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1988-0216_LIFECARE AMBULANCE SERVICES, INC_Agreement11 0 AN AGREEMENT FOR PROVISION OF EMERGENCY MEDICAL TRANSPORTATION SERVICES BETWEEN THE CITY OF SAN JUAN CAPISTRANO AND f IFECARE AMBULANCE SERVICES, INC. THIS AGREEMENT is made this 16th day of FopruarX , 1988, by and between the City of San Juan Capistrano, hereinafter referred to as "City", and Lifecare Ambulance Services, Inc., a California corporation, hereinafter referred to as "Contractor". WITNESSETH: WHEREAS, City desires to assure the availability of prompt emergency medical transportation services within the City of San Juan Capistrano; and WHEREAS, Contractor desires to provide such services upon the terms and conditions set forth in this Agreement, NOW, THEREFORE, BE IT MUTUALLY AGREED between City and Contractor as follows: I. CONTRACTOR DESIGNATED AS SECONDARY PROVIDER In consideration of the services Contractor agrees to provide pursuant to this Agreement, City designates Contractor as the secondary responder and provider for emergency medical transportation services within the corporate city limits of the City of San Juan Capistrano. City may suspend or terminate such designation for failure to maintain compliance with or for violation of any provisions of this Agreement and any applicable law, rules, or regulations of any governmental entity. City assumes no financial liability for the cost of services to be provided to patients pursuant to this Agreement, including financial liability for the costs of dry -runs. II. OPERATIONAL STANDARDS, EQUIPMEiVTLSERVICES Contractor shall adhere to the following operational standards: Page 1 of 7 • 0 1. Emergency response time (Code 3 - red lights and siren) within the City shall not exceed 10 minutes. 2. Urgent response time (expeditious response without red lights and siren) within the City not to exceed 15 minutes. 3. Upon request for response, the emergency medical transportation provider for the City shall have the responding unit enroute within 3 minutes. 4. A field supervisor shall be immediately available, by telephone on a 24-hour basis. 5. There will be a permanently designated ambulance for service to San Juan Capistrano. It will be fully equipped to meet all rules and requirements of the California Highway Patrol, the California Vehicle Code, and the Policy Procedures Memorandum Number 730-00 dated July of 1986 from the County EMS Agency. Once the dedicated unit is responding to a call, a second ambulance shall be available to the City to serve as a cover unit. This cover unit shall serve in the same manner as the dedicated unit until the dedicated unit is returned to the City. The purpose of this cover unit is to ensure that response time criteria can be met. 6. All emergency ambulance vehicles shall be equipped, maintained, and operated in compliance with the applicable portions of the California Vehicle Code, California Highway Patrol rules and regulations, State of California EMS or authority, and County of Orange EMS policies and procedures. Page 2 of 7 0 • 7. Contractor shall provide a quarterly activity report based upon City specifications as outlined in Section VIII of this Agreement. 8. Contractor shall possess, maintain, and provide equipment, facilities, and supplies, and shall hire, train, and provide such personnel and dispatch such equipment and personnel as are necessary, and as are usually or customarily employed in the provision of services by emergency responders, all as are required to respond on a 24-hour basis to requests by the emergency dispatch center for EMTS. If, for any reason, Contractor is unable to respond in accordance with the time response periods set forth in Paragraph II, Contractor shall notify the Orange County Emergency Center and the secondary provider so as to provide ample notice to all affected parties. 9. Contractor shall have at least one dispatcher on a 24-hour per day basis who is adequately trained in radio operations and protocol standards established by all applicable laws, rules, and regulations. 10. Contractor shall install and maintain radios acceptable to the County EMS in each first line and reserve unit, as required by any governmental rules, laws, or regulations. III. OTHER APPLICABLE STANDARDS OF OPERATION The Request for Proposals and Contractor's response are included by reference. Where the RFP and Contractor's response conflict with this Agreement, this Agreement shall prevail. Page 3 of 7 • IV. ALTERATION OF TERMS This Agreement, together with any exhibits attached hereto which are incorporated by reference, fully expresses all understandings of the City and Contractor with respect to the subject matter. This Agreement shall constitute the total Agreement between the parties for these purposes. No addition or alteration of the terms of this Agreement or any exhibits thereto, whether written or verbal, shall be valid unless made in writing and formally approved and executed by both parties. V. ASSIGNMENTS Contractor may not delegate or assign the rights or obligations hereunder, either whole or in part, without prior written consent of the City. Any attempted assignment or delegation in derogation of this paragraph shall be void. A transfer by any shareholder of greater than ten percent (10%) of the stock currently issued by Contractor, or a sale or transfer of over twenty-five percent (25%) of the assets of the Contractor, will be deemed an assignment. VI. LVOE:y1NIFICArION AND INSURANCE A. Contractor agrees to indemnify and hold harmless City, its officers, agents, and employees from all liability, claims, losses, and demands, including defense costs, whether resulting from court action or otherwise arising out of the acts or omissions of Contractor, its officers, agents, or employees or the condition of property used in the performance of this Agreement, excepting acts or omissions directed by City, its officers, agents, or employees acting within the scope of their employment for which City agrees to indemnity Contractor in a like manner. Page 4 of 7 0 9 B. Without limiting Contractor's indemnification, it is agreed that Contractor shall maintain in force at all times during the performance of this Agreement, comprehensive automobile liability insurance, professional liability insurance, and Worker's Compensation insurance as required by applicable laws, and governmental rules and regulations, and subject to approval of the Office of the City Attorney. C. All insurance policies, excepting Worker's Compensation, shall contain a clause adding the City of San Juan Capistrano as an additional named insured with respect to the operation of the named insured performed under contract with the City of San Juan Capistrano. D. The insurance policies shall not be cancelled, limited, or allowed to lapse until after 30 days written notice has been given to the City of San Juan Capistrano. VII. LICENSES AND LAW Contractor shall maintain all necessary licenses, permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States, the State of California, the County of Orange, and any other governmental agencies. Contractor shall notify City immediately and in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, or exemptions. VIIl. REPORTS AND RESPONSES Contractor shall provide the following reporting information to City on a quarterly basis beginning January 1, 1988. 1. Number of emergency runs per month. 2. ;Number of runs cancelled enroute per month. Page 5 of 7 3. Number of runs cancelled at scene per month. 4. Number of times not available to handle calls per month. 5. Percent of Code III calls at scene within 10 minutes. 6. Percent of Urgent Response Calls at scene within 15 minutes. 7. Copies of all written and verbal complaints received, and information outlining corrective action taken. IX. INDEPENDENT CONTRACTOR Contractor is and shall at all times be deemed to be an independent contractor and shall be wholly responsible for the manner in which it performs services required of it by the terms of this Agreement. Contractor assumes exclusively the responsibility for the acts of its employees as they relate to the services to be provided during the course and scope of their employment. X. TERM The term of this Agreement shall commence on the effective date of this Agreement and expire on December 31, 1988, unless sooner terminated as specified in this Agreement. XI. TERMINATION The City and Contractor acknowledge that the services to be performed under this Agreement are unique and specialized. City and Contractor therefore agree that in the event City desires to change provider, it shall have the right to do so without restriction, and therefore may terminate this Agreement without cause. In such event, the City shall provide thirty (30) calendar days written notice of its intent to terminate said Agreement. XII. WAIVER OF DEFAULT Waiver of any defaults shall not be deemed to be a waiver of any subsequent default. Waiver or breach of any provision of this Agreement shall not be deemed to be a waiver of any other or subsequent breach, and shall not be construed to Page 6 of 7 E • be a modification of the terms of this Agreement unless stated to be such in writing by the City and attached to the original Agreement. XIII. NOTICES All notices, correspondence, reports, and/or statements authorized or required by this Agreement shall be addressed as follows: CITY: City Manager City of San Juan Capistrano 32400 Paseo Adelanto San Juan Capistrano, CA 92675 CONTRACTOR: Lifecare Ambulance Services, Inc. 25260 E. La Paz Road, Suite 4 Laguna Hills, CA 92653 IN WITNESS WHEREOF, the parties have executed this Agreement in the County of Orange, State of California, on the day and year first above written. LIFECARE AMBULANCE SERVICES, INC. Title CITY OF SAN JJAN CAPISTRANO Anthony Bland TitleMayor ATTEST: Mary Ann Ilan,,01er, City Clerk �1 0 substantial compliance with the approved tentative map. As set forth in the report dated February 16, 1988, from the Director of Public Works, the Improvement Agreement was approved and the :Mayor and City Clerk were authorized to execute the agreement for forwarding to the County Recorder. APPROVAL OF FINAL MAP AND IMPROVEMENT AGREEMENT, TRACT 12830 GLENFED 600.30 It was moved by Mayor Bland, seconded by Councilman Buchheim and unanimously carried to approve Final Tract Map 12830 with the determination that it was in substantial compliance with the approved tentative map. As set forth in the report dated February 16, 1988, from the Director of Public Works, the Improvement Agreement was approved and the Mayor and City Clerk were authorized to execute the agreement for forwarding to the County Recorder. RECESS AND RECONVENE Council recessed at 7:55 p.m., to convene the San Juan Capistrano Community Redevelopment Agency, and reconvened at 8:05 p.m. ADMINISTRATIVE ITEMS CITY MANAGER ---�> 1. APPROVAL OF CONTRACT (LIFECARE .AMBULANCE SERVICE) (600.30) Written Communications: Report dated February 16, 1988, from the Senior Administrative Assistant, advising that in May, 1987, the City had selected Scudder's Ambulance Service, Inc., as the secondary provider of emergency ambulance transport services. Since that time all assets of the company have been sold to LifeCare Ambulance Services Inc. All contracts in the County which were previously awarded to Scudder's have been transferred to LifeCare by the Board of Supervisors. The report advised that LifeCare had reviewed the contract drafted for the secondary provision of emergency ambulance transport services and had agreed to meet all conditions. Approval of Agreement: It was moved by Councilman Schwartze, seconded by Councilman Buchheim and unanimously carried to approve the agreement for the provision of secondary Emergency Medical Transportation Services with LifeCare Ambulance Services Inc., and to authorize the Mayor and City Clerk to execute the agreement on behalf of the City. The contract will be in effect until December 31, 1988. 2. AMENDMENT TO THE INVENTORY OF HISTORICAL AND Written Communications: Report dated February 16, 1988, from the Secretary to the Cultural Arts and Heritage Commission, forwarding the Commission's recommendation to include the Esslinger Building, located at 31866 Camino Capistrano, in the Inventory of Historical and Cultural Landmarks. The building is the only example of Streamline Moderne architecture in the City. -7- 2/16/88 E AGENDA ITEM TO: Stephen B. Julian, City Manager 41 February 16, 1988 FROM: Jennifer M. Williams, Senior Administrative Assistant SUBJECT: Approval of Contract, LifeCare Ambulance Services, Inc. SITUATION: In May of last year, the City Council considered the award of primary and secondary contracts for the provision of emergency ambulance transport services. At that time, they selected Medix Ambulance Service, Inc. as the primary provider for the community, and designated Scudder's Ambulance Service, Inc. as the secondary provider. City staff was authorized to negotiate agreements with both ambulance companies, which would be approved by the City Council. The agreement with Medix Ambulance Service, Inc., the primary provider, was approved in June, 1987. Since the City Council made the decision to award the secondary contract to Scudder's, this firm has sold its assets to LifeCare Ambulance Services, Inc. LifeCare is owned and operated by Bruce Tovar and Sally Cleem. Both of these individuals formerly served as the Vice Presidents of Scudder's. Mr. Craig Scudder, President of Scudder's, has sold all of the assets of his firm to LifeCare and is no longer in the emergency transportation business. All contracts in the County of Orange for emergency transport services which were previously awarded to Scudder's have been transferred to LifeCare by the Orange County Board of Supervisors. LifeCare has reviewed the proposed contract drafted for the secondary provision of emergency ambulance transport services. They agree to meet all of the conditions contained within the agreement which were previously requested of Scudder's. Also, the Orange County Fire Department has indicated that LifeCare has done a good job in meeting all of their contractual obligations with the County of Orange. The Orange County Fire Department is satisfied with the quality of service that is being rendered by LifeCare. For these reasons, staff requests the City Council approve the attached agreement with LifeCare Ambulance Services, Inc. A unique provision of this contract provides that LifeCare shall provide a quarterly activity report to the City. The information which shall be provided will include the number of emergency runs per month and statistics indicating the percentages of "Code 3" and urgent response calls answered in a timely manner. Also, the contractor has agreed to provide copies of all written and verbal complaints received and information outlining corrective action which has been taken. These contract provisions are also included in the contract that was negotiated with Medix as our primary provider. Finally, staff proposes this contract be in effect until December 31, 1988. This expiration date coincides with the expiration date of the contract awarded to Medix. � �r.�, y-. ri T.. �✓�,..��,i,R 4i�'L. J^'.iiL,l'QKl1 I d.. �.� Agenda Item: LifeCare Ambulance Contract Pg 2 COMMISSION/BOARD REVIEW & RECOMMENDATIONS: Not applicable. FINANCIAL CONSIDERATIONS: None NOTIFICATION: 2/16/88 Mr. Bruce Tovar of LifeCare Ambulance Services, Inc. has been notified that this contract would be considered at this time. ALTERNATE ACTIONS: 1. Move to approve the agreement for the provision of Emergency Medical Transportation Services between the City of San Juan Capistrano and LifeCare Ambulance Services, Inc. and authorize the Mayor to execute this agreement on behalf of the City. 2. Modify the proposed agreement for the provision of Emergency Medical Transportation Services between the City of San Juan Capistrano and LifeCare Ambulance Services, Inc. and authorize the Mayor to execute this revised agreement. 3. Request more information from Staff. ------------------------------------------------------------------ ------------------------------------------------------------------ RECOMMENDATION: 1. Move to approve the agreement for the provision of Emergency Medical Transportation Services between the City of San Juan Capistrano and LifeCare Ambulance Services, Inc. and authorize the Mayor to execute this agreement on behalf of the City. ------------------------------------------------------------------ ------------------------------------------------------------------ Respectfully submitted, ennifer . Williams JMW:jd Enclosure 1 � J ACOR SSUE DATE IMNDDlW7 9/06/89 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY Gr egg -M i I I er $I Associates AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGES PO Box 16891 Phoenix,AZ 85014 602-279-6296 COMPANYA AzStar Insurance Company LETTER COMPANY formerly TriStar Ins. Company LETTER INSURED Life Care Ambulance Serv.,lnc. 27075 Cabot Road 9109 COMPANY LETTER C Laguna HI I IS CA 92653 COMPANY D y LETTER COMPANY I as cc LETTER E yZC.)AQ THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED O OR E POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY TR T q� O R DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURA .V$EOR[i!D BY E POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF S&VA=P0LIC= T LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MNDO/YV) POLICY EXPIRATION DATE 04NDD/YY) ALL LIMT�S IN THO DS GENERAL LIABILITY GENERAL AGGREGATE 1000 COMMERCIAL GENERAL LIABILITY CLAIMS MADE 0 OCCURRENCE APK100086 9/09/89 9/09/90 PRODUCTS-COMP/OPS AGGREGATE$ 1000 PERSONAL & ADVERTISING INJURY $ 1000 EACH OCCURRENCE $ 1000 OWNER'S& CONTRACTORS PROTECTIVE FIRE DAMAGE (ANY ONE FIRE) $ 50 MEDICAL EXPENSE (ANY ONE PERSON) $ 5 AUTOMOBILE LIABILITY ANY AUTO TAU100860 9/09/89 9/09/90 CSL 1000 ALL OWNED AUTOS AUTOS BODILY (PERRY INJUSCHEDULED HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (PER Arrmmn GARAGE LIABILITY PROPERTY DAMAGE EXCESS LIABILITY OCL PRFNCF AGGREGATE $ $ OTHER THAN UMBRELLA FORM WORKERS' STATUTORY $ (EACH ACCIDENT) COMPENSATION AND EMPLOYERS' LIABILITY $ (DISEASE -POLICY LIMIT) $ (DISEASE -EACH EMPLOYEE) OTHER DESCRIPTION OF OPERATIONS / LOCATIONS J VEHICLES / RESTRICTIONS / SPECIAL ITEMS ERIFICATION OF INSURANCE - CITY OF SAN JUAN CAPISTRANO IS NAMED AS ADDITIONA INSURED WITH RESPECTS TO THE OPERATION OF THE NAMED INSURED PERFORMED UNDER ONTRACT WITH THE CITY OF SAN JUAN CAPISTRANO. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED City of San Juan Capistrano BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE 32400 Paseo A d e I a n t o CERTIFICATE HOLDER, NAMED TO THE LEFT, BUT FAILURE TO MAIL San Juan Capistrano, CA 92675 SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. Attn: Mary Ann Hanover AUTHORIZED REPRESENTATIVE 271939000 • 0 STATE P.O. BOX 807, SAN FRANCISCO, CALIFORNIA 94101-0807 COMPENSATION INSURANCE FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE . c,ZT1. J, '1.'id3 POLICY NUMBER. C,, Z2 7 CERTIFICATE EXPIRES: iJ-1 -oJ r 1'i'Y 3P Stir< JUA(d CAP7 Yf;A�e -L)1 LuTI,I: ✓: ...A2L'i.Y JJueAPc_'i°,h c�"i Jz40J c.'1:;EU A,. L.A-ii'v L 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 tenays' advance written notice to the employer. u We will also give you TEN 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. PRESIDENT ,� ::vn,i rs L,i ,1 rtt�JJJ ,tl i'1 iL?0 1L^:PTC i.Ja"; ;'vLii. iAC % �31,L F Jit '1 Cll: @ ini5 =CLT _Y r L EMPLOYER L.i ZJu 1'l ALA wtiL,, J uCwLi�� ;iT[,La SCIF 10262 (REV. 10-86) OLD 262A D _ c3.o C7 171 M cy Ji SCIF 10262 (REV. 10-86) OLD 262A 7�m_ K mid QUIMAL41 A 1 6. EFSM ISSUE DATE (MM/DD/YY) kill JIL" 103 0- -TI "! " A18 PRODUCER - THIS CER LED AS A MATTER OF INFORMATION ONLY AND CONFERS NOR EFETIFICATE HOLDER, THIS CERTIFICATE DOES NOT AMEND, IGH7jtgo&r EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. M 1. 1 & R11C, S;�rF 12 IN AFFORDING COVERAGE 4. 01t.501A, COMPANY �;i IT I;LtKK LETTER D21PART!E1., IN) ID �..j Ely COMPAWAg !-,'A P i �TRAN 0 LETTER If Go rnt..�r 1.)" y 1 1. a 0 r. Yr, 1. If I- �'tl TIC. 0 INSURED COMPANY c 1.4 LETTER Roti Cl COMPANY D LETTER COMPANY E COMPANY 5F5 ER 1)7 THIS IS TO CERTIFY THAT 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 CONDI- TIONS OF SUCH POLICIES. Co LTR TYPE OF INSURANCE POLICY NUI METER POLICY EF ECTIVE DATE fMM%OYY, POLICY EXPIRATION DATE (M MIDDW) ALL LIMITS IN THOUSANDS S CIS GENERAL LIABILITY GENERAL AGGREGATE $ -.1. o o ,I') % COMMERCIAL GENERAL LIABILITY TLA -3.'a W?36 9/09`/`G�43 9/09/89 PRODUCTS COMPIOPS AGGREGATE $ :1-()()0 -xi CLAIMS MADE FIOCCURRENCE PERSONAL & ADVERTISING INJURY $ :1.0. ) OWNER'S & CONTRACTORS PROTECTIVE EACH OCCURRENCE $ I 000 FIRE DAMAGE )ANY ONE FRE) $ F50 MEDICAL EXPENSE (ANY ONE PERSON) $ !F5 -AUTOMOBILE LIABILITY r.ANY AUTO T AU 1. 00531_.; 911109/8�3 9/09/89 CSL $ :1.000 ALL OWNED AUTOS BODILY SCHEDULED AUTOS INJURY RY (PER PERSON) $ p HIRED AUTOS BODILY INJURY NON OWNED AUTOS �CCRDEND $ GARAGE LIABILITY PROPERTY DAMAGE $ EXCESS LIABILITY EACH AGGREGATE OCCURRENCE OTHER THAN UMBRELLA FORM STATUTORY WORKERS' COMPENSATION $ (EACH ACCIDENT) AND $ (CUSEASE POUCY UNIT) EMPLOYERS' LIABILITY $ (DISEASE EACH EMPLOYEE) _OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS 1: !'Ci^. T .1. ON '01I I. C 1"If It, OF CDAN Jt. (I CAP]. STRAND .1. £.; NIA0117.1.1 A13T T' Ot4nj INlUi-11i"11 W11-1.1 U.) 'IFIE. OF THE Kh,-)MED IM313RU.'11 PERFORME.1i UNDER w:i:,T,I.i TA -11... cj,y,y OF SAN JI.M.)N SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX C I t v of Ga T1 J Uzi n Cla ID I st) a Y70 PIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO S !400 Add-:,!.i;snto MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE Juan Cap istrc.Tno. C, Fb 91,26 , LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR I LIABILITY OF ANY KIND UPON THE COMPANY, ITS JJENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTAT E 271. 9 13. Z��gff ot t", Mary Aym i-lanove.n" IIIIIIIL I >9, Aaflv E JSao I � 1 (moi ' IIIIIHM�II IIIN111111 1961 1776 September 13, 1988 LifeCare Ambulance Services, Inc. 27075 Cabot Road Laguna Hills, California 92653 Re: Renewal of Workers' Gentlemen: MKMDERS OF THE CITY COUNCIL ANTHONY L. ELAND LAWRENCE F. DUCNN[IM KENNETH E. FIVES• GARY L. HAU•DORFER PHILLIP I1. •CHWARTZE CITY MANAGER STEPHEN E JULIAN The Workers' Compensation Certificate of Insurance, regarding emergency medical r, transportation services for the City, is due to expire on October 1, 1988. In accordance with your contract, the insurance certificate needs to be renewed for an additional period of one year. Please forward an updated certificate to the City, attention City Clerk's Department, before the October 1, 1988, expiration date. If you have any questions, please contact Dawn Schanderl, Records Coordinator, at (714) 493-1171 extension 244. Thank you for your cooperation. I O' 9 188 Very truly yours, Mary Ann anover, CMC City Clerk MAH/dms Ll i j Q? 2� I7. -2-e-88 Wlkr L' , ,. r ��, l L rZ/U un W h� 32400 PASEO ADELANTO, SAN JUAN CAPISTRANO /f u5t bv� uv2,Q I C�rrc,�aJrwcl tern i 6PL ,a 0,d,,I�N !�,(�/ 493-1171 UT- ZIN I I jq l88 LJ AJ CALIFORN n 1b,T' 92675 4) 493.1171 Xid &&COIL 06 PMNE-O-GRAM .: qq,3-; M � )CPofilrelfa L1al Q ❑ Telephoned Returned your call ❑ Came In ❑(� (Will �caall again ❑ Please r}ettumm the c/alll�� ,� ❑ eeI me (� Messal a: . .... S�-- �"..,. �*^�..,....t.; , 11 . �C n...'..: ..%.Tt 7............no'...... VV.......... ............... ........II............... ..................... .Y.................. Phone Date F Tim:I e(B I ft • March 23, 1988 Mr. Bruce Tovar LifeCare Ambulance Services, Inc. 25260 East La Paz Road, Suite 4 Laguna Hills, California 92653 7g-0 MEMBERS OF TME CITY COUNCIL ANTHONY L. BLA ND LAWRENCE P. BUCMHEIM KENNETH E. FRIESS GARY L, HAUSDORF ER PHILLIH P SCHWARTZE CITY MANAGER STEPHE4 S JULIAN Re: Certificates of Insurance (LifeCare Ambulance Services) Dear Mr. Tovar: Thank you for the revised Certificate of Insurance, which was received by the City on March 18, 1988. Please be advised that the following items are needed for your contract to be effective: (1) Page 5, Item B, a Workers' Compensation certificate is needed. (2) Page 5, Item D states the policies shall not be cancelled, limited, or allowed to lapse until 30 days written notice has been given to the City of San Juan Capistrano. This portion on the certificate received will have to be corrected. (Please see attached example). Please forward the certificates to the attention of the City Clerk's Department by April 1, 1988. l If you have any questions, please contact Dawn Schanderl, Records Coordinator, at (714) 493-1171 extension 244. / Thank you for your cooperation. 1 Very truly yours, Mary Ann Hanover, CMC City Clerk I MAH/dms 32400 PASEO ADELANTO, SAN JUAN CAPISTRANO, CALIFORNIA 92675 9 (714) 493-1171 I ,MM:OO,Yv, 3/15/88 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. GRF.GG—MILLER & ASSOCIATES, INC COMPANIES AFFORDING COVERAGE 1129 EAST MISSOURI PHOENIX, AZ 83014 COMPANY LETTER A TriStar Insurance Com y COMPANY s INSURED SETTER C -OMPANY ._ :; _ r" C I..ife Care Ambulance Serv.,Inc. E ER A A CIS 27075 Cabot Road COMPANY I._Aguna Hitls TETTER 0 COMPANY - 3 CA 92653 i :E' ER THIS IS TO CERTIFY THAT 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 CONDI. TIONS OF SUCH POLICIES. CO LTR TYPE OF INSURANCE POLICY NUMBER O' -C` C0cE ''E ;A-E MMlcol 'OL CY E'P'PATION :a TE MM.'Dp.Yn ALL LIMITS IN THOUSANDS GENERAL LIABILITY ;=_RAL AGGREGATE $ X COMMERCIAL GENERAL I ABILITY "AMENDEDAF PRODUC"S OMP,OPS AGGREGATE $ A X X L:AIM$ MAGE ❑OCCURRENCE TOL 100448 9/09/ 9/09/ RSONA: 6 ADVERTISING IN�LRY $ Igo OWNER S 8 CONTRACTORS PROTECTIVE EACP OCCURRENCE $ 100 X PROFESSIONAL ;IPE ^AMAGE ANY ONE FIRE $ J 1 TARTL TTY MEDICAL EXPENSE (ANY ONE PERSON $ AUTOMOBILE LIABILITY A X ANN AUTO TAU 100281 9/09/ 9: 09/ L $ 1000 ALL OWNED AUTOS epOILY SCHEDULED AUTOS III PERSOW $ HIRED AUTOS NOILY INJURY NON -OWNED AUTOS ALCADENT) $ DAMPER GARAGE LABILITY DAMAGE $ EXCESS LIABILITY xaRRENCE AGGREGATE $ $ OTHER THAN UMBRELLA FORM WORKERS' COMPENSATION STATUTOPv $ EA, ALC'pEvi� AND $ CiEEaSE POnCv _MI' EMPLOYERS' LIABILITY $ C�SEaSE EACH EMPL�•-- OTHER DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES I RESTRICTIONS, SPECIAL ITEMS VFRiFT.CATION OF INSURANCE — CITY OF SAN JUAN CAPISTRANO IS NAMED AS ADDITIONA INSURED WITH RESPECTS TO THE OPERATION OF THE NAMED INSURED PERFORMED UNDER CONTRACT WITH THE CITY OF SAN JUAN CAPISTRANO. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX City of San Juan Capistrano PIRATION DATE THEREOF. THE ISSUING COMPANY WILL j•v 324 Paseo Ade La nt o MAIL 310YS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE San Juan Capistrano, CA 926 LEFT. �iI QIARJOK� At t n S I AUTHORIZED REPR NTATI',= 27193 Cl+y Ger k Dept !i LlreCare Ambulance Services, Inc. March 7, 1988 Mary Ann Hanover, CMC City Clerk City of San Juan Capistrano 32400 Paseo Adelanto San Juan Capistrano, CA. 92075 RECEIV79 MAR IO 2 52 PM '88 Dear Ms. Hanover: Thank you for your letter of February 18, 1988. our insurance carrier is currently working on a certificate of insurance which will meet your. requirements. Your assistance is appreciated. Sincerely, Bruce R. Tovar, Ph.D. President BRT;bb 27075 Cabot Road, Suite 109 • Laguna Hills, California 92653 • (714) 768-7848 CORD 25-S (11/85) IIR/ACORD CORPORATION 1985 ISSUE DATE (MM/DD/Y1) • • 3/15/88 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS PRODUCER NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. CREGG-MILLER S ASSOCIATES, INC 1.1.29 EAST MISSOURI COMPANIES AFFORDING COVERAGE PHOENIX, 85016 COMPANY ,AZ. LETTER A TriStar Insurance Cowt*py COMPANY B LETTER — Y INSURED COMPANY C. Life Care Ambulance Serv.,Inc. LETTER " .��, eb I1► 270*75 Cabot Road COMPANY D l+ + Laguna HiLLs LETTER 4 T Ht COMPANY E CA 92.653 1 LETTER THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REOUIREMENT, 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 CONDI- TIONS OF SUCH POLICIES. CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE OMI POLICY EXPIRATION DATE (MM/DD/YY) qLL LIMITS IN THOUSANDS GENERAL LIABILITY GENERAL AGGREGATE $ X COMMERCIAL GENERAL LIABILITY "AMENDED" PRODUCTS-COMPIOPS AGGREGATE $ A X X CLAIMS MADE ❑OCCURRENCE TOL 100448 9/()9/E'7 9/09/E RRSONAL 8 ADVERTISING INJURY $ OWNER'S B CONTRACTORS PROTECTIVE EACH OCCURRENCE $ X PROFESSIONAL FIRE DAMAGE (ANY ONE FIRE) $ J I_ -TAH TLTTY MEDICAL EXPENSE (ANY ONE PERSON) $ AUTOMOBILE LIABILITY A X ANY AUTO TALI 100281 9/09/E7 9/09/ L $ 1000 ALL OWNED AUTOS BODILY SCHEDULED AUTOS NJURY IPER PERSON) $ HIRED AUTOS BODILY INJURY NON -OWNED AUTOS ZE,EDENT) $ GARAGE LIABILITY PROPERTY DAMAGE $ EXCESS LIABILITY EACH CCCURRENGE AGGREGATE $ $ OTHER THAN UMBRELLA FORM STATUTORY WORKERS' COMPENSATION $ (EACH ACCIDENT)AND $ (DISEASEPOLICYLIMIT) EMPLOYERS' LIABILITY $ DI EASE EACH EMPLOYEE) OTHER J DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS WRIF.T.CATION OF INSURANCE — CITY OF SAN JUAN CAPISTRANO IS NAMED AS ADDITIONA INSURED WITH RESPECTS TO THE OPERATION OF THE NAMED INSURED PERFORMED UNDER CONTRACT WITH THE CITY OF SAN JUAN CAPISTRANO. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX City of San Juan C:aPiStra TIO PIRATION DATE THEREOF, THE ISSUING COMPANY WILL •IIY M 324 Paseo ACIe L a n t O MAIL 31@YS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE San Juan Cap istra n0, CA 92..6 LEFT, At t n : �g G*y cite AUTHORIZED REPR NTA IVE 27193 CORD 25-S (11/85) IIR/ACORD CORPORATION 1985 F February 29, 1988 Mr. Bruce Tovar LifeCare Ambulance Services, Inc. 25260 East La Paz Road, Suite 4 Laguna Hills, California 92653 Joe" 177 it6.l� �. 1961 76 Re: Certificates of Insurance (LifeCare Ambulance Services) Dear Mr. Tovar: MEMBERS OF THE CITY COUNCIL ANTHONY L. BLAND LAWRENCE F. BUCHHEIM KENNETH E. FRIESS GARY L. HAUSOORFER PHILLIP R. SCHWARTZE CITY MANAGER STEPHEN 8 JULIAN Thank you for the Certificate of Insurance, which was received by the City on February 24, 1988. In accordance with your contract, please be advised of the following: (1) Page 5, Item B, a Workers' Compensation certificate is needed. (2) Page 5, Item C states that a clause adding the City of San Juan Capistrano as an additional named insured with respect to the operation of the named insured performed under contract with the City of San Juan Capistrano will be added to the certificate. (3) Page 5, Item D states the policies shall not be cancelled, limitetd, or allowed to lapse until 30 days written notice has been given to the City of San Juan Capistrano. This portion on the certificate received will have to be corrected. Please forward the corrected certificates to the attention of the City Clerk's Department by March 14, 1988. If you have any questions, please contact Dawn Schanderl, Records Coordinator, at (714) 493-1171 extension 244. Thank you for your cooperation. Very truly yours, Mary Ann nover, CMC City Clerk MAH/dms 32400 PASEO ADELANTO. SAN JUAN CAPISTRANO. CALIFORNIA 92675 • (714) 493-1171 A ISSUE DATE (MM/DDM') - 2/16/99 PRODUCER THIS CERTIFICATE ISSUED MATTER OF INFORMATION ONLY AND CONFERS E HOLDER. THIS CERTIFICATE DOES NOT AMEND, NO RIGHTS UPON THE CERTIFICATE EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. c;rF:(:3(:3---MIL.L..ER & AS80CIATESP INC :1.1:29 EAST MISSOURI COMPANIES AFFORDING COVERAGE PHOENIX, AZ 850:L4 COMPANY LETTER A -TriStar Insurance Company COMPANY B LETTER INSURED COMPANY C LETTER 1... i f e Care AmhuLance Serv.,InE_. :2707:; Calot Road Laguna 6.11 L Ls COMPANY p LETTER CA 9'2653 COMPANY LETTER E • '• THIS IS TO CERTIFY THAT 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 CONDI- TIONS OF SUCH POLICIES. LTR LT TYPE OF INSURANCE POLICY NUMBER DATE EPPECTIVE DATEMMIOATS EXPIRATION POLICY EXPIRATION ALL LIMITS IN THOUSANDS GENERAL LIABILITY GENERAL AGGREGATE $ 1000 A COMMERCIAL GENERAL LIABILITY LI CLAIMS MADE I (OCCURRENCE TOL J.00448 9/09/437 9/09/99 X PRODUCTS COMP/OPS AGGREGATE $ PERSONAL 8 ADVERTISING INJURY $ OWNER'S 8 CONTRACTORS PROTECTIVE EACH OCCURRENCE $ 1.000 E'RO E SS I (JNA._ FIRE DAMAGE (ANY ONE FIRE) $ J L• I AB I L.. I TY MEDICAL EXPENSE (ANY ONE PERSON) $ J AUTOMOBILE LIABILITY A ANY AUTO TALI 100281 9/09/87 9/(>9/89 DSL $ 1000 ALL OWNED AUTOS SCHEDULED AUTOS BODILY (PPERR"PERSON) $ 1000 HIRED AUTOS IxB00Jul�v NON -OWNED AUTOS �ci0exn $ GARAGE LIABILITY PaGPERn OPMAGE $ EXCESS LIABILITY FACE OCCURRENCE $ AGGREWTE $ OTHER THAN UMBRELLA FORM WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY STATUTORY $ (EACH ACCIDENT) $ (DISEASE -POLICY LIMIT) $ (DISEASE -EACH EMPLOYEE) OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS VERIFICATION OF INSURANCE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX- ( i tY 0 SAn ,J ua Tl Cap l s t r a no PIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO ,. 24 Paseo Ad a La nt o MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE San JUaTl Cap I strano CA 926*75 LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPW, ITS AGENTS OR REPRESENTATIVES. A t t TI : JenniferW 1 L L f a ms AUTHORIZED REPRES TV 2*71939 • February 18, 1988 Bruce Tovar LifeCare Ambulance Services, Inc. 25260 East La Paz Road, Suite 4 Laguna Hills, California 92653 JMon � it '�IOA�t P�tO �N�nem �' 1961 1776 Re: Approval of Contract (LifeCare Ambulance Service) Dear Mr. Tovar: MEMBERS OF THE CITY COUNCIL ANTHONY L. BLAND LAWRENCE F. SUCHMEIM KENNETH E. FRIESS GARY L. MAUSDORFER PHILLIP R. SCHWARTZE CITY MANAGER STEPHEN B JULIAN The City Council of the City of San Juan Capistrano at its regular meeting held February 16, 1988, approved the agreement for the provision of emergency medical transportation services with LifeCare Ambulance Services, Inc. A fully executed copy of the Agreement is enclosed for your records. Note pages four and five regarding insurance requirements. Please forward Certificates of Insurance in the indicated amounts and naming the City of San Juan Capistrano as additional insured to this office as soon as possible. The insurance requirements must be met before the Agreement is effective. If you have any questions regarding insurance, please contact Dawn Schanderl of my staff. Thank you for your cooperation. If we can be of further assistance, please call. Very truly yours, U Mary Ann HaQiver, CMC City Clerk MAH/mac Enclosure cc: City Manager 32400 PASEO ADELANTO, SAN JUAN CAPISTRANO, CALIFORNIA 92675 0 (714) 493-1171