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Council Meetmg December 9, 1997 Santa Monica, California
STAFF REPORT DEe 0 9 1997
TO Mayor and City Council
FROM City Staff
SUBJECT Recommendation to Authorize City Manager to Execute an Agreement with
Fitness Appraisal, Inc to Provide Fitness Evaluations for Employee Wellness
Benefit Program
INTRODUCTION
ThiS report recommends that the CIty Council authorize the City Manager to execute an
agreement with Fitness Appraisal, Inc to provide employees wIth fitness evaluations as
part of the City's employee wellness program In an amount not to exceed $35,000 for
Fiscal Year 1997-98
BACKGROUND
For approxImately 9 years, the CIty has used FItness AppraIsal, Inc to conduct fitness and
nutrition evaluations for full-time permanent employees Fitness Appraisal, Inc has
conducted the confidential on-site evaluations tWice a year for mterested employees
Several other companies have offered to prOVide wellness evaluations for the City, but
were not able to compete In pnce or range of services with those offered by Fitness
Appraisal, Inc Furthermore, because of the long standmg relationship with Fitness
Appraisal, Inc., City employees have enjoyed a continUIty In their fitness evaluatIon results
and recommendatIons A full proposal process IS planned for the spnng of 1998 Until
then, the City needs to conlinue to receive thiS source from Fitness Appraisal, 'n6C~ 1997
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BUDGET/FINANCIAL IMPACT
Funds are Included In the FY97-98 budget to cover the cost of the employee wellness
program (Funds are Included In account number 01-700-274-00000-1197-00000
established for employee fnnge benefits)
RECOMMENDATION
It IS recommended that the City Council authorize the CIty Manager to execute an
agreement With Fitness Appraisal, Inc With regard to employee fitness evaluations and
related services In an amount not to exceed $35,000 for FY97-98
Prepared by Karen Bancroft, Director of Personnel
AGREEMENT
THIS AGREEMENT, entered into th~s 1st day of August 1997,
by and between the CITY OF SANTA MONICA, a munlclpal corporat1on
(herelnafter referred to as "Clty"), and Fitness Appra1sal, Inc.
whose address is 5674 El Camino Real, Carlsbad, CA 92008
{hereinafter referred to as "Contractor"} , 1S made wlth reference
to the following:
R E .c .I 1: A .L S:
A. City 1S a municlpal corporatlon duly organized and
valldly existing under the laws of the State of Cal1forn1a with the
power to carry on 1tS bUSlness as it is now being conducted under
the statutes of the State of Callfornla and the Charter of the
Clty.
B. City and Contractor desire to enter luto an agreement
for the Contractor to provlde physiologlcal evaluations,
educat10nal workshops, presentations, and written reports for the
admlnistrat10n of a Health Improvement Program upon the terms and
condltions set forth herein.
NOW, THEREFORE, it 15 mutually agreed by and between the
undersigned partles as follows:
1
l. TE.EM
The term of th1S Agreement shall commence on the 1st day of
August, 1997, and shall term1nate on the 1st day of August, 1998,
unless term1nated earlier as set forth herein.
2. SERVICES TO BE PERFORMED BY CONTRACTOR:
Contractor shall perform each and every serv1ce set forth
in Exhib1t "A, II Wh1Ch is attached hereto and 1ncorporated herein by
th1S reference.
3 . COMPENSATION TO CONTRACTOR.
Contractor shall be compensated for serv1ces performed
pursuant to th1S Agreement 1n the amount and manner set forth 1n
Exhibit IrB," wh1ch is attached hereto and incorporated herein by
th1S reference.
4. STANDARD OF CARE.
Contractor warrants and guarantees that all services
performed hereunder by Contractor or any subcontractor shall be
prov1ded 1n a manner commensurate with the highest professional
standards and shall be performed by qualified and experienced
personnel.
5. INDEPENDENT CONT~CTOR.
Both parties hereto 10 the performance of this Agreement
will be acting in an lndependent capac1ty and not as agents,
employees, partners, or joint venturers of one another.
Neither C1ty nor 1tS officers or employees shall have any
control over the conduct of Contractor or any of Contractor's
employees, except as herein set forth.
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6. HOLD HARMLESS.
Contractor shall lndemn~fy, defend, and hold harmless Clty,
its Clty Council, boards and commissions, offlcers, agents, and
employees from and against any and all loss, damages, llabllity,
clalms, SUltS, costs and expenses, whatsoever, includlng reasonable
attorneys' fees, regardless of the merlt or outcome of any such
claim or suit, arlsing from or in any manner connected to the
serVlces or work conducted pursuant to this Agreement.
Contractor shall indemn~fy, defend, and hold harmless Clty,
its City Counc~l, boards and comrrllSSlons, officers, agents, and
employees from and agalnst any and all claims and losses
whatsoever, includlng reasonable attorney's fees, accrulng or
resultlng to any and all persons, firms, or corporatlons furnishing
or SupplYlng work, services, materlals, equipment, or supplies in
connectlon wlth servlces or work conducted or performed pursuant to
thlS Agreement and arising out of such activities or work, and
from any and all clalffis and losses whatsoever, includlng reasonable
attorneys' fees, accruing or resultlng to any person, firm, or
corporation for damage, inj ury, or death arlslng out of
Contractor's operatlons.
7. INSURANCE.
On or before the commencement of the term of thlS Agreement,
Contractor shall furnish Clty with certificates showing the type,
amount, class of operations covered, effectlve dates and dates of
expiratlon of ~nsurance pollcles. Such certificates, which do not
llmlt Contractor's indemnification, shall also contain
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substant~ally the follow1ng statement: "The ~nsurance covered by
th~s certlficate wlll not be canceled or materially altered, except
after th~rty (3 0) days written notice has been recelved by the
City. It
It 1S agreed that Contractor shall ma~nta~n 1n force at all
times during the performance of this Agreement all appropr~ate
policies of ~nsurance, and that sa~d pol1cies of ~nsurance shall be
secured from a good and responsible company or companies, do~ng
insurance business in the State of Californ1a.
Contractor shall ma~nta1n the following lnsurance coverage:
A. Liab1litv Insurance. General liab~llty coverage in the
following m~nimum l~m~ts:
Bodily Injury ----------------- $250,000 each person
$500,000 each occurrence
$500,000 aggregate
Property Damage --------------- $100,000 each occurrence
$250,000 aggregate
A combined single limit policy with aggregate l~mits 1n the
amount of One Million Dollays ($1,000,000.00) will be cons~dered
equ1valent to the required minimum limits.
B. Maloractice. Errors and Omission Insurance. Errors and
omlSS1ons insurance and coverage for profess1onal malpractice, 1n
a combined 81ngle lim~t in the amount of One Mill~on Dollars
($1,000,000.00) shall be mainta~ned at all times by Contractor.
The policy shall provide for coverage of all cla1ms occurring
during the term. of the policy notwithstanding the fact that the
cla~m may be asserted subsequent to the expiration of the policy.
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14 Seating arrangements for all floor areas shall not exceed 212 seats and the
- number of total seats shall not be expanded by more than 10% unless approved
by the Director of Planning
15 Take out service shall be only InCidental to the primary Sit-down use
16 No alcoholic beverage shall be sold for consumption beyond the rn-door or out-
door premIses
17 No danCing or lIve entertainment shall be permItted on the premIses
18 Fmal plans for any changes to extenor deSIgn, landscaping, trash enclosures,
and/or slgnage shall be subject to review and approval by the Architectural
ReVIew Board.
19 Minor amendments to the plans shall be subject to approval by the Director of
Planmng. An Increase of more than 10% of the square footage or a Significant
change In the approved concept shall be subject to Planning Commission
Review Construction shall be In substantial conformance With the plans
submitted or as modified by the Planning Commission, Architectural ReView
Board, or Director of Planning
20 The apphcant shall comply With all legal requirements regarding proVISions for
the disabled, including those set forth in the California Administrative Code, Title
24, Part 2
21 Refuse areas, storage areas, and mechanical equipment shall be screened In
accordance With Sec 9127 J 2-4 (SMMC) Refuse areas shall be of a size
adequate to meet on-site need
22 The operation shall at all times be conducted In a manner not detnmental to
surrounding properties or reSidents by reason of hghts, nOise, actiVities, parking,
or other actIons
23 No nOIse generating compressors or other such equipment shall be placed
adjacent to neighbOring reSidential buildings
24 The condltlons of thiS approval shall supersede all previous approvals on thiS
property Including CUP 89-100
Prepared by Gina SZIIak, ASSistant Planner
Attachments
A MUniCipal Code and General Plan Conformance
B Notice of Public Hearing
C RadIUS and Location Map
0 Letter from Bayslde DIstrict Board
E Memo from SMPD
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necessary.
8 . PROHIBITION AGAINST TRANSFERS.
Contractor shall not assl.gn, sublease, hypothecate, or
transfer thl.s Agreement or any interest therein directly or
l.ndirectly, by operatl.on of law or otherwl.se. Any attempt to do so
w~thout sa~d consent shall be null and void, and any ass~gnee,
sublessee, hypothecatee, or transferee shall acquire no r~ght or
~nterest by reason of such attempted ass~gnment, hypothecat~on, or
transfer.
The sale, assignment, transfer, or other dl.sposl.tl.on of any
of the issued and outstandl.ng capital stock of Contractor, or of
the interest of any general partner or jOl.nt venturer or syndl.cate
member or cotenant, if Contractor is a partnership or joint venture
or syndicate or cotenancy, which shall result in changing the
control of Contractor, shall be construed as assignment of this
Agreement. Control means fifty percent {SO%)or more of the vot1ng
power of the corporation.
9. SUBCONTRACTORS.
Contractor shall ensure that any subcontractor or agent
utilized by l.t in the performance of this Agreement complies wl.th
all of the terms of this Agreement.
10. NONDISCRIMINATION.
Contractor certifl.es and agrees that it will not
dl.scriminate agal.nst any employee or applicant for employment
because of race, color, religl.on, national orl.gin, ancestry, sex,
age, mar:l tal status, sexual orientation, disability, or AIDS, in
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accordance Wl.th the requ.lrements of state and federal law
Contractor shall take aff.lrmat~ve act~on to ensure that quall.fied
applicants are employed, and that employees are treated dur.lng
employment without regard to race, color, religl.on, nat.lonal
or~gin, ancestry, sex, age, marl.tal status, sexual orl.entation,
disability, or AIDS, in accordance Wl.th the requirements of state
and federal law. Such shall include, but not be l~mited to, the
followl.ng:
A. Employment, upgradl.ng, demotJ.on, transfer, recrUl.tment
or recruitment advertisl.ng, layoff or termination, rates of pay, or
other forms of compensatl.on.
B. Select.lon for tra.lning, including interns and
apprentices.
Contractor agrees to post l.n conspicuous places in each of
Contractor's facilitl.es providing services hereunder, aval.lable and
open to employees and applicants for employment, notJ.ces setting
forth the provl.sions of this Sectl.on.
Contractor shall, J.n all sol.lcitations or advertJ.sements for
employees placed by or on behalf of Contractor, state that all
qualif~ed appll.cants will recel.ve consideration for employment
wl.thout regard to race, color, religl.on, national origl.n, ancestry,
sex, age, marital status, sexual orlentation, disabill.ty, or AIDS,
~n accordance with the requirements of state and federal law.
Contractor shall send to each labor un~on or representative
of workers with which it has a collective bargaining agreement or
other contract or understanding, a notice advising the labor union
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or workers' representat~ve of Contractor's comm~tments under th~s
Section.
Contractor certifies and agrees that it will deal w~th its
subcontractors, bidders, or vendors wlthout regard to race, color,
rellg~on, national orlgin, ancestry, sex, age, marltal status,
sexual orientation, dlsabillty, or AIDS, In accordance wlth the
requlrements of state and federal law.
In accordance w~th appl~eable law, Contractor shall allow
duly authorlzed Clty, county, state and federal representatives,
access to its employment records during regular buslness hours in
order to verify compliance with this Section. Contractor shall
provide such other informatlon and records as such representatlves
may reqlllre ~n order to verify compliance wlth this Section.
If Clty flnds that any of the provlsions of thls Seetlon
have been v~olated, the same shall const~tute a material breach of
thlS Agreement upon whlch Clty may determlne to cancel, terminate,
or suspend thls Agreement. Whlle Clty reserves the right to
determlne lndependently that this Section has been violated, In
additlon, a determination by the Californla Fair Employment and
Houslng Commission or the Federal Equal Employment Opportunity
Commlssion that Contractor has vlolated state and federal
ant~-discrimination laws shall const~tute a flndl.ng by Clty that
Contractor has vlolated this Seetlon.
The parties agree that in the event Contractor vl.olates thls
Seetlon, City shall be entltled, at lts option, to the sum of Five
Hundred Dollars ($500.00) pursuant to CiVll Code Section 1671 as
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l~quidated damages ~n lieu of canceling, term~nating, or suspend~ng
th~s Agreement
Contractor hereby agrees that ~t will comply w~th Sect~on
504 of the Rehabilitation Act of 1973, as amended (29 U.S.C.
Section 794) , all requirements imposed by the appl~cable federal
regulations, and all guidelines and ~nterpretations issued pursuant
thereto, to the end that no qual~fied d1.sabled person shall, on
the bas~s of disability, be excluded from part1.c1.pat~on in, be
denied the benefits of, or otherwise be subJected to discrim~nation
under any program or activ~ty of the Contractor receiving federal
f1.nancial aSS1.stance.
1l. SAFETY REQUIREMENT.
All work performed under th~s Agreement shall be performed
~n such a manner as to prov1.de safety to the publ1.c and to meet or
exceed the safety standards outl~ned by CAL-OSHA. City reserves
the r~ght to ~ssue restraint or cease and desist orders to
Contractor when unsafe or harmful acts are observed or reported
relat~ve to the performance of the work under th1.s Agreement.
Contractor shall mainta~n the work sites free of hazards to
persons and property resulting from its operat1.ons. Any hazardous
cond~t~on noted by Contractor, wh~ch is not a result of its
operations, shall ~mmediately be reported to C1.ty.
12. NUISANCE.
Contractor shall not ma1.nta~n, commit, or perm~t the
ma1.ntenance or commlssion of any nu~sance in connection w~th the
performance of serV1.ces under this Agreement.
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13. PERMITS AND LICENSES.
Contractor, at ~ts sole expense, shall obtain and ma~nta~n
during the term of this Agreement, all appropr~ate perm~ts,
licenses, and cert~f~cates that may be requlred In connection with
the performance of services hereunder.
14 REPORTS.
Except as prov~ded ~n Exhlbit A wlth respect to
confldentiality of examinatlons, reports, tests, and assessments,
each and every report, draft, work-product, map, record, and other
document reproduced, prepared, or caused to be prepared by
contractor pursuant to or ~n connectlon with th~s Agreement shall
be the exclusive property of Clty.
Except for employee physiological examlnations, reports,
tests, and assessments, which shall be confidential and disclosed
only to the affected individual employee, no report, informatl.on,
or other data glven to or prepared or assembled by Contractor
pursuant to this Agreement shall be made available to any
~ndividual or organ~zatlon by Contractor without prior approval by
Clty.
Contractor, shall, at such time and in such form as City may
require, furnish reports concerning the status of services required
under th~s Agreement.
15. RECORDS.
Contractors shall maintaln complete and accurate records
with respect to sales, costs, expenses, receipts, and other such
lnformation required by City.
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(c) The above-described real property, or interest in real property, IS necessary for the
Project.
(d) The offer requrred by SecTIon 72622 of the Government Code has been made to the
owners of record
SECTION 4. The CIty of Santa MOllica is hereby authorized and empowered to acqUlre by
condemnatIOn the fee tItle to the herem-above descnbed real property, or such lesser estate as
described
SECTION 5. The CIty Attorney IS authonzed to employ the law fIrm of HIll, Farrer &
Bumll as Special Counsel to the City in this condemnatlon proceedmg The law firm of Hill. Farrer
& Burrill is authonzed to prepare and prosecute in the name of the CIty, such proceedmg or
proceedmgs m the proper court having jurisdiCTIon thereof, as are necessary for such acquisition; and
to prepare and fIle all pleadings, documents, briefs, and other instruments and to make such
arguments and to take such acuon as may be necessary m their opmion to acqillre the real property.
The CIty'S SpeCIal Counsel IS specifically authonzed to take whatever steps and/or procedures are
available to It under the Emment Domain Law of the State ofCahfomia (Code of CIvil Procedure,
TItle 7, Chapters 1-12, 99 1230.010-1273.050)
SECTION 6. The Drrector ofFmance IS authorized and directed to draw such warrants as
may be required by the Supenor Court for deposit of probable compensatlon m accordance WIth
Califorrua Code of CIvil Procedure ~1255 010
SECTION 7 The Cny Clerk shall certIfy to the adopTIon oftlus Resolution and, thenceforth
and thereafter the same shall be m full force and effect.
APPROVED AS TO FORM:
n! ~ou~
MARSHA JON
CIty Attorney
17. TERMINATION.
In the event Contractor falls or refuses to perform any of
the provislons hereof at the tlme and in the manner requ1red
hereunder, Contractor shall be deemed 1n default in the performance
of this Agreement. If such default 15 not cured with1n a per10d of
two (2 ) days after recelpt by Contractor from Clty of written
notlce of default, specifying the nature of such default and the
steps necessary to cure such default, City may terminate this
Agreement forthw1th by g~ving to Contractor written notice thereof.
City shall have the opt lon, at its sole dlscretion and
without cause, of termlnating th1S Agreement by giv1ng seven (7 )
days wrltten not~ce to Contractor as provlded hereln. Upon
termlnatlon of this Agreement, each party shall pay to the other
party that portion of compensatlon spec~fied in thlS Agreement that
1S earned and unpa1d prior to the effective date of term1nat1on.
18. WAIVER.
A wa1ver by Clty of any breach of any term, covenant, or
conditlon contalned herein shall not be deemed to be a waiver of
any subsequent breach of the same or any other term, covenant, or
condition contained herein, whether of the same or a different
character.
19. NOTICES.
All notices, demands, requests, or approvals to be given
under th1S Agreement, shall be given in writlng and conclus1vely
shall be deemed served when delivered personally or on the second
buslness day after the depos1t thereof in the United States mail,
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postage prepa~d, registered or certif~ed, addressed as here~nafter
provided
All not~ces, demands, requests, or approvals from Contractor
to C~ty shall be addressed to C~ty at.
Karen L. Bancroft
D~rector of Personnel
Santa Mon~ca C~ty Hall
1685 Ma~n Street
Santa Mon~ca, Cal~fornia 90401
All notices, demands, requests, or approvals from City to
Contractor shall be addressed to Contractor at:
Robert Antonacc~
c/o F~tness Appraisal, Inc.
5674 E1 Cam~no Real
Carlsbad, California 92008
20. COST OF LITIGATION
If any legal action is necessary to enforce any prov~sion
hereof or for damages by reason of an alleged breach of any
prov~s~ons of th1S Agreement, the preva~l~ng party shall be
entitled to rece~ve from the los1ng party all costs and expenses,
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and such an amount as the court may adjudge to be reasonable
attorneys' fees.
IN WITNESS WHEREOF, the parties have caused this Agreement
to be executed the day and year first above wrltten
APPROVED A~~ORM'
~ A ~tw.
SHA JONES MOUTRIE
City Attorn
CITY OF SANTA MONICA
ATTEST. a munlcipal corporation
By
MARIA STEWART JOHN JALILI
City Clerk City Manager
CONTRACTOR:
Fitness Appralsal, Inc.
By
ROBERT ANTONACCI
President
:ghQ bene b1111ng~ hwcon95}
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EXHIBIT A
SERVICES TO BE PERFORMED BY CONTRACTOR
For each City employee partlclpating in the Health
Improvement Program, Contractor hereby agrees to perform the
following act~vit~es as spec~fically d~rected by C~ty:
1. A. Blood Prof~le. A 10 hour fasting complete blood
panel (25 parameters)
B. Health/Fitness Appraisal. Two EXerclse Phys~olog~sts
w1ll conduct the follow1ng tests for each employee. Each employee
will be tested ind~v~dually and 1nformat1on 1S strictly
confident~al. The ln~tial test~ng and consultat~on wlll take one
hour.
1. Med1cal h1stOry and blood proflle review.
ii. Resting heart rate and blood pressure.
1ii. Body fat analysis and body we1ght.
~v One mlnute abdom~nal curls.
v Lung capacity.
vi EKG monltored treadmill stress test.
vii. Flexibillty analysls.
vlil. Safe liftlng llmits.
lX. Nutrltion and stress analysls.
Each employee wl1l recelve an 1ndividualized computerized report
and consultat~on lmmediately following the appraisal.
c. Incentivee. Each partlc1pant w11l rece1ve a NOVlce
card and T-shlrt (dependent upon budget approval) for jOlnlng the
program.
D. Educatlonal Workshops and Exercise Pro9ram. Monthly
workshops ln stress, nutritlon, injury prevention, and heart
dlsease risk reductlon will be available. Moreover, walking
groups, exercise classes, running groups, bicycle groups, etc. wlll
be started at varlOUS times during the program.
E. Reevaluations. Reevaluatlons will be held two times
durlng the year for employees who have already completed the
inltlal health/fltness appraisal. These rechecks will consist of.
1. Medlcal h1story and blood profile review
11. Resting heart rate and blood pressure.
lii. Body fat analysls and body welght.
iv. Blcycle ergometer stress test or EKG monitored
treadmlll stress test.
v. Sit and reach flexlbility test.
vi. Consultation and updated evaluation report.
Each employee will recelve an lndividual1zed computer1zed report
and consultation lmmedlately following his/her reevaluation{s} .
F. IIS1qnlf~cant Other" Participation. Spouses (or
IIsignlflcant othersll) can join the City'S employee wellness program
for the same fees speclfied in Exhibit B.
2. Conduct presentations and orientations to prospective
partlclpants.
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In order to accompllsh the above objectives, Clty wlll be
responsible for the initlal contacts, schedullng, and overall
evaluation of the program.
Contractor wlll furnlsh inltlal evaluatlon reports only to
employees as the evaluations are completed. Except for dlsclosure
to such employees, Contractor shall malntaln the confldentiallty of
the evaluatl.ons, including results of any medlcal tests, health
hlstorles, appraisals, assessments, recommendatlons, or other data
obtalned from or for employees. Group summation reports Wh1Ch do
not dlsclose the identity of employees will be presented to Clty
after the f1nal reevaluation. Contractor shall mal.nta1n lndivldual
employee appralsal files 1n order to provide ongolng consultatlon
to employees while pursulng the1r individual exercise/diet
prescr1ptions. Contractor shall keep these appraisals
confldential, allowlng release only to the lndividual employee
assessed.
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EXHIBIT B
COMPENSATION TO CONTRACTOR
Contractor shall be pa1d as follows
1. One Hundred Fifty Dollars ($150.00) per ln1tial
evaluatlon, lncluding blood proflle, for non-safety personnel.
2. One Hundred Seventy-flve Dollars ($175.00) per lnltlal
evaluatlon, lncludlng blood profile, for sworn pollce and f1re
safety personnel
3. Thirty-Flve Dollars ($35.00) per blood proflle
evaluatlon only.
4. Seventy-five ($75.00) per participant for each
reevaluatlon.
S. One-hundred Dollars ($100 00) per sworn police or flre
safety partlclpant for each reevaluation.
The promotion of the Health Improvement Program,
presentation to and orientatlon of prospective partic1pants,
educat10nal group presentatlons, and group summary presentatlons
w1ll be performed free of charge.
All bills are due net fifteen (15) days after the b1ll is
received by City after services are rendered Clty agrees to pay
lnterest ln the amount of 10% annually in the event of a late
payment of thlrty (30) days after the b1ll 1S received.
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C ER TJFICA TE 0 F IN SURA NeE .
~ PrImary I"suranee Truck Insurance Exchange. LoS Angel.., CA
[2J CExce.u Insurance) Exce.. over Primary WIth Company a.slgnated on reverse Ilde as letter A and/or B
N.med e PACIFlCARE HEALTIi SYSTEMS. INC
Insurrd PAClFICARE '~;F:U-l"l"ESS COMPANY CJOM 1 -1186
- - e.cua CertJficoIIe
Addmse 5995 Plaza Dnvc 10-01-00 1 1 -4200540-1186
C\-press. CA 90630 PmIuy PaIIcy
Pr..wy Auto PaIIIcy
ThIS nrtificate or venfic:atlon of Ins....ance IS not an InsUfWICe policy and du.a 1'IDl.-....d. utMM1. or aller the ~ aftorded ..,.... .......
and eaceu certlficatetSI r.ferdd to above.. Notwtth&tandcng MY reqUI~ tann. or condition of any contAc:l or au. Gac:umenl ... ..
wtuch this certlficata or wnficataon of msurance may bI: IUuad or may pen.an. the msurance .nordad by the prnIry policy .... ~ artHk
AbjeCt tD all the tenns. uCluuan&, and conditions of UICI'l poacy ... certific:ale(s). Unds InCtucie ~ PnrNry and bcess. InSUNd has Cl
L.In'IIt5 or Single ~ .. tndlcatad belOw.
SINGLE UMIT
5504\.000 um Occurrence" ComprehnSlft Hospiw PmaslUft.' U8biUty. "Ocwl'ftlln
Ge_ral t.ability. Bodily InjUry 4 Prope~'
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Each Occurnnce- AUlOmobilc LaabllJiy
Bodily InjUry & Properly Da.....e U.bilil}'
Deduaibta: COIIIflrebelUne
CoIlwOll.
S1.~OO.OOD E1Im Oc:eul'Trllu" I Excess Laahl"~ .. Modified OcC1lrrnce
S2.041Cl.fNlO TOTAL LIMIT OF UABILITY- NO ANNUAL ACGREGA TE
DESCRIPTION OF OPERA nONS I VEHICLES I SPECIAL ITEMS I REMARKS-
Re. Venfic:allon of Inlu ranee for fitnen n .Iuallon sen Ice 10 elly empm,'ftS.
--Total lImui S2.OCIO,OOO Per Oecur-renlCt' NO ANNUAL AGGREGATE.
After Until cancelled this ~rtificate. becomes void and without ett-=t.
IT IS HEREBY AGREED THAT UPON CANCELLATION OR TERMINATION OF THIS POUCY OR
POLICIES FROM ANY CAUSE THE COMPANY WILL ENDEAVOR TO MAlL 30 DAYS NOTtCE IN
WRITING THEREOF TO THE OTHER INTeREST SHOWN BELOW.
Notice of canceUatlon of the primary co~e automatlcany termlnat.. coverage. A breakdown of the pnmary limita and ttM
excess hmlts will be provided upon demand.
Effectne Date e February 1. 199'
Place . Los Angeles. California
Other Internl e Cl~' ofSanla. MODIca
Address . 1685 Mam Slreel
Santa Monica. CA 9(),I0 I
2/t ~I')~ t~ ~t.~
Dale T~ fled ~ RSIGHED f ...........
SUUJVAN. ,rll'l LV & ASSOCIATES. INC.
! BRANOI 1_ ~A I ~~ NUH8EJI. I DATE OF ISSUE I ,",-lOR CB.IKATE NUI1BEJ. I
j
I 32) A I 00291t51 · 200 10/17/96 J RENEWAL I
SPECIFIED MEDICAL PROFESSIONAL LIABILITY
r-- OCCURRENCE INSURANCE POLICY
,
OFfERED THROUGH THE ,." sn HEALTH PUROIASING GROUP ASSOCIA1'JOtl.I
PURCH,t,SI'.IG GRCIlW POUCY NUMBER... .......2010129
101m DECLARATIONS CERTlFICA TE NUMBER AHC- 0000093158
I Named Insured
FITNESS APPRAISAL INC
2- MAILING ADDRESS SUITE G
CARLSBAD CA 92008-7130
3 Polley Penod 12.-0 I A.M. Standard Time At From: 10/01/96 To: 10/01/91
Locaaon of DeslpteCI PremISeS
4. The IflSUrance afforded IS only W1th respect to suctl of <<he followmg types of InSUrance as indicated by speafic premIUm charge
or charges.
COVERAGE PR.l:MIUM
A Professional Liability [!] $ 2,211.00
B. General liability 0
Endorsement(s) 0
TOTAl PREMrUM: $ 2.211.00
s I LIMITS OF LIABILITY
I S 1.000,000 eactllnctdent $ 3,000,000 III the Agrepte
or Occurrence
I
6 I Deductible (If applicable) $ 0 each InCIdent
or Occurrence
7 The Named Insured as: ~ Sole Propnetor (ndudng IndMdual ) Partnership 0 Corpondon C
r o Other.
I 8 BuSIness or oca..p..c.on of the. Named Insured:
I SPORTS HEDICINE
I 9 [llllS pohcy IS made and accepted subject to the prn:ed condItIOnS of thIS potacy together with the pro"llSlClN, ~latlOnS and
, , agreements ~ ... the followlni fann(s) or endorsernent(s):
PlPZOZ5. PlJZOZ5, PlEZ081, PlEeOO3
I CHICAGO INSURANCE COMPANY
55 E. MONROE STREET, CHICAGO, ILLINOIS 60603
REPRESENT A TIve: Alent or BroIcer. ALBERT H. WOHLERS & CO.
Office Address: 1440 N. NORTHWEST HIGHWAY
Town and State: PARK RIDGE, ILLINOIS 60068
.J
PlP-2025 (OIJ95b) CAH- 2068826