Loading...
HomeMy WebLinkAboutLeaf Mental Health Inc; 2025-07-01; HR2509HR2509 Page 1 City Attorney Approved Version 5/22/2024 AGREEMENT FOR EMPLOYEE ASSISTANCE PROGRAM (EAP) SERVICES Leaf Mental Health, Inc. THIS AGREEMENT is made and entered into as of the ______1st______ day of ___July_______________, 2025, by and between the City of Carlsbad, California, a municipal corporation ("City") and Leaf Mental Health, Inc., a Delaware C Corporation, ("Contractor"). RECITALS A. City requires the professional services of a consultant that is experienced in Employee Assistance Program (EAP) services. B. Contractor has the necessary experience in providing professional services and advice related to EAP services. C. Contractor has submitted a proposal to City and has affirmed its willingness and ability to perform such work. NOW, THEREFORE, in consideration of these recitals and the mutual covenants contained herein, City and Contractor agree as follows: 1. SCOPE OF WORK City retains Contractor to perform, and Contractor agrees to render, those services (the "Services") that are defined in attached Exhibit "A," which is incorporated by this reference in accordance with this Agreement’s terms and conditions. 2. STANDARD OF PERFORMANCE While performing the Services, Contractor will exercise the reasonable professional care and skill customarily exercised by reputable members of Contractor's profession practicing in the Metropolitan Southern California area, and will use reasonable diligence and best judgment while exercising its professional skill and expertise. 3. TERM The term of this Agreement will be effective for a period of three (3) years from the date first above written with the option to renew for up to two (2) additional one-year terms upon mutual agreement of the parties. 4. TIME IS OF THE ESSENCE Time is of the essence for each and every provision of this Agreement. 5. COMPENSATION The total fee payable for the Services to be performed during the initial Agreement term shall not exceed forty-five thousand dollars ($45,000) per Agreement year. No other compensation for the Services will be allowed except for items covered by subsequent amendments to this Agreement. Incremental payments, if applicable, should be made as outlined in attached Exhibit "A." 6. STATUS OF CONTRACTOR Contractor will perform the Services in Contractor's own way as an independent contractor and in pursuit of Contractor's independent calling, and not as an employee of City. Contractor will be under control of Docusign Envelope ID: 07123769-5F7A-420D-8DEE-7480DCE99DA8Docusign Envelope ID: E9A5F9B9-48E6-4C9E-8AE5-AC291489658E HR2509 Page 2 City Attorney Approved Version 5/22/2024 City only as to the result to be accomplished, but will consult with City as necessary. The persons used by Contractor to provide services under this Agreement will not be considered employees of City for any purposes. The payment made to Contractor pursuant to the Agreement will be the full and complete compensation to which Contractor is entitled. City will not make any federal or state tax withholdings on behalf of Contractor or its agents, employees or subcontractors. City will not be required to pay any workers' compensation insurance or unemployment contributions on behalf of Contractor or its employees or subcontractors. Contractor agrees to indemnify City within thirty (30) days for any tax, retirement contribution, social security, overtime payment, unemployment payment or workers' compensation payment which City may be required to make on behalf of Contractor or any agent, employee, or subcontractor of Contractor for work done under this Agreement. At the City’s election, City may deduct the indemnification amount from any balance owing to Contractor. 7. SUBCONTRACTING Contractor will not subcontract any portion of the Services without prior written approval of City. City hereby approves the subcontracting of certain services to CCA as further described in Exhibit A. Contactor is fully responsible to City for the acts and omissions of CCA and any other approved subcontractor and of the persons either directly or indirectly employed by CCA or by the subcontractor, as Contractor is for the acts and omissions of persons directly employed by Contractor. Nothing contained in this Agreement will create any contractual relationship between any subcontractor of Contractor and City. Contractor will be responsible for payment of subcontractors. Contractor will bind every subcontractor and every subcontractor of a subcontractor by the terms of this Agreement applicable to Contractor's work unless specifically noted to the contrary in the subcontract and approved in writing by City. 8. OTHER CONTRACTORS The City reserves the right to employ other Contractors in connection with the Services. 9. INDEMNIFICATION Contractor agrees to defend (with counsel approved by the City), indemnify, and hold harmless the City and its officers, elected and appointed officials, employees and volunteers from and against all claims, damages, losses and expenses including attorneys fees arising out of the performance of the work described herein caused by any negligence, recklessness, or willful misconduct of the Contractor, any subcontractor, anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable. If Contractor’s obligation to defend, indemnify, and/or hold harmless arises out of Contractor’s performance as a “design professional” (as that term is defined under Civil Code section 2782.8), then, and only to the extent required by Civil Code Section 2782.8, which is fully incorporated herein, Contractor’s indemnification obligation shall be limited to claims that arise out of, pertain to, or relate to the negligence, recklessness, or willful misconduct of the Contractor, and, upon Contractor obtaining a final adjudication by a court of competent jurisdiction. Contractor’s liability for such claim, including the cost to defend, shall not exceed the Contractor’s proportionate percentage of fault. The parties expressly agree that any payment, attorney’s fee, costs or expense City incurs or makes to or on behalf of an injured employee under the City’s self-administered workers’ compensation is included as a loss, expense or cost for the purposes of this section, and that this section will survive the expiration or early termination of this Agreement. Docusign Envelope ID: 07123769-5F7A-420D-8DEE-7480DCE99DA8Docusign Envelope ID: E9A5F9B9-48E6-4C9E-8AE5-AC291489658E HR2509 Page 3 City Attorney Approved Version 5/22/2024 10. INSURANCE Contractor will obtain and maintain for the duration of the Agreement and any and all amendments, insurance against claims for injuries to persons or damage to property which may arise out of or in connection with performance of the services by Contractor or Contractor’s agents, representatives, employees or subcontractors. The insurance will be obtained from an insurance carrier admitted and authorized to do business in the State of California. The insurance carrier is required to have a current Best's Key Rating of not less than "A-:VII"; OR with a surplus line insurer on the State of California’s List of Approved Surplus Line Insurers (LASLI) with a rating in the latest Best’s Key Rating Guide of at least “A:X”; OR an alien non-admitted insurer listed by the National Association of Insurance Commissioners (NAIC) latest quarterly listings report. 10.1 Coverages and Limits. Contractor will maintain the types of coverages and minimum limits indicated below, unless Risk Manager or City Manager approves a lower amount. These minimum amounts of coverage will not constitute any limitations or cap on Contractor's indemnification obligations under this Agreement. City, its officers, agents and employees make no representation that the limits of the insurance specified to be carried by Contractor pursuant to this Agreement are adequate to protect Contractor. If Contractor believes that any required insurance coverage is inadequate, Contractor will obtain such additional insurance coverage, as Contractor deems adequate, at Contractor's sole expense. The full limits available to the named insured shall also be available and applicable to the City as an additional insured. 10.1.1 Commercial General Liability (CGL) Insurance. Insurance written on an “occurrence” basis, including personal & advertising injury, with limits no less than $2,000,000 per occurrence. If a general aggregate limit applies, either the general aggregate limit shall apply separately to this project/location or the general aggregate limit shall be twice the required occurrence limit. 10.1.2 Automobile Liability. (if the use of an automobile is involved for Contractor's work for City). $2,000,000 combined single-limit per accident for bodily injury and property damage. 10.1.3 Workers' Compensation and Employer's Liability. Workers' Compensation limits as required by the California Labor Code. Workers' Compensation will not be required if Contractor has no employees and provides, to City's satisfaction, a declaration stating this. 10.1.4 Professional Liability. Errors and omissions liability appropriate to Contractor’s profession with limits of not less than $1,000,000 per claim. Coverage must be maintained for a period of five years following the date of completion of the work. 10.2 Additional Provisions. Contractor will ensure that the policies of insurance required under this Agreement contain, or are endorsed to contain, the following provisions: 10.2.1 The City will be named as an additional insured on Commercial General Liability which shall provide primary coverage to the City. 10.2.2 Contractor will obtain occurrence coverage, excluding Professional Liability, which will be written as claims-made coverage. Docusign Envelope ID: 07123769-5F7A-420D-8DEE-7480DCE99DA8Docusign Envelope ID: E9A5F9B9-48E6-4C9E-8AE5-AC291489658E HR2509 Page 4 City Attorney Approved Version 5/22/2024 10.2.3 If Contractor maintains higher limits than the minimums shown above, the City requires and will be entitled to coverage for the higher limits maintained by Contractor. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage will be available to the City.” 10.2.4 This insurance will be in force during the life of the Agreement and any extensions of it and will not be canceled without thirty (30) days prior written notice to City sent by certified mail pursuant to the Notice provisions of this Agreement. 10.3 Providing Certificates of Insurance and Endorsements. Prior to City's execution of this Agreement, Contractor will furnish certificates of insurance and endorsements to City. 10.4 Failure to Maintain Coverage. If Contractor fails to maintain any of these insurance coverages, then City will have the option to declare Contractor in breach, or may purchase replacement insurance or pay the premiums that are due on existing policies in order to maintain the required coverages. Contractor is responsible for any payments made by City to obtain or maintain insurance and City may collect these payments from Contractor or deduct the amount paid from any sums due Contractor under this Agreement. 10.5 Submission of Insurance Policies. City reserves the right to require, at any time, complete and certified copies of any or all required insurance policies and endorsements. 11. BUSINESS LICENSE Contractor will obtain and maintain a City of Carlsbad Business License for the term of the Agreement, as may be amended from time-to-time. 12. ACCOUNTING RECORDS Contractor will maintain complete and accurate records with respect to costs incurred under this Agreement. All records will be clearly identifiable. Contractor will allow a representative of City during normal business hours to examine, audit, and make transcripts or copies of records and any other documents created pursuant to this Agreement. Contractor will allow inspection of all work, data, documents, proceedings, and activities related to the Agreement for a period of four (4) years from the date of final payment under this Agreement. This provision shall not require disclosure of any information protected under HIPAA or other applicable privacy laws. Contractor shall maintain the confidentiality of any protected health information (PHI) in accordance with state and federal law. 13. OWNERSHIP OF DOCUMENTS All work product produced by Contractor or its agents, employees, and subcontractors pursuant to this Agreement is the property of City. In the event this Agreement is terminated, all work product produced by Contractor or its agents, employees and subcontractors pursuant to this Agreement will be delivered at once to City. Contractor will have the right to make one (1) copy of the work product for Contractor’s records. This section shall not apply to any information classified as protected health information (PHI) under HIPAA or other privacy laws. Such PHI shall remain confidential and not be transferred unless permitted by law and subject to appropriate safeguards. 14. COPYRIGHTS Contractor agrees that all copyrights that arise from the services will be vested in City and Contractor relinquishes all claims to the copyrights in favor of City. Docusign Envelope ID: 07123769-5F7A-420D-8DEE-7480DCE99DA8Docusign Envelope ID: E9A5F9B9-48E6-4C9E-8AE5-AC291489658E HR2509 Page 5 City Attorney Approved Version 5/22/2024 15. NOTICES The name of the persons who are authorized to give written notice or to receive written notice on behalf of City and on behalf of Contractor under this Agreement are: For City: For Contractor: Name Sandra Smith Name Anja Dunphy Title Human Resources Analyst Title Chief Executive Officer Dept Human Resources Address 4270 Bright Bay Way CITY OF CARLSBAD ELLICOTT CITY, MD 21042 Address 1635 Faraday Ave Phone (888)728-1125, ext 1 Carlsbad CA 92008 Email anja@leafmentalhealth.com Phone 442-339-2535 Email Sandra.Smith@carlsbadca.gov Each party will notify the other immediately of any changes of address that would require any notice or delivery to be directed to another address. 16. CONFLICT OF INTEREST Contractor shall file a Conflict of Interest Statement with the City Clerk in accordance with the requirements of the City of Carlsbad Conflict of Interest Code. The Contractor shall report investments or interests as required in the City of Carlsbad Conflict of Interest Code. Yes ☐ No ☒ If yes, list the contact information below for all individuals required to file: Name Email Phone Number 17. GENERAL COMPLIANCE WITH LAWS Contractor will keep fully informed of federal, state and local laws and ordinances and regulations which in any manner affect those employed by Contractor, or in any way affect the performance of the Services by Contractor. Contractor will at all times observe and comply with these laws, ordinances, and regulations and will be responsible for the compliance of Contractor's services with all applicable laws, ordinances and regulations. Contractor will be aware of the requirements of the Immigration Reform and Control Act of 1986 and will comply with those requirements, including, but not limited to, verifying the eligibility for employment of all agents, employees, subcontractors and consultants whose services are required by this Agreement. Docusign Envelope ID: 07123769-5F7A-420D-8DEE-7480DCE99DA8Docusign Envelope ID: E9A5F9B9-48E6-4C9E-8AE5-AC291489658E HR2509 City Attorney Approved Version 5/22/2024 Page 6 18. CALIFORNIA AIR RESOURCES BOARD (CARB) ADVANCED CLEAN FLEETS REGULATIONS Contractor’s vehicles with a gross vehicle weight rating greater than 8,500 lbs. and light-duty package delivery vehicles operated in California may be subject to the California Air Resources Board (CARB) Advanced Clean Fleets regulations. Such vehicles may therefore be subject to requirements to reduce emissions of air pollutants. For more information, please visit the CARB Advanced Clean Fleets webpage at https://ww2.arb.ca.gov/our-work/programs/advanced-clean-fleets. 19. DISCRIMINATION AND HARASSMENT PROHIBITED Contractor will comply with all applicable local, state and federal laws and regulations prohibiting discrimination and harassment. 20. DISPUTE RESOLUTION If a dispute should arise regarding the performance of the Services the following procedure will be used to resolve any questions of fact or interpretation not otherwise settled by agreement between the parties. Representatives of Contractor or City will reduce such questions, and their respective views, to writing. A copy of such documented dispute will be forwarded to both parties involved along with recommended methods of resolution, which would be of benefit to both parties. The representative receiving the letter will reply to the letter along with a recommended method of resolution within ten (10) business days. If the resolution thus obtained is unsatisfactory to the aggrieved party, a letter outlining the disputes will be forwarded to the City Manager. The City Manager will consider the facts and solutions recommended by each party and may then opt to direct a solution to the problem. In such cases, the action of the City Manager will be binding upon the parties involved, although nothing in this procedure will prohibit the parties from seeking remedies available to them at law. 21. TERMINATION In the event of the Contractor's failure to prosecute, deliver, or perform the Services, City may terminate this Agreement for nonperformance by notifying Contractor by certified mail of the termination. If City decides to abandon or indefinitely postpone the work or services contemplated by this Agreement, City may terminate this Agreement upon written notice to Contractor. Upon notification of termination, Contractor has five (5) business days to deliver any documents owned by City and all work in progress to City address contained in this Agreement. City will make a determination of fact based upon the work product delivered to City and of the percentage of work that Contractor has performed which is usable and of worth to City in having the Agreement completed. Based upon that finding City will determine the final payment of the Agreement. City may terminate this Agreement by tendering thirty (30) days written notice to Contractor. Contractor may terminate this Agreement by tendering thirty (30) days written notice to City. In the event of termination of this Agreement by either party and upon request of City, Contractor will assemble the work product and put it in order for proper filing and closing and deliver it to City. Contractor will be paid for work performed to the termination date; however, the total will not exceed the lump sum fee payable under this Agreement. City will make the final determination as to the portions of tasks completed and the compensation to be made. 22. COVENANTS AGAINST CONTINGENT FEES Contractor warrants that Contractor has not employed or retained any company or person, other than a bona fide employee working for Contractor, to solicit or secure this Agreement, and that Contractor has not paid or agreed to pay any company or person, other than a bona fide employee, any fee, commission, percentage, brokerage fee, gift, or any other consideration contingent upon, or resulting from, the award or making of this Agreement. For breach or violation of this warranty, City will have the right to annul this Docusign Envelope ID: 07123769-5F7A-420D-8DEE-7480DCE99DA8Docusign Envelope ID: E9A5F9B9-48E6-4C9E-8AE5-AC291489658E HR2509 City Attorney Approved Version 5/22/2024 Page 7 Agreement without liability, or, in its discretion, to deduct from the Agreement price or consideration, or otherwise recover, the full amount of the fee, commission, percentage, brokerage fees, gift, or contingent fee. 23. CLAIMS AND LAWSUITS By signing this Agreement, Contractor agrees that any Agreement claim submitted to City must be asserted as part of the Agreement process as set forth in this Agreement and not in anticipation of litigation or in conjunction with litigation. Contractor acknowledges that if a false claim is submitted to City, it may be considered fraud and Contractor may be subject to criminal prosecution. Contractor acknowledges that California Government Code sections 12650 et seq., the False Claims Act applies to this Agreement and, provides for civil penalties where a person knowingly submits a false claim to a public entity. These provisions include false claims made with deliberate ignorance of the false information or in reckless disregard of the truth or falsity of information. If City seeks to recover penalties pursuant to the False Claims Act, it is entitled to recover its litigation costs, including attorney's fees. Contractor acknowledges that the filing of a false claim may subject Contractor to an administrative debarment proceeding as the result of which Contractor may be prevented to act as a Contractor on any public work or improvement for a period of up to five (5) years. Contractor acknowledges debarment by another jurisdiction is grounds for City to terminate this Agreement. 24. JURISDICTION AND VENUE This Agreement shall be interpreted in accordance with the laws of the State of California. Any action at law or in equity brought by either of the parties for the purpose of enforcing a right or rights provided for by this Agreement will be tried in a court of competent jurisdiction in the County of San Diego, State of California, and the parties waive all provisions of law providing for a change of venue in these proceedings to any other county. 25. SUCCESSORS AND ASSIGNS It is mutually understood and agreed that this Agreement will be binding upon City and Contractor and their respective successors. Neither this Agreement nor any part of it nor any monies due or to become due under it may be assigned by Contractor without the prior consent of City, which shall not be unreasonably withheld. 26. THIRD PARTY RIGHTS Nothing in this Agreement should be construed to give any rights or benefits to any party other than the City and Contractor. 27. ENTIRE AGREEMENT This Agreement, together with any other written document referred to or contemplated by it, along with the purchase order for this Agreement and its provisions, embody the entire Agreement and understanding between the parties relating to the subject matter of it. In case of conflict, the terms of the Agreement supersede the purchase order. Neither this Agreement nor any of its provisions may be amended, modified, waived or discharged except in a writing signed by both parties. This Agreement may be executed in counterparts. Docusign Envelope ID: 07123769-5F7A-420D-8DEE-7480DCE99DA8Docusign Envelope ID: E9A5F9B9-48E6-4C9E-8AE5-AC291489658E HR2509 City Attorney Approved Version 5/22/2024 Page 8 28. AUTHORITY The individuals executing this Agreement and the instruments referenced in it on behalf of Contractor each represent and warrant that they have the legal power, right and actual authority to bind Contractor to the terms and conditions of this Agreement. Executed by Contractor this___________ day of _______________________, 20____. CONTRACTOR CITY OF CARLSBAD, a municipal corporation of the State of California Leaf Mental Health, Inc. By: By: (sign here) Darrin Schwabe Interim Human Resources Director Anja Dunphy, CEO anja@leafmentalhealth.com (print name/title) ATTEST: By: SHERRY FREISINGER, City Clerk (sign here) By: Raquel Damona, VP of Client Experience raquel@leafmentalhealth.com Assistant City Clerk (print name/title) If required by City, proper notarial acknowledgment of execution by contractor must be attached. If a corporation, Agreement must be signed by one corporate officer from each of the following two groups. Group A Group B Chairman, Secretary, President, or Assistant Secretary, Vice-President CFO or Assistant Treasurer Otherwise, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering the officer(s) signing to bind the corporation. APPROVED AS TO FORM: CINDIE K. McMAHON, City Attorney BY: _____________________________ Senior Assistant City Attorney Docusign Envelope ID: 07123769-5F7A-420D-8DEE-7480DCE99DA8 25June23rd Docusign Envelope ID: E9A5F9B9-48E6-4C9E-8AE5-AC291489658E HR2509 City Attorney Approved Version 5/22/2024 Page 9 EXHIBIT A SCOPE OF SERVICES AND FEE Contractor will provide EAP Services on behalf of the City as follows: A. THE SCOPE OF THE EMPLOYEE ASSISTANCE PROGRAM - Assistance and counseling services will address the following concerns: • Emotional Wellbeing • Behavioral, emotional and mental health • Substance abuse • Work-related Issues • Marriage/Family/Relationships • Divorce or separation • Family/marital conflict • Relationship issues • Child Care • Adoption • Babysitters, au pairs, centers, nannies • Back-up/emergency care • Health and safety • Parenting • Summer programs/after school • Adult Care • Caregiver support • Independent living – adult day care, meal delivery, transportation, senior centers • Legal/financial • Living arrangements – assisted living, nursing homes, retirement communities • Health and Wellness • Physical health issues • Wellness • Daily Living • Consumer purchases • Home improvement • Legal and financial • Pet care • Relocation B. DIRECT EMPLOYEE SERVICES 1. Access: 24/7/365 - Access Line • All calls are personally answered 24 hours a day, 7 days a week to guarantee that the EAP will immediately respond to the needs of the City of Carlsbad employees/families, no matter where they are or when they need help. • All calls are answered by professional master’s Level counselors. • Access is also available via chat, email, through member website and app. Docusign Envelope ID: 07123769-5F7A-420D-8DEE-7480DCE99DA8Docusign Envelope ID: E9A5F9B9-48E6-4C9E-8AE5-AC291489658E HR2509 City Attorney Approved Version 5/22/2024 Page 10 2. Initial Telephone Assessment - CCA counselors perform the following functions during an initial telephone assessment: • Clarifies and gathers facts related to the presenting problem. • Establishes a rapport with the troubled employee. • Performs crisis counseling, as necessary. • Develops an action plan with employees, including in-person assessments, short term • counseling, or referral. • Appointments for in-person assessments and short-term counseling are offered by the • counselor to occur usually within 5 business days at a convenient CCA staff office or • provider location. In urgent situations, appointments are usually offered within 2 business days. • In emergencies, employee/family members will usually be seen immediately. 3. Comprehensive Clinical Assessment - An in-person or virtual consultation is offered to all employees and family members who call the program. This will be in addition to the initial telephone assessment and will allow the counselor to accurately assess the presenting problem and engage the employee in seeking help. The in-person assessment will be provided by either a CCA staff counselor or provider at an office, which is generally within 30 minutes traveling time from the employee’s home or work location. 4. Short-term Counseling - CCA provides short-term counseling (1-4 sessions, in-person, telephonic or virtual) as a service covered under the per capita fee because we believe the EAP is in the best position to help people who are in crisis, who might only require several sessions to resolve their issue, or who might need a period of preparatory counseling before accepting a referral. 5. Referral Services a. Referrals to an extensive network of community resources and providers will be made when the EAP, in consultation with the employee, determines that additional or specialized help is required. b. Adult Care referrals will be made, when necessary, to various community resources including Nursing Homes, Home Health Agencies, Hospices, Social Service and Community Agencies, Meals on Wheels, Support Groups, Medical Specialists, etc. c. Childcare referrals will be provided for employees who request them. Resources include childcare centers, preschools, nanny agencies, after school programs, camps, special needs programs, parenting services, etc. d. Education referrals consist of information and resources for all levels of academic institutions from preschool through Ph.D. programs, continuing education, financial aid, special education, etc. e. Daily living referrals include information and resources for services such as consumer purchases, home repair, chore services, relocation, travel, pet care and personal care. 6. Educational Materials - Employees who request childcare, adult care, education or daily living assistance will be sent educational materials pertaining to their request. 7. Follow-Up - Follow up services are provided to all employees and family members who contact the EAP. Docusign Envelope ID: 07123769-5F7A-420D-8DEE-7480DCE99DA8Docusign Envelope ID: E9A5F9B9-48E6-4C9E-8AE5-AC291489658E HR2509 City Attorney Approved Version 5/22/2024 Page 11 8. Critical Incident Management - CCA will provide immediate, emergency consultation and on-site services to help employees and the organization cope with the aftermath of a trauma such as the death of an employee, accident, an employee act of violence, natural disaster, or act of terrorism. CCA will provide a bank of 6 hours annually for both critical incident services and wellness seminars (provided onsite or virtually). Additional critical incident services will be billed at $250.00 per counselor per hour. 9. My CCA Online - My CCA OnLine is the web-based version of our high touch EAP. Our website can be linked to your Intranet site and serves as another resource to communicate benefits to employees. My CCA OnLine offers thousands of articles, informational tools, calculators, self-assessments, locators and other resources, all designed to support employees with a myriad of lifecycle and daily living challenges. The site is organized in seven modules: • Parenting • Aging • Mental Health • Wellness • Working • Living • International 10. CCA@YourService App - Our CCA@YourService App is a free, personalized, self-paced wellbeing tool aimed at empowering our members to be happier and healthier. Grounded in the practices of cognitive behavioral therapy and mindfulness, the app provides self- paced sessions which include tips, exercises, and new skills to create positive change in many different aspects of life. These programs include over 800 animated videos and audio pieces. The program offers coping skills, science-based techniques to manage emotional problems and foster resilience, as well as mindfulness-based relaxation exercises. In addition, members can access resources and referrals for work-life and everyday needs, saving employee’s time while supporting wellbeing and work-life balance. C. HR; MANAGER CONSULTATION - The primary objective of the EAP is to help the management of the City of Carlsbad identify and respond to the serious personal problems that represent a potential risk to the productivity and health of its employees. 1. HR; Manager Consultation - HR and managers can contact their Account Executive Team 24 hours per day, 7 days per week to consult on any type of employee or organizational issue affecting their workplace. This can include, but is not limited to, an employee with serious job performance issues, employees exhibiting bizarre or aberrant behavior, threats of violence or harassment situation. Consultations are also offered for organizational issues such as work-life policy and procedures, diversity initiatives, performance management, downsizings and re-organizations. 2. HR and Manager Referral - HR and managers can refer employees to the EAP at various points in the managerial and disciplinary process following procedures that we will establish in consultation with you. Once a referral is made, a counselor will regularly communicate information regarding the Employee’s cooperation and progress to designated Human Resource and line managers. The EAP will provide as much information as appropriate and allowable by either the referred employee and/or federal and state laws. Docusign Envelope ID: 07123769-5F7A-420D-8DEE-7480DCE99DA8Docusign Envelope ID: E9A5F9B9-48E6-4C9E-8AE5-AC291489658E HR2509 City Attorney Approved Version 5/22/2024 Page 12 D. HR and MANAGER TRAINING - HR and manager training are an essential component in the effective delivery of the EAP. This training process is essential in ensuring optimum program utilization and support by managers and supervisors. The standard training format is 30-45 minutes in length and all levels of management and supervisory staff are encouraged to attend these meetings. The training will ideally take place during the implementation phase of the program. The purpose of the training is to: • Introduce the concepts of the EAP and the troubled employee. • Present the types of problems and resulting behaviors employees display that can affect • their work. • Communicate the City of Carlsbad’s policy regarding substance abuse, disciplinary • procedures and the role of the EAP. • Train managers in identifying and referring employees with these problems to the EAP. E. PUBLICITY AND PROMOTIONAL SERVICES - Employees understand the value of the EAP and utilize its services when it is effectively promoted. To achieve a strong utilization rate, Contractor will provide a comprehensive communications plan to introduce, promote and brand your program. Major features of the Program Launch include: • Senior staff briefings • Management letter and wallet card • Employee orientations – live onsite or via webinar • Manager training seminars and guide – live onsite or via webinar • Templates for internal communications materials for: o Articles, newsletters or memos o Posters o Brief teasers for newsletter, e-mail or bulletin board o Wallet cards Major features of the ongoing Promotional Campaign include: • Ongoing orientations and manager training sessions • Quarterly promotional packet consisting of posters, newsletters, brief teasers • Annual calendar of monthly webinars with posters and email reminders • Participation at health fairs to promote the program. • Lunchtime seminars and wellness programs to encourage program utilization and • promote problem prevention on over 125 topics including: o Anxiety o Building Resiliency o Childcare o Communication o Depression o Eldercare o Exercise & Fitness o Healthy Aging o Mindfulness o Money Basics o Nutrition o Parenting 101 o Relationships 101 o Parenting o Stress Management Docusign Envelope ID: 07123769-5F7A-420D-8DEE-7480DCE99DA8Docusign Envelope ID: E9A5F9B9-48E6-4C9E-8AE5-AC291489658E HR2509 City Attorney Approved Version 5/22/2024 Page 13 F. UTILIZATION AND PERFORMANCE REPORTS 1. Records Management - A case record is maintained, electronically, for each employee using the service. Records are kept ensuring continuity and quality of service, to assess the performance of our counselors and resources, and to provide a basis for staff supervision as a part of our ongoing quality review process. All records are confidential. Data is retrieved for Leaf client utilization reports. Access to this database is limited to Leaf and CCA staff. 2. Confidentiality Procedures - Protecting the employee’s privacy is a major concern of our program. The program must be strictly confidential for people to reveal their sensitive, personal problems and for employees on all levels of the organization to feel comfortable using the service. We therefore consistently stress and reinforce that the program is confidential by emphasizing that we will not, and cannot, release any personal information concerning our clients to anyone unless the employee/client authorizes our counselor in writing to do so or unless disclosure is, in the exercise of our discretion, either required by applicable law or is legally permissible because such information involves a contemplated criminal act. 3. HIPAA - Leaf and CCA, as a providers of the service, conduct business in accordance with HIPAA standards, California State Department of Health regulations and those standards established by the National Association of Social Workers and the American Psychological Association. 4. Utilization Reports - Leaf believes an EAP’s performance must be measurable and demonstrable for it to continue to receive the support and acceptance of management and employees. As part of its contract, we will provide comprehensive quarterly usage reports. Only statistical data is reported so that the individual client’s confidentiality is protected. These reports, collected from our intake form, include but are not limited to information on the number of calls per month, the types of problems presented to the program, case disposition and demographic data. Each report includes an analysis and program recommendations, prepared by the Account Executive, summarizing observations and trends considering the organization’s business and people challenges. G. FEES – EAP services to be provided for 750 employees for a fee of $2.06 per employee per month (PEPM). The fee will be adjusted if the employee population increases or decreases by 10%. The fee will be payable quarterly. All Leaf and CCA pre-approved travel expenses will be reimbursed by the City of Carlsbad. Docusign Envelope ID: 07123769-5F7A-420D-8DEE-7480DCE99DA8Docusign Envelope ID: E9A5F9B9-48E6-4C9E-8AE5-AC291489658E CERTIFICATE HOLDER © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) AUTHORIZED REPRESENTATIVE CANCELLATION DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE POLICY GEN'L AGGREGATE LIMIT APPLIES PER: OCCURCLAIMS-MADE COMMERCIAL GENERAL LIABILITY GENERAL LIABILITY PREMISES (Ea occurrence) $DAMAGE TO RENTED EACH OCCURRENCE $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $RETENTIONDED CLAIMS-MADE OCCUR $ AGGREGATE $ EACH OCCURRENCE $ UMBRELLA LIAB EXCESS LIAB INSRLTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)LIMITS PERSTATUTE OTH-ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ $ $ ANY PROPRIETOR/PARTNER/EXECUTIVE If yes, describe underDESCRIPTION OF OPERATIONS below (Mandatory in NH)OFFICER/MEMBER EXCLUDED? WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED HIRED AUTOS NON-OWNEDAUTOSAUTOS AUTOS COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE $ $ $ $ THIS IS TO CERTIFY THAT 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 THISCERTIFICATE 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL WVD SUBR N / A $ $ (Ea accident) (Per accident) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). The ACORD name and logo are registered marks of ACORD COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: INSURED PHONE(A/C, No, Ext): PRODUCER ADDRESS:E-MAIL FAX(A/C, No): CONTACTNAME: NAIC # INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S) AFFORDING COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Coverdash 286 5th Ave New York NY 10001 Coverdash Agents agents@coverdash.com /2&352-(C7 27+(5 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) TKLVFertLILFDteZDVJeQerDteGDXtRPDtLFDOO\E\tKeLQVXreGtKrRXJKtKe&RYerGDVKVeOIVerYLFeSRrtDO 06/17/2025 10200 10200 A Y P105.047.888.1 2025-06-16 2026-06-16 2,000,000 100,000 5,000 2,000,000 2,000,000 2,000,000 Hiscox Insurance Company Inc Hiscox Insurance Company Inc Leaf Mental Health Inc 4270 Bright Bay Way, Ellicott City 21042 B 4 4 4 P105.047.887.1 2025-06-16 2026-06-16 Y MD City of Carlsbad 1635 Faraday Ave Carlsbad 92008CA Professional Liability Per Occurrence Aggregate $1,000,000 $1,000,000 Deductible $5,000 Y Y Docusign Envelope ID: 07123769-5F7A-420D-8DEE-7480DCE99DA8Docusign Envelope ID: E9A5F9B9-48E6-4C9E-8AE5-AC291489658E EFFECTIVE DATE: POLICY NUMBER NAIC CODECARRIER AGENCY LOC #: AGENCY CUSTOMER ID: ofPageADDITIONAL REMARKS SCHEDULE ADDITIONAL REMARKS FORM TITLE:FORM NUMBER: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORD 101 (2008/01) 2 2 Coverdash 25 CERTIFICATE OF LIABILITY INSURANCE Docusign Envelope ID: 07123769-5F7A-420D-8DEE-7480DCE99DA8Docusign Envelope ID: E9A5F9B9-48E6-4C9E-8AE5-AC291489658E CERTIFICATE HOLDER © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) AUTHORIZED REPRESENTATIVE CANCELLATION DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE POLICY GEN'L AGGREGATE LIMIT APPLIES PER: OCCURCLAIMS-MADE COMMERCIAL GENERAL LIABILITY GENERAL LIABILITY PREMISES (Ea occurrence) $DAMAGE TO RENTED EACH OCCURRENCE $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $RETENTIONDED CLAIMS-MADE OCCUR $ AGGREGATE $ EACH OCCURRENCE $ UMBRELLA LIAB EXCESS LIAB INSRLTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)LIMITS PERSTATUTE OTH-ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ $ $ ANY PROPRIETOR/PARTNER/EXECUTIVE If yes, describe underDESCRIPTION OF OPERATIONS below (Mandatory in NH)OFFICER/MEMBER EXCLUDED? WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED HIRED AUTOS NON-OWNEDAUTOSAUTOS AUTOS COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE $ $ $ $ THIS IS TO CERTIFY THAT 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 THISCERTIFICATE 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL WVD SUBR N / A $ $ (Ea accident) (Per accident) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). The ACORD name and logo are registered marks of ACORD COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: INSURED PHONE(A/C, No, Ext): PRODUCER ADDRESS:E-MAIL FAX(A/C, No): CONTACTNAME: NAIC # INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S) AFFORDING COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Coverdash 286 5th Ave New York NY 10001 Coverdash Agents agents@coverdash.com /2&352-(C7 27+(5 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) TKLVFertLILFDteZDVJeQerDteGDXtRPDtLFDOO\E\tKeLQVXreGtKrRXJKtKe&RYerGDVKVeOIVerYLFeSRrtDO 06/20/2025 10200 10200 A Y P105.047.888.1 2025-06-16 2026-06-16 2,000,000 100,000 5,000 2,000,000 2,000,000 2,000,000 Hiscox Insurance Company Inc Hiscox Insurance Company Inc Leaf Mental Health Inc 4270 Bright Bay Way, Ellicott City 21042 B 4 4 4 P105.047.887.1 2025-06-16 2026-06-16 Y MD City of Carlsbad 1635 Faraday Ave Carlsbad CA 92008 Professional Liability Per Occurrence Aggregate $1,000,000 $1,000,000 Deductible $5,000 Y Y Docusign Envelope ID: 07123769-5F7A-420D-8DEE-7480DCE99DA8Docusign Envelope ID: E9A5F9B9-48E6-4C9E-8AE5-AC291489658E EFFECTIVE DATE: POLICY NUMBER NAIC CODECARRIER AGENCY LOC #: AGENCY CUSTOMER ID: ofPageADDITIONAL REMARKS SCHEDULE ADDITIONAL REMARKS FORM TITLE:FORM NUMBER: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORD 101 (2008/01) 2 2 Coverdash 25 CERTIFICATE OF LIABILITY INSURANCE 06/20/2025 City of Carlsbad is included as Additional Insured on the General Liability as per written contract. Leaf Mental Health Inc 4270 Bright Bay Way, Ellicott City 21042Maryland Docusign Envelope ID: 07123769-5F7A-420D-8DEE-7480DCE99DA8Docusign Envelope ID: E9A5F9B9-48E6-4C9E-8AE5-AC291489658E Hiscox Insurance Company Inc. Policy Number: Named Insured:Endorsement Number: Endorsement Effective: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CGL E5421 CW (02/14)Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 ADDITIONAL INSURED –AUTOMATIC STATUS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A.Section II –Who Is An Insured is amended to include as an additional insured any per-son(s) or organization(s)for whom you are performing operations or leasing a premises when you and such person(s) or organiza-tion(s) have agreed in writing in a contract or agreement that such person(s) or organiza-tion(s) be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to lia-bility for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part,by your acts or omissions or the acts or omissions of those acting on your behalf: 1.In the performance of your ongoing opera-tions; or 2.In connection with your premises owned by or rented to you. A person's or organization's status as an addi-tional insured under this endorsement ends when your operations or lease agreement for that additional insured are completed. P105.047.888.1 Leaf Mental Health Inc 7 06/16/2025 Docusign Envelope ID: 07123769-5F7A-420D-8DEE-7480DCE99DA8Docusign Envelope ID: E9A5F9B9-48E6-4C9E-8AE5-AC291489658E Hiscox Insurance Company Inc. Policy Number: Named Insured:Endorsement Number: Endorsement Effective: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CGL E5581 CW (03/16)Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 1 of 1 PRIMARY AND NONCONTRIBUTORY –OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following is added to the Other InsuranceCondition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy, pro-vided: 1.you have agreed in a written contract oragreement to add such additional insured toa policy providing the type of coverage af-forded by this policy; and 2. you have agreed in a written contract oragreement with such additional insured thatthis insurance would be primary and wouldnot seek contribution from any other insur-ance available to the additional insured. P105.047.888.1 Leaf Mental Health Inc 18 06/16/2025 Docusign Envelope ID: 07123769-5F7A-420D-8DEE-7480DCE99DA8Docusign Envelope ID: E9A5F9B9-48E6-4C9E-8AE5-AC291489658E Hiscox Insurance Company Inc. Policy Number:Named Insured:Endorsement Number:Endorsement Effective: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CGL E5402 CW (03/10) Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. MODIFIED WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV – Conditions: You may waive your rights against another party so long as you do so in writing prior to: (i) an offense arising out of your business that caused a “personal and advertising injury”; or (ii) an “occurrence” that caused “bodily injury” or “property damage”. P105.047.888.1 Leaf Mental Health Inc 19 06/16/2025 Docusign Envelope ID: 07123769-5F7A-420D-8DEE-7480DCE99DA8Docusign Envelope ID: E9A5F9B9-48E6-4C9E-8AE5-AC291489658E CERTIFICATE HOLDER © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) AUTHORIZED REPRESENTATIVE CANCELLATION DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE POLICY GEN'L AGGREGATE LIMIT APPLIES PER: OCCURCLAIMS-MADE COMMERCIAL GENERAL LIABILITY GENERAL LIABILITY PREMISES (Ea occurrence) $DAMAGE TO RENTED EACH OCCURRENCE $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $RETENTIONDED CLAIMS-MADE OCCUR $ AGGREGATE $ EACH OCCURRENCE $ UMBRELLA LIAB EXCESS LIAB INSRLTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)LIMITS PERSTATUTE OTH-ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ $ $ ANY PROPRIETOR/PARTNER/EXECUTIVE If yes, describe underDESCRIPTION OF OPERATIONS below (Mandatory in NH)OFFICER/MEMBER EXCLUDED? WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED HIRED AUTOS NON-OWNEDAUTOSAUTOS AUTOS COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE $ $ $ $ THIS IS TO CERTIFY THAT 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 THISCERTIFICATE 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL WVD SUBR N / A $ $ (Ea accident) (Per accident) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). The ACORD name and logo are registered marks of ACORD COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: INSURED PHONE(A/C, No, Ext): PRODUCER ADDRESS:E-MAIL FAX(A/C, No): CONTACTNAME: NAIC # INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S) AFFORDING COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Coverdash 286 5th Ave New York NY 10001 Coverdash Agents agents@coverdash.com /2&352-(C7 27+(5 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) TKLVFertLILFDteZDVJeQerDteGDXtRPDtLFDOO\E\tKeLQVXreGtKrRXJKtKe&RYerGDVKVeOIVerYLFeSRrtDO 06/16/2025 10200 A P105.047.888.1 2025-06-16 2026-06-16 2,000,000 100,000 5,000 2,000,000 2,000,000 2,000,000 Hiscox Insurance Company Inc Leaf Mental Health Inc 4270 Bright Bay Way, Ellicott City 21042 4 4 4 MD Intentionally left blank Docusign Envelope ID: 07123769-5F7A-420D-8DEE-7480DCE99DA8Docusign Envelope ID: E9A5F9B9-48E6-4C9E-8AE5-AC291489658E EFFECTIVE DATE: POLICY NUMBER NAIC CODECARRIER AGENCY LOC #: AGENCY CUSTOMER ID: ofPageADDITIONAL REMARKS SCHEDULE ADDITIONAL REMARKS FORM TITLE:FORM NUMBER: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORD 101 (2008/01) 2 2 Coverdash 25 CERTIFICATE OF LIABILITY INSURANCE Docusign Envelope ID: 07123769-5F7A-420D-8DEE-7480DCE99DA8Docusign Envelope ID: E9A5F9B9-48E6-4C9E-8AE5-AC291489658E CERTIFICATE HOLDER © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) AUTHORIZED REPRESENTATIVE CANCELLATION DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE POLICY GEN'L AGGREGATE LIMIT APPLIES PER: OCCURCLAIMS-MADE COMMERCIAL GENERAL LIABILITY GENERAL LIABILITY PREMISES (Ea occurrence) $DAMAGE TO RENTED EACH OCCURRENCE $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $RETENTIONDED CLAIMS-MADE OCCUR $ AGGREGATE $ EACH OCCURRENCE $ UMBRELLA LIAB EXCESS LIAB INSRLTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)LIMITS PERSTATUTE OTH-ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ $ $ ANY PROPRIETOR/PARTNER/EXECUTIVE If yes, describe underDESCRIPTION OF OPERATIONS below (Mandatory in NH)OFFICER/MEMBER EXCLUDED? WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED HIRED AUTOS NON-OWNEDAUTOSAUTOS AUTOS COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE $ $ $ $ THIS IS TO CERTIFY THAT 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 THISCERTIFICATE 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL WVD SUBR N / A $ $ (Ea accident) (Per accident) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). The ACORD name and logo are registered marks of ACORD COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: INSURED PHONE(A/C, No, Ext): PRODUCER ADDRESS:E-MAIL FAX(A/C, No): CONTACTNAME: NAIC # INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S) AFFORDING COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Coverdash 286 5th Ave New York NY 10001 Coverdash Agents agents@coverdash.com /2&352-(C7 27+(5 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) TKLVFertLILFDteZDVJeQerDteGDXtRPDtLFDOO\E\tKeLQVXreGtKrRXJKtKe&RYerGDVKVeOIVerYLFeSRrtDO 06/16/2025 10200Hiscox Insurance Company Inc Leaf Mental Health Inc 4270 Bright Bay Way, Ellicott City 21042 A P105.047.887.1 2025-06-16 2026-06-16 MD Insured's Use Professional Liability Per Occurrence Aggregate $1,000,000 $1,000,000 Deductible $5,000 Y Y Docusign Envelope ID: 07123769-5F7A-420D-8DEE-7480DCE99DA8Docusign Envelope ID: E9A5F9B9-48E6-4C9E-8AE5-AC291489658E EFFECTIVE DATE: POLICY NUMBER NAIC CODECARRIER AGENCY LOC #: AGENCY CUSTOMER ID: ofPageADDITIONAL REMARKS SCHEDULE ADDITIONAL REMARKS FORM TITLE:FORM NUMBER: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORD 101 (2008/01) 2 2 Coverdash 25 CERTIFICATE OF LIABILITY INSURANCE Docusign Envelope ID: 07123769-5F7A-420D-8DEE-7480DCE99DA8Docusign Envelope ID: E9A5F9B9-48E6-4C9E-8AE5-AC291489658E