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HomeMy WebLinkAboutMINUTES - 12271977 - COB BOX 69 ISA - IF / In the Board of Supervisors of Contra Costa County, State of California June 30 19 81 In the Matter of Approval of Extension of Contract with Adminco IT IS BY THE BOARD ORDERED that the contract between the County and Adminco foi claims adjustment services for the Workers' Compensation program is EXTENDED for the period July 1, 1981 to August 31, 1981 at a total additional cost of $22,924.34. ----- PASSED BY THE BOARD on June 30, 1981, by the following vote : AYES : Supervisors Fanden, Schroder, McPeak, Torlakson, Powers. NOES : None. ABSENT : None. 1 hereby certify that the foregoing is a true and correct copy of an order entered on the minutes of said Boord.of Supervisors on the date aforesaid. Witness my hand and the Seal of the Board of aa: Administrator Supervisors Personnel Adminco (via CAO) affixed this 30th day of June 19 81 Auditor-Controller Contra Costa County FPD J. R. OLSSON, Clerk Riverview Fire District By Deputy Clerk C. Matthews H-24 4/77 15m Contra � " County COSI$ PERSONNEL DEPARTMENT CountyAdministration Building JUN 2 1981 Martinez, California Office of County Administrator Date: June 23, 1981 TO: M. G. Wingett„County Administrator FROM: Harry D. Cisterman, Director of Personnel By: Howard E. Brownson, County Safety & Benefits Officer SUBJECT: Adminco Contract For Workers ' Compensation Claims Adjusting Services We have had discussions for several months with the management of Adminco to try to improve the quality of their claims adjusting services. The attached letter from Thomas A. Cockrell, Senior Vice President of Adminco., states that they will need $175,800 per year to assure us the quality we desire. This is a 90% increase over the current fee. We are exploring the possibilities of improving our lot and are in the process of evaluating other claims contractors . However, we cannot complete the evaluation until early July and if we choose another contractor it will take several weeks to make the transition. Accordingly, we ask that the Board of Supervisors approve a 60 day extension of the Adminco contract to August 31, 1981 at the lower of the renewal options. The two month fee will be $22,924.34. This is a 49% increase over the current fee. HDC:HEB:sjw Attachments , OL r -i AK 63 �� I In the Board of Supervisors of Contra Costa County, State of California July 8 1980 In the Matter of Approval of Extension of Contract with Adminco IT IS BY THE BOARD ORDERED that the contract between the County and Adminco for claims adjustment services for the Workers' Compensation program is EXTENDED for the period July 1, 1980 to June 30, 1981 at a total additional cost of $92, 112 . PASSED BY THE BOARD on July 8, 1980 . I hereby certify that the foregoing is a true and correct copy of an order entered on the minutes of said Board of Supervisors on the date aforesaid. cc: Administrator Witness my hand and the Seal of the Board of Personnel Supervisors Adminco (via CAO) affixed this 8th day of July 1980 -Auditor-Controller Contra Costa Count FPD J. R. OLSSON, Clerk Riverview Fire Dis rict By ti's� . Deputy Clerk R. if Fluhrer H -24 4/77 15m 'F co IIC.ra Costai.t�:l il�j . . ✓%'r,.-!a Cd Fr)r IC CONTRACT EXTENSION AGREEMENT 1. Contract Identification. Number Adminco 1-4 Department: Personnel Subject: Workers ' Compensation Claims & Administration Service Effective Date of Contract: July 1, 1980 2. Parties. The County of Contra Costa, California (County) for its Department named above, and the following named Contractor mutually agree and promise as follows: Contractor: Adminco Capacity: California Corporation Address: 2815 Mitchell Drive Walnut Creek, CA 94598 3. Extension of Term. The term of the above described contract between the parties hereto is hereby extended from July 1, 1980 to June 30 , 1981 unless sooner terminated as provided in said contract. 4. Payment Limit. As to the extended term of the contract, the maximum amount payable by the County is increased by the following amount $92,112 5. Other Provisions. As to the term during which the above described contract is extended, the parties mutually agree to those Special Provisions (if any) attached hereto, which are incorporated herein by reference. 6. Legal Authority. This Contract Extension Agreement is entered into under and subject to the following legal authorities: Government Code Section 31000. 8 7. Signatures. These signatures attest the parties ' agreement hereto. COUNTY OF CONTRA COSTA, CALIFORNIA CONTRACTOR By BY I-2% %011e Designee, B rd of Supervisors q/ Attest: County Clerk (Designate official capacity in organi- zation and affix corporations seal or attach resolution of governing board) By_, Deputy State of California ) County of Contra Costa ) ss. Recommended by Department ACKNOWLEDGEMENT (CC 1190.1) The person signing above for Contractor, known to me in those individual and By / business capacities, personally appeared Designee before me today and acknowledged that he/they signed it and that the corporation or partnership named above executed this Form Approved: instrument pu 71, o,;''_c�:. t resolution of 5 and 4 a s,- , NOTARY PUI]LIC CALIFORNIA �) W So d �^/ COUNTY OF ALAMi T.VA By Dated. g �. n ab m-`�isV 4 '.s4A0.ri...'�L.TF l Notary Public/ R'O (A-4621 REV 3/79) AMENDMENT SPECIFICATIONS Number : Adminco 1-4 In consideration of Contractor' s agreement to extend services as set forth' in the Service Plan incorporated by reference into Contract Number Adminco -1, as amended by Contract Numbers Adminco 1-1 , 1-2 and Adminco 1-3, County and Contractor agree to further amend the contract identified herein as specified below: 1. Term: The term of the Contract is extended to June 30, 1981. 2. Payment Limit: County' s total payment to Contractor under this contract is increased by $92 ,112 for the extended term of the contract (July 1, 1980 through June 30, 1981) to a total amount of $295, 512 . 3 . Payment Amounts: Subject to the payment limits of the contract as increased by this modification, County will pay Contractor $7 ,676 monthly. All other terms and conditions of this agreement are to remain unchanged and in full force and effect. Initials: "� A6 Contractor County epartment I r • AMENDMENT SPECIFICATIONS Number : Adminco 1'-4 In consideration of Contractor' s agreement to extend services as set forth' in the Service Plan incorporated by reference into Contract Number Adminco -1, as amended by Contract Numbers Adminco 1-1 , 1-2 and Adminco 1-3, County and Contractor agree to further amend the contract identified herein as specified below: 1. Term: The term of the Contract is extended to June 30, 1981. 2 . Payment Limit: County' s total payment to Contractor under this contract is increased by $92 ,112 for the extended term of the contract (July 1, 1980 through June 30, 1981) to a total amount of $295,512 . 3. Payment Amounts: Subject to the payment limits of the contract as increased by this modification, County will pay Contractor $7 ,676 monthly. All other terms and conditions of this agreement are to remain unchanged and in full force and effect. Initials: Contractor Country" Department r� R pL5�UF VI`OR' CORK ''i { G�' In the Board of Supervisors of Contra Costa County, State of California September 11 , 19 ,19 In the Matter of Contract Amendment Agreement with Adminco (Adminico-1-3) IT IS BY THE BOARD ORDERED that its Chairman is AUTHORIZED to execute third amendment to contract with Adminco for workers ' compensation claims services effective July 1, 1978 , to extend the term of the contract to June 30 , 1980 and to increase total payments to contractor by $78 ,720 for the extended period. Passed by the Board on September 11, 1979. I hereby certify that the foregoing is a true and correct copy of an order entered on the minutes of said Board of Supervisors on the date aforesaid. Orig• Administraty r Witness my hand and the Seal of the Board of cc• Contractor l via CAO) Supervisors Auditor-Controller affixed this 11th day of September . 19 79 Personnel Director Treasurer-Tax Collector County Counsel J. R. OLSSON, Clerk Retirement AdministratorBy. ae,- Deputy Clerk 71iihr er a� H -24 4/77 15m .f � / Lo, Unica Costa County . Standard Form 6— CONTRACT AMENDMENT AGREEMENT Number Adminco 1-3 1. Identification of Contract to be Amended. Number: Adminco-1, as amended by Adminco 1-1 and Adminco 1-2 Department: County Administrator Subject: Workers ' Compensation Claims and Administration Service Effective Date of Contract: July 1 , 1977 2. Parties. The County of Contra Costa, California (County) for its Department named above, and the following named Contractor mutually agree and promise as follows: Contractor: Adminco Capacity: California Corporation Address: 2815 Mitchell Drive Walnut Creek, CA 94598 3. Amendment Date. The effective date of this Contract Amendment Agreement is July 1, 1979 4. Amendment Specifications. The Contract identified above is hereby amended as set forth in the "Amendment Specifications" attached hereto which are incorporated herein by reference. 5. Legal Authority. This Contract Amendment Agreement is entered into under and subject to the following legal authorities: Government Code Section 31000. 8 6. Signatures. These signatures attest the parties' agreement hereto. COUNTY OF CONTRA COSTA CALIFORNIA CONTRACTOR By ��. &/ By Chairman, Board of Supervisors (Designate official capacity in organi- zation and affix corporation seal or Attest: J. R. Olsson, County Clerk attach resolution of governing board) State of California ) By , /� �je� , County of Contra Costa ) ss' -�� Deputy ACKNOWLEDGEMENT (CC 1190. 1) The person signing above for Contractor, Recommended by Department known to me in those individual and business capacities, personally appeared before me today and acknowledged that By he/they signed it and that the corporation Designee or partnership named above executed this instrument pursuant to its bylaws or a resolution of its b Form Approved: County Counsel ' OFFICIAL sNn, PEAR� TELLf Dated: atELLf IAHk VIIHIIL - CALIFORNIA COUNTY OF ALAMEDA By My Commission Expires sept.tl,tssl Deputy Notary Public/Deputy County Clerk (A-4622 REV 8/78) A AMENDMENT SPECIFICATIONS Number: Adminco-1-3 In consideration of Contractor ' s agreement to extend services as set forth in the Service Plan incorporated by reference into Contract Number Adminco-1, as amended by Contracts Numbers Adminco 1-1 and Adminco 1-2 , County and Contractor agree to further amend the contract identified herein as specified below: 1. Term. The term of the contract is extended to June 30, 1980. 2 . Payment Limit. County' s total payments to Contractor under this contract is increased by $78 , 720 for the extended term of the contract (July 1, 1979 through June 30, 1980) to a total amount of $203 , 400. Payment increase is attributable to projected additional claims to be handled by Contractor. 3. Payment Amounts. Subject to the payment limits of the contract as increased by this modification, County will pay Contractor $6 , 560. 00 monthly. The following amendment is added to the contract: 4 . Payment Modifications. In the event of a reduction in County work force due to the operation of Article XIII A of the California Constitution (Proposition 13) with a concomitant material decrease in the projection of 1150 claims for the year, the amount of the monthly payment will be subject to further negotiation. All other terms and conditions of this agreement are to remain unchanged and, in full force and effect. Initials : Cont actor County Department OFFICE OF COUNTY ADMINISTRATOR 7RECEIVED CONTRA COSTA COUNTY t_r� , E. H. Hasseltine 1 B79 N. C. Fanden Administration Building J. R. OLSSON T. Powers Martinez, California CLERK BOARD F UP RVISORS R. I. Schroder C T TA To: S. W. McPeak Date: September 6, B ' + M. G. Wingett, From: County Administra or Subject: Adminco Contract (Item 6g) by F. Fernandez T Upon embarking on our self-insured workers ' compensation insurance program, proposals for claims and administrative services were solicited from most of the major firms in this field with public agency experience. Adminco was selected on the basis of the proposal submitted and negotiations were conducted on the provision of services over a three year term. Multi-year arrangements are usually .made for such services due to substantial start-up costs and staffing commitments. Rather than one contract for the entire period, it was suggested by County Counsel that annual agreements be entered into which will readily allow for necessary changes. The Personnel Department and this office are pleased with the services provided by Adminco. The Contra Costa County Fire Protection District and the Riverview Fire Protection District are included in this program and each is charged for its share of this expense. Under this arrangement the county will pay $63 , 750; Contra Costa Fire, $11, 130; and Riverview Fire, $3 , 840. Based upon a projection of 1150 claims, the cost .will approximate $68 per claim which is considered a reasonable charge for the service performed. FF: lm RECEIVED ,-P I1 I J- R OLSSON CLERK BOA F SSU ERVISORS u a� In the Board of Supervisors of Contra Costa County, State of California July 25 fig 78 In the Matter of Contract Amendment Agreement with Adminco (Adminco-1-2) IT IS BY THE BOARD ORDERED that its Chairman is AUTHORIZED to execute second amendment to contract with Adminco for worker' s compensation claims services effective July 1, 1978 , to extend the term of the contract to June 30 , 1979 and to increase total payments to contractor by $68 ,120 for the extended period. Passed by the Board on July 25, 1978. i r I hereby certify that the foregoing is a true and correct copy of an order entered on the minutes of said'Board of Supervisors on the date aforesaid. Orig: Administrator Witness my hand and the Seal of the Board of cc: Contractor- ye 4-4z( Supervisors Auditor-Controller affixed this 25th day of July 1978 Director of Personnel Treasurer-Tax Collector County Counsel J. R. OLSSON, Clerk Retirement Administratio y Deputy Clerk M ine M. Neuf d �H - 24 4/77 15m CONTRACT AMENDMENT AGREEMENT (Contra Costa County) Number: Adminco-1-2 1. Identification of Contract to be Amended. Number: Adminco-1, as amended by Adminco 1-1 Department: County Administrator Subject: Workers ' Compensation Claims Service Effective Date of Contract: 7-1-77 2. Parties. The County of Contra Costa, California (County) , for it Des Des its named above, and the following named Contractor mutually agree and promise as follows : Contractor: Adminco Capacity: California Corporation Address : 1333 Broadway, Oakland, CA 94612 3 . Amendment Date. The effective date of this Contract Amendment Agreement is 7-1-78 . 4 . Amendment Specifications. The Contract identified above is hereby amended as set forth in the "Amendment Specifications" attached hereto which are incorporated herein by reference. 5. Legal Authority. This Contract Amendment Agreement is entered into under and subject to the following legal authorities : Government Code Section 31000 . 8 6 . Signatures. These signatures attest the parties ' agreement hereto. COUNTY OF TA, CALIFORNIA CONTRACTC) �. 1. Schrnd@r by ' by /429!i"14 Chairman, Board of Supervisors (Designate official capacity Attest: J. OLSSON, County Clerk in business and .affix corporation seal)15e( y State of California ) puty County of Contr« 'Costa ) Recommended by Department ACKNOWLEDGEDMENT "(cc 1190 . 1) The person signing above for Contractor known to me in those by individual and business capac- Designee ities, personally appeared before me today and acknowledged that he/they signed it and that the corporation or partnership nambed above executed the within instrument pursuant to its bylaws or a resolution of its board of directors. Dated: q Notary Public/De-14 + ^} ^lern 2 OFFICIAL SEAL WWTA P. PDWRU • NOTART PUBLIC - CAUFORW COUNTY OF ALAMEDA r/il■INttlo�feQMs trµ.i1J111 �� Microfilmed with board order AMENDMENT SPECIFICATIONS Number: Adminco-1-2 In consideration of Contractor' s agreement to extend services as set forth in the Service Plan to Contra Costa. County, Contra Costa County Fire Protection District, County and Contractor agree to further amend Contract Adminco-1 as specified. below: 1. Term. The term of the agreement is extended to June 30, 1979. 2. Payment Limit. County' s total payments to Contractor under this contract is increased by $68 ,120 for the extended term of the contract (July 1, 1978 through June 30, 1979) to a total amount of $124 , 680. Payment increase is attributable to projected additional claims to be handled by Contractor. . 3 . Payment Amounts. Subject to the payment limits of the contract as increased by this modification, County will pay Contractor $5, 676 . 66 monthly. The following amendment is added to the contract: 4 . Payment Modifications. In the event of a reduction in County work force due to the operation of Article XIII A of the California Constitution (Proposition 13) which becomes effective July 1, 1978 , with a concomitant material decrease in the projection of 800 claims for the year, the amount of the monthly payment will be subject to further negotiation. All other terms and conditions of this agreement are to remain unchanged and in full force and effect. Initials: ---- � C591tractor Count D partment BOARD OF SUPERVISORS, CONTRA COSTA COUNTY In .the Matter of Establishment ) of Workers' Compensation Reserve ) Trust Fund for the Contra Costa ) RESOLUTION No. 77/1078 County Fire Protection District ) and the Riverview Fire Protection) District ) - The Board of Supervisors of the County of Contra Costa has deemed it to be in the best interest of the Contra Costa County Fire Protection District and the Riverview Fire :Protection District to establish a program of self-insurance as regards the worker§' compensation program; and It is the policy of this Board that estimated liabilities be fully funded., during the fiscal year in which their approximate amounts can be determined and that reserves be accumulated to cover catastrophic losses and losses incurred but not reported; and A trust procedure is appropriate for financing obligations arising from workers' compensation claims; NOW, THEREFORE, IT IS BY THE BOARD RESOLVED that : 1. The County Auditor-Controller is hereby requested to establish trust funds , effective January 1 , 1978, for each aforesaid District which shall be titled "Workers' Compensa- tion Reserve Trust Fund" hereafter referred to as "reserve fund." 2 . There shall be deposited into each of the reserve funds a. Amounts appropriated in the operating budget of each District as finally approved by the Board of Super- visors . These amounts shall be transferred at times and in such amounts and manner as authorized by the County Administrator. b . Workers' compensation subrogation recoveries . C . Interest earned on investments of the reserve fund. 3. The County Administrator shall determine which workers, compensation claims , if any, shall be paid directly by the District rather than by any administering farm, for example, temporary disability payments to employees qualifying for the Continuing Pay Plan. The Auditor-Controller is authorized to charge these claim payments directly to the appropriate reserve fund. 4. The Auditor-Controller is authorized to draw warrants on the proper reserve fund to pay costs and expenses related to claims , contract administration costs and excess insurance premiums for policies ordered. PASSED by the Board on December 27 , 1977 . - Orig: CAO CERTIFIED COPY i certify that this is a full, true & correct copy of cc. Treasurer-Tax Collector the original document which is on file in my office, Auditor-Controller and that it was passed & adopted by the Board of CountCounsel Supervisors of CNontra costa County. California, an County the date shnwn. ATTEST: J. R. OLSSO , County Director of Personnel Clerk&ex-officio Clerk of said Board of Supervisors, County Administrator by Deputy Clerk. Retirement Administration a� 77 RESOLUTION NO. 77/1078 CONTRACT AMENDMP,[,T AGREEIMIENT (ConVra Costa County) Number Adminco-1-1 I . IdenLif i.cati_on o-f Contract to be Amended . Number : Adminco-1 Department : Civil Service SubjecL : Workers Compensation Claims Service iiffecLive Date of Contract : 7/1/77 I P< rtie-;; . 7'he County of. Contra Costa , Ca-lifornia (County) , Contra -i-ts DepirLmen.t named above , and the. following named Contractor ,,•iutually agree and upromise as follows : Contractor: . Adminco Capacity : California Corporation Address : 1333 Broadway, Oakland, CA 94612 3 . Arundiixunt. Date . The effective date of this - Contract Amendment-yreement is 1/1/78 Amendment Specifications . The Contract identified above is hereby amended as set forth in the "Amendment Specifications" attached hereto which are incorporated herein by reference . 5 . Legal. Authority . This Contract Amendment Aar.eement is entered into under and subject to the following legal authorities : Government Code Section 31000 . 8 6 . Signatures . "hese signatures attest the parties ' agreement hereto . COUNTY C COSTA, CALIFORNIA CONTRACTOR By- k d ou-- By airman , ),ervisors ' •4��i� UrLC ` P - "- - _ Designate official capacity Attest : J . R. OLSSON, County Clerk in business and .rffix corporation seal=) D u L y State of California ) County of Contra Costa) Recomn ended by DepartmentID ACKNOWLEDGEMENT IT (CC 1.190 . 1) 1'y_ The person signing above Designee in CnntracLOr known to me in those individual and business capacities , personally appeared before me today and acknowledged that he/they signed it and that the corporation or partnership named above executed the within instrument pursuant to its bylaws or a resolution of its board of dir-Jectors . OFFICIAL SEAL Dated : I a ROBERTA P. PENARELLI �• so NOTARY PUBLIC CAUFDRNIAJ COUNTY OF AIAMEDA M/ Commission Expires sepc.n,ceec ary Public/Deputy County Clerk Mkrofilmed with board order AMENDMENT SPECIFICATIONS Number Adminco-1-1 In consideration of Contractor ' s agreement to extend services as set forth in the Service Plan to the Contra Costa County Fire Protection District and the Riverview Fire Protection District , County agrees to increase the amount payable to Contractor under the Payment Limit (paragraph 4). by an additional $13, 120 . County and Contractor agree , therefore, to amend the contract identified herein, as specified below, while all other parts of the contract remain unchanged and in full force and effect : 1 . Payment Limit Increase : The total amount payable to Contractor, as, specified in paragraph 4 (Payment Limit) of said contract, is hereby increased from $50 , 000 to $56 , 560 . The increase of $6 , 560 is to be allocated by County to the Contra Costa County Fire Protection District ($4, 880) and the Riverview Fire Protection District ($1, 680) . 2 . Payment Provisions Increase : The monthly payment to Contractor, as specified in paragraph -1 (a) -of the Payment Provisions , is- hereby increased from $4, 166 . 66 monthly to $5 , 260 monthly . 3 . Project Extension : The workers ' compensation self-insurance . services, as specified in pages 1 and 2 of Service Plan, are hereby extended in the same form and manner, to the Contra Costa County Fire Protection District and the Riverview Fire Protection District, effective January 1 , 1978 . Initials : Co tra for County Dept . j i I BOARD OF SUPERVISORS, CONTRA COSTA COUNTY In the Matter of Implementing ) Government Code §31000 . 8 Respecting Workers Compensation ) RESOLUTION N0. 77/401 Claims ) ) The Board of Supervisors of the County of Contra .Costa has deemed it to be in the best interest of the County to establish a program of self-insurance as regards the workers compensation program; and Pursuant to Government Code Section 31000 . 83 this. Board will contract with a qualified firm for the purpose of having such firm render investigative , administrative, and claims adjust- ment services relating to workers compensation claims against the County ; and ' In order to administer the workers compensation self-insurance program properly and effectively , it is necessary that authority be granted pursuant to Government Code §31000 . 8 to promptly reject , settle , compromise and approve workers compensation claims . NOW, THEREFORE, IT IS BY THE BOARD RESOLVED: 1 . This Board approves and authorizes the Board Chairman to execute on behalf of Contra Costa County , contract no. Adminco-1 between the County and Adminco, a California corporation, for the purpose of having such firm render investigative!, administrative and claims adjustment services relating to workers compensation claims against the County, as provided in Government Code §31000. 8. 2. Adminco and/or the Director of Personnel are authorized to reject , settle, compromise , and approve for payment ; workers compensation claims not to exceed $7,500. 00 for any one person. . 3• With the .concurrence of. the Auditor-Coritro,ller. and Treasurer-Tax Collector, Adminco may execute and issue checks in payment of such workers compensation claims from the Workers Compensation Revolving Trust Fund. PASSED by the Board on June 14, 1977 cc : Treasurer-Tax Collector CERTIFIED COPY Auditor-Controller I certify that this is a full, true F correct copy, of County COU'=sel the or'.gnal 'document which is on fire in my office, and that it was passed & ador'.ed by the Board of Director Of perS01= 21 Supervisors or Contra Costa County-, California, on County Administrator the date shown. ATTEST: J. R. OLSSON, Ccuncy Clerk & ex-officio Clerk of said Board of Supervisors, Adn.iin-.o by Deputy Cterw:. p �� �.�Gti✓ . `_ lie . d . RESOLUTION .NO. 77/491 a � I� Cu:ctra -Ctt sta County � � Standard Form STANDARD CONTRACT (Purchase of Services) 1. Contract Identification. Number Adminco-1 Department : Civil Service Subject: Workers Compensation Claims Services 2. Parties. The County of Contra Costa California (County) , for its Department named above, and the following named Contractor mutually agree and promise as follows: Contractor: Adm inco Capacity: California Corporation Address: 1333 Broadway, Oakland CA 94612 3. Term'. The effective date of this Contract is July 1 , 1977 and it terminates June 30 , 1978 unless sooner terminated as provided herein. 4. PayTent Limit. County's total payments to Contractor under this Contract shall not exceed $ 50 ,000 . 00 . 5. County's Obligations. County shall make to the Contractor those payments described in the Payment Provisions attached hereto which are incorporated herein by reference, subject to all the terms and conditions contained or incorporated herein. 6. Contractor's Obligations. Contractor shall provide those services and carry out that work described in the Service Plan attached hereto which is incorporated herein by reference, subject, to all the terms and conditions contained or incorporated herein. 7. General and Special Conditions. This Contract is subject to the General Conditions and Special Conditions (if any) attached hereto, which are incorporated herein by reference. 8. Project. This Contract implements in whole or in part the following described Project, the application and approval documents of which are incorporated herein by reference: Adminco Proposal of Service to Contra Costa County , Workers Compensation (Permissibly Uninsured) Self-Insurance 9. Legal Authority. This Contract is entered into under and subject to the following legal authorities: Government. Code §31000 . 8 10. Signatures. These signatures attest the parties' agreement hereto: CO TY OF C KTR��COSTA, CALIFORNIA CONTRACTOR �pj M- a°S BY ��' - - Chairman, Board o Supervisors y Thomas R. Leon2r Beni nr Vl P-Pr> "i (Designate official capacity in business At;-est: J. R. Olsson,: County Clerk and affix corporation se,-.1) � State of California ) , BI County of Contra Costa Deputy ACKNOWLEDGEMENT (CC 1190:1) The person signing above for Contractor Recommended by Department known to me in those individual and business capacities, personally appeared before me today and acknowledged that he/ By �_ they signed it and that the corporation Designee or partnership named above executed the within instrument pursuant to its bylaws or a resolution of its board of directors. Form Approved: County Counsel r 9�7� Dated: ARTHUR W. Wr\LENTA,JR: �/-_F��KG����K'� By Deputy 6d Microfilmed Notary Publ / eputy County Clerk Microfilmed with board order CHIEF DEPUTY COUNTY COUNSL'L CONTRA COSTA CuU,�iN, CALIF, ,(A 4617 REV 6/76) _ Contra Costa County Standard Form PAYMENT PROVISIONS (Fee Basis Contracts) Number Adminco-1 1. Payment Amounts. Subject to the Payment Limit of this Contract and subject to the following Payment Provisions, County will pay Contractor the following fee: [Check one alternative only. ] [ X] ,a• $ L�166 . 6h _ monthly, or [ ] b. $ per unit, as d"Ofined in the Service Plan, or [ ] c. $ after completion of all obligations and conditions herein and as full compensation for all services, work, and expenses provided or incurred by Contractor hereunder. 2. Payment Demands. Contractor shall submit written demands monthly or as specified in 1. (Payment Amounts) above, for payment in accordance with Paragraph 1. (Payment Amounts) above. Said demands shall be made on County Demand Form D-15 and in the manner and form prescribed by County. Contractor shall submit said demands for payment for services rendered no later than 90 days from the end of the month in which said services are actually rendered. Upon approval of said payment demands by the head of the County Department for which this Contract is made or his designee, County will make payments as specified in Paragraph 1. (Payment ,Amounts) above. 3. Right to Withhold. County has the right to withhold payment to the Contractor when, in the opinion, of the County expressed in writing to the Contractor, (a) the Contractor's performance, in whole or in part, either has not been carried out or is insufficiently documented, (b) the Contractor has neglected, failed or refused to furnish information or to cooperate with any inspection, review or audit of its program, work or records, or (c) Contractor has failed to sufficiently itemize or document its demand(s) for payment. 4. Audit Exceptions. Contractor agrees to accept responsibility for receiving, replying to, and/or complying with any audit exceptions by. appro.priate County, State, or Federal audit agencies occurring as a result of its performance of this Contract. Contractor also agrees to pay to the County within 30 days of demand by County the full amount of the County's liability, if any, to the State and/or Federal government resulting from any audit exceptions, to the extent such are attributable to the Contractor's failure to perform properly any of its obligations under this Contract. II (A-4619 REV 6/76) I SERVICE PLAN Number: Adminco-1 In accordance with the written proposal submitted to the County , the Contractor shall perform the following services : A. Program Implementation 1 . Conduct educational meetings prior to the effective date of self-insurance for the purposes of introducing the system and de- veloping rapport with County personnel. Provide complete instructions and all forms . 2 . Establish departmental coding for reporting purposes in accordance with County ' s needs and desires . 3 . Establish occupation coding specifically for the County for future statistical reports . 4 . In cooperation with County personnel, notify medical providers of the change to self-insurance . h 5 . Arrange with the County the convenient scheduling of regular monthly coordination visits to discuss on an ongoing basis all aspects of the service program. 6 . With County permission and as necessary, contact injured employees to explain benefits and aspects oftheir claim in an effort to develop an atmosphere of cooperation and promote "litigation avoidance . " B. Claims Management 1 . Conduct initial and continuing educational meetings and seminars with any of County personnel designated anywhere in the County. 2 . Provide "claims kits" containing written guidelines for the reporting of industrial injuries , including all necessary forms . 3. Examine and process all County industrial cases in accord- ance with the requirements of the Department of Industrial Relations and the Workers Compensation Appeals Board. Conduct such investigation of cases as deemed necessary. 4 . Maintain a physical record or claim file of each industrial injury reported to County , in addition to Contractor' s normal data processing records , which shall be available for inspection at all times by County . 5 . Determine on behalf of County what benefits should be paid under the applicable Workers Compensation laws for each reported claim. 6 . Pay compensation and medical expense out of funds provided by the County . The Contractor shall not reject , settle , compromise and approve any claims which exceed $7 ,500 without prior County authorization and shall consult with the County on all cases which have the potential of approaching such amounts . 7 . Maintain on a case-by-case basis current estimates of future cost . 8 . When indicated and with County approval , retain on County behalf certain necessary services such as legal defense ; specialized professional investigation, and rehabilitation. 9 . Develop a claim payment system acceptable to County and coordinate it wit.. County ' s salary continuation program. Furnish without additional charge to County all forms necessary to implement the program. 10 . Prepare all necessary reports to the various State agencies . -1- C . Rehabilitation and Severity Control Program 1 . Contractor shall develop , and with approval by County , implement procedures for an employee rehabilitation and severity control program to encourage early return of the injured worker to the job . D. Safety and Loss Control 1. Assist County ' s loss control personnel :in the review of existing safety and loss control programs and assist in the maintenance of these programs , including promotion, training, evaluation of perform- ance , identification of hazards , accident investigation and evaluation. 2 . Perform physical surveys of County operations on a regular basis and provide detailed written reports (OSHA oriented) . 3 . Provide periodic reviews of County ' s accident experience with appropriate personnel of the County . 4 . Participation in safety and loss control meetings as often as agreed upon. 5 . Provide statistical data for identification of loss trends . 6 . Assist in any way possible to control occupational hazards that contribute to industrial injuries . E. Statistical Data Provide for County all statistical logs and reports necessary to meet CAL/OSHA requirements and for management purposes as requested by County . I -2- /// SPECIAL CONDITIONS Number: Adminco-1 First : The General Conditions of this Contract are modified as follows : 1 . General condition 5 . Termination, a. Written Notice , is modified to provide for sixty-day advance written notice . 2 . General condition 5 . Termination, c . Cessation of Funding, is eliminated. 3 . General condition 13. Subcontract and Assignment , is modified to read as follows : 13. Subcontract and Assignment . This Contract binds the heirs , successors , assigns and representatives of Contractor. The Contractor shall not assign this Contract or monies due or to become due , without the prior written consent of the County Administrator or his designee , subject to any required State or Federal approval. 4 . General condition 18. Indemnification, is modified to read as follows : 18. Indemnification. The Contractor shall defend, save harmless and indemnify the County .and its officers , agents and employees from all liabilities and claims for damages for death, sickness or injury to persons or property , including,: without limitation, all consequential damages , from any cause whatsoever, arising from or connected with the operations or the services of the . Contractor hereunder, resulting from the conduct , negligent or otherwise , of the Contractor, its agents or employees . Notwithstanding the foregoing, however, nothing herein contained in this service agreement with respect to Company ' s furnishing . safety or loss control services , shall constitute 'an undertaking on behalf of or for the benefit of the County or others to determine or warrant that such performance or operations are safe or healthful. 5 . General condition 19 . Insurance , parts b . Workers Compensation . and c . Additional Provisions , only, are modified to read as follows : b . Workers Compensation. The Contractor shall provide workers compensation insurance coverage- for its employees . C . Additional Provisions . The policies shall include a provision for thirty ( 30T days written notice to County before cancellation or material change of the above specified coverage . Said policies shall constitute primary insurance for any claims as to the County , the State and Federal Governments , their officers , agents , and employees , so that other insurance policies held by them shall not be required to contribute to any loss covered under the Contractor' s insurance policy or policies . Not later than the effective date of this Contract , the Contractor shall provide the County with a certificate( s ) of insurance evidencing the above comprehensive liability and workers compensation insurance coverage . 6 . General condition 20 . Notices is modified to read as follows : 20 . Notices . All notices provided for by this Contract shall be in writing and may be delivered by deposit in the Un=ited States mail , postage prepaid. Notices to the County shall be addressed to the County Department for which this Contract is made , c/o Safety Division, 651 Pine Street , Martinez , California 94553 • Notices to the Contractor shall be addressed to the Contractor' s address designated herein. The effective date of notice shall be the date of deposit in the mails or of other delivery . Second : The Payment Provisions of this contract are modified so that Payment Provisioni4 . Audit Exceptions , is eliminated. Third : As additional insurance during the entire term of this Contract and any extension or modification thereof, the Contractor shall keep in -1- of,pct Insurance policies croviding coverage in favor of the County for errors and omissions , an'd employee dishonesty and fidelity , at limits not .less than $1 , 000 ,000 . 00 . Contractor shall provide Certificates of Insurance evidencing that the above reauired insurance coverages are in effect . Fourth : In the event of termination, the Contractor will be obligated to deliver all data, records and information developed with respect to County ' s program includin all loss records to the County on the estab- lished termination data. Such records will be current and in good condition to assist County in the transition desired by County . All claims files , documents , and data prepared by Contractor under this agreement shall be and become upon termination of this agreement County property . All of the foregoing, together with all ]-�nowledge otherwise acquired by Contractor during the term hereof relating to County business is considered confidential information and shall not be disclosed or used , directly or indirectly , at any time other than for the performance of services under this agreement unless written consent is first obtained from County . -2- a1 .Contra Costa County . Standard Form GENERAL CONDITIONS (Purchase of Services) 1. Compliance with Law. Contractor shall be subject to and comply with all Federal, State and local laws and regulations applicable with respect to its performance hereunder, including but not limited to, licensing, employment and purchasing practices; and wages, hours and conditions of employment. 2. Inspection. Contractor's performance, place of business and records pertaining to this Contract are subject to monitoring, inspection, review and audit by authorized representatives of the County, the State of California, and the United States Government. 3. Records. Contractor shall keep and make available for inspection by authorized representatives of the County, the State of California, and the United States Government, the Contractor's regular business records and such additional records pertaining to this Contract as may be required by the County. 4. Retention of Records. The Contractor and County agree to retain all documents pertaining to this Contract for three years from the date of submission of Contractor's final payment demand or final Cost Report (whichever is later) under this Contract, and until all Federal/State audits are complete and exceptions resolved for the funding period covered by this Contract or for such further period as may be required by law. Upon request, Contractor shall make these records available to authorized representatives of the County, the State of California, and the United States Government. 5. Termination. a. Written Notice. This Contract may be terminated by either party, at their sole discretion, upon thirty-day advance written notice thereof to the other, or cancelled immediately by written mutual consent. b. Failure to Perform. The County, upon written notice to Contractor, may terminate this Contract should the Contractor fail to perform properly any of its obligations hereunder. In the event of such termination, the County may proceed with the work in any reasonable manner it chooses. The cost to the County of completing Contractor's performance shall be deducted from any sum due the Contractor under this Contract. C. Cessation of Funding. Notwithstanding Paragraph 5.a. above, in the event that Federal, State., or other non-County funding for this Contract ceases, this Contract is terminated without notice. 6. Entire Agreement. This Contract contains all the terms and conditions agreed upon by the parties. Except as expressly provided herein, no other understandings, oral or otherwise, regarding the subject matter of this Contract shall be deemed to exist or to bind any of the parties hereto. 7. Further Specifications for Operating Procedures. Detailed specifications of operating procedures and budgets required by this Contract, including but not limited to, monitoring, auditing, billing, or regulatory changes, may be developed and set forth in a written Informal Agreement entered between the Contractor and the County. Such Informal Agreements shall be designated as such and shall not be amendments to this Contract except to the extent that they further detail or clarify that which is already required hereunder. Such Informal Agreements may not enlarge in any manner the scope of this Contract, including any sums of money to be paid the Contractor as provided herein. Informal Agreements may be approved and signed by the head of the County Department for which this Contract is made or his designee. 8. Modifications and Amendments. a. General Amendments. This Contract may be modified or amended by a written document executed by the Contractor and the Contra Costa County Board of Supervisors or, after Board approval, by its designee, subject to any required State or Federal approval. b. Administrative Amendments. Subject to the Payment Limit; the Payment Provisions and the Service Plan may be amended by a written administrative amendment executed by the Contractor and the County Administrator or his designee, subject to any required State or Federal approval, provided that such administrative amendments may not materially change the Payment Provisions or the Service Plan. - (A-4616 REV 6/76) -1- Contra. Costa County • Standard Form GENERAL CONDITIONS• (Purchase of Services) 9: Disputes. Disagreements between the County and Contractor concerning the meaning, requirements,, or performance of this Contract shall be subject to final determination in writing by the head of the County Department for which this Contract is made or- his designee or in accordance with the applicable procedures (if any) required by the State or Federal Government. 10. Choice of Law and Personal Jurisdiction. a. This Contract is made in Contra Costa County and shall be governed and construed in accordance with the laws of the State of California. b, Any action relating to this Contract shall be instituted and prosecuted in the- courts of Contra Costa County. 11. Conformance with Federal and State Regulations. Should Federal or State regulations touching upon- the subject of this Contract be adopted• or revised during the term hereof, this Contract shall be amended to assure conformance with such Federal or State requirements. 12: No Waiver by County. Subject to Paragraph 9i.. (Disputes) of these General Conditions, inspections or approvals, or statements by any officer, agent or employee of the County indicating the Contractor's performance or any part thereof complies with the requirements of this Contract, or acceptance of the whole or any part of said performance, or payments therefor, or any combination of these acts,. shall not relieve the Contractor's obligation to fulfill this. Contract as prescribed;. nor shall the County be thereby estopped from bringing any action for damages or enforcement arising, from any failure to comply with any of the terms and conditions hereof. 13. Subcontract and Assignment. This Contract binds the heirs, successors, assigns and representatives of Contractor. The Contractor shall not enter into subcontracts for any work contemplated under this Contract and shall not assign this Contract or monies due or to become due, without the prior written consent of the County Administrator or his designee, subject to any required State or Federal approval.. 14. Independent Contractor Status. This Contract is by and between two independent contractors and is not intended to and shall not be construed to create the relationship of agent, servant, employee, partnership, joint venture or association. 15. Conflicts of Interest. Contractor promises and attests that the Contractor and any members of its governing body shall avoid any actual or potential conflicts of interest. If Contractor is a corporation,, Contractor agrees to furnish to the County upon demand a valid copy of its most recently adopted bylaws and also a complete and accurate list of its governing body (Board of Directors or Trustees) and to timely update said bylaws or the list of its governing body as changes in such governance occur. 16. Confidentiality. Contractor agrees to comply and to require its employees to comply with all applicable State or Federal statutes or regulations respecting confi- dentiality, including but not limited to, the identity of persons served under this Contract, their records, or services provided them, and assures that: a. All applications and records concerning any individual made or kept by Contractor or any public officer or agency in connection with the administration of or relating to services provided under this Contract will be confidential, and will not be open to examination for any purpose not directly connected with the administration of such service. b. No person will publish or disclose or permit or cause to be published or disclosed, any list of persons receiving services, except as may be required in the administration of such service. Contractor agrees to inform all employees, agents and partners of the above provisions, and that any person knowingly and intentionally ' disclosing such information other than as authorized by law may be guilty of a misdemeanor. 17. Nondiscriminatory Services. Contractor agrees that all goods and services under this Contract shall be available to all qualified persons regardless of age, sex, race, religion, color, national origin, or ethnic background, and that none shall be used, in whole or in part, for religious worship or instruction. (A-4616. REV 6/76) -2- ' {C•o .tfa Costa County . Standard Form GENERAL CONDITIONS • I (Purchase of Services) 18. Idemnification. The Contractor shall defend, save harmless and indemnify the County and its officers, agents and employees from all liabilities and claims for damages for death, sickness or injury to persons or property, including without limitation, all consequential damages, from any cause whatsoever arising from or connected with the operations or the services of the Contractor hereunder, resulting from the conduct, negligent or otherwise, of the Contractor, its agents or employees, the County, its agents or employees, or any other person or entity. 19. Insurance. During the entire term of this Contract and any extension or modification thereof, the Contractor shall keep in effect insurance policies meeting the following insurance requirements unless otherwise .expressed in the Special Conditions: a. Liability Insurance. The Contractor shall provide a policy or policies of comprehensive liability insurance, including coverage for owned and non-owned auto- mobiles, naming the County and its officers and employees as additional insureds, with a minimum combined single limit coverage of $500,000 for all damages because of bodily injury, sickness or disease, or death to any person and damage to or destruction of property, including the loss of use thereof, arising from each accident or occurrence. b. Workers' Compensation. The Contractor shall provide the County with a certificate of insurance evidencing workers' compensation insurance coverage for its employees. i i c. Additional Provisions. The policies shall include a provision for thirty (30) days written notice to County before cancellation or material change of the above specified coverage. Said policies shall constitute primary insurance as to the County, the State and Federal Governments, their officers, agents, and employees, so that other insurance policies held by them shall not be required to contribute to any loss covered under the Contractor's insurance policy or policies. Not later than the effective date of this Contract, the Contractor shall provide the County with a certificate(s) of insurance evidencing the above liability insurance. 20. Notices. All notices provided for by this Contract shall be in writing and may be delivered by deposit in the United States mail, postage prepaid. Notices to the County shall be addressed to the head of the County Department for which this Contract is made, c/o Contracts & Grants Unit, Human Resource: Agency, 651 Pine Street, Martinez, California 94553. Notices to the Contractor shall be addressed to the Contractor's address designated herein. The effective date of notice shall be the date of deposit in the mails or of other delivery. 21. Primacy of General Conditions. Except for Special Conditions which expressly supersede General Conditions, the Special Conditions (if any) and Service Plan do not limit any term of the General Conditions. 22, Nonrenewal. Contractor understands and agrees that there is no representation, implication, or understanding that the services provided by Contractor under this Contract will be purchased by County under a new contract following expiration or termination of this Contract, and waives all rights or claims to notice or hearing respecting any failure to continue purchase of all or any such services from Contractor. 6/76) _3_ (A-4616 .ORE IPI .THE BOARD OF SUPERVISORS i OF CONTRA COSTA COUNTY, STATE OF CALIFORNIA I In the Matter of Self-Insuring ) Workers ' Compensation Liability. ) June 14 , 1977 The County .Administrator having presented a report dated June 9 , 1977 entitled "5,'orkers ' Compensation Self:-Insurance Program" wherein it is recommended that the Country should proceed immediately to complete the actions necessary to self-insure the workers ' conpensation risk, effective July 1 , 1977 ; anc? The Board having reviewed the report and discussed the proposal and having deemed it to be in the best interest of the County to establish the program of self-insurance does hereby authorize the following actions .- 1. ctions :1. The self-insurance program is to include. all County government departments and employees and be effective July 1, 1977 . It is determined that no excess insurance will be purchased and that in-lieu thereof adequate reserves should be built up to cover such contingencies as may develop. Following implementation of the County program, staff is directed to study possible extension of self-insurance of the workers ' compensation risk to districts and other public agencies for whicil the Board of Supervisors acts as the governing body, such as County Fire Protection Districts. 2. Direct County staff, with assistance provided by ,the Contractor (Adminco) , to establish procedures for implementation. of the system and to appropriately charge departments for workers' compensation costs . ' 3. Direct the Countv Administrator to include in the proposed County budget appropriations considered adequate and prudent to finance County liabilities and obligations arising under the self-insurance program; such appropriations to be subject to annual budget review and approval by the Board of Supervisors. 4. Direct that an effective safety and loss control program be established and that. all department heads and employees pay particular attention to such a. program and cooperate fully in achieving goals and objectives established . In connection therewith and in order to -place additional emphasis on this program, authorize an additional position of Safety Services Specialist I to be assigned to the Safety Division, Civil Service Department. PASSED by the .Board on June 14 , 1977. CERTIFIED COPY CC , County Auditor—Controller $ oertlfy that this is a full, true & correct copy of County Treasurer-Tax Collecter the original document which is on file in illy office. Director of Personnel and that it was passed Fs ado- ted fay the Board of Supervisors of Contra Costa County. Cailfornia, on County . Counsel the date shown. ATTEST: J. V. 01,Sc0tiT, County County .Administrator Clerk & ex-officio Clerk of said Board of Supervisora y by Deputy Clerk, jUN 1 d _1977