs. -5- 0 0 2. Submit a comprehensive annual statistical summary survey and narrative report to serve as the basis for evaluation of CITY's self - insurance' program and to permit preparation of reports required by the Department of Industrial Relations. 3. Provide periodic projections of cash flow and budget requirements as well as actuarial projections of annual incurred costs. 4. Establish procedures and the necessary documentation in order for the CONSULTANTS to determine entitlement to benefits, and forward to the CITY such authorization as will be necessary to enable payment checks to be issued from appro- priate budget accounts. 5. Prepare any reports on CITY claims and expenditures as may be required by the California Department of Industrial Relations. IV The terms of this Agreement and the scope of services required herein include those services set forth in that docu- ment which is attached hereto, marked Exhibit "A ", and which is by this reference incorporated herein as if fully set forth. IN WITNESS WHEREOF, the parties hereto have set their hands the day and,,year as is written above. CITY OF NEWPORT BEACH, a municipal corporation 7 Mayor ATTEST: City Clerk APPROVED ,,TO FORM: z Y A stant ity Attorney FRED S. JAMES & COMPANY, insurance brokers and consultants 1T. 0 0 Attachment I The conditions desired in the formulation of any proposals to be submitted are as follows: I. Administrative Services a. Formulate, in cooperation with the City, a Manual of Operating Procedures pertaining to the operation and administration of the Workmens' Compensation Self - insurance Program. b. Complete, in cooperation with the City, any forms that will facilitate implementation of this Program. c. Assist the City in the development of a system of accounting by which the costs of industrial injury experience may be assessed against the appropriate City department. d. Provide all necessary injury benefit adjustment services, and in that connection specifically: 1. Examine EMPLOYER'S REPORTS OF INDUSTRIAL INJURY forwarded by the City and determine compensability of such claims under the California Workmens' Compensation Laws. 2. Assist in the pursual of quality medical care for injured employees whose claims are adjusted under this Program in conjunction with the City's Panel of Doctors. 3. Determine temporary disability compensation benefits and permanent disability compensation benefits for injured employees whose claims are adjusted and apprise the City in order that medical payments are promptly paid and disability benefit payments or wages under the City's industrial leave schedule as appropriate are made. 4. Assist the City in coordinating Workmens' Compensation benefits with: special survivors benefit for Safety personnel under the State Retirement Code; leave and wage continuation benefits provided by City regulations and /or California Labor Code; and any benefits that may accrue to disabled employees from outside agencies who provide such services under contract to the City. 0 0 5. Coordinate the payment of compensation benefits, medical care costs and special loss expenses. 6. Assign a specific claims adjuster mutually acceptable to the City and the agency to perform appropriate services under this Program. 7. Consult with the City on the occasion of unre- solved claims. 8. Conduct preliminary inquiries into questionable claims, and in concert with, and approval of, the City, engage the services of outside persons or firms for special investigation of such claims. Cost of such investigations may be borne by the City if not coming within the scope of the services outlined above. 9. Advise the City concerning retraining and rehabilitation of seriously injured employees within the meaning and intent of the California Labor Code bearing on this matter; cause notifi- cation as required to be made; and, arrange for and direct vocational retraining of the injured employees so affected. 10. Identify claims potentially subject to compromise and release settlements and confer with the City regarding such claims. 11. Consult with the City prior to institution of litigation reduction proceedings. e. Provide necessary claims administration and reporting services, and in that connection specifically: 1. Set up and maintain a file for each disability claim, maintain a record of each nondisability claim and make these files and records available for review by the City. 2. Maintain loss data and assist the City in maintaining payroll data as prescribed in the California Workmens' Compensation Unit Statistical Plan. 3. Calculate Workmens' Compensation Insurance Experience Modifications according to the California Experience Rating Plan. 4. Compute informal permanent disability ratings. 5. Consult with the City in the administration of personnel matters and policies involving or affecting the Workmens' Compensation Self- Insurance Program. - 2 - 6. Provide the City with a periodic report of accident profile as required. 7. Provide a periodic report or series of reports as required by the City listing employee injury claims by City department and showing status of each claim, amounts paid for medical and compensa- tion benefits per claim, amount of reserves required for medical and compensation benefits per claim, and total amounts paid out and total amounts required for reserves. 8. Advise the City of its obligations and legal rights on each occasion of an employee application filed with the Workmens' Compensation Appeals Board, for disability benefits. 9. Provide the City with a semi- annual audit recon- ciliation of benefit disbursements and special loss expenses for the City's Workmens' Compensation Self - Insurance Program. 10. Transmit claims file medical reports on employees who have sustained disability injuries in order that the City be made aware of any work restrictions. II. Legal Representation of the City in Workmens' Compensation Matters a. Provide legal representation in defense of the City at Workmens' Compensation Appeals Board hearings and any proceedings before appellate courts involving claims adjusted under the self - insurance program including compromise and release agree- ments as deemed mutually acceptable to both the City and legal staff. b. Assign a specific member of the legal staff, mutually accept- able to the City and the agency to perform appropriate services under this Program. c. Confer with designated City representatives regarding: 1. The course to be taken in the City's defense at Workmens' Compensation Appeals Board hearings. 2. The advisability of pursuing third party claims. 3. The coordination of Workmens' Compensation cases which involve the City with the Public Employees' Retirement System. d. Initiate and pursue all necessary proceedings and actions to effect subrogation. (Costs of subrogation investigation may be considered separately in any proposal.) - 3 - III. Safety Services a. Assist in the implementation and administration of the City's industrial safety program and in that connection: Provide safety inspection services as requested. 2. Submit periodic evaluation reports, as appropriate, concerning the progress of the safety program. 3. Assist the City in the development of safety training programs. Alert the City when accident /injury trends develop. 5. Make available film library catalogs of safety films and provide such films on request. IV. Evaluation of Workmens' Compensation Self- Insurance Program a. The City will conduct a continuing feasibility study of program effectiveness and costs. Toward this objective the design of certain forms for the collection of appropriate data is anticipated. The agency will be expected to partici- pate in developing such performance evaluation data, to review problem areas, and make recommendations for improvement in each of these areas. Such an evaluation will include a summary of the paid claims and outstanding case liabilities reflecting the City's experience as a whole, according to departmental experience. Also included will be a compilation of certain program performance indicators of the Workmens' Compensation Self- Insurance Program as mutually agreed upon by the City and the agency. Inspection and Audit of Records a. The City will reserve the right to inspect and audit the agency's records relevant to the City's account at any time upon giving of reasonable notice. The City will permit the agency to inspect and audit the City's payroll and workmens' compensation records at any time upon giving reasonable notice. The City will provide necessary information per- taining to claims reported for adjustment under the pro- visions of any agreement. - 4 - VI. Termination of Agreement a. Any agreement arrived at between the City and agency will have a termination clause of sixty (60) days, exercisable by either party. b. Upon termination of this agreement the agency agrees to deliver to the City all files and records pertaining to claims administered by it under the provisions of this agreement. - 5 - • 0 WORKMEN'S COMPENSATION EXCESS INSURANCE POLICY STATE COMPENSATION INSURANCE FUND OF THE STATE OF CALIFORNIA (Herein called the Fund) The State Compensation.Insurance Fund and the insured mutually agree to the terms, conditions, and limitations of this policy as follows: INSURING AGREEMENT I. WORKMEN'S COMPENSATION AND EMPLOYERS' LIABILITY The Fund hereby agrees to indemnify the insured against excess loss which the insured shall become obligated to pay on account of: a. Compensation required of the insured by the Workmen's Compensation Laws of the State of California; and b• Damages imposed as the result of suits filed against the insured as an employer under the laws of the State of California by employees covered by this policy on account of bodily injuries or occupational diseases, including death therefrom. II. LIMIT OF INDEMNITY AND RETENTION The Fund's liability shall be for the amount in excess of the retention and up to the limit of indemnity as stated in this policy, provided that the retention and limit of indemnity shall apply: a. To bodily injury or death sustained by one or more employees in each accident, and b. Separately as to bodily injury or death caused by occupational disease sustained by each employee. III. INDEMNIFICATION a. For excess loss as provided for elsewhere in this policy. . b. For allocated expenses in the same proportion as the loss ultimately borne by the Fund is to the total loss, providing that this provision shall apply to appeals from decisions of the Workmen's Compensation .Appeals Board, or any court, only if the Fund agrees in advance of the filing of the appeal. STA■ E CNSURAN'CE FUN D 525 GOLDEN GATE AYE.' SAN FRANCISCO. CALIFOR4IA 94102 d ie t. Page 2 of 5 i R C. Indemnification for expenses under Section III.(b), above, is in addition to the retention and limit of indemnity provided by this policy. d. Loss shall mean actual payments in money for benefits as provided for in Section I, parts (a) and (b) of this policy. e. "Allocated expenses" shall mean actual court costs, legal and allocated investigation expenses. f. Loss and allocated expenses shall not include salaries of insured's employees, expenses of adjusting claims or expenses of "claims adjusting agencies, EXCLUSIONS This policy does not apply as respects Section I, part (b) of the Insurance Agreement to liability assumed by the insured under any written, oral, or implied contract or agreement. CONDITIONS I. PREMIUM AND AUDIT a. Premium shall be determined at the rates shown in the policy and shall be based upon the entire remuneration earned during the policy period by all employees. The insured agrees to maintain accurate records of the remuneration and to make such records available for examination and audit by the Fund. . b. The premium stated in the declarations is an estimated premium. When earned premium exceeds the premium paid, the insured agrees to pay the difference to the Fund; when less, the Fund shall return the difference to the insured. The earned premium shall be the minimum premium for this policy. II. REIMBURSEMENT The insured agrees to provide a statement of expenditures for each claim covered by this policy. Proof of payment may be required by the Fund. Such statement shall be presented not less than four times per year and shall indicate the reason for each payment. The Fund shall make prompt- reimbursement to the insured. I77 . CLAI1145 ADMINISTRATION The insured agrees to investigate and settle all claims STATECiVSURA"CE FUND 525 GOLDEN GATE AVE.' SAN FRANCISCO, CALIFORNIA 94102 t • • Page 3 of 5 and to conduct the defense and appeal in all actions, suits, and proceedings commenced against it, and shall give prompt notice to the Fund of: a. Any action or suit commenced against the insured; and any proceeding, event, or development which might result In a claim upon the Fund; and b. Shall forward promptly to the Fund copies of pleadings and reports of investigation; and other information or documents requested by the Fund. The Fund, at its own election and expense, shall have the right to participate with the insured in the defense or appeal of any action, suit, or proceeding in which the Fund deems it may become involved. The insured agrees not to make any voluntary settlement involving loss to the Fund except with the written consent of the Fund. The insured agrees to give written notice to the Fund of any claim which may eventually require indemnification. In addition, the insured agrees to notify and to keep the Fund informed as respects each claim: a. When the expected cost equals one -half the retention. b. When monies paid out reach one -half the retention. C. Involving paraplegics, quadriplegics, severe head injuries, bilateral amputations or blindness. The insured agrees to effectively pursue all subrogation and salvage rights it may have growing out of the claim as it deems appropriate. The Fund may at all reasonable times examine the books and records of the insured as respects all workmen's compensation insurance claims; but the Fund waives no rights and undertakes no responsibility by reason of such examination or the omission thereof. IV. OTHER INSURANCE If the insured has other excess insurance, reinsurance, or indemnity against a loss covered by this policy, the Fund shall not be liable to the insured hereunder for a greater proportion of such loss than the amount which would have been payable under this policy, had no such other excess insurance, reinsurance, or inde -mitY against loss existed, STATECN SURA NICE f UN® 525 GOLDEN GATE AVE.- SAN FRANCISCO, CALIFORNIA 94102 Page 4 of 5 • • bears to the sum of said amount and the amounts which would have been payable under each other policy applicable to sudh loss, had each such policy been the only policy so applicable. V. SUBROGATION AND SALVAGE The insured agrees to prosecute all claims it may have against any person or entity which result, or may result, in the payment of loss by the Fund. If the insured makes recovery, such recovery shall first be applied against indemnity and expenses paid by the Fund on account of the claim or claims involved in the subrogation or salvage. If the insured does not prosecute any such claim within a reasonable time, the Fund shall be subrogated to such claim; .and the insured agrees to execute any and all papers and documents necessary to vest full right, title, and interest in said claim; and the Fund may prosecute said claim in its own name or in the name of the insured. The insured agrees to cooperate to the fullest extent with the Fund in the enforcement of any such claim. The net proceeds derived from such claim shall first be used by the Fund to.pay its loss and expenses, and any remainder shall be paid to the insured. VI. CHANGES Notice to any representative of the Fund or knowledge possessed by any representative of the Fund or by any other person shall not effect a waiver or a change in any part of this policy or estop the Fund from asserting any right under the terms of this policy; nor shall the terms of this policy be waived or changed, except by endorsement issued to form a part of this policy, signed by a duly authorized repre- sentative of the Fund. VII. ASSIGNMENT The interest of the insured in this policy cannot be assigned. VIII. CANCELLATION This policy may be cancelled by either party at any time upon written notice mailed to the other stating when, not less than 30 days after the date of the notice, cancellation shall be effective. If cancelled, the earned premium shall be computed upon the entire remuneration of all employees for the period of time the policy was in effect. STATECOMPEN INSURA NICE PUND 525 GOLDEN GATE A`/E,- SAN FRANCISCO, CALIFORNIA 94102 • IY,. THE CONTRACT C J i at�S J tit J This policy, including the declarations, and all endorse- ments or riders hereon, constitutes the entire contract of insurance. No condition, provision, agreement, or understanding not set forth in the policy or in such declarations, endorsements, or riders shall affect such contract or any rights, duties, or privileges arising therefrom. STATECOMPENON INSURANICE FUND 525 GOLDEN GATE AVE. - SAN FRANC15CC. CAUFORMA 94102 DECLARATIONS POLICY NO.: XS 734 -73 NAME OF INSURED: CITY OF NEWPORT BEACH ADDRESS: 3300 NEWPORT BOULEVARD, NEWPORT BEACH, CALIFORNIA 92660 As a condition precedent, this policy is null and void unless the total initial premium stated herein is tendered to the Fund on or before JULY 21, 1973 at 12:01 A.M.. standard time. The period during which this policy shall remain in force, unless cancelled, shall be from JULY 1, 1973' at 12 :01 A.M. standard time to JULY 1, 1974 at 12:01 A.M. standard time. LIMIT OF INDEMNITY: $10,00(),000. OVER $100,,.000. RETAINED BY INSURED INITIAL PREMIUM: $3,200 ADJUSTMENT: SEMI ANNUAL BILL In witness whereof, the State Compensation Insurance Fund has caused this policy to be signed by its President but the same shall not be binding upon the Fund unless countersigned by a duly authorized officer or representative of the Fund. Countersigned at San Francisco, this date June 20, 1973 FiUtl�Orl Z�31 IZEr j1 ?'E':; :`ntai: :LVe � iTA E [ NSURA N'CE FUN 525 GOLDEN GATE AVE.' SAN FRANCISCO, CALIFORNIA 94102 PR SIOENT _ ESTIMATED PAYROLL RATE PER $100 PAYROLL ESTIMATED ANNUAL PREMIUM $7,393,000 $o.o872 $6,446.7o. In witness whereof, the State Compensation Insurance Fund has caused this policy to be signed by its President but the same shall not be binding upon the Fund unless countersigned by a duly authorized officer or representative of the Fund. Countersigned at San Francisco, this date June 20, 1973 FiUtl�Orl Z�31 IZEr j1 ?'E':; :`ntai: :LVe � iTA E [ NSURA N'CE FUN 525 GOLDEN GATE AVE.' SAN FRANCISCO, CALIFORNIA 94102 PR SIOENT _ I t • 0 ATTEST: City Clerk APPROVED AS TO FORM: Assistant City Attorney CITY OF NEWPORT BEACH Mayor i 0 RES OLUT ION NO. 8 U 2 8 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF NE'NPORT BEACH AUTHORIZING THE EXECUTION OF A_N AGREEMENT BETWEEN THE CITY OF NEWPORT BEACH AND FRED S. JAMES & COMPANY TO ADMIN- ISTER THE CITY'S LEGALLY UNINSURED WORKMEN'S COMPENSATION INSURANCE PROGRAM WHEREAS, there has been presented to the City Council of the City of Newport Beach a certain agreement between the City of Ne- :roort Beach and Fred S. James & Company to administer the City's legally uninsured Workmen's Compen- sation Insurance Program; and WHEREAS, the City Council has considered the terms and conditions of said agreement and found them to be fair and equitable; NOW, THEREFORE, BE IT RESOLVED that said agreement is approved, and the Mayor and City Clerk are hereby author- ized and directed to execute the same on behalf of the City of Newport Beach. ADOPTED this 25th day of June, 1973. Mayor ATTEST: .City Clerk DON: sh 6/21/73