Loading...
HomeMy WebLinkAbout12820 ., " ! I o~ pt..:i i I I RESOLUTION NO. /,;2 Pc::t1J RBSOLUTION OF THE CITY OF SAN BERNARDIlfO AUTHORIZING THE ExECUTI:ON OF AN AGREElIIEN'l' WITH WILLI:AM EDWARD FLEMING, DBA FLEMING & ASSoCIA'mS, RELATING 'lO THE ADMINISTRA'l'I:ON OF CITY'S WORKERS' COMPENSAtiON CLAIMS. BE IT RESOLVED BY THE MAYOR AND COMMON COUNCIL OF THE CITY OF SAN BERNARDINO AS FOLLOWS: SECTION 1. The Mayor of the City of San Bernardino is authorized and directed to execute on behalf of said City an agreement with William Edward Fleming, dba Fleming & Associates, relating to the administration of City's Workers' Compensation claims, a copy of which is attached hereto, marked Exhibit "I- and incorporated herein by reference as fully as though set forth at length. I HEREBY CERTI:FYthat the foregoing resolution was duly adopted by the Mayor and Common Council of the City of San vote, to wit: meeting thereof, held , 1977, by the following Bernardino at a on the tt ~ day of AYES: CO~7~~~~~7 NAYS: of , 1977. - ABSENT: foregoing resolution is hereby . It I I , 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 .' . AGREEMENT (consultant - workers' compensation audit and administration) THIS AGREEMENT is made and entered into this 78-a.ay of / , 1977, by and between the CITY OF SAN BERNARDINO corporation, hereinafter called "City", and WILLIAM EDWARD FLEMING, dba Fleming & Associates, hereinafter called "Consultant" . WIT N E SSE T H: ---------- WHEREAS, City is in the process of undertaking the ad- ministration of its self-insurance program for its employees pursuant to the Workers' Compensation Laws of the State of California; and WHEREAS, Consultant is a State Certified Workers' Compen- sation Claims Administrator with extensive experience and expertis in performing competent audits of workers' compensation files establishing management practices and procedures for the adminis- tration of self-insurance programs; and WHEREAS, City desires to retain and employ Consultant to perform certain services in connection with the City's program for administering its own workers' compensation claims and to perform the tasks and duties hereinafter set forth; and WHEREAS, Consultant accepts said employment upon the terms and conditions herein set forth, NOW, THEREFORE, the parties hereto agree as follows: I. Audit. A. Consultant shall commence an audit of all City's open workers' compensation claims files and complete the audit of all of said files within two weeks after the receipt of the :. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 files from ESIS, the City's previous claims management agent. Said audit shall encompass and include: 1. A complete review of all open files with emphasis up0n disability, medical and legal control. Consultant will note all relevant deficiencies and recommend appropriate control measures. 2. A complete reconciliation of claims file expenditures with those listed in the Loss Experience Report. Consultant shall note and tabulate all discrepancies. 3. The adjustment and approval for payment of all unpaid, reasonably incurred bills and accrued benefits. 4. A review of all reserves and the necessary ad- justments to indicate a true and accurate value for each claim. All changes to reserves shall be recorded and tabulated. 5. A list of all files requiring indemnity pay- ents in the payment diary book. Diary entries shall be provided for all files on the basis of priority for periodic technical review. 6. The preparation and submission to City of a omprehensive audit report which shall tabulate, summarize and total all of the foregoing and which shall relate all relevant information ascertained as a result of the audit to City. B. It is understood and agreed by the parties hereto hat this audit to be conducted by Consultant involves approxi- ately 150 indemnity files and an unascertained number of pending "Medical Only" claims. C. Consultant's total fee for the work set forth in his Section I shall be the sum of fifteen hundred dollars -2- :' 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 W 21 n 23 24 25 26 27 28 ($1500.00) which shall be paid promptlY by City upon receipt by City from Consultant of the audit report which is in a form satisfactory to City's Loss Prevention Coordinator. D. Time is of the essence with respect to completion of this audit report prior to July 1, 1977, and Consultant warrant and represents that he will have the report delivered to city prio to July 1, 1977. city agrees to direct ESIS to deliver all files to Consultant and to cooperate with Consultant to enable Con- sultant to obtain said files promptly. II. Consulting Services. A. During the period from July 1, 1977 through June 30, 1978, Consultant shall work with city's-LosS Prevention Coordinator and staff in order to provide, establish and implement all systems required in order to efficiently and thoroughly administer the City's workers' compensation self-insurance pro- gram, Consultant's work shall include: 1. The making of appropriate recommendations to City as to the type, number and quantity of forms required to report, log, and process all workers' compensation claims. This work shall include designing appropriate documents including, but not limited to, face sheets, checks, payment orders, change order notices, and all documents needed for City's administration pro- gram. The said forms are to be adequate for providing the statis- tical analyses to be provided in the Monthly Loss Experience Report required by Section III hereof. 2. The establishing, implementing and insuring of the efficient operation of City's clerical procedures for claims administration including, but not limited to, a mail system, -3- 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 a pay diary system, technical diary system, and all systems re- quired for adequate administration and reporting of claims. 3. The establishing of routine and non-routine technical examination procedures including, but not limited to, the establishment of claims reserves: Arising Out of Employment - During Course of Employment investigations, regulation of dis- ability, medical and legal programs and preparation of litigation claims and contentions. 4. In connection with 1, 2 and 3 hereof, Con- sultant shall personally establish the system, together with all ancillary systems adequate for the administration of all claims, and instruct and train city's Loss Prevention Coordinator and staff so that they are knowledgeable and competent to perform all clerical and technical procedures for the complete adminis- tration of the program. As a part of this procedure, Consultant shall: (a) During the month of July, 1977, spend eight (8) full work days in city's offices establishing the pro- . gram and doing all things required of him. city shall have the right to designate the "work days" Consultant shall so perform. (b) During the month of August, 1977, Con- sultant shall spend at least one full day per week in City's offices doing the tasks required of him for the accomplishment of the work set forth in this Section II. In the event the one full day per week is determined by the city's Loss Prevention Co- ordinator to be insufficient for the month of August, 1977, then city's Loss Prevention Coordinator shall have the right to direct Consultant to be present in city's offices to perform the -4- II , , I 1 required work; provided that, notwithstanding the foregoing, Consultant shall not spend and charge for more than eight (8} full work days during said month of August. (c} During the month of September, 1977, Con- 2 3 4 5 sultant shall spend one work day per week in City's offices 6 performing his work; provided, however, he shall not be required 7 to spend more than four (4} days during the month of said 8 september. 9 (d} During the period from October 1, 1977 10 through June 30, 1978, Consultant shall spend one full work day 11 per month performing his tasks set forth herein; provided that 12 City's Loss Prevention Coordinator shall have the right to direct 13 Consultant to spend additional days during said months not 14 exceeding a total of four (4} days per month. City shall have the 15 right to designate the specific work days. 16 (e} The term work day as used herein shall 17 an City's normal eight (8} hour work day and Consultant shall be 18 present for his work during all normal working hours. 19 (f} During the one year term hereof, Con- 20 sultant shall make himself available by correspondence or 21 telephone for answering all relevant calls and inquiries of City's 22 Loss Prevention Coordinator in order to assist and encourage the 23 expeditious installation of the administrative system. ~ 5. Based on the foregoing, it is anticipated that 25 Consultant will be required to spend from 34 to 38 working days 26 in City's Loss Prevention Coordinator's offices. Consultant 27 shall be paid by City a per diem rate of one hundred eighty dol- 28 lars ($180.00} per work day, and it is anticipated that City's -5- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 n 23 24 25 26 n 28 ". total cost for Consultant's services that are to be provided under this Section II will be from the sum of $6,120.00 to $6,840.00 for the one year period from July 1, 1977 through June 30, 1978. Notwithstanding the foregoing, Consultant's total compensation paid by city hereunder shall not exceed said maximum sum of $6,840.00. Consultant shall be responsible for and pay for all of his expenses in connection with the work and his presence with City performed pursuant to Section II. 6. Consultant shall bill City on a calendar month basis at the per diem rate for his services as provided for herein, and city shall promptly pay Consultant's said billings after they are approved by City's Loss Prevention Coordinator and in accordance with City's normal accounting and payment procedures III. Loss Experience Report. A. City shall promptly provide copies of all face sheets, checks, payment orders, statistical change notices, and any other relevant documents to Consultant in order that Con- sultant may provide city with a computerized monthly compre- hensiv.e Loss Experience Report. It is understood and agreed by the parties hereto that all such documents received by Con- sultant on or before the last Friday of each month shall be processed into that month's Loss Experience Report. B. Consultant shall promptly provide City with monthly computerized comprehensive Loss Experience Reports which shall include printed detailed departmental and summary reports by the 10th day of the month following the cut off date of the last Friday of the preceding month. C. Consultant shall provide twelve (12) monthly -6- 1 reports for the year commencing July 1, 1977 and ending J~e 30, 2 1978, in a form satisfactory to City's Loss Prevention Coordinator 3 and adequate to provide City with all data necessary for City's 4 proper administration of its claims administration program. 5 D. Computer runs of the Loss Experience Report shall 6 be in a form and provide the information shown on a sample, a copy 7 of which is attached hereto, marked Exhibit "A" and incorporated 8 herein. 9 E. Consultant's compensation for this service shall 10 be at the rate of one hundred dollars ($100.00) per report for a 11 total of twelve hundred dollars ($1200.00) for the twelve month 12 period. Consultant shall bill for this service concurrently with 13 his billing for his services provided under Section II A-6 here- 14 linabove, and City shall promptly pay said bills as provided in 15 said Section II. 16 IV. General. 17 A. Consultant warrants his experience and 18 capabilities for the performance of all work to be performed by 19 Consultant hereunder to be as set forth in the Second Whereas 20 Clause hereinabove. 21 B. The experience, skill and expertise of Consultant 22 is of the essence, Consultant shall not assign (whether by assign- 23 ment, novation or otherwise) this Agreement in whole or in part or 24 any right or interest hereunder without the prior written consent 25 of City. 26 C. Consultant covenants that he presently has no 27 interest and shall not acquire any interest, direct or indirect, 28 which would conflict in any manner or degree with the performance I -7- 1 IOf services required to be performed under this Agreement. Con- sultant further covenants that in the performance of this Agree- ment no person having any such interest shall be employed. 2 3 4 D. Any reports, information, data, etc., given to or 5 prepared or assembled by Consultant under this Agreement shall not 6 be made available to any individual or organization by Consultant 7 without the prior written approval of City. 8 E. No material produced in whole or in part under this 9 Agreement shall be subject to copyright in the united States or 10 in any other country. The final audit report furnished by Con- 11 sultant to City shall become the sole property of City and City 12 shall have unrestricted authority to publish, disclose, distribute 13 and otherwise use, in whole or in part, any reports, data, or 14 other materials prepared under this Agreement. 15 F. Termination for Cause. If for any cause, Consultan 16 shall fail to fulfill in a timely and proper manner his obligation 17 under this Agreement, or if Consultant shall violate any of the 18 oovenants, agreements or stipulations of this Agreement, City 19 shall have the right to terminate this agreement by giving 20 written notice to Consultant of such termination and specifying 21 the effective date thereof at least five (5) days before the 22 effective date of such termination. In that event, all finished 23 or unfinished documents, data, studies, surveys, reports, files 24 or other material prepared by Consultant under this Agreement 25 shall, at the option of City, become its property and Consultant 26 shall be entitled to receive just and equitable pro-rata compen- 27 sat ion for any satisfactory work completed on such documents, 28 files or other materials. Notwithstanding the foregoing, Con- -8- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 , I i i I , II II II :'. sultant shall not be relieved of liability to City for damages sustained by City by virtue of any breach of this Agreement by Consultant, and City may withhold any payments to Consultant for the purpose of set-off until such time as the exact amount of damages due to City from Consultant is determined. G. City may terminate this Agreement at any time by giving written notice to Consultant of such termination and specifying the effective date thereof at least fifteen (15) days before the effective date of such termination. In such event, all finished or unfinished documents and other materials as des- cribed in paragraph F above shall, at the option of City, become its property. If the Agreement is terminated by City as provided herein, Consultant will be entitled to be paid all compensation fo work performed to the date of termination. If this Agreement is terminated due to the fault of Consultant, paragraph F hereof relative to termination shall apply. H. Should City require changes in the scope of the services of Consultant to be performed hereunder, such changes, including any corresponding increase or decrease in the amount of Consultant's compensation, which shall be mutually agreed upon by and between City and Consultant, shall be incorporated in this Agreement only by written amendment hereto. I. All notices herein required shall be in writing, and delivered in person or sent by certified mail, postage prepaid, as follows: City of San Bernardino Loss Prevention Coordinator 300 North "D" Street San Bernardino, California 92418 William Edward Fleming P.o. Box 193 . Sunland, California 91040 -9- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 ; ~ il " J. It is understood that the contractual relationship of the Consultant to the City is that of independent contractor. City shall not exercise control of the meanS or manner by which Consultant provides services under this Agreement. consultant as an independent contractor shall obtain at his own expense any and all required business licenses and permits. K. Consultant hereby agrees to, and shall, hold City, its elective and appointive boards, commissions, officers, agents and employees, harmless from any and all liability for damages and claims which may arise from Consultant's operation under this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement on the day and year first above written. ATTEST: '/ WILLIAM EDWARD FLEMING A~t1L/ito form: /. 0 . ". . ;;U~ Cl.ty . orney FILEO -1~W1 Luat.j.f~H, Clly Clerk ~p, . '" . 'I LC" '-.:_'::.:~ "-- .' _ .,. ~.__1EPUI'r -10- ~D t~ ". ~. .~, ("-.1 I' C'CI W~I- 1::)',0 <I: il. o Z H o (( ~ Z (( W ~ ~') t~ t--........ z~ W...... E~ I- ir: (~ <I <r (L I..iJ l1J >- l~ f- t,,~ '7 I!J [J:i ILl ~:::, ft: ~.-t }_.~ 1,-.) 1(1" '1 . .1: z ~ U) lL I] >- I- H U l- e! I] u. w (( W(I'. "lLl 1,.11- 7r.:I ........ Wo " HOO (rl ((<t 111(') r..... r..... LUzt.....t-..... .. "'-;I~"", ,~. LL E ("l () X 1.1.1 (<') ..J...... "'" Wl.L~i<t' >- Z tJ.. 0) C!I C) CI iMa :!t -ii:: 1_'<1: Jft 'J::: il. [-I- EE t.LI il. il. c') _J:> ....... <l:n:WI-O I-WI-Z CI(l)c:I:lJ.J1--- I-'Iti,::)n:: W CC: O:::Z .=, =:t t-C) () .;::' ,:;:. .':;:' .:.::' .~ (:) (j (:) ....... . . . () () (1) () lD 0) 10 ("'~ ... ..-J (.) C') ..-oot... ... I>~ (I) P) ~-... (;. () <::. (:) c:. 0:::' ,;:) () ,3 (".)U)1< ":::)>::::'1:"-10" r.....~..,"'f'... .- .-. .- .~. ~....' '.....' '....' '....,. 0::::> 0;:::' ,;:::. ',:::;' c' .::>.:::' () 0::-.:, (;:;. c:. <.:;. .:':: (0") (') r-: () 0) (I) ~.-1 ("'~,lO o;;:t ~D . . . . (~.~ f') ..-.. f") (,) 0) ("~ If) I';"r ..."" ....... ('.~ " . t......q-- (f) . . G., e.4 .,:() f".~ ...... ~-t ... ... ... ... 0'" t-.~ ........ I>~ t;~ ("'~ 1>4 f- l- .:::. ) ':::0 (::- <) '-' ';:::'0 i:) E E () ) .:::... ..... .;::;. - -:> ':::- lti il. il. .3 .:;': . . . f- () (~") '--~..' ...... (:) C) <I: W I- 0) 1>4 U I- Z lO ~ (J <I: W ..J l::l n:: .J cr: .J: (J ::1 I- (j 1-1- -.JltiEE ~:I :> fL 0_ (I) (j 0::: ~..... '"'....Wl1Jl-l~ ~::. (I) J..- z 11.1 1.1.1 <r I1J f.- E(I.:(7.iO::: l.i.J n::: ;2: CI:) }-I,..). 1-.1- EE l-LJ (L LL "'"> f,) LL 11:: LjJ 1- <'.:. EWl-:ZCI C) ((I <C ILJ I:...) LJJ C:i fr:: ~- II: (J': ItJ I::):') :;~~ J- (.) , , '.:::) " ,',.., .- ,::.:;:, ',,~) ',~ ..-.. ..... (:) (::;. (:) -' ~:) ::::. ,"~~,4., .;?().::) ';2 .....1.::).:..;)....1 c~ Lr) u'-:: 1I) .::) r"" ("~ ("~ .::) (~" "''''1 (:) - . ~7' ("'~ ~..,.. .:::;. () 0::) ..::;. 0:::).:..::0 (.;> (:) (:) lI') l.i) II) () t-.... r-:t (",~ .~.:) r.... I"~ I:~~ () >:::0 (:;. <:.:0 (::> .::. (:) (:;''' 05 f') IJ') Li1 C) I)) "7' r',~ f-'4 ~'-I ...0 (::) "", :* . '\"" - :-;;.' ! ,,~, :).3,.3 ~) f"~ .:::." ... (1.,..-01 I.~-.I (I ~ . ""'~ . . f"-~ U) (i) .,.... .. . t..... I,') ,,~t ..-'" ..~... ,n . ,;,.- ;tl(~~' . "... .: ~'.. > :. :' (.') 0::) )0(::. ....". ' .~_> t~f~~~. 0:::0 () (:) .:::::' (:;. ,',::. .:::::' .~") 'J'::) .;::. >::~ c:. C::. C).:) () () (J 0:::' <..... (~".:' (':;' () . . . .:::0 (I) () ) J) f.} I:"~ ') (,) ("~ ...." . . . . () U)'::) ("" C) 1:'.4 f'... t.... ~~ I:'," (2 1~!.5 O? .:,"~ '.,J ',_:, 1'.1 I)'" ("~ to I"'~ f') . . . . I.J) .::::. ',.0 0) ("~ () t'-... ("~ ("~ C. r:;t ('-4 " ,) ('.~ 'P'" .,'.... .,,-1 " . (,) '"-,, I,"." 1"'.... ('J (,) ...." .~... -. . f',.f 0:::1"' n) I') ~-t ....... I) E ':) II) t,- G". t.", 1_," ".t' ..... 1"1 ,::.:. f- I'" ft: <t # I: (..~ f.. ~. ("~ <:1: _.J t~ ItJ (.) ) :r:: ~- ";:r (I) LiJ I1J C:' I.J """'M t"... rt:: (',! I,) I.... w"'.)::c ':1: 't ::._" . ~,<. ..).J .',:t (I') ,,_,) ...... IPI r':.... r-::: I:"~ ....... "'~ "" ~..... ~-... (.) ..~) (,) I",) !'-" "..... ~() (:, ~~ ~~ (.~ lt~) (:) ~'... .... "~.~ "-.." 1:'.4 b) t.." ,.< 0'.. () <) >::) "'.1"...... "J"" (,) (;. 0::::' 0) I~') I:')>:::''::::> C:' (i) "-.-:1"' ~.,,~ ....... (.... 1"1'-. t.J 'uf:::'~ ~ 'j- fL (~.~ ~~ C) (1_ t.~ W :~ 0_ :> ~ -:> .J I', .:> -') If) f') ~....'" , I I f~) .I iL (,) -I) ~ ~. <> C) , ..... '.0 .-0 ~ Z it:: .,j H ::) * * ,::. I" ~-:I , * '.1) * n:: ..-D ::~~ z >- '* [- ~ " <I: I' ItJ I""" tl.J (I) .<< Z --. << :~ ....... ..ll l~ Z .-. * III ~.. ,~ (Yo ,.. ~-: H IL fr:: :> E * E ,., W (( "I (j CJ fr:: ',.' ..J t.- ,.~. p:J ". 2 I:::> 1,- 11.1 Ci . ItJ . n: I, 1-- 'I Z [- :~ (J: fi_ ll. '..' .--1 (( ,J :;,~ .~:.. .0 () <I: (I) IIJ f~J . :I: n-:: u: <I: fL (:I <1: .- IL H lLl I)) (I) ~.. '1: l:::t ~" I.LI I ~- I)) I ,. CI I.' -:;r ,::. 1-.... () ttJ C) ,c::, C) ~- t:! fI- e.. C) ~~ III I E I:C I I- ~') t" IJ_ ~") . tll H -') ,.... ;';~ ((I >- ::::) 1-- !'-- (':) ~ (I) 0: ...J H ..J fa f-- ...J lJJ ", ...... - =1 C) <r .J 'J: <I: . I'....) <I: '* 11.1 .... '* :~ ~ . I <I: (I) I~ il. .J ,(. C) ....) [.. <I: c') '* 0::: * ~- , C.) W 1!J d IIJ ('L W . .-. n:: 11.1 * 1,- .'..... ,<< ..... ". l::l .J IL (I) ..J fiM :1: IJ. ...J .., (I) ~ '* C) 1-, ...~ .." ",,' "- "5:: '..,..., \-\) .. . '-';".: ~\ ,,.;.' j .~. 9 "1.