HomeMy WebLinkAbout2020 CON Richard J. Donovan Correctional Facility - Temporary Right of Entry and License Agreement - Firing Range UseDocuSign Envelope ID: E57D4243-E303-4969-9F9E-B8C0C8A71F17
TEMPORARY RIGHT OF ENTRY AND LICENSE AGREEMENT FOR
FIRING RANGE USE AT
RICHARD J. DONOVAN CORRECTIONAL FACILITY
This Temporary Right of Entry and License Agreement (License) is made and entered into on
August 3, 2021 by and between the State of California acting by and through the Director of
the Department of General Services (DGS) with the consent of the Department of Corrections
and Rehabilitation (CDCR), Richard J. Donovan Correctional Facility (RJD) collectively
"State", as (Licensor), and the National City Police Department (NC PD) as (Licensee). The
Licensor and Licensee are sometimes individually referred to as "Party" and collectively as
"Parties".
RECITALS
WHEREAS, pursuant to Government Code (GC) §14670 (a)(1), the Director of the
Department of General Services, with the consent of the California Department of Corrections
and Rehabilitation, is authorized to let State real property for a period not to exceed five (5)
years if the Director deems such letting is in the best interest of the State; and
WHEREAS, Licensee's officers or employees require continuing firearms education,
which includes classroom education and training at an authorized Range facility, to
comply with California Penal Code Section 830; and
WHEREAS, Licensee is requesting temporary, scheduled access, ingress and egress to the
Firing Range (Range) which is located at 480 Alta Road, San Diego, CA 92179. State real
property identified as RJD, located within assessor's parcel number 648-040-26-00 currently
under the CDCR control and possession; and
WHEREAS, CDCR operates the RJD Range; and
WHEREAS, the State engages law enforcement entities for range use in exchange for certain
services and equipment which allows the range operation to run efficiently while meeting
necessary training needs; and
WHEREAS, Licensee desires to secure dates and times for law enforcement weapons
training for its officers at the RJD range; and
WHEREAS, public safety is an essential mission for the State and Licensee, the parties agree
that this training is in the best interest of the State and the State has identified existing
capacity to enter into this License with Licensee; and
WHEREAS, Licensee's activities will be conducted in accordance with standard industry
practices and in a prudent and careful manner.
WITNESSETH
NOW THEREFORE, IN CONSIDERATION of the mutual agreements by the Parties set forth
NATIONAL CITY POLICE DEPARTMENT, FIRING RANGE USE
AGREEMENT AT RICHARD J. DONOVAN CORRECTIONAL
FACILITY
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DocuSign Envelope ID: E57D4243-E303-4969-9F9E-B8C0C8A71F17
herein and other good and valuable consideration contributing to public safety in the State, the
Parties agree to the following terms and conditions:
1. Grant of License: The State hereby grants permission to Licensee, its qualified officers,
employees, and representatives, to enter upon those lands within the RJD firing range, located
at 480 Alta Road, San Diego, CA 92179, more specifically described in Exhibit "A" (Premises),
attached herein and by this reference made a part hereof, for the purpose of ingress, egress
and scheduled Range use intended for training and continuing education of law enforcement
personnel and for no other purposes whatsoever. Licensee's access onto said Premises shall
be allowed by CDCR only upon State's execution of this License.
2. License Term: This License shall commence on August 3, 2021 and expire without written
notification on August 2, 2026, with such rights of renewal or termination as are hereinafter
expressly set forth. Licensee shall have the option to renew the License upon expiration.
Should Licensee desire to renew, the request for such renewal will be for an additional five (5)
year term and should be made within one hundred twenty 120 days of the expiration date
hereof by written notification to the Range Master. Nothing precludes the Licensee from
making their renewal request earlier than one hundred twenty 120 days.
3. Holding Over: Any holding over by Licensee after expiration or termination shall not be
considered a renewal or extension of this License. The use of the Premises after the
expiration or termination of this License shall constitute a week -to -week use, and all other
terms and conditions of this License shall continue in full force and effect; provided however,
that said hold over tenancy shall be subject to and at the State's sole discretion.
4. Termination: The Parties hereto agree that either Party may terminate this License at any time
during the term hereof by giving notice to the other in writing at least thirty (30) days prior to
the date when such termination shall become effective. Any willful violation of the License
terms or the RJD Firing Range Rules and Regulations shall be grounds for termination of this
License and removal of Licensee. With exception that the Licensee may have the right to
receive notice of such violation and granted a period of ten (10) calendar days to cure prior to
any such termination, if such violation is curable. If Licensee fails to cure the specified
violation, termination and removal shall be permitted pursuant to this section.
5. Use: Licensee's use is permitted for the express purpose of conducting classroom and hands-
on weapons training which is more particularly described in Exhibit "B"(Training Curriculum)
attached herein and by this reference made a part hereof. Training coordination and
scheduling is more particularly described in Exhibit "C" (Scheduling) attached herein and by
reference made a part hereof. Weapons training requires the use of special equipment,
including firearms, ammunition, and protective gear which is more particularly described in
Exhibit "D" (Equipment), attached herein and by this reference made a part hereof. Licensee
and its qualified officers shall use only that equipment identified in Exhibit "D" unless the
Equipment list is amended in writing and agreed to by both Parties.
6. Conduct During Use: The Licensee agrees to follow the Richard J. Donovan Correctional
Facility Firing Range General Rules and Regulations, identified as Exhibit "E" (Rules and
Regulations), attached herein and by reference made a part hereof.
NATIONAL CITY POLICE DEPARTMENT, FIRING RANGE USE
AGREEMENT AT RICHARD J. DONOVAN CORRECTIONAL
FACILITY
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7. Medical: Licensee shall take all necessary and reasonable safety precautions and shall
comply with all applicable laws pertaining to the safety of person and real and personal
property at or on the Premises. Licensee shall immediately report to the onsite Range Master
any death, loss time injury, or property damage that occurs within RJD. Any emergency
medical or surgical care of Licensee's officers or employees required, as a result of range use,
will be the sole responsibility of Licensee. As used herein, this section is intended to mean
that Licensee shall be liable for any and all medical and/or surgical care costs for Licensee's
employees, its qualified officers and representatives served by this License.
8. Subordination: This License is subject to existing contracts, leases, licenses, encumbrances
and claims, which may affect said property. This License is subordinate to all existing prior
and/or future rights and obligations of the State, except that the State shall grant no rights
inconsistent with the reasonable exercise by Licensee of its rights under this License unless
warranted by the direction of the State's Governor, CDCR Secretary, Director of DGS, or the
State's Public Works Board.
9. Licensee Responsibility: This License is granted to Licensee and its qualified officers,
employees, and representatives, to enter upon the Premises at their sole cost and expense.
Licensee is solely responsible for the safety and conduct of persons entering upon the
Premises to exercise the rights under this License. Licensee is solely responsible for the
protection of all persons, property, materials, tools, equipment, and supplies brought on to the
Premises. Licensee agrees to keep and maintain the Premises in a clean and orderly
condition at all times during their use. Licensee further agrees to remove all of its personal
property and return the Premises to its pre -use condition upon completion of training
exercises and conclusion of Licensee's activities on the Premises. Licensee agrees to comply
with, and ensure all persons/participants under their jurisdiction comply with, any and all
direction and policy implemented by the Range Master for use of the range.
10. Waiver: Licensee waives all claims, judgements, penalties, awards, fines, settlements, losses
against the State, their officers, agents, contractors and employees for loss or damage caused
by, arising out of, or in any way connected with the exercise of this License. Licensee shall
protect, indemnify, hold harmless and defend the State, its officers, agents, consultants and
employees from and against any lawsuits, actions, judgments, legal or administrative
proceedings, arbitrations, claims, demands, causes of actions, damages, liabilities, interests,
attorney fees, fines, penalties, losses, costs and expenses whatsoever arising out of, in
connection with, or incidental to entry upon and use of the Premises.
11. Compliance with Laws: Licensee shall conduct all activities in compliance with all Federal,
State, and Municipal statutes and ordinances, and will comply with all regulations and orders
as such exist during the term of this License. Licensee agrees to require in its contract(s) with
its subcontractor(s) that the subcontractor(s) be obligated to Licensee in the same manner
and extent, as Licensee owes to the State, and State under this License.
12. Prohibited Items: Exhibit "F" (State Prison & Detention Facility Regulations for On -site
Conduct) attached herein and by reference made a part hereof; no article or material, which
the CDCR considers contraband, shall be brought onto the premises with the exception of
those items listed in Exhibit "D", which include weapons, munitions and protective gear.
CDCR prohibited contraband includes, but is not limited to cell phones, alcoholic beverages,
narcotics, firearms, explosives, edged weapons, restricted and/or controlled substances, or
NATIONAL CITY POLICE DEPARTMENT, FIRING RANGE USE
AGREEMENT AT RICHARD J. DONOVAN CORRECTIONAL
FACILITY
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DocuSign Envelope ID: E57D4243-E303-4969-9F9E-B8C0C8A71F17
wagering and gambling paraphernalia. Smoking, tobacco use, including vaping, is strictly
prohibited at RJD. Any willful violation of regulations and conduct or the terms of this License
shall be grounds for immediate termination of the License and removal of the Licensee and its
representatives. Nothing in this paragraph is intended to limit law enforcement personnel,
who are authorized by law, to carry a firearm or communication devices such as cell phones in
the scope of their duties, from possessing a firearm on the Premises. Nothing in this section
is intended to prohibit possession of a cell phone for Licensees purposes by law enforcement
personnel while on the Premises.
13. Property Rights: Licensee understands this License does not convey any interest in real
property. There are no expressed or implied terms that would induce the Licensee into
thinking that this temporary approval to enter the Premises for training conveys any real
property interest whatsoever.
14. Assignment, Subletting and Change in Use: Licensee shall not transfer or assign this License,
and shall not sublet, license, permit or suffer any use of the premises or any part thereof, and
will not permit the use of the Premises by anyone other than the Licensee.
15. Spectator Waiver: To the extent that Licensee provides access to a non -participating officer or
employee, Licensee guarantee's said Spectator shall indemnify State and complete Exhibit
"G", (Spectator Waiver and Release of Liability, Assumption of Risk, Covenant Not to Sue and
Indemnity Agreement) attached herein and by reference made a part hereof.
16. Insurance: Prior to or at License execution Licensee shall furnish to the State a Certificate of
Insurance, along with all License endorsements, identifying the State as Certificate Holder on
the face of said certificate or endorsements with evidence of insurance as follows:
a) Commercial General Liability: Licensee shall maintain general liability coverage with limits
of not less than $1,000,000 per occurrence and $2,000,000 aggregate annually for bodily
injury and property damage liability combined and fire legal liability of at least $500,000.
The License shall include coverage for liabilities arising out of Premises, operations,
independent contractors, products, completed operations, personal and advertising injury,
and liability assumed under an insured contract. The License must include State of
California, and their officers, agents and employees as additional insureds, but only to the
extent as the operations under the License are concerned. The additional insured
endorsement must be provided with the certificate of insurance.
b) Automobile Liability: Licensee shall maintain motor vehicle liability with limits of not less
than $1,000,000 per accident for bodily injury and property damage. The State of
California and DGS are to be additional insured with respect to liability arising out of all
vehicles owned, hired and non -owned. The additional insured endorsement must be
provided with the certificate of insurance.
c) Workers Compensation: Licensee shall maintain statutory workers' compensation and
employer's liability coverage for all its employees who will be engaged in the performance
of the License, including special coverage extensions where applicable. Employer's
liability limits of $1,000,000 shall be required, and the coverage shall include a waiver of
subrogation in favor of the State of California. The waiver of subrogation endorsement
NATIONAL CITY POLICE DEPARTMENT, FIRING RANGE USE
AGREEMENT AT RICHARD J. DONOVAN CORRECTIONAL
FACILITY
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DocuSign Envelope ID: E57D4243-E303-4969-9F9E-B8C0C8A71F17
must be provided with the Certificate of Insurance.
17. General Requirements: Licensee shall ensure that the following general requirements are
met:
i) Insurance companies must be acceptable to DGS, and the Office of Risk and
Insurance Management (ORIM).
ii) Coverage needs to be current for complete term of this License. If insurance expires
during the term of the License, a new certificate must be received by the State within
thirty (30) days of the expiration date of the existing License. This new insurance must
still meet the terms of the original contract.
iii) Licensee shall notify the State within five (5) business days of Licensee's receipt of any
notice of cancellation or non -renewal of any insurance required by this License.
iv) Licensee is responsible for any deductible or self -insured retention contained within
the insurance program.
v) In the event Licensee fails to keep in effect at all times the specified insurance
coverage, the State may, in addition to any other remedies it may have, terminate this
License upon the occurrence of such event, subject to the provisions of this License.
vi) Any insurance required to be carried shall be primary, and not excess, to any other
insurance carried by the State.
vii) It is agreed that the State shall not be liable for the payment of any premiums or
assessments on the required insurance coverage.
18. Self -Insured: As indicated in Exhibit "H" (Certificate of Self -Insurance Coverage), attached
herein and by reference made a part hereof, Licensee is self -insured. If Licensee is self -
insured in whole, or in part as to any of the above described types and levels of coverage,
Licensee shall provide the State with written acknowledgment of this fact upon execution of
this License. The State may require financial information to justify Licensee's self -insured
status. If, at any time after the execution of this License, Licensee abandons its self -insured
status Licensee shall immediately notify the State of this fact and shall comply with all of the
terms and conditions of the Insurance Clause pertaining to policies of insurance in regard to
those types and levels of insurance.
19. Licensee Continuing Liability: The obligations of Licensee to indemnify the State shall survive
the termination of this License. No termination of this License shall release Licensee from any
liability or obligations hereunder resulting from any acts, omissions, or events happening prior
to the termination of this License and restoration of the Premises to its prior condition.
20. Attorney's Fees: In the event of a dispute between the Parties with respect to the terms of
condition of this License, the prevailing Party shall be entitled to collect from the other Party its
reasonable attorneys' fees and costs as established by the judge or arbitrator presiding over
such dispute.
NATIONAL CITY POLICE DEPARTMENT, FIRING RANGE USE
AGREEMENT AT RICHARD J. DONOVAN CORRECTIONAL
FACILITY
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21. Governing Law: This contract shall be governed by and interpreted in accordance with the
laws of the State of California, excluding such State's conflict of law principles. Venue for any
action to enforce this license shall be in Sacramento, California.
22. Notices: All notices or other communications required or permitted hereunder shall be in
writing, and shall be personally delivered (including by means of professional messenger
service), or sent by overnight courier, or sent by registered or certified mail, postage prepaid,
return receipt requested to the addresses set forth below. All such notices or other
communications shall be deemed received upon the earlier of (1)if personally delivered or
sent by overnight courier, the date of delivery to the address of the person to receive such
notice, (2) if mailed as provided above, on the date of receipt or rejection, or (3) if given by
electronic mail (email), when received by the other Party if received Monday through Friday
between 6:00 AM and 5:00 PM Pacific Standard Time, so long as such day is not a State or
Federal holiday and otherwise on the next day provided that if the next day is Saturday,
Sunday or a State or Federal holiday, such notice shall be effective on the following business
day:
TO: Department of Corrections & Rehabilitation (CDCR)
Facilities Asset Management Branch
9838 Old Placerville Road, Suite B Sacramento, CA 95827
ATTN: Real Estate and Land -Use Management Section
TO: Richard J. Donovan Correctional Facility (RJD)
480 Alta Road,
San Diego, CA 92179
ATTN: Range Master
TO: National City Police Department
1200 National City Blvd,
National City, CA 91950
ATTN: Range Master
23. Indemnification: Licensee acknowledges that entry onto the Premises under this License shall be at
Licensee's own risk and expense. Licensee, its qualified employees, representatives, agents,
officers, contractors, consultants' et al., who enter the Premises, acknowledge potential known and
unknown dangers may exist and enter at their own risk, taking full responsibility to conduct
themselves in the safest manner possible. The State does not warrant the safety of any persons
accessing the Premises. Licensee agrees to indemnify, defend and hold harmless the State, its
officers, employees, consultants, representatives, and contractors from any and all claims and losses
accruing or resulting to any and all contractors, subcontractors, suppliers, laborers, and any other
person, firm or corporation furnishing or supplying work services, materials, equipment or supplies in
connection with the performance of this License. In addition to any and all claims and losses
accruing or resulting to any persons, including neighbors, firms or corporations who may be injured or
damaged by Licensee or its qualified officers, employees, consultants, representatives and
contractors in the course of its activities on the Premises under this License.
24. Partnership Disclaimer: Licensee, its agents and employees shall act in an independent capacity
NATIONAL CITY POLICE DEPARTMENT, FIRING RANGE USE
AGREEMENT AT RICHARD J. DONOVAN CORRECTIONAL
FACILITY
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DocuSign Envelope ID: E57D4243-E303-4969-9F9E-B8C0C8A71F17
and not as officers or employees of State. Nothing herein contained will be construed as
constituting the parties herein as partners.
25. Entire License: This License contains the entire agreement of the Parties regarding the License upon
the Premises and supersedes any prior License, agreement, or negotiations. The Parties
acknowledge that there have been no representations by the State or understandings made between
the Licensor and Licensee regarding License other than those set forth in this License. Licensor
makes no additional disclosures or promises other than those expressly made in this License
This License may not be modified except by a written instrument duly executed by the Parties hereto.
26. Section Headings: All section headings contained herein are for convenience of reference
only, and are not intended to define or limit the scope of any provision of this license.
27. Counterparts: This license may be executed in one or more counterparts, each of which shall
be deemed as original but all of which together shall constitute one and the same instrument.
28. Signatories: The signatories to this License herein represent they have the requisite legal
authority to bind the Parties to the terms of this license.
[Remainder of Page Left Intentionally Blank]
NATIONAL CITY POLICE DEPARTMENT, FIRING RANGE USE
AGREEMENT AT RICHARD J. DONOVAN CORRECTIONAL
FACILITY
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DocuSign Envelope ID: E57D4243-E303-4969-9F9E-B8C0C8A71F17
IN WITNESS WHEREOF, the Parties have executed this License by their duly authorized
representatives.
DEPARTMENT OF CORRECTIONS AND REHABILITATION
DocuSigned by:
fi �a t,f.
By-,--2Ubu 2 iF3E664Ag...
TAMER AHMED, PE, PMP
Associate Director
Facilities Asset Management Branch
Facility Planning, Construction and Management
Department of Corrections and Rehabilitation
8/19/2021
Date Executed
NATIONAL CITY POLICE DEPARTMENT, INVESTIGATIONS DIVISION
DocuSigned b
By:
OSE I�.LI_Lo4w...
Chief of Police
National City Police Department
8/12/2021
Date Executed
APPROVED:
STATE OF CALIFORNIA
DIRECTOR OF DEPARTMENT OF GENERAL SERVICES
DocuSigned by:
By: /O*7 3M�1
0
TONTtE&&tAS, Manager
State Owned Leasing & Development
Department of General Services
8/19/2021
Date Executed
NATIONAL CITY POLICE DEPARfiViEN i, FIRING RANGE USE
AGREEMENT AT RICHARD J. DONOVAN CORRECTIONAL
FACILITY
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DocuSign Envelope ID: E57D4243-E303-4969-9F9E-B8C0C8A71 F17
EXHIBIT A
PREMISES
DocuSign Envelope ID: E57D4243-E303-4969-9F9E-B8C0C8A71F17
R.J. Donovan Correctional
Facility APN 648-040-26-00
November 2020
RJD-NC PD-01
st Mesa
ntion C
Ri and db Donovan
Correctional Facility
DocuSign Envelope ID: E57D4243-E303-4969-9F9E-B8C0C8A71F17
R.J. Donovan Correctional Facility
APN 648-040-26-00
November 2020
RJ D-C H P-01
DocuSign Envelope ID: E57D4243-E303-4969-9F9E-B8C0C8A71 F17
EXHIBIT B
TRAINING CURRICULUM
DocuSign Envelope ID: E57D4243-E303-4969-9F9E-B8C0C8A71 F17
R.J. LJVIIVVd11 LW f CL.I.IUIIdI rduilLy
APN 648-040-26-00
November 2020
RJD-NC PD-01
To be provided to the Range Master or designee upon approval of schedule; prior to
entry.
DocuSign Envelope ID: E57D4243-E303-4969-9F9E-B8C0C8A71 F17
EXHIBIT C
SCHEDULING
DocuSign Envelope ID: E57D4243-E303-4969-9F9E-B8C0C8A71 F17
R.J. Donovan Correctional Facility
APN 648-040-26-00
November 2020
RJD-NC PD-01
RJD Armory Staff or designee are responsible for coordinating all firing range scheduling. The
RJD range times are as follows:
• All live fire will be restricted to 0600-1800 hours.
• Reserved night- shoots shall be conducted 1700-2100 hours.
LICENSEE shall receive range dates and availability from RJD Armory Staff or designee forty-
eight hours in advance of training dates.
DocuSign Envelope ID: E57D4243-E303-4969-9F9E-B8C0C8A71 F17
EXHIBIT D
EQUIPMENT
DocuSign Envelope ID: E57D4243-E303-4969-9F9E-B8C0C8A71 F17
R.J. LJLJIILJVdII LLJI1el-LILJIIdI rdl.11lly
APN 648-040-26-00
November 2020
RJD-NC PD-01
To be provided to the Range Master or designee upon approval of schedule; prior to
entry.
DocuSign Envelope ID: E57D4243-E303-4969-9F9E-B8C0C8A71 F17
EXHIBIT E
R.J. DONOVAN CORRECTIONAL FACILITY FIRING RANGE GENERAL
RULES AND REGULATIONS
DocuSign Envelope ID: E57D4243-E303-4969-9F9E-B8C0C8A71 F17
R.J. Donovan Correctional Facility
APN 648-040-26-00
November 2020
RJD-NC PD-01
Range
1. R.J. Donovan Correctional Facility (hereby referred to as RJD) agrees that the Licensee shall have use
of all on -site facilities located on the range for training purposes.
2. The Licensee agrees to appoint a person to act as a liaison to communicate with the RJD Armory/Range
Sergeant, and further agrees that upon any change in the Licensee liaison, RJD will be notified
immediately.
3. The use of said range by the Licensee shall be limited to those members of the Licensee. Anyone under
the age of 18 years must have their agencies waiver and medical insurance forms signed by a parent or
legal guardian.
4. RJD and the Licensee agree that said shooting range shall be open and useable by members of the
Licensee at such times that are mutually agreeable to all parties hereto, but that exclusive use of the
facilities for any time or times is with the mutual agreement of all parties and based on availability.
5. Both parties hereto agree that all empty cartridges resulting from the Licensee utilizing the RJD Range
will remain the property of Licensee and will be removed from the firing range after each use.
6. The Licensee agrees that all members of the Licensee will be subject to the range safety rules
established by California Department of Corrections and Rehabilitation.
7. The Licensee agrees to avoid shooting the wooden target frames, as much as possible.
8. The Licensee agrees not to change or alter the target frame system. There will be no target changes
without permission from the RJD Armory/Range Sergeant.
9. All Licensee staff that enter RJD grounds for the purpose of utilizing the range facility, must drive
directly to the range and not stop anywhere on prison grounds.
10. All participants must adhere to the clothing restrictions of RJD. The wearing of blue denim pants, blue
denim/chambray-type shirts and grey colored sweat clothing are prohibited. If tactical clothing such
as camouflage is the uniform of the day while at the range facility, the RJD Armory/Range Sergeant
will be advised at the time of request.
11. Prior to commencing any live fire training, range pennants must be raised. Once training is completed,
Pennant flags will be lowered.
12. All live fire will be restricted to 0600-1800 hours.
13. Reserved night- shoots shall be conducted 1700-2100 hours.
14. Upon completion of training Range -Master in charge will contact RJD Range- Master to conduct a
joint Range inspection. The Licensee will remove all expended shell casings and place all used targets
and trash into the dumpster provided. The range will be inspected for all shell casings, litter and a
full inventory of weapons, equipment and live ammunition will be completed before leaving the range.
If the Range Classroom is utilized, the trash from the classroom will also be emptied.
DocuSign Envelope ID: E57D4243-E303-4969-9F9E-B8C0C8A71 F17
R.J. Donovan Correctional Facility
APN 648-040-26-00
November 2020
RJ D-CH P-01
Safety
1. All incidents or unusual occurrences must be reported to the RJD Watch Commander at extension
5302 and the RJD Armory/Range Sergeant at (760) 348-7000 extension 7558. All medical
emergencies can be reported by utilizing the telephone system in the classroom by dialing 7705 and or
5500, RJD's Fire Department (No inmates will respond to any medical emergency at the range).
Emergencies may also be called directly to the Licensee Dispatch, via the radio system utilized by the
Licensee. All range related incidents/accidents must also be reported to the Armory/Range Sergeant.
Per Departmental policy, Licensee will be required to complete a CDCR 837-C Crime/Incident
Report, Part C documenting the incident/accident.
2. No weapons or ammunition of any sort will be permitted on the range when inmates are present.
3. Weapons or ammunition shall never be left unattended.
4. The Range master/Firearms Instructor for the Licensee will ensure that all firearm safety procedures
are followed at all times.
5. All Agencies must create an emergency medical plan annually; the plan must be reviewed and
approved by RJD Range -Master.
6. Chemical agents are not authorized unless prior approval has been received by the IST Manager via
the RJD Range -Master. No Hazardous materials shall be stored at the range, unless they meet the
standards of CAL OSHA/ACA STANDARDS and there is the MSDS on site, perpetual inventory
utilized and stored in a flammable locker.
Accountability and Cleanliness
1. All live rounds will be collected and accounted for.
2. All expended brass will be policed, collected and placed in containers.
3. All participants shall vigorously pursue the cleanliness of the range and surrounding areas. All
shattered wood, used cardboard, paper targets will be placed in an available dumpsters.
4. All agencies are responsible for cleanliness and stocking toilet supplies of all restrooms utilized by
their staff.
DocuSign Envelope ID: E57D4243-E303-4969-9F9E-B8C0C8A71F17
RJD-NC PD-01
EXHIBIT F
STATE PRISON & DETENTION FACILITY REGULATIONS FOR ON -SITE CONDUCT
Lessees, Licensees, Promoters, Contractors and their employee(s), volunteer(s), invitee(s), and
subcontractor(s), non -department employees and their agent(s), employee(s), volunteer(s) and
invitee(s) who are not employed by the California Department of Corrections and Rehabilitation
(CDCR) hereinafter collectively referred to as "NON CDCR PARTIES", but are working, accessing
or parking within proximity to inmates and wards housed at CDCR's
properties/Institutions/facilities and/or camps, also called "premises", are to be apprised of the
laws, rules and regulations governing behaviors and conduct while on or within CDCR
properties/Institutions/facilities and/or camps.
NON CDCR PARTIES agree that if the provisions of the agreement require NON CDCR PARTIES to
enter State property under the jurisdiction of CDCR where inmates are housed and/or working
either at a prison facility, camp or surrounding property, the NON CDCR PARTIES shall be made
aware of and shall abide by the following laws, rules and regulations governing conduct at
CDCR's properties/Institutions/facilities and/or camps.
a. Persons who are not employed by CDCR, but working, accessing or parking at CDCR
properties/Institutions/facilities and/or camps must observe and abide by all laws, rules
and regulations governing their conduct and behavior. Failure to comply with these
guidelines may lead to expulsion from STATE properties/Institutions/facilities and/or
camps.
SOURCE: California Penal Code (PC) Sections 5054 and 5058; California Code of
Regulations (CCR), Title 15, Sections 3285 and 3415, and California Welfare and
Institutions Code (WIC) Section 1712.
b. STATE does not recognize hostages for bargaining purposes. STATE has a "NO
HOSTAGE" policy and all prison inmates, wards, visitors, NON CDCR PARTIES and
employees shall be made aware of this.
SOURCE: PC Sections 5054 and 5058; CCR, Title 15, Section 3304 and 4603; WIC Section
1712.
c. All persons entering onto CDCR's properties/Institutions/facilities and/or camps consent
to search of their person, property or vehicle at any time. Refusal by individuals to
submit to a search of their person, property, or vehicle, may be cause for denial of
access to the premises.
SOURCE: PC Sections 2601, 5054, and 5058; CCR, Title 15, Sections 3173, 3177, 3288,
4696, and 4697; WIC 1712.
Regulations and Conduct, Exhibit G Page 1
DocuSign Envelope ID: E57D4243-E303-4969-9F9E-B8C0C8A71F17
CEN-DOJDEA-01
d. Persons normally permitted to enter properties/Institutions/facilities and/or camps may
be barred, for cause, by the CDCR Secretary, Warden, and/or Parole Administrator.
SOURCE: PC Sections 5054 and 5058; CCR, Title 15, Section 3176(a) and 4696; WIC
Section 1712.
e. It is illegal for an individual who has been previously convicted of a felony offense to
enter into a CDCR adult institutions/facilities or camps, or youth institutions/facilities or
camps during evening hours, without the prior approval of the Warden or officer in
charge. It is also illegal for an individual to enter onto these premises for unauthorized
purposes or to refuse to leave said premises when requested to do so. Failure to
comply with this provision could lead to prosecution.
SOURCE: PC Section 602, 4570.5 and 4571: CCR, Title 15, Sections 3173 and 3289; WIC
Section 1001.7.
f. Encouraging and/or assisting prison inmates to escape, is a crime. It is illegal to bring
firearms, deadly weapons, explosives, tear gas, drugs, or drug paraphernalia onto CDCR
properties/Institutions/facilities and/or camps premises. It is illegal to give prison
inmates or wards firearms, explosives, alcoholic beverages, narcotics, or any drug or
drug paraphernalia, including cocaine or marijuana. It is illegal to give wards sex
oriented objects or devices and written materials and pictures whose sale is prohibited
to minors.
SOURCE: PC Sections 2772, 2790, 4533, 4535, 4550, 4573, 4573.5, 4573.6 and 4574;
Title 15 Sections 4681 and 4710; WIC Sections 1001.5 and 1152.
g. It is illegal to give or take letters from inmates or wards without the authorization of the
Warden or officer in charge. It is also illegal to give or receive any type of gift and/or
gratuities from prison inmates or wards.
SOURCE: PC Sections 2540, 2541 and 4570; CCR, Title 15, Sections 3010, 3399, 3401,
3424, 3425 and 4045; WIC Section 1712.
h. In an emergency situation, the visiting program and other program activities may be
suspended.
SOURCE: PC Section 2601: CCR, Title 15, Sections 3383, 4002.5 and 4696.
i. Interviews with SPECIFIC INMATES are not permitted. Conspiring with an inmate to
circumvent policy and/or regulations constitutes a rule violation that may result in
appropriate legal action. Interviews with individual wards are permitted with written
consent of each ward if he/she is 18 years of age or older, or with written consent of a
parent, legal guardian, or committing court, if 17 years of age or younger.
Regulations and Conduct, Exhibit G Page 2
DocuSign Envelope ID: E57D4243-E303-4969-9F9E-B8C0C8A71F17
CEN-DOJDEA-01
SOURCE: CCR, Title 15, Sections 3261.5, 3315(a)(3)(X), and 3177 and 4700(a)(1).
Security Regulations
a. NON CDCR PARTIES are required to complete a Request for Gate Clearance to enter the
facility a minimum of ten (10) business days prior to commencement of service. All NON
CDCR PARTIES must be cleared prior to providing services. The Request for Gate
Clearance must include the person's full legal name, social security number, valid state
driver's license number or state identification card number and date of birth.
Information shall be submitted to the Business Services Office contact or his or her
designee. CDCR uses the Request for Gate Clearance to run a California Law
Enforcement Telecommunication System (CLETS) check. The check will include
Department of Motor Vehicles check, Wants and Warrants check, and Criminal History
check. Gate clearance may be denied for the following reasons: Individual's presence in
the institution presents a serious threat to security, individual has been charged with a
serious crime committed on institution property, inadequate information is available to
establish positive identity of prospective individual, and/or individual has deliberately
falsified his/her identity.
b. All persons (CDCR Employees and NON CDCR PARTIES) entering the facility must have a
valid state driver's license or photo identification card on their person.
c. Excepting situations where alternate access has been granted by written agreement
with CDCR, unless otherwise directed by the entrance gate officer and/or Business
Services Manager, NON CDCR PARTIES shall enter and exit through the ingress and
egress points identified in the "Site Plan Exhibits" of this agreement. In all instances
NON CDCR PARTIES shall remove keys from the vehicle ignition when not seated in the
vehicle. Unattended vehicles shall be locked and secured at all times while on
institution grounds.
d. If any state-owned and non -state-owned equipment is used by NON CDCR PARTIES for
the provision of contract services, the equipment shall be rendered temporarily
inoperative when not in use, by locking or other means unless specified otherwise.
e. In the event that the services required under this Agreement, License, Lease or Contract
will be performed within a CDCR institution/parole office/community-based program,
NON CDCR PARTIES who are assigned to work with, near or around inmates/parolees
shall be required to be examined and tested or medically evaluated by a licensed
healthcare provider for Tuberculosis (TB) in an infectious or contagious stage prior to
the performance of contracted duties, and at least once a year thereafter (within 12-
months of their initial or previous TB test under this Agreement, License or Lease), or
more often as directed by CDCR. NON CDCR PARTIES who have any contact (physical or
nonphysical) with inmates/parolees, shall be required to furnish to the CDCR
Program/Institution Contract Manager, at no cost to CDCR, a documented TB
evaluation/test for TB infection via Tuberculin Skin Test (TST) or a blood test Interferon
Regulations and Conduct, Exhibit G Page 3
DocuSign Envelope ID: E57D4243-E303-4969-9F9E-B8C0C8A71F17
CEN-DOJDEA-01
Gamma Release Assay (IGRA) completed within (30) thirty -days of the start date of the
services and certified to be free of TB in an infections or contagious stage by a licensed
healthcare provider prior to assuming their contracted duties and annually thereafter.
f. In order to maintain institution safety and security periodic fire prevention inspections
and site searches may become necessary and NON CDCR PARTIES must allow access to
any and all locked areas at the Premises, if any. The State shall in no way be responsible
for NON CDCR PARTIES loss due to fire.
g. NON CDCR PARTIES shall observe all security rules and regulations and comply with all
instructions given by institutional authorities.
h. Electronic and communicative devices such as: pagers; mobile (cell) phones; wearable
technology with stand-alone cellular phone or internet capability, photographic
capability, and audio/video replay and transmission capabilities; and cameras/micro
cameras are not permitted on institution grounds. If NON CDCR PARTIES are not
entering prison property this section is for informational purposes only.
i. NON CDCR PARTIES shall not cause undue interference with the operations of the
institution.
j. Picketing/protesting is prohibited on State property.
k. Due to security procedures, NON CDCR PARTIES may be delayed at any time at the
institution vehicle/pedestrian gates and sally ports. Any loss of time checking in and out
of the institution gates and sally ports shall be borne by NON CDCR PARTIES.
I. When driving onto or off of prison grounds, NON CDCR PARTIES are required to stop at
the front entrance gate for staff to conduct a visual inspection of the interior of your
vehicle, your vehicles trunk, and may also utilize Narcotic Detection K-9's to assist in the
inspection.
Tobacco -Free Environment
Pursuant to Penal Code Section 5030.1, the use of tobacco products by any person on
the grounds of any Institution or facility under the jurisdiction of the CDCR is prohibited.
Clothing Restrictions
While on Institution grounds, representatives of the CDCR and NON CDCR PARTIES shall
be professionally and appropriately dressed in clothing distinct from that worn by
inmates at the institution. Specifically, blue denim pants and blue chambray shirts,
orange/red/yellow/white/chartreuse jumpsuits and/or yellow rainwear shall not be
worn onto Institution grounds as this is inmate attire. NON CDCR PARTIES should
Regulations and Conduct, Exhibit G Page 4
DocuSign Envelope ID: E57D4243-E303-4969-9F9E-B8C0C8A71F17
CEN-DOJDEA-01
contact the institution regarding clothing restrictions prior to requiring access to the
institution to assure all NON CDCR PARTIES are in compliance.
For security reasons, visitors must not wear clothing that in any way resembles State
issued prison inmate or ward clothing (blue denim shirts, blue denim pants).
SOURCE: CCR, Title 15, Section 3174(b)(1) and 4696.
Prison Rape Elimination Policy
This policy applies to all offenders and persons employed by the CDCR, including NON
CDCR PARTIES assigned to an institution, community correctional facility, conservation
camp, or parole as described in Department Operations Manual (DOM), Chapter 5,
Article 44.
CDCR maintains a zero tolerance for sexual violence, staff sexual misconduct and sexual
harassment in its institutions, community correctional facilities, conservation camps,
and for all offenders under its jurisdiction. All sexual violence, staff sexual misconduct,
and sexual harassment is strictly prohibited.
CDCR is committed to providing a safe, humane, secure environment, free from
offender on offender sexual violence, staff sexual misconduct, and sexual harassment.
This will be accomplished by maintaining a program to address education/prevention,
detection, response, investigation, and tracking of these behaviors and to address
successful community re-entry of the offender.
All staff, including CDCR employees and NON CDCR PARTIES, shall receive instruction
related to the prevention, detection, response, and investigation of offender sexual
violence, staff sexual misconduct, and sexual harassment. This training will be
conducted during new employee orientation, annual training, and will be included in the
curriculum of the Correctional Training Academy. The training will be gender specific
based on the offender population at the assigned institution and will include how to
communicate professionally with inmates, including inmates who identify themselves as
Lesbian, Gay, Bi-Sexual, Transgender, Intersex, and Gender Officer Non — Conforming in
accordance with Inmate/Staff Relations Training, on file with the Peace Officer Selection
and Employee Development (POSED). Participation in the training will be documented
on a CDCR 844, Training Participation Sign -in Sheet.
Prohibited discriminatory, harassing, or retaliatory behavior which may be found to
constitute a violation of CDCR's PREA policy includes, but is not limited to: 1) Bullying or
abusive conduct, including repeated infliction of verbal abuse and use of derogatory
remarks, insults, and epithets 2) Repeatedly calling a transgender inmate by the wrong
pronouns or name, after the transgender inmate has provided notice of his or her
gender identity to staff.
Regulations and Conduct, Exhibit G Page 5
DocuSign Envelope ID: E57D4243-E303-4969-9F9E-B8C0C8A71F17
CEN-DOJDEA-01
NON CDCR PARTIES contracted with CDCR, shall not assign an employee to a CDCR
facility or assign an employee to duties if that employee will have contact with CDCR
inmates, if that employee has 1) engaged in sexual abuse in a prison, jail, lockup,
community confinement facility, juvenile facility, or other institution (as defined in 42
U.S.C.1997); 2) been convicted of engaging of attempting to engage in sexual activity in
the community facilitated by force, overt or implied threats of force, or coercion, or if
the victim did not consent or was unable to consent or refuse; or 3) has been civilly or
administratively adjudicated to have engaged in the activity described in this section.
NON CDCR PARTIES shall conduct a criminal background records check for each
contracted employee who will have contact with CDCR inmates and retain the results
for audit purposes. By signing this Lease, License, Agreement, or Contract, the NON
CDCR PARTIES agree to ensure that all of the mandates of this Section Prison Rape
Elimination Policy are complied with. Material omissions, by the contract employee,
regarding such misconduct or the provision of materially false information shall be
grounds for removal from Institution grounds.
NON CDCR PARTIES who appear to have engaged in staff sexual misconduct shall be
prohibited from contact with offenders and shall be reported to relevant licensing
bodies by the hiring authority or designee. Offender's allegation of sexual misconduct is
subject to administrative and/or criminal investigation. Referral shall be made to the
District Attorney unless the activity was clearly not criminal.
Retaliatory measures against employees or offenders who report incidents of sexual
violence, staff sexual misconduct, or sexual harassment as well as retaliatory measures
against those who cooperate with investigations shall not be tolerated and shall result in
disciplinary action and/or criminal prosecution. Retaliatory measures include, but are
not limited to, coercion, threats of punishment, or any other activities intended to
discourage or prevent a staff or offenders from reporting the incident(s) or cooperating
with investigation of an incident(s).
SOURCE: CCR, Title 15, Sections 3316, 3335, 3337, 3377.1(c), 3401.5; DOM Sections
54040.1, 54040.4, 54040.4.1, 54040.12.4, and 54040.15.
Regulations and Conduct, Exhibit G Page 6
DocuSign Envelope ID: E57D4243-E303-4969-9F9E-B8C0C8A71F17
txmoit li
RJD-NC PD-01
STATE OF CALIFORNIA
DEPARTMENT OF CORRECTIONS AND REHABILITATION
SPECTATOR WAIVER AND RELEASE OF LIABILITY, ASSUMPTION OF RISK, COVENANT
NOT TO SUE AND INDEMNITY AGREEMENT
In consideration of being allowed to participate, this Spectator Waiver and Release of Liability, Assumption of Risk,
and Indemnity Agreement ("Spectator Waiver Agreement") is required for voluntary participation of spectator
activities on State of California Prison Property under the jurisdiction of the California, Department of Corrections
and Rehabilitation ("CDCR").
As used in this Spectator Waiver Agreement, any references to the "State" and/or the "CDCR" refers to the State
of California, the California Department of Corrections and Rehabilitation and all related entities that may control
or are controlled by CDCR or together its personnel, employees, agents, invitees, contractors, and subcontractors.
I, [Insert Name] represent that I am at least eighteen years of age and enter into
this Spectator Waiver Agreement for permission to access and view training at the premises located on the State's
property generally known as [insert Institution Name and Address]
(hereinafter "Premises") for the purposes of observing training methods used by the CDCR. I understand the
Premises is a non-commissioned state detention facility with hazardous conditions both known and unknown.
further understand that these conditions may be unsafe and may pose an element of risk, including serious injury
or death, associated with my access and presence.
knowingly and freely hereby assume the inherent and extraordinary risks involved in the observation of training
activities and any risks inherent in any other activities connected with the training, even if arising from the
negligence of CDCR or others, and assume full responsibility for my participation and observation. I fully
understand that there is a risk of injury or death from this training due to my presence at or near the training and
training location. If, however, I observe any unusual and/or significant hazard during my presence I will remove
myself form the area that I perceive as a hazard and shall bring such hazard to the attention of the nearest official.
I, for myself and on behalf of my heirs, assigns, personal representatives and/or next of kin, hereby release and
hold harmless CDCR as well as its officers, directors, representatives, agents and/or employees, contractors,
subcontractors or volunteers WITH RESPECT TO ANY AND ALL INJURY, COSTS, LIABILITY, DISABILITY,
DEATH and/or loss or damage to person or property incurred by me in connection with my participation as a
training spectator whether arising from the negligence of the CDCR or otherwise, to the fullest extent permitted by
law. I further agree to indemnify, defend and hold harmless CDCR from any loss, liability, cost, claim or damages
arising from my association with and presence at the training activities, including reasonable attorney fees.
My participation is entirely voluntary.
I consent to administration of first aid and other medical treatment in the event of injury or illness and hereby
release and indemnify CDCR from any and all liability or claims arising out of such treatment.
I HAVE READ THIS AGREEMENT AND FULLY UNDERSTAND THAT I AM GIVING UP SUBSTANTIAL RIGHTS
BY SIGNING IT, INCLUDING THE RIGHT TO DEMAND ANY COMPENSATION FOR INJURY OR DAMAGE
THAT MAY OCCUR AS A RESULT OF MY PARTICIPATION AND PRESENCE. I am signing this Agreement and
agreeing to its terms feely and without any inducement of any nature. I agree that if any portion of this Agreement
is held to be invalid, all other terms shall continue in full force and effect.
Printed Name Date
Signature
DocuSign Envelope ID: E57D4243-E303-4969-9F9E-B8C0C8A71 F17
ISSUE DATE
CATE NO.
WC-913
CERTIFICATE OF COVERAGE
06/25/2021
PUBLIC RISK INNOVATION,
SOLUTIONS, AND MANAGEMENT
CIO ALLIANT INSURANCE SERVICES, INC.
PO BOX 6450
NEWPORT BEACH, CA 92658-6450
PHONE (949) 756-0271 / FAX (619) 699-0901
LICENSE #0C36861
THIS CERTIFICATE 1S 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 BELOW. THIS
CERTIFICATE OF COVERAGE DOES NOT CONSTITITUE A CONTRACT BETWEEN THE
ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE
CERTIFICATE HOLDER
IMPORTANT: If the certificate holder is requesting a WAIVER OF SUBROGATION, the
Memorandums of Coverage must be endorsed. A statement on this certificate does not confer
rights to the certificate holder in lieu of such endorsement(s).
COVERAGE
AFFORDED BY: A - See attached schedule of insurers
Member:
CITY OF NATIONAL CITY
MICHAEL GOMEZ
1243 NATIONAL CITY BLVD.
NATIONAL CITY, CA 91950
COVERAGE
AFFORDED BY: B
COVERAGE
AFFORDED BY: C
COVERAGE
AFFORDED BY: D
Coverages
THIS IS TO CERTIFY THAT THE MEMORANDUMS OF COVERAGE AND POLICIES LISTED BELOW HAVE BEEN ISSUED TO THE MEMBER
NAMED ABOVE FOR THE 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 COVERAGE AFFORDED BY
THE MEMORANDUMS AND POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH
MEMORANDUMS AND POLICIES.
CO
LTR
TYPE OF COVERAGE
MEMORANDUM/
POLICY NUMBER
COVERAGE EFFECTIVE
DATE
COVERAGE EXPIRATION
DATE
LIABILITY LIMITS
A
EXCESS WORKERS'
COMPENSATION &
EMPLOYER'S LIABILITY
See attached
Schedule of Insurers
for policy numbers
07/01/2021
07/01/2022
WORKERS' COMPENSATION:
Difference between
Statutory and Member's
$500,000 Retention
EMPLOYERS' LIABILITY:
Difference between
$5,000,000 and Member's
Retention
LIMITS APPLY PER OCCURRENCE FOR ALL PROGRAM MEMBERS COMBINED.
Description of OperationsfLocationsNehicles/Special Items:
AS RESPECTS EVIDENCE OF COVERAGE FOR TEMPORARY RIGHT OF ENTRY AGREEMENT DATED MARCH 22, 2021 BETWEEN CITY OF
NATIONAL CITY AND STATE OF CALIFORNIA DEPARTMENT OF GENERAL SERVICES WITH CONSENT OF DPEARTMENT OF CORRECTIONS
AND REHABILITATION FOR NATIONAL CITY POLICE DEPARTMENTS USE OF FIRING RANGE AT RICHARD J. DONOVAN CORRECTIONAL
FACILITY LOCATED AT 480 ALTA ROAD, SAN DIEGO, CA 92179.
THE AUTHORITY WAIVES ITS RIGHTS OF SUBROGATION AGAINST STATE OF CALIFORNIA AND THE DIRECTOR OF THE DEPARMENT OF
GENERAL SERVICES (DGS) AND THEIR OFFICERS, AGENTS AND EMPLOYEES PURSUANT TO ENDORSEMENT NUMBER U-2.
Certificate Holder
STATE OF CALIFORNIA
ATTN: REAL ESTATE AND LAND -USE MANAGEMENT
9838SECTION
OLD C RD., STE B
SACRAMENTO, CA 95827
Cancellation
SHOULD ANY OF THE ABOVE DESCRIBED MEMORANDUMS OF COVERAGE/POLICIES
BE CANCELLED BEFORE THE EXPIRATION THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE MEMORANDUMS OF COVERAGE/POLICIES PROVISIONS.
AUTHORIZED REPRESENTATIVE
.Y-
Public Risk Innovation, Solutions, and Management
DocuSign Envelope ID: E57D4243-E303-4969-9F9E-B8C0C8A71 F17
PUBLIC RISK INNOVATION, SOLUTIONS, AND MANAGEMENT
EXCESS WORKERS' COMPENSATION PROGRAM
2021/2022 SCHEDULE OF INSURERS
CITY OF NATIONAL CITY
PROVIDER
MEMORANDUM /
POLICY NUMBER
LIMIT
Public Risk Innovation, Solutions,
PRISM PE 21 EWC-58
Workers' Compensation:
and Management
$50,000,000 each accidentleach employee
for disease
(Difference between $50,000,000 and the
individual member's retention)
Employers' Liability:
$5,000,000 each accidentleach employee
for disease
(Difference between $5,000,000 and the
individual member's retention)
Liberty Insurance Corporation
EW7-64N-444785-011
Statutory each accidentleach employee
for disease excess of
$50,000,000
DocuSign Envelope ID: E57D4243-E303-4969-9F9E-B8C0C8A71 F17
ENDORSEMENT NO. U-2
PUBLIC RISK INNOVATION, SOLUTIONS, AND MANAGEMENT
EXCESS WORKERS' COMPENSATION
WAIVER OF SUBROGATION ENDORSEMENT
It is understood and agreed that Section VIII. SUBROGATION of the CONDITIONS section of the
Memorandum of Coverage is deleted in its entirety and replaced by the following:
VIII. SUBROGATION: In the event of any payment under this Memorandum, PRISM shall be
subrogated, to the extent of such payment, to all the Covered Party's rights of recovery therefore,
and the Covered Party shall execute all papers required and shall do everything that may be
necessary to secure such rights. Any amount recovered as a result of such proceedings, together
with all expenses necessary to the recovery of any such amount shall be apportioned as follows:
PRISM shall first be reimbursed to the extent of its actual payment hereunder. If any balance then
remains, said balance shall be applied to reimburse the Covered Party. The expenses of all
proceedings necessary to the recovery of such amount shall be apportioned between the Covered
Party and PRISM in the ratio of their respective recoveries as finally settled. If there should be no
recovery in proceedings instituted solely on the initiative of PRISM, the expenses thereof shall be
borne by PRISM.
However, in the event of any loss payment under this Memorandum for which you have waived the
right of recovery in a written contract entered into prior to the loss, we hereby agree to also waive our
right of recovery but only with respect to such Toss.
It is further agreed that nothing herein shall act to increase PRISM's limit of indemnity.
This endorsement is part of the Memorandum of Coverage and takes effect on the effective date of
the Memorandum of Coverage unless another effective date is shown below. All other terms and
conditions remain unchanged.
Effective Date:
Issued to: ALL MEMBERS
Issue Date: June 25, 2021
orized Representative
Public Risk Innovation, Solutions, and Management
Memorandum No.: PRISM 21 EWC-00
DocuSign Envelope ID: E57D4243-E303-4969-9F9E-B8C0C8A71 F17
RJD-NC PD-01
EXHIBIT H
CERTIFICATE OF SELF-INSURANCE COVERAGE
DocuSign
Certificate Of Completion
Envelope Id: E57D4243E30349699F9EB8C0C8A71 F17
Subject: Please DocuSign: RJD - National City Police Dept. Fire Range
Source Envelope:
Document Pages: 31 Signatures: 3
Certificate Pages: 2 Initials: 0
AutoNav: Enabled
Envelopeld Stamping: Enabled
Time Zone: (UTC-08:00) Pacific Time (US & Canada)
Status: Completed
Right of Entry and License Agreement
Envelope Originator:
Kelly Campbell
1900 Birkmont Drive
Rancho Cordova, CA 95742
KELLY.CAMPBELL@cdcr.ca.gov
IP Address: 153.48.247.250
Record Tracking
Status: Original
8/3/2021 10:13:58 AM
Security Appliance Status: Connected
Storage Appliance Status: Connected
Holder: Kelly Campbell
KELLY.CAMPBELL@cdcr.ca.gov
Pool: StateLocal
Pool: CDCR DocuSign Parent Account
Location: DocuSign
Location: DocuSign
Signer Events
Signature
Timestamp
Jose Tellez
JTellez@nationalcityca.gov
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Tamer Ahmed
Tamer.Ahmed@cdcr.ca.gov
Associate Director, Facilities Asset Management
Branch
CDCR Carahsoft OBO California Department of
Corrections and Rehabilitation (CDCR)
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Tony Psihopaidas
Tony.Psihopaidas@dgs.ca.gov
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
r—Doc///uuSigned by:
'—99
AF5ABBFD...
Signature Adoption: Drawn on Device
Using IP Address: 12.188.214.220
—DocuSigned by:
to r atuitl . L
9D8D021F3E6B4A8...
Signature Adoption: Pre -selected Style
Using IP Address: 153.48.247.250
,—DocuSigned by:
"—DBEEECC820594E5..
Signature Adoption: Pre -selected Style
Using IP Address: 66.74.45.2
Sent: 8/3/2021 10:21:06 AM
Resent: 8/11/2021 9:30:20 AM
Viewed: 8/12/2021 3:26:07 PM
Signed: 8/12/2021 3:31:19 PM
Sent: 8/12/2021 3:31:31 PM
Viewed: 8/19/2021 9:22:55 AM
Signed: 8/19/2021 9:23:09 AM
Sent: 8/19/2021 9:23:20 AM
Viewed: 8/19/2021 9:25:44 AM
Signed: 8/19/2021 9:26:13 AM
In Person Signer Events
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Timestamp
Editor Delivery Events
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Timestamp
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Status
Timestamp
Intermediary Delivery Events
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Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 8/3/2021 10:21:06 AM
Certified Delivered Security Checked 8/19/2021 9:25:44 AM
Signing Complete Security Checked 8/19/2021 9:26:13 AM
Completed Security Checked 8/19/2021 9:26:13 AM
Payment Events Status Timestamps