HomeMy WebLinkAbout1998-09-22; City Council; Resolution 98-3121
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RESOLUTION NO. 98-312 0 I
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF
CALRSBAD, CALIFORNIA, RETAINING BLUE CROSS OF
CALIFORNIA AS THE CITY’S EMPLOYEE ASSISTANCE
PROGRAM (EAP) PROVIDER.
WHERAS, since January 1984, the City of Carlsbad has offered an Employee
Assistance Program (EAP) to its employees and their dependents; and
WHERAS, the City is interested in continuing to offer this service in the future; and
WHERAS, the contract with Blue Cross of California for such services expired on
September 30, 1997; and
WHERAS, staff has evaluated three separate EAP providers and is recommending
that Blue Cross of California continue to be retained as the City’s Employee Assistance
Program (EAP) provider; and
WHERAS, Blue Cross of California has continued to provide such services in the
interim.
NOW, THEREFORE, BE IT RESOLVED by the City Council of the City of
Carlsbad, California, as follows:
I. That the above recitations are true and correct.
2. That the City Council approves Blue Cross of California as the City’s Employee
Assistance Program (EAP) provider effective October 1, 1997.
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3. That the City Council ratifies the attached contract with Blue Cross of California
to provide EAP services for eligible employees of the City of Carlsbad and their dependents.
This is a three year contract, and the City Manager is given the authority to extend this
agreement for two one (1) year periods.
PASSED, APPROVED, AND ADOPTED at a regular meeting of the Carlsbad City
Council held on the 2nd day of September , 1998, by the following vote, to wit:
AYES: Council Members Lewis, Finnila, Nygaard, Kulchin and Hall
NOES: None
ABSENT: None
ATTEST:
\ cL=Ak"
ALETHA L. RAUTENKRANZ, city Clerq
(SEAL)
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BLUE CROSS OF CALIFORNIA
GROUP SUBSCRIBER CONTRACT
Contract made on September 22, 1998 and effective
as of October 1, 1997, by and between Blue Cross of California, hereinafter referred to as “BCC”
and the City of Carlsbad, hereinafter referred to as “Group,” is made with reference to the
following facts:
A. BCC is a licensed health care service plan which offers managed care and
Employee Assistance Programs (“ED”).
B. Group desires to obtain the services herein specified for and on behalf of
subscribers and enrollees as defined herein.
THEREFORE, the parties agree:
ARTICLE I
DEFINITIONS
The following terms, when used in this Contract or any amendments hereof are defined as
follows:
1.1 Act means the Knox-Keene Health Care Service Plan Act of 1975 (California
Health and Safety Code Sections 1340 eq seq.).
1.2 Benefits mean those services an eligible Enrollee is entitled to receive hereunder.
1.3 Group means the City of Carlsbad.
1.4 Enrollee is defined as a Subscriber and any eligible dependents as defined under
the eligibility requirements of this Contract and as determined by Group who are actually
enrolled in and eligible to receive benefits under said Contract.
1.5 Evidence of Coverage or Combined Evidence of Coverage and Disclosure Form
means the document issued to the Subscriber which summarizes the essential terms of this
Contract.
1.6 Provider means a licensed California professional under contract to BCC to
perform assessments, brief counseling, and referral. This term also refers to outside professional
who perform services upon referral fiom BCC.
1.7 Regulations includes those regulations promulgated and officially adopted by the
California Department of Corporations under the Knox-Keene Act, in addition to any other
regulation or applicable State or Federal law.
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1.8 Subscriber is defined as an eligible employee, retired employee or surviving
spouse who is otherwise eligible for coverage under the eligibility requirements determined by
Group, and who is enrolled hereunder and for whom periodic payments are made by a Group.
ARTICLE I1
PREPAYMENT FEES
2.1 Group shall pay BCC the total fee(s) indicated in subparagraph 2.2, per month per
Subscriber.
2.2 Group shall pay to BCC a premium for each eligible Subscriber (which shall
include dependents at no additional charge to Group) as follows: $2.19 per month during the first
contract year. During the second contract year and the third contract year, BCC may increase the
premium up to 4 percent, unless utilization exceeds 10 percent as calculated by the BCC EAP
utilization formula, in which case the increase may range fiom 6-8 percent at the end of each
contract year. The premium increase will be based on the cost of doing business as determined by
BCC. Group has the option to extend the contract for two one-year renewals under the same
conditions as above.
2.3 All fees are paid by Group, unless other provisions for payment are agreed to in
advance by BCC.
2.4 Group shall send one check covering all Subscribers to:
Blue Cross of California
P.O. Box 85068
San Diego, CA 921 86-5068
commencing on the date indicated in paragraph 6.1, and continuing each month thereafter on said
date for the duration of this contract.
ARTICLE I11
PRINCIPAL BENEFITS, EXCLUSIONS,
LIMITATIONS AND ADMINISTRATIVE POLICIES
3.1 BCC and Group agree that BCC staff shall provide services to Subscribers of
Group under the Plan set forth attached as EXHIBIT ONE. EXHIBITS ONE IS AN
ESSENTIAL PART OF THIS CONTRACT.
3.2 EAP Services must be obtained fiom BCC designated Providers by calling the
BCC toll-free number 800-999-7222 or (619) 571-8222 in San Diego.
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3.3 Additional services beyond the EAP may be covered by Group's full service health
plan.
ARTICLE IV
HOW TO OBTAIN BENEFITS
Benefits must be obtained from BCC designated EAP Providers by calling BCC.
BCC provides a toll-free or local telephone number. In non-emergency situations, Enrollees are
offered an appointment within 48 hours. BCC does not reimburse Enrollees for any unauthorized
treatment from non-contracting Providers. During business hours, any Enrollee calling for service
outside the BCC service area or with an emergency or urgent situation is immediately referred to a
licensed mental health professional for a telephone assessment. The telephone assessor may
provide crisis intervention over the telephone, arrange a same-day appointment with the EAP
Provider in the Enrollee's area, locate an EAP Provider if necessary, or assist the Enrollee in
obtaining more intensive, acute care services. After business hours, Enrollees are forwarded to
BCC's 24-hour phone number and speak with a licensed mental health professional for a telephone
assessment.
ARTICLE V
ELIGIBILITY
5.1 Group shall provide a monthly count of eligible Subscribers. Group shall send an
eligibility list to BCC upon BCC's request, specifying the names and other mutually agreed upon
identifying data for each Subscriber to be covered for the succeeding month.
5.2 The determination of who is eligible to be a Subscriber and who is actually a
Subscriber in the Plan shall be determined by Group, and BCC shall have the right to rely upon that
determination. Any disputes or inquiries regarding eligibility, including rights regarding renewal,
reinstatement and the like, if any, shall be referred by BCC to Group, which shall then advise BCC
of its determination.
5.3 Dependents shall include:
a. The lawfid spouse who shares the same household of the Subscriber, and all
newborn infants whose coverage shall commence from and after the moment
of birth. Adopted children shall be covered from and after the date of
placement. Except as stated above, dependents shall be eligible for coverage
on the day the Subscriber acquires such dependent.
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b. Dependents shall also include all unmarried children under the age of nineteen
(19) years who are chiefly dependent on the Subscriber for support and
maintenance. Extension of eligibility may be made up through age twenty-
three (23) years for unmarried children who are principally dependent upon the
Subscriber.
c. Coverage shall not terminate while a dependent child is and continues to be (1)
incapable of self-sustaining employment by reason of mental disability or
physical handicap; and (2) chiefly dependent upon the Subscriber for support
and maintenance.
d. Upon request, BCC may choose to extend the definition of dependent to
include a significant other who shares the same household, parents in the
Subscriber's household who are chiefly dependent on the Subscriber for
support and maintenance, or other person whose impact on the Subscriber
might adversely affect the Subscriber's well-being or work performance. If
such a person is not covered under the Group's definition of eligibility, the
referral may be limited to specific community resources.
ARTICLE VI
COMMENCEMENT AND DURATION OF THIS CONTRACT
TERMINATION - RENEWAL
6.1 Coverage shall commence at 12:Ol A.M. on October 1, 1997 for all Subscribers
enrolled on the day when this Group Subscriber Contract starts. Coverage for new subscribers shall
commence at 12:Ol A.M. on the first day of employment or at the end of any Group designated
probationary period as defined by Group. Coverage terminates at 1159 P.M. on the last day of
eligibility for participation in the Group, whether the last day of employment or the last day of
eligibility for any continuation of coverage period.
6.2 This contract shall be effective on the date indicated in paragraph 6.1 above, and
shall continue until the end of the month of September 30,2002. BCC shall not decrease benefits
in this Contract except upon 30 days written notice.
6.3 The term of this contract shall be three years beginning on the effective date of this
contract at which time it may renew for two one-year periods. Or, the parties may renew this
contract at the end of the term hereof, and by mutual consent modify or alter this contract; provided,
however, that said modifications, amendments, alterations or renewals shall be in writing, duly
executed by both parties hereto, and attached to this contract. There is no individual right of
renewal. Only Groups are eligible to enter into or renew Subscriber Contracts with BCC.
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6.4 Should either party be in default by the failure to reasonably perform any of the covenants
and conditions contained herein, the non-defaulting party shall have the right to give the defaulting
party thirty (30) days written notice, specifying the default. If the default is not cured, the contract
will be terminated, excepting therefrom Group's failure to remit the monthly prepayment fees, or
provide eligibility list if requested, in which case fifteen (1 5) days written notice shall apply. The
defaulting party shall then have the thuty (30) days, or fifteen (1 5) days in the case of the failure to
remit the appropriate prepayment fees, or eligibility list when due, from receipt of notice, in which
to remedy the default or failure to perform.
Both parties agree that BCC shall have the absolute right to terminate this contract
should Group fail to remit the monthly prepayment fees or eligibility list, within the fifteen (1 5) day
period after notice.
Both parties may terminate this Contract immediately if the other party should
engage in fraudulent conduct with respect to this Contract.
This Contract may be terminated at any time without cause by Group upon 30
days written notice.
6.5 In the event of termination of this contract, each BCC participating Provider has
agreed to complete all assessment, brief counseling, and referral services which have been started
prior to the date of termination, pursuant to the terms of this contract.
6.6 Pursuant to Section 1365(b) of the Knox-Keene Act, BCC will not terminate or
fail to renew the eligibility of any individual Subscriber or Enrollee because of health status or use
of the EM. If any person believes that this Contract has been terminated or any Enrollee or
Subscriber has been denied services under this Contract because of health status or requirements for
health services, the Enrollee may request a review by the Commissioner of Corporations of the
State of California.
ARTICLE VI1
ADMINISTRATION
7.1 With regard to the distribution of all materials, such as Combined Evidence of
Coverage and Disclosure Form and other materials required to be distributed pursuant to the Knox-
Keene Act or any regulation issued pursuant thereto, Group shall be responsible to distribute such
materials to the Subscribers andor eligible participants.
7.2 BCC staff shall provide telephone or in-person emergency service twenty-four
hours a day, seven days a week, to all Enrollees. If the Enrollee's Provider office is unavailable, the
Enrollee shall call BCC's offices during normal business hours, or in the case of an after-hours
emergency.
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7.3 BCC agrees to duly investigate and resolve any and all complaints received from
Enrollees with regard to the nature of professional services rendered. Any inquiries or complaints
shall be made to BCC by writing or calling BCC at the address and telephone number indicated
herein. BCC shall maintain a grievance system in compliance with the Knox-Keene Act.
Grievance Report Forms and copies of the Grievance Procedures are available at
each facility of BCC, Enrollees may send a written complaint or call BCC directly to resolve their
complaint. BCC will acknowledge receipt of the complaint and provide notice to the complainant
of whom may be contacted with respect to the complaint within 20 days.
If the Enrollee is not satisfied with the resolution offered at the first level, the
grievance is directed to the next management level.
If the grievance is not resolved to the Enrollee's satisfaction at the second level, it
will be directed to the Quality Management Committee in the case of a quality of care issue, or the
General Manager or designee in the case of an administrative issue. The Quality Management
Committee or the General Manager or hisher designee will review all applicable data within 15
days.
The Enrollee will be advised in writing of the findings and recommendations
within 30 days of the receipt of the Grievance Report.
Enrollees may file a complaint or grievance in writing or by calling (619) 571 -
8222 in San Diego or 1-800-999-7222 in all other areas regarding the complaint.
ARTICLE VI11
QUALITY CONTROL AND
PROFESSIONAL-PATIENT RELATIONSHIP
8.1 BCC will make every reasonable effort to arrange for services and care as herein
provided in accordance with the prevailing national and regional professional standards.
8.2 It is expressly understood that the relationship between the Enrollee and BCC
participating professionals shall be subject to the rules, limitations, and privileges incident to the
doctor-patient or therapist-patient relationship. BCC shall be solely responsible, without
interference from Group or any of its agents, to the Enrollee for arranging counseling and treatment.
8.3 It is understood by Group that the operation and maintenance of the participating
offices, and the rendition of all services shall be solely and exclusively under the control and
supervision of the BCC Provider, including all authority and control over the selection of staff,
supervision of personnel, and operation of the professional practice, and/or the rendition of any
particular professional service or treatment
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8.4 BCC will undertake to see that the services provided to Enrollees by Providers
shall be performed in accordance with nationally accepted professional standards of reasonable
competence and skill of Providers as applicable prevailing at the time of service.
8.5 If BCC shall subcontract any of the work to be performed under this contract by
BCC, BCC shall be fully responsible to Group for the acts and omissions of BCC’s subcontractor
acts and omissions of persons directly employed by BCC. Nothing contained in this contract shall
create any contractual relationship between any subcontractor of BCC and Group. BCC shall bind
every subcontractor and every subcontractor of a subcontractor by the terms of this contract
applicable to BCC’s work unless specifically noted to the contrary in the subcontract in question
and approved in writing by Group.
and of the persons either directly or indirectly employed by the subcontractor, as BCC is for the
ARTICLE M
GENERAL PROVISIONS
9.1 Group acknowledges and understands that this Contract provides solely and
exclusively for services to be performed at BCC Provider facilities. This Contract provides for
services only, is not an insurance policy and does not indemnify nor reimburse any Subscriber or
Group for the cost of health care services.
9.2 Group will furnish announcement brochures, management guidebooks, and cards
as required by the program.
9.3 Group agrees to pay BCC for pre-approved, reasonable travel expenses outside
San Diego County.
9.4 Any dispute or controversy arising between Group and BCC involving this
Contract, any of its terms and conditions, its breach or nonperformance may be submitted for non-
binding arbitration. The arbitration shall take place in San Diego, California. Neither party shall be
precluded fiom pursuing any and all remedies that they are entitled to at law which remedies shall
be pursued in San Diego County only.
9.5 Whenever it shall become necessary for either party to serve notice on the other
respecting this Contract, such notice shall be in writing and shall be served by certified mail, return
receipt requested, addressed as follows:
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a. If served on Group, it shall be addressed to:
The City of Carlsbad, Human Resources Department
1200 Carlsbad Village Drive
Carlsbad, CA 92008
(61 9) 434-2852
Fax: (619) 720-1875
b. If served on BCC, it shall be addressed to:
BLUE CROSS OF CALIFORNIA
9655 Granite Ridge Drive, Sixth Floor
San Diego, CA 92 123
(619) 571-8300
9.6 BCC is subject to the requirements of Chapter 2.2 of Division 2 of the Health and
Safety Code (the "Act") and Subchapter 5.5 of Chapter 2 of Title 10 of the California Code of
Regulations (the "Regulations"), and any provisions required to be in the contract by either of the
above shall bind BCC whether or not provided in the contract.
In the event that the Act or Regulations thereunder set forth any requirement
which is not included herein or is contrary to this Contract, it shall supersede the applicable
provisions of this Contract and shall be binding unto the parties hereto. BCC will make every
reasonable effort to comply with all requirements of the Act.
9.7 Nothing contained herein shall preclude BCC from changing the location of any of
its Provider offices, as long as it retains a sufficient Provider network to provide services to Group.
9.8 In the event any of BCC's contracted participating Providers should terminate
hisher relationship with BCC, breach hisher contract with BCC or be unable to render services
hereunder, and Group and/or its Subscribers will be adversely or materially affected, BCC will give
the Group andor its Subscribers written notice thereof.
9.9 Upon termination of a Provider contract, BCC shall be liable for covered services
rendered by such Provider to a Subscriber or Enrollee who retains eligibility under this contract or
by operation of law under the care of such Provider at the time of such termination until the
services being rendered to the Subscriber or Enrollee by such Provider are completed, unless BCC
makes reasonable and medically appropriate provision for the assumption of such services by a
contracting Provider.
9.10 In the event that BCC fails to pay the participating Provider for costs of
assessment, brief counseling, and referral, the Enrollee shall not be liable to the Provider for any
sums owed. BCC does not pay non-participating providers nor reimburse Enrollees for any sums
they may pay directly to any provider for services rendered. All EAP services must be obtained by
calling BCC directly for authorization and referral for services to a BCC participating Provider.
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9.11 If any provision of this contract is held to be illegal or invalid for any reason, such
decision shall not affect the validity of the remaining provisions of this contract, and such
remaining provisions shall continue in full force and effect unless the illegality or invalidity prevent
the accomplishment of the objectives and purposes of this contract.
9.12 In the event Group is regulated under the Employee Retirement Income Security
Act of 1974 (ERISA), Group covenants and agrees that it and not BCC shall be responsible for
meeting all requirements of ERISA. BCC will cooperate with Group in supplying Group with any
information within its possession to aid Group in meeting any ERISA reporting requirements.
BCC is not and shall not be designated the administrator or fiduciary of any Group health or
employee benefit plan offered to Group's employees and their eligible family members.
9.13 If the Subscriber andor Enrollees are eligible to retain coverage under this
Contract during any Continuation of Coverage period or election period necessary for Group's
compliance with requirements of the Consolidated Omnibus Budget Reconciliation Act (COBRA)
and any regulations adopted thereunder, or any similar state law requiring the Continuation of
Benefits for Subscriber andor Enrollees, the Group must continue to certify the eligibility of the
Subscriber andor Enrollees and pay the monthly prepayment fees for COBRA coverage for such
Subscribers andor Enrollees if the Enrollee elects such COBRA coverage.
9.14 BCC shall designate an administrator of their program who shall serve as the
liaison between BCC and Group.
9.15 BCC and its employees and agents will comply with all applicable federal, state,
and local laws, rules, and professional ethical standards, and will observe all applicable laws
concerning records retention and confidentiality.
9.16 The relationship between Group and BCC arising from this Contract is that of
independent contractors. Neither this Contract, nor the activities of Group and BCC pursuant to
this Contract, shall constitute the parties as joint venturers, partners, principal and agent, master and
servant, or employer and employee; and neither party shall hold itself out to the public as having
other than an independent contractor relationship with the other party. Neither party shall have the
power to bind or obligate the other party in any manner, other than as is expressly set forth in this
Contract.
9.17 BCC agrees to indemnify and hold harmless the City of Carlsbad and its officers,
officials, and employees from and against all claims, damages, losses and expenses including
attorney's fees arising out of the performance of the work described herein caused by any willful
misconduct or negligent act or negligent omission of BCC, its subcontractors and their employees,
except where caused by the active negligence, sole negligence, or willful misconduct of the City of
Carlsbad. BCC shall at its own expense, upon written request by the City, defend any such suit or
action related to this Agreement brought against the City, its officers, officials, employees and
volunteers. BCC's indemnification of City shall not be limited by any prior or subsequent
declaration by the Contractor.
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9.18 Iuxance. BCC shall obtain and maintain for the duration of the Contract 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 work hereunder by the BCC, its agents,
representatives, employees or subcontractors. Said insurance shall be obtained from an insurance
carrier admitted an 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-:V” and shall meet the City’s
policy for insurance as stated in Resolution No. 91-403.
a. Coverape and Limits, ..
BCC shall maintain the types of coverage and minimum limits indicated herein,
unless a lower amount is approved by the City Attorney or City Manager:
1. Comprehensive General Liability Insurance. $1,000,000 combined single-
limit per occurrence for bodily injury, personal injury and property damage. If the submitted
policies contain aggregate limits, general aggregate limits shall apply separately to the work under
this contract or the general aggregate shall be twice the required per occurrence limit.
2. Automobile Liability (If the use of an automobile is involved for
Contractor’s work for the City). $1,000,000 combined single-limit per accident for bodily injury
and property damage.
3. Workers’ Compensation and Employer’s Liability. Workers’ Compensation
limits as required by the Labor Code of the State of California and Employer’s Liability limits of
$1,000,000 per accident for bodily injury.
b. Additional Provisions.
BCC shall ensure that the policies of insurance required under this agreement
contain, or are endorsed to contain, the following provisions.
1. The City shall be named as an additional insured on all policies excluding
Workers’ Compensation.
2. BCC shall furnish certificates of insurance to the City before
commencement of work.
3. BCC shall obtain occurrence coverage.
4. This insurance shall be in force during the life of the Contract and any
extension thereof and shall not be canceled without 30 days prior written notice to the City sent by
certified mail.
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5. If BCC fails to maintain any of the insurance coverages required herein, then
the City will have the option to declare BCC in breach, or may purchase replacement insurance or
pay the premiums that are due on existing policies in order that the required coverages may be
maintained. BCC is responsible for any payments made by the City to obtain or maintain such
due BCC under this Contract
insurance and the City may collect the same from BCC or deduct the amount paid from any sums
9.19 This Contract is non-assignable by either party without the prior written consent of
the other party. BCC may, in its sole discretion, delegate administrative functions to other entities.
9.20 This Contract constitutes the entire Contract of the parties. This Contract may
only be modified by a writing executed by the parties.
9.21 The parties acknowledge that this contract and all of its provisions shall be
effective retroactive to October 1, 1997.
IN WITNESS WHEREOF, the parties have executed this Contract on: September 24, 1998
I
(ht) CLAUDE A. LEWIS, myor
BLUE CROSS OF CALIFORNIA
/
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EXHIBIT ONE
PRINCIPAL BENEFITS, EXCLUSIONS, AND LIMITATIONS
Benefits
BCC agrees to provide the following services:
1.
2.
3.
4.
5.
6.
7.
8.
9.
Up to 20 onsite hours for training and orientation during the first year.
Up to 10 hours for onsite training and orientation each additional year.
Up to 100 hours per year of management consultation and account service
Toll-free 24-hour 800 number access line.
Professional assessment, consultation and referral.
Caller follow up and emergency counseling services.
Standard reports of utilization and effectiveness provided bi-annually.
Legal information.
Dependent care referrals.
The following additional services are available at $150.00 per hour.
1. Consultation on management of critical incidents and coordination and provision of
onsite debriefings on next business day.
2. Consultation, coordination and group sessions to “defuse” reactions to the off-site
death of a coworker, lay-offs, reorganizations, or other unusually upsetting issues and
events.
3. Wellness seminars.
4. EAP training and orientation beyond 20 hours in the first year or 10 hours in each
subsequent year.
5. Consultation and account service beyond 100 hours per year.
6. Policy development including but not limited to drug-free workplace, drug testing,
Department of Transportation, or other regulatory compliance and workplace violence
prevention.
7. Organizational consultation and training including but not limited to team building,
managing stress and change, managing layoffs, customer service, and conflict resolution.
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All D.O.T. referrals are scheduled with a designated SAP and are evaluated in accordance with
D.O.T. guidelines. The following is an outline of the process:
A. Determine specific rule violation and identify referral source.
B, Review city policy and collective bargaining agreements,
C. Conduct a full assessment of the individual, including administration of standardized
D. Determine appropriate level of care and make referral to coordinate with health benefits, if
E. Report recommendations to employer and/or other designated party.
F. Monitor treatment compliance.
G. Conduct re-evaluation and report recommendations to employer/designated party. In
consultation with the employee’s Medical Review Officer, release employee to be considered
for return to safety sensitive duty, when appropriate.
assessment tool.
possible.
BCC believes that it is best for the employee and the organization to provide a separate system
for managing the S.A.P. evaluation and the subsequent follow-up. In this way the S.A.P.
provides a conflict-free evaluation with no financial incentive to increase the amount of
monitoring or follow-up.
BCC will manage the S.A.P. evaluation for $600.00 per case. This fee includes Sections A
through E of the D.O.T. process outlined above. A different EAP counselor conducts processes
described under F and G above. Our charge for this is $35.00 per month. We recommend that
the S.A.P. evaluation and referral be separated from the ongoing monitoring of treatment
compliance.
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Executed by Contractor this /ti+ day of b-q4fd >- 19 qT.
CONTRACTOR CITY OF CARLSBAD, a municipal
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// (%@ /
d.h-4/(- Brint name/title) %d@/* Jd*+&4@T
ATT T:
SEE ATTACHED By:
(Sign here)
\ ALETHA L. RAUTENKRANZ I
(Print namehitle) City Clerk
(Proper notarial acknowledgment of execution by Contractor must be attached)
(President or vice-president and secretary or assistant secretary must sign for corporations. If
only one officer signs, the corporation must attach a resolution certified by the secretary or
assistant secretary under corporate seal empowering that officer to bind the corporation.)
APPROVED AS TO FORM:
RONALD R. BALL
BY city3- ityAttorney7. 23.78.
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CALIFORNIA ALL-PURPO~ACKNOWLEDGMENT 0 ATTACHMENT I
California
Countyof Sari Diego
On Auqust 18, 1998 beforeme, Barbara A. Bowers, Notarv Public
personally appeared ’ Chervl Noncarrow
Date
Name(s) of Signer(s)
and acknowledged to me that he/she/they executed the
same in his/her/their authorized capacity(ies), and that by
executed the instrument.
3 WITNESS my hand and official seal.
&-&. &;3-
Slgnature of Notary Public
$~,S””
Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent
fraudulent removal and reattachment of this form to another document.
Description of Attached Document
Title or Type of Document:
Document Date: Undated Number of Pages: 13
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Group Subscriber Contract
0 Individual 0 lndividlual 0 Corporate Officer
0 Partner - 0 Limited General
El Attorney-in-Fact 0 Attorney-in-Fact
0 Guardian or Conservator 0 Guardian or Conservator
Signer Is Representing: Signer Is Representing:
D 1994 Nattonal Notary Assmiation * 8236 Remmet Ave.. P.O. Box 7184 * Canoga Park. CA 91309-7184 Prod. No. 5907 Reorder: Call Toll-Free 1-800-876-6827
Ahq 13 '36 M:;SBM -11 P ,-YMN is,- aq~,72:-=~~ E,;~,- 1 3 - s & ~ jq~ ~ - 4 : 2 e FQ ' ' %&@)/~~~s ifii -d"X3- FA'J ji6, $;;* 3214 - ?.Z/? , .. 1
ATTACHMENT ft
AUTHOAl[ZATION TO EWVDTBE CORPORATION
che~yl Noncamw is gaud rnmqez of WeWoint Bthrwiod Hsalth/Blnt Cross of
C&omja's Behavioral Health Progmn @ID) aad Eqiloyee Assistance Program GAP)
divisions. As an office afthe many, she is ~mpoweacld to bind conbactudl agwmcnts
with pdve clients ti>r BHP aad EAP rolstcd servicas-
APPROVED:
" -
Joan Eknnan v
President Specialty Busintsscs
DaV I t