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AGREEMENT FOR COACHING SERVICES JESSICA PADILLA BOWEN
THIS AGREEMENT is made and entered into as of the ______________ day of _________________________, 20___, by and between the CITY OF CARLSBAD, a municipal
corporation, ("City"), and Jessica Padilla Bowen, a sole proprietorship ("Contractor"). RECITALS A. City requires the professional services of a contractor that is experienced in employee development and coaching. B. Contractor has the necessary experience in providing professional services and advice related to employee development and coaching. 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 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 be in an
amount not to exceed forty thousand dollars ($40,000) per Agreement year. 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 attached Exhibit "A". 6. STATUS OF CONTRACTOR Contractor will perform the Services in Contractor's own way as an independent contractor and
in pursuit of Contractor's independent calling, and not as an employee of City. Contractor will be under control of 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.
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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 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 (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
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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 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.
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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 For Contractor
Name Emily Guinaugh Name Jessica Padilla Bowen
Title Management Analyst Title Sole Proprietor
Department Human Resources Address 1017 San Andrade Drive
City of Carlsbad Encinitas CA 92024
Address 1635 Faraday Ave Phone No. 858-663-2328
Carlsbad CA 92008 Email jessica@padillabowen.com
Phone No. 760-621-1222
Each party will notify the other immediately of any changes of address that would require any notice or delivery to be directed to another address. 16. CONFLICT OF INTEREST Contractor shall file a Conflict of Interest Statement with the City Clerk in accordance with the requirements of the City of Carlsbad Conflict of Interest Code. The Contractor shall report investments or interests in all categories. Yes No
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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. City may terminate this Agreement by tendering thirty (30) days written notice to Contractor.
Contractor may terminate this Agreement by tendering 30 days written notice to City. In the event of termination of this Agreement by either party and upon request of City, Contractor will assemble the work product and put it in order for proper filing and closing and deliver it to City. Contractor will be paid for work performed to the termination date; however, the total will not exceed the lump sum fee payable under this Agreement. City will make the final determination as to the portions of tasks completed and the compensation to be made. 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
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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, 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.
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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 CITY OF CARLSBAD, a municipal corporation of the State of California
By: By:
(sign here) Human Resources Director
Jessica Padilla Bowen
ATTEST:
By:
(sign here) FAVIOLA MEDINA
City Clerk Services Manager
(print name/title)
If required by City, proper notarial acknowledgment of execution by contractor must be attached.
If a corporation, Agreement must be signed by one corporate officer from each of the following two groups. Group A Group B Chairman, Secretary, President, or Assistant Secretary, Vice-President CFO or Assistant Treasurer Otherwise, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering the officer(s) signing to bind the corporation. APPROVED AS TO FORM:
CINDIE K. McMAHON, City Attorney
BY: _____________________________ City Attorney
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EXHIBIT “A” SCOPE OF SERVICES
Under the direction of the Human Resources Director or designee, Contractor will provide the following services on an as needed basis: Professional Coaching Provide individual and team coaching to include:
• Identifying city/department/team goals and priorities related to the employee development
• Assessing employee/team needs
• Developing customized coaching plans to include employee goals, milestones and performance measures
• Providing one on one sessions in person at a City of Carlsbad facility or by phone/web chat
• Assessing results and making recommendations for future or ongoing
development Other During the course of the coaching assignment, related needs may arise, including, but not limited to:
• Team alignment and development
• Workforce planning
• Succession planning
• Organizational development
• Classification and compensation Contractor will note these issues during progress reports with the HR project manager and department director/designee so a coordinated strategy can be developed. Contractor will not pursue strategies to address these related needs without prior approval from the HR project manager. Fees All services will be billed at $180/hr with the exception of assessment tools (e.g., MBTI). City will reimburse Contractor for the actual cost of assessment tools without any associated mark up costs.
Invoices Invoices will be sent monthly and will itemize costs to include a brief description of the service (e.g., coaching), the name of the person receiving the service, dates of service, number of hours spent on the service, hourly rate per service. Invoices will be emailed
to jessica.van@carlsbadca.gov. Travel Reimbursement Travel expenses will be pre-approved by the City. Reimbursement for travel and transportation will follow provisions outlined in City of Carlsbad Council Policy No. 2
Travel Policy.
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Coverage No 67643
CERTIFICATE OF INSURANCE EFFECTED WITH CERTAIN UNDERWRITERS AT LLOYD'S, LONDON FOR THE MEMBERS OF
THE MASTER POLICYHOLDER
PROFESSIONAL LIABILITY, GENERAL LIABILITY AND ADVERTISING LIABILITY CLAIMS MADE AND REPORTED INSURANCE
This Certificate of Insurance is issued as a Notice of Insurance for information only. It does not constitute a legal contract of
insurance. The Master Policy, Declarations and Application of the Named Insured, if any, form the entire contract. This
Certificate is furnished in accordance with, and in all respects is subject to all terms, conditions and exclusions of the Master
Policy, a copy of which is attached hereto. The original Master Policy may be inspected at the offices of the Master
Policyholder.
This Certificate is to notify the member named below (the "Named Insured") that the following insurance has been effected
with certain Underwriters at Lloyd's, London (not incorporated) (the "Underwriters") for the Policy Period specified below
under the Master Policy (the "Master Policy") issued to the Master Policyholder.
The attached Master Policy provides coverage on a claims made and reported basis and apply only to Claims first made
against the Insured during the Policy Period or the Extended Reporting Period (if applicable) and reported to underwriters
during the Policy Period or otherwise provided in clause VIII. of the attached Master Policy.
Coverage Reference No: 67643
1.Named Insured:
Ms Jessica Padilla Bowen
Daily Joy Coaching
1017 SAN ANDRADE DR, Encinitas, CA 92024-3951, US.
Additional Insureds:
2.Master Policyholder: Westminster Group, Inc
c/o 23 Federal Plaza W BDM10 Youngstown, OH 44503
Master Policy Number: B0572MR21W123
3.Policy Period: The Policy Period shall commence during the Policy Period set forth below. Coverage shall commence from the
date upon which the Named Insured holds a valid membership with the Master Policyholder during the Policy Period and shall
continue up to but not exceeding 365 days in all.
From:4TH JANUARY 2022
To:4TH JANUARY 2023
Both dates at 12:01 a.m Local Time at the address stated in Item 1 above.
4.Policy Administrator:
Huntington Insurance
23 Federal Plaza W
BDM10
Youngstown, OH 44503
ProgramServices@Huntington.com
5.Limits of Liability:
1.Professional Liability Section
Limit of Liability for Insuring Agreement I.A.1., (Professional Liability)
a.Each Claim including Claims Expenses
But sublimited to:
$2,000,000
i.Sexual/Physical Misconduct Each Claim
including Claims Expenses
$25,000
b.Aggregate including Claims Expenses
But sublimited to:
$2,000,000
i.Sexual/Physical Misconduct Aggregate
including Claims Expenses
$75,000
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2.General Liability Section
Limit of Liability for Insuring Agreement I.A.2., (General Liability and Advertising Liability), and
Insuring Agreement I.A.3., (Fire Legal Liability)
a.Each Claim including Claims Expenses
But sublimited to:
$0
i.Fire Legal Liability (Insuring Agreement I.A.3.)
each Claim including Claims Expenses
$0
b.Aggregate including Claims Expenses $0
3.Products/Completed Operations Section
Limit of Liability for Insuring Agreement I.A.4., (Products/Completed Operations Liability),
a.Each Claim including Claims Expenses $0
b.Aggregate including Claims Expenses $0
4.Computer Information Security Liability Section
Limit of Liability for Insuring Agreement I.A.5., (Computer Information Security Liability),
a.Each Claim including Claims Expenses $50,000
b.Aggregate including Claims Expenses $50,000
5.Privacy Liability Section
Limit of Liability for Insuring Agreement I.A.6., (Privacy Liability),
a.Each Claim including Claims Expenses $50,000
b.Aggregate including Claims Expenses
But sublimited to:
i.Aggregate for the Policy Period for all Privacy Violation costs
covered under Insuring Agreement I.A.6.
$50,000
6.Policy Aggregate Limit of Liability
The Limits of Liability stated under 1, 2, 3, 4 and 5 above are part of, and not in addition to, the overall Policy
Aggregate Limit of Liability stated under this Section 6.
$2,000,000
The Limits of Liability under Item 5. shall apply separately to each Section. Under no circumstances shall any one Claim trigger multiple
sections.
6.Retroactive Dates: Professional Liability: 29TH DECEMBER 2020
Privacy Endorsement: 29TH DECEMBER 2020
7.Terrorism Coverage: No
8.Waiver of Subrogation: No
9.Territory: Worldwide
10.Notification under this
Policy:
Huntington Insurance Inc
Michael Dercoli, CPCU, CIC
Senior Sales Executive
23 Federal Plaza W
Youngstown, OH, 44503
Tel: 866-318-5028
Fax: 877-243-0712
Email: ProgramServices@Huntington.com
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Coverage No 67643
11.Notice of Claim or
Circumstances:
Claims Department
Beazley Group
30 Batterson Park Road,
Farmington CT 06032
Email: uspeclaims@beazley.com
Tel: 888-222-1123 Fax: 866-910-1397
When reporting a claim please provide Program Name (WG US) and Master Policy Number
B0572MR21W123
The Master Policy contains the following exclusions:
1. Exclusions applicable to Insuring Agreement I.A.1 (Professional Liability)
a.Bodily Injury, Property Damage or Advertising Liability, except with respect to Bodily Injury arising out of any negligent
act, error or omission of any Insured in rendering or failing to render Professional Services.
b.Criminal, dishonest, fraudulent or malicious acts, error or omissions.
c.Contractual liability
d.Claims based upon an express or implied warranty or guarantee, or breach of contract in respect of an agreement to perform
work for a fee
e.Insured's activities as a trustee, partner, officer, director or employee of any trust, charitable organization, corporations,
company or business other than that of the Named Insured
f.Financial or investment advice
g.Libel or slander
i.No valid license for the performance of Professional Services
j.Rendering or failing to render Professional Services to Professional Athletes
2. Exclusions applicable to Insuring Agreement I.A.2 (General Liability and Advertising Liability) and Insuring Agreement I.A.3
(Fire Legal Liability).
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a.Claims arising out of the rendering or failing to render Professional Services;
b.Use of force expected or intended from the standpoint of the Insured;
c.Ownership, maintenance, operation, use, loading or unloading of any Automobile, aircraft or watercraft.
d.Transportation of Mobile Equipment by any Automobile;
e.Alcoholic beverages;
f.Personal Injury to any Employee;
g.Property Damage to property owned, rented or temporarily occupied by the Insured, personal property in the care, custody
and control of the Insured;
h.Recall
i.Claims against or in connection with any business enterprise not named in the Declarations which is owned by the Insured or
in which any Insured is a trustee, partner, officer, director or employee
j.Employee Retirement Income Security Act 1974 and amendments
k.Claim or circumstance in respect of which any Insured has given notice to any insurer of any other policy or self-insurance
prior to the inception date
l.Claim or circumstance known to the Insured prior to the inception date
m.Acts, error, omissions or Accidents which first took place prior to the Retroactive Date
n.Discrimination
o.Insolvency or Bankruptcy of the Insured
p.Punitive and exemplary damages, fines, sanctions, taxes, costs or expenses
q.Employer-employee relations, policies, practices, acts or omissions.
r.Violation of Securities Acts, of Racketeer Influenced and Corrupt Organizations Act
s.Anti-trust
t.Regulatory actions
u.Plagiarism, misappropriation of likeness, infringement of any intellectual property right, including patent, trademark, trade
secret, trade dress and copyright; unless covered under Insuring Agreement I.A.2.
v.Product Liability
w.Pharmacy services
x.Manufacture, handling sale or distribution of Phenylpropanolamine, Phenylpropanolamine Hydrochloride, PPA or any product
or drug containing any of these substances
y.Asbestos, Mould, Electromagnetic Field or Radiation, Pollution.
z.Insured vs Insured
aa.HIV, AIDS, hepatitis or any other infectious disease or any complex or syndrome related.
PLEASE NOTE THIS IS NOT AN EXHAUSTIVE LIST OF THE EXCLUSIONS AND
YOU SHOULD READ THE MASTER POLICY FOR FULL DETAILS.
The underwriters shall have the right and duty to defend any Claim against the Insured seeking Damages. Underwriters will pay
Claims Expenses with respect to any Claim seeking Damages which are payable under the terms of the Master Policy. Claims
Expenses shall reduce and may exhaust the Limits of Liability.
If any payment is made under the Master Policy and there is available to the Underwriters any of the Insured's rights of recovery
against any other party, then the Underwriters shall maintain all such rights of recovery. The Insured shall execute and deliver
instruments and papers and do whatever else is necessary to secure such rights. The Insured shall do nothing after an incident or
event giving rise to a Claim to prejudice such rights.
By acceptance of the attached Master Policy, all Insureds agree that the statements contained in the Application are their
agreements and representations, that they shall be deemed material to the risk assumed by the Underwriters, and that the Master
Policy is issued in reliance upon the truth thereof.
NO ADMISSION OF LIABILITY, ASSUMPTION OF OBLIGATION OR PROMISE TO PAY EITHER EXPRESS OR IMPLIED MAY
BE MADE EITHER VERBALLY OR IN WRITING.
IF THE INSURED RECEIVES ANY NOTICE OF A CLAIM OR IS AWARE OF A CIRCUMSTANCE WHICH MAY RESULT IN A
CLAIM FULL DETAILS OF THE CLAIM, CIRCUMSTANCE OR INCIDENT SHOULD BE SENT IMMEDIATELY IN WRITING BY
EMAIL OR LETTER (INCLUDING THE INSURED MEMBERSHIP NUMBER) TO THE ADDRESS STATED IN ITEM 10 OF THIS
CERTIFICATE OF INSURANCE.
NOTE: THE MASTER POLICY APPLIES IN EXCESS OF ANY OTHER VALID AND COLLECTIBLE INSURANCE AVAILABLE TO
ANY INSURED.
THE INSURANCE HEREBY EVIDENCED IS WRITTEN BY AN APPROVED NON-LICENSED INSURER IN THE STATE OF OHIO
AND IS NOT COVERED IN CASE OF INSOLVENCY BY THE OHIO INSURANCE GUARANTY ASSOCIATION.
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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:
(Name and Department) (Date)
Proposed modification(s) to the __________________ requirement(s) for
(Type of insurance) (Name of contract)
Reduce coverage to the amount of: $ .
Waive coverage
Other:
FACTOR(S) IN SUPPORT OF MODIFICATION(S)
(check those that apply)
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]
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]
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].
Other (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) (Date)
H:\WORD\Insurance\Admin Order #68.doc
Debbie Porter, Human Resources 11/1/22
GL & Work. Comp Jessica Padilla Bowen
Contractor will only be providing employee coaching.
Minimal exposure/risk for these types of insurance. Contractor is a sole proprietor and has her own auto insurance.
DocuSign Envelope ID: EA3A2DF9-37E7-4F88-BBC2-60472BA1FCCC
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Coverage No 67643
CERTIFICATE OF INSURANCE EFFECTED WITH CERTAIN UNDERWRITERS AT LLOYD'S, LONDON FOR THE MEMBERS OF
THE MASTER POLICYHOLDER
PROFESSIONAL LIABILITY, GENERAL LIABILITY AND ADVERTISING LIABILITY CLAIMS MADE AND REPORTED INSURANCE
This Certificate of Insurance is issued as a Notice of Insurance for information only. It does not constitute a legal contract of
insurance. The Master Policy, Declarations and Application of the Named Insured, if any, form the entire contract. This
Certificate is furnished in accordance with, and in all respects is subject to all terms, conditions and exclusions of the Master
Policy, a copy of which is attached hereto. The original Master Policy may be inspected at the offices of the Master
Policyholder.
This Certificate is to notify the member named below (the "Named Insured") that the following insurance has been effected
with certain Underwriters at Lloyd's, London (not incorporated) (the "Underwriters") for the Policy Period specified below
under the Master Policy (the "Master Policy") issued to the Master Policyholder.
The attached Master Policy provides coverage on a claims made and reported basis and apply only to Claims first made
against the Insured during the Policy Period or the Extended Reporting Period (if applicable) and reported to underwriters
during the Policy Period or otherwise provided in clause VIII. of the attached Master Policy.
Coverage Reference No: 67643
1.Named Insured:
Ms Jessica Padilla Bowen
Daily Joy Coaching
1017 SAN ANDRADE DR, Encinitas, CA 92024-3951, US.
Additional Insureds:
2.Master Policyholder: Westminster Group, Inc
c/o 23 Federal Plaza W BDM10 Youngstown, OH 44503
Master Policy Number: B0572MR21W123
3.Policy Period: The Policy Period shall commence during the Policy Period set forth below. Coverage shall commence from the
date upon which the Named Insured holds a valid membership with the Master Policyholder during the Policy Period and shall
continue up to but not exceeding 365 days in all.
From:4TH JANUARY 2022
To:4TH JANUARY 2023
Both dates at 12:01 a.m Local Time at the address stated in Item 1 above.
4.Policy Administrator:
Huntington Insurance
23 Federal Plaza W
BDM10
Youngstown, OH 44503
ProgramServices@Huntington.com
5.Limits of Liability:
1.Professional Liability Section
Limit of Liability for Insuring Agreement I.A.1., (Professional Liability)
a.Each Claim including Claims Expenses
But sublimited to:
$2,000,000
i.Sexual/Physical Misconduct Each Claim
including Claims Expenses
$25,000
b.Aggregate including Claims Expenses
But sublimited to:
$2,000,000
i.Sexual/Physical Misconduct Aggregate
including Claims Expenses
$75,000
Coverage No 67643
2.General Liability Section
Limit of Liability for Insuring Agreement I.A.2., (General Liability and Advertising Liability), and
Insuring Agreement I.A.3., (Fire Legal Liability)
a.Each Claim including Claims Expenses
But sublimited to:
$0
i.Fire Legal Liability (Insuring Agreement I.A.3.)
each Claim including Claims Expenses
$0
b.Aggregate including Claims Expenses $0
3.Products/Completed Operations Section
Limit of Liability for Insuring Agreement I.A.4., (Products/Completed Operations Liability),
a.Each Claim including Claims Expenses $0
b.Aggregate including Claims Expenses $0
4.Computer Information Security Liability Section
Limit of Liability for Insuring Agreement I.A.5., (Computer Information Security Liability),
a.Each Claim including Claims Expenses $50,000
b.Aggregate including Claims Expenses $50,000
5.Privacy Liability Section
Limit of Liability for Insuring Agreement I.A.6., (Privacy Liability),
a.Each Claim including Claims Expenses $50,000
b.Aggregate including Claims Expenses
But sublimited to:
i.Aggregate for the Policy Period for all Privacy Violation costs
covered under Insuring Agreement I.A.6.
$50,000
6.Policy Aggregate Limit of Liability
The Limits of Liability stated under 1, 2, 3, 4 and 5 above are part of, and not in addition to, the overall Policy
Aggregate Limit of Liability stated under this Section 6.
$2,000,000
The Limits of Liability under Item 5. shall apply separately to each Section. Under no circumstances shall any one Claim trigger multiple
sections.
6.Retroactive Dates: Professional Liability: 29TH DECEMBER 2020
Privacy Endorsement: 29TH DECEMBER 2020
7.Terrorism Coverage: No
8.Waiver of Subrogation: No
9.Territory: Worldwide
10.Notification under this
Policy:
Huntington Insurance Inc
Michael Dercoli, CPCU, CIC
Senior Sales Executive
23 Federal Plaza W
Youngstown, OH, 44503
Tel: 866-318-5028
Fax: 877-243-0712
Email: ProgramServices@Huntington.com
Coverage No 67643
11.Notice of Claim or
Circumstances:
Claims Department
Beazley Group
30 Batterson Park Road,
Farmington CT 06032
Email: uspeclaims@beazley.com
Tel: 888-222-1123 Fax: 866-910-1397
When reporting a claim please provide Program Name (WG US) and Master Policy Number
B0572MR21W123
The Master Policy contains the following exclusions:
1. Exclusions applicable to Insuring Agreement I.A.1 (Professional Liability)
a.Bodily Injury, Property Damage or Advertising Liability, except with respect to Bodily Injury arising out of any negligent
act, error or omission of any Insured in rendering or failing to render Professional Services.
b.Criminal, dishonest, fraudulent or malicious acts, error or omissions.
c.Contractual liability
d.Claims based upon an express or implied warranty or guarantee, or breach of contract in respect of an agreement to perform
work for a fee
e.Insured's activities as a trustee, partner, officer, director or employee of any trust, charitable organization, corporations,
company or business other than that of the Named Insured
f.Financial or investment advice
g.Libel or slander
i.No valid license for the performance of Professional Services
j.Rendering or failing to render Professional Services to Professional Athletes
2. Exclusions applicable to Insuring Agreement I.A.2 (General Liability and Advertising Liability) and Insuring Agreement I.A.3
(Fire Legal Liability).
Coverage No 67643
a.Claims arising out of the rendering or failing to render Professional Services;
b.Use of force expected or intended from the standpoint of the Insured;
c.Ownership, maintenance, operation, use, loading or unloading of any Automobile, aircraft or watercraft.
d.Transportation of Mobile Equipment by any Automobile;
e.Alcoholic beverages;
f.Personal Injury to any Employee;
g.Property Damage to property owned, rented or temporarily occupied by the Insured, personal property in the care, custody
and control of the Insured;
h.Recall
i.Claims against or in connection with any business enterprise not named in the Declarations which is owned by the Insured or
in which any Insured is a trustee, partner, officer, director or employee
j.Employee Retirement Income Security Act 1974 and amendments
k.Claim or circumstance in respect of which any Insured has given notice to any insurer of any other policy or self-insurance
prior to the inception date
l.Claim or circumstance known to the Insured prior to the inception date
m.Acts, error, omissions or Accidents which first took place prior to the Retroactive Date
n.Discrimination
o.Insolvency or Bankruptcy of the Insured
p.Punitive and exemplary damages, fines, sanctions, taxes, costs or expenses
q.Employer-employee relations, policies, practices, acts or omissions.
r.Violation of Securities Acts, of Racketeer Influenced and Corrupt Organizations Act
s.Anti-trust
t.Regulatory actions
u.Plagiarism, misappropriation of likeness, infringement of any intellectual property right, including patent, trademark, trade
secret, trade dress and copyright; unless covered under Insuring Agreement I.A.2.
v.Product Liability
w.Pharmacy services
x.Manufacture, handling sale or distribution of Phenylpropanolamine, Phenylpropanolamine Hydrochloride, PPA or any product
or drug containing any of these substances
y.Asbestos, Mould, Electromagnetic Field or Radiation, Pollution.
z.Insured vs Insured
aa.HIV, AIDS, hepatitis or any other infectious disease or any complex or syndrome related.
PLEASE NOTE THIS IS NOT AN EXHAUSTIVE LIST OF THE EXCLUSIONS AND
YOU SHOULD READ THE MASTER POLICY FOR FULL DETAILS.
The underwriters shall have the right and duty to defend any Claim against the Insured seeking Damages. Underwriters will pay
Claims Expenses with respect to any Claim seeking Damages which are payable under the terms of the Master Policy. Claims
Expenses shall reduce and may exhaust the Limits of Liability.
If any payment is made under the Master Policy and there is available to the Underwriters any of the Insured's rights of recovery
against any other party, then the Underwriters shall maintain all such rights of recovery. The Insured shall execute and deliver
instruments and papers and do whatever else is necessary to secure such rights. The Insured shall do nothing after an incident or
event giving rise to a Claim to prejudice such rights.
By acceptance of the attached Master Policy, all Insureds agree that the statements contained in the Application are their
agreements and representations, that they shall be deemed material to the risk assumed by the Underwriters, and that the Master
Policy is issued in reliance upon the truth thereof.
NO ADMISSION OF LIABILITY, ASSUMPTION OF OBLIGATION OR PROMISE TO PAY EITHER EXPRESS OR IMPLIED MAY
BE MADE EITHER VERBALLY OR IN WRITING.
IF THE INSURED RECEIVES ANY NOTICE OF A CLAIM OR IS AWARE OF A CIRCUMSTANCE WHICH MAY RESULT IN A
CLAIM FULL DETAILS OF THE CLAIM, CIRCUMSTANCE OR INCIDENT SHOULD BE SENT IMMEDIATELY IN WRITING BY
EMAIL OR LETTER (INCLUDING THE INSURED MEMBERSHIP NUMBER) TO THE ADDRESS STATED IN ITEM 10 OF THIS
CERTIFICATE OF INSURANCE.
NOTE: THE MASTER POLICY APPLIES IN EXCESS OF ANY OTHER VALID AND COLLECTIBLE INSURANCE AVAILABLE TO
ANY INSURED.
THE INSURANCE HEREBY EVIDENCED IS WRITTEN BY AN APPROVED NON-LICENSED INSURER IN THE STATE OF OHIO
AND IS NOT COVERED IN CASE OF INSOLVENCY BY THE OHIO INSURANCE GUARANTY ASSOCIATION.
06/15/2006 27
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:
(Name and Department) (Date)
Proposed modification(s) to the __________________ requirement(s) for
(Type of insurance) (Name of contract)
Reduce coverage to the amount of: $ .
Waive coverage
Other:
FACTOR(S) IN SUPPORT OF MODIFICATION(S)
(check those that apply)
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]
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]
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].
Other (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) (Date)
H:\WORD\Insurance\Admin Order #68.doc
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PROOF OF INSURANCE :
lnterinsurance Exchange of the Automobile Club ,
NAIC #: 15598 :
Named Insured Policy Number: CAA 059119235
BOWEN, NATHAN
Effective Date: 12-12-21 Expiration Date: 12-12-22
This policy provides at least the minimum amounts of liability insurance
required by the CA VEH CODE SECTION 16056 for the specified
vehicles and named insureds. Coverage subject to policy terms and
limits.
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VEHICLES ON POLICY
YEAR MAKE VEH I D # 2018 NSSN 5N1DR2MN2JC633975 2021 TESL SY JYGDEE3MF276223
DRIVERS ON POLICY
BOWEN, NATHAN
PADILLA, JESSICA