04-0706_TRAUMA INTERVENTION PROGRAMS_Personal Services AgreementPERSONAL SERVICES AGREEMENT
THIS AGREEMENT is made and entered into thi ,*day of July 2004, by and
between the City of San Juan Capistrano (hereinafter referred to as the "City') Trauma
Intervention Programs (TIP), (hereinafter referred to as "Consultant").
RECITALS:
WHEREAS, City desires to retain the services of Consultant regarding the City's
emotional and practical support services to victims of traumatic events and their
families; and
WHEREAS, Consultant is qualified by virtue of experience, training, education
and expertise to accomplish such services.
NOW, THEREFORE, City and Consultant mutually agree as follows:
Section 1. Scope of Work.
The scope of work to be performed by Consultant shall consist of those tasks as
set forth in Exhibit "A," attached and incorporated herein by reference.
Consultant warrants that all of its services shall be performed in a competent,
professional and satisfactory manner and in accordance with the prevalent standards of
its profession.
Section 2. Term.
This Agreement shall commence on the effective date of this Agreement and
services required hereunder shall be completed by no later June 30, 2005.
Section 3. Compensation.
3.1 Amount.
Total compensation for the scope of services for this Project shall not
exceed $4,152.00 (34,600 population x $.12), as set forth in Exhibit "B," attached and
incorporated herein by reference.
TIP psa.doc
July 6, 2004
SC
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3.2 Method of Payment.
Consultant shall submit quarterly invoices based on total services. The
City will pay quarterly progress payments based on approved invoices in accordance
with this Section.
For extra work not part of this Agreement, a written authorization from City
is required prior to Consultant undertaking any extra work.
3.3 Records of Expenses.
Consultant shall keep complete and accurate records of all costs and
expenses incidental to services covered by this Agreement. These records will be
made available at reasonable times to City.
Section 4. Independent Contractor.
It is agreed that Consultant shall act and be an independent contractor and not
an agent or employee of City, and shall obtain no rights to any benefits which accrue to
City's employees.
Section 5. Limitations Upon Subcontracting and Assignment.
The experience, knowledge, capability and reputation of Consultant, its principals
and employees were a substantial inducement for City to enter into this Agreement.
Consultant shall not contract with any other entity to perform the services required
without written approval of the City. This Agreement may not be assigned, voluntarily or
by operation of law, without the prior written approval of the City. If Consultant is
permitted to subcontract any part of this Agreement by City, Consultant shall be
responsible to City for the acts and omissions of its subcontractor as it is for persons
directly employed. Nothing contained in this Agreement shall create any contractual
relationships between any subcontractor and City. All persons engaged in the work will
be considered employees of Consultant. City will deal directly with and will make all
payments to Consultant.
Section 6. Changes to Scope of Work.
In the event of a change in the Scope of Work provided for in the contract
documents as requested by the City, the Parties hereto shall execute an addendum to
this Agreement setting forth with particularity all terms of the new agreement, including
but not limited to any additional Consultant's fees.
TIP psa.doc - 2 - July 6, 2004
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Section 7. Familiarity with Work and Construction Site.
By executing this Agreement, Consultant warrants that: (1) it has investigated
the work to be performed; (2) it understands the facilities, difficulties and restrictions of
the work under this Agreement. Should Consultant discover any latent or unknown
conditions materially differing from those inherent in the work or as. represented by City,
it shall immediately inform City of this and shall not proceed with further work under this
Agreement until written instructions are received from the City.
Section 8. Time of Essence.
Time is of the essence in the performance of this Agreement.
Section 9. Compliance with Law.
Consultant shall comply with all applicable laws, ordinances, codes ' and
regulations of federal, state and local government.
Section 10. Conflicts of Interest.
Consultant covenants that it presently has no interest and shall not acquire any
interest, direct or indirect, which would conflict in any manner or degree with the
performance of the services contemplated by this Agreement. No person having such
interest shall be employed by or associated with Consultant.
Section 11. Ownership of Documents.
All reports, information, data and exhibits prepared or assembled by Consultant
in connection with the performance of its services pursuant to this Agreement are
confidential to the extent permitted by law, and Consultant agrees that they shall not be
made available to any individual or organization without prior written consent of the City.
All such reports, information, data, and exhibits shall be the property of the City and
shall be delivered to the City upon demand without additional costs or expense to the
City. The City acknowledges such documents are instruments of Consultant's
professional services. No client privileged information will be released without the
client's written consent.
Section 12. Indemnity
Consultant agrees to protect, defend and hold harmless City, its elected and
appointed officials and employees from any and all claims, liabilities, expenses or
damages of any nature, including attorneys' fees, for injury or death of any person or
damage to property or interference with use of property and for errors and omissions
committed by Consultant arising out of or in connection with the work, operation or
activities of Consultant, its agents, employees and subcontractors in carrying out its
obligations under this Agreement.
TIP psa.doc - 3 - July 6, 2004
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Section 13. Insurance.
Insurance required herein shall be provided by Admitted Insurers in good
standing with the State of California and having a minimum Best's Guide Rating of A -
Class VII or better.
13.1 Comprehensive General Liability.
Throughout the term of this Agreement, Consultant shall maintain in full
force and effect Comprehensive General Liability coverage in the following minimum
amounts:
$500,000 property damage;
$500,000 injury to one person/any one occurrence/not limited to
contractual period;
$1,000,000 injury to more than one person/any one occurrence/not limited
to contractual period.
13.2 Worker's Compensation.
If Consultant intends to employ employees to perform services under this
Agreement, Consultant shall obtain and maintain, during the term of this Agreement,
Worker's Compensation Employer's Liability Insurance in the statutory amount as
required by state law.
13.3 Proof of Insurance Requirements/Endorsement.
Prior to beginning any work under this Agreement, Consultant shall submit
the insurance certificates, including the deductible or self -retention amount, and an
additional insured endorsement to the Consultant's general liability and umbrella liability
policies to the City Clerk's office for certification that the insurance requirements of this
Agreement have been satisfied.
13.4 Errors and Omissions Coverage
Throughout the term of this Agreement, Consultant shall maintain Errors
and Omissions Coverage (professional liability coverage) in an amount of not less than
One Million Dollars ($1,000,000). Prior to beginning any work under this Agreement,
Consultant shall submit an insurance certificate to the Clerk of the Board's office for
certification that the insurance requirements of this Agreement have been satisfied.
TIP psa.doc 4- July 6, 2004
0
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13.5 Notice of Cancel lation/Tarm ination of Insurance.
The above policy/policies shall not terminate, nor shall they be cancelled,
nor the coverages reduced, until after thirty (30) days' written notice is given to City,
except that ten (10) days' notice shall be given if there is a cancellation due to failure to
pay a premium.
13.6 Terms of Compensation.
Consultant shall not receive any compensation until all insurance
provisions have been satisfied.
13.7 Notice to Proceed.
Consultant shall not proceed with any work under this Agreement until the
City has issued a written "Notice to Proceed" verifying that Consultant has complied
with all insurance requirements of this Agreement.
Section 14. Termination.
City and Consultant shall have the right to terminate this Agreement without
cause by giving thirty (30) days' advance written notice of termination to the other party
In addition, this Agreement may be terminated for cause by providing ten (10)
days' notice to the other party of a material breach of contract. If the other party does
not cure the breach of contract, then the agreement may be terminated subsequent to
the ten (10) day cure period.
TIP psa.doc - 5 - July 6, 2004
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Section 15. Notice.
All notices shall be personally delivered or mailed to the below listed addresses,
or to such other addresses as may be designated by written notice. These addresses
shall be used for delivery of service of process:
To City: City of San Juan Capistrano
32400 Paseo Adelanto
San Juan Capistrano, CA 92675
Attn: Mike Cantor, Senior Management Analyst
To Consultant: Trauma Intervention Programs, Inc.
1420 Phillips Street
Vista, CA 92083
Attn: Wayne Fortin, CEO
Section 16. Attorneys' Fees.
If any action at law or in equity is necessary to enforce or interpret the terms of
this Agreement, the prevailing party shall be entitled to reasonable attorneys' fees, costs
and necessary disbursements in addition to any other relief to which he may be entitled.
Section 17. Dispute Resolution.
In the event of a dispute arising between the parties regarding performance or
interpretation of this Agreement, the dispute shall be resolved by binding arbitration
under the auspices of the Judicial Arbitration and Mediation Service ("JAMS").
Section 18. Entire Agreement.
This Agreement constitutes the entire understanding and agreement between the
parties and supersedes all previous negotiations between them pertaining to the subject
matter thereof.
TIP psa.doc - 6 - July 6, 2004
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IN WITNESS WHEREOF, the parties hereto have executed this Agreement.
CITY OP -SAN JUA(N)CAPISTRANO
Joe
CONSU�CTANT
By: / -L
Wayne ortin, Chief Executive Officer
ATTEST:
R. Monahan, City Clerk
APPROVED AS TO FORM:
John R. Shalboeftorney
TIP psa.doc - 7 - July 6, 2004
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EXHIBIT "A"
Project Overview and Scope of Work
Trauma Intervention Programs, Inc. (TIP), upon the request of or referral
by the City, or as otherwise agreed upon, shall provide on -scene
emotional and practical support to the victims of traumatic events and their
family members. Said support shall include but not be limited to making
necessary telephone calls; making arrangements for clean-up services;
notifying family, friends and others; referring to follow-up services;
providing information and referral services; performing one follow-up
contact to verify the client's welfare.
2. TIP shall make aivailable to the City sufficient information to enable the
City to contact the appropriate TIP volunteer, including 24-hour on-call
phone number, address, and names of volunteers, supervisors (when
appropriate), as well as alternate or backup telephone numbers.
3. TIP shall provide all personnel, volunteers, supplies, and equipment
necessary for the efficient and effective operation of the services and
programs provided for herein.
4. Tip or TIP's employees and/or volunteers shall provide all vehicles and
equipment necessary for the performance of this Agreement and shall be
responsible for maintenance df said equipment and vehicles.
0
EXHIBIT "B"
Compensation and Payment
0
The City agrees to pay TIP $4,300.00 for all services performed. This
amount is based on $.12 per capita based on a population of 35,834.
2. Consultant shall submit quarterly invoices of $1075.00 for services.
3. The City shall make payments within 14 days of receipt of Consultant's
bill.
4. Payments shall be made to Trauma Intervention Programs, Inc.
5. The parties understand and agree that the City's payments to Consultant
as compensation under this Agreement shall not exceed Four Thousand
Three Hundred Dollars ($4,300.00).
TIP
Date: June 10, 2004
To: Lt. J.B. Davis
From: Wayne Fortin
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Trauma
Intervention
Programs
Inc.
"Citizens helping citizens in crisis"
National Office
1420 Phillips Street
Vista, CA 92083
(714) 314-0744
Re: Services Provided the City of San Juan Capistrano July 1, 2003 to May 31, 2004
Services Provided to the City of San Juan Capistrano by TIP of Orange County
A. Crisis Intervention Services: TIP volunteers will respond 24 -hours a day, 365 -days a year
within 20 minutes to support citizens in crisis.
B. Follow Up Services: TIP volunteers provide written follow up services and a resource manual
to residents who are victims of traumatic events.
C. Volunteer Training and Supervision: San Juan Capistrano residents are provided a significant
volunteer opportunity and are provided extensive training and supervision.
D. Summary of Services: (See attached)
II Statistical Data (July 1, 2003 to May 31, 2004 -11-month period)
A. # of volunteer hours contributed to Orange County Cities (including San Juan Capistrano) _
17,520
B. # of TIP Responses = 36
C. # of San Juan Capistrano residents provided service = 108
D. # of TIP volunteers serving the City = 37
E. # of Emergency Responders trained to use the TIP program = 85
F. Average response time = 19 minutes
G. Reliability = 100% of calls for service responded to when requested by emergency responders
III Summary of Results
A. Citizens who are traumatized — many of whom are experiencing the worst few hours of their
lives — are given immediate support which they would not have without TIP services.
B. Emergency Responders report that TIP was "very helpful' and report TIP frees them up to
perform other emergency services.
C. Citizens are given extensive training. These citizens report that this training not only is helpful
on TIP calls, but also is very useful in making them more effective when called upon to help
others on the job, in their family, and in their neighborhoods.
D. The TIP program provides the City of San Juan Capistrano with a well trained and experienced
critical incident response team capable of responding to major incidents within the City.
Winner
National Crime Victim Service Award
Innovations in State and Local Covernment Award
'IIP
Trauma
Intervention
Programs
Inc.
"Citizens helping citizens in crisis"
Services Offered
#1 Volunteers provide 24-hour, 7 -day a week Crisis Response services.
#2 Professional Mental Health Intervention: Mental health professionals
offer short term counseling services at no cost to victims.
#3 TIPTeens Program: TIPTeens are young people who are well trained
volunteers in the TIP program. TIPTeens are called upon by TIP volunteers
to help traumatized teens and children.
#4 TIP4kids Program: TIP offers counseling services for children who have
been emotionally traumatized and for parents struggling to help their
children after a crisis event.
#5 Critical Incident/Disaster Response Team: A specially trained team of
TIP volunteers responds to major incidents and disasters on a 24-hour 365 -
day basis.
#6 Senior Crisis Team: Extensive follow up services are provided to elderly
citizens who are in crisis.
#7 TravelersCare: Special arrangements are made with the travel industry to
call TIP when travelers have experienced a crisis event while away from
home. TIP volunteers provide support until the traveler is reunited with
loved ones.
#8 Bilingual Services: Bilingual TIP volunteers are available to respond to
emergency scenes when requested. All TIP resource materials are available
in English and Spanish.
Winner
Innovations in Si.1, end Local Government
An Awards Program of the Ford Foundation
and Harvard Universitv
#9 Victims Resource Service: Helpful written materials and video tapes are
delivered to victims of crisis events on a 24-hour , 365 -day a year basis.
#10 TIPLine: A telephone information and referral service is available to help
emotionally traumatized citizens.
#11 Hospital Response Program: TIP volunteers are called by hospital
emergency room staff to assist victims and their families. Also, hospital
personnel are authorized to call a TIP volunteer when family members need
volunteer accompaniment from the hospital back home.
#12 Traffic Accident Response Team: Specially trained TIP volunteers
respond to scenes of traffic accidents at the request of the Highway Patrol
and other law enforcement agencies to assist emotionally traumatized
accident victims.
#13 TIP National Emotional First Aid Course: This 8 -hour course is offered
to emergency personnel, nurses, mental health professionals, managers, and
the general public.
#14 Good Samaritan Awards: Emergency responders and citizens who have
demonstrated exceptional compassion in assisting victims of crisis events
are recognized on a regular basis.
#15 National Assistance Network: By working with TIP programs across the
nation, the local TIP Chapter ensures that local residents receive crisis
support services while traveling away from home.
0 i
CITY CLERK'S DEPARTMENT - ACTION REMINDER
TO: Michael Cantor, Senior Management Analyst
FROM: Mitzi Ortiz, Deputy City Clerk DATE: June 1, 2005
SITUATION:
At their meeting on July 6, 2004 the City Council of the City of San Juan Capistrano
approved an agreement with Trauma Intervention Programs to provide a range of emotional
and practical support services to victims of traumatic events and their families.
ACTION REQUESTED:
Said Agreement states services shall be completed by June 30, 2005.
Please notify this office if agreement has been extended or completed.
ACTION TO BE TAKEN:
/��i lv~
DATE WHEN NEXT ACTION (S) SHOULD BE TAKEN:
SIGNATURE OF OFFICIAL TAKING ACTION: �w�
DATE SIGNED:
***FOR CITY CLERK'S DEPARTMENT USE ONLY***
Tickler Date: 06/01/05
Deadline Date: 06/30/05
(600.30Arauma)
�L
L�
�� oC�'
SO
• WTHOLDER COPY
STATE P.O. BOX 807, SAN FRANCISCO,CA 94142-0807
COMPENSATION
INSURANCE
FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
ISSUE DATE: 05-01-2005 GROUP:
POLICY NUMBER: 1187336-2005
CERTIFICATE ID: 14
CERTIFICATE EXPIRES: 05-01-2006
05-01-2005/05-01-2006
CITY OF SAN JUAN CAPISTRANO SD JOB: ALL OPERATIONS
ATTNt CHERYL JOHNSON
32400 PASEO ADELANTO
SAN JUAN CAPISTRANO CA 92675
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the
California Insurance Commissioner to the employer named below for the policy period indicated.
This policy is not subject to cancellation by the Fund except upon 30 days' advance written notice to the employer.
We will also give you 30 days' advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded
by the policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other document
with respect to which this certificate of insurance may be issued or may pertain, the insurance afforded by the
policies described herein is subject to all the terms, exclusions and conditions of such policies.
X" C -
AUTHORIZED REPRESENTATIVE PRESIDENT
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000.00 PER OCCURRENCE.
ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 05-01-2005 IS ATTACHED TO AND
FORMS A PART OF THIS POLICY.
EMPLOYER
TRAUMA INTERVENTION PROGRAMS INC.
1930 W SAN MARCOS BLVD # BL156
SAN MARCOS CA 92078
LEGAL NAME
TRAUMA INTERVENTION PROGRAMS, INC.
(A NON-PROFIT CORP.)
..
(REV.3-03) PRINTED: 04/11S/
THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND Sar 1026E
32400 PASEO ADELANTO
SAN JUAN CAPISTRANO, CA 92675
(949) 493-1171
(949) 493.1053 FA
www.sanjuancapistrano.org
April 15, 2005
E
Trauma Intervention Program
1420 Phillips Street
Vista, CA 92083
MEMBERS OF THE CITY COUNCIL
SAM ALLEVATO
DIANE BATHGATE
WYATT HART
JOE SOTO
DAVID M. SWERDLIN
RE: Compliance with Insurance Requirements — TIP Program
The following insurance document is due to expire:
✓ Workers Compensation Certificate 05/01/2005
Please submit updated documentation to the City of San Juan Capistrano, attention City
Clerk's office, 32400 Paseo Adelanto, San Juan Capistrano, CA 92675 by the above
expiraoe3h dateAlf you,,hpve any questions, please contact me at (949) 443-6309.
M&iA.4Guev
Administrate Secretary
cc: Michael Cantor, Senior Management Analyst
} San Juan Capistrano: Preserving the Past to Enhance the Future
(',j PmW on reWc d paper
A 4RDCERTIFIC*E OF LIABILITY INSURAI�
TM.
DATEIMM/12/21/20042004 Y)
PROPsCCR
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
NATIONAL INSURANCE PROFESSIONALS CORP
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
A DIVISION OF RISK PLACEMENT SERVICES, INC.
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1040 NE HOSTMARK STREET #200
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
POULSBO WA 98370.7454
'
, GENERAL LIABILITY
INSURERS AFFORDING COVERAGE NAIC #
INSURED
INSURER A: UNITED NATIONAL INSURANCE COMPANY -
TRAUMA INTERVENTION PROGRAMS, INC.
INSURER e:
1930 WEST SAN MARCOS BLVD #156
SAN MARCOS CA 92078
INSURER C: _
INSURER D:
MED. EXP (Any one person) S Not Included
INSURER E
COVFRAnF_S
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
AEC
INSR
TYPE OF INSURANCE
VOLIGY NUMBEfl
POLICY EFFECTIVE
POLICY
DATE MM/DD/YY
POLICY EXPIRATION LIMITS
DATE MM/DDNY
'
, GENERAL LIABILITY
CGA044873
12/15/04
12/15/05
EACH OCCURRENCE $__ 1,000,000
PREMISE TO RENT£De
PREMISES REIn a ce) Is 100,000
X COMMERCIAL GENERAL LIABILITY
X CLAIMSMADE[::] OCCUR
MED. EXP (Any one person) S Not Included
PERSONAL & ADV INJURY IS 1,000,000
A
-
GENERAL AGGREGATE $ 3,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS-COMP/OP AGG. $ 3,000,000
X POLICY PRO LOC
ECT
AUTOMOBILE
LIABILITY
ANY AUTO
CGA044873
12115/04
12/15/05
COMBINED SINGLE LIMIT
(Ea accident) $ 1,000,000
BODILY INJURY
ALL OWNED AUTOS
(Per person) $ Not Included
SCHEDULED AUTOS
A
BODILY INJURY g Not Included
(Per accident)
HIRED AUTOS
NON -OWNED AUTOS
X
PROPERTY DAMAGE $ Not Included
(Per accident)
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT $ Not Included
OTHER THAN EA ACC $ Notlncluded
ANY AUTO
AUTO ONLY: AGG $ Notlncluded
EXCESS/ UMBRELLA LIABILITY
EACH OCCURRENCE $ Not Included
OCCUR CLAIMS MADE
AGGREGATE S Not Included
$ Not Included
$ Not Included
__
DEDUCTIBLE
RETENTION $
$ Not Included
WORKERS COMPENSATION AND
EMPLOYERS'LIABILITY
ANYCERUMEETOB/PXCLUDE/E%ECUTIVE
we STATu- OTHER
CORY LIMITS
E.L. EACH ACCIDENT $ Not Included
E . DISEASECAEMPLOYEE $ Not Included
OFFICEiLMEMBEfl EXCLUDED'
if yes, EescUEe under
SPECIAL PROVISIONS IaIow
-
E L. DISEASE -POLICY LIMIT $ Not Included
OTHER: PROFESSIONAL LIABILITY
CGA044873
12/15/04
12/15/05
$1,000,000 PER OCCURRENCE
A
$3,000,000 AGGREGATE LIMIT
AGG LIMIT IS COMBINED PL & CGL
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS
CERTIFICATE HOLDER TO BE NAMED AS ADDITIONAL INSURED UNDER THE ABOVE POLICY BUT ONLY AS THEIR INTERESTS MAY
APPEAR AND ONLY WITH RESPECT TO THE OPERATIONS OF THE NAMED INSURED.
IT IS FURTHER AGREED THAT PC154 (PRIMARY WORDING ENDT.) IS ATTACHED AND MADE PART OF THIS POLICY WITH RESPECTS TO
THIS ADDITIONAL INSURED.
CEH Ul FICA] E HULUEH CANCELLATION
CITY OF SAN JUAN CAPISTRANO
CITY CLERKS OFFICE
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS
WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE
32400 PASEO ADELANTO
TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,
SAN JUAN CAPISTRANO CA 92675
ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Attention:
Sa . Clipsha
ACORD 25 (2001/08) Certificate # 37883 9 ACORD CORPORATION 1988
02/28/2005 10:47 FAX � • Q 002
ENDORSEMENT Number 2
This endorsement, effective 12:01 A.M. GE'C 15 04
rt of I
policy Ne ao OGA044873 issued to TRAUMA INTERVENTION PROGRAMS, INC.
BY x United National Insurance Comf anY
r7 Cfamond State Insurance Company
United National Speclaltylnsurince Company
I
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
IT IS UNDERSTOOD AND AGREED THAT, FOR THE PREMIUM PAID, THE FOLLOWING ARE ADDED TO THIS POLICY
AS ADDITIONAL INSUREDS, BUT ONLY AS RESPLA; I S I HEIR INTEREST AS A FUNDING SOURCE OF OR FOR THE
NAMED INSURED.
CITY OF COSTA MESA
77 FAIR DRIVE
COSTA MESA CA 92628
CITY OF RANCHO SANTA MARGARITA
22112 EAST PASEO
RANCHO SANTA MARGARITA CA 92688
ATTN: CINDY LONG, FINANCE DIRECTOR
CITY OF SAN JUAN CAPISTRANd
CITY CLERKS OFFICE
$2400 PASEO ADELANTO
SAN JUAN CAPISTRANO CA 8265
IT IS FURTHER UNDERSTOOD AND AGREED THAT FORM PC154 (5/98), IS ATTACHED AS RESPECTS THE ABOVE
MENTIONED ADDITIONAL INSUREDS.
PC153 (7197)
Page 1
02/28/2005 10:48 FAX • @1009
(Tho attaching clause uoed be compktedjonly when this endorsement is issued subsequent to preparation of the policy.)
i
i
This endorsement, effective at 12:01 a.m. standard time, forms a part of
Policy #:
Issued to:
By:
TRIS ENDORSEMENT CfL4NGES TRE POLICY. PLEASE READ IT CAREFULLY
ADDITIONAL INSURED -PRIMARY COVERAGF
This endorsement modifies insurarim provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
In consideration of the premium charged, I warrant the following:
WHO IS AN INSURED (Section Il) is amended to include as an insured the person or organization shown in
the schedule, but only with respect to liability arising out of the work for that insured by or for you.
I
Furthermore, the following is added to SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS
paragraph 4, Other insurance:
4. Other insurance:
d) This insurance is primary for the person or organization shown in the schedule, but only
with respect to liability arising out of your work for that insured by or for you. Other
insurance afforded to that insured will apply as excess and not contribute as primary to
the insurance afforded by this endorsement.
All other terms and conditions of the policy remain unchanged.
PCI 54 (5/99)
32400 PASEO ADELANTO
SAN JUAN CAPISTRANO, CA 92675
(949) 493-1171
(949) 493-1053 FAX
www.sanjuancapistrano.org
•
j Inuit Popp u
• fsueusxlo 1 1961
1776
December 2, 2004
Trauma Intervention Program
1420 Phillips Street
Vista, CA 92083
RE: Compliance with Insurance Requirements —TIP Program
The following insurance documents are due to expire:
✓ General Liability Certificate 12/15/04 1_-
MEMBERS OF THE CITY COUNCIL
✓ General Liability Endorsement Form naming the City of San Juan
Capistrano as additional insured. _,gyp^ -
✓ Automobile Liability Certificate 12/15/04 v�"�
✓ Professional Liability Certificate 12/15/04'1�`--�
SAM ALLEVATO
DIANE L. BATHGATE
MATT HART
JOE SOTO
DAVID M. SWERDLIN
Please submit updated documentation to the City of San Juan Capistrano, attention City
Clerk's office, 324AO Paseo Adelanto, San Juan Capistrano, CA 92675 by the above
e."ationoatesyou have any questions, please contact me at (949) 443-6309.
cc: Michae�rantor, Senior Management Analyst
San Juan Capistrano: Preserving the Past to Enhance the Future
ACORDDATE
ACTM CERTIFICA'' OF LIABILITY
(MM/DD/YY)
INSURAN_C JAN 2104
PROOL aLi:
NATIONAL INSURANCE PROFESSIONALS CL-
THIS CERTIFICATE ISD AS A MATTER OF INFORMATION
ONLY AND CONFERS �. IGHTS UPON THE CERTIFICATE
1040 NE HOSTMARK STREET #200
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
POULSBO WA 98370-7454
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
POLICY EXPIRATION
DATE MM/DD/YY
LIMITS
PHONE: (360)697-3611
FAX: (360)697-3688
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
INSURER A. UNITED NATIONAL INSURANCE COMPANY
DAMAGE TO RENLEO
F0 MI $
INSURER R.
X COMMERCIAL GENERAL LIABILITY
X CLAIMS MADE Il OCCUR
TRAUMA INTERVENTION PROGRAMS, INC.
1930 WEST SAN MARCOS BLVD #156
SAN MARCOS CA 92069
INSURER C
--
------- -
INSURER D
INSURER E.
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
IN
LT
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MM/DD/YY
POLICY EXPIRATION
DATE MM/DD/YY
LIMITS
GENERAL LIABILITY
CGA044317
DEC 15 03
DEC 15 04
EACH OCCURRENCE $71ncluded
DAMAGE TO RENLEO
F0 MI $
X COMMERCIAL GENERAL LIABILITY
X CLAIMS MADE Il OCCUR
MED. EXP (Any One Person) $A
PERSONAL A ADV INJURY $GENERAL
AGGREGATE $GEN'L
AGGREGATE LIMIT APPLIES PER:
PRODUCTS-COMP/OP AGE. $
X POLICY
AUTOMOBILE
LIABILITY
ANY AUTO
CGA044317
DEC 15 03
DEC 15 04
COMBINED SINGLE LIMIT $ 1,000,000
(Ea accident)
BODILY INJURY
ALL OWNED AUTOS
(Per person) $ Not Included
SCHEDULED AUTOS
A
BODILY INJURY $ Not Included
(Per accident)
HIRED AUTOS
NON -OWNED AUTOS
X
PROPERTY DAMAGE $ Not included
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT $ Notincluded
OTHER THAN EA ACC $ Not Included
ANY AUTO
AUTO ONLY: AGG $ Not Included
EXCESS/ UMBRELLA DABIDTY
EACH OCCURRENCE $ Not Included
OCCUR ❑ CLAIMS MADE
AGGREGATE $ NotIncluded
$ Not Included
$ NotIncluded
DEDUCTIBLE
RETENTION $
$ Not Included
WORKERS COMPENSATION AND
WC STATU- OTHER
TORY LIMITS
EMPLOYERSLIABILITY
E.L. EACH ACCIDENT $ Not Included
ANY PROPRIETORPARTNEWEXECIITIVE
E.L. DISEASE -EA EMPLOYEE $ Not included
OFRCERAIEMBER EXCLUDED?
II E AL PRO.ISIP
ePEQAL PROVISIONS eebw
E.L. DISEASE -POLICY LIMB $ Not Included
OTHER: PROFESSIONAL LIABILITY
CGA044317
DEC 15 03
DEC 15 04
$1,000,000 EACH CLAIM
A
$3,000,000 AGGREGATE
AGG LIMIT IS COMBINED PL & CGL
DESCRIPTION OF OPERATIONS/LOCATIONNEHICLES/EXCLUSIONS ADDED ENDORSEMENT/ SPECIAL PROVISIONS
CERTIFICATE HOLDER TO BE NAMED AS ADDITIONAL INSURED UNDER THE ABOVE POLICY BUT ONLY AS THEIR INTERESTS MAY
APPEAR AND ONLY WITH RESPECT TO THE OPERATIONS OF THE NAMED INSURED.
CERTIFICATE HOLDER I I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION
CITY OF SAN JUAN CAPISTRANO
CITY CLERK'S OFFICE
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30
DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT
32400 PASEO ADELANTO
FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
SAN JUAN CAPISTRANO, CA 92675
INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Attention:
Ba Clipsha
ACORD 25 (2001/08) Certificate # 33254 /
• • a002
ENDORSEMENT Number 5
This endorsement, effective 12'01 A.M. DEC 15 04
forms a part of
policy No. CGA044317 issued to TRAUMA INTERVENTION PROGRAMS, INC.
BY I-X_I United National Insurance Company
Diamond State Insurance Company
United National Specialty Insurance Company
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
IT IS UNDERSTOOD AND AGREED THAT FOR PREMIUM PAID, FORM PC154 IS ATTACHED AND MADE PART OF
THIS POLICY AS RESPECTS THE FOLLOWING ADDITIONAL INSUREDS;
City of San Juan Capistrano
PC153 (7197)
) lf� Page 1
Authorized Representative
Iiauma Intervention Programs, Ino
E
(The attaching clause need be completed only when this endorsement is issued subsequent to preparation of the policy.)
This endorsement, effective at 12:01 a.m. standard time, forms a part of
Policy 9: CGA044317
Issued to: City of San Juan Capistrano
By: United National Insurance Company
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
ADDITIONAL INSURED -PRIMARY COVERAGE
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
In consideration of the premium charged, I warrant the following:
WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in
the schedule, but only with respect to liability arising out of the work for that insured by or for you.
Furthermore, the following is added to SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS
paragraph 4, Other insurance:
Other insurance:
d) This insurance is primary for the person or organization shown in the schedule, but only
with respect to liability arising out of your work for that insured by or for you. Other
insurance afforded to that insured will apply as excess and not contribute as primary to
the insurance afforded by this endorsement.
All other terms and conditions of the policy remain unchanged.
PC 154 (5/98)
/� • *HOLDER COPY
STATE P O. BOX 807e,, SM FF ANCISCO,CA 94142-0807
COMPENSATION �•.
INSURANCE �O
FUND CERTIFICATE OF IgEI',�OMPENSATION INSURANCE
ISSUE DATE: 05-01-2004 .-.'t :`� GROUP:
POLICY NUMBER: 1197336-2004
r-' CERTIFICATE ID: 14
P•,I tvCERTIFICATE EXPIRES: 05-01-2005
05-01-2004/05-01-2005
CITY OF SAN JUAN CAPISTRANO SO JOB: ALL OPERATIONS
ATTN: CHERYL JOHNSON
32400 PASEO ADELANTO
SAN JUAN CAPISTRANO CA 92675
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the
California Insurance Commissioner to the employer named below for the policy period indicated.
This policy is not subject to cancellation by the Fund except upon 30 days' advance written notice to the employer.
We will also give you 30 days' advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded
by the policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other document
with respect to which this certificate of insurance may be issued or may pertain, the insurance afforded by the
policies described herein is subject to all the terms, exclusions and conditions of such policies.
AUTHORIZED REPRESENTATIVE
PRESIDENT
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000.00 PER OCCURRENCE.
ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 05-01-2004 IS ATTACHED TO AND
FORMS A PART OF THIS POLICY.
EMPLOYER
TRAUMA INTERVENTION PROGRAMS INC.
1930 W SAN MARCOS BLVD # BL156
SAN MARCOS CA 92069
LEGAL NAME
TRAUMA INTERVENTION PROGRAMS, INC.
(A NON-PROFIT CORP.)
EV.3-03) 04/16/2004
THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND sar rosr'
I
•
32400 PASEO ADEL-ANTO
SAN JUAN CAPISTRANO, CA 92675
(949) 493-1171
(949) 493-1053 FAX
www.sanluancapisti-ano.org
July 9, 2004
Trauma Intervention Programs, Inc.
1420 Phillips Street
Vista, CA 92083
Attention: Wayne Fortin, CEO
Dear:
JV_
If POUTED
alAAnsAlA I 1961
1776
MEMBERS OF THE CITY COUNCIL
SAM ALLEVATO
DIANE L. BATHGATE
WYATT HART
JOE SOTO
DAVID M. SWERDLIN
Enclosed is an executed, original professional services agreement related to providing
emotional and practical support services to victims of traumatic events and their
families.
Thank you for maintaining current evidence of insurance documentation with the city.
Please keep in mind that - should this documentation lapse, all work under this
agreement must stop and all payments will be withheld until we receive proper evidence
of insurance.
You may proceed with work under this agreement in coordination with the Project
Manager, Michael Cantor, Senior Management Analyst (949) 234-4565.
Yours
,CMC
Agreement
cc: Michael Cantor, Senior Management Analyst
San Juan Capistrano: Preserving the Past to Enhance the Future
AGENDA REPORT
TO: David F. Adams, City Manager 6�\
FROM: Michael Cantor, Senior Management Analyst
7/6/2004
D11
SUBJECT: Consideration of Renewal of Agreement for Crisis Intervention Services
(Trauma Intervention Program, Inc.)
RECOMMENDATION:
By motion, renew the agreement with Trauma Intervention Programs, Inc., for volunteer
trauma intervention response to critical incidents for $4300 from July 1, 2004 to June
30, 2005.
SITUATION:
The Trauma Intervention Program (TIP) is a volunteer, non-profit, organization that
assists victims of traumatic experiences. TIP volunteers respond to emergency scenes
to provide intervention assistance to victims, family members, witnesses and
emergency personnel. These volunteers are trained to assist individuals with stress
management subsequent to a critical and/or traumatic event. Additional program
benefits include assistance to emergency personnel by tending to the needs of grieving
victims and family members, thus relieving emergency personnel at the scene of these
duties so that they may perform more critical job -specific tasks.
TIP recruits volunteers from the community at large. This ensures quick response to
calls for service. They guarantee a 20 -minute response time from the time of
notification. Each volunteer receives approximately 55 hours of classroom training in
topics related to crisis and stress management, as well as 3 -hours of monthly in-service
training.
As stated, TIP is a non-profit organization. They provide the aforementioned services
free of charge to those in crisis. The program is funded by both public and private
organizations. Public funding accounts for approximately 15% to 20% of the operating
budget. Private funds are obtained through fund raising efforts conducted by TIP
personnel. TIP provides services to its contract partners, such as the City of San Juan
Capistrano, based on the population of the municipality. The cost to the City of San
Juan Capistrano is $.12 per capita, which amounts to $4,300.00 annually (based on the
recorded population of 35,834 at the time the agreement was drawn.
Agenda Report
Page 2 July 6, 2004
There are 85 trained volunteers serving South Orange County, which includes Lake
Forrest, Laguna Woods, Mission Viejo, Laguna Niguel, Aliso Viejo, Dana Point, San
Clemente and San Juan Capistrano. Although only one volunteer resides in San Juan
Capistrano, there are 37 volunteers assigned to the City. TIP volunteers donated
17,520 hours of on-call service last year and the average response time was
approximately 19 minutes. TIP volunteers responded to 36 calls for service within the
City, during which they served 108 San Juan Capistrano residents.
COMMISSION/BOARD REVIEW AND RECOMMENDATIONS:
Not Applicable.
FINANCIAL CONSIDERATIONS:
Funds in the amount of $4300 have been allocated in the fiscal year budget 2004-2005
for this agreement. The amount of the contract is based on $.12 per capita. Last year's
agreement was based on a population of 34,600 and this year's is based on a
population of 35,834. Based on population, this reflects an increase of $148.
NOTIFICATION:
Trauma Intervention Programs
1420 Phillips Street
Vista, CA 92083
RECOMMENDATION:
By motion, renew the agreement with Trauma Intervention Programs, Inc., for volunteer
trauma intervention response to critical incidents for $4300 from July 1, 2004 to June
30, 2005.
Respectfully submitted,
W"CC4�-
Michael Cantor
Senior Management Analyst
Attachments
1. Personal Services Agreement
2. TIP services provided to City
•
i
PERSONAL SERVICES AGREEMENT
THIS AGREEMENT is made and entered into this 1st day of July 2004, by and
between the City of San Juan Capistrano (hereinafter referred to as the "City") Trauma
Intervention Programs (TIP), (hereinafter referred to as "Consultant").
RECITALS:
WHEREAS, City desires to retain the services of Consultant regarding the City's
emotional and practical support services to victims of traumatic events and their
families; and
WHEREAS, Consultant is qualified by virtue of experience, training, education
and expertise to accomplish such services.
NOW, THEREFORE, City and Consultant mutually agree as follows:
Section 1. Scope of Work.
The scope of work to be performed by Consultant shall consist of those tasks as
set forth in Exhibit 'A" attached and incorporated herein by reference.
Consultant warrants that all of its services shall be performed in a competent,
professional and satisfactory manner and in accordance with the prevalent standards of
its profession.
Section 2. Term.
This Agreement shall commence on the effective date of this Agreement and
services required hereunder shall be completed by no later June 30, 2005.
Section 3. Compensation.
3.1 Amount.
Total compensation for the scope of services for this Project shall not
exceed $4,152.00 (34,600 population x $.12), as set forth in Exhibit "B," attached and
incorporated herein by reference.
TIP psa.aoc - I - Attachment 1
3.2 Method of Payment.
Consultant shall submit quarterly invoices based on total services. The
City will pay quarterly progress payments based on approved invoices in accordance
with this Section.
For extra work not part of this Agreement, a written authorization from City
is required prior to Consultant undertaking any extra work.
3.3 Records of Expenses.
Consultant shall keep complete and accurate records of all costs and
expenses incidental to services covered by this Agreement. These records will be
made available at reasonable times to City.
Section 4. Independent Contractor.
It is agreed that Consultant shall act and be an independent contractor and not
an agent or employee of City, and shall obtain no rights to any benefits which accrue to
City's employees.
Section 5. Limitations Upon Subcontractina and Assianment.
The experience, knowledge, capability and reputation of Consultant, its principals
and employees were a substantial inducement for City to enter into this Agreement.
Consultant shall not contract with any other entity to perform the services required
without written approval of the City. This Agreement may not be assigned, voluntarily or
by operation of law, without the prior, written approval of the City. If Consultant is
permitted to subcontract any part of this Agreement by City, Consultant shall be
responsible to City for the acts and omissions of its subcontractor as it is for persons
directly employed. Nothing contained) in this Agreement shall create any contractual
relationships between any subcontractor and City. All persons engaged in the work will
be considered employees of Consultant. City will deal directly with and will make all
payments to Consultant.
Section 6. Changes to Scope of Work.
In the event of a change in the Scope of Work provided for in the contract
documents as requested by the City, the Parties hereto shall execute an addendum to
this Agreement setting forth with particularity all terms of the new agreement, including
but not limited to any additional Consultant's fees.
TIP psa.doc - 2 - July 6, 2004
0
Section 7. Familiarity with Work and Construction Site.
By executing this Agreement, Consultant warrants that: (1) it has investigated
the work to be performed; (2) it understands the facilities, difficulties and restrictions of
the work under this Agreement. Should Consultant discover any latent or unknown
conditions materially differing from those inherent in the work or as represented by City,
it shall immediately inform City of this and shall not proceed with further work under this
Agreement until written instructions are received from the City.
Section 8. Time of Essence.
Time is of the essence in the performance of this Agreement.
Section 9. Compliance with Law.
Consultant shall comply with all applicable laws, ordinances, codes and
regulations of federal, state and local government.
Section 10. Conflicts of Interest.
Consultant covenants that it presently has no interest and shall not acquire any
interest, direct or indirect, which would conflict in any manner or degree with the
performance of the services contemplated by this Agreement. No person having such
interest shall be employed by or associated with Consultant.
Section 11. Ownership of Documents.
All reports, information, data and exhibits prepared or assembled by Consultant
in connection with the performance of its services pursuant to this Agreement are
confidential to the extent permitted by law, and Consultant agrees that they shall not be
made available to any individual or organization without prior written consent of the City.
All such reports, information, data, and exhibits shall be the property of the City and
shall be delivered to the City upon demand without additional costs or expense to the
City. The City acknowledges such documents are instruments of Consultant's
professional services. No client privileged information will be released without the
client's written consent.
Section 12. Indemnity.
Consultant agrees to protect, defend and hold harmless City, its elected and
appointed officials and employees from any and all claims, liabilities, expenses or
damages of any nature, including attorneys' fees, for injury or death of any person or
damage to property or interference with use of property and for errors and omissions
committed by Consultant arising out of or in connection with the work, operation or
activities of Consultant, its agents, employees and subcontractors in carrying out its
obligations under this Agreement.
TIP psa.doc - 3 - July 6, 2004
Section 13. Insurance.
Insurance required herein shall be provided by Admitted Insurers in good
standing with the State of California and having a minimum Bests Guide Rating of A -
Class VII or better.
13.1 Comprehensive General Liability.
Throughout the term of this Agreement, Consultant shall maintain in full
force and effect Comprehensive General Liability coverage in the following minimum
amounts:
$500,000 property damage;
$500,000 injury to one person/any one occurrence/not limited to
contractual period;
$1,000,000 injury to more, than one person/any one occurrence/not limited
to contractual period.
13.2 Worker's Compensation.
If Consultant intends to employ employees to perform services under this
Agreement, Consultant shall obtain and maintain, during the term of this Agreement,
Worker's Compensation Employer's Liability Insurance in the statutory amount as
required by state law.
13.3 Proof of Insurance Requirements/Endorsement.
Prior to beginning any work under this Agreement, Consultant shall submit
the insurance certificates, including the deductible or self -retention amount, and an
additional insured endorsement to the Consultant's general liability and umbrella liability
policies to the City Clerk's office for certification that the insurance requirements of this
Agreement have been satisfied.
13.4 Errors and Omissions Coverage
Throughout the term of this Agreement, Consultant shall maintain Errors
and Omissions Coverage (professional: liability coverage) in an amount of not less than
One Million Dollars ($1,000,000). Prior to beginning any work under this Agreement,
Consultant shall submit an insurance certificate to the Clerk of the Board's office for
certification that the insurance requirements of this Agreement have been satisfied.
TIP psa.doc - 4 - July 6, 2004
C,
J
13.5 Notice of Cancellation/Termination of Insurance.
The above policy/policies shall not terminate, nor shall they be cancelled,
nor the coverages reduced, until after thirty (30) days' written notice is given to City,
except that ten (10) days' notice shall be given if there is a cancellation due to failure to
pay a premium.
13.6 Terms of Compensation.
Consultant shall not receive any compensation until all insurance
provisions have been satisfied.
13.7 Notice to Proceed.
Consultant shall not proceed with any work under this Agreement until the
City has issued a written "Notice to Proceed" verifying that Consultant has complied
with all insurance requirements of this Agreement.
Section 14. Termination.
City and Consultant shall have the right to terminate this Agreement without
cause by giving thirty (30) days' advance written notice of termination to the other party
In addition, this Agreement may be terminated for cause by providing ten (10)
days' notice to the other party of a material breach of contract. If the other party does
not cure the breach of contract, then the agreement may be terminated subsequent to
the ten (10) day cure period.
TIP psa.doc - 5 - July 6, 2004
0 0
Section 15. Notice.
All notices shall be personally delivered or mailed to the below listed addresses,
or to such other addresses as may be designated by written notice. These addresses
shall be used for delivery of service of process:
To City: City of San Juan Capistrano
32400 Paseo Adelanto
San Juan Capistrano, CA 92675
Attn: Mike Cantor, jSenior Management Analyst
To Consultant: Trauma Intervention Programs, Inc.
1420 Phillips Street
Vista, CA 92083
Attn: Wayne Fortin; CEO
Section 16. Attorneys' Fees.
If any action at law or in equity is necessary to enforce or interpret the terms of
this Agreement, the prevailing party shall be entitled to reasonable attorneys' fees, costs
and necessary disbursements in addition to any other relief to which he may be entitled.
Section 17. Dispute Resolution.
In the event of a dispute arising between the parties regarding performance or
interpretation of this Agreement, the dispute shall be resolved by binding arbitration
under the auspices of the Judicial Arbitration and Mediation Service ("JAMS").
Section 18. Entire Aareement!
This Agreement constitutes the entire understanding and agreement between the
parties and supersedes all previous negotiations between them pertaining to the subject
matter thereof.
TIP psa.doc - 6 - July 6, 2004
0
IN WITNESS WHEREOF, the parties hereto have executed this Agreement.
CITY OF SAN JUAN CAPISTRANO
Joe Soto, Mayor
CONSULTANT
By: t (
C:L —
Wayne F rtin, Chief Executive Officer
ATTEST:
Margaret R. Monahan, City Clerk
APPROVED AS TO
John R. Shaw,
TIP psa.doc - 7 - July 6, 2004
EXHIBIT "A"
Project Overview and Scope of Work
Trauma Intervention Programs, Inc. (TIP), upon the request of or referral
by the City, or as otherwise agreed upon, shall provide on -scene
emotional and practical support to the victims of traumatic events and their
family members. Said support shall include but not be limited to making
necessary telephone calls; making arrangements for clean-up services;
notifying family, friends and oIthers; referring to follow-up services;
providing information and referral services; performing one follow-up
contact to verify the client's welfare.
2. TIP shall make available to the City sufficient information to enable the
City to contact the appropriate TIP volunteer, including 24-hour on-call
phone number, address, and inames of volunteers, supervisors (when
appropriate), as well as alternate or backup telephone numbers.
3. TIP shall provide all personnel, volunteers, supplies, and equipment
necessary for the efficient and effective operation of the services and
programs provided for herein.
4. Tip or TIP's employees and/or volunteers shall provide all vehicles and
equipment necessary for the 'performance of this Agreement and shall be
responsible for maintenance of said equipment and vehicles.
EXHIBIT "B"
Compensation and Payment
The City agrees to pay TIP $4,152.00 for all services performed. This
amount is based on $.12 per capita based on a population of 34,600.
2. Consultant shall submit quarterly invoices of $1038.00 for services.
3. The City shall make payments within 14 days of receipt of Consultant's
bill.
4. Payments shall be made to Trauma Intervention Programs, Inc.
5. The parties understand and agree that the City's payments to Consultant
as compensation under this Agreement shall not exceed Four Thousand
One Hundred and Fifty Two Dollars ($4,152.00).
Date: June 10, 2004
To: Lt. J.B. Davis
From: Wayne Fortin
National Office
Trauma 1420 Phillips Street
Vista, CA 92083
Intervention (714) 314-0744
Programs
Inc.
"Citizens helping citizens in crisis"
Re: Services Provided the City of San Juan Capistrano July 1, 2003 to May 31, 2004
Services Provided to the City of San Juan Capistrano by TIP of Orange County
A. Crisis Intervention Services: TIP volunteers will respond 24 -hours a day, 365 -days a year
within 20 minutes to support citizens in crisis.
B. Follow Un Services: TIP volunteers provide written follow up services and a resource manual
to residents who are victims of traumatic events.
C. Volunteer Training and Supervision: San Juan Capistrano residents are provided a significant
volunteer opportunity and are provided extensive training and supervision.
D. Summary of Services: (See attached)
II Statistical Data (July 1, 2003 to May 31, 2004 -11-month period)
A. # of volunteer hours contributed to Orange County Cities (including San Juan Capistrano) _
17,520
B. # of TIP Responses = 36
C. # of San Juan Capistrano residents provided service = 108
D. # of TIP volunteers serving the City = 37
E. # of Emergency Responders trained to use the TIP program = 85
F. Average response time = 19 minutes
G. Reliability =100% of calls for service responded to when requested by emergency responders
III Summary of Results
A. Citizens who are traumatized — many of whom are experiencing the worst few hours of their
lives — are given immediate support which they would not have without TIP services.
B. Emergency Responders report that TIP was "very helpful' and report TIP frees them up to
perform other emergency services.
C. Citizens are given extensive training. These citizens report that this training not only is helpful
on TIP calls, but also is very useful in making them more effective when called upon to help
others on the job, in their family, and in their neighborhoods.
D. The TIP program provides the City of San Juan Capistrano with a well trained and experienced
critical incident response team capable of responding to major incidents within the City.
ATTACHMENT
Winner
National Crime Victim Service Rivard
Innovations in State and Local Government Award
ZIP
0 0
Trauma
Intervention
Programs
Inc.
"Citizens helping citizens in crisis"
Services Offered
#1 Volunteers provide 24-hour, 7 -day a week Crisis Response services.
#2 Professional Mental Health Intervention: Mental health professionals
offer short term counseling services at no cost to victims.
#3 TIPTeens Program: TIPTeens are young people who are well trained
volunteers in the TIP program. TIPTeens are called upon by TIP volunteers
to help traumatized teens and children.
#4 TIP4kids Program: TIP offers counseling services for children who have
been emotionally traumatized and for parents struggling to help their
children after a crisis event.
#5 Critical Incident/Disaster Response Team: A specially trained team of
TIP volunteers responds to major incidents and disasters on a 24-hour 365 -
day basis.
#6 Senior Crisis Team: Extensive follow up services are provided to elderly
citizens who are in crisis.
#7 TravelersCare: Special arrangements are made with the travel industry to
call TIP when travelers have experienced a crisis event while away from
home. TIP volunteers provide support until the traveler is reunited with
loved ones.
#8 Bilingual Services: Bilingual TIP volunteers are available to respond to
emergency scenes when requested. All TIP resource materials are available
in English and Spanish.
Winner
Innovations in State and local Government
An Awards Program of the Ford Foundation
and Harvard University
#9 Victims Resource Service: Helpful written materials and video tapes are
delivered to victims of crisis events on a 24-hour , 365 -day a year basis.
#10 TIPLine: A telephone information and referral service is available to help
emotionally traumatized citizens.
#11 Hospital Response Program: TIP volunteers are called by hospital
emergency room staff to assist victims and their families. Also, hospital
personnel are authorized to call a TIP volunteer when family members need
volunteer accompaniment from the hospital back home.
#12 Traffic Accident Response Team: Specially trained TIP volunteers
respond to scenes of traffic accidents at the request of the Highway Patrol
and other law enforcement agencies to assist emotionally traumatized
accident victims.
#13 TIP National Emotional First Aid Course: This 8 -hour course is offered
to emergency personnel, nurses, mental health professionals, managers, and
the general public.
#14 Good Samaritan Awards: Emergency responders and citizens who have
demonstrated exceptional compassion in assisting victims of crisis events
are recognized on a regular basis.
#15 National Assistance Network: By working with TIP programs across the
nation, the local TIP Chapter ensures that local residents receive crisis
support services while traveling away from home.
i
ii
r
32400 PASEO ADELANTO
SAN JUAN CAPISTRANO, CA 92675
(949) 493.1171
(949) 493-1053 FAx
www sat juancapistrano.org
11
MEMBERS OF THE CITY COUNCIL
NOTIFICATION OF MEET11AUVP POTENTIAL INTEREST
OF THE SAN JUAN CAPISTRANO CITY COUNCIL
SAM ALLEVATO
DIANE L. BATNGATE
WYATT HART
JOE SOTO
DAVID M. SWERDLIN
The City Council of San Juan Capistrano will meet at 7:00 p.m. on July 6, 2004, in the
City Council Chamber in City Hall, to consider: "Consideration of Renewal of
Agreement for Crisis Intervention Services (Trauma Intervention Program, Inc.)" —
Item No. D11
If you have specific thoughts or concerns regarding this item, you are encouraged to
participate in this decision making process. You can communicate with the City Council
through correspondence addressed to the Board and/or by attending the meeting and
speaking to the Council during the public meeting.
Correspondence related to this item must be received at City Hall by 12:00 p.m. on
Tuesday, July 6, 2004 to allow time for the Council to consider its content.
If you would like to speak at the meeting, please complete a blue 'Request to Speak"
form found inside the entrance to the Council Chamber. This form is turned in at the
staff table, just in front of the Council dais. You will be called to speak by the Mayor
when the item is considered.
You have received this notice at the request of the City staff member Michael Cantor,
Senior Management Analyst. You may contact that staff member at (949) 234-4565
with any questions.
The Agenda, including agenda reports, is available to you on our web site:
www.sanivancapistrano.oro. If you would like to subscribe to receive a notice when
agendas are posted to the web site, please make that request by sending an e-mail to:
council-agendas(a)sanivancapistrano.oro.
Thank you for your interest,
Meg Monahan, CMC
City Clerk
cc: Trauma Intervention Program, Inc.; Michael Cantor, Senior Management Analyst
* Received staff report
San Juan Capistrano: Preserving the Past to Enhance the Future