COI - Morgan Hill Unified School District - Expires 2023-07-01
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)
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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
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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