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HomeMy WebLinkAboutSafe Hearing America Inc SHA; 2026-02-11;Contact Jason Kennedy Phone (442)339-2470Company City of Carlsbad Email jason.kennedy@carlsbadca.gov Address 1635 Faraday Ave. Carlsbad, CA 92008 February 11, 2026 The following constitutes an agreement between Safe Hearing America, Inc. (SHA) and City of Carlsbad, a California charter city (CUSTOMER) for hearing conservation services as outlined below. SHA will, in return for compensation outlined in FEES section below, provide on-site hearing testing that meets OSHA Hearing Conservation Program standards, as described in CAL-OSHA Title 8, Article 105 regulations at the Carlsbad Safety Training Center, 5750 Orion Street, Carlsbad, CA 92010 (SUBJECT PROPERTY). •SHA will perform otoscopic exams on all employees who have a Standard Threshold Shift (STS). •SHA will provide summarized results (Employee Notification Letter) to each employee upon exiting the test van. •SHA will provide, at the conclusion of testing, complete statistical reports to CUSTOMER. •SHA will mail original English & Spanish Audiometric Forms for CUSTOMER to copy for their use. •Additional services will be provided as outlined in ADDITIONAL SERVICES section below. •CUSTOMER will provide facilities (a quiet site with dedicated 110V-20AMP AC circuit within 50 ft of test van) and staff, as necessary, to facilitate flow of employees to be tested. •To the fullest extent permitted by law, SHA agrees to indemnify, defend (with independent counsel approved bythe Customer) and hold harmless CUSTOMER and its officers, elected and appointed officials, employees andvolunteers (each, an “Indemnified Party”) from and against all liabilities (including without limitation all claims,damages, losses, penalties, fines, and judgments, associated investigation and administrative expenses, anddefense costs, including but not limited to attorneys’ fees, court costs and costs of alternative dispute resolution)regardless of nature or type, expressly including but not limited to those arising out of or resulting from any act oromission to act of SHA, SHA’s agents, officers, employees, subconsultants, or independent contractors hired bySHA pursuant to this agreement or SHA’s use of the SUBJECT PROPERTY. •SHA will obtain and maintain for the duration of the Agreement and any and all amendments, insurance againstclaims for injuries to persons or damage to property which may arise out of or in connection with performance ofthe services by Contractor or Contractor’s agents, representatives, employees or subcontractors. The insurancewill be obtained from an insurance carrier admitted and authorized to do business in the State of California. Theinsurance carrier is required to have a current Best's Key Rating of not less than "A-:VII"; OR with a surplus lineinsurer on the State of California’s List of Approved Surplus Line Insurers (LASLI) with a rating in the latest Best’sKey Rating Guide of at least “A:X”; OR an alien non-admitted insurer listed by the National Association ofInsurance Commissioners (NAIC) latest quarterly listings report. •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 notconstitute 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 carriedby 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, asContractor 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. •Commercial General Liability (CGL) Insurance. Insurance written on an “occurrence” basis, includingpersonal & advertising injury, with limits no less than $2,000,000 per occurrence. If a general aggregatelimit applies, either the general aggregate limit shall apply separately to this project/location or the generalaggregate limit shall be twice the required occurrence limit. •Automobile Liability. (if the use of an automobile is involved for Contractor's work for City). $2,000,000combined single-limit per accident for bodily injury and property damage. •Workers' Compensation and Employer's Liability. Workers' Compensation limits as required by theCalifornia Labor Code. Workers' Compensation will not be required if Contractor has no employees andprovides, to City's satisfaction, a declaration stating this. AMERICA, CONSERVATION • EDUCATION • INNOVATION DATA PROCESSING 130 Allison Ct., Suite G-1 Vacaville, CA 95688 BILLING OFFICE P. O. Box 1207 Priest River, ID 83856 SCHEDULING 1 (800) 359-1030 Docusign Envelope ID: D9AB566E-8880-491F-AF6C-7D49A02DAF35 •Professional Liability. Errors and omissions liability appropriate to Contractor’s profession with limits of notless than $1,000,000 per claim. Coverage must be maintained for a period of five years following the dateof completion of the work. •CUSTOMER will copy and distribute Audiometric Forms and have employees fill out forms prior to testing. •CUSTOMER understands and agrees that the scheduled time and price is an estimate dependent on actualnumber of employees tested and the timely flow of employees and as a result, the amount due and payable willreflect actual times with prorated fees. •CUSTOMER understands and agrees that SHA employees are subject to California labor law, and accordingly willbe afforded one 10-minute break midway through each 4-hour testing segment, as well as 1/2-hour meal breakbetween 4-hour testing segments. SHA technicians and trucks are booked according to availability. •Any missed breaks and/or meal breaks will be billable to CUSTOMER at current SHA overtime rates. •CUSTOMER agrees to fees & payment terms outlined in FEES and/or ADDITIONAL SERVICES section below. •This agreement will be governed by the laws of the State of California. Any action at law or in equity brought byeither of the parties for the purpose of enforcing a right or rights provided for by this agreement will be tried in acourt of competent jurisdiction in the County of San Diego, State of California, and the parties waive all provisionsof law providing for a change of venue in these proceedings to any other county. FEES/TERMS 8 hours Testing (per day): $1,000.00 for the first 4 hours, $250.00/hr. up to 8 hours, $375.00/hr. over 8 hours. 2 hours Drive time: $55.00 per hour, to be pro-rated in 15 min. increments, (estimate only, actual cost will be determined on the day of travel). Down time is $125.00 per hour. 90 miles Mileage: $1.95/mi. roundtrip (estimate only, actual cost will be determined on the day of travel). Per Diem: $275.00-$325.00/day based on facilities available if an overnight stay is required before, during and/or after site visits. Terms: DUE AND PAYABLE UPON RECEIPT OF INVOICE – Credit card fee of 3% will apply. 15% reschedule/cancellation fee when less than 2 weeks’ notice is given. ADDITIONAL SERVICES/FEES Please note that our fees for data input & analysis are increasing to $15 per clinic hearing test March 1, 2023. Training: No charge for English or Spanish transcript. Day/Date: Wednesday, February 25, 2026 Testing location is 5750 Orion Street, Carlsbad, CA 92010 Setup: 7:30 AM Start: 8:00 AM Lunch: ½ hour End: 3:30 PM APPROVED AS TO FORM: CINDIE K. McMAHON, City Attorney BY: _____________________________ Assistant City Attorney CUSTOMER: _____________________________________ SHA: _____________________________________ PLEASE SIGN Sharla Chavez, HR & Marketing Manager CUSTOMER P.O.# Docusign Envelope ID: D9AB566E-8880-491F-AF6C-7D49A02DAF35 01/28/2026 Riverbend Insurance Corporation 405 W. Walnut Suite 1 Newport, WA 99156 License #: WA-178141 ID-85923 Kevin Wright (509)447-0426 (509)447-2599 kevin@riverbendins.com 00002730-3534997 5 Safe Hearing America Inc PO Box 1207 Priest River, ID 83856 Ohio Security Insurance Company 24082 A Y BKS58817514 07/01/2025 07/01/2026X X X 1,000,000 1,000,000 15,000 1,000,000 2,000,000 2,000,000 Ohio Security Insurance Company 24082 A Y BAS58817514 07/01/2025 07/01/2026 X X X X 1,000,000 Ohio Casualty Insurance Co. 24074 B Y USO58817514 07/01/2025 07/01/2026XX X 10,000 2,000,000 2,000,000 Ohio Security Insurance Company 24082 A Y XWS58817514 07/01/2025 07/01/2026 X 1,000,000 1,000,000 1,000,000 City of Carlsbad is included as addtional insured as required by contract per endorsements CG88100413 and AC85430821. Workers Compensation Waiver of Subrogation attached. City of Carlsbad 1635 Faraday Ave Carlsbad, CA 92008 (KMW) Printed by KMW on 01/28/2026 at 03:09PM ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED? INSR ADDL SUBRLTRINSD WVD DATE (MM/DD/YYYY) PRODUCER CONTACTNAME:FAXPHONE(A/C, No):(A/C, No, Ext):E-MAILADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATIONAND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGG $JECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $AUTOS ONLY AUTOSHIREDNON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE $ CLAIMS-MADE AGGREGATE $ DED RETENTION $$ PER OTH-STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $If yes, describe under E.L. DISEASE - POLICY LIMIT $DESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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. 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). COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORDACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE BKS58817514 SAFE HEARING POLICY NUMBER BKS58817514