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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 0 0 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 0 E 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 0 0 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 P 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 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, 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 0 0 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 0 0 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 0 0 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