HomeMy WebLinkAboutC-7054-1 - PSA for Leadership Training for Fire ManagementAMENDMENT NO. TWO TO
PROFESSIONAL SERVICES AGREEMENT
WITH LILLESTRAND LEADERSHIP CONSULTING, INC. FOR
LEADERSHIP TRAINING FOR FIRE MANAGEMENT
THIS AMENDMENT NO. TWO TO PROFESSIONAL SERVICES AGREEMENT
("Amendment No. Two") is made and entered into as of this 14th day of March, 2017
("Effective Date"), by and between the CITY OF NEWPORT BEACH, a California
municipal corporation and charter city ("City"), and LILLESTRAND LEADERSHIP
CONSULTING, INC., a California corporation ("Consultant"), whose address is 2729
Brookside Drive, Chino Hills, CA 91709, and is made with reference to the following:
RECITALS
A. On March 16, 2016, City and Consultant entered into a Professional Services
Agreement ("Agreement") to provide a yearlong leadership training for the City's
Four Battalion Chiefs ("Project").
B. On June 6, 2016, City and Consultant entered into Amendment No. One to the
Agreement ("Amendment No. One") to reflect additional Services not previously
included in the Agreement and to increase the total compensation.
C. The parties desire to enter into this Amendment No. Two to reflect additional
Services not included in the Agreement, as amended, to extend the term of the
Agreement to October 31, 2017 and to increase the total compensation.
NOW, THEREFORE, it is mutually agreed by and between the undersigned parties
as follows:
1. TERM
Section 1 of the Agreement is amended in its entirety and replaced with the
following: "The term of this Agreement shall commence on the Effective Date, and shall
terminate on October 31, 2017, unless terminated earlier as set forth herein."
2. SERVICES TO BE PERFORMED
Exhibit A to the Agreement shall be supplemented to include the Scope of
Services, attached hereto as Exhibit A-1 and incorporated herein by reference ("Services"
or "Work"). Exhibit A to the Agreement, Exhibit A to Amendment No. One and Exhibit A-
1 to Amendment No. Two shall collectively be known as "Exhibit A." The City may elect
to delete certain Services within the Scope of Services at its sole discretion.
2.1 Consultant shall perform the services described in the Scope of Services
attached hereto as Exhibit A-1 on an on-call basis. Upon written request from the Project
Administrator as defined herein, Consultant shall provide a letter proposal for Services
requested by the City (hereinafter referred to as the "Letter Proposal"). The Letter
Proposal shall include the following:
2.1.1 A detailed description of the Services to be provided;
2.1.2 The position of each person to be assigned to perform the Services,
and the name of the individuals to be assigned, if available;
and
2.1.3 The estimated number of hours and cost to complete the Services;
2.1.4 The time needed to finish the specific project.
2.2 No Services shall be provided until the Project Administrator has provided
written acceptance of the Letter Proposal. Once authorized to proceed, Consultant shall
diligently perform the duties in the approved Letter Proposal.
3. COMPENSATION TO CONSULTANT
Section 4.1 of the Agreement is amended in its entirety and replaced with the
following: "City shall pay Consultant for the Services on a time and expense not -to -
exceed basis in accordance with the provisions of this Section and the Schedule of Billing
Rates attached hereto as Exhibit B and incorporated herein by reference. Consultant's
compensation for all Work performed in accordance with this Agreement, including all
reimbursable items and subconsultant fees, shall not exceed Fifty Three Thousand Two
Hundred Twenty Five Dollars and 00/100 ($53,225.00), without prior written
authorization from City. No billing rate changes shall be made during the term of this
Agreement without the prior written approval of City."
The total amended compensation reflects Consultant's additional compensation
for additional Services to be performed in accordance with this Amendment No. Two,
including all reimbursable items and subconsultant fees, in an amount not to exceed
Twenty Five Thousand Dollars and 00/100 ($25,000.00).
4. INTEGRATED CONTRACT
Except as expressly modified herein, all other provisions, terms, and covenants
set forth in the Agreement shall remain unchanged and shall be in full force and effect.
[SIGNATURES ON NEXT PAGE]
Lillestrand Leadership Consulting, Inc. Page 2
IN WITNESS WHEREOF, the parties have caused this Amendment No. Two to be
executed on the dates written below.
APPROVED AS TO FORM:
CITY ATTORN Y'S OFFICE
Date:
By: (g'
Aaron C. Harp K"
City Attorney 41tb
ATTEST:
Date: 3`
By: 4 G '
Leilani I. Brown
City Clerk
CITY OF NEWPORT BEACH,
a Californi at corporation
Date: t
By: l
Charles Duncan
Acting Fire Chief
CONSULTANT: Lillestrand Leadership
Consulting, Inc., a California corporation
Date:
B:
oren Lillestr
Chief Executive Officer
[END OF SIGNATURES]
Attachments: Exhibit A-1 — Scope of Services & Schedule of Billing Rates
Lillestrand Leadership Consulting, Inc. Page 3
EXHIBIT A-1
SCOPE OF SERVICES
& SCHEDULE OF BILLING RATES
Lillestrand Leadership Consulting, Inc. Page A-1
Lillestrand
Leadership
Consulting ii
Introduction
INDIVIDUAL & TEAM EFFECTIVENESS
"SCOPE OF WORK"
CITY OF NEWPORT BEACH FIRE DEPT.
Every organization, or organizational unit, is a direct reflection of the leadership it's been
given, for benefit or for harm. The effective practices of leaders move the organization and its
team members towards realizing the vision, and in a manner that honors the organization's
values while simultaneously building up those they lead. The ineffectual and/or harmful
practices of the leader yield the opposite.
This Scope of Work is dedicated to enhancing the personal and group effectiveness of the
leadership that impact the Fire Department.
Typically organizations dedicate their most significant per person compensation and benefits
packages for their leaders. It follows that making a further investment in their development is
wise—especially when that development investment is focused upon identifying and
developing the practices each leader needs for making their optimum contribution to the
achieving the organization's vision. Lillestrand Leadership Consulting has a long history of
developing an organization's leadership for increased effectiveness.
Tailor-made "1 -on -1" Coaching
Certain situations lend themselves to a highly individualize approach to leadership
development. In those cases, Lillestrand Leadership Consulting is able to tailor make a
coaching engagement designed around the unique needs of the person and/or situation.
Content, focus and length can all be specified based on the need at hand. When a specific
situation requires individualization, this is the type of coaching that is often the most effective
and productive. As directed by leadership, "1 -on -1" Coaching Services will be made provided.
Leadership Team Development and Facilitation
Collectively the City of Newport Beach Fire Department's Leadership enjoys a formidable
range of strengths. However, optimizing those strengths on behalf of the city requires
optimizing team unity and effectiveness along with achieving clarity of vision and strategic
direction. In order to fully release this leadership potential it may be appropriate, as directed
by leadership, to focus on two key team areas.
First, it is important to optimize the team's group interaction, communication, tracking,
strength utilization and unified forward momentum. This may require facilitation, observation
and, if needed, specific development of those skills. The skills to be developed will be
determined by what is observed when either facilitating the group and/or observing key
leaders as they facilitate the group.
2729 Brookside Drive ♦ Chino Hills, CA 91709 ♦ 909-496-9060
Loren@Lillestrand.com ♦ www.Lillestrand.com ♦ LorenLillestrand@gmaii.com
Second, it may be decided that extending these team facilitation services in the service of
Strategic Planning is wise... especially since it is the role of the Fire Department's Leadership to
establish /propose and implement the organizations' Strategic Direction. Always guided by
the organizations Mission (i.e., the long term reason for its existence) it may be desirable to
help the Fire Department's Leadership Team clarify their Vision (i.e., the better and desired
future this generation of leadership seeks for its constituents, staff, management and
leadership). This also may involve helping them identify relevant Strategies (i.e., the few high
priority "big picture" areas that will be focused upon to achieve the vision) along with setting
specific goals (i.e., by [a] reviewing existing goals, [b] adjusting those goals as necessary and
[c] adding new goals for the next phase of Vision Achievement).
Fees and Charges
Fees for Lillestrand Leadership Consulting Services are $3200 per 8 -hour day plus minor
incidentals. Fees are billed proportionately for partial days (e.g., 4 hour sessions costs $1550).
Incidentals cost a flat fee of $20 per 8 -hour day for copy and phone charges, round trip mileage
from Chino Hills, CA at the current IRS rate and meals at actual costs for the unusual situation
where a meeting needs to be conducted over a meal and is paid for by the consultant.
Costs
The use of these services will be on an "on-call" basis with the total budget for all services
combined not to exceed $25,000.
As always, it is a distinct privilege to serve you,
Loren Lillestrand
2729 Brookside Drive ♦ Chino Hills, CA 91709 ♦ 909-496-9060
Loren@Lillestrand.com ♦ www.Lillestrand.com • LorenLillestrand@gmail.com
AMENDMENT NO. 1 TO
f` PROFESSIONAL SERVICES AGREEMENT
U WITH LILLESTRAND LEADERSHIP CONSULTING, INC. FOR
LEADERSHIP TRAINING FOR FIRE MANAGEMENT
THIS AMENDMENT NO. 1 TO PROFESSIONAL SERVICES AGREEMENT
("Amendment No. 1") is made and entered into as of this 6th day of June, 2016
("Effective Date"), by and between the CITY OF NEWPORT BEACH, a California
municipal corporation and charter city ("City"), and LILLESTRAND LEADERSHIP
CONSULTING, INC., a California corporation ("Consultant"), whose address is 2729
Brookside Drive, Chino Hills 91709, and is made with reference to the following:
RECITALS
A. On March 1, 2016, City and Consultant entered into a Professional Services
Agreement ("Agreement") for Consultant to provide a yearlong leadership training
for the City's Four Battalion Chiefs ("Project").
B. The parties desire to enter into this Amendment No. 1 to reflect additional
Services not included in the Agreement and to increase the total compensation.
NOW, THEREFORE, it is mutually agreed by and between the undersigned
parties as follows:
1. SERVICES TO BE PERFORMED
Exhibit A to the Agreement shall be supplemented to include the Scope of
Services and Schedule of Billing Rates, attached hereto as Exhibit A and incorporated
herein by reference ("Services" or "Work") which reflects additional services not
included in the Agreement. Exhibit A to the Agreement and Exhibit A to this
Amendment No. One shall collectively be known as "Exhibit A." The City may elect to
delete certain Services within the Scope of Services at its sole discretion.
2. COMPENSATION TO CONSULTANT
Exhibit A to the Agreement shall be supplemented to include the Scope of
Services and Schedule of Billing Rates, attached hereto as Exhibit A and incorporated
herein by reference ("Services" or "Work") which reflects an increase in total
compensation for additional services not included in the Agreement. Exhibit A to the
Agreement and Exhibit A to Amendment No. One shall collectively be known as "Exhibit
A."
Section 4.1 of the Agreement is amended in its entirety and replaced with the
following: "City shall pay Consultant for the Services on a time and expense not -to -
exceed basis in accordance with the provisions of this Section and the Scope of
Services and Schedule of Billing Rates attached hereto as Exhibit A and incorporated
herein by reference. Consultant's compensation for all Work performed in accordance
with this Agreement, including all reimbursable items and subconsultant fees, shall not
exceed Twenty Eight Thousand Two Hundred Twenty Five Dollars and 001100
($28,225.00), without prior written authorization from City. No billing rate changes shall
be made during the term of this Agreement without the prior written approval of City."
The total amended compensation reflects Consultant's additional compensation
for additional Services to be performed in accordance with this Amendment No. 1,
including all reimbursable items and subconsultant fees, in an amount not to exceed
Four Thousand One Hundred Twenty Five Dollars and 001100 ($4,125.00).
3. INTEGRATED CONTRACT
Except as expressly modified herein, all other provisions, terms, and covenants
set forth in the Agreement shall remain unchanged and shall be in full force and effect.
[SIGNATURES ON NEXT PAGE]
Lillestrand Leadership Consulting, Inc. Page 2
IN WITNESS WHEREOF, the parties have caused this Amendment No. [1] to be
executed on the dates written below.
APPROVED AS TO FORM:
CITY ATTORNEY'S OFFICE
Date: �Y-
By:
Aaron C. Harp
City Attorney
ATTEST: J_ ' I^
Date: 1E
By: YW� y�
Leilani I. Brown
City Clerk
Attachments:
CITY OF NEWPORT BEACH,
a California uni . I corporation
Date: "� /,
By:
4—
Scott Poster
Fire Chief
CONSULTANT: Lillestrand Leadership
Consulting, Inc. , a California corporation
Date:
By:
Signed in Counterpart
Loren Lillestrand
Chief Executive Officer
Date:
Bv: Signed in Counterpart
Loren Lillestrand
Secretary
[END OF SIGNATURES]
Exhibit A — Scope of Services & Schedule of Billing Rates
Lillestrand Leadership Consulting, Inc. Page 3
IN WITNESS WHEREOF, the parties have caused this Amendment No. [1] to be
executed on the dates written below.
APPROVED AS TO FORM:
CITY ATTORNEY'S OFFICE
Date:
Wy
air�Karrp
City Attorneyt
CITY OF NEWPORT BEACH,
a California uni pal corporation
Date:
By:
Scott Poster
Fire Chief
ATTEST: CONSULTANT: Lillestrand Leadership
Date: Consulti g, nc. a California corporation
Date:
By: B e
Leilani I. Brown ren Lillestr
City Clerk Chief Exrutlive Officer
Date: b 1 I! I l
Loren Lille
Secretary
[END OF SIGNATURES]
Attachments: Exhibit A — Scope of Services & Schedule of Billing Rates
Lillestrand Leadership Consulting, Inc. Page 3
EXHIBIT A
SCOPE OF SERVICES AND
SCHEDULE OF BILLING RATES
Lillestrand Leadership Consulting, Inc. Page A-1
Lillestrandr
Leadership
Consulting ,
Effective communication is the life blood of any organization and, furthermore, every
organization is a direct reflection of the leadership being given. Therefore it is wise to
seek to enhance the leadership team's awareness and effectiveness. This workshop is
designed with that end in mind. The session will consist of three segments.
One segment will be devoted to the subject of Personality Awareness. This is designed
to increase personal awareness, reduce inaccurate projections, strengthen relationships
and enhance team effectiveness.
Another segment will begin a team discussion with the desired outcome of clarifying
communication overall. This discussion will involve topics such as, but not limited to:
What are the symptoms of the need for enhancing communication; what information
needs to be shared with everyone on the Executive Team; what does each person on
the team expect from fellow team members in terms of degree of communication (i.e.,
level of detail and frequency), what items need to be communicated to the others on
the team and to which team members prior to action (especially those items being
disseminated to staff); and, which items require staff involvement prior to broad
communication. Someone on the team will be designated to take notes on the
discussion with the idea that any unfinished aspects will be carried through to the next
day of the workshop for further discussion (i.e., without the facilitator).
The last segment will be dedicated to the subject of Elegant Persuasion. This portion of
the day is designed... to help enhance each team member's persuasion awareness and
skill; to be help each team member be motivated to improve effectiveness; to discover
key elements for getting to a mutually agreeable "yes" more often; and, to be able to
begin to utilize the concepts immediately.
This initiative will require a quarter day (i.e., 2 hours) for preparation and one day on
site facilitating the event. The total cost is $3975 (i.e., 1.25 days at $3100 per day)
plus minor incidentals not to exceed $150 (e.g., mileage at the IRS rate).
As always, it is a distinct privilege to serve you,
Loren Lillestrand
2729 Brookside Drive ♦ Chino Hills, CA 91709 ♦ 909-496-9060
Loren@Lillestrand.com ♦ www.Lillestrand.com ♦ LorenLiIIestrand@gmail.com
6
Al
PROFESSIONAL SERVICES AGREEMENT
WITH LILLESTRAND LEADERSHIP CONSULTING, INC. FOR
LEADERSHIP TRAINING FOR FIRE MANAGEMENT
THIS PROFESSIONAL SERVICES AGREEMENT ("Agreement') is made and
entered into as of this 1st day of March, 2016 ("Effective Date"), by and between the
CITY OF NEWPORT BEACH, a California municipal corporation and charter city
("City"), and LILLESTRAND LEADERSHIP CONSULTING, INC. a California corporation
("Consultant'), whose address is 2729 Brookside Drive, Chino Hills, California 91709,
and is made with reference to the following:
RECITALS
A. City is a municipal corporation duly organized and validly existing under the laws
of the State of California with the power to carry on its business as it is now being
conducted under the statutes of the State of California and the Charter of City.
B. City desires to engage Consultant to provide a yearlong leadership training for
the City's Four Battalion Chiefs ("Project').
C. Consultant possesses the skill, experience, ability, background, certification and
knowledge to provide the professional services described in this Agreement.
D. City has solicited and received a proposal from Consultant, has reviewed the
previous experience and evaluated the expertise of Consultant, and desires to
retain Consultant to render professional services under the terms and conditions
set forth in this Agreement.
NOW, THEREFORE, it is mutually agreed by and between the undersigned
parties as follows:
1. TERM
The term of this Agreement shall commence on the Effective Date, and shall
terminate on June 30, 2017, unless terminated earlier as set forth herein.
2. SERVICES TO BE PERFORMED
Consultant shall diligently perform all the services described in the Scope of
Services and Schedule of Billing Rates attached hereto as Exhibit A and incorporated
herein by reference ("Services" or "Work'). City may elect to delete certain Services
within the Scope of Services at its sole discretion.
3. TIME OF PERFORMANCE
3.1 Time is of the essence in the performance of Services under this
Agreement and Consultant shall perform the Services in accordance with the schedule
included in Exhibit A. In the absence of a specific schedule, the Services shall be
performed to completion in a diligent and timely manner. The failure by Consultant to
strictly adhere to the schedule set forth in Exhibit A, if any, or perform the Services in a
diligent and timely manner may result in termination of this Agreement by City.
3.2 Notwithstanding the foregoing, Consultant shall not be responsible for
delays due to causes beyond Consultant's reasonable control. However, in the case of
any such delay in the Services to be provided for the Project, each party hereby agrees
to provide notice within two (2) calendar days of the occurrence causing the delay to the
other party so that all delays can be addressed.
3.3 Consultant shall submit all requests for extensions of time for performance
in writing to the Project Administrator as defined herein not later than ten (10) calendar
days after the start of the condition that purportedly causes a delay. The Project
Administrator shall review all such requests and may grant reasonable time extensions
for unforeseeable delays that are beyond Consultant's control.
3.4 For all time periods not specifically set forth herein, Consultant shall
respond in the most expedient and appropriate manner under the circumstances, by
hand -delivery or mail.
4. COMPENSATION TO CONSULTANT
4.1 City shall pay Consultant for the Services on a time and expense not -to -
exceed basis in accordance with the provisions of this Section and Exhibit A.
Consultant's compensation for all Work performed in accordance with this Agreement,
including all reimbursable items and subconsultant fees, shall not exceed Twenty Four
Thousand One Hundred Dollars and 00/100 ($24,100.00), without prior written
authorization from City. No billing rate changes shall be made during the term of this
Agreement without the prior written approval of City.
4.2 Consultant shall submit monthly invoices to City describing the Work
performed the preceding month. Consultant's bills shall include the name of the person
who performed the Work, a brief description of the Services performed and/or the
specific task in the Scope of Services to which it relates, the date the Services were
performed, the number of hours spent on all Work billed on an hourly basis, and a
description of any reimbursable expenditures. City shall pay Consultant no later than
thirty (30) calendar days after approval of the monthly invoice by City staff.
4.3 City shall reimburse Consultant only for those costs or expenses
specifically identified in Exhibit A to this Agreement or specifically approved in writing in
advance by City.
4.4 Consultant shall not receive any compensation for Extra Work performed
without the prior written authorization of City. As used herein, "Extra Work" means any
Work that is determined by City to be necessary for the proper completion of the
Project, but which is not included within the Scope of Services and which the parties did
not reasonably anticipate would be necessary at the execution of this Agreement.
Lillestrand Leadership Consulting, Inc. Page 2
Compensation for any authorized Extra Work shall be paid in accordance with the
Schedule of Billing Rates as set forth in Exhibit A.
5. PROJECT MANAGER
5.1 Consultant shall designate a Project Manager, who shall coordinate all
phases of the Project. This Project Manager shall be available to City at all reasonable
times during the Agreement term. Consultant has designated Loren Lillestrand to be its
Project Manager. Consultant shall not remove or reassign the Project Manager or any
personnel listed in Exhibit A or assign any new or replacement personnel to the Project
without the prior written consent of City. City's approval shall not be unreasonably
withheld with respect to the removal or assignment of non -key personnel.
5.2 Consultant, at the sole discretion of City, shall remove from the Project
any of its personnel assigned to the performance of Services upon written request of
City. Consultant warrants that it will continuously furnish the necessary personnel to
complete the Project on a timely basis as contemplated by this Agreement.
5.3 If Consultant is performing inspection services for City, the Project
Manager and any other assigned staff shall be equipped with a cellular phone to
communicate with City staff. The Project Manager's cellular phone number shall be
provided to City.
6. ADMINISTRATION
This Agreement will be administered by the Fire Department. City's Fire Chief or
designee shall be the Project Administrator and shall have the authority to act for City
under this Agreement. The Project Administrator shall represent City in all matters
pertaining to the Services to be rendered pursuant to this Agreement.
7. CITY'S RESPONSIBILITIES
To assist Consultant in the execution of its responsibilities under this Agreement,
City agrees to provide access to and upon request of Consultant, one copy of all
existing relevant information on file at City. City will provide all such materials in a
timely manner so as not to cause delays in Consultant's Work schedule.
8. STANDARD OF CARE
8.1 All of the Services shall be performed by Consultant or under Consultant's
supervision. Consultant represents that it possesses the professional and technical
personnel required to perform the Services required by this Agreement, and that it will
perform all Services in a manner commensurate with community professional standards
and with the ordinary degree of skill and care that would be used by other reasonably
competent practitioners of the same discipline under similar circumstances. All
Services shall be performed by qualified and experienced personnel who are not
employed by City. By delivery of completed Work, Consultant certifies that the Work
Lillestrand Leadership Consulting, Inc. Page 3
conforms to the requirements of this Agreement, all applicable federal, state and local
laws, and legally recognized professional standards.
8.2 Consultant represents and warrants to City that it has, shall obtain, and
shall keep in full force and effect during the term hereof, at its sole cost and expense, all
licenses, permits, qualifications, insurance and approvals of whatsoever nature that is
legally required of Consultant to practice its profession. Consultant shall maintain a City
of Newport Beach business license during the term of this Agreement.
8.3 Consultant shall not be responsible for delay, nor shall Consultant be
responsible for damages or be in default or deemed to be in default by reason of strikes,
lockouts, accidents, acts of God, or the failure of City to furnish timely information or to
approve or disapprove Consultant's Work promptly, or delay or faulty performance by
City, contractors, or governmental agencies.
9. HOLD HARMLESS
9.1 To the fullest extent permitted by law, Consultant shall indemnify, defend
and hold harmless City, its City Council, boards and commissions, officers, agents,
volunteers and employees (collectively, the "Indemnified Parties") from and against any
and all claims (including, without limitation, claims for bodily injury, death or damage to
property), demands, obligations, damages, actions, causes of action, suits, losses,
judgments, fines, penalties, liabilities, costs and expenses (including, without limitation,
attorneys' fees, disbursements and court costs) of every kind and nature whatsoever
(individually, a Claim; collectively, "Claims"), which may arise from or in any manner
relate (directly or indirectly) to any breach of the terms and conditions of this
Agreement, any Work performed or Services provided under this Agreement including,
without limitation, defects in workmanship or materials or Consultant's presence or
activities conducted on the Project (including the negligent, reckless, and/or willful acts,
errors and/or omissions of Consultant, its principals, officers, agents, employees,
vendors, suppliers, consultants, subcontractors, anyone employed directly or indirectly
by any of them or for whose acts they may be liable, or any or all of them).
9.2 Notwithstanding the foregoing, nothing herein shall be construed to
require Consultant to indemnify the Indemnified Parties from any Claim arising from the
sole negligence or willful misconduct of the Indemnified Parties. Nothing in this
indemnity shall be construed as authorizing any award of attorneys' fees in any action
on or to enforce the terms of this Agreement. This indemnity shall apply to all claims
and liability regardless of whether any insurance policies are applicable. The policy
limits do not act as a limitation upon the amount of indemnification to be provided by
Consultant.
10. INDEPENDENT CONTRACTOR
It is understood that City retains Consultant on an independent contractor basis
and Consultant is not an agent or employee of City. The manner and means of
conducting the Work are under the control of Consultant, except to the extent they are
Lillestrand Leadership Consulting, Inc. Page 4
limited by statute, rule or regulation and the expressed terms of this Agreement. No
civil service status or other right of employment shall accrue to Consultant or its
employees. Nothing in this Agreement shall be deemed to constitute approval for
Consultant or any of Consultant's employees or agents, to be the agents or employees
of City. Consultant shall have the responsibility for and control over the means of
performing the Work, provided that Consultant is in compliance with the terms of this
Agreement. Anything in this Agreement that may appear to give City the right to direct
Consultant as to the details of the performance of the Work or to exercise a measure of
control over Consultant shall mean only that Consultant shall follow the desires of City
with respect to the results of the Services.
11. COOPERATION
Consultant agrees to work closely and cooperate fully with City's designated
Project Administrator and any other agencies that may have jurisdiction or interest in the
Work to be performed. City agrees to cooperate with the Consultant on the Project.
12. CITY POLICY
Consultant shall discuss and review all matters relating to policy and Project
direction with City's Project Administrator in advance of all critical decision points in
order to ensure the Project proceeds in a manner consistent with City goals and
policies.
13. PROGRESS
Consultant is responsible for keeping the Project Administrator informed on a
regular basis regarding the status and progress of the Project, activities performed and
planned, and any meetings that have been scheduled or are desired.
14. INSURANCE
Without limiting Consultant's indemnification of City, and prior to commencement
of Work, Consultant shall obtain, provide and maintain at its own expense during the
term of this Agreement or for other periods as specified in this Agreement, policies of
insurance of the type, amounts, terms and conditions described in the Insurance
Requirements attached hereto as Exhibit B, and incorporated herein by reference.
15. PROHIBITION AGAINST ASSIGNMENTS AND TRANSFERS
Except as specifically authorized under this Agreement, the Services to be
provided under this Agreement shall not be assigned, transferred contracted or
subcontracted out without the prior written approval of City. Any of the following shall
be construed as an assignment: The sale, assignment, transfer or other disposition of
any of the issued and outstanding capital stock of Consultant, or of the interest of any
general partner or joint venturer or syndicate member or cotenant if Consultant is a
partnership or joint -venture or syndicate or co -tenancy, which shall result in changing
the control of Consultant. Control means fifty percent (50%) or more of the voting
Lillestrand Leadership Consulting, Inc. Page 5
power or twenty-five percent (25%) or more of the assets of the corporation, partnership
or joint -venture.
16. SUBCONTRACTING
The subcontractors authorized by City, if any, to perform Work on this Project are
identified in Exhibit A. Consultant shall be fully responsible to City for all acts and
omissions of any subcontractor. Nothing in this Agreement shall create any contractual
relationship between City and any subcontractor nor shall it create any obligation on the
part of City to pay or to see to the payment of any monies due to any such
subcontractor other than as otherwise required by law. City is an intended beneficiary
of any Work performed by the subcontractor for purposes of establishing a duty of care
between the subcontractor and City. Except as specifically authorized herein, the
Services to be provided under this Agreement shall not be otherwise assigned,
transferred, contracted or subcontracted out without the prior written approval of City.
17. OWNERSHIP OF DOCUMENTS
17.1 Each and every report, draft, map, record, plan, document and other
writing produced, including but not limited to, websites, blogs, social media accounts
and applications (hereinafter "Documents"), prepared or caused to be prepared by
Consultant, its officers, employees, agents and subcontractors, in the course of
implementing this Agreement, shall become the exclusive property of City, and City
shall have the sole right to use such materials in its discretion without further
compensation to Consultant or any other party. Additionally, all material posted in
cyberspace by Consultant, its officers, employees, agents and subcontractors, in the
course of implementing this Agreement, shall become the exclusive property of City,
and City shall have the sole right to use such materials in its discretion without further
compensation to Consultant or any other party. Consultant shall, at Consultant's
expense, provide such Documents, including all logins and password information to City
upon prior written request.
17.2 Documents, including drawings and specifications, prepared by
Consultant pursuant to this Agreement are not intended or represented to be suitable
for reuse by City or others on any other project. Any use of completed Documents for
other projects and any use of incomplete Documents without specific written
authorization from Consultant will be at City's sole risk and without liability to
Consultant. Further, any and all liability arising out of changes made to Consultant's
deliverables under this Agreement by City or persons other than Consultant is waived
against Consultant, and City assumes full responsibility for such changes unless City
has given Consultant prior notice and has received from Consultant written consent for
such changes.
17.3 All written documents shall be transmitted to City in formats compatible
with Microsoft Office and/or viewable with Adobe Acrobat.
Lillestrand Leadership Consulting, Inc. Page 6
i .3 0191.13r74.ti1101 A 1161
All Documents, including drafts, preliminary drawings or plans, notes and
communications that result from the Services in this Agreement, shall be kept
confidential unless City expressly authorizes in writing the release of information.
19. INTELLECTUAL PROPERTY INDEMNITY
Consultant shall defend and indemnify City, its agents, officers, representatives
and employees against any and all liability, including costs, for infringement or alleged
infringement of any United States' letters patent, trademark, or copyright, including
costs, contained in Consultant's Documents provided under this Agreement.
20. RECORDS
Consultant shall keep records and invoices in connection with the Services to be
performed under this Agreement. Consultant shall maintain complete and accurate
records with respect to the costs incurred under this Agreement and any Services,
expenditures and disbursements charged to City, for a minimum period of three (3)
years, or for any longer period required by law, from the date of final payment to
Consultant under this Agreement. All such records and invoices shall be clearly
identifiable. Consultant shall allow a representative of City to examine, audit and make
transcripts or copies of such records and invoices during regular business hours.
Consultant shall allow inspection of all Work, data, Documents, proceedings and
activities related to the Agreement for a period of three (3) years from the date of final
payment to Consultant under this Agreement.
21. WITHHOLDINGS
City may withhold payment to Consultant of any disputed sums until satisfaction
of the dispute with respect to such payment. Such withholding shall not be deemed to
constitute a failure to pay according to the terms of this Agreement. Consultant shall
not discontinue Work as a result of such withholding. Consultant shall have an
immediate right to appeal to the City Manager or designee with respect to such disputed
sums. Consultant shall be entitled to receive interest on any withheld sums at the rate of
return that City earned on its investments during the time period, from the date of
withholding of any amounts found to have been improperly withheld.
22. ERRORS AND OMISSIONS
In the event of errors or omissions that are due to the negligence or professional
inexperience of Consultant which result in expense to City greater than what would
have resulted if there were not errors or omissions in the Work accomplished by
Consultant, the additional design, construction and/or restoration expense shall be
borne by Consultant. Nothing in this Section is intended to limit City's rights under the
law or any other sections of this Agreement.
Lillestrand Leadership Consulting, Inc. Page 7
23. CITY'S RIGHT TO EMPLOY OTHER CONSULTANTS
City reserves the right to employ other Consultants in connection with the
Project.
24. CONFLICTS OF INTEREST
24.1 Consultant or its employees may be subject to the provisions of the
California Political Reform Act of 1974 (the "Act"), which (1) requires such persons to
disclose any financial interest that may foreseeably be materially affected by the Work
performed under this Agreement, and (2) prohibits such persons from making, or
participating in making, decisions that will foreseeably financially affect such interest.
24.2 If subject to the Act, Consultant shall conform to all requirements of the
Act. Failure to do so constitutes a material breach and is grounds for immediate
termination of this Agreement by City. Consultant shall indemnify and hold harmless
City for any and all claims for damages resulting from Consultant's violation of this
Section.
25. NOTICES
25.1 All notices, demands, requests or approvals, including any change in
mailing address, to be given under the terms of this Agreement shall be given in writing,
and conclusively shall be deemed served when delivered personally, or on the third
business day after the deposit thereof in the United States mail, postage prepaid, first-
class mail, addressed as hereinafter provided.
25.2 All notices, demands, requests or approvals from Consultant to City shall
be addressed to City at:
Attn: Scott Poster, Fire Chief
Fire Department
City of Newport Beach
100 Civic Center Drive
PO Box 1768
Newport Beach, CA 92658
25.3 All notices, demands, requests or approvals from City to Consultant shall
be addressed to Consultant at:
Attn: Loren Lillestrand
Lillestrand Leadership Consulting, Inc.
2729 Brookside Drive
Chino Hills, CA 91709
Lillestrand Leadership Consulting, Inc. Page 8
26. CLAIMS
Unless a shorter time is specified elsewhere in this Agreement, before making its
final request for payment under this Agreement, Consultant shall submit to City, in
writing, all claims for compensation under or arising out of this Agreement.
Consultant's acceptance of the final payment shall constitute a waiver of all claims for
compensation under or arising out of this Agreement except those previously made in
writing and identified by Consultant in writing as unsettled at the time of its final request
for payment. Consultant and City expressly agree that in addition to any claims filing
requirements set forth in the Agreement, Consultant shall be required to file any claim
Consultant may have against City in strict conformance with the Government Claims Act
(Government Code sections 900 et seq.).
27. TERMINATION
27.1 In the event that either party fails or refuses to perform any of the
provisions of this Agreement at the time and in the manner required, that party shall be
deemed in default in the performance of this Agreement. If such default is not cured
within a period of two (2) calendar days, or if more than two (2) calendar days are
reasonably required to cure the default and the defaulting party fails to give adequate
assurance of due performance within two (2) calendar days after receipt of written
notice of default, specifying the nature of such default and the steps necessary to cure
such default, and thereafter diligently take steps to cure the default, the non -defaulting
party may terminate the Agreement forthwith by giving to the defaulting party written
notice thereof.
27.2 Notwithstanding the above provisions, City shall have the right, at its sole
and absolute discretion and without cause, of terminating this Agreement at any time by
giving no less than seven (7) calendar days' prior written notice to Consultant. In the
event of termination under this Section, City shall pay Consultant for Services
satisfactorily performed and costs incurred up to the effective date of termination for
which Consultant has not been previously paid. On the effective date of termination,
Consultant shall deliver to City all reports, Documents and other information developed
or accumulated in the performance of this Agreement, whether in draft or final form.
28. STANDARD PROVISIONS
28.1 Recitals. City and Consultant acknowledge that the above Recitals are
true and correct and are hereby incorporated by reference into this Agreement.
28.2 Compliance with all Laws. Consultant shall, at its own cost and expense,
comply with all statutes, ordinances, regulations and requirements of all governmental
entities, including federal, state, county or municipal, whether now in force or hereinafter
enacted. In addition, all Work prepared by Consultant shall conform to applicable City,
county, state and federal laws, rules, regulations and permit requirements and be
subject to approval of the Project Administrator and City.
Lillestrand Leadership Consulting, Inc. Page 9
28.3 Waiver. A waiver by either party of any breach, of any term, covenant or
condition contained herein shall not be deemed to be a waiver of any subsequent
breach of the same or any other term, covenant or condition contained herein, whether
of the same or a different character.
28.4 Integrated Contract. This Agreement represents the full and complete
understanding of every kind or nature whatsoever between the parties hereto, and all
preliminary negotiations and agreements of whatsoever kind or nature are merged
herein. No verbal agreement or implied covenant shall be held to vary the provisions
herein.
28.5 Conflicts or Inconsistencies. In the event there are any conflicts or
inconsistencies between this Agreement and the Scope of Services or any other
attachments attached hereto, the terms of this Agreement shall govern.
28.6 Interpretation. The terms of this Agreement shall be construed in
accordance with the meaning of the language used and shall not be construed for or
against either party by reason of the authorship of the Agreement or any other rule of
construction which might otherwise apply.
28.7 Amendments. This Agreement may be modified or amended only by a
written document executed by both Consultant and City and approved as to form by the
City Attorney.
28.8 Severability. If any term or portion of this Agreement is held to be invalid,
illegal, or otherwise unenforceable by a court of competent jurisdiction, the remaining
provisions of this Agreement shall continue in full force and effect.
28.9 Controlling Law and Venue. The laws of the State of California shall
govern this Agreement and all matters relating to it and any action brought relating to
this Agreement shall be adjudicated in a court of competent jurisdiction in the County of
Orange, State of California.
28.10 Equal Opportunity Employment. Consultant represents that it is an equal
opportunity employer and it shall not discriminate against any subcontractor, employee
or applicant for employment because race, religious creed, color, national origin,
ancestry, physical handicap, medical condition, marital status, sex, sexual orientation,
age or any other impermissible basis under law.
28.11 No Attorneys' Fees. In the event of any dispute or legal action arising
under this Agreement, the prevailing party shall not be entitled to attorneys' fees.
28.12 Counterparts. This Agreement may be executed in two (2) or more
counterparts, each of which shall be deemed an original and all of which together shall
constitute one (1) and the same instrument.
[SIGNATURES ON NEXT PAGE]
Lillestrand Leadership Consulting, Inc. Page 10
IN WITNESS WHEREOF, the parties have caused this Agreement to be
executed on the dates written below.
APPROVED AS TO FORM:
CITY ATTORNEY'S OFFICE
Date: 3 /a /16
Al
Aaron C. Harp
City Attorney
ATTEST:
Date: -34.1(�
By: c bw—.
Leilani I. Brown
City Clerk
CITY OF NEWPORT BEACH,
a California municipal corporation
Date: MA fl L 9016
By:
_ �4
Scott Poster
Fire Chief
CONSULTANT: Lillestrand Leadership
Consulting,nc.,p California corporation
Date: )/� // 1v
Loren LiJte-frand
Chief Executive Officer
Date: 3
Loren Lille
Secretary
[END OF SIGNATURES]
f //%
Attachments: Exhibit A – Scope of Services and Schedule of Billing Rates
Exhibit B – Insurance Requirements
Lillestrand Leadership Consulting, Inc. Page 11
EXHIBIT A
SCOPE OF SERVICES AND
SCHEDULE OF BILLING RATES
Lillestrand Leadership Consulting, Inc. Page A-1
Lillestrand
Leadership
Consulting ;
Introduction
LEADERSHIP DEVELOPMENT
CITY OF NEWPORT BEACH
SCOPE OF WORK
Every organization, or organizational unit, is a direct reflection of the leadership it's been
given, for benefit or for harm. The effective practices of leaders move the organization and its
team members towards realizing the vision, and in a manner that honors the organization's
values while simultaneously building up those they lead. The ineffectual and/or harmful
practices of the leader yield the opposite.
Typically organizations dedicate their most significant per person compensation and benefits
packages for their leaders. It follows that making a further investment in their development is
wise—especially when that development investment is focused upon identifying and
developing the practices each leader needs for making their optimum contribution to the
achieving the organizations vision.
Lillestrand Leadership Consulting has a long history of developing an organization's
leadership for increased effectiveness. In the quest to continue to expand their leadership
development capabilities, Lillestrand Leadership Consulting is now partnered with
Management Research Group. MRG is one of the premier leadership development research
and assessment organizations in the world—arguably best in class. Based on over 30 years of
research using a uniquely accurate and highly validated assessment methodology, they have
accumulated more than a million assessment -based profiles of real leaders in ten different
language groups throughout the globe from numerous organizations (e.g., Motorola
Semiconductor, Intel, The Walt Disney Company, Microsoft, Unum Insurance, Coca Cola,
ADP and LL Bean).
Process Overview
The process involves the individual and a few observers (e.g., their boss, their direct reports
and a few peers) completing a standardized assessment inventory (i.e., test). The inventory
assesses 22 distinct practices related to the six key leadership areas of (1) creating a vision; (2)
developing followership, (3) implementing the vision, (4) follow-through, (5) achieving results
and (6) team play. A report is generated from this input.
2729 Brookside Drive ♦ Chino Hills, CA 91709 ♦ 909.496-9060
Loren@Lillestrand.com ♦ www.Lillestrand.com ♦ LorenLillestrand@gmail.com
Page 2
The report provides the individual leader with objective, persuasive insights into their current
leadership practices. It helps leaders understand how their behavior helps or hinders their
effectiveness in their leadership role. The report, combined with the guidance of the leadership
coach, creates a clear, non -threatening process for forming a customized development
direction with specific developmental activities for each individual leader. These activities are
tracked and facilitated by periodic one-on-one sessions with the leadership coach.
This initiative will be focused on four City of Newport Beach Leaders, namely, the four
Battalion Chiefs.
Budget
Pre -planning and administrative set-up work for one half day of consulting at $3100 per 8 -
hour day is $1550. The cost for the standardized leadership assessment inventory is $400 for
each of the four Leaders (no matter how many "observers" provide feedback) or $1600.
The initial coaching meeting with each of these four Leaders requires 2 hours per participant;
review of each LEA 360 (i.e., 8 hours) and the identification of developmental opportunities
needs 2 hours each (i.e., 8 hours); finalizing developmental plans with each participant runs an
additional 2 hours each (i.e., 8 hours) for a total of 3 days of consulting (i.e., 24 hours) or
$9,300. The cost of ongoing one-on-one follow up leadership coaching sessions (at a duration
of 90 minutes to two hours each and at a frequency of about once a month) for the duration of
the initiative requires 3.5 days of consulting at $3100 per day or $10,850. To provide adequate
preparation plus follow through for the ongoing one-on-one coaching sessions, to cover
incidentals (e.g., mileage at the current IRS rate) and to provide periodic debriefings as needed
requires $800. The total budget for this leadership development initiative is $24,100.
As always, it is a distinct privilege to serve you,
Loren Lillestrand
2729 Brookside Drive ♦ Chino Hills, CA 91709 ♦ 909-496-9060
Loren@Lillestrand.com ♦ www.Lillestrand.com ♦ LorenLillestrand@gmail.com
EXHIBIT C
INSURANCE REQUIREMENTS — PROFESSIONAL SERVICES
1. Provision of Insurance. Without limiting Consultant's indemnification of City, and
prior to commencement of Work, Consultant shall obtain, provide and maintain at
its own expense during the term of this Agreement, policies of insurance of the
type and amounts described below and in a form satisfactory to City. Consultant
agrees to provide insurance in accordance with requirements set forth here. If
Consultant uses existing coverage to comply and that coverage does not meet
these requirements, Consultant agrees to amend, supplement or endorse the
existing coverage.
2. Acceptable Insurers. All insurance policies shall be issued by an insurance
company currently authorized by the Insurance Commissioner to transact
business of insurance in the State of California, with an assigned policyholders'
Rating of A- (or higher) and Financial Size Category Class VII (or larger) in
accordance with the latest edition of Best's Key Rating Guide, unless otherwise
approved by the City's Risk Manager.
3. Coverage Requirements.
A. Workers' Compensation Insurance. Consultant shall maintain Workers'
Compensation Insurance, statutory limits, and Employer's Liability
Insurance with limits of at least one million dollars ($1,000,000) each
accident for bodily injury by accident and each employee for bodily injury
by disease in accordance with the laws of the State of California, Section
3700 of the Labor Code.
Consultant shall submit to City, along with the certificate of insurance, a
Waiver of Subrogation endorsement in favor of City, its officers, agents,
employees and volunteers.
B. General Liability Insurance. Consultant shall maintain commercial general
liability insurance, and if necessary umbrella liability insurance, with
coverage at least as broad as provided by Insurance Services Office form
CG 00 01, in an amount not less than one million dollars ($1,000,000) per
occurrence, two million dollars ($2,000,000) general aggregate. The
policy shall cover liability arising from premises, operations, personal and
advertising injury, and liability assumed under an insured contract
(including the tort liability of another assumed in a business contract).
C. Automobile Liability Insurance. Consultant shall maintain automobile
insurance at least as broad as Insurance Services Office form CA 00 01
covering bodily injury and property damage for all activities of Consultant
arising out of or in connection with Work to be performed under this
Agreement, including coverage for any owned, hired, non -owned or rented
vehicles, in an amount not less than one million dollars ($1,000,000)
combined single limit each accident.
Lillestrand Leadership Consulting, Inc. Page B-1
4. Other Insurance Reguirements. The policies are to contain, or be endorsed to
contain, the following provisions:
A. Waiver of Subrogation. All insurance coverage maintained or procured
pursuant to this Agreement shall be endorsed to waive subrogation
against City, its elected or appointed officers, agents, officials, employees
and volunteers or shall specifically allow Consultant or others providing
insurance evidence in compliance with these requirements to waive their
right of recovery prior to a loss. Consultant hereby waives its own right of
recovery against City, and shall require similar written express waivers
from each of its subconsultants.
B. Additional Insured Status. All liability policies including general liability,
excess liability, pollution liability, and automobile liability, if required, but
not including professional liability, shall provide or be endorsed to provide
that City and its officers, officials, employees, and agents shall be included
as insureds under such policies.
C. Primary and Non Contributory. All liability coverage shall apply on a
primary basis and shall not require contribution from any insurance or self-
insurance maintained by City.
D. Notice of Cancellation. All policies shall provide City with thirty (30)
calendar days notice of cancellation (except for nonpayment for which ten
(10) calendar days notice is required) or nonrenewal of coverage for each
required coverage.
5. Additional Agreements Between the Parties. The parties hereby agree to the
following:
A. Evidence of Insurance. Consultant shall provide certificates of insurance
to City as evidence of the insurance coverage required herein, along with
a waiver of subrogation endorsement for workers' compensation and other
endorsements as specified herein for each coverage. Insurance
certificates and endorsement must be approved by City's Risk Manager
prior to commencement of performance. Current certification of insurance
shall be kept on file with City at all times during the term of this
Agreement. City reserves the right to require complete, certified copies of
all required insurance policies, at any time.
B. City's Right to Revise Requirements. City reserves the right at any time
during the term of the Agreement to change the amounts and types of
insurance required by giving Consultant sixty (60) calendar days advance
written notice of such change. If such change results in substantial
additional cost to Consultant, City and Consultant may renegotiate
Consultant's compensation.
C. Enforcement of Agreement Provisions. Consultant acknowledges and
agrees that any actual or alleged failure on the part of City to inform
Lillestrand Leadership Consulting, Inc. Page B-2
Consultant of non-compliance with any requirement imposes no additional
obligations on City nor does it waive any rights hereunder.
D. Requirements not Limiting. Requirements of specific coverage features
or limits contained in this Section are not intended as a limitation on
coverage, limits or other requirements, or a waiver of any coverage
normally provided by any insurance. Specific reference to a given
coverage feature is for purposes of clarification only as it pertains to a
given issue and is not intended by any party or insured to be all inclusive,
or to the exclusion of other coverage, or a waiver of any type. If the
Consultant maintains higher limits than the minimums shown above, the
City requires and shall be entitled to coverage for higher limits maintained
by the Consultant. Any available insurance proceeds in excess of the
specified minimum limits of insurance and coverage shall be available to
the City.
E. Self-insured Retentions. Any self-insured retentions must be declared to
and approved by City. City reserves the right to require that self-insured
retentions be eliminated, lowered, or replaced by a deductible. Self-
insurance will not be considered to comply with these requirements unless
approved by City.
F. City Remedies for Non -Compliance. If Consultant or any subconsultant
fails to provide and maintain insurance as required herein, then City shall
have the right but not the obligation, to purchase such insurance, to
terminate this Agreement, or to suspend Consultant's right to proceed until
proper evidence of insurance is provided. Any amounts paid by City shall,
at City's sole option, be deducted from amounts payable to Consultant or
reimbursed by Consultant upon demand.
G. Timely Notice of Claims. Contractor shall give City prompt and timely
notice of claims made or suits instituted that arise out of or result from
Contractor's performance under this Contract, and that involve or may
involve coverage under any of the required liability policies. City assumes
no obligation or liability by such notice, but has the right (but not the duty)
to monitor the handling of any such claim or claims if they are likely to
involve City.
H. Consultant's Insurance. Consultant shall also procure and maintain, at its
own cost and expense, any additional kinds of insurance, which in its own
judgment may be necessary for its proper protection and prosecution of
the Work.
Lillestrand Leadership Consulting, Inc. Page B-3
CERTIFICATE OF INSURANCE
CHECKLIST
City of Newport Beach
This checklist is comprised of requirements as outlined by the City of Newport Beach. *
Date Received: 3/7/16 Dept./Contact Received From: Jenny
Date Completed: 3/11/16 Sent to: Jenny By: Alicia
Company/Person required to have certificate: Lillestrand Leadership Consulting Inc.
Type of contract: All Other
I. GENERAL LIABILITY
EFFECTIVE/EXPIRATION DATE: 5/13/15-5/13/16
A.
INSURANCE COMPANY: Sentinel Ins. Co. LTD
B.
AM BEST RATING (A-: VII or greater): A+: XV
INSURANCE COMPANY: State Farm Mutual Automobile Ins Co
C.
ADMITTED Company (Must be California Admitted):
B.
Is Company admitted in California?
® Yes ❑ No
D.
LIMITS (Must be $1 M or greater): What is limit provided?
2,000,000/4,000,000
E.
ADDITIONAL INSURED ENDORSEMENT — please attach
® Yes ❑ No
F.
PRODUCTS AND COMPLETED OPERATIONS (Must
Is Company admitted in California?
include): Is it included? (completed Operations status does
❑ No
D.
not apply to Waste Haulers or Recreation)
® Yes ❑ No
G.
ADDITIONAL INSURED FOR PRODUCTS AND
1,000,000
COMPLETED OPERATIONS ENDORSEMENT (completed
LIMITS Waiver of Auto Insurance / Proof of coverage (if individual)
Operations status does not apply to Waste Haulers)
® Yes ❑ No
H.
ADDITIONAL INSURED WORDING TO INCLUDE (The City
its officers, officials, employees and volunteers): Is it
PRIMARY & NON-CONTRIBUTORY WORDING (For Waste
included?
® Yes ❑ No
I.
PRIMARY & NON-CONTRIBUTORY WORDING (Must be
® N/A
❑ Yes
included): Is it included?
® Yes ❑ No
J.
CAUTION! (Confirm that loss or liability of the named insured
❑ Yes
® No
is not limited solely by their negligence) Does endorsement
NOTICE OF CANCELLATION:
0 N/A
include "solely by negligence" wording?
❑ Yes ® No
K.
ELECTED SCMAF COVERAGE (RECREATION ONLY):
® NIA ❑ Yes ❑ No
L.
NOTICE OF CANCELLATION:
❑ N/A ® Yes ❑ No
II. AUTOMOBILE LIABILITY
EFFECTIVE/EXPIRATION DATE: 11/1/15-5/1/16
A.
INSURANCE COMPANY: State Farm Mutual Automobile Ins Co
B.
AM BEST RATING (A-: VII or greater) A++: XV
C.
ADMITTED COMPANY (Must be California Admitted):
Is Company admitted in California?
® Yes
❑ No
D.
LIMITS - If Employees (Must be $1 M min. BI & PD and $500,000
250/500/100 + Umbrella
UM, $2M min for Waste Haulers): What is limits provided?
1,000,000
E
LIMITS Waiver of Auto Insurance / Proof of coverage (if individual)
(What is limits provided?)
N/A
F.
PRIMARY & NON-CONTRIBUTORY WORDING (For Waste
Haulers only):
® N/A
❑ Yes
❑ No
G.
HIRED AND NON -OWNED AUTO ONLY:
❑ N/A
❑ Yes
® No
H.
NOTICE OF CANCELLATION:
0 N/A
® Yes
0 No
III. WORKERS' COMPENSATION
EFFECTIVE/EXPIRATION DATE: Exempt Letter on File 3/9/16
A. INSURANCE COMPANY:
B. AM BEST RATING (A-; VII or greater):
C. ADMITTED Company (Must be California Admitted):
D. WORKERS' COMPENSATION LIMIT: Statutory
E. EMPLOYERS' LIABILITY LIMIT (Must be $1 M or greater)
F. WAIVER OF SUBROGATION (Tc include): Is it included?
G. SIGNED WORKERS' COMPENSATION EXEMPTION FORM
H. NOTICE OF CANCELLATION:
ADDITIONAL COVERAGE'S THAT MAYBE REQUIRED
IV. PROFESSIONAL LIABILITY
V POLLUTION LIABILITY
f�=1s1Lti7�:�9:i69
HAVE ALL ABOVE REQUIREMENTS BEEN MET?
IF NO, WHICH ITEMS NEED TO BE COMPLETED?
Approved:
3/11/16
Agent of Alliant Insurance Services Date
Broker of record for the City of Newport Beach
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
® NIA ❑ Yes ❑ No
❑ N/A ® Yes ❑ No
® N/A ❑ Yes ❑ No
® N/A ❑ Yes ❑ No
® N/A ❑ Yes ❑ No
® Yes ❑ No
RISK MANAGEMENT APPROVAL REQUIRED (Non -admitted carrier rated less than
Self Insured Retention or Deductible greater than $ ) ❑ N/A ❑ Yes ❑ No
Reason for Risk Management approval/exception/waiver:
Approved:
Risk Management Date
* Subject to the terms of the contract.