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On Duty Health; 2025-09-10;
Attachment A Sept. 9, 2025 Item #8 Page 6 of 18 Docusign Envelope ID: 13FE0DC3-87DA-4C0D-871E-E37A10B157BB 10th 25Sept. Docusign Envelope ID: 41D63F9E-E456-496F-87DA-CC474E862A31 AGREEMENT FOR FIREFIGHTER HEALTH AND FITNESS ASSESSMENTS On Duty Health, PC THIS AGREEMENT ("Agreement") is made and entered into as of the ______ day of ----------~ 20__, by and between the City of Carlsbad, California, a municipal corporation ("City") and On Duty Health, a professional corporation ("Contractor"). RECITALS A. City requires the professional services of a licensed physician with experience conducting medical tests and physical examinations in compliance with National Fire Protection Association Standard 1580 governing occupational health and wellness programs for first responders. B. Contractor has the necessary experience in providing professional services and advice specialized in firefighter health. 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 in this Agreement, City and Contractor agree as follows: 1. SCOPE OF WORK City retains Contractor to perform, and Contractor agrees to render, those services ("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 from the date first above written through June 30, 2027. The City Manager may amend the Agreement to extend it for two (2) additional years or parts of a year. Extensions will be based upon a satisfactory review of Contractor's performance, City needs, and appropriation of funds by the City Council. The parties will prepare a written amendment indicating the effective date and length of the extended Agreement. 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 one hundred and fifty thousand dollars ($150,000.00) per Agreement year. No other compensation for the Services will be allowed except for items covered by subsequent amendments to this Agreement. If City elects to extend the Agreement, the amount shall not exceed one hundred and fifty thousand dollars ($150,000.00) per Agreement year. Payment terms are Net 30 unless otherwise provided in Exhibit 11A11 or Page 1 City Attorney Approved Version 5/30/2025 Sept. 9, 2025 Item #8 Page 7 of 18 Docusign Envelope ID: 13FE0DC3-87DA-4C0D-871E-E37A10B157BB Docusign Envelope ID: 41D63F9E-E456-496F-87DA-CC474E862A31 agreed to in writing by the parties. City reserves the right to withhold a ten percent {10%) retention until City has accepted the work and/or Services specified in Exhibit "A." 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 the control of 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 this 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 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. If Contractor subcontracts any of the Services, Contractor will be fully responsible to City for the acts and omissions of Contractor's subcontractor and of the persons either directly or indirectly employed 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 City reserves the right to employ other Contractors in connection with the Services. 9. INDEMNIFICATION Contractor agrees to defend (with counsel approved by 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 in this Agreement caused by any negligence, recklessness, or willful misconduct of 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 California Civil Code Section 2782.8), then, and only to the extent required by California Civil Code Section 2782.8, which is fully incorporated in this Agreement, Contractor's indemnification obligation shall be limited to claims that Page 2 City Attorney Approved Version 5/30/2025 Sept. 9, 2025 Item #8 Page 8 of 18 Docusign Envelope ID: 13FE0DC3-87DA-4C0D-871E-E37A10B157BB Docusign Envelope ID: 41 D63F9E-E456-496F-87DA-CC474E862A31 arise out of, pertain to, or relate to the negligence, recklessness, or willful misconduct of 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 Contractor's proportionate percentage of fault. The parties expressly agree that any payment, attorneys fee, costs or expense City incurs or makes to or on behalf of an injured employee under City's self-administered workers' compensation program 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. 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 City as an additional insured. 10.1.1 Commercial General Liability (CGL) Insurance. Insurance written on an "occurrence" basis, including personal and 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. Page 3 City Attorney Approved Version 5/30/2025 Sept. 9, 2025 Item #8 Page 9 of 18 Docusign Envelope ID: 13FE0DC3-87DA-4C0D-871E-E37A10B157BB Docusign Envelope ID: 41063F9E-E456-496F-87DA-CC474E862A31 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 City will be named as an additional insured on Commercial General Liability which shall provide primary coverage to City. 10.2.2 Contractor will obtain occurrence coverage, excluding Professional Liability, which will be written as claims-made coverage. 10.2.3 If Contractor maintains higher limits than the minimums shown above, 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 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. 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. Page 4 City Attorney Approved Version 5/30/2025 Sept. 9, 2025 Item #8 Page 10 of 18 Docusign Envelope ID: 13FE0DC3-87DA-4C0D-871E-E37A10B157BB Docusign Envelope ID: 41D63F9E-E456-496F-87DA-CC474E862A31 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. 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 Nathan Pearson Name Greg Batla Title Division Chief Title CEO Dept Fire Address 1752 E Lugonia Ave, STE 117-4949 CITY OF CARLSBAD REDLANDS, CA 92373 Address 2560 Orion Way Phone 512-655-3578 Carlsbad, CA 92010 Email greg@onduty.health Phone 442-339-2141 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. Contractor shall report investments or interests as required in the City of Carlsbad Conflict of Interest Code. Yes D No IX] 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. Page 5 City Attorney Approved Version 5/30/2025 Sept. 9, 2025 Item #8 Page 11 of 18 Docusign Envelope ID: 13FE0DC3-87DA-4C0D-871E-E37A10B157BB Docusign Envelope ID: 41D63F9E-E456-496F-87DA-CC474E862A31 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. HARASSMENT. AND RETALIATIONPROHIBITED Contractor will comply with all applicable local, state and federal laws and regulations prohibiting discrimination, harassment, and retaliation. 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 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 ninety (90) 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 City Attorney Approved Version 5/30/2025 Page 6 Sept. 9, 2025 Item #8 Page 12 of 18 Docusign Envelope ID: 13FE0DC3-87DA-4C0D-871E-E37A10B157BB Docusign Envelope ID: 41D63F9E-E456-496F-87DA-CC474E862A31 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 attorneys 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 without regard to, or application of, choice of law rules or principles. 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 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. City Attorney Approved Version 5/30/2025 Page 7 Sept. 9, 2025 Item #8 Page 13 of 18 Docusign Envelope ID: 13FE0DC3-87DA-4C0D-871E-E37A10B157BB Docusign Envelope ID: 41D63F9E-E456-496F-87DA-CC47 4E862A31 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 th is_2_5 ____ day of AuguSt CONTRACTOR On Duty Health, a professional corporation By: (sign here) Greg Batla, CEO (print name/title) By: kvisfo,,._, f;oJG, (sign here) Kristin Batla, CFO (print name/title) 20~. CITY OF CARLSBAD, a municipal corporation of the State of California By: Geoff Patnoe, City Manager ATTEST: SHERRY FREISINGER, City Clerk By: Deputy/ Assistant City Clerk If required by City, proper notarial acknowledgment of execution by contractor must be attached . .!f..g_ corporation, Agreement must be signed by one corporate officer from each of the following two groups. Group A Chairman, President, or Vice-President Group B Secretary, Assistant Secretary, 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: JUA-W& ~-~ Sr. Assistant City Attorney City Attorney Approved Version 5/30/2025 Page 8 Sept. 9, 2025 Item #8 Page 14 of 18 Docusign Envelope ID: 13FE0DC3-87DA-4C0D-871E-E37A10B157BB Docusign Envelope ID: 41D63F9E-E456-496F-87DA-CC474E862A31 EXHIBIT A SCOPE OF SERVICES AND FEES 1. General On Duty Health, PC ("Contractor") shall provide specialized medical testing and physical examinations in compliance with National Fire Protection Association (NFPA) Standard 1580 and the Wellness-Fitness Initiative (WFI). The Contractor shall provide a mobile medical clinic to perform all testing and examinations on city property, staffed by a licensed physician, and scheduled over various shifts and days to accommodate operational needs. 2. Project Scope • Contractor shall provide services on an as-needed basis, as requested by the city. • Contractor shall provide the city with a de-identified Health Dashboard summarizing Fire Department health metrics. • Contractor shall provide each patient secure access to a web-based patient portal for electronic medical records, test results, year-over-year health metrics and trends, and secure doctor- patient messaging. • If the Contractor develops a health application, the Contractor shall grant the city access at no additional cost. Access shall be limited to Fire Department employees. 3. Specifications Laboratory Testing & Urinalysis • Urinalysis • Complete Blood Count (CBC) • Complete Metabolic Panel (CMP) • Lipid Panel with LDL/HDL Ratio • Hemoglobin AlC • Thyroid Stimulating Hormone (TSH) • Prostate Specific Antigen (PSA) -males age 40+ • CA-125 -females • QuantiFERON Gold TB Test • FIT Fecal Occult Screening Kit -members age 40+ • On-site phlebotomy (as applicable) Comprehensive Physical Examination • Full physical examination with medical history review and vitals • Titmus V2 Advanced Vision testing • Audiometry testing • Skin cancer screening • Behavioral health assessment • Review of results with development of a personalized health plan City Attorney Approved Version 5/30/2025 Page 9 Sept. 9, 2025 Item #8 Page 15 of 18 Docusign Envelope ID: 13FE0DC3-87DA-4C0D-871E-E37A10B157BB Docusign Envelope ID: 41D63F9E-E456-496F-87DA-CC474E862A31 Cardiopulmonary Screening & Fitness Assessment • Cardiopulmonary Exercise Testing (CPET) consisting of: o 12-lead EKG treadmill/stepmill stress test to maximal volition (per WFI protocol) o Blood pressure monitoring o TRUE VO2 Max testing • Pulmonary function testing (spirometry) • Metabolic analysis with body composition assessment • Muscular endurance, strength, and flexibility evaluation • Radiology follow-up interpretation for irregular results, if indicated Ultrasound-Enhanced Cancer Screening • Ultrasound imaging of: carotid arteries, thyroid, liver, pancreas, gall bladder, spleen, kidneys, bladder, pelvic (female), testicular and prostate (male) • Radiology follow-up interpretation for irregular results, if indicated 4. Internal and External Standards and Guidelines • Contractor services shall comply with NFPA 1580, and the IAFF/IAFC Wellness-Fitness Initiative {WFI), 4th Edition. • City shall provide the Contractor a comprehensive list of all employees scheduled to receive services no later than six (6) weeks prior to commencement of services. • Upon receipt of the employee list, Contractor shall provide the city with a schedule template outlining each available appointment. The schedule template shall be provided no later than two (2) weeks prior to the City's first appointment. • Contractor shall provide all equipment and supplies necessary for the services, except for a treadmill. The city shall provide a properly functioning treadmill (variable speed and incline) and adequate space for services. • The city shall make best efforts to ensure all employees arrive with their patient intake (online check-in) completed. • Employees arriving more than 15 minutes late shall be turned away, except when tardiness is due to an emergency call. o Contractor shall allow substitution of another city employee when an appointment is vacated due to tardiness. • If nearby agencies cannot receive services during their scheduled time, the city may allow a limited number of members from other agencies to be served on city premises, at the city's sole discretion. o Contractor shall not invoice the city for services provided to another agency's employee on city premises. o All Contractor requests to provide services to outside agencies on city premises require prior city approval (email approval permitted). o Contractor shall promptly notify the city of any outside agency individuals receiving services, to allow sufficient time for waiver/release forms to be completed. o Contractor shall not serve any outside agency member who fails to submit a completed waiver/release form. o Contractor shall provide the same reciprocity to city employees when serving other agencies. City Attorney Approved Version 5/30/2025 Page 10 Sept. 9, 2025 Item #8 Page 16 of 18 Docusign Envelope ID: 13FE0DC3-87DA-4C0D-871E-E37A10B157BB Docusign Envelope ID: 41D63F9E-E456-496F-87DA-CC474E862A31 6. Compensation The compensation rate for the Firefighter Health and Fitness Assessment shall be seven hundred forty- nine dollars ($749.00) per participant. The total annual compensation under this agreement shall not exceed one hundred fifty thousand dollars ($150,000.00) per agreement year. 7. Additional Services The following price list shall apply to any additional services requested of the Contractor. Compensation for such services shall be made in accordance with the rates set forth below: Category General Services Cancer Labs Other Labs CT Screening Continuous Health Monitoring Personal Training Service On-site Phlebotomy Flu Vaccination Galleri Multi-Cancer Early Detection Blood Test Cancer Antigen 15-3 (CA 15-3) -Breast Cancer Additional Fecal Occult Colorectal Cancer Screening Kits CA-125 Ovarian Cancer Hepatitis A, B, and C Test (Acute Hepatitis Panel) QuantiFERON Gold TB Blood Test Medical Professionals Urine Drug Screen (12 Drug Panel) Nicotine Screening (Urine) HIV Testing Heavy Metals Profile I, Blood (arsenic, lead, mercury) Heavy Metals Profile II, Blood (arsenic, cadmium, lead, mercury) Cholinesterase (HazMat) Testing Testosterone Levels Low Dose CT Lung, Screening (via regional partners) CT Coronary Artery Calcium Scoring (via regional partners) Smartwatch monitoring with 24/7 on-call providers Certified personal trainer -individual or group packages Price $29.00 $59.00 $739.00 $99.00 $59.00 $49.00 $69.00 $89.00 $99.00 $49.00 $49.00 $129.00 $159.00 $69.00 $49.00 $349.00 $249.00 Nutrition Counseling Licensed nutritionist -individual or group packages $99.00/month $199.00/month $199.00/month New Hire & Return to Duty Mental Health Support Ongoing with regional scheduling or Rapid Strike option Variable Pricing Firefighter-focused behavioral health assessments, counselors, and V . bl p .. therapists (PTSD-trained) aria e ricing City Attorney Approved Version 5/30/2025 Page 11 Docusign Envelope ID: 41D63F9E-E456-496F-87DA-CC474E862A31 ____---, ACORD® CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDD/YYYY) ~ 8/22/2025 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 have ADDITIONAL INSURED provisions or 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). PRODUCER ~~~r,cT Juanita Ortiz Arthur J. Gallagher Risk Management Services, LLC ;.~~N.t Ext\-713-623-2451 I FAX 2850 Golf Road IA/C Nol: 713-623-0967 Rolling Meadows IL 60008 irl~~SS: Juanita Ortiz@aio.com INSURER(S) AFFORDING COVERAGE NAIC# INSURER A: Evanston Insurance Companv 35378 INSURED ONDUTYH-01 INSURER B : StarStone National Insurance Comoanv 25496 ON DUTY HEAL TH -TEXAS, PLLC INSURER c: Chubb National Insurance Companv 10052 On Duty Health -Texas, PLLC; On Duty Health PC; On Duty Health LLC INSURER D : Coalition Insurance Companv 2028 East Ben White Boulevard Ste 240-4949 Austin TX 78741 INSURER E : Ohio Casualtv Insurance Companv 24074 INSURER F: COVERAGES CERTIFICATE NUMBER: 223926458 REVISION NUMBER: 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 THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE •••en un,n POLICY NUMBER IMMIDD/YYYY\ IMMIDD/YYYY\ LIMITS A X COMMERCIAL GENERAL LIABILITY y y 3AA851511 1/11/2025 1/11/2026 EACH OCCURRENCE $1,000,000 -□ CLAIMS-MADE 0 OCCUR DAMAGE TO RENTED -PREMISES IEa occurrence\ $100,000 MED EXP (Any one person) $5,000 - PERSONAL & ADV INJURY $ Excluded - GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 ~ □PRO-□LOC PRODUCTS -COMP/OP AGG $2,000,000 POLICY JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ /Ea accident\ -ANY AUTO BODILY INJURY (Per person) $ -OWNED -SCHEDULED BODILY INJURY (Per accident) $ -AUTOS ONLY -AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY /Per accident\ --$ B UMBRELLA LIAB NOCCUR y y 73756X251ALI 1/11/2025 1/11/2026 EACH OCCURRENCE $2,000,000 -X EXCESS LIAB CLAIMS-MADE AGGREGATE $2,000,000 OED I I RETENTION $ $ C WORKERS COMPENSATION y 71811212 2/26/2025 2/26/2026 X I ~ffTuTE I I OTH-ER AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE □ NIA E.L. EACH ACCIDENT $1,000,000 OFFICERIMEMBEREXCLUDED? (Mandatory in NH) E.L. DISEASE -EA EMPLOYEE $1,000,000 lf yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 D Cyber Liability C4NH9258445CYBER2025 8/5/2025 8/5/2026 Limit/ Retention $2M I $5,000 E Equipment Floater BMO68155411 9/6/2025 9/6/2026 limit $60,000 Deductible $1,000 DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) MEGL0009-01 0918 Blanket Additional Insured City of Carlsbad, its officials, officers, agents, employees, volunteers are included as Additional Insureds as respects to General Liability and Umbrella Liability policies, pursuant to and subject to the policy's terms, definitions, conditions and exclusions. Waiver of Subrogation applies to Additional Insureds as respects to General Liability, Umbrella Liability and Workers Compensation policies, pursuant to and subject to the policy's terms, definitions, conditions and exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Carlsbad 1635 Faraday Ave AUTHORIZED REPRESENTATIVE Carlsbad CA 92008 /f; C---0 -·-. j_ )h·•. /l:;J".!·C • I .,,,.,..z ~it:__., _ _;,'V -" / ---·--~--.- © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Docusign Envelope ID: 41D63F9E-E456-496F-87DA-CC474E862A31 POLICY NUMBER: 3AA851511 COMMERCIAL GENERAL LIABILITY CG 20 10 10 01 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: City of Carlsbad, its officials, officers, agents, employees, volunteers (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. Section II -Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions This insurance does not apply to "bodily in- jury" or "property damage" occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the addi- tional insured(s) at the site of the cov- ered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another con- tractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 10 01 © ISO Properties, Inc., 2000 Page 1 of 1 □ Docusign Envelope ID: 41D63F9E-E456-496F-87DA-CC474E862A31 COMMERCIAL GENERAL LIABILITY CG20010413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY -OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition 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 provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. CG 20 01 0413 © Insurance Services Office, Inc., 2012 Page 1 of 1 Docusign Envelope ID: 41D63F9E-E456-496F-87DA-CC474E862A31 111 COMMERCIAL GENERAL LIABILITY POLICY NUMBER: 3AA851511 MARKEL® EVANSTON INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE Name Of Person Or Organization: City of Carlsbad, its officials, officers, agents, employees, volunteers Additional Premium: $ 100 The following is added to Condition 8. Transfer Of Rights Of Recovery Against Others To Us under Section IV - Commercial General Liability Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule of this endorsement with respect to written contracts that exist between you and such person or organization, provided you have agreed in writing to furnish this waiver. This waiver applies only to the person or organization shown in the Schedule of this endorsement. All other terms and conditions remain unchanged. MEGL 0241 5 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 Docusign Envelope ID: 41D63F9E-E456-496F-87DA-CC474E862A31 StarStone Port of !he Core Specially Group STARSTONE NATIONAL INSURANCE COMPANY HOME OFFICE: WILMINGTON DELAWARE Harborside 5 185 Hudson Street, Suite 2600 Jersey City, NJ 07311 Tel: 201 743 7700 Fax: 201 743 7701 ,vww.starstone.com Report claims to: claims@starstone.com FOLLOWING FORM EXCESS LIABILITY INSURANCE POLICY DECLARATIONS 12/23/2024 4:18:24 PM POLICY NO.: 73756X251ALI RENEWAL OF: 73756X240ALI ITEM 1. (a) NAMED INSURED: On Duty Health-Texas, PLLC; On Duty Health PC; On Duty Health LLC (b) ADDRESS: 2028 E Ben White Blvd, Ste 240-4949 Austin, TX 78741 ITEM 2. POLICY PERIOD: From: 01/11/2025 To:01/11/2026 ITEM3. ITEM4. ITEMS. ITEMS. ITEM7. (12:01 A.M. prevailing time at the address stated in Item 1. above) RETROACTIVE DATE: Not Applicable COVERAGE: Following Form Excess Liability LIMITS OF LIABILITY: $2,000,000 $2,000,000 Included In GL Per Occurrence Other Aggregate Products/Completed Operations Aggregate Excess of Total Limits in Item 6. below TOTAL LIMITS OF UNDERLYING POLICIES: See Schedule of Followed Policies and Limits FOLLOWED POLICY: See Schedule of Followed Policies and Limits SSN EXS 0002 CW 03 16 Page 1 of 2 RPSSMB/2024.12.30 Docusign Envelope ID: 41D63F9E-E456-496F-87DA-CC474E862A31 StarStone Part of the Core Specialty G1ovp STARSTONE NATIONAL INSURANCE COMPANY HOME OFFICE: WILMINGTON DELAWARE Harborside 5 185 Hudson Street, Suite 2600 Jersey City, NJ 07311 Tel: 201 743 7700 Fax: 201 743 7701 www.starstone.com Report claims to: claims@starstone.com FOLLOWING FORM EXCESS LIABILITY INSURANCE POLICY ITEM 8. (a) PREMIUM: $2,025 $20 Additional TRIPRA Premium (b) MINIMUM EARNED PREMIUM: $0 ITEM 9. NOTICES TO THE INSURER: ITEM 10. (a) All notices of Occurrence or Claim: Claim Department (b) All other notices: Underwriting Department At the address and numbers shown at the top of the Declarations Page. POLICY FORM: SSN EXS 0001 CW 03 16 together with endorsements as per attached form SSN EXS 0004 CW 03 16 Schedule of Endorsements: ~ Authorized Representative Date of Issue: 12/23/2024 SSN EXS 0002 CW 03 16 Page 2 of 2 Docusign Envelope ID: 41063F9E-E456-496F-87DA-CC474E862A31 Named Insured: On Duty Health-Texas, PLLC; On Duty Health PC; On Duty Health LLC Policy No: 73756X251ALI Endorsement No: 2 Endorsement Effective Date: 01/11/2025 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FOLLOWING FORM EXCESS LIABILITY INSURANCE POLICY SCHEDULE OF FOLLOWED POLICIES AND TOTAL LIMITS OF UNDERLYING POLICIES ITEM 6.TOTAL LIMITS OF UNDERLYING POLICIES and ITEM 7. FOLLOWED POLICY of the DECLARATIONS are amended to read as follows: ITEMS. ITEM7. TOTAL LIMITS OF UNDERLYING POLICIES: $1,000,000 Per Occurrence $2,000,000 Other Aggregate Included In GL Products/Completed Operations Aggregate $1,000,000 Personal and Advertising Injury FOLLOWED POLICIES: Company: Policy Number: Coverage: Policy Period: Limits of Liability: $1,000,000 $2,000,000 Included In GL $1,000,000 Evanston Insurance Company 3AA851511 COMMERCIAL GENERAL LIABILITY 01/11/2025 to 01/11/2026 Per Occurrence Other Aggregate Products/Completed Operations Aggregate Personal and Advertising Injury ALL OTHER TERMS, CONDITIONS AND EXCLUSIONS SHALL REMAIN THE SAME. SSN EXS 0005 CW 03 16 Page 1 of 1 Docusign Envelope ID: 41D63F9E-E456-496F-87DA-CC474E862A31 ------, ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYY) ~ 8/20/2025 ONDUTYH-02 LEUJA1 THIS CERTIFICATE 15 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION 15 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). PRODUCER CONTACT NAME: Auto Club Services, LLC rit)g_Ntio, Ext): (888) 416-2402 I FAX 2601 5. Figueroa St (AIC, No): E-MAIL MS H302 ADDRESS: Los Angeles, CA 90007 INSURERIS\ AFFORDING COVERAGE NAIC# INSURER A: lnfinitv Select 20260 INSURED INSURER B: On Duty Health PC INSURERC: Greg Balta 1752 E Lugonia Av Ste 117-494 INSURERD: Redlands, CA 92374 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER· REVISION NUMBER· 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 THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD fMMJQnNVVV\ """DD/YYVVl COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ -D CLAIMS-MADE DAMAGE TO RENTED OCCUR -PREMISES IEa occurrence\ $ MED EXP I Anv one person) -$ PERSONAL & ADV INJURY -$ =7 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY □ ~f8r □ LOG PRODUCTS -COMP/OP AGG $ OTHER: $ A AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT /Ea accident\ $ 1,000,000 X ANY AUTO X 50004878601 3/10/2025 9/10/2025 BODILY INJURY (Per person) $ -OWNED -SCHEDULED -AUTOS ONLY -AUTOS BODILY INJURY (Per accident) $ HIRED NON-OWNED iP~?~2c~d1.it~AMAGE $ -AUTOS ONLY -AUTOS ONLY $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ f--- EXCESS LIAB CLAIMS-MADE AGGREGATE $ OED I I RETENTION $ $ WORKERS COMPENSATION I PER I IOTH- AND EMPLOYERS' LIABILITY STATUTE ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE □ N/A E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE -EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES /ACORD 101, Additional Remarks Schedule, may be attached if more space is required) It is agreed that City of Carlsbad, its officials, o ficers, agents, employees, volunteers are named as additional insureds. * 30 DAY NOC/ 10 DAY NOC ONLY FOR NON-PAYMENT OF PREMIUM* * Policy is primary and non-contributory * CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Carlsbad, its officials, officers, agents, THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. employees, volunteers 1635 Faraday Ave Carlsbad, CA 92008 AUTHORIZED REPRESENTATIVE I /j,,Lf,,w'f ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Docusign Envelope ID: 41063F9E-E456-496F-87DA-CC474E862A31 KEMPER Auto COMMERCIAL Customer Service: (800) 722-3391 Kemper Auto Commercial 11700 Great Oaks Way, Suite 450 Alpharetta, GA 30022 Underwritten by: Infinity Select Insurance Company Claims Service: (800) 353-6737 ADDITIONAL NAMED INSURED ENDORSEMENT CopyT() City of Carlsbad its officials, officers, agents, employees, volunteers 1635 Faraday Ave Carlsbad, CA 92008 50004878601 09/10/2025 12:01 a.m. ✓:Narned lbsurect. ON DUTY HEALTH PC This endorsement is attached to and forms a part of the listed policy. No changes will be effective prior to the lime changes are requested. Additional Insured City of Carlsbad its officials, officers, agents, employees, volunteers Part A -Liability Coverage, is changed as follows: The definition of insured is changed to include the additional insured named above. Adding an insured will not increase the limit of our liability. The insurance provided by this endorsement will be excess over any other valid and collectible insurance. All other parts of this Policy remain unchanged. ADDL INSURED COPY 50461AIS01 AMEND DATE: 08/20/2025 ENDORSEMENT: 5-18 Docusign Envelope ID: 41063F9E-E456-496F-87DA-CC474E862A31 KEMPER Auto COMMERCIAL Customer Service: (800) 722-3391 Kemper Auto Commercial 11700 Great Oaks Way, Suite 450 Alpharetta, GA 30022 Underwritten by: Infinity Select Insurance Company Claims Service: (800) 353-6737 PRIMARY AND NONCONTRIBUTORY ENDORSEMENT City of Carlsbad its officials, officers, agents, employees, volunteers 1635 Faraday Ave Carlsbad, CA 92008 50004878601 09/10/2025 12:01 a.m. Named lnsl.lted ON DUTY HEALTH PC This endorsement is attached to and forms a part of the listed policy. The following endorsement applies only if Form Number 500PNCV01 appears on your Declarations Page. This endorsement modifies the insurance provided under your COMMERCIAL AUTO POLICY. PART A -LIABILITY COVERAGE OTHER INSURANCE -PART A ONLY The following is added to this section: The coverage afforded under your Commercial Auto Policy is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: a. You have agreed in writing in a contract or agreement that the coverage afforded under your Commercial Auto Policy would be primary and would not seek contribution from any other insurance available to such additional insured; and b. Such additional insured is a named insured under such other insurance. ALL OTHER TERMS, LIMITS, CONDITIONS, AND PROVISIONS OF THE POLICY REMAIN UNCHANGED. ADDL INSURED COPY 500PNCV01 AMEND DATE: 08/20/2025 ENDORSEMENT: 5-18 Docusign Envelope ID· 41D63F9E E456 496F 87DA CC474E862A31 ---- AeRb® CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDNYYY) 08/21/2025 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 have ADDITIONAL INSURED provisions or 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). PRODUCER CONTACT NAME: Credentialing Team Arthur J. Gallagher Risk Management Services, Inc. PHONE I FAX 11550 Fuqua, Suite 205 (A/C, NO, EXT): 281-674-1420 (A/C, No): 281-674-1460 E-MAIL Houston, TX 77034 ADDRESS: GSHIS@AJG. COM INSURER(S) AFFORDING COVERAGE NAIC# COMPANY A: Evanston Insurance Company 35378 INSURED COMPANY B: On Duty Health PC COMPANYC: 2028 E Ben White Blvd # 240-4949 COMPANY D: Austin, TX 78741-6966 COMPANYE: COMPANY F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYYl LIMITS I I I EACH OCCURRENCE 1 $N/A I i5AMAGE t◊ RENTED COMMERCIAL GENERAL LIABILITY I PREMISES (Ea occurr~n.c_e). $ N/A ------.·J CLAIMS MADE 1 •• I OCCUR .. ' N/A N/A N/A MEQ.!:><£'_ (/l.~t_c>nBJ>erson)_ -------$ N/A_ PERSONAL & ADV INJURY $N/A_ -------. ------ GENERAL AGGREGATE $ N/A _________ " ______ ·------------. ---- GEN'L AGGREGATE LIMIT APPLIES PER: __ PRODUCTS -COMP/OPAGG -$ N/A '1 •• •••• I f PRO-T POLICY I I JECT j LOC $ N/A COMBINED SINGLE LIMIT $ N/A AUTOMOBILE LIABILITY .. (Ea accidenl) _ ----·------------...... ANY AUTO BODILY INJURY person) __________ $ N/A -----OWNED SCHEDULED N/A N/A N/A BODILY INJURY (Per accident) $ N/A AUTOS ONLY AUTOS ... HIRED AUTOS ' • : NON-OWNED PROPERTY DAMAGE ... ... ONLY AUTOS ONLY (Per accident). $ N/A --.. ,,., ...... ' $ N/A UMBRELLA LIAB I I OCCUR I EACH OCCURRENCE JN/1' __ ..... I CLAIMS MADE i N/A N/A N/A --------··~··--·--·-· ·-· EXCESS LIAB AGGREGATE $N/A ~-... ,. ! ---------------------- D~DT .. r RETENTION $ I ! $ N/A I WORKERS COMPENSATION i I WCSTATU-I 1 OTH-I AND EM PLOVERS' LIABILITY YIN _ _ TQRY LIMITS j iER j$N/1' ANY PROPRIETOR/PARTNER/EXECUTIVE □ N/A N/A N/A N/A E.".EA_c;l::l.t\C::(;I.0El".JT I$ N/A OFFICER/MEMBER EXCLUDED? I$ N/A (Mandalory in NH) E.L DISEASE-EA EMPLOYEE: If yes, describe under i I$ N/A DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT A OTHER Each Med. Incident: $2,000,000 Medical Prof. Liability MKLV3PSM002861 01/07/2025 01/07/2026 Aggregate Limit: $3,000,000 Retro Date: 01/07/2022 Type: Claims Made DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) ADDITIONAL INSURED: On Duty Health PC INSURED SPECIALTY: Entity City of Carlsbad, its officials, officers, agents, employees, volunteersl/7/2022-05/14/2025 Limits are $1M/3M, Effective 05/14/2025 limits are $2M/$3M CERTIFICATE HOLDER CANCELLATION City of Carlsbad SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1635 Faraday Ave ACCORDANCE WITH THE POLICY PROVISIONS. Carlsbad, CA 92008 AUTHORIZED REPRESENTATIVE ~~ ~-Jy © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Docusign Envelope ID· 41D63F9E-E456-496F-87DA-CC47 4E862A31 ALC~[lb® CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDNYYY) 08/21/2025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or 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). PRODUCER CONTACT NAME: Credentialing Team Arthur J. Gallagher Risk Management Services, Inc. PHONE I FAX (A/C, NO, EXT): 281-674-1420 (AIC, No): 281-674-1460 11550 Fuqua, Suite 205 E-MAIL Houston, TX 77034 ADDRESS: GSHIS@AJG. COM INSURER(S) AFFORDING COVERAGE NAIC# COMPANY A: Evanston Insurance Company 35378 INSURED COMPANY 8: On Duty Health PC COMPANY C: 2028 E Ben White Blvd # 240-4949 COMPANY D: Austin, TX 78741-6966 COMPANY E: COMPANYF: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR A TYPE OF INSURANCE I COMMERCIAL GENERAL LIABILITY , f J CLAIMS MADE [ 1 OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: --i;;u~~ T ·-1 • j:iT ;--r:;~ AUTOMOBILE LIABILITY ' ]ANYAUTO ' -i OWNED i ____ I AUTOS ONLY HIRED AUTOS ONLY SCHEDULED AUTOS NON-OWNED AUTOS ONLY UMBRELLA LIAB I i OCCUR I EXCESS LIAB I I CLAIMS MADE !-D~D I r ~~;~~;I;-~; ---•• WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE □ OFFICER/MEMBER EXCLUDED? ! (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below OTHER Medical Prof. Liability Retro Date: 01/07/2022 Type: Claims Made AODL SUBR INSR WVD N/A POLICY NUMBER N/A N/A N/A N/A MKLV3PSM002861 POLICYEFF (MM/DD/YYYY) N/A N/A N/A N/A POLICY EXP (MM/DD/YYYY) N/A N/A N/A N/A LIMITS EACH OCCURRENCE iSAMAGEt6RENfEb _f'_REcMlSES (Ea occ_um,nc_e) j $ N/A $ N/A _ MED EXP (Any one person) _ _ $ _N/A ______ _ PERSONAL & ADV INJURY __ $_ N/A ____ _ _ GENERAL AGGREGATE _ $_N/A _____ _ PRODUCTS-::COMP/OPAGG __ $ N/A COMBINED SINGLE LIMIT __ (Ea accident) ____ _ BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE _ (Per accident) ___ _ _EACH OCCURRENCE AGGREGATE __________________ .__,. ____ _ ... $ N/A $ N/A $ N/A $ N/A $ N/A It _ N/A $ N/A __ Lt~R~Tc;~TS _ I i OTH- -$ N/A __ E.L_ EACH _ACCIDENT __ _ $ N{A _ _ _ E.LCJl~~_SE_-::Efl_E_MPLQYEE $ N/A E.L. DISEASE -POLICY LIMIT $ N/A Each Med. Incident: Shared $2M 01/07/2025 01/07/2026 Aggregate Limit: Shared $3M DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is recuired) ADDITIONAL INSURED: On Duty Heath,PLLC INSURED SPECIALTY: Entity City of Carlsbad, its officials, officers, agents, employees, volunteersl/7/2022-05/14/2025 Limits are $1M/3M, Effective 05/14/2025 limits are shared $2M/$3M CERTIFICATE HOLDER City of Carlsbad 1635 Faraday Ave Carlsbad, CA 92008 ACORD 25 (2016/03) CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ...