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Himelstein, Mandel E.; 2019-06-24;
' ... AGREEMENT FOR ADMINISTRATIVE HEARING OFFICER SERVICES MANDEL E. HIMELSTEIN -~HIS AGREEMENT is made and entered into as of the d l/th day of \,._ti J...D Q , 2019, by and between the CITY OF CARLSBAD, a municipal corporation, ("City"), and MANDEL E. HIMELSTEIN, a sole proprietor, ("Contractor''). RECITALS A. City requires the professional services of an Administrative Hearing Officer that is experienced in conducting hearings and making determinations regarding code violations across various city departments, including all work necessary for the effective handling of the city's administrative hearings. B. Contractor has the necessary experience in providing professional services and advice related to conducting hearings and making determinations regarding code violations across various city departments. 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 five (5) years from the date first above written. 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 Agreement term will not exceed thirty-five thousand dollars ($35,000) per each year of the Agreement, based on the fee schedule in Exhibit "A". No other compensation for the Services will be allowed except for items covered by subsequent amendments to this Agreement. The 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 the attached Exhibit "A". City Attorney Approved Version 6/12/18 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 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. 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 The City reserves the right to employ other Contractors in connection with the Services. 9. INDEMNIFICATION Contractor agrees to indemnify and hold harmless the City and its officers, 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. The parties expressly agree that any payment, attorney's fee, costs or expense the 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. 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 City Attorney Approved Version 6/12/18 2 (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 Coverage and Limits. Contractor will maintain the types of coverage and minimum limits indicated below, unless the 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. 10.2.3 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 City Attorney Approved Version 6/12118 3 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 three (3) 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. 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. For City Name Laureen Ryan Title Management Analyst Community & Economic Department Development City of Carlsbad Address 1635 Faraday Ave. Carlsbad, CA 92008 Phone No. (760) 602-4615 For Contractor Name Mandel E. Himelstein Title Sole Proprietor Address 1730 Avenida Del Mundo, Ste.907 Coronado, CA 92118 Phone No. (619) 435-5514 Email mandellaw@aol.com 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. City Attorney Approved Version 6/12/18 4 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 in all categories. Yes~ NoD 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. 18. DISCRIMINATION AND HARASSMENT PROHIBITED Contractor will comply with all applicable local, state and federal laws and regulations prohibiting discrimination and harassment. 19. 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. 20. 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. Either party upon tendering thirty (30) days written notice to the other party may terminate this Agreement. In this event 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 City Attorney Approved Version 6/12/18 5 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. 21. 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 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. 22. 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. 23. JURISDICTION AND VENUE 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. 24. 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. 25. 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, embodies 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. City Attorney Approved Version 6/12/1 B 6 26. 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. CONTRACTOR, MANEL HIMELSTEIN, a sole proprietor CITY OF CARLSBAD, a municipal corporation of the State of California (/ (sign here), . J1AtJPtL £ Ht f-1 R-l > rre1,eJ CoM tJ\ \> (\) IT'-f + ECC;>N OM IC DEVEL.oPM ctv-r-oir2..ec.'"{t)te_ (print name/title) ATTEST: By: (sign here) ~-iu«u bO !Zll!~J BARBARA ENGLESON fr1--eity 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 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: CELIA A. BREWER, City Attorney City Attorney Approved Version 6/12/18 7 EXHIBIT "A" SCOPE OF SERVICES Contractor will comply with all aspects of City Admin Order #79 Rules and Procedures to Establish a Pool of Qualified Administrative Hearing Officers (Exhibit B). The Contractor will provide administrative hearing services as a Hearing Officer. The Contractor will be responsible for hearing appeals and making determinations regarding a wide range of code violations (see the Carlsbad Municipal Code, http-//www geode us/codesJcartsbadO. The Contractor will preside over the public hearing and hear testimony from both parties regarding contested issues. Hearings will be conducted between 15 and 60 days from when a hearing request is filed with the City. Either at the hearing or within 10 working days of its conclusion, the Contractor shall make a decision and adopt findings as required by the Carlsbad Municipal Code. The Contractor will issue a written decision to uphold or cancel the administration citation, including the reasons for that decision. The Contractor will comply with the full procedures for administrative hearings as set forth in Carlsbad Municipal Code section 1.10.1 30. The types of violations appealed may include parking, public nuisances, building permits, health and safety, building codes, storm drain pollution/drainage issues, vacation rentals, housing, transient occupancy tax payments and/or other related issues. However, any violation under the Carlsbad Municipal Code could be appealed. The Contractor, as Hearing Officer may also impose fines, award enforcement costs or issue corrective/abatement orders. The city will provide the necessary clerical support for the Hearing Officer. Hearing preparation will include reading the agenda and file materials; consultation with staff; knowledge and research of relevant city ordinances and on-site inspections; and coordinating and collaborating with other internal departments regarding scheduling, administrative problems, resident inquiries and legal questions. The city will also provide a hearing room, use of copying equipment, case file packets and hearing documents. Fee Schedule Parking Hearin s $300 $210 $150 8 Administrative Hearin s $300 $300 $210 $150 Crty Attorney Approved Version 6/12/18 **Agreement for Administrative Hearing Officer Services -Mandel E. Himelstein** ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accurac , or validit of that document. State of California County of--~-';'-· ,'"-'·;..__.,-'-, _ _.'[_)~c.__· ...,,.f]-+-=~------ On , ::::i_ ) 1 c1 ) / c; before me, T , ) )c i'J,")J '<j S.-:J , x 1( ,_ , , A Notary Public personally appeared : :) =:i c\ , ic ( · ( L '------·(d·_ ----------·~ ·--·--·--·--- '--··. C ------- who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. (Seal) Exhibit B Administrative Order No. 79 To: From: Re: All City Departments Scott Chadwick, City Manager Rules and Procedures to Establish a Pool of Qualified Administrative Hearing Officers PURPOSE: These policies and procedures must be created per Carlsbad Municipal Code Section 1.10.140 to regulate and facilitate the hiring and administration of hearing officers. I. RULES AND PROCEDURES TO ESTABLISH A POOL OF QUALIFIED ADMINISTRATIVE HEARING OFFICERS A. HEARING OFFICER QUALIFICATIONS i. The City of Carlsbad may contract with one or more hearing officers with training and experience in administrative law, municipal law and due process to hear and make unbiased determinations in administrative hearings. ii. The hearing officer(s) shall be a licensed attorney or shall possess other comparable and adequate qualifications as determined by the City Attorney or designee. iii. Additional factors for consideration when selecting Hearing Officers shall include, but are not limited to: a. Past experience as an adjudicator (e.g., judge, judge pro-tern, arbitrator) or otherwise demonstrates an ability to conduct an impartial and fair hearing, analyze the Carlsbad Municipal Code, weigh evidence, prepare decision reports and make unbiased judgments; b. Relevant expertise, including knowledge of administrative law, local government processes, code enforcement procedures, nuisance law, environmental law and housing law; c. Professional standing and quality of references; d. Demonstrated ability to handle volume and meet time demands; e. Effective verbal and written communication skills; f. Proposed rates for service; g. Availability; h. Ability to commute to the city; i. Interview performance; ii. The city shall promptly notify the hearing officer of his or her selection to preside over a hearing. The hearing officer shall select a hearing date not less than 15 days and not more than 60 days from the date that the request for hearing was filed, in accordance with Carlsbad Municipal Code section 1.10.130(A){2). If the hearing officer is unable to schedule a hearing within 60 days of the filing for a hearing, then at the request of either party, the city shall provide a new hearing officer who can timely hear the case. Otherwise, the parties may agree to a hearing date more than 60 days from the date that the request for hearing is filed. c. IMPARTIALITY AND CONFLICTS SCREENING i. Any hearing officer residing or owning property within 500 feet of the subject property of the appeal shall be excluded from the selection process for that particular hearing. ii. Hearing officers are subject to due process requirements and must conduct hearings in an impartial manner. A hearing officer must not be contacted by the city or the responsible party to discuss any item that will come before him or her in a hearing. If such contact occurs, the hearing officer may be subject to recusal from that item. However, communication of ministerial matters, such as scheduling a hearing, is permissible. iii. A hearing officer has an utmost obligation to remain impartial and neutral throughout the hearing process. He or she shall carefully monitor and disclose any business or personal conflicts of interest and recuse himself or herself from the hearing if necessary. Failure to disclose a conflict of interest may result in termination of the hearing officer. iv. In the event the hearing officer believes that a conflict of interest does not exist but might be perceived, he or she is required to disclose this to both parties no less than eight (8) days prior to the hearing date. Either party may then request that a new hearing officer be selected, provided that such request is made known to the hearing officer within two (2) business days of such notification. v. In the event that the hearing officer does not disqualify him-or herself or does not announce a relationship that might be perceived as a potential conflict of interest and either party believes that a conflict of interest may exist, that party may request of the Community & Economic Development Director that a different hearing officer be selected, provided such request is made within five (5) days before the hearing date. The Community & Economic Development Director or designee shall determine whether or not to take such action based on the evidence presented of a relationship, prejudice or bias that might impede the hearing officer's ability to provide a fair hearing. ii. A party seeking to disqualify a hearing officer may do so only upon the filing of a motion which is supported by a sufficient affidavit showing the particular facts and matters which constitute good cause for disqualification under lll(a). The party must file the motion and affidavit no later than 30 days after that party has notice of the assigned presiding hearing officer. iii. Following the filing of a motion and affidavit of disqualification and a reasonable period of time for an opposing party to comment upon it, the Community & Economic Development Director or designee shall either enter an order of recusal or decline disqualification. This order must specify the particular facts and grounds upon which it is based and will be deemed final and non-appealable. iv. A hearing officer may make an order or give a notice of recusal or self-disqualification at any time. ACORD® CERTIFICATE OF LIABILITY INSURANCE I DATE(MM/00/YYYYJ ~ 05/03/19 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 rlahts to the certificate holder In lieu of such endorsementlsl. PRODUCER ~!°!'lf;'CT COMPLETE EQUITY MARKETS INC COMPLETE EQUITY MARKETS INC r.!°!~N.r_ ~-•· (847)541-0900 I FAX iAJC Nol: (847)541-0444 1190 Flex Court ~i"-1!!!,. ___ Lake Zurich, IL 60047 INSURERfSI AFFORDING COVERAGE NAIC# dba Complete Equity Markets Insurance Agency Inc INSURER A: Undeiwriters at Llovd's London INSURED INSURERS: Mandel E. Himelstein INSURERC: 1730 Avenida del Mundo #907 INSURER 0: Coronado, CA 92118 INSURERE: INSURERF: 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. l~f: TYPE OF INSURANCE ADDL SUBR POLICYEFF POLICY EXP LIMITS ···--, .. __ POLICY NUMBER •yyy COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ I CLAIMS-MADE □ OCCUR OAMAG--e-To RENTED PREMISES rc:a ---urrencel $ -MED EXP (Anv one oerson) s PERSONAL & ADV INJURY $ - GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s 1 POLICY □ ~T □ LOC PRODUCTS -COMP/OP AGG s OTHER: $ AUTOMOBILE LIABILITY fr::~~~!_~~11SINGLE LIMIT $ -ANY AUTO BOOIL Y INJURY (Per person) $ --OWNED SCHEDULED -AUTOS ONLY r---AUTOS BODILY INJURY (Per accident) $ HIRED NON-OV',,NED ~.;>~%~1?AMAGE $ -AUTOS ONLY r---AUTOS ONLY s UMBRELLA LIAB H OCCUR EACH OCCURRENCE $ - EXCESSLIAB CLAIMS-MADE AGGREGATE $ OED I I RETENTION$ $ WORKERS COMPENSATION I ~~TIITC:: I l~H-ANO EMPLOYERS" LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE □ N/A EL. EACH ACCIDENT s OFFICER/MEMBER EXCLUDED? (Mandatory in NH) EL DISEASE -EA EMPLOYEE $ ~~~~~~ ~~~PERATIONS below EL. DISEASE -POLICY LIMIT $ Professional Liability Each Claim !li5D0,uuu A 627527 05/01/19 05/01/20 Aggregate $1,000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS/ vetlCLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Subject to all policy terms, conditions, exclusions and endorsements. City of Carlsbad is listed as an Additional Insured with 30 Day Notice of Cancellation but only per the terms & conditions of the endorsement generated and subject to all policy terms, conditions, exclusions, and endorsements. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Carlsbad ACCORDANCE WITH THE POLICY PROVISIONS. 1635 Faraday Avenue AUTHORIZED REPRESENTATIVE Carlsbad CA 92008 ~T.P~ I © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD ---------------------------· AMENDATORY ENDORSEMENT NO.: 857672 TRANSACTION NO.: NI A ADDITIONAL PREMIUM: NIA ASSURED: MANDEL lil.MELSTEIN EFFECTIVE: March 15, 2019 to May 1, 2019 TOTAL: NOTICE OF CANCELLATION .,. ,r% l ~ /"~--,, In consideration of the additio~l pieniiurh( pzjo· as'>spown above, it is hereby understood and agree,d ~at'if'Underwriters cancei tlvsJI].Sµ,rance for any reason oth7r than non-piypi~nt 'of premiu:111, Underwriters slitl:l..yr,oyide a 30-day written notice of cancellattoh to the followmg: ·' ,, City of Carlsbad 1635 Faraday A venue Carlsbad CA 92008 All other terms, conditions, limits and exclusions remain unchanged. Attached to and forming part of Certificate No.: CEM-14-17 Dated: March 26, 2019 AIF 2119 (09108) Lib<el99)""<39)23 revised 7104 8104 Endorsement #15 L. UNDERWRITERS AT LLOYD'S, LONOON Complete Equity Markets, Inc. dba Complete l!quity Markets Insurance Agency, Inc. (CASL#OD44077) By~?Y~ Lawrence T.P. Molloy TOTAL:NIA WAIVER REQUEST FORM FACTORS IN SUPPORT OF REQUEST TO MODIFY INSURANCE REQUIREMENT(S) Generally, a modification to the coverage requirement will be accepting a lower limit of coverage or waiving the requirement( s ). Requested by: Laureen Ryan/CED 5/21/2019 (Name and Department) (Date) Proposed modification( s) to the Comme,dal Gene,al/Automobole/Worl<er.; Comp requirement( s) for _M_a_nd_e_l E_._H_im_e_ls_te_in ________ _ (Type of insurance) (Name of contract) D Reduce coverage to the amount of: =$ ______ _ Ii] Waive coverage D Other: FACTOR(S) IN SUPPORT OF MODIFICATION(S) (check those that apply) [i]Significance of Contractor: Contractor has previous experience with the City that is important to the efficiency of completing the scope of work and the quality of the work-product. [explain} _______ _ The city needs a pool of administrative hearing officers to prevent using just one administrative hearing officer for all city hearings. [i]Significance of Contractor: Contractor has unique skills and there are few if any alternatives. [explain: include number of candidates RFP sent to and number responded if applicable J There were only 3 responses to the RFP and all of the hearing officers were requested to contract with the city. The city needs a pool of non-biased hearing officers. □Contract Amount/Term of Contract: $ _______ . Work will be completed over a period of __ _ □Professional Liability coverage is not available to this contractor or would increase the cost of the contract by $ [explain]. O0ther (e.g. explain why exposures are minimal, how exposures are covered in another policy, exposure control mechanisms, and any other information pertinent to your request): _____________ _ Approved by Risk Manager for this contract only: (Signature) H:\WORD\Insurance\Admin Order #68.doc 06/15/2006 27