HomeMy WebLinkAbout2011 CON Grossman Psychological Associates - Amendment #1 Officer Assistance ProgramFIRST AMENDMENT TO AGREEMENT
BETWEEN THE CITY OF NATIONAL CITY
AND GROSSMAN PSYCHOLOGICAL ASSOCIATES, APC
This First Amendment to Agreement is entered into this 1st day of July, 2011, by and between the
City of National City, a municipal corporation (the "CITY"), and GROSSMAN PSYCHOLOGICAL
ASSOCIATES, a professional corporation (the "CONSULTANT),.
RECITALS
A. The CITY and the CONTRACTOR entered into an Agreement on July 1, 2010 ("the Agreement"),
wherein the CONSULTANT agreed to provide Pre -Placement Suitability Evaluations, Pre -
Employment Psychological Examinations, an Officer Assistance Program, Critical Incident
Debriefing, and Fitness for Duty Examinations for the National City Police Department located at
1200 National City Boulevard from July 1, 2010 through June 30, 2011, for an amount not to exceed
$49.500.
B. The Agreement provided an option to extend the term of the Agreement for one-year, with up to
three extensions.
C. The parties desire to exercise the option to extend the Agreement for the first of the three one-year
extensions by extending the term of the Agreement for one additional year, beginning July I, 2011
and expiring on June 30, 2012.
NOW, THEREFORE, the parties hereto agree that the Agreement entered into on July 1, 2010, shall
be amended as follows:
1. The term of the Agreement dated July 1, 2010, is extended for an additional one-year term to provide
Pre -Placement Suitability Evaluations, Pre -Employment Psychological Examinations, an Officer
Assistance Program, Critical Incident Debriefing, and Fitness for Duty Examinations for the
National City Police Department located at 1200 National City Boulevard from July 1, 2011 through
June 30, 2012, for an amount not to exceed $49,500, for a total agreement amount of $99,000.
2. The parties further agree that with the foregoing exceptions, each and every term and provision of
the Agreement dated July 1, 2010, shall remain in full force and effect.
IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to the Agreement
on the date and year first above written.
CITY OF NATIONAL CITY
on Morrison,
Mayor
A' "RAVED AS TO FORM:
CI
City Attor
ilva, Esq.
y
GROSSMAN PSYCHOLOGICAL
ASSOCIATES, APC
By
Ira Grossman, PHD
President
10/26/10 - A
DARWIN NATIONAL ASSURANCE COMPANY
PSYChTHIS TS A CLAIMS MADE POL C Ya PLEA E READtCARE1�ULEYy
*** RENEWAL * * *
NOTICE: A LOWER LIMIT OF LIABILITY APPLIES TO JUDGMENTS OR SETTLEMENTS WHEN THERE ARE ALLEGATIONS
OF SEXUAL MISCONDUCT (SEE THE SPECIAL PROVISION "SEXUAL MISCONDUCT" IN THE POLICY).
DECLARATIONS
POLICY NO: 5010-5098 ACCOUNT NO: CA-GROS455-0 0222406C
ITEM 1. (a) NAME AND ADDRESS OF INSURED: ITEM 1. (b) ADDITIONAL NAMED INSUREDS:
IRA GROSSMAN, PH.D.
GROSSMAN PSYCHOLOGICAL
ASSOCIATES, APC
4550 KEARNY VILLA RD.
SUITE 214
SAN DIEGO, CA 92123
TYPE OF ORG:
PROFESSIONAL CORPORATION
ITEM 2. ADDITIONAL INSUREDS:
CITY OF CHULA VISTA
PURCHASING DIVISION
276 FOURTH AVE MS F-10
CHULA VISTA, CA 91910
ITEM 3. POLICY PERIOD:
ITEM 4. LIMITS OF LIABILITY: (a) $
(b) $
CITY OF SAN DIEGO- BID #
7584 PURCHASING DEPT
6 1200 THIRD AVE STE 200
SAN DIEGO, CA 92101
FROM: 12/01/10 TO: 12/01/11
12:01A.M. STANDARD TIME AT THE ADDRESS OF THE INSURED AS STATED HEREIN:
2,000, 000 EACH WRONGFUL ACT OR SERIES OF CONTINUOUS, REPEATED
OR INTERRELATED WRONGFUL ACTS OR OCCURRENCE
25, 000 COSTS RELATED TO ANY SINGLE PROCEEDING
4 , 000 , 000 AGGREGATE, FOR ALL CLAIMS AND ALL PROCEEDINGS
ITEM 5.
ITEM 6
rxr.iviiurvi a rmL,vl.r..
CLASSIFICATION
NUMBER
RATE
ANNUAL PREMIUM
1ST PSYCHOLOGIST
DEFENSE LIMIT
ADDITIONAL INSUREDS
1
2
1494.00
1,195.00
75.00
75.00
RFTRnACTIVEDATE: 12/01/92 TOTAL PREMIUM:
1,226.00
ITEM 7.
IIEM 8.
EXTENDED REPORTING PERIOD
ADDY CLONAL PREMIUM (if exercised):$
CRED
2,146.00 SCHEDULED RATING CREDIT INCLUDED
POLICY FORMS AND ENDORSEMENTS ATTACHED TO THIS POLICY
PRGE2000 (3/2006) PRGe1069 (1/2006) EPRGe1121
AUTJX5RIZED COMPANY REPRESENTATIVE
AmericaiiProfessional Agency * 95 Broadway, Amityville, NY 11701
THIS IS NOT A BILL. PREMIUM HAS BEEN PAID.
PRGE2005 (3/20061
Rug 1 / u l 3rp
p.2
CERTIFICATE OF INSURANCE
This certifies that ❑ STATE FARM FIRE AND CASUALTY COMPANY, Bloomington, Illinois
® STATE FARM GENERAL INSURANCE COMPANY, Bloomington, Illinois
❑ STATE FARM FIRE AND CASUALTY COMPANY, Aurora, Ontario
❑ STATE FARM FLORIDA INSURANCE COMPANY, Winter Haven, Florida
❑ STATE FARM LLOYDS, Dallas, Texas
insures the following policyholder for the coverages indicated below:
Policyholder RI00PRD T. 3UCCIGROSS MD A MEDICAL CORP & GROSSMAN PSYCfOLOGICAL ASSOC
Address of policyholder 9550 KEARNEY VILLA RD STE 214 SAN DIEGO CA 92123
Location of operations
Description of operations
SAME
BUSINESS -OFFICE
The policies listed below have been issued to the policyholder for the policy periods shown. The insurance described in these polities is subject
to all the terms, exclusions, and conditions of those policies. The limits of liability shown may have been reduced by any paid claims.
POLICY NUMBER
TYPE OF INSURANCE
POLICY PERIOD
Effective Date Expiration Date
LIMITS OF LIABILITY
(at beginning of policy period)
90-51.-4271-4
This insurance includes:
Comprehensive
Business Liability
■ Products - Completed Operations
■ Contractual Liability
• Personal Injury
❑ Advertising Injury
■
I■
❑
01/09/2011 ; 01/09/2012
BODILY INJURY AND
PROPERTY DAMAGE
Each Occurrence $ 1, 000, 30e
General Aggregate $ 2, 000, 000
Products - Completed $ 2,000, 000
Operations Aggregate
EXCESS LIABILITY
❑ Umbrella
El Other
POLICY PERIOD
Effective Date 1 Expiration Date
BODILY INJURY AND PROPERTY DAMAGE
(Combined Single Limit)
Each Occurrence $
Aggregate $
Workers' Compensation
and Employers Liability
POLICY
Effective Date
PERIOD
Expiration Date
Part I - Workers Compensation - Statutory
Part II - Employers Liability
Each Accident $
Disease - Each Employee $
Disease - Policy Limit $
POLICY NUMBER
TYPE OF INSURANCE
POLICY PERIOD
Effective Date ; Expiration Date
LIMITS OF LIABILITY
at beginning of policy period)
_
THE CERTIFICATE OF INSURANCE IS NOT A CONTRACT OF INSURANCE AND NEITHER AFFIRMATIVELY NOR NEGATIVELY
AMENDS, EXTENDS OR ALTERS THE COVERAGE APPROVED BY ANY POLICY DESCRIBED HEREIN.
Name and Address of Certificate Holder
ADDL INSURED - SECTION TI
The City of National City
IL's officers, agents & employees
1243 NaL-_onal City Blvd
National City, CA 91950-4301
556-994 a.6 Pririled in U.S.A. Rev. D5-09-2006
If any of the described policies are canceled before
their expiration date, State Farm will try to mail a
written notice to the certificate holder 30 days before
cancellation. If however, we fail to mail such notice,
no obligation or liability will be imposed on State Farm
or its agents orrepresentativves.
Signature of Authorized Represent
AGENT License 0656407 09/17/2011
Title Data
MARILYN BILLINGSLEY
Agent Name
Telephone Number 6192966505
Agent's Code Stamp
Agent Code B56C
AFO Code F410
II II V I.J/F1
p.i
J06M Policy No.: 90 514271 4
SECTION II ADDITIONAL INSURED ENDORSEMENT
Policy No.: 90 514271 4
Named Insured: BUCCIGROSS, RICHARD L MD
A MEDICAL CORP & GROSSMAN
PSYCHOLOGICAL ASSOC
FE-6609
Additional Insured (include address):
CITY OF NATIONAL CITY ITS OFFICERS, AGENTS & EMPLOYEES
1243 NATIONAL CITY BLVD
NATIONAL CITY. CA 91950-4301
WHO IS AN INSURED, under SECTION II DESIGNATION OF INSURED, is amended to include as
an insured the Additional Insured shown above, but only to the extent that liability is imposed on that
Additional Insured solely because of your work performed for that Additional insured shown above.
Any insurance provided to the Additional Insured shall only apply with respect to a claim made or a
suit brought for damages for which you are provided coverage.
The Primary Insurance coverage below applies only when there is an "X" in the box,
Z Primary Insurance. The insurance provided to the Additional Insured shown above shall be
primary insurance. Any insurance carried by the Additional Insured shall be noncontributory
with respect to coverage provided to you.
All other policy provisions apply.
FE-6609 Printed in U.SA.
Hug "I! "I'I u1:;.3ip p.4
FE-6671
Page 1 of 1
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST
OTHERS TO US
SCHEDULE
Policy Number: 90 514271 4
Named Insured: BUCCIGROSS, RICHARD L MD
A MEDICAL CORP & GROSSMAN
PSYCHOLOGICAL ASSOC
Name and Address of Person or Organization:
CITY OF NATIONAL CITY ITS OFFICERS, AGENTS & EMPLOYEES
1243 NATIONAL CITY BLVD
NATIONAL CITY, CA 91950-4301
The following is added to Paragraph 10.b. of SECTION I AND SECTION II — COMMON
CONDITIONS:
We waive any right of recovery we may have against the person or organization shown in the
Schedule because of payments we make for injury or damage arising out of:
a. Your ongoing operations; or
b. Your work done under contract with that person or organization and included in the products -
completed operations hazard.
This waiver applies only to the person or organization shown in the Schedule.
All other policy provisions apply.
FE-6671
®, Copyright, State Farm Mutual Automobile insurance Company, 2008
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
FE-6071
(04f09)
Pnnted in U.S.A.
RESOLUTION NO. 2011 — 146
RESOLUTION OF THE CITY COUNCIL OF THE CITY OF NATIONAL CITY
AUTHORIZING THE MAYOR TO EXECUTE THE FIRST AMENDMENT TO
THE AGREEMENT WITH GROSSMAN PSYCHOLOGICAL ASSOCIATES, APC,
IN THE NOT -TO -EXCEED AMOUNT OF $49,500 FOR AN ADDITIONAL
ONE YEAR TERM TO PROVIDE PRE -PLACEMENT EVALUATIONS,
PRE -EMPLOYMENT EXAMS, AN OFFICER ASSISTANCE PROGRAM,
CRITICAL INCIDENT DEBRIEFINGS, AND FITNESS FOR DUTY
EVALUATIONS FOR THE NATIONAL CITY POLICE DEPARTMENT
WHEREAS, on July 1, 2010, the City entered into a one year agreement with
Grossman Psychological Associates, APC, in the amount of $49,500 to provide pre -placement
evaluations, pre -employment exams, an officer assistance program, critical incident debriefings,
and fitness for duty evaluations for the National City Police Department; and
WHEREAS, said Agreement provided the option to extend the term of the
Agreement for three additional one-year terms; and
WHEREAS, the parties desire to exercise the option to extend the Agreement for
the first of the three one-year extensions by extending the term of the Agreement for one
additional year, beginning July 1, 2011, and expiring on June 30, 2012, in the amount of
$49,500, for a total agreement amount of $99,000.
NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of
National City hereby authorizes the Mayor to execute a First Amendment to the Agreement in
the not -to -exceed amount of $49,500 with Grossman Psychological Associates, APC, to provide
pre -placement evaluations, pre -employment exams, an officer assistance program, critical
incident debriefings, and fitness for duty evaluations to the Police Department from July 1, 2011
through June 30, 2012. Said First Amendment to Agreement is on file in the office of the City
Clerk.
PASSED and ADOPTED this 5th day of July, 2011.
ATTEST:
Michael R. DallaCity Clerk
ROVED AS TO FORM:
Iva
ty At
Morrison, Mayor
Passed and adopted by the Council of the City of National City, Califomia, on July 5,
2011 by the following vote, to -wit:
Ayes: Councilmembers Morrison, Natividad, Rios, Sotelo-Solis, Zarate.
Nays: None.
Absent: None.
Abstain: None.
AUTHENTICATED BY: RON MORRISON
Mayor of the City of National City, California
letR4
City Clerk of the City f National City, California
By:
Deputy
I HEREBY CERTIFY that the above and foregoing is a full, true and correct copy of
RESOLUTION NO. 2011-146 of the City of National City, California, passed and
adopted by the Council of said City on July 5, 2011.
City Clerk of the City of National City, California
By:
Deputy
CITY OF NATIONAL CITY, CALIFORNIA
COUNCIL AGENDA STATEMENT
MEETING DATE: July 5, 2011
AGENDA ITEM NO. 14
i I'EM TITLE:
Resolution of the City Council of the City of National City authorizing the Mayor to execute a First
Amendment to the Agreement with Grossman Psychological Associates, APC, in the not -to exceed
amount of $49,500 to provide Pre -Placement evaluations, Pre -Employment exams, an Officer
Assistance Program, Critical Incident Debriefing and Fitness for Duty Evaluations for the Police
Department for the term of one year.
PREPARED BY: Ronni Zengota, Operations Assistant
PHONE: 4516
EXPLANATION:
DEPARTMENT: Police pp
APPROVED BY:
On July 1, 2010, the City entered into an Agreement with Grossman Psychological Associates, APC, to
provide Pre -Placement evaluations, Pre -Employment Exams, Officer Assistance Program, Critical
Incident Debriefing and Fitness for Duty Exams for the Police Department from July 1, 2010 through
June 30, 2011, for the not to exceed amount of $49,500. The Agreement provides the option to extend
the Agreement for three (3) one-year terms.
This First Amendment to the Agreement in the not to exceed amount of $49,500 exercises the option for
the first one-year extension through June 30, 2012.
Grossman Psychological Associates, APC is a licensed psychologist that has specialized in police
;ychology since 1982, and is qualified by experience and ability to perform the services required by the
)lice Department.
FINANCIAL STATEMENT: APPROVED: pq0,2 JAI, Finance
ACCOUNT NO. Budgeted through the General Fund APPROVED: MIS
001-411-000-205-0000 — Pre -placement, Pre -employment, Critical Incident Debriefing, Fitness For Duty
001-411-000-299-0000 — Officer Assistance Program
ENVIRONMENTAL REVIEW:
N/A
ORDINANCE: INTRODUCTION:
FINAL ADOPTION:
STAFF RECOMMENDATION:
Adopt Resolution
BOARD / COMMISSION RECOMMENDATION:
N/A
'TTACHMENTS:
...nendment to Agreement
RESOLUTION NO. 2011 —
RESOLUTION OF THE CITY COUNCIL OF THE CITY OF NATIONAL CITY
AUTHORIZING THE MAYOR TO EXECUTE THE FIRST AMENDMENT TO
THE AGREEMENT WITH GROSSMAN PSYCHOLOGICAL ASSOCIATES, APC,
IN THE NOT -TO -EXCEED AMOUNT OF $49,500 FOR AN ADDITIONAL
ONE YEAR TERM TO PROVIDE PRE -PLACEMENT EVALUATIONS,
PRE -EMPLOYMENT EXAMS, AN OFFICER ASSISTANCE PROGRAM,
CRITICAL INCIDENT DEBRIEFINGS, AND FITNESS FOR DUTY
EVALUATIONS FOR THE NATIONAL CITY POLICE DEPARTMENT
WHEREAS, on July 1, 2010, the City entered into a one year agreement with
Grossman Psychological Associates, APC, in the amount of $49,500 to provide pre -placement
evaluations, pre -employment exams, an officer assistance program, critical incident debriefings,
and fitness for duty evaluations for the National City Police Department; and
WHEREAS, said Agreement provided the option to extend the term of the
Agreement for three additional one-year terms; and
WHEREAS, the parties desire to exercise the option to extend the Agreement for
the first of the three one-year extensions by extending the term of the Agreement for one
additional year, beginning July 1, 2011, and expiring on June 30, 2012, in the amount of
$49,500, for a total agreement amount of $99,000.
NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of
National City hereby authorizes the Mayor to execute a First Amendment to the Agreement in
the not -to -exceed amount of $49,500 with Grossman Psychological Associates, APC, to provide
pre -placement evaluations, pre -employment exams, an officer assistance program, critical
incident debriefings, and fitness for duty evaluations to the Police Department from July 1, 2011
through June 30, 2012. Said First Amendment to Agreement is on file in the office of the City
Clerk.
PASSED and ADOPTED this 5th day of July, 2011.
Ron Morrison, Mayor
ATTEST:
Michael R. Dalla, City Clerk
APPROVED AS TO FORM:
Claudia G. Silva
City Attorney
FIRST AMENDMENT TO AGREEMENT
BETWEEN THE CITY OF NATIONAL CITY
AND GROSSMAN PSYCHOLOGICAL ASSOCIATES, APC
This First Amendment to Agreement is entered into this 1st day of July, 2011, by and between the
City of National City, a municipal corporation (the "CITY"), and GROSSMAN PSYCHOLOGICAL
ASSOCIATES, a professional corporation (the "CONSULTANT),.
RECITALS
A. The CITY and the CONTRACTOR entered into an Agreement on July 1, 2010 ("the Agreement"),
wherein the CONSULTANT agreed to provide Pre -Placement Suitability Evaluations, Pre -
Employment Psychological Examinations, an Officer Assistance Program, Critical Incident
Debriefing, and Fitness for Duty Examinations for the National City Police Department located at
1200 National City Boulevard from July 1, 2010 through June 30, 2011, for an amount not to exceed
$49,500.
B. The Agreement provided an option to extend the term of the Agreement for one-year, with up to
three extensions.
C. The parties desire to exercise the option to extend the Agreement for the first of the three one-year
extensions by extending the term of the Agreement for one additional year, beginning July 1, 2011
and expiring on June 30, 2012.
NOW, THEREFORE, the parties hereto agree that the Agreement entered into on July 1, 2010, shall
be amended as follows:
1. The term of the Agreement dated July 1, 2010, is extended for an additional one-year term to provide
Pre -Placement Suitability Evaluations, Pre -Employment Psychological Examinations, an Officer
Assistance Program, Critical Incident Debriefing, and Fitness for Duty Examinations for the
National City Police Department located at 1200 National City Boulevard from July 1, 2011 through
June 30, 2012, for an amount not to exceed $49,500, for a total agreement amount of $99,000.
2. The parties further agree that with the foregoing exceptions, each and every term and provision of
the Agreement dated July 1, 2010, shall remain in full force and effect.
IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to the Agreement
on the date and year first above written.
CITY OF NATIONAL CITY GROSSMAN PSYCHOLOGICAL
ASSOCIATES, APC
By: By:
Ron Morrison, Ira Grossman, PHD
Mayor President
APPROVED AS TO FORM:
Claudia G. Silva, Esq.
City Attorney
OFFICE OF THE CITY CLERK
1243 National City Blvd.
National City, California 91950
YNCOIiJQ*ATED J Michael R. Dalla, CMC - City Clerk
619-336-4228 phone 619-336-4229 fax
August 22, 2011
Dr. Ira Grossman
Grossman Psychological Associates, APC
Landmark Centre
4550 Kearney Villa Road, Suite 214
San Diego, CA 92123-1563
Dear Dr. Grossman,
On July 5th, 2011, Resolution No. 2011-146 was passed and adopted by the City
Council of the City of National City, authorizing execution of Amendment #1 to an
Agreement with Grossman Psychological Associates, APC.
We are enclosing for your records a certified copy of the above Resolution and a
fully executed original Amendment.
Michael R. Dalla, CMC
City Clerk
Enclosures
cc: Police Dept.