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Home My WebLink About2009 CON Independent Forensic Services - Amendment #1 Sexual Assault Victims & SuspectsAMENDMENT TO AGREEMENT BETWEEN THE CITY OF NATIONAL CITY AND INDEPENDENT FORENSIC SERVICES, LLC This Amendment to Agreement is entered into this 1st day of July, 2009, by and between the City of National City, a municipal corporation ("the CITY"), and Independent Forensic Services, LLC, (the "CONTRACTOR"). RECITALS A. The CITY and the CONTRACTOR entered into an agreement on July 1, 2009, ("the Agreement") wherein the CONTRACTOR agreed to provide examinations of sexual assault victims and suspects for the National City Police Department located at 1200 National City Boulevard from July 1, 2009 through June 30, 2010. B. In consideration of the mutual benefit to be derived therefrom, the parties agree to amend the term of the Agreement between the City of National City and Independent Forensic Services, LLP to extend the term for one additional year, expiring on June 30, 2011, in the amount not to exceed $23,000.00 The parties further agree that with the foregoing exception, each and every term and provision of the Agreement dated July 1, 2009, shall remain in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this Agreement on the date and year first above written. CITY OF NATIONAL CITY By: a, Chris Zapa : , ►= Manager APROVED AS TO FORM: • a, Esq. City Attorne INDEPENDENT FORENSIC SERVICES, LLC By: /'C t�� Claire Nelli Owner 4276C 54TH PLACE SAN DIEGO, CA. 92115 619-501-0958 FAX 619-501-2513 ifs@cox.net INDEPENDENT FORENSIC SERVICES Effective October 1, 2009 the following increase will apply. Forensic examination of victims of sexual assault $954.00 Follow-up Forensic exams 503.50 Examinations performed at other facilities 1123.60 Suspect Forensic examinations 450.50 Dry run call outs (SANE called out and exam cancelled by L.E.) 250.00 Ar-w, - °Fs rJAi- Tr SNRD' O,RA�E? City of National City (To be submitted only when there are no employees subject to Workers' Compensation) DECLARATION AND ADDENDUM TO ALL CONTRACTS AWARDED TO: (Company Name) sF-k Jr� rd3' For the purpose of inducing the City of National City to go forward with any contracts awarded to N u eP6-ra E..✓7 (—Oa-AZ 'L SE40u.�� (company name), I declare as 1-t-4- follows: I, &,4_ C. i.-af2`~' (name) , (7 �r�'`(title), am an independent contractor for the purposes of the California Workers' Compensation and Labor laws. I will hire no employees other than my parents, spouse, or children for work required for any bid or contract awarded to my company. All work required will be performed personally and solely by me, my parents, spouse, or children. If, however, I shall ever be required to hire employees or Subcontractors to perform this contract, I shall obtain Workers' Compensation Insurance and/or provide proof of Workers' Compensation Insurance coverage to the City of National City. This document constitutes a declaration by me against my financial interest, relative to any claims I should assert under the California Workers' Compensation and/or Labor laws against the City of National City relating to any bid or contract awarded florA-u.e^it' $ if 4M ic. S tictfl (company name). LLt� I will defend, indemnify, and hold harmless the City of National City, its officers and employees, from any and all claims and liability, including Workers' Compensation claims and liability that may be asserted or established by any party in the event I hire an employee in violation of this addendum, and I will further indemnify the City of National City, its officers and employees, for all damages the City thereby suffers. I agree that these declarations shall constitute an addendum to any bid awarded to: S ?�,EPr+.. jj ., J7 F�4...)s r � 1R" (company name). Dated: 9"_)1K• , 20U 7 (Company) By: (Signature of Authorized Representative) C,L.f,Rt 1VELZ CSWNFP.. (Name and Title) 4276C 54TH PLACE SAN DIEGO, CA, 92115 619-501-0958 FAX 619-501-2513 ifs@cox.net INDEPENDENT FORENSIC SERVICES Independent forensic Services LLC hires only contract employees, following is a list. All are SANES and or SANE-A's. Joy Brychta Abigail Hathaway Danella Kawachi Madeline Marini Loretta Melby Patti Rankle Grace Sotomine Commercial Certificate of Insurance Alger ley Name, Se Address Si 30 Insured Name Address • Robert Leutc • 21053 Devonshire St Sic.'05 • Chatsworth, CA 91111-8./5,3 • 3t8-366-i711 Dist. 2i Ng, it '174 - VFW, Ct.AIRE • INDEPENDENTFOkLNSIC SLRVIC .s • 4276 54TH PL STE C-S4 • SAN DIEGO. CA 92 15 Coverages Issue Date (WA/OD/Yr) '08127/2010 This cYn.Gcate o issued as a nutter of In' notion only and ('orders no nghts upon the certificate holder. This certificate does not amend, mend or alter the c vn➢IK afnnled by the polities shown Mlr w Companies Providing Coverage: t ..nReny A Tn,ck 1tt+uradtc Esch.,npa_ rtia i::nrnp.iny 8 Farmers Insurance Exchange i nun :unpan). C Mtd-Cenntry Iruurance Company p phi a to cattily Mai the pouua tit uo+uente listen Delow tuve peen issued to the btrured named above for the policy period indicated- Nolwithntandirtg any requirement. teen or condition of any contract or other document with respect to which Ns certificate may be issued or :ray pertain. the insurance afforded by the policies described burein is tutyect to ati the tenni. eaduoutu and conditions of such policies, Limits shown may have been reduced by paid drum !.0 Type Policy Number Polity Effecdvis Polic • auon 1 e of 1r.suiante y Lunits ,Date (tJinyDn pr, Date:(rtrt+ronim Policy A , Gen r i Liability ,tsi 14 ± 5194 09 0 i.`201 b 09%01201 t neat Aggregate . S 2.000,000 Products-Conip/OPS ,rt' i 1,000.000 firI Pettonal Rr 1dvertising injur/ ! Coin nmal Cenral I.wbtlity Oecurrencx Vgsitni Gitttractuat - Incidental Ordy Orden', & Contactors Pr. ! Automobile Liability AU Owned Commercial Autos WieduIed Autos Hired Autos K Non -Owned Autos Garage Liability Umbrella Liability Workers Compensation and I Employers' Liability Description of Operations/Vehicles Reairicelnns/Speciai items 4276 54TH PL STE C•54, SAN DIEGO, •�.A 92115 Certificate Holder Name & Address • 562497 4- 4 S 1,000,000 1,W0,000 I00,t)00 Mcdital Any ateExpenpastor)ir j $ 5,000 Cranh,ne-J Simple Limit arch Ckcttrrente Fire Damage ;Alny Gore Gres tivdtly Injury A,svni &Atly injury (Pr aaident! Property Damage Garage Aggregate Ltrmt 1.000,000 Sialutory Each Accident Divatse - Each Fnµdvyee $ Lt•mase - Policy lint S Canceilatior Should any of the above described policies be cancelled belore t r expiation date thereof. the issuing rornpany will endeavor to mail 30 days written notice to the crrtitkute holder named to the left. but !allure to nail mil make shall Impose r10 oWleanun or liability of any kind upon the company. its agents or representatives. Authorized fuptexivahrt C3py Distribution: Service Center Copy and Agent's Copy IAr • I CNA 018098 970 HEALTHCARE PROVIDERS SERVICE ORGANIZATION PURCHASING GROUP CERTIFICATE OF INSURANCE OCCURRENCE POLICY FORM 0004006777 Cla.3.re M Nell a_ 4136 Oregon St San Diego, CA 92104-1726 Medical Specialty: Registered Nurse Code: from:12:01 AM Standard Time on: 09/26/10 to: 12:01 AM Standard Time on: 09 2. 11 Nurses Service Organization 159 East County Line Road Hatboro, PA 19040-1218 American Casualty Company of Reading, Pennsylvania 333 S. Wabash Avenue, Chicago, IL 60604 A. PROFESSIONAL LIABILITY Professional Liability (PL) Good Samaritan Liability PersonaTrjury Lia-67ity-'_ ""tGralpTacement Liatx-`Fty B. COVERAGE EXTENSIONS: License Protection Defendant Expense Benefit Deposition Representation Assault Medical Payments First Aid Damage to Property of Others C. WORKPLACE LIABILITY Workplace Liability Fire & Water Legal Liability Personal Liability D. GENERAL LIABIUTY General Liability (GL) Hired Auto & Non Owned Auto Fire 8 Water Legal Liability Personal Liability Total: $ 154.00 $ 2,000,000 each claim included above included above included above 25,000 25,000 25,000 roceedi $ 25,000 _ aggreeate; $ 25,000 aggregate per . eposdion $ 10 aggregate Wiper incident $ 25,000 aggregate,_` person $ 100,000 aggregate $ 10,000 aggregate $ 10,000 aggregate 10,000 per incdent Coverage part C. Workplace Liability does not apply if Coverage part D. General Liability is made parr d this policy. included in A. PL limit shown above included in A. PL limit shown above su.'tact to $150,000 sub -limit .ice It $1,000,000 aggregate Coverage part D. General Liability does not apply it Coverage part C. Workplace Liability is made part of this policy. QUESTIONS? CALL: 1-800-247-1500 G-121500-D G-121503-C G-121501-C1 G-145184-A G-147292-A G-123846-D04 GSL3886 GSL3908 Master Policy # 188711433 Keep this document in a safe place. n and pool ol payment are c i 't--evrx,v..doc pe..11Q Chairman of the Board G-141241-A (07/2001) Coverage Change Date: d your insurance cvi rage. Secretary Endorsement Change Date: OFFICE OF THE CITY CLERK 1243 National City Blvd. National City, California 91950 Michael R. Dalla, CMC - City Clerk 619-336-4228 phone • 619-336-4229 fax INDEPENDENT FORENSIC SERVICES, LLC Amendment #1 Sexual Assault Victims & Suspects Ronni Zengota (PD) Forwarded Copy of Amendment to Contractor