Agreement - Morgan Hill Unified School District - Contract No. 24PD1288 - City of Gilroy - South County Youth Task Force - Signed 2023-07-01MORGAN HILL UNIFIED SCHOOL DISTRICT
CONTRACT APPROVAL ROUTING SHEET
2023-24
The District employee that is providing the attached Services Agreement to the person or entity that will be providing special
services to the District should first do the following:
1.Provide only the Morgan Hill Unified School District’s approved Services Agreement.The Services Agreement should
be completed in lieu of signing any vendor contract for services.
2.The completed Services Agreement needs to be submitted to the Deputy Superintendent's office the Thursday prior
to the Board deadline date,unless otherwise noted.
Title of MOU /Contract /Grant Agreement:City of Gilroy -South County Youth Task Force
(SCYTF)
Program Name:LCFF Supp &Title IV
Budget Code(s):010 -0000 -0 -5800 -00 -1110 -3110 -301010 -000 -0000 50 %
Budget Code(s):060 -4127 -0 -5800 -00 -1110 -3110 -412700 -000 -0000 50 %
Date Routed:Google Sheet under $100k Amount:$45,000
Site:All Secondary Sites Board Approval Date:Link to Google Doc
1.Contract Initiator:Claudia Estrada Google Comment/Approval
2.Contract Administrator:Jessic Swift Google Comment/Approval
3.Assistant Superintendent HR:
(Only for personnel contracts,ex:psychologist)
Google Comment/Approval
4.Contract Executive:Dr.Diana JimenezSelect One Google Comment/Approval
5.Fiscal Services,Buyer:Dianne Dalton Google Comment/Approval
6.Fiscal Services,Director:Lisa Lee Google Comment/Approval
7.Fiscal Services,Accounting Specialist:Tracey James Google Comment/FYI
8.Department Executive Assistant,Confidential:Claudia Estrada Google Comment/Approval
9.Business Services:Tricia Campbell Google Comment/Approval
10.Deputy Superintendent and CFO:Phoung Le/Lisa Lee Google Comment/Approval
15600 Concord Circle •Morgan Hill,California 95037 •P.408-201-6000 •F.408-825-6257
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DocuSign Envelope ID: 49BDEE33-79E1-4483-850E-E8D498B2ABFC
VENDOR:City of Gilroy Tax ID#:946000340 SY:2023-24
MORGAN HILL UNIFIED SCHOOL DISTRICT
SERVICES AGREEMENT
2023-24
THIS AGREEMENT (“Agreement ”)is made between Morgan Hill Unified School District,15600 Concord
Circle,Morgan Hill,CA 95037,hereinafter referred to as the DISTRICT,and the following named service
provider hereinafter referred to as VENDOR:
Vendor:City of Gilroy Signer Name:Jimmy Forbis,City Administrator
Address:7351 Rosanna St,Gilroy,CA 95020 Mailing Address:
City:Gilroy State:California Zip:95020
Phone:408-846-0250 Fax:4088460339
Email:jimmy.forbis@cityofgilroy.org DIR Number:
Federal Tax ID:946000340 Federal Tax Classification:Government
VENDOR IS RESPONSIBLE FOR UPDATING CONTACT INFORMATION IN A TIMELY MANNER
NOTE:Federal Regulations (Code Sections 6041 and 6209)require non-corporate recipients of
$600.00 or more to furnish their taxpayer identification number to the payer.The regulations also
provide that a penalty may be imposed or failure to furnish the taxpayer identification number.The
DISTRICT requires your federal tax identification number or Social Security Number,whichever is
applicable,in order to comply with these regulations.
Pursuant to Government Code 16.5,public entities,including districts,are permitted to use digital
signatures in their communications and operations.A digital signature is a type of electronic signature,
as defined in Civil Code 1633.1.Any such digital or electronic signature has the same force and effect as a
manual signature,provided the signature is created using acceptable technology and includes attributes
specified in 2 CCR 22000-22005.
Submittal of Documents:The VENDOR shall not commence the work under this Agreement until the
VENDOR has submitted and the DISTRICT has approved the certificate(s)and affidavit(s),and the
endorsement(s)of the insurance required as indicated below:
●Signed Agreement
●Insurance Certificates and Endorsements
●W-9 Form
●Workers’Compensation
●Tuberculosis Clearance
●Student Data Confidentiality Agreement
●Fingerprinting /Criminal Background
●Addendum for Technology Service Agreement (if
applicable)
●Economic Sanctions Form
●Amendment
15600 Concord Circle •Morgan Hill,California 95037 •P.408-201-6000 •F.408-825-6257
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VENDOR:City of Gilroy Tax ID#:946000340 SY:2023-24
1.TERM
This Agreement is effective on 7/1/2023 and terminates on 6/30/2024 or upon completion of
services,whichever occurs first.
VENDOR shall not undertake any work under this Agreement until this Agreement is reviewed
and approved by the DISTRICT’s Board of Education,and VENDOR is in receipt of a signed
Agreement.
2.TERMINATION
2.1.Without cause by DISTRICT.DISTRICT may,at any time,with or without reason,
terminate this Agreement and compensate VENDOR only for services satisfactorily
rendered to the date of termination.Written notice by DISTRICT shall be sufficient to
stop further performance of services by VENDOR.Notice shall be deemed given when
received by the VENDOR no later than three (3)days after the day of mailing,whichever
is sooner.
2.2.Without cause by VENDOR.VENDOR may,upon thirty (30)day notice,with or without
reason,terminate this Agreement.Upon this termination,DISTRICT shall only be
obligated to compensate VENDOR for services satisfactorily rendered to the date of
termination.Written notice by VENDOR shall be sufficient to stop further performance
of services to DISTRICT.VENDOR acknowledges that this thirty (30)day notice period is
acceptable so that the DISTRICT can attempt to procure the services from another
source.
2.3.With cause by DISTRICT.DISTRICT may terminate this Agreement upon giving of written
notice of intention to terminate for cause.Cause shall include:
2.3.1.Material violation of this Agreement by the VENDOR;or
2.3.2.Any act by VENDOR exposing the DISTRICT to liability to others for personal
injury or property damage;or
2.3.3.VENDOR is adjudged bankrupt,VENDOR makes a general assignment for the
benefit of creditors or a receiver is appointed on account of VENDOR’S
insolvency.
Written notice by DISTRICT shall contain the reasons for such intention to terminate and unless
within three (3)calendar days after that notice the condition or violation shall cease,or
satisfactory arrangements for the correction thereof be made,this Agreement shall upon the
expiration of the three (3)calendar days cease and terminate.In the event of this termination,
the DISTRICT may secure the required services from another VENDOR.If the expense,fees,
and/or costs to the DISTRICT exceed the cost of providing the services pursuant to this
Agreement,the VENDOR shall immediately pay the excess expense,fees,and/or costs to the
DISTRICT upon the receipt of the DISTRICT’S notice of these expenses,fees,and/or costs.The
foregoing provisions are in addition to and not a limitation of any other rights or remedies
available.
15600 Concord Circle •Morgan Hill,California 95037 •P.408-201-6000 •F.408-825-6257
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VENDOR:City of Gilroy Tax ID#:946000340 SY:2023-24
3.SUBCONTRACT OR ASSIGNMENT
Neither party shall assign,delegate or subcontract any part of this Agreement without the
written consent of the other party.
4.INTERPRETATION
In the event of any conflict or inconsistency between VENDOR’S agreement or documents and
this MORGAN HILL UNIFIED SCHOOL DISTRICT SERVICES AGREEMENT,the MORGAN HILL
UNIFIED SCHOOL DISTRICT SERVICES AGREEMENT shall prevail and supersede all other
agreements or contract language.
5.INDEPENDENT CONTRACTOR STATUS
In the performance of the services to be provided,VENDOR is an independent contractor with
the authority to control and direct the performance of the details of the work,and this
Agreement shall not be construed to create the relationship of agent,employee,partnership,
joint venture,or association.VENDOR understands and agrees that it and all of its employees are
not employees of the DISTRICT and are not entitled to benefits to which DISTRICT employees are
normally entitled,including,but not limited to,State Unemployment Compensation,Workers’
Compensation,vacation or sick pay.
6.TAX REPORTING /PAYMENT
VENDOR shall assume full responsibility for payment of all federal,state,and local taxes or
contributions,including,but not limited to,Unemployment Insurance,Social Security and
Income Taxes with respect to VENDOR’S employees.Pursuant to IRS regulations,the DISTRICT
shall provide VENDOR in IRS identified tax classification with an annual statement of
compensation on the appropriate federal forms (currently IRS Form 1099 Misc.).
7.REGULATIONS
VENDOR shall comply with all federal,state,and local laws,ordinances,regulations,permit
requirements,and Board of Education’s policies and regulations in performance of this
Agreement,including as set forth herein at Paragraph 8.
8.FINGERPRINTING AND CRIMINAL RECORDS CHECK
The Fingerprinting/Criminal Background Investigation Certification must be completed and
attached to this Agreement prior to the VENDOR performing any of the services as listed in Item
12 of this Agreement.DISTRICT retains authority to remove any VENDOR employee from
DISTRICT site upon the determination that he/she has not complied with this fingerprinting and
background check requirement,or has been convicted of a violent or serious felony,as defined
in Education Code §45122.1.VENDOR must notify the DISTRICT and remove any employee
immediately should the VENDOR learn that an employee working on a DISTRICT site has been
convicted of a serious or violent felony,or sex offense.Failure to provide notice as required
above may result in cancellation of this Agreement by DISTRICT and further legal action by the
DISTRICT where applicable.
15600 Concord Circle •Morgan Hill,California 95037 •P.408-201-6000 •F.408-825-6257
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VENDOR:City of Gilroy Tax ID#:946000340 SY:2023-24
9.GOVERNING LAW
This Agreement shall be governed under the laws of the State of California.VENDOR hereby
consents to the jurisdiction of the state or federal courts of Santa Clara County,California.
10.MISCELLANEOUS
This Agreement contains the entire agreement between DISTRICT and VENDOR and supersedes
any and all prior discussions,understandings,and negotiations,whether oral or in writing.This
Agreement may not be modified or amended unless in writing and signed by both parties.
11.INSURANCE AND INDEMNIFICATION
VENDOR agrees to defend,indemnify,and hold harmless the DISTRICT,its Board of Education,
officers,employees and agents,individually and collectively,from and against all costs,losses,
claims,demands,suits,actions,payments,liabilities and judgments,including attorneys fees,
arising from personal or bodily injuries,property damage or otherwise,regardless of and
however caused that may arise for any reason from VENDOR’S performance of this Agreement.
VENDOR must keep in full force and effect a policy or policies of Workers’Compensation
Insurance in the amount or amounts required by applicable law.
During the term of this Agreement,VENDOR shall procure and maintain general liability
and/or professional liability (errors and omissions)and automobile liability (if applicable),
from a California licensed insurer acceptable to DISTRICT with per-occurrence limits of $1
Million unless otherwise specified by the DISTRICT.VENDOR shall provide DISTRICT with a
Certificate(s)of Insurance evidencing such coverage.High risk activities may require
additional coverage as determined by the DISTRICT.Certificate Holder is Morgan Hill Unified
School District.VENDOR shall also provide an Additional Insured Endorsement,naming
Morgan Hill Unified School District as Additional Insured.Such insurance coverage shall be
primary insurance and any insurance or self-insurance maintained by the DISTRICT shall be
non-contributory.These certificates shall contain a provision that coverage afforded under the
policy will not be canceled or allowed to expire until at least thirty (30)days prior written
notice has been delivered to the DISTRICT.
12.DESCRIPTION OF SERVICES (SCOPE OF WORK)
VENDOR shall supply all required payment and performance bonds and shall pay employees
applicable prevailing wages in accordance with state and federal law where required.VENDOR
shall furnish,at its own expense,all labor,materials,equipment and other items necessary to
carry out the terms of this Agreement.Additional pages may be added and shall be marked
Exhibit “A”and are incorporated herein by this reference.VENDOR shall provide the following
services to DISTRICT:
Company Information:The South County Youth Task Force (SCYTF)is a regional collaboration of local
governments,school districts,community and faith-based organizations,community members,and
law enforcement agencies in South Santa Clara County who are committed to serving,supporting,and
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VENDOR:City of Gilroy Tax ID#:946000340 SY:2023-24
uplifting our youth so that they have the opportunity to thrive.SCYTF strives to fulfill the
collaborative’s Mission and Vision:
Mission:To promote a safe and nurturing community that creates and ensures sustainable access to
opportunities,resources,and services for South County youth and their families,while empowering
their voice and supporting their growth and success.
Vision:A community that is safe and free of youth violence where young people are strong,thriving
and connected to their families,schools,and neighborhoods.
Scope of Work:Scope of Work:This agreement will provide funding to support the work of the South
County Youth Task Force (SCYTF).The SCYTF is a collaboration that seeks to reduce juvenile delinquent
behaviors,recruitment of youth into gangs,and youth violence in South Santa Clara County.This
MHUSD agreement will provide matching funds to complement funding from the County of Santa
Clara,the City of Gilroy and the Gilroy Unified School District.
SCYTF will provide the following services to MHUSD:Youth Outreach,Youth Groups,Case
Management,School Based Team Crisis Response and Trainings totaling $45,000.These services will
be available to the middle and high schools during the 2023-24 school year.Approximately eight youth
groups using an evidenced-based curriculum will be rendered at the following schools:Britton Middle
School,Martin Murphy Middle School,San Martin/Gwinn,Ann Sobrato High School,Central
Continuation High School,and Live Oak High School.Each group will have about 10-15 youths per
session.Additionally,at least one Restorative Justice/Practice training will take place during the school
year for school staff/administrators.Ongoing outreach and case management will be provided based
on school needs and requests The City of Gilroy will invoice the MHUSD for a lump sum payment in
the amount of $45,000 within 30 days prior to the end of the 2023-24 school year.
Location(s):All Secondary Sites
Rate:$45,000
13.COMPENSATION AND EXPENSES
DISTRICT agrees to pay the VENDOR for services satisfactorily rendered pursuant to this
Agreement at the rate set forth in Section 12 for a total fee not to exceed $45,000.District shall
pay VENDOR according to the following terms and conditions:
13.1.Payment shall be made for all undisputed amounts in installment payments within thirty
(30)days after the VENDOR submits an invoice to the DISTRICT.VENDOR will only be
paid after the MHUSD Board of Education has approved/ratified this Agreement.
13.2.VENDOR invoices will be subject to verification that services have been rendered and
subject to written approval by the Deputy Superintendent or designee.
13.3.DISTRICT shall not be liable to VENDOR for any costs or expenses paid or incurred by
VENDOR in performing services for DISTRICT including but not limited to travel,
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VENDOR:City of Gilroy Tax ID#:946000340 SY:2023-24
professional development related expenses, duplication, etc.
13.4. VENDOR shall not increase prices during the term of this Agreement.
13.5. All invoices must be submitted within 30 days of rendering services.DISTRICT reserves
the right to reject invoices submitted for payment more than 30 days after services are
performed.
14. OWNERSHIP OF WORK PRODUCT
VENDOR agrees all work prepared or produced during the course of this Agreement and arising
from the services rendered (see Paragraph 12) shall be owned by and assigned to DISTRICT as its
sole and exclusive property.
15. AUDIT
VENDOR shall establish and maintain books, records, and systems of account, in accordance with
generally accepted accounting principles, reflecting all business operations of VENDOR
transacted under this Agreement. VENDOR shall retain these books, records, and systems of
account during the Term of this Agreement and for five (5) years thereafter. VENDOR shall permit
the DISTRICT, its agent, other representatives, or an independent auditor to audit, examine, and
make excerpts, copies, and transcripts from all books and records, and to make audit(s) of all
billing statements, invoices, records, and other data related to the services covered by this
Agreement. Audit(s) may be performed at any time, provided that the DISTRICT shall give
reasonable prior notice to VENDOR and shall conduct audit(s) during VENDOR’S normal business
hours, unless VENDOR otherwise consents.
16. CERTIFICATES / PERMITS / LICENSES
VENDOR and all VENDOR’S employees or agents shall secure and maintain in force such
certificates, permits and licenses as are required by law in connection with the furnishing of
services pursuant to this agreement.
17. CONFIDENTIALITY
VENDOR and all VENDOR’S agents, personnel, employee(s), and/or subcontractor(s) shall
maintain the confidentiality of all information received in the course of performing the services.
This requirement to maintain confidentiality shall extend beyond the termination of this
Agreement.
18. NOTICE
Any notice required or permitted to be given under this Agreement shall be deemed to have
been given, served, and received if given in writing and either personally delivered or deposited
in the United States mail, registered or certified mail, postage prepaid, return receipt required,
or sent by overnight delivery service, or facsimile transmission, addressed as follows:
District Vendor
Morgan Hill Unified School District
ATTN: Deputy Superintendent
15600 Concord Circle
Morgan Hill, CA 95037
City of Gilroy
ATTN: Jimmy Forbis
7351 Rosanna St, Gilroy, CA 95020
Gilroy , California 95020
15600 Concord Circle • Morgan Hill, California 95037 • P. 408-201-6000 • F. 408-825-6257
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VENDOR:City of Gilroy Tax ID#:946000340 SY:2023-24
19. ATTORNEY FEES / COSTS
Should litigation be necessary to enforce any terms or provisions of this Agreement, then each
party shall bear its own litigation and collection expenses, witness fees, court costs and
attorney’s fees.
20. COMPLETION
The work completed herein must meet the approval of the DISTRICT and shall be subject to the
DISTRICT’S general right of inspection and supervision, in a manner consistent with VENDOR’S
status as an independent contractor, to secure the satisfactory completion thereof. Work must
be completed in good workmanship like manner and in accordance with the generally accepted
standard of care in the industry.
21. SEVERABILITY
If any provision of this Agreement shall be held to be invalid, illegal or unenforceable, the
validity, legality and enforceability of the remaining portions hereof shall not in any way be
affected or impaired thereby, except where enforcement is inconsistent with the parties’ intent.
22. RELEASE, DISCHARGE OR WAIVER
No release, discharge or waiver of any provision hereof shall be enforceable against or binding
upon either party hereto unless in writing and executed by both parties hereto. Neither the
failure to insist upon strict performance of any of the agreements, terms, covenants or
conditions hereof, nor the acceptance of monies due hereunder with knowledge of a breach of
this Agreement, shall be deemed a waiver of any rights or remedies that either party hereto may
have or a waiver of any subsequent breach or default in any of such agreements, terms,
covenants or conditions.
23. EXECUTION IN COUNTERPARTS
This Agreement may be executed in several counterparts each of which shall be an original and
all of which shall constitute but one and the same agreement.
Any party signing this Agreement on behalf of the VENDOR hereby represents that he/she is
duly authorized by the VENDOR to execute this Agreement and that the VENDOR has agreed
to be bound by the provisions hereof.
15600 Concord Circle • Morgan Hill, California 95037 • P. 408-201-6000 • F. 408-825-6257
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District Vendor
Signature Signature
Jimmy Forbis
Name Name
Deputy Superintendent and CFO City Administrator
Title Title
Date Date
Penny Timboe
DocuSign Envelope ID: 49BDEE33-79E1-4483-850E-E8D498B2ABFC
11/15/2023
VENDOR:City of Gilroy Tax ID#:946000340 SY:2023-24
Signature
Name
City Attorney
Title
_____________________________________________
Date
Signature
Name
City Clerk
Title
Date
For MHUSD Only
$45,000
Contract Reviewed Contract Amount Date to BOE
15600 Concord Circle • Morgan Hill, California 95037 • P. 408-201-6000 • F. 408-825-6257
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Andrew L. Faber
11/15/2023
Thai Nam Pham
11/15/2023
VENDOR:City of Gilroy Tax ID#:946000340 SY:2023-24
MORGAN HILL UNIFIED SCHOOL DISTRICT
W9 FORM
https://drive.google.com/open?id=1Id4hKE2XvTUSEeXQOK_c3rLxVy91Gj5p
15600 Concord Circle • Morgan Hill, California 95037 • P. 408-201-6000 • F. 408-825-6257
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DocuSign Envelope ID: 49BDEE33-79E1-4483-850E-E8D498B2ABFC
VENDOR:City of Gilroy Tax ID#:946000340 SY:2023-24
MORGAN HILL UNIFIED SCHOOL DISTRICT
LIABILITY INSURANCE
https://drive.google.com/open?id=1DMpa4hRs-bucXpPJ1G867KepaLpNgScF
15600 Concord Circle • Morgan Hill, California 95037 • P. 408-201-6000 • F. 408-825-6257
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DocuSign Envelope ID: 49BDEE33-79E1-4483-850E-E8D498B2ABFC
VENDOR:City of Gilroy Tax ID#:946000340 SY:2023-24
MORGAN HILL UNIFIED SCHOOL DISTRICT
FINGERPRINTING / CRIMINAL BACKGROUND INVESTIGATION
CERTIFICATION
Questionnaire Response:There will be continued and constant supervision of all the vendor's non
fingerprinted by a fingerprinted vendor employee who has pass the fingerprinting/criminal
background investigations.
VENDOR’S services under this Agreement shall be limited to the construction, reconstruction,
rehabilitation, or repair of a school facility and although all Employees will have contact, other than
limited contact, with DISTRICT pupils, pursuant to Education Code § 45125.2 DISTRICT shall ensure the
safety of the pupils by continual supervision and monitoring of all VENDOR’S on-site employees of
VENDOR by an employee of VENDOR, whom the Department of Justice has ascertained has not been
convicted of a violent or serious felony.
I am a representative of the VENDOR entering into this Agreement with the DISTRICT and I am familiar
with the facts herein certified, and am authorized and qualified to execute this certificate on behalf of
the VENDOR.
Vendor Sign Here
Director of Human Services
Signature Title
LeeAnn McPhillips
Name Date
15600 Concord Circle • Morgan Hill, California 95037 • P. 408-201-6000 • F. 408-825-6257
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Certificate applies to CIty of Gilroyemployee, Sandra Cruz, Youth Task Force Coordinatoras the assigned employee,
DocuSign Envelope ID: 49BDEE33-79E1-4483-850E-E8D498B2ABFC
11/10/2023
VENDOR:City of Gilroy Tax ID#:946000340 SY:2023-24
MORGAN HILL UNIFIED SCHOOL DISTRICT
TUBERCULOSIS CLEARANCE
The undersigned does hereby certify to the governing board of the DISTRICT as follows:
I am a representative of the VENDOR currently entering into this Agreement with the DISTRICT and I am
familiar with the facts herein certified, and am authorized and qualified to execute this certificate on
behalf of the VENDOR. VENDOR’S responsibility for tuberculosis clearance extends to all of its
employees, subcontractors, and employees of subcontractors coming into contact with DISTRICT pupils
regardless of whether they are designated as employees or acting as independent contractors of the
VENDOR.
VENDOR certifies that the following items applies to the Scope of Work that is the subject of this
Agreement:
Questionnaire Response:Any and all of vendor's staff who will have contact with MHUSD students or
employees will have TB clearance.
The VENDOR ensures that any person providing any portion of the services has completed the
Tuberculosis Risk Assessment Questionnaire (in accordance with California Education Code Section
49406 and Health and Safety Code Sections 121525-121555) and found that VENDOR does not have risk
factors, or if tuberculosis risk factors were identified, the patient has been examined and determined to
be free of infectious tuberculosis, by a physician or surgeon, within 60 days of Board approval of the
Agreement, or if previous contractor to the DISTRICT, within the last four (4) years. If there is however a
positive result, chest x-ray verification is required. Upon the DISTRICT’S request, a complete and accurate
list of VENDOR’S employees and of all of its subcontractors’ employees, who may come in contact with
DISTRICT pupils during the course and scope of the Agreement, will be required to furnished – indicating
the date of each person’s completion of the questionnaire and if necessary physical examination.
Vendor Sign Here
Director of Human Resources
Signature Title
LeeAnn McPhillips
Name Date
15600 Concord Circle • Morgan Hill, California 95037 • P. 408-201-6000 • F. 408-825-6257
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Certificate only applies to City of
Gilroy employee, Sandra Cruz,
Youth Task Force Coordinator as the
assigned employee.
DocuSign Envelope ID: 49BDEE33-79E1-4483-850E-E8D498B2ABFC
11/10/2023
VENDOR:City of Gilroy Tax ID#:946000340 SY:2023-24
MORGAN HILL UNIFIED SCHOOL DISTRICT
WORKERS’ COMPENSATION CERTIFICATION
California law requires all employers to carry workers’ compensation insurance, even if they have only
one employee. If you are the sole owner and you have no employees, or if your business is an out of
state corporation with no employees working in California, you may not be required to carry workers’
compensation insurance. It is your responsibility to comply with the law. If you do not know whether
you are required to carry workers’ compensation insurance, find out by contacting the California
Department of Industrial Relations (“DIR”). Information is also available on the DIR’s website at
http://dir.ca.gov.
Labor Code § 3700 in relevant part provides that every employer except the State shall secure the
payment of compensation in the following way:
Questionnaire Response:Vendor will supply certificate showing Workers' Compensation Insurance is
valid and not expired.
By being insured against liability to pay compensation by one or more insurers duly authorized to write
compensation insurance in this State.
I am aware of the provisions of Labor Code § 3700 which requires every employer to be insured against
liability for workers’ compensation or to undertake self-insurance in accordance with the provisions of
that code, and I will comply with such provisions before commencing the performance of the Scope of
Work of this Agreement.
Vendor Sign Here
Director of Human Resources
Signature Title
LeeAnn McPhillips
Name Date
https://drive.google.com/open?id=1QMk01sPLkmThmgUEUg5hTPb6mDv9K4nw,
https://drive.google.com/open?id=1CRFA_JZt8ev52_UPlfrsypF7rD4qqReE,
https://drive.google.com/open?id=1wxE9_5vWJUiNTUUImUObCXbwZqX6JIjU,
https://drive.google.com/open?id=1Z0zrCLDWjIBoL_ucncsnsyN1Jv-ZxlKX
15600 Concord Circle • Morgan Hill, California 95037 • P. 408-201-6000 • F. 408-825-6257
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11/10/2023
VENDOR:City of Gilroy Tax ID#:946000340 SY:2023-24
MORGAN HILL UNIFIED SCHOOL DISTRICT
ECONOMIC SANCTIONS IN RESPONSE TO
RUSSIA’S ACTIONS IN UKRAINE
On February 21, 2022, President Biden issued Executive Order 14065* imposing economic sanctions and
prohibiting many activities including, but not limited to, investing, importing, exporting, and contracting,
in areas of Ukraine and in Russia. On March 4, 2022, California Governor Newsom issued Order N-6-22**
requiring state agencies to take steps to ensure any agency and entity under contract with state agencies
comply with the Federal Order.
If awarded a contract with the District, your Firm must comply with the economic sanctions imposed in
response to Russia’s actions in Ukraine, including the orders and sanctions identified in the U.S.
Department of the Treasury website.***
As part of this procurement, please respond to the the following:
Is your Firm in compliance with the required economic sanctions of the Federal and State Orders?Yes
If yes, please list the steps your Firm has taken in response to Russia's actions in Ukraine,
including, but not limited to, desisting from making new investments in, or engaging in financial
transactions with, Russian entities, not transferring technology to Russia or Russian entities, and
directly providing support to the government and people of Ukraine:
N/A
[MUST BE COMPLETED BY CONSULTANT’S AUTHORIZED REPRESENTATIVE.] I am a representative of the
Consultant entering into this Agreement with the District and I am familiar with the facts herein certified,
and am authorized and qualified to execute this certificate on behalf of Consultant.
Vendor Sign Here
Director of Human Resources
Signature Title
LeeAnn McPhillips
Name Date
*https://www.whitehouse.gov/briefing-room/presidential-actions/2022/02/21/executive-order-on-blocking-property-of-certain-persons-and-pr
ohibiting-certain-transactions-with-respect-to-continued-russian-efforts-to-undermine-the-sovereignty-and-territorial-integrity-of-ukraine/
**https://www.gov.ca.gov/wp-content/uploads/2022/03/3.4.22-Russia-Ukraine-Executive-Order.pdf
***https://home.treasury.gov/policy-issues/financial-sanctions/sanctions-programs-and-country-information/ukraine-russia-related-sanctions
15600 Concord Circle • Morgan Hill, California 95037 • P. 408-201-6000 • F. 408-825-6257
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11/10/2023
VENDOR:City of Gilroy Tax ID#:946000340 SY:2023-24
MORGAN HILL UNIFIED SCHOOL DISTRICT
STUDENT DATA CONFIDENTIALITY AGREEMENT
I will be collecting personal information on MHUSD students.I acknowledge my responsibility to respect
the confidentiality of student records and to act in a professional manner in the handling of student
data. I will ensure that confidential data, including personally identifiable information (PII) is not created,
collected, stored, maintained, or disseminated in violation of state and federal laws.
Furthermore, I agree to the following guidelines regarding the appropriate use of student data collected
by myself or made available to me from other school or district employees:
●I will comply with school district confidentiality policies, as well as state and federal
confidentiality laws including Family Educational Rights and Privacy Act (FERPA):
http://www.ed.gov/offices/OM/fpco/ferpa/, and the Children’s Online Privacy Protection Act
(COPPA):
https://www.ftc.gov/enforcement/rules/rulemaking-regulatory-reform-proceedings/childrens-o
nline-privacy-protection-rule
●Student data will only be accessed for students for whom I have a legitimate professional need
and will be used for the sole purpose of improving student achievement or ensuring student and
school safety.
●I understand that student specific data is never to be transmitted via email or as an email
attachment unless the file is encrypted, password protected or PII has been redacted.
●I will securely log in and out of the programs that store student specific data. I will not share my
password nor keep password information in an accessible location. Any documents I create
containing student specific data will be stored securely within the district network or within a
password-protected environment. I will not store student specific data on any personal
computer and/or external devices that are not password protected. (External devices include but
are not limited to USB/thumb drives, external hard drives, cell phones and tablets.)
●I will not record any digital or online virtual learning or assessment sessions that would become
part of a student's record.
●Regardless of its format, I will treat all information with respect for student privacy. I will not
leave student data in any form accessible or unattended, including information on a computer
display or hard copy documents.
●Any digital or hard copy records containing PII will be returned to the district office or school site
when employment or job assignment has been completed or terminated.
By signing below, I acknowledge, understand and agree to accept all terms and conditions of the Morgan
Hill Unified School District’s Student Data Confidentiality Agreement.
Vendor Sign Here
15600 Concord Circle • Morgan Hill, California 95037 • P. 408-201-6000 • F. 408-825-6257
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VENDOR:City of Gilroy Tax ID#:946000340 SY:2023-24
Director of Human Resources
Signature Title
LeeAnn McPhillips
Name Date
15600 Concord Circle • Morgan Hill, California 95037 • P. 408-201-6000 • F. 408-825-6257
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VENDOR:City of Gilroy Tax ID#:946000340 SY:2023-24
MORGAN HILL UNIFIED SCHOOL DISTRICT
PUPIL RECORDS ADDENDUM TO TECHNOLOGY SERVICES AGREEMENT
FOR CALIFORNIA EDUCATION CODE 49073.1 COMPLIANCE
Questionnaire Response:No
This Addendum is entered into between Morgan Hill Unified School District (“District”) and City of Gilroy
(“Service Provider”) on 7/1/2023.
WHEREAS,the District is a California public entity subject to all state and federal laws governing
education, including but not limited to California Assembly Bill 1584 (“AB1584”), the California Education
Code, the Children’s Online Privacy and Protection Act (“COPPA”), the Family Educational Rights and
Privacy Act (“FERPA”), and the Student Online Personal Information Protection Act (“SOPIPA”);
WHEREAS,AB 1584 requires, in part, that any agreement entered into, renewed or amended
after January 1, 2015 between a local education agency and a third-party service provider must include
certain terms; and
WHEREAS,the District and the Service Provider desire to have the Technology Services
Agreement and the services provided comply with AB 1584.
NOW, THEREFORE,the parties agree as follows:
1. The terms and conditions of the Technology Services Agreement and any addenda are
incorporated herein by reference.
2. The term of this Addendum shall expire on the termination date stated in the Technology
Services Agreement or in any addenda to such Technology Services Agreement, whichever
controls.
3. Pupil records obtained by Service Provider from District continue to be the property of and
under the control of the District. The District (or the applicable school) maintains control of all
data, and has the ability to login to the platform and make any required modifications.
4. The procedures by which pupils may retain possession and control of their own pupil-generated
content are outlined as follows:
5. The options by which a pupil may transfer pupil-generated content to a personal account
include:
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6. Parents, legal guardians, or eligible pupils may review personally identifiable information in the
pupil’s records and correct erroneous information by the following protocol:
7. Service Provider shall take actions to ensure the security and confidentiality of pupil records,
including but not limited to designating and training responsible individuals on ensuring the
security and confidentiality of pupil records, by the following measures:
8. In the event of an unauthorized disclosure of a pupil’s records, Service Provider shall report to an
affected parent, legal guardian, eligible pupil, and District pursuant to the following procedure:
9. Service Provider shall not use any information in a pupil record for any purpose other than those
required or specifically permitted by the Technology Services Agreement. Service Provider will
provide access to pupil records only to its employees and subcontractors who need to access the
data to fulfill Service Provider’s obligations under the Contract or this Addendum.
10. Service Provider certifies that a pupil’s records shall not be retained or available to the Service
Provider upon completion of the terms of the Technology Services Agreement, except for a case
where a pupil chooses to establish or maintain an account with Service Provider for the purpose
of storing pupil-generated content, either by retaining possession and control of their own
pupil-generated content, or by transferring pupil-generated content to a personal account. Such
certification will be enforced through the following procedures:
In furtherance of the foregoing, upon termination or expiration of the Service Agreement and
this Addendum, Service Provider will, as applicable, securely return or destroy pupil records as
reasonable directed by the District. In the event that the District requests destruction of any
pupil records, Service Provider agrees to securely destroy all pupil records in its possession and
in the possession of any subcontractors or agents to which the Service Provider might have
transferred pupil records. Upon request by the District, Service Provider agrees to provide
documentation of data destruction to the District.
11. Service Provider will not use pupil records for advertising or marketing purposes unless such use
is specifically authorized by the Service Agreement or otherwise authorized in writing by the
District.
IN WITNESS WHEREOF, parties execute this Agreement on the dates set forth below.
District Vendor
Signature Signature
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VENDOR:City of Gilroy Tax ID#:946000340 SY:2023-24
LeeAnn McPhillips
Name Name
Deputy Superintendent and CFO Director of Human Resources
Title Title
Date Date
District Vendor
Morgan Hill Unified School District
ATTN: Deputy Superintendent
15600 Concord Circle
Morgan Hill, CA 95037
City of Gilroy
ATTN: Jimmy Forbis
7351 Rosanna St, Gilroy, CA 95020
Gilroy , California 95020
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Penny Timboe
DocuSign Envelope ID: 49BDEE33-79E1-4483-850E-E8D498B2ABFC
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VENDOR:City of Gilroy Tax ID#:946000340 SY:2023-24
15600 Concord Circle •Morgan Hill,California 95037 •P.408-201-6000 •F.408-825-6257
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VENDOR: City of Gilroy (SCYTF)Tax ID#: 946000340 SY: 2023-24
MORGAN HILL UNIFIED SCHOOL DISTRICT
AMENDMENT TO SERVICE AGREEMENT
This Amendment to the Service Agreement is hereby entered into on by Morgan Hill Unified School
District, (hereinafter referred to as “DISTRICT”), and City of Gilroy (SCYTF) (hereinafter referred to as
“VENDOR”) for the following services:
The following changes and/or revisions will be reflected as follows to the original Service Agreement. All
prior agreements remain in force; Amendment only reflects a change in the following: (PLEASE ONLY
CHECK CHANGES THAT APPLY).
ORIGINAL PURCHASE ORDER NUMBER:
Change/Revision Explanation
Term(s) of Contract:**
Description of Services:**
Amount:**
Original Amount:$Total Encumbered Prior to this Agreement
Change:$Additional Amount to be Encumbered
New Total:$Total
Old Budget Code Amount
$
New Budget Code
$
Waive Liability Insurance:
Other:Page 11 & 12 add: Certification applies to City of Gilroy employee
Sandra Cruz, Youth Task Force Coordinator as the assigned
employee
Original Board Approval Date:Board Amended Date:
15600 Concord Circle • Morgan Hill, California 95037 • P. 408-201-6000 • F. 408-825-6257
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DocuSign Envelope ID: 49BDEE33-79E1-4483-850E-E8D498B2ABFC
VENDOR: City of Gilroy (SCYTF)Tax ID#: 946000340 SY: 2023-24
District Vendor
Signature Signature
Name Name
Title Title
Date Date
**The Service Agreement Amendment is required to change: terms, description of service(s) or contractual amount and may
require approval by the Board of Education.
15600 Concord Circle • Morgan Hill, California 95037 • P. 408-201-6000 • F. 408-825-6257
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Effective: July 1, 2022
MUNICIPAL POOLING AUTHORITY
MEMORANDUM OF COVERAGE
GENERAL & AUTO LIABILITY
Throughout this Memorandum of Coverage (“Memorandum”), words and phrases that appear in
italics and quotation marks have special meaning. They are defined in Section II, “Definitions.” In consideration of the payment of the premium, the Authority agrees with the “covered parties” as follows:
SECTION I - COVERAGES
The Authority will pay up to the “limit of coverage” those sums on behalf of the “covered parties” for “ultimate net loss” in excess of the applicable self-insured retention that the “covered parties” become legally obligated to pay as “damages” by reason of liability imposed by law or liability assumed by contract because of:
A. “Bodily injury” or “property damage” and/or
B. “Personal injury” and/or
C. “Public officials’ errors and omissions”
as those terms are herein defined and to which this Memorandum applies, caused by an “occurrence” during the coverage period. As a condition precedent for the Authority to have any duty under this Memorandum, including the duty to pay “ultimate net loss” or any portion thereof, a “covered party” shall first have complied fully with the provisions of SECTION VIII – CONDITIONS. A “covered party’s” failure to so comply shall void the coverage described herein, unless coverage is extended by a two-thirds vote of the full Board. This Memorandum does not provide insurance, but instead provides for pooled self-insurance. This Memorandum is a negotiated agreement amongst the Members of the Authority, and as such, no party to the Memorandum is entitled to interpret it by reference to legal principles specific to contracts of adhesion, or to commercial insurers. Similarly, no party to this Memorandum may rely on any contract interpretation principles which require interpretation of ambiguous language against the drafter of such agreement. This Memorandum shall be applied according to the principles of contract law, giving full effect to the intent and reasonable expectation of the members of the Authority, acting through the Board of Directors. As the Authority is not an insurer, it has no obligation (but may choose) to issue reservation of rights letters, nor is it bound by the provisions of Civil Code §2860, which pertains to an insurer’s obligation to provide independent counsel to an insured under circumstances defined by that statute. Failure to provide notice to a “covered party” of any coverage dispute shall not operate to
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waive any of the provisions of this Memorandum; however, the Authority will use its best efforts to identify coverage disputes and to alert the “covered party” of such as soon as possible.
SECTION II - DEFINITIONS
1. “Additional covered party” means any person or “entity” named as an “additional covered
party” and holding a certificate of coverage duly issued by the Authority, for “occurrences” during the coverage period identified in the certificate of coverage; if a particular activity is identified in the certificate of coverage, the person or “entity” is a “covered party” only for “occurrences” arising out of the described activity. Coverage for an “additional covered party” shall be provided only when and to the extent required under the contract, subject to the terms and conditions of this Memorandum.
2. “Aircraft” means a vehicle designed for the transport of persons or property principally in the air, not including an “unmanned aerial vehicle.”
3. “Automobile” means a land motor vehicle, trailer or semi-trailer.
4. “Bodily injury” means bodily injury, sickness, disease, or emotional distress sustained by a person, including death resulting from any of these at any time. Bodily injury includes “damages” claimed by any person or organization for care, loss of service or death resulting at any time from the bodily injury.
5. “Covered indemnity contract” means that part of a contract or agreement pertaining to the “covered party's” governmental operations, including but not limited to: a) Leases; b) Mutual aid agreements; c) Public works contracts; d) Special events sponsored by the “covered party,” e) Easement or license agreements; or f) Use of facilities or equipment by the “covered party,” under which the “covered party” assumes the tort liability of another party to pay for “bodily injury” or “property damage” to a third person or organization. This definition applies only to tort liability arising out of an “occurrence” to which this Memorandum applies. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. 6. “Covered individuals” means persons who are past or present elected or appointed officials, employees or volunteers of the “entity”, whether or not compensated, while acting for or on behalf of the “entity,” including while acting on outside boards, commissions, agencies, or similar bodies or entities, conditioned on the following:
(a) The Authority's coverage will be excess and will not contribute to any other coverage available to the outside board, commission, agency, or similar body or entity;
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(b) If the outside board, commission, agency, or similar body or entity does not carry coverage, the member should encourage they obtain coverage of their own;
(c) To be afforded coverage, the individual must be acting in good faith, without malice or oppression, and in the best interest of the “entity;” and
(d) Extension of coverage must be in the best interest of the “entity;”
Persons who are past or present elected or appointed officials, employees or volunteers of the
“entity” are not “covered individuals” while acting on an airport or hospital board regardless of how such body is denominated.
Under no circumstances shall the Authority have a duty to defend or indemnify any
“covered individual” under circumstances in which the “entity” itself is not legally required to do so. The Board, at its sole discretion, may waive this section if it deems it is in the best interest of the Authority.
7. “Covered party” means any person, organization, trust or agency qualifying as a covered party in the covered parties section of this Memorandum.
8. “Damages” means compensation in money recovered by a party for loss or detriment it has suffered through the acts of a “covered party.” For purposes of this Memorandum, “damages” includes statutory attorneys’ fees and costs if the attorneys’ fees and costs are related to a claim for “damages” which would otherwise be covered by this Memorandum.
9. “Defense costs” means all fees and expenses caused by and relating to the investigation, defense or litigation of a claim including attorney's fees, court costs and interest on judgments accruing after entry of judgment. Defense costs shall not include the office expenses of the Authority or the “covered party” nor the salaries of employees or officials of the Authority or any “covered party.” Defense costs shall not include any fee or expense relating to coverage issues or disputes between the authority and any “covered party.” Defense costs shall not include attorney fees or costs awarded to a prevailing plaintiff against the “covered party.”
10. “Entity” means the entity named in the Declarations, including any and all commissions, agencies, districts, authorities, boards (including the governing board) or similar entities coming under the entity's direction or control or for which the entity's board members sit as the governing body. Entity includes all departments and constituent agencies of the entity. 11. “Limit of coverage” means the amount of coverage stated in the declaration page or certificate of coverage for each “covered party” per “occurrence.” With respect to “bodily injury,” “property damage,” and “personal injury,” that amount is $1,000,000.00 and the self-insured retention is the amount chosen by the “covered party” and reflected in its Declaration page. With respect to “public officials’ errors & omissions,” that amount is $250,000.00 and the self-insured retention is $25,000.00. For each “occurrence,” there shall be only one limit of coverage regardless of the number of claimants or “covered parties” against whom a claim is made. In the event of allegations of “sexual abuse,” regardless of the number of alleged victims, regardless of the number of alleged acts of “sexual abuse,” and regardless of the number of locations where the alleged acts of “sexual
abuse” took place, all instances of “sexual abuse” by the same alleged perpetrator or perpetrators acting together shall be deemed to be one “occurrence” taking place at the time of the first alleged act
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of “sexual abuse.” Coverage in effect at the time the “occurrence” takes place shall be the only coverage that may apply, regardless of whether other instances of “sexual abuse” by the same alleged perpetrator or perpetrators took place during other Memorandum periods. In the event subsequent allegations of “sexual abuse” are made by different alleged victims involving the same alleged perpetrator or perpetrators, they shall be deemed to be part of the same “occurrence” taking place at the time of the first reported “occurrence” involving the same alleged perpetrator or perpetrators, and coverage in effect at the time of the first reported “occurrence” shall be the only coverage that may apply. In the event that a structured settlement, whether purchased from or through a third- party, or paid directly by the “covered party” in installments, is utilized in the resolution of a claim or suit, the Authority will pay only up to the amount stated in the Declarations or certificate of coverage in present value of the claim, as determined on the date of settlement, regardless of whether the full value of the settlement exceeds the amount stated in the Declarations or certificate of coverage.
12. “Medical malpractice” means the rendering of or failure to render any of the following services: a. Medical, surgical, dental, psychiatric, psychological counseling, x-ray or nursing services, or treatment or the furnishing of any food or beverage in connection therewith; or any services provided by a health care provider as defined in section 6146(c), (2), of the California Business and Professions Code. b. Furnishing or dispensing of drugs or medical, dental or surgical supplies or appliances. Medical malpractice does not include first aid administered by employees, nor does it include advice or services rendered by a 911 emergency dispatcher.
13. “Nuclear material” means source material, special nuclear material, or by-product material. “Source material,” “special nuclear material,” and “by-product material” have the meanings given to them by the Atomic Energy Act of l954 or in any law amendatory thereof.
14. “Occurrence” means: a. With respect to “bodily injury” or “property damage:” an accident, including continuous or repeated exposure to substantially the same generally harmful conditions, which results in “bodily injury” or “property damage” neither expected nor intended from the standpoint of the “covered party.” b. With respect to “personal injury” and “public officials’ errors and omissions” respectively: an offense described in the definitions of those terms in this Memorandum. Subject to specific provisions of this Memorandum regarding “sexual abuse,” with respect to “personal injury” and “public official’s errors and omissions,” an “occurrence” with a duration of more than one coverage period shall be treated as a single “occurrence” arising during the coverage period when the “occurrence” begins.
Subject to specific provisions of this Memorandum regarding “sexual abuse,” “property
damage” or “bodily injury” with a duration of more than one coverage period shall be deemed to occur during only one coverage period, and that coverage period shall be
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when any “property damage” or “bodily injury” was first discovered. Coverage for such “property damage” or “bodily injury” shall be provided by, at most, one Memorandum of Coverage by the Authority. In the event of allegations of “sexual abuse,” regardless of the number of alleged victims, regardless of the number of alleged acts of “sexual abuse,” and regardless of the number of locations where the alleged acts of “sexual abuse” took place, all instances of “sexual abuse” by the same alleged perpetrator or perpetrators acting together shall be deemed to be one “occurrence” taking place at the time of the first alleged act of “sexual abuse.” Coverage in effect at the time the “occurrence” takes place shall be the only coverage that may apply, regardless of whether other instances of “sexual abuse” by the same alleged perpetrator or perpetrators took place during other Memorandum periods. In the event subsequent allegations of “sexual abuse” are made by different alleged victims involving the same alleged perpetrator or perpetrators, they shall be deemed to be part of the same “occurrence” taking place at the time of the first reported “occurrence” involving the same alleged perpetrator or perpetrators, and coverage in effect at the time of the first reported “occurrence” shall be the only coverage that may apply.
15. “Personal injury” means injury, other than “bodily injury,” arising out of one or more of the following: a. False arrest, detention or imprisonment, or malicious prosecution; b. Abuse of legal process; c. Wrongful entry into, or eviction of a person from, a room, dwelling or premises that the person occupies; d. Publication or utterance of material that slanders or libels a person or organization or disparages a person's organization's goods, products or services, or oral or written publication of material that violates a person's right of privacy; e. Unlawful discrimination or violation of civil rights; or f. Injury resulting from the use of reasonable force for the purpose of protecting persons or property.
16. “Pollutants” means any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, vapor, soot, fumes, acids, alkalis, chemicals, airborne particles or fibers, molds and/or fungus, fungal pathogens, electromagnetic fields, and waste. Waste includes materials to be recycled, reconditioned or reclaimed. The term pollutants, as used herein, do not mean potable water, agricultural water, water furnished to commercial users, or water used for fire suppression.
17. “Property damage” means: a. Physical injury to tangible property, including all resulting loss of use of that property; or b. Loss of use of tangible property that is not physically injured or destroyed.
18. “Public officials’ errors and omissions” means any actual or alleged misstatement or misleading statement or any actual or alleged error or omission by “covered individuals” individually or collectively in the discharge of their duties with the “entity” and resulting in damage neither expected nor intended from the standpoint of the “covered party.” All claims involving the same actual or alleged misstatement or misleading statement or actual or alleged error or omission or a series of continuous or interrelated actual or alleged misstatements or misleading statements or actual or
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alleged error or omissions will be considered as arising out of one “occurrence.”
19. “Sexual abuse” means any actual, attempted, or alleged criminal sexual conduct of a person, or persons acting in concert, regardless if criminal charges or proceedings are brought, which causes physical and/or mental injuries. “Sexual abuse” also includes actual, attempted, or alleged: sexual molestation, sexual assault, sexual exploitation or sexual injury. Any or all acts of “sexual abuse” shall be deemed to constitute intentional conduct by the perpetrator done with willful and conscious disregard of the rights or safety of others, or with malice, or conduct that is malicious, oppressive or in reckless disregard of the claimant’s or plaintiff’s rights, and no coverage shall be provided in any event for the alleged perpetrator.
20. “Ultimate net loss” means the sum actually paid or payable in cash in the settlement or satisfaction, investigation or defense of losses for which the “covered party” is liable either by adjudication or by compromise with the written consent of the Authority, after making proper deduction for all recoveries and salvages and other collectible insurance. Ultimate net loss shall include “defense costs” and related expenses incurred by the Authority. Ultimate net loss does not include statutory attorney fees or costs awarded to a prevailing plaintiff unless such fees or costs are related to a claim for “damages” covered by this Memorandum. 21. “Unmanned aerial vehicle” means an aircraft, aerial system, or device that is not designed, manufactured, or modified after manufacture to be controlled directly by a person from within or on the aircraft, aerial system, or device.
SECTION III - DEFENSE AND SETTLEMENT
With respect to claims or suits for “damages” to which this Memorandum applies, the Authority shall have the right and duty to defend any claim or suit against the “covered party” even if any allegations are groundless, false or fraudulent. However, in making the determination of its duty to defend, the Authority may rely on the facts alleged within a third party’s complaint, and those extrinsic facts known to it. The Authority shall have no duty to speculate about unpled theories of recovery in order to determine its obligations to defend or to indemnify, nor shall the Authority be under any continuing duty to investigate whether a potential for coverage has arisen at some future date. The Authority shall have the right to manage, and the “covered party” shall fully cooperate in, all matters pertaining to the investigation, defense, negotiation, and settlement of any claim or suit for “damages” to which this Memorandum applies. The “covered party” shall be obligated to pay or reimburse the Authority for the entire “ultimate net
loss,” up to the applicable self-insured retention. If the “ultimate net loss” exceeds the “covered party's” self-insured retention, the Authority shall be obligated to pay or cause to be paid the “ultimate
net loss” in excess of the applicable self-insured retention, up to the Limit of Liability. The Authority shall not be obligated to pay any judgment or settlement or to participate in the defense of any claim or suit after the Authority’s “limit of coverage” has been totally exhausted by the payment of “defense costs” and/or judgments or settlements. No claim or suit shall be settled for an amount in excess of the applicable self-insured retention without the prior written consent of the Authority, and the Authority shall not be required to contribute to any settlement to which it has not consented.
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If the “covered party” prevents settlement of any claim or suit for a reasonable amount, defined as the amount the Authority is willing to pay and the claimant is willing to accept, increasing the “covered
party’s” potential liability for “damages” and continued “defense costs,” the “covered party” shall pay or shall reimburse the Authority for those “defense costs” incurred after the claim could have been settled, and for any “damages” awarded or settlement agreed upon in excess of the amount for which the claim could have been settled. This includes, but is not limited to, a refusal by the “covered party” to agree to a reasonable non-monetary term of settlement. The Authority, at its own expense, and with a two-thirds vote of the full Board, shall have the right to assume the control of the negotiation, investigation, defense, appeal or settlement of any claim or suit that the Authority determines, in its sole discretion, to have a reasonable probability of resulting in an “ultimate net loss” in excess of the applicable self-insured retention. If the Authority assumes control of a claim or suit, the “covered party” shall be obligated at the request of the Authority, to pay any sum necessary for the settlement of the claim or suit, or to satisfy liability imposed by law, up to its applicable self-insured retention, and to satisfy every other requirement to effect a final resolution of the claim or suit. If the “covered party” refuses to pay its applicable self-insured retention on request by the Authority, the claim or suit shall not be covered under this Memorandum, except by majority vote of the full Board.
SECTION IV - THE AUTHORITY'S LIMIT OF LIABILITY
Regardless of the number of:
(1) Persons or “entities” covered under this Memorandum,
(2) Persons or organizations making claims or bringing suits, or
(3) Claims made or suits brought, the each “occurrence” limit is the most the Authority will pay for “ultimate net loss” arising out of anyone “occurrence.”
The “limit of coverage” for any additional “additional covered party” as defined in Section 2, # 1, subject to the per “occurrence” limitation above, shall not exceed the limit stated in its “additional
covered party” certificate regardless of the limit which applies to the member. For the purpose of determining the “limit of coverage,” all “damages” arising out of continuous or repeated exposure to substantially the same general conditions shall be considered as arising out of one “occurrence.” In the event of allegations of “sexual abuse,” regardless of the number of alleged victims, regardless of the number of alleged acts of “sexual abuse,” and regardless of the number of locations where the alleged acts of “sexual abuse” took place, all instances of “sexual abuse” by the same alleged perpetrator or perpetrators acting together shall be deemed to be one “occurrence” taking place at the time of the first alleged act of “sexual abuse.” Coverage in effect at the time the “occurrence” takes place shall be the only coverage that may apply, regardless of whether other instances of “sexual abuse” by the same alleged perpetrator or perpetrators took place during other Memorandum periods. In the event subsequent allegations of “sexual abuse” are made by different alleged victims involving the same alleged perpetrator or perpetrators, they shall be deemed to be part of the same “occurrence” taking place at the time of the first reported “occurrence” involving the same alleged perpetrator or perpetrators, and coverage in effect at the time of the first reported “occurrence” shall be the only coverage that may apply.
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SECTION V - COVERAGE PERIOD AND TERRITORY This Memorandum applies to “bodily injury,” “personal injury,” “property damage” or “public
officials’ errors and omissions” which occur anywhere in the world during the coverage period.
SECTION VI - "COVERED PARTIES"
The parties covered by this Memorandum are:
(A) The “entity.”
(B) “Covered individuals.”
(C) With respect to any “automobile” owned or leased by the “entity” or loaned to or hired for use by or on behalf of the “entity,” any person while using such “automobile” and any person or organization legally responsible for the use thereof, provided the actual use is with the permission of the “entity,” and with respect to any “automobile” owned or leased by an employee of the “entity” or by a member of the “entity's” governing board, if the “entity” reimburses or pays the employee or governing board member for use of such “automobile,” and only if such “automobile” is operated by said employee or governing board member in the course and scope of employment and only to the extent that the coverage provided hereunder shall be in excess of any other insurance for said “automobile.” The foregoing notwithstanding, this coverage does not apply to:
(1) Any person or organization or any agent or employee thereof, operating an “automobile” sales agency, repair shop, service station, storage garage or public parking place, with respect to an “occurrence” arising out of the operation thereof; or
(2) The owner or any lessee, other than the “entity,” of a leased or hired “automobile” or any agent or employee of such owner or lessee.
(D) Any “additional covered party.”
(E) “Covered party” does not include any person, organization, trust or estate or any other type of entity for any risk, claim, or loss which is incurred or occurs under any other joint powers authority, or any joint powers agreement which creates a separate agency or entity, unless added hereto by endorsement. However, as to any person who is an official, employee, or volunteer of an “entity” named in the Declarations and is participating in the activities of any other joint powers authority or any separate agency or entity created under any joint powers agreement on behalf of that “entity,” the coverage afforded in this Memorandum of Coverage will apply in excess of and shall not contribute with any collectible insurance or other coverage provided to or through the other joint powers authority or joint powers agreement covering a loss also covered hereunder, whether on a primary, excess, or contingent basis.
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SECTION VII - EXCLUSIONS
This Memorandum does not apply to:
1. (a) Claims arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, plumage, release or escape of “pollutants” into or upon land, the atmosphere, or any watercourse or body of water. This exclusion does not apply to fire fighting activities, including training burns, or intentional demolition or burns for the purpose of controlling a fire, or the discharge of “pollutants” for the purpose of controlling a fire; or to police use of mace, oleoresin capsicum (O.C.), pepper gas or tear gas; to weed abatement or tree spraying; or spraying of any pesticide. This exclusion does not apply to claims arising from sudden and accidental sewer backups. This exclusion does not apply to claims arising from the sudden and accidental discharge, dispersal, release, or escape of chlorine and other chemicals (gas, liquid or solid) which are being used or being prepared for use in fresh or waste water treatment or in water used in swimming pools, wading pools or decorative fountains. As used herein, "sudden" means abrupt or immediate, and occurring within a period not exceeding twenty-four (24) hours; "accidental" means causing harm neither expected nor intended by a “covered party.”
This exclusion does not apply to claims arising from mold and/or fungus, with coverage limited to an amount up to $100,000 over the “covered party’s” self-insured retention per “occurrence.” This exclusion does not apply to claims arising from materials being collected as part of any drop- off or curbside recycling program implemented and operated by the “covered
party,” if the materials have not been stored by the “covered party” or “parties” for a continuous period exceeding ninety (90) days. (b) Any loss, cost, or expense arising out of any governmental order, directions or request that the “covered party” or any other person or organization test for, monitor, clean up, remove, contain, treat, detoxify, neutralize, remediate, or assess the effects of “pollutants.”
(c) Any loss, cost or expense, including but not limited to costs of investigation or attorneys’ fees, incurred by a governmental unit or any other person or organization to test for, monitor, clean-up, remove, contain, treat, detoxify, neutralize, remediate, or assess the effects of “pollutants.”
2. Claims arising out of the manufacture, mining, use, sale, installation, removal or distribution of or exposure to radon, asbestos, asbestos products, asbestos fibers, asbestos dust, or other asbestos-containing materials and:
(a) Any obligation of the “covered party” to indemnify any party because of such claims, or
(b) Any obligation to defend any suit or claims against the “covered party” because of such claims.
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3. Any claim (including attorney's fees or salary or wage loss claims) by any potential, present or former employee or official of the “covered party” arising out of, but not limited to, a violation of civil rights or employment-related practices, policies, acts, or omissions. This exclusion applies to claims of negligent supervision and/or claims of failure to prevent employment-related practices.
4. (a) Any claim by:
(1) Any present or former employee or co-employee of the “covered party” arising out of or sustained in the course of employment with the “covered party,” or
(2) The spouse, child, unborn child or fetus, parent, brother or sister of any such employee or co-employee as a consequence of exclusion 3, 4(a) (1) or 4(b) herein. This exclusion applies whether the “entity” may be held liable as an employer or in any other capacity, except with respect to liability of others assumed under a “covered
indemnity contract.” (b) Any obligation for which the “covered party” or any insurance company as its insurer may be held liable under any workers' compensation, unemployment compensation or disability benefits law or any similar law.
5. Liability imposed under the “Employment Retirement Income Security Act of l974” or any law amendatory thereof, or any law or liability arising out of fiduciary activities as respects employee benefit plans.
6. The cost of providing reasonable accommodation pursuant to the Americans with Disabilities Act, Fair Employment and Housing Act, or other similar law.
7. Liability imposed under the Fair Labor Standards Act or any law amendatory thereof.
8. Benefits payable under any employee benefit plan (whether the plan is voluntarily established by the “entity” or mandated by statute).
9. Claims by any “entity” against its own past or present elected or appointed officials, employees, volunteers, or additional covered parties where such claim seeks “damages” payable to the “entity.”
10. Claims arising out of any professional “medical malpractice” except “medical malpractice” committed by any employee of the “covered party,” if that employee is licensed and certified as an RN, LPN, LVN, EMT, paramedic or laboratory technician, and is not employed by or working for any hospital or hospital operated out-patient, in-patient or other clinic at the time of the “occurrence” giving rise to the loss.
11. Claims arising out of ownership, maintenance, management, supervision, or the condition or operation of any hospital or airport.
12. Fines, assessments, fees, penalties, restitution, disgorgement, statutorily multiplied (including but not limited to treble) damages, exemplary damages, or punitive damages,
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whether awarded by a court or by an administrative or regulatory agency. Restitution and disgorgement, as used herein, refer to the order of a court or administrative agency for the return of a specific item of property or a specific sum of money, because such item of property or sum of money was not lawfully or rightfully acquired by the “covered party.”
13. “Bodily injury” or “property damage” arising out of the hazardous properties of “nuclear
material.”
14. Claims arising out of or in connection with:
(a) Land use regulation, land use planning, the principles of eminent domain, condemnation proceedings or inverse condemnation by whatever name called, resulting from deliberate decision making by the “covered party” and whether or not liability accrues directly against the “covered party” or by virtue of any agreement entered into by or on behalf of any “covered party.”
However, the above exclusion shall not apply to inverse condemnation liability arising from accidentally caused physical injury to or destruction of tangible property, including all resulting loss of use of such property, for which the “covered
party” may be legally responsible. Further, the above exclusion shall not apply to claims for nuisance. This exclusion does not apply to enforcement of parking ordinances or regulations. Notwithstanding any of the above, this Memorandum of Coverage shall not apply to any claim arising out of the design, construction, ownership, maintenance, operation, or use of any water treatment plant or waste water treatment plant, no matter how or under what theory such claim is alleged, unless it is a claim based upon the accidental failure of the equipment utilized or contained within the water treatment plant or waste water treatment plant.
(b) The initiative process, whether or not liability accrues directly against any “covered
party” by reason of any agreement entered into by or on behalf of any “covered party.”
15. “Property damage” to:
(a) Property owned by the “entity” or employee.
(b) Property rented to or leased to the “entity” where it has assumed liability for “damages” to or destruction of such property, unless the “entity” would have been liable in the absence of such assumption of liability.
(c) “Aircraft,” “unmanned aerial vehicles,” or watercraft in the “entity's” care, custody or control.
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16. “Bodily injury” or “property damage” arising out of the ownership, operation, use or maintenance of:
(a) any watercraft while being used for public commercial purpose; or
(b) any “aircraft”; or
(c) any “unmanned aerial vehicle.” Ownership, operation, use or maintenance as used herein does not include static displays or aircraft or watercraft in a park or museum setting. This exclusion does not apply to claims arising out of the ownership, operation, use, maintenance or entrustment to others of any “unmanned aerial vehicle” owned or operated by or rented to or loaned by or on behalf of any “covered party” if operated at the time of the “occurrence” in accordance with all applicable federal, state, and local laws, rules and regulations, including but not limited to Federal Aviation Administration (FAA) Rules and Regulations for Unmanned Aircraft Systems detailed in part 107 of Title 14 of the Code of Federal Regulations and if also approved by the governing body of the "entity” for use before use.
17. “Bodily injury” or “property damage” arising out of the operation of any transit authority, transit system or public transportation system owned or operated by the “entity,” except a transit system operating over non-fixed route systems such as dial-a-ride, senior citizen transportation, or handicapped transportation.
18. Claims arising out of the failure to supply or provide an adequate supply of gas, water, electricity or sewage capacity when such failure is a result of the inadequacy of the “entity's” facilities to supply or produce sufficient gas, water, electricity or sewage capacity to meet the demand. If an electrical or natural gas plant, enterprise, utility, or entity, including but not limited to those involved in power supply, power distribution, or power generation is owned, operated, maintained, managed, or supervised by the “entity,” the provisions of exclusion 19 apply in place of this exclusion.
19. Claims arising out of the ownership, operation, maintenance, management, supervision, or the condition of any electrical or natural gas plant, enterprise, utility, or entity, including but not limited to those involved in power supply, power distribution, or power generation. This includes but is not limited to, any: (a) failure to supply or provide power from any such plant, enterprise, utility, or entity; (b) liability arising out of the ownership, operation, maintenance, use, or entrustment of any “automobile” in connection with activities unique to the ownership, operation, maintenance, management, supervision, or the condition of any such plant, enterprise, utility, or entity; or (c) obligation, whether or not based on contract, of the “covered party” to indemnify any person, entity, or governmental agency because of such claims. This exclusion does not apply to claims arising out of the ownership, operation, maintenance, use, or entrustment of any “automobile” in connection with activities other than those that are unique to the ownership, operation, maintenance, management, supervision, or the
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condition of any electrical or natural gas plant, enterprise, utility, or entity, including but not limited to those involved in power supply, power distribution, or power generation.
20. “Bodily injury” arising out of the ownership, maintenance or use of any trampoline, bungee jumping, or any other rebound tumbling device, including but not limited to bounce houses, Bubble Soccer, or any inflatable aquatic/pool device that includes a trampoline component.
21. “Bodily injury” arising out of the: (a) ownership, maintenance or use of any course, location, or other facility officially designated for use as a Parkour course, location, or facility; or (b) operation or sponsorship of any Parkour program, class, event, or instruction.
22. “Bodily injury” arising out of the ownership, maintenance or use of (a) any skate or skateboard park or other facility officially designated for use of skates, skateboards, or other wheeled recreational devices, or (b) any bicycle park or other facility officially designated for use of bicycles or mixed use of bicycles in a skate or skateboard park or facility. This exclusion does not apply to “bodily injury” arising out of the ownership, maintenance or use of such parks or facilities if operated at the time of the “occurrence” in accordance with all applicable federal, state, and local laws, rules and regulations, including but not limited to California Health & Safety Code section 115800, and if written approval is obtained by the Authority prior to the “occurrence.” Such written approval may be conditioned on the member “entity” meeting certain requirements, including but not limited to an inspection of the plans for the park or facility and the facility, and compliance with industry standards related thereto.
23. “Bodily injury” arising out of the operation or sponsorship of any rollerblade hockey league, program, class, or instruction. This exclusion does not apply to “bodily injury” arising out of the operation or sponsorship of any rollerblade hockey league, program, class, or instruction if operated at the time of the “occurrence” in accordance with all applicable federal, state, and local laws, rules and regulations, and if written approval is obtained by the Authority prior to the “occurrence.”
24. “Bodily injury” arising out of competition among students authorized by the instructor in martial arts classes, or arising out of martial arts tournaments or contests.
25. Under Coverage C, “public officials’ errors and omissions,” to “bodily injury” or “personal
injury.”
26. Under Coverage C, “public officials’ errors and omissions,” to physical injury to tangible property, including all resulting loss of use of that property.
27. Refund of taxes, fees or assessments.
28. Claims arising out of the intentional conduct done with willful and conscious disregard of the rights or safety of others, or with malice. However, where the “entity” did not authorize, ratify, participate in, consent to or have knowledge of such conduct by its past or present employee, elected or appointed official, or volunteer, and the claim against the “entity” is
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based solely on its vicarious liability arising from its relationship with such employee, official or volunteer, this exclusion does not apply to said “entity.” This exclusion does not apply to “bodily injury,” “property damage,” or “personal injury,” as those terms are defined, resulting from the use of reasonable force to protect persons or property.
29. Claims arising out of or related to “sexual abuse” as to the alleged perpetrator.
30. Claims arising, in whole or in part, out of a “covered party” obtaining remuneration or financial gain to which the “covered party” was not legally entitled.
31. Claims arising, in whole or in part, out of the violation of a statute, ordinance, order or decree of any court or other judicial or administrative body, or rule of law, committed by or with the knowledge or consent of a “covered party.”
32. Claims arising out of oral or written publication of material, if done by or at the direction of a “covered party” with knowledge of its falsity.
33. Claims arising out of estimates of probable cost or cost estimates being exceeded or faulty preparation of bid specifications or plans, including architectural plans, unless prepared by a qualified, licensed and/or registered engineer or architect who is the appointed City Engineer or an employee of the “covered party.”
34. Claims arising out of:
(a) A failure to perform, or breach of, a contractual obligation, or fraudulent inducement to contract.
(b) “Bodily injury” or “property damage” for which the “covered party” is obligated to pay “damages” by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for “damages:”
(1) Assumed in a contract or agreement that is a “covered indemnity contract,” provided the “bodily injury” or “property damage” occurs subsequent to the execution of the contract or agreement, and then only to the extent required by the terms of the “covered indemnity contract;” or
(2) That the “covered party” would have in the absence of the contract or agreement.
35. “Ultimate net loss” arising out of relief, or redress, in any form other than money “damages.”
36. Claims arising out of liability imposed on any “covered party” under any uninsured/underinsured motorist law or “automobile” no-fault law.
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SECTION VIII - CONDITIONS
1. “Covered Party's” Duties in the Event of “Occurrence,” Claim or Suit. As a condition precedent for the Authority to have any duty under this Memorandum, including the duty to pay “ultimate net loss” or any portion thereof, a “covered party” shall first have complied fully with (A) – (E) below. A “covered party’s” failure to so comply shall void the coverage described herein, unless coverage is extended by a two-thirds vote of the full Board.
(A) In the event of an “occurrence,” written notice containing particulars sufficient to identify the “covered party” and also reasonably obtainable information with respect to the time, place and circumstances thereof, addresses of the injured or damaged party(ies) and the identity and addresses of available witnesses, shall be given by or for the “covered party” to the Authority as soon as practicable. Such notice must be given within 30 days of either: (1) notice of any claim reasonably likely to exceed fifty percent of the “covered party’s” self-insured retention; or (2) any notice of “occurrence” involving any of the following:
• One or more fatalities;
• Loss of limb or amputation;
• Loss of use of any sensory organ;
• Spinal cord injuries, including but not limited to quadriplegia and paraplegia;
• Third degree burns involving 10% or more of the body;
• Serious cosmetic disfigurement;
• Paralysis;
• Closed head injuries;
• Loss of use of any body function;
• Long-term hospitalization;
• Alleged sexual abuse, molestation, or harassment; or
• Title 42 U.S.C. section 1983 claims or other claims involving civil rights violations. The Authority shall have the right, by two-thirds vote of the all the members of the Board, to deny coverage under this Memorandum, or to reduce the “ultimate net loss” payable, for failure to provide notice as required herein, including but not limited to the following: 1. A reduction up to 25% in the “ultimate net loss” that would have been payable on behalf of the “covered party” under this Memorandum had notice been timely given to the Authority, if notice is given between 31 days and 180 days after the date on which it should have been given. 2. A reduction of 26% up to 50% in the “ultimate net loss” payable on behalf of the “covered party” under this Memorandum had notice been timely given to the Authority, if notice is given between 181 days and 270 days after the date on which it should have been given. 3. A reduction of 51% up to 75% in the “ultimate net loss” payable on behalf of the “covered party” under this Memorandum had notice been timely given to the Authority, if notice is given between 271 days and 365 days after the date on which it should have been given.
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4. A reduction of 76% up to No coverage, and no payment of any “ultimate net loss” if notice is given more than one year after the date on which it should have been given.
(B) If claim is made or suit is brought against the “covered party,” the “covered party” shall be obligated upon demand to forward to the Authority every demand, notice, summons or other process received by it or its representative.
(C) The “covered party” shall cooperate with the Authority and, upon its request, assist in the conduct of suits and in enforcing any right of contribution or indemnity against any person or organization who may be liable to the “covered party” because of “bodily injury,” “personal
injury,” “property damage” or “public officials’ errors and omissions” with respect to which coverage is afforded under this Memorandum of Coverage; and the “covered party” shall, as deemed desirable by the Authority, attend hearings and trials and assist in securing and giving evidence and obtaining the attendance of witnesses. The “covered party” shall not, except at its own cost, voluntarily make any payment, assume any obligation or incur any expense on behalf of the Authority. The “covered party” shall reimburse the Authority for the “ultimate
net loss” up to its self-insured retention.
(D) The “covered party” shall comply with all obligations set forth under Section III – DEFENSE AND SETTLEMENT herein.
(E) Upon tender of a claim, the Authority shall be entitled to complete access to the “covered
party’s” claim file, the defense attorney’s complete file, and all investigation material and reports, including all evaluations and information on negotiations. The “covered party” shall be responsible to report on the progress of the litigation and any significant developments at least quarterly to the Authority, and to provide the Authority with simultaneous copies of all correspondence provided to the “covered party” by its defense attorneys and/or agents.
2. Bankruptcy or Insolvency:
Bankruptcy or insolvency of the “covered party” shall not relieve the Authority of any of its obligations hereunder.
3. Other Coverage:
If collectible insurance or any other coverage with any insurer, joint powers insurance authority or other source respectively is available to the “covered party” covering a loss also covered hereunder (whether on a primary, excess or contingent basis), the coverage hereunder shall be in excess of, and shall not contribute with, such other coverage.
4. Severability of Interests:
The term “covered party” and its sub-terms including “entity,” “covered individual” and “additional
covered party” are used severally and not collectively, but the inclusion herein of more than one “covered party” shall not operate to increase the limits of the Authority's liability or the applicable self-insured retention per “occurrence.”
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5. Accumulation of Limits:
Subject to specific provisions of this Memorandum regarding “sexual abuse,” with respect to “personal injury” and “public official’s errors and omissions,” an “occurrence” with a duration of more than one coverage period shall be treated as a single “occurrence” arising during the coverage period when the “occurrence” begins.
Subject to specific provisions of this Memorandum regarding “sexual abuse,” “property damage” or “bodily injury” with a duration of more than one coverage period shall be deemed to occur during only one coverage period, and that coverage period shall be when any “property damage” or “bodily injury” was first discovered. Coverage for such “property damage” or “bodily injury” shall be provided by, at most, one Memorandum of Coverage by the Authority. In the event of allegations of “sexual abuse,” regardless of the number of alleged victims, regardless of the number of alleged acts of “sexual abuse,” and regardless of the number of locations where the alleged acts of “sexual abuse” took place, all instances of “sexual abuse” by the same alleged perpetrator or perpetrators acting together shall be deemed to be one “occurrence” taking place at the time of the first alleged act of “sexual abuse.” Coverage in effect at the time the “occurrence” takes place shall be the only coverage that may apply, regardless of whether other instances of “sexual
abuse” by the same alleged perpetrator or perpetrators took place during other Memorandum periods. In the event subsequent allegations of “sexual abuse” are made by different alleged victims involving the same alleged perpetrator or perpetrators, they shall be deemed to be part of the same “occurrence” taking place at the time of the first reported “occurrence” involving the same alleged perpetrator or perpetrators, and coverage in effect at the time of the first reported “occurrence” shall be the only coverage that may apply.
6. Termination: This Memorandum may be terminated at any time in accordance with the Joint Powers Agreement or by action approved by the Authority's Board of Directors.
7. Changes: Notice to any agent or knowledge possessed by any agent of the Authority or by another person shall not affect a waiver or a change in any part of this Memorandum of Coverage, nor shall the terms of this Memorandum of Coverage be waived or changed, except by endorsement issued to form a part of this Memorandum of Coverage.
8. No action: No person, organization or other entity shall have the right under this Memorandum of Coverage to join the Authority as a party in any action against any “covered party” to determine the Authority's liability.
9. Subrogation: The Authority shall be subrogated to the extent of any payment hereunder to all the “covered
party's” rights of recovery therefor; and the “covered party” shall do nothing after loss to prejudice
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such rights and shall do everything necessary to secure such rights. This subrogation right is automatic and no further approval or direction from the “covered party” is necessary. Any amount recovered by the Authority shall be apportioned as follows:
(A) The Authority shall be reimbursed first to the extent of its actual payment hereunder. If any balance remains, it shall be applied to reimburse the “covered party.”
(B) The expenses of all such recovery proceedings shall be apportioned in the ratio of respective recoveries. If there is no recovery in the proceedings conducted solely by the Authority, it shall bear the expenses thereof.
SECTION IX - RESOLUTION OF COVERAGE DISPUTES
THE PARTIES TO THIS MEMORANDUM UNDERSTAND THAT BY AGREEING TO THIS
MEMORANDUM OF COVERAGE THEY WAIVE ANY RIGHT THEY MAY HAVE TO A COURT OR JURY
TRIAL AND TO CERTAIN TYPES OF DAMAGES FOR THE PURPOSE OF ADJUDICATING ANY
DISPUTE OR DISAGREEMENT AS TO COVERAGE UNDER THIS MEMORANDUM.
1. GENERAL The following procedures shall be followed in resolving any dispute, claim, or controversy arising out of or connected with this Memorandum of Coverage. Such disputes shall be resolved by either administrative proceedings or binding arbitration as provided herein.
2. PROCEDURES FOR RESOLVING DISPUTES Decisions whether to assume control of the negotiation, investigation, defense, appeal, or settlement of a claim, or whether or not coverage exists for a particular claim or part of a claim, shall be made initially by staff, in consultation with coverage counsel if necessary. An appeal to the Board from a written coverage opinion by staff or coverage counsel must be made in writing to the Authority by the covered party within ninety (90) days of receipt of such opinion. If, either prior to or following the Board’s decision, a new coverage opinion is sent by staff or coverage counsel to the
covered party, a new ninety (90) day period commences from receipt of such new opinion in which the covered party may appeal to the Board. Any dispute concerning a decision by the Board must first be submitted to non-binding mediation within sixty (60) days of written notification of the Board’s decision. The parties shall cooperate in selecting a mediator and scheduling a mediation within that timeframe. Each party shall bear one-half the cost of the selected mediator. Except for the shared cost of the mediator, each party shall be responsible for its own fees, costs and expenses of mediation. If the dispute is not resolved at mediation, it shall be submitted to final binding arbitration within ninety (90) days of the date such mediation is held. The arbitration shall be held before a neutral arbitrator, selected by mutual agreement of the parties, who is a lawyer experienced in contract interpretation or a retired federal or California State judge. The arbitrator shall not be employed by or affiliated with the Authority, the covered party, or any Member of the Authority. Such arbitration shall be conducted under the auspices of, and in accordance with, the procedures and rules of the California Code of Civil Procedure. Any hearings held in the course of such arbitration
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shall be held in Walnut Creek, California, unless the parties mutually agree in writing to another location. The selection of the arbitrator shall take place within twenty (20) calendar days from the receipt of the request for arbitration. The arbitration hearing shall commence within forty-five (45) calendar days from the date of the selection of the arbitrator. These timelines may be extended by agreement of the parties. Initially, each party shall bear one-half the cost of the selected arbitrator. Upon conclusion of the arbitration, the prevailing party shall be entitled to reimbursement from the other party of its share of such cost, payable within 20 days of the date of the decision of the arbitrator. Each party shall otherwise be responsible for its own fees, costs and expenses of arbitration. Except for notification of appointment and as provided in the California Code of Civil Procedure, there shall be no communication between the parties and the arbitrator relating to the subject of the arbitration other than at oral hearings, with the exception of briefing and written communications copied to all parties. The decision of the arbitrator shall be final and binding and shall not be subject to appeal.
3. FUNDING OF DEFENSE AND CLAIMS PENDING RESOLUTION OF DISPUTE During the course of the administrative and arbitration proceedings provided herein for which coverage is denied, the “covered party” will be responsible for all fees and expenses for the defense or litigation of a claim or lawsuit. In the event the arbitrator determines that a duty of defense applies, the Authority will reimburse the “covered party” for “defense costs” as defined in Section II (9).
4. EFFECT OF ARBITRATION DECISIONS All decisions on appeals, whether by the Board of Directors (after the time to request arbitration has expired) or by an arbitrator, shall be final and binding upon the “parties.”
5. NOT APPLICABLE TO EXCESS CARRIERS These arbitration provisions are intended to bind only the Authority and its member agencies. They are not intended to be binding upon any of the Authority's excess carriers.
Adopted May 12, 2022 Issued By:
MUNICIPAL POOLING AUTHORITY
By: _____________________________________________________________________ Date: _______________________________________ Linda M. Cox, Chief Administrative Officer
06-21-2022
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P.O. Box 67 * Walnut Creek, CA 94597 * (925) 943-1100 * Fax (925) 946-4183
Page 20 FY 2022/2023
MUNICIPAL POOLING AUTHORITY PROGRAM YEAR JULY 1, 2022 THROUGH JUNE 30, 2023 ENDORSEMENT NUMBER 1 This Endorsement, effective 12:01 a.m., July 1, 2022, and expiring on 12:00 a .m., July 1, 2023 forms a part of the Memorandum of Coverage for the Municipal Pooling Authority. This Endorsement is intended to supplement the Memorandum of Coverage, and to be read in conjunction with that document. Except as expressly amended herein, all coverages, definitions, exclusions, and other terms and conditions contained in the Memorandum of Coverage apply to this Endorsement, and govern its interpretation. In consideration of underwriting requirements having been met, Exclusion 10, set forth in Section VII of the Memorandum of Coverage, is hereby modified by exempting therefrom the member entity(s) listed below, that have formally adopted a policy on non-medical professiona l staff assisting with the administration of medications to participants in custodial care programs. This endorsement is issued to:
City of Antioch; Town of Danville; City of Hercules; City of Lafayette; City of Manteca; City of Martinez;
Town of Moraga; City of Oakley; City or Orinda; City of Pinole; City of Pittsburg; City of San Pablo; City
of San Ramon ; City of Walnut Creek
______________________ ________________________________________________ Date Linda M. Cox, Chief Administrative Officer 06-21-2022
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Schedule A - LAWCX Members
As of July 1, 2022
LOCAL AGENCY WORKERS’ COMPENSATION EXCESS
JOINT POWERS AUTHORITY
(LAWCX)
2022/2023 MEMORANDUM OF COVERAGE
Policy Number: LAWCX 22.23
DECLARATION
ITEM #1 COVERED MEMBER: City of Gilroy
7351 Rosanna Street
Gilroy, CA 95020
Expanded Covered Members
Identified in Schedule A of MOC
ITEM #2 COVERAGE PERIOD: FROM 7/1/2022 TO 7/1/2023
12:01 a.m. Pacific Standard Time
ITEM #3 LIMIT OF LIABILITY:
a. COVERED MEMBER’S RETAINED LIMIT:
Workers’ Compensation Coverage $500,000
Employer’s Liability Coverage $500,000
b. LAWCX SELF-INSURED RETENTION:
Workers’ Compensation Coverage $5 Million Less
Member’s Retained
Limit
Employer’s Liability Coverage $5 Million Less
Member’s Retained
Limit
ON BEHALF OF THE LOCAL AGENCY WORKERS’
COMPENSATION EXCESS JOINT POWERS AUTHORITY
_________________________________________________
Authorized Signature
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LOCAL AGENCY WORKERS’ COMPENSATION
EXCESS JOINT POWERS AUTHORITY
(LAWCX)
MEMORANDUM OF COVERAGE
2022/2023 PROGRAM YEAR
POLICY NUMBER: LAWCX 22.23
ADOPTED JUNE 7, 2022
TO BECOME EFFECTIVE JULY 1, 2022
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LOCAL AGENCY WORKERS’ COMPENSATION EXCESS
JOINT POWERS AUTHORITY
Memorandum of Coverage
For Self-Insurance of
Excess Workers’ Compensation and Employers’ Liability
The Local Agency Workers’ Compensation Excess Joint Powers Authority in consideration for the payment of
applicable premiums, assessments, and contributions, does hereby agree to provide coverage to the Covered Members
subject to the terms and conditions set forth in the Memorandum, Agreement, and Byl aws:
GENERAL SECTION
A. The Memorandum
This Memorandum includes at its effective date the Declarations Page and all endorsements listed on the
Declarations Page. This Memorandum is the coverage document between the Covered Members and the
Authority. The terms of this Memorandum may not be changed or waived except by endorsement issued by
the Authority to be part of this Memorandum.
B. Who Is Covered
Each Covered Member as defined in Part One shall be covered by the Authority for excess workers’
compensation coverage on and subject to the terms of this Memorandum. If a Covered Member named in
Item 1 of the Declarations Page loses its status as an active “Member” of the Authority, the coverage under
this Memorandum of Coverage shall terminate immediately upon such change in status.
C. Qualified Self-Insurer
The Covered Member represents that it is a duly qualified self -insured under the Workers’ Compensation
Act of the State of California, with a current and valid certificate of self -insurance, and will continue to
maintain such qualification during the term this Memorandum is in effect. If the Covered Member should
fail to qualify or fail to maintain such qualification, the coverage provided under this Memorandum may be
terminated pursuant to the Bylaws.
PART ONE – DEFINITIONS
The term:
A. “Agreement” means the Joint Exercise of Powers Agreement Local Agency Workers’
Compensation Excess Joint Powers Authority dated June 18, 1992, as the same may be amended
from time to time.
B. “Bodily injury” shall have the meaning as provided by the applicable Workers’ Comp ensation Act,
and include death resulting therefrom, but shall not include occupational disease.
C. “Bylaws” mean the Bylaws of the Local Agency Workers’ Compensation Excess Joint Powers
Authority, as the same may be amended from time to time.
D. “Communicable disease” shall mean a disease caused by an infectious organism, which is
transmissible from one source to another, directly or indirectly.
E. “Covered Member” shall mean the entities named in Item 1 of the Declarations, those entities added
by endorsement as indicated under FORMS AND ENDORSEMENTS of the Declarations, and any
other agency, district, commission, authority, board, or other affiliated entity that is governed by the
named Covered Member’s governing board members (through the same or a different g overning
board) or otherwise under the named Covered Member’s direction and control.
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F. “Covered Member’s service organization” shall mean an agent of the Covered Member paid to
service or administer the Covered Member’s self-insured Workers’ Compensation and/or
Employers Liability program.
G. “Employee” shall mean any person (including a volunteer as defined below and officers) performing
work that renders the Covered Member legally liable for workers’ compensation benefits under the
Workers’ Compensation Act of the State of California.
H. “Volunteer” shall mean any person while acting within the scope of his or her duties for or on behalf
of the Covered Member, provided that, prior to the occurrence, the governing board of the Covered
Member has adopted a resolution as provided in Division 4, Part 1, Chapter 2, Article 2, Section
3363.5 of the California Labor Code, declaring such volunteer workers to be employees of the
Covered Member for purposes of the Workers’ Compensation Act; or provided that such volunteer
workers are statutorily deemed by the Workers’ Compensation Act of the State of California to be
employees for the purpose of workers’ compensation.
I. “Loss” shall mean only such amounts as are actually paid by the Covered Member as benefits for
an employee under the applicable Workers’ Compensation Act of the State of California in
settlement of claims or in satisfaction of awards or judgments for liabilities imposed by the Workers’
Compensation Act of the State of California or other law for bodily injury or occupational disease
to an employee. The term loss shall include claim-related expenses, court costs, interest upon awards
and judgments, and investigation, adjustment, and legal expenses that are actually paid by the
Covered Member as it pertains to the loss. However, the term loss shall not include the salaries paid
to employees of the Covered Member, nor fees and retainers paid to the Covered Member’s service
organization.
Notwithstanding the foregoing, loss does not include any amounts paid by the cover party as
benefits, or in payment of amounts imposed upon the covered party by employers liability, deriving
solely from any covered parties enactment, resolution, or other act establishing a presumption of
work related illness or injury or any other expansion of benefits beyond those prescribed by the
applicable Workers’ Compensation Act in the State of California. Despite any such enactment,
resolution, or act, the covered parties shall retain the burden of establishing loss withi n the
Memorandum of Coverage.
J. “Occupational disease” shall have the meaning as provided by the applicable Workers’
Compensation Act of the State of California and include (1) death resulting therefrom and (2) related
cumulative trauma injuries or illnesses.
K. “Occurrence” means an injury or disease of an employee arising out of and in the course of
employment. Bodily injury, illness, or disease sustained by one or more employees, as a result of a
single accident, incident or exposure, shall be deemed to arise from a single occurrence. The
occurrence shall be deemed to take place on the earlier of (a) the last day of the last exposure, in the
employment of the Covered Member, to conditions causing or aggravating the disease, or (b) the
date upon which the employee first suffered disability and either knew, or in the exercise of
reasonable diligence should have known, that such disability was caused by employment with the
Covered Member. All occupational disease sustained by one or more employees as a result of an
outbreak of the same communicable disease shall be deemed to arise from a single occurrence. An
outbreak of the same communicable disease that spans more than one coverage period shall be
deemed to take place during the first such coverage period.
L. “State” means any state of the United States of America, and the District of Columbia.
M. “Workers’ Compensation Act” shall mean California Labor Code Division 4, the other acts as
described below in Part Two; however, it shall not inclu de any non-occupational disability benefit
provisions of any such act.
N. “Labor Code 4850” means the Covered Member’s obligation to pay salary in lieu of temporary
disability benefits for the period of disability, but not exceeding one year, or until the earlier date as
the employee is retired on permanent disability pension, and is actually receiving disability pension
payments, or advanced disability pension payments.
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PART TWO – WORKERS’ COMPENSATION COVERAGE
The Authority will reimburse the Covered Member for loss resulting from an occurrence during the Coverage Period
provided that such loss would be compensable under the Workers’ Compensation Act of the State of California for an
employee who is normally employed in the State of California, but only if such employee’s activity in any other state
is incidental to the employee’s regular employment and duties in the State of California and California workers’
compensation benefits are administered.
However, if the Covered Member is not a duly qualified self -insurer at the time of the occurrence, the Authority will
reimburse the Covered Member only for amounts that would have been paid had the Covered Member been a duly
qualified self-insurer and the Authority will not pay or reimburse for any penalties, costs, expenses, or other amounts
due to or arising from the failure to maintain good standing as a duly qualified self -insurer.
The indemnity afforded by this Memorandum shall also apply to loss paid by the Covered Member because of any
compensation, benefits, or liability paid by the Covered Member under (a) the Longshoremen’s and Harbor Workers’
Compensation Act (33 USC Sections 901-950), as may be amended, or (b) the Merchant Marine Act of 1920, also
known as the Jones Act (46 U.S. Code, Section 30104), as may be amended; however, only if such liability is incidental
to the employee’s regular employment and duties in the State of California.
The Authority’s liability includes “bodily injury” to the master and members of the crew of a vessel, provided the
“bodily injury” occurred in the territorial limits of, or the operation of a vessel sailing directly between the ports of
the Continental United States of America, Alaska, Hawaii, or Canada.
Coverage under this Memorandum will be provided in accordance with the benefits, requirements, limitations, and
other provisions of the Workers’ Compensation Act and this Memorandum will be implemented, administered, and
construed pursuant to the Workers’ Compensation Act. If there is a conflict between this Memorandum and the Act,
the Act will govern.
PART THREE – EMPLOYER’S LIABILITY COVERAGE
The Authority will reimburse the Covered Member for loss resulting from an occurrence during the Coverage Period
because of the Covered Member’s legal liability for damages arising out of bodily injury or occupational disease
sustained by employees normally employed in the State of California.
PART FOUR – THE COVERED MEMBER’S RETENTION AND AUTHORITY’S LIMIT OF LIABILITY
A. The Covered Member’s Retention
The Covered Member shall pay from its own account for an occurrence up to the amount stated in Item 3.a.
of the Declarations Page as the Covered Member’s Retained Limit.
If, as a result of an occurrence that is a single accident, incident or exposure, employees from two or more
Covered Members incur bodily injury, illness, or disease, then the Retained Limits of the involved Covered
Members will be adjusted as provided in this provision. Initially, each Covered Member’s stated Retained
Limit (i.e., the amount stated in the Declarations Page) will be applied to the calculation of the Authority’s
payment of reimbursement under this Memorandum for the Covered Member’s losses paid as a result of the
multiple-Covered Member accident, incident or exposure. Five years after the end of the program year in
which the accident, incident or exposure occurred, the Aut hority will undertake the following adjustment:
(1) calculate the total amount of the losses paid over that period for all Covered Members and employees
involved in the multiple-Covered Member accident, incident or exposure; (2) calculate each involved
Covered Member’s percentage share (based on the losses paid for the Covered Member’s involved employee
or employees) of the total losses paid; (3) multiply each involved Covered Member’s percentage share of the
total incurred losses times its stated Retained Limit; (4) use and apply the amount determined under step 3
as the Covered Member’s adjusted Retained Limit for purposes of determining the Authority reimbursement
for the losses paid for the multiple-Covered Member accident, incident or exposure; (5) calculate the amount
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of the Authority’s payment of reimbursement, if any, to each involved Covered Member based on the
adjusted Retained Limit of the Covered Member; and (6) if applicable, pay reimbursement or additional
reimbursement to the involved Covered Member based on the adjusted Retained Limit. If losses for the
multiple-Covered Member accident, incident or exposure remain payable after the five year period, the
adjusted Retained Limits for the involved Covered Members will continue to apply to the calc ulation of
Authority reimbursement until the employees’ claims are closed and the Authority will not again readjust the
involved Covered Members’ Retained Limits. If the total losses for all involved Covered Members exceed
the maximum program limit of indemnity, then the allocation of liability for the excess amount will be
calculated based on each involved Covered Member’s pro rata percentage share of the final total losses paid.
B. Authority’s Limit of Liability
The Authority will reimburse the Covered Member for any loss for an occurrence over the amount stated as
the Covered Member’s retained limit in Item 3.a. of the Declarations Page provided California workers’
compensation benefits are administered. The Authority’s Limit of Liability for workers’ c ompensation
coverage, Part One of this document, will not exceed the limit stated in Item 3.b. of the Declarations Page.
The Authority’s Limit of Liability for employers’ liability coverage, Part Two of this document, will not
exceed the limit stated in Item 3.b. of the Declarations Page. The reimbursement of any loss shall be limited,
by amount and time of payment, to the benefits that are paid or payable pursuant to the Workers’
Compensation Act.
The Authority will reimburse the Covered Member for liability imposed upon the Covered Member by
Section 4850 of the California Labor Code in excess of the Covered Member’s retained limit. Payments made
by the Covered Member in accordance with this section shall be credited to the satisfaction of the Covered
Member’s retained limit. The Covered Member shall report payments made by the Covered Member or its
third party administrator in two separate entries: (1) maximum temporary disability benefits are coded as a
temporary disability benefit, and (2) the remaining full salary amount is coded as a 4850 benefit.
C. Attachment of Coverage By Authority
The coverage provided by this Memorandum shall not apply to any claim until the amount paid by or on
behalf of the Covered Member shall have equaled or exceeded the per occurrence retained limit of the
Covered Member. The Authority shall then only be liable for the loss amount actually incurred that is in
excess of the Covered Member’s per occurrence retained limit, regardless of whether the Covered Membe r
has other insurance, has other pooled coverage, or pays the per occurrence retained limit itself. Amounts to
be paid on a claim otherwise covered under this memorandum shall not be paid until such time that the
underlying per occurrence retained limit has been paid.
D. Subrogation of Claims – Recovery from Others
1. Settlement may include the subrogation of a claim covered under, or that may be covered under,
this Memorandum of Coverage.
2. The Covered Member will do everything necessary to protect the rights of the Authority to recover
the Authority’s loss from any third party liable for the injury, illness, or disease. The Covered
Member shall assist in enforcing the Authority’s rights.
Any subrogation recovery by the Authority, after deducting the Authority’s recovery expenses, will first be used to
reduce the Authority’s loss. The balance, if any, will be disbursed to the Covered Member.
PART FIVE – EXCLUSIONS
This Memorandum shall not apply:
A. to punitive or exemplary damages, fines, interest, or penalties assessed against or imposed upon the
Covered Member;
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B. additionally under Employer’s Liability Coverage in Part Three of this Memorandum of Coverage:
1. to liability assumed by the Covered Member under any contract or agreement;
2. to bodily injury or occupational disease to an employee while employed in violation of law
with the actual knowledge of the Covered Member;
3. to any obligation for which the Covered Member or any carrier as the Covered M ember’s
insurer may be held liable under any unemployment compensation or disability benefits
law, or under any similar law;
4. to bodily injury or occupational disease intentionally caused or aggravated by or at the
direction of the Covered Member;
5. to loss or damages arising out of the coercion, criticism, demotion, evaluation,
reassignment, discipline, defamation, harassment, humiliation, discrimination against or
termination of an employee or any personnel practices, policies, acts, or omissions;
6. to loss or damages arising out of operations for which the Covered Member has violated
or failed to comply with any Workers’ Compensation Law of the State of California; or
7. to punitive or exemplary damages, fines, or penalties assessed against or imposed upon the
Covered Member.
C. to claims involving a waiver of subrogation approved by a member after the date of injury , illness, or
disease that resulted in the claim. This exclusion shall not apply to a waiver of subrogation contained in
an agreement or contract that was approved by the Covered Member and the Authority prior to the date
of injury, illness, or disease that resulted in the claim;
D. to losses resulting from damages imposed in any lawsuit brought in, or any judgment rendered by any
court outside the United States of America, its territories or possessions, or Canada, or to any action on
such judgments, wherever brought;
E. to losses involving benefits paid or filed in accordance with any Workers’ Compensation Act outside the
State of California.
F. to “bodily injury” covered by a protection and indemnity coverage or similar policy issued to or on behalf
of the Covered Member; or
G. to bodily injury or occupational illness or disease sustained by a peace officer, as defined in Section
50920 of the California Government Code, when he or she was off-duty, not acting under the immediate
direction of his or her employer, and outside the state of California. However, this exclusion shall not
apply to bodily injury or occupation disease sustained by a peace officer under such circumstances if:
1. the peace officer at the time of sustaining the injury, illness, or disease was engaging in the
apprehension or attempted apprehension of law violators or suspected law violators, the
protection or preservation of life or property, or the preservation of the peace; and
2. prior to the occurrence, the governing board of the Covered Member has adopted a
resolution, as provided for in California Labor Code Section 3600.2, subdivision (b)(4),
accepting liability for such bodily injury or occupational illness or disease under the
Workers’ Compensation Act.
PART SIX – CLAIMS
A. The Covered Member’s Claims Reporting Duties
The Covered Member shall immediately notify the Authority in writing of any claim for potential coverage
under the Memorandum when the loss amount reaches a total incurred amount at 50% or more of the Covered
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Member’s retained limit stated in Item 3.a. of the Declarations Page.
The Covered Member also shall give the Authority immediate written notice of any of the following:
1. a fatality;
2. any claim involving an infectious disease
3. an amputation of a major extremity;
4. any serious head injury (including skull fracture or loss of sight of either or both eyes);
5. any injury to the spinal cord;
6. any second or third degree burn of 25% or more of the body;
7. any accident which causes serious injury to two or more employees;
8. any claim believed to be fraudulent and $20,000 or more has been paid in allocated
expenses;
9. any claim likely to result in a permanent disability of 50% or more; or
10. any disability of more than one year or when it appears reasonably likely that there will be
a disability of more than one year.
Notice given to the Authority shall contain complete details. If a suit, claim, or other proceeding is
commenced because of an incident described above or of any injury that might involve a loss to the Authority,
the Covered Member shall give the Authority:
1. all notices and legal papers related to the claim, proceeding, or suit, or copies of these
notices and legal papers;
2. copies of narrative medical reports;
3. copies of reports on investigations made by the Covered Member on such claims,
proceedings, or suits; and
4. copies of DWC Form 1 (Employee Claim Form), Form 5020 (Employer’s Report of
Injury), and any report completed by a supervisor investigating or reporting the claim.
The Covered Member also shall provide the Authority with supplemental reports on any incident stated in
Part Six, paragraph A of this Memorandum of Coverage. The report shall be on a form satisfactory to the
Authority and submitted 90 days from the date of the initial notice and every 90 days thereafter, unless
indicated otherwise by the Authority. For claims involving infectious disease, supplemental reports should
be provided every 60 days and at time of closing. The supplemental report shall include the paid-to-date
amounts, the reserve amounts, the employee’s medical status, and the status of the settlement. Copies of
narrative medical reports and legal correspondence received since the last report was submitted should also
be included with subsequent supplemental reports.
B. Settlement
Any claim, suit, or proceeding with a total incurred amount in excess of the Covered Member’s retained limit
shall not be settled without the written consent of the Authority’s Claims Manager. The Authority’s Claims
Manager also has the right to consult and participate with the Covered Member in the settlement, defense, or
appeal of any other claim, suit, or proceeding that might involve a loss to the Authority.
PART SEVEN – CONDITIONS
A. Acceptance
By acceptance of this Memorandum, the Covered Member agrees that the state ments made on the
Declarations Page are the Covered Member’s agreements and representations, that this Memorandum is
issued in reliance upon the truth of such representations, and that this Memorandum embodies all agreements
existing between the Covered Member and the Authority or any of the Authority’s agents relating to this
coverage.
B. Cancellation
The Covered Member may not withdraw from this Memorandum during the program year.
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C. Inspection
The Authority has the right, but is not obligated, to inspect the Covered Member’s workplaces at any time.
The Authority’s inspections are not safety inspections. They relate only to the insurability of the workplaces
and premiums to be charged. The Authority may give the Covered Member reports on the conditions the
Authority finds. The Authority may recommend changes. While they may help reduce losses, the Authority
does not undertake to perform the duty of any person to provide for the health or safety of the Covered
Member’s employees or the public. The Authority does not warrant that the Covered Member’s workplaces
are safe or healthful or that they comply with law, regulations, codes, or standards.
D. Transfer of The Covered Member’s Rights and Duties
The Covered Member’s rights and duties under this Memorandum may not be transferred without the
Authority’s prior written consent.
E. Dispute Resolution
Decisions by the Authority concerning a claim (including, but not limited to, decisions regarding claim
resolution, negotiation, investigation, defense, appeal or settlement, and decisions about whether coverage
exists for a particular claim or part of a claim) shall be made by the Authority’s Executive Director or his or
her designee. If the affected Covered Member disagrees with a written decision by the Executive Director
(including, but not limited to, a decision denying coverage of all or part of a clai m), the Covered Member
may appeal that decision to the Authority’s Executive Committee by filing a written notice of appeal with
the Executive Director within 30 days of the date of the Executive Director’s written decision. If the affected
Covered Member fails to timely file a notice of appeal, the decision of the Executive Director shall be final
and binding and not subject to further appeal, arbitration, or judicial review. Upon timely filing a notice of
appeal, the matter shall be placed on the agenda of the next regularly scheduled Executive Committee
meeting. The Authority shall notify the Covered Member about the date and time of the meeting and given
an opportunity to provide oral and written evidence and legal argument. The Executive Committee shall
render a decision by resolution and the Authority shall provide the resolution to the Covered Member. The
resolution of any dispute concerning the Executive Committee’s decision will be subject to binding
arbitration. If the Covered Member disagrees with the decision of the Executive Committee, it may file a
written demand for arbitration with the Executive Director within 30 days from the date of the Executive
Committee’s resolution. If the affected Covered Member fails to timely file a demand for arbitration, the
decision of the Executive Committee shall be final and binding and not subject to further appeal, arbitration,
or judicial review.
Upon timely filing a demand for arbitration, the dispute shall be submitted to and decided by final and binding
arbitration pursuant to the California Arbitration Act (Code of Civil Procedure sections 1280 -1294.2). There
shall be a single neutral arbitrator. The parties shall strive in good faith to agree upon and appoint an
arbitrator. If the parties fail to agree upon an arbitrator, then either party may petition the Sacramento County
Superior Court to appoint an arbitrator pursuant to Code of Civil Procedure section 1281.6. The costs of the
arbitrator will be shared equally by the parties. The scope of an arbitrator’s authority shall be limited to
deciding disputes of the type described in this subpart, and nothing in this subpart shall be construed to give
the arbitrator jurisdiction to decide any other type of dispute. Each party shall be responsible for its own costs
and expenses of arbitration.
LOCAL AGENCY WORKERS’ COMPENSATION EXCESS
JOINT POWERS AUTHORITY
By: ____Authority
________________________________
Jim Elledge, Executive Director
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As of July 1, 2022
SCHEDULE A
LOCAL AGENCY WORKERS’ COMPENSATION EXCESS
JOINT POWERS AUTHORITY (LAWCX) MEMBERS
Bay Cities Joint Powers Insurance Authority (BCJPIA)
Central Marin Police Authority
Central Marin Fire Authority
City of Albany
City of Brisbane
Town of Corte Madera
City of Emeryville
Town of Fairfax
City of Larkspur
City of Menlo Park
City of Mill Valley
City of Novato
City of Piedmont
Town of San Anselmo
City of Sausalito
Town of Tiburon
City of Union City
California Housing Workers’ Compensation Authority (CHWCA)
Area Housing Authority of the County of Ventura
City of Eureka & County of Humboldt Housing Authority
Housing Authority of the City and County of Fresno
Housing Authority of the City of Alameda
Housing Authority of the City of Benicia
Housing Authority of the City of Madera
Housing Authority of the City of Paso Robles
Housing Authority of the City of Riverbank
Housing Authority of the City of San Luis Obispo
Housing Authority of the City of Santa Barbara
Housing Authority of the County of Alameda
Housing Authority of the County of Butte
Housing Authority of the County of Contra Costa
Housing Authority of the County of Kern
Housing Authority of the County of Kings
Housing Authority of the County of Marin
Housing Authority of the County of Merced
Housing Authority of the County of San Bernardino
Housing Authority of the County of San Joaquin
Housing Authority of the County of San Mateo
Housing Authority of the County of Santa Clara
Housing Authority of the County of Tulare
Monterey County Housing Authority
Plumas County Community Development Commission
Regional Housing Authority
Sacramento Housing & Redevelopment Agency
San Diego Housing Commission
Stanislaus Regional Housing Authority
Yolo County Housing
Central Contra Costa Transit Authority (CCCTA)
DocuSign Envelope ID: 49BDEE33-79E1-4483-850E-E8D498B2ABFC
Schedule A - LAWCX Members Page 2 of 8
As of July 1, 2022
Central San Joaquin Valley Risk Management Authority (CSJVRMA)
City of Angels Camp
City of Arvin
City of Atwater
City of Avenal
City of Ceres
City of Chowchilla
City of Corcoran
City of Delano
City of Dinuba
City of Dos Palos
City of Escalon
City of Exeter
City of Farmersville
City of Firebaugh
City of Fowler
City of Gustine
City of Hughson
City of Huron
City of Kerman
City of Kingsburg
City of Lathrop
City of Lemoore
City of Lindsay
City of Livingston
City of Los Banos
City of Madera
City of Maricopa
City of McFarland
City of Mendota
City of Newman
City of Oakdale
City of Orange Cove
City of Parlier
City of Patterson
City of Porterville
City of Reedley
City of Ripon
City of Riverbank
City of San Joaquin
City of Sanger
City of Selma
City of Shafter
City of Sonora
City of Sutter Creek
City of Taft
City of Tehachapi
City of Tracy
City of Tulare
City of Wasco
City of Waterford
City of Woodlake
City of Alameda
City of Benicia
City of Clovis
DocuSign Envelope ID: 49BDEE33-79E1-4483-850E-E8D498B2ABFC
Schedule A - LAWCX Members Page 3 of 8
As of July 1, 2022
City of Coronado
City of Encinitas
City of Gilroy
City of Livermore
City of Lodi
City of Merced
City of Morgan Hill
City of Newark
City of Placentia
City of Pleasanton
City of Roseville
City of San Leandro
City of Santa Maria
City of Santee
City of South Lake Tahoe
City of Suisun City
City of Vacaville
City of Vista
Fire Agencies Self Insurance System (FASIS)
Adin Fire Protection District
Alta Fire Protection District
Amador Fire Protection District
American Canyon Fire Protection District
Anderson Fire Protection District
Arbuckle-College City Fire Protection District
Bald Mountain Fire Protection District
Big Valley Fire Protection District
Bolinas Fire Protection District
Borrego Springs Fire Protection District
Bridgeport Fire Protection District
Burbank-Paradise Fire Protection District
Cachagua Fire Protection District
Canby Volunteer Fire Department
Carlotta Community Services District
Carmel Highlands Fire Protection District
Castella Fire Protection District
Cazadero Community Services District
Cedarville Fire Protection District
Central Calaveras Fire and Rescue Protection District
Chalfant Valley Fire Department Community Service District
Clements Rural Fire Protection District
DocuSign Envelope ID: 49BDEE33-79E1-4483-850E-E8D498B2ABFC
Schedule A - LAWCX Members Page 4 of 8
As of July 1, 2022
Cloverdale Fire Protection District
Coastside Fire Protection District
Collegeville Fire Protection District
Copperopolis Fire Protection District
Cordelia Fire Protection District
Cottonwood Fire Protection District
Covelo Fire Protection District
Crescent Mills Fire Protection District
Cypress Fire Protection District
Daggett Community Services District
Davis Creek Fire Protection District
Denair Fire Protection District
Diamond Springs/El Dorado Fire Protection District
Douglas City Community Services District
Doyle Fire Protection District
Eastern Plumas Rural Fire Protection District
El Dorado County Fire Protection District
Escalon Consolidated Fire District
Fairview Fire Protection District
Farmington Rural Fire Protection District
Ferndale Fire Protection District
Foresthill Fire Protection District
Fort Bidwell Fire District
Fort Bragg Fire Protection Authority
Fort Dick Fire Protection District
French Camp-McKinley Rural Fire Protection District
Fresno County Fire Protection District
Garberville Fire Protection District
Gasquet Fire Protection District
Gazelle Fire Protection District
Georgetown Fire District
Gold Ridge Fire Protection District
Graeagle Fire Protection District
Graton Fire Protection District
Happy Valley Fire Protection District
Hayfork Fire Protection District
Herald Fire Protection District
Huntington Lake Volunteer Fire Department
Hyampom Community Services District
Independence Fire Protection District
Indian Valley Community Services District
Janesville Fire Protection District
Junction City Fire Protection District
June Lake Fire Protection District
Kanawha Fire Protection District
Kelseyville Fire Protection District
Kentfield Fire Protection District
Kenwood Fire Protection District
Keyes Fire Protection District
Klamath Fire Protection District
Lake City Volunteer Fire Department
Lake County Fire Protection District
Lake Forest Fire Protection District
Lathrop-Manteca Fire Protection District
Lee Vining Fire Protection District
Leggett Valley Fire Protection District
Liberty Rural County Fire Protection District
Linden-Peters Rural Fire Protection District
Little Lake Fire Protection District
DocuSign Envelope ID: 49BDEE33-79E1-4483-850E-E8D498B2ABFC
Schedule A - LAWCX Members Page 5 of 8
As of July 1, 2022
Lockwood Fire Protection District
Loma Rica/Browns Valley Community Services District
Lone Pine Fire Department
Long Valley Community Services District
Lookout Fire Protection District
Mammoth Lakes Fire Protection District
Mayten Fire District
Meadow Valley Fire Protection District
Meeks Bay Fire Protection District
Milford Fire District
Millville Fire Protection District
Mokelumne Hill Fire Protection District
Mokelumne Rural County Fire Protection District
Mono City Volunteer Fire Protection District
Monte Rio Fire Protection District
Monterey County Regional Fire District
Moraga-Orinda Fire Protection District
Mosquito Fire Protection District
Mountain Gate Community Services District
Mountain Valley Fire Department
Mountain View Fire Protection District
Murphys Fire Protection District
Newberry Community Services District
Newcastle Fire Protection District
North County Fire Protection District
North San Juan Fire Protection District
North Sonoma Coast Fire Protection District
North Tahoe Fire Protection District
Northern Sonoma County Fire Protection District
Novato Fire Protection District
Occidental Community Services District
Olancha Community Service District
Ophir Hill Fire Protection District
Orange Cove Fire Protection District
Paradise Fire Protection District
Peardale-Chicago Park Fire Protection District
Peninsula Community Services District
Penryn Fire Protection District
Petrolia Fire Protection District
Pioneer Fire Protection District
Plumas Eureka Community Services District
Post Mountain Public Utility District
Prattville-Almanor Fire Protection District
Princeton County Fire Protection District
Quincy Fire Protection District
Rescue Fire Protection District
Rio Dell Fire Protection District
Ripon Consolidated Fire District
Rodeo-Hercules Fire Protection District
Ross Valley Fire Department
Rough & Ready Fire Protection District
Sacramento River Fire Protection District of Colusa County
Salida Fire Protection District
Salyer Community Service District
Santa Margarita Fire Protection District
Schell-Vista Fire Protection District
Scott Valley Fire Protection District
Shasta Lake Fire Protection District
Shaver Lake Volunteer Fire Department
DocuSign Envelope ID: 49BDEE33-79E1-4483-850E-E8D498B2ABFC
Schedule A - LAWCX Members Page 6 of 8
As of July 1, 2022
Sierra City Volunteer Fire Protection District
Sierra Valley Fire Protection District
Smith River Fire Protection District
Sonoma County Fire District
Sonoma Valley Fire District
South Coast Fire Protection District
South Lake County Fire Protection District
South Monterey County Fire Protection District
South Placer Fire Protection District
Southern Inyo Fire Protection District
Southern Marin Fire Protection District
Southern Trinity Volunteer Fire Department
Spalding Community Service District
Standish-Litchfield Fire District
Stanislaus Consolidated Fire Protection District
Stones-Bengard Community Service District
Suisun Fire Protection District
Susan River Fire Protection District
Sutter Basin Fire District
Sutter Creek Fire Protection District
Telegraph Ridge Fire Protection District
Thornton Rural County Fire Protection District
Tiburon Fire Protection District
Timber Cove Fire Protection District
Turlock Rural Fire Protection District
Vacaville Fire Protection District
Valley Center Fire Protection District
Walnut Grove Fire Protection District
Waterloo-Morada Rural County Fire Protection District
West Almanor Community Services District
West Point Fire Protection District
West Stanislaus County Fire Protection District
Westport Fire Protection District
Westport Volunteer Fire Department
Wheeler Crest Fire Protection District
Whitethorn Fire Protection District
Willow Ranch Fire District
Woodbridge Rural Fire Protection District
Woodland Avenue Fire Protection District
Public Entity Risk Management Authority (PERMA)
City of Banning
City of Barstow
City of Blythe
City of Canyon Lake
City of Cathedral City
City of Coachella
City of Colton
City of Desert Hot Springs
City of Hesperia
City of Holtville
City of La Mesa
City of Murrieta
City of Norco
City of Perris
City of Rancho Mirage
City of San Jacinto
SunLine Transit Agency
DocuSign Envelope ID: 49BDEE33-79E1-4483-850E-E8D498B2ABFC
Schedule A - LAWCX Members Page 7 of 8
As of July 1, 2022
City of Victorville
City of Westmorland
Shared Agency Risk Pool (SHARP)
City of American Canyon
Town of Los Altos Hills
City of Saratoga
Town of Ross
Small Cities Organized Risk Effort (SCORE)
City of Biggs
City of Colfax
City of Dunsmuir
City of Etna
City of Live Oak
Town of Loomis
City of Loyalton
City of Montague
City of Mt Shasta
City of Portola
City of Rio Dell
City of Shasta Lake
City of Susanville
City of Tulelake
City of Weed
City of Yreka
Town of Los Gatos
Vector Control Joint Powers Agency (VCJPA)
Alameda County Mosquito Abatement District
Burney Basin Mosquito Abatement District
Butte County Mosquito and Vector Control District
Coachella Valley Mosquito and Vector Control District
Coalinga-Huron Mosquito Abatement District
Colusa Mosquito Abatement District
Compton Creek Mosquito Abatement District
Consolidated Mosquito Abatement District
Contra Costa Mosquito and Vector Control District
Delta Mosquito and Vector Control District
Durham Mosquito Abatement District
Fresno Mosquito and Vector Control District
Glenn County Mosquito and Vector Control District
Greater Los Angeles County Vector Control District
Kings Mosquito Abatement District
Lake County Vector Control District
Los Angeles County West Vector Control District
Marin-Sonoma Mosquito and Vector Control District
Monterey County Mosquito Abatement District (formerly Northern Salinas Valley MAD)
Mosquito and Vector Management District of Santa Barbara County
Napa County Mosquito Abatement District
Northwest Mosquito and Vector Control District
Orange County Mosquito and Vector Control District
Pine Grove Mosquito Abatement District
Placer Mosquito and Vector Control District
Sacramento-Yolo Mosquito and Vector Control District
San Gabriel Valley Mosquito and Vector Control District
San Joaquin County Mosquito and Vector Control District
San Mateo County Mosquito and Vector Control District
DocuSign Envelope ID: 49BDEE33-79E1-4483-850E-E8D498B2ABFC
Schedule A - LAWCX Members Page 8 of 8
As of July 1, 2022
Shasta Mosquito and Vector Control District
Sutter-Yuba Mosquito and Vector Control District
Tehama County Mosquito and Vector Control District
Turlock Mosquito Abatement District
West Valley Mosquito and Vector Control District
DocuSign Envelope ID: 49BDEE33-79E1-4483-850E-E8D498B2ABFC
2022-2023 GL MOC
Final Audit Report 2022-06-21
Created:2022-06-15
By:Erwin Chang (echang@mpa-nc.com)
Status:Signed
Transaction ID:CBJCHBCAABAAQPEoa1g_ClH158aXwcy020DTOS75-cU3
"2022-2023 GL MOC" History
Document created by Erwin Chang (echang@mpa-nc.com)
2022-06-15 - 4:59:40 PM GMT- IP address: 71.202.232.101
Document emailed to Linda Cox (lcox@mpa-nc.com) for signature
2022-06-15 - 5:00:42 PM GMT
Email viewed by Linda Cox (lcox@mpa-nc.com)
2022-06-21 - 7:00:45 PM GMT- IP address: 71.202.77.27
Document e-signed by Linda Cox (lcox@mpa-nc.com)
Signature Date: 2022-06-21 - 7:01:35 PM GMT - Time Source: server- IP address: 71.202.77.27
Agreement completed.
2022-06-21 - 7:01:35 PM GMT
DocuSign Envelope ID: 49BDEE33-79E1-4483-850E-E8D498B2ABFC