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HomeMy WebLinkAbout2011-306 CONT Addendum - Beecher Carlson Insurance ADDENDUM TO CITY OF ASHLAND CONTRACT FOR RISK MANAGEMENT ADVISOR Addendum made this 15TH day of November, 2011, between the City of Ashland ("City") and Beecher Carlson Insurance Agency, LLC ("Consultant"). Recitals: A. On December 3. 2008 the City and Consultant entered into a "City of Ashland Contract for a Risk Management Advisor" (further referred to in this addendum as "the agreement"). B. The parties desire to amend the agreement to extend the date of completion and include the compensation to be paid to the Consultant for the additional term. City and Consultant agree to amend the agreement in the following manner: 1. The date for completion is extended to December 31, 2012 and the compensation for the term beginning January 1, 2012 and ending on December 31, 2012 will be $17,505.00, 2. Except as modified above the terms of the agreement shall remain in full force and effect. CONS CITY OF ASHLAND: BY BY eS� D partment ead Its Date �?d DATE _0 c Purchase Order# ` Acct. No.: 2"lao . o3. c�. crtm. �oL1(TO (For City purposes only) 1-CITY OF ASHLAND,ADDENDUM TO CONTRACT FOR RISK MANAGEMENT ADVISOR CONSULTING FEE AGREEMENT General Beecher Carlson Insurance Agency LLC (hereinafter Consultant) in consideration for providing services shall receive a fee directly from City of Ashland (hereinafter Client). This Agreement is not an Agent of Record letter, an authorization letter, or a proposal of services. Term This agreement shall be in effect for the period of January 1, 2012 to January 1, 2013. This agreement shall remain in effect during this term unless 60(sixty) days written notice of termination is given by either party to the other. Fee Amount Client agrees to compensate Consultant in the amount of$17,505. If combining Property/Casualty and Employee Benefit services under one fee, please indicate allocation between both services: $ Property&Casualty $ Employee Benefits If multi-year term, fee schedule as follows: Term $ Amount Term $ Amount Term $ Amount ® 3% Escalation Clause included on multi-year agreements. Payment Terms The Fee Amount shall be paid directly to Consultant by Client in equal payments. The payments shall be made: ® Annually, beginning January 1, 2012 or ❑ Other beginning lb CONSULTING FEE AGREEMENT 2 , 6. o- CERTIFICATE OF LIABILITY INSURANCE DATE(MM 2011) `/ _ 11/17/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Judith L. Boich NAME: Beecher Carlson Insurance Services, LLC P-(H E EX (678)539-4800 �aC Na;1678)539-1890 E-MAIL h®beechercarlson.com Six Concourse Parkway ADDRESS:]boic Suite 2300 PRODUCER 00011538 -CUSTOMER to#. Atlanta CA 30319 INSURERS AFFORDING COVERAGE NAICN INSURED INSURERA:Zuri Ch American Ins. Co. 16535 INSURER B:Chartis Specialty Insurance Co. 26883 Beecher Carlson Holdings Inc INSURER C: Six Concourse Parkway INSURER D: Suite 2300 INSURER E Atlanta GA 30319 1 INSURER F: COVERAGES CERTIFICATE NUMBER:11.15 Liab.E&O REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN$R TYPE OF INSURANCE PIER MD. POLICY NUMBER MMIDDDYIYrn MMILDIDI VYPY LIMITS LTR GENERAL LIABILITY EACH OCCURRENCE S 11000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 1,000,000 PREMISES Ea once) $ A CLAIMS-MADE OCCUR POS477096-01 7/17/2011 7/17/2012 MED EXP(My one person) $ 10,000 PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPX)P AGG $ Included JE F1 X POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 ANY AUTO A ALL OWNED AUTOS P05477096-01 /17/2011 /17/2012 BODILY INJURY(Per person) $ BODILY INJURY(Per atldent) $ SCHEDULED AUTOS X PROPERTY DAMAGE $ HIRED AUTOS (Per accident) X NON-OWNED AUTOS Hired 6 Norumned Auto $ Hired Cdlision $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 10,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE $ 10,000,000 DEDUCTIBLE $ A RETENTION $ 5477098-01 /17/2011 7/17/2012 $ A WORKERS COMPENSATION X WC$TATU- OTH- ANDEMPLOYERS'LIABILITY YIN T ANY PROPRIETORIPARTNEWEXECUTIVE 11 E.L.EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? MIA (Mandatory in NH) WC5477097-01 7/17/2011 /17/2012 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If es,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 B 8&O !01-330-37-61 11/15/201111/15/2012 10,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,AddlOonal Remarlts Schedule,N more apace Is required) The City of Ashland, Oregon, and its elected officials, officers and employees are included as Additional Insured, subject to policy provisions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. 20 East Main Street Ashland, OR 97520 AUTHORIZED REPRESENTATIVE Robert Hessel/.TBOICH eKkj esn ACORD 25(2009/09) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025(200909) The ACORD name and logo are registered marks of ACORD Additional Named Insureds Other Named Insureds Beecher Carlson Insurance Services LLC Additional Named Insured Beecher Carlson Insurance Agency LLC Additional Named Insured RiskCap Inc Additional Named Insured Riskcap Management LLC Additional Named Insured Riskcap Cayman LTD Additional Named Insured Sawyer Foster Insurance Services LLC Additional Named Insured OnPoint Insurance Services LLC Additional Named Insured OnPoint Underwriting Inc Additional Named Insured Beecher Carlson of Florida Inc Additional Named Insured Tribal Nation Insurance Services LLC Additional Named Insured OFAPPINF(02/2007) COPYRIGHT 2007,AMS SERVICES INC t} ,1 Page 1 / 1 J� CITY OF 1,41 [Y RECD DER - �. ASHLAND dJ'i PO NUMBER 20 E MAIN ST. 11/29/2011 10567 ASHLAND, OR 97520 (541)488-5300 VENDOR: 013898 SHIP TO: Ashland Finance Deartment BEECHER CARLSON INSURANCE (541)488-5300 LOCKBOX#79084 20 E MAIN STREET 3440 FLAIR DR ASHLAND, OR 97520 EL MONTE, CA 91731 FOB Point: Req.No.: Terms: Net Dept.: Req. Del.Date: contact: Lee Tuneberq Special Inst: Confirming? NO Description Unit PriceExt:Price_. Risk Management Advisor to provide 17,505.00 comprehensive insurance services to the City of Ashland. Flat fee for the 4th year of the contract is$17,505.00. Contract For Services Date of original agreement: 12/0312008 Beginning date: January 2, 2009 Completion date: January 1, 2012 Insurance required/On file Contract Addedum processed November 15, 2011 to extend the contract for an additional year(4th year of contract). Completion date will now be Dec 31, 2012. SUBTOTAL 17 505.00 SILL To:Account Payable TAX 0.00 20 EAST MAIN ST FREIGHT 0.00 541-552-2028 TOTAL 17,505.00 ASHLAND, OR 97520 Account Number;yK PFojectNumber 'Amount'. '' Account.Number. _ .: _ P`ecfNumber _,. _J_ :Amount E 720.03.00.00.604100 17 505.00 d Authofized Signature VENDOR COPY FORM #10 CITY OF CONTRACT AMENDMENT APPROVAL REQUEST FORM ASHLAND Request for a Change Order Name of Supplier/Contractor)Consultant: f �. o Aso S .arc. w ?total amount of ttils 5/contract amendment: Purchase Order Number: Title l Description: &rl�Per attached contract amendment Co ntracf'Amendment Original contract amount $ °a t+ (J m, crt5 100 %of original contract Total amount of Previous contract amendments %of original contract Amount of this contract amendment 111 `c3 C, crc7 3 Ll %of original contract TOTAL AMOUNT OF CONTRACT $ ` ,`, U-6 %of original contract In accordance with OAR 137-047-0800:1)The amendment is within the scope of procurement as described in the solicitation documents,Sole Source notice or approval of Special Procurement 2)The amendment is necessary to amply with a change in law that affects performance of the contract 3)The amendment results from renegotiation of the terns and conditions,including the contract price,of a contract and the amendment is advantageous to the City of Ashland,subject to all of the following conditions:a)goods and services to be provided under the amended contract are the same as the goods and services to be provided under the unamended contract;b)The City determines that,with all things considered,the amended contract is at least as favorable to the City as the unamended contract;c)The amended contract does not have a total term greater than allowed in the solicitation document, contractor approval of a Special Procurement.An amendment is not within the sane of the procurement if the City determines that if it had described the changes to be made by the amendment in the procurement documents,it would likely have increased competition or affected award of contract. Contract amendment is within the scope of procurement: YES NO' (If"NO",Council approval is required) Sourcing Method: SMALL PROCUREMENT-Less than$5,000 INVITATION- COOPERATIVE PROCUREMENT QRF or ❑Total amount of contract and cumulative REQUEST FOR PROPOSA EXEMPTION PURSUANT TO AMC 2.50 amendments<-$6,000. YES I NO we amendments ❑Total amount of original contract and cumulative ❑If'NO',amount exceeding authority requires s 25%of original contract amount or$250,000 amendments s $100K for Goods&Services, Council approval.Attach copy of Council whichever is less.YES I NO <-$75K for Personal Services,<$50K for Attorney Communication. ❑If'NO',amount exceeding authority requires Fees. YES I NO ❑ Exempt-Reason: Council approval.Attach copy of Council ❑ If'NO*,amount exceeding authority requires Communication. 2.' ' t et+wS- +council approval.Attach copy of Council xempt-Reason:s84eA-k-8 mmunication. fu ce arcn..�1! Exem t-Reason: INTERMEDIATE PROCUREMENT - SOLE SOURCE �r EME GENCY PROCUREMENT Goods&Services-$5,000 to$100.000 ❑ Total amount of is a 1}�'ei d ritten Findings:Document the nature of the Personal Services -$5,000 to$75,000 s 25%of original contract amount or$250,000 emergency,including necessity and circumstances ❑ Total amount of cumulative amendments whichever is less.YES I NO requiring the contract amendment s 25%of original contract amount.YES 1 NO ❑If'NO',amount exceeding authority requires ❑ Obtain direction and written approval from City ❑If'NO*,amount exceeding authority requires Council approval.Attach copy of Council Administrator Council approval.Attach copy of Council Communication. ❑ If applicable,attach copy of Council Communication. ❑ Exempt-Reason: Communication ❑ Exempt-Reason: ❑ Exempt-Reason: SPECIAL PROCUREMENT INTERGOVERNMENTAL AGREEMENT ❑Total amount of original contract and cumulative amendments are ❑Original contract approved by City Council. YES I NO within the amount and terms initially approved by Council as a Special Provide date approved by City Council: (Date) Procurement YES 1 NO If'NO',Council approval is required.Attach copy of Council Communication. ❑ If'NO',amount exceeding authority requires Council approval. ❑ Contract amendment approved and signed by City Administrator. Attach copy of Council Communication. Project Number______-___ Account Number • 03 `'C° k� 6ok4rcOAccountNumber 'Expenditure must be charged to the appropriate account numbers for the financials to reflect the actual expenditures accurately. Attach extra pages if needed. Employee Sign Department Head Signature: Funds appropriated for current fiscal year. YE$ / NO /1-�'11� �r____ Finance Director Date Comments: Form#10-Contract Amendment Approval Request Form, Request for a Change Order, Page 1 of 1, 11/18/2011