HomeMy WebLinkAboutAG 16-1371
' RETURN TO: dQadt EXT: a S 3�
CITY OF FEDERAL AY LAW DEPARTMENT ROUTING FORM
1. ORIGINATING DEPT./DIV: urn ay? ,'] eSD ( r C es
2. ORIGINATING STAFF PERSON: Gea k 64-etedu4
4. TYPE OF DOCUMENT (CHECK ONE):
❑ CONTRACTOR SELECTION DOCUMENT (E.
❑ PUBLIC WORKS CONTRACT
PROFESSIONAL SERVICE AGREEMENT
❑ GOODS AND SERVICE AGREEMENT
❑ REAL ESTATE DOCUMENT
❑ ORDINANCE
❑ CONTRACT AMENDMENT (AG #):
❑ OTHER
EXT: 0753 3. DATE REQ. BY: 10/27/2Wh
G., RFB, RFP, RFQ)
❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT
❑ MAINTENANCE AGREEMENT
❑ HUMAN SERVICES / CDBG
❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
❑ RESOLUTION
❑ INTERLOCAL
5. PROJECT NAME: Ejnfilp yCe /31/7e Fj / 61 LL7/'7C% Q /Z rI czLS
6. NAME OF CONTRACTOR: / L. Er2/7S & ., SIN 6 • `f
ADDRESS: 3535- ) e#oR,A et-VD IZO� &.Uevu. h1A 98004 • 1Z9 0 TELEPHONE *25 - cm's- O3 )
E -MAIL: dour .6)r /evarr3.e„i FAX: q25 -4f47 -326%'
I TITLE eSrded 1-
SIGNATURE N E: `PA „q F %id ns
7. EXHIBITS AND ATTACHMENTS: S-COPE, WORK OR SERVICES E COMPENSATION ❑ INSURANCE REQUIREMENTS /CERTIFICATE ❑ ALL
OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT /AMENDMENTS
8. TERM: COMMENCEMENT DATE: J2Ini 4rc/ 1, RID/ 7 COMPLETION DATE: D2CCrn ber 81/ • 0
d l rh24+Cr'e` f�0ur,�j Le io maw/mu PENSES AND oo a
9. TOTAL COMPENSATION $ VQfzre - r 1l4'4! y poi by (INCLUDE EXPENSES AND SALES TAX, IF ANY)
(IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TI ES AND HOLIDAY RATES)
REIMBURSABLE EXPENSE: ❑ YES ❑ NO IF YES, MAXIMUM DOLLAR AMOUNT: $
IS SALES TAX OWED ❑ YES ❑ NO IF YES, $
RETAINAGE: RETAINAGE AMOUNT:
PAID BY: ❑ CONTRACTOR ❑ CITY
❑ RETAINAGE BY (SEE CONTRACT) OR ❑ RETAINAGE BOND PROVIDED
PURCHASING: PLEASE CHARGE TO:
56 -11as -SS ?- 5/1 -3o- IF1b
10. DOCUMENT /CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL / DATE APPROVED
❑ PROJECT MANAGER
❑ DIRECTOR
❑ RISK MANAGEMENT (IF APPLICABLE)
❑ LAW 1N2-C/ �O (Q d o
11. COUNCIL APPROVAL (IF APPLICABLE)
12. CONTRACT SIGNATURE ROUTING
VI,SENT TO VENDOR/CONTRACTOR
❑ ATTACH: SIGNATURE AUTHORITY,
LAW DEPARTMENT
❑ CHIEF OF STAFF
IKIGNATORY (MAYOR OR DIRECTOR)
❑ CITY CLERK
❑ ASSIGNED AG#
❑ SIGNED COPY RETURNED
COMMENTS:
COMMITTEE APPROVAL DATE:
COUNCIL APPROVAL DATE:
DATE SENT: /0/2i/.2 01 V DATE REC'D: I 0 1 2 1 0 I 201 Le
INSURANCE CERTIFICATE, LICENSES, EXHIBITS
INITIAL DATE SIGNS
b�C
/ /i iaffr '1
1 -1-
AG#
DATE SENT:
CITY OF
Federal Way
CITY HALL
33325 Sth Avenue South
Federal Way, WA 98003 -6325
(253) 835 -7000
try0fh2citaVivroy
PROFESSIONAL SERVICES AGREEMENT
FOR
EMPLOYEE BENEFIT CONSULTING SERVICES
This Professional Services Agreement ( "Agreement ") is madc between the City of Federal Way, a Washington municipal
corporation ( "City"), and R.L. Evans Co., Inc., a Washington corporation ( "Contractor "). The City and Contractor
(together "Parties ") arc located and do business at the below addresses, which shall be valid for any notice required under
this Agreement:
R.L. EVANS CO., INC.:
Doug L. Evans
3535 Factoria Blvd. SE, Ste. 120
Bellevue, WA 98006
(425) 455 -0501 (telephone)
(425) 476 -5264 (facsimile)
dou e(a)rlevansco.com
The Parties agree as follows:
CITY OF FEDERAL WAY:
Jean Stanley
33325 8th Avenue South
Federal Way, WA 98003 -6325
(253) 835 -2532 (telephone)
(253) 835 -2509 (facsimile)
jean.stan ley @cityoffederalway.com
1. TERM. The term of this Agreement shall commence on January 1, 2017 the effective date of this Agreement, and
shall continue until the completion of the Services specified in this Agreement, but in any event no later than December 31,
2019 ( "Term "). This Agreement may be extended for additional periods of time upon the mutual written agreement of the
Parties.
2. SERVICES. The Contractor shall perform the services more specifically described in Exhibit A ( "Services "),
attached hereto and incorporated by this reference, in a manner consistent with the accepted professional practices for other
similar services within the Puget Sound region in effect at the time those services are performed, performed to the City's
satisfaction, within the time period prescribed by the City and pursuant to the direction of the Mayor or his or her designee.
The Contractor warrants that it has the requisite training, skill, and experience necessary to provide the Services and is
appropriately accredited and licensed by all applicable agencies and governmental entities, including but not limited to
obtaining a City of Federal Way business registration. Services shall begin immediately upon the effective date of this
Agreement. Services shall be subject, at all times, to inspection by and approval of the City, but the making (or failure or
delay in making) such inspection or approval shall not relieve Contractor of responsibility for performance of the Services
in accordance with this Agreement, notwithstanding the City's knowledge of defective or non - complying performance, its
substantiality or the ease of its discovery.
3. TERMINATION. Either party may terminate this Agreement, with or without cause, upon providing the other
party thirty (30) days' written notice at its address set forth above. The City may terminate this Agreement immediately if
the Contractor fails to maintain required insurance policies, breaches confidentiality, or materially violates Section 12 of
this Agreement. Termination for such conduct may render the Contractor ineligible for City agreements in the future.
4. COMPENSATION.
4.1 Amount. In return for the Services, the City shall pay the Contractor an amount not to exceed a maximum
amount and according to a rate or method as delineated in Exhibit B, attached hereto and incorporated by this reference.
The Contractor agrees that any hourly or flat rate charged by it for its services contracted for herein shall remain locked at
the negotiated rate(s) for the Term. Except as otherwise provided in Exhibit 13, the Contractor shall he solely responsible
for the payment of any taxes imposed by any lawful jurisdiction as a result of the performance of Services and payment
under this Agreement.
PROFESSIONAL SERVICES AGREEMENT 1 9/2016
CITY OF
Afr!
Federal Way
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003 -6325
(253) 835 -7000
vtivty. ci: yofteder i i v y corn
4.2 Method of Payment. On a monthly basis, the Contractor shall submit a voucher or invoice in the form
specified by the City, including a description of what Services have been performed, the name of the personnel performing
such Services, and any hourly labor charge rate for such personnel. The Contractor shall also submit a final bill upon
completion of all Services. Payment shall be made on a monthly basis by the City only after the Services have been
performed and within thirty (30) days following receipt and approval by the appropriate City representative of the voucher
or invoice. If the Services do not meet the requirements of this Agreement, the Contractor will correct or modify the work
to comply with the Agreement. The City may withhold payment for such work until the work meets the requirements of the
Agreement.
4.3 Non- Appropriation of Funds. If sufficient funds are not appropriated or allocated for payment under this
Agreement for any future fiscal period, the City will not be obligated to make payments for Services or amounts incurred
after the end of the current fiscal period, and this Agreement will terminate upon the completion of all remaining Services
for which funds are allocated. No penalty or expense shall accrue to the City in the event this provision applies.
5. INDEMNIFICATION.
5.1 Contractor Indemnification. The Contractor agrees to release, indemnify, defend, and hold the City, its
elected officials, officers, employees, agents, representatives, insurers, attorneys, and volunteers harmless from any and all
claims, demands, actions, suits, causes of action, arbitrations, mediations, proceedings, judgments, awards, injuries,
damages, liabilities, taxes, losses, fines, fees, penalties expenses, attorney's fees, costs, and /or litigation expenses to or by
any and all persons or entities, including, without limitation, their respective agents, licensees, or representatives; arising
from, resulting from, or in connection with this Agreement or the acts, errors or omissions of the Contractor in performance
of this Agreement, except for that portion of the claims caused by the City's sole negligence. Should a court of competent
jurisdiction determine that this Agreement is subject to RCW 4.24.115, then, in the event of liability for damages arising
out of bodily injury to persons or damages to property caused by or resulting from the concurrent negligence of the
Contractor and the City, the Contractor's liability, including the duty and cost to defend, hereunder shall be only to the
extent of the Contractor's negligence. Contractor shall ensure that each sub - contractor shall agree to defend and indemnify
the City, its elected officials, officers, employees, agents, representatives, insurers, attorneys, and volunteers to the extent
and on the same terms and conditions as the Contractor pursuant to this paragraph. The City's inspection or acceptance of
any of Contractor's work when completed shall not be grounds to avoid any of these covenants of indemnification.
5.2 Industrial Insurance Act Waiver. It is specifically and expressly understood that the Contractor waives any
immunity that may be granted to it under the Washington State industrial insurance act, Title 51 RCW, solely for the
purposes of this indemnification. Contractor's indemnification shall not be limited in any way by any limitation on the
amount of damages, compensation or benefits payable to or by any third party under workers' compensation acts, disability
benefit acts or any other benefits acts or programs. The Parties acknowledge that they have mutually negotiated this
waiver.
5.3 City Indemnification. The City agrees to release, indemnify, defend and hold the Contractor, its officers,
directors, shareholders, partners, employees, agents, representatives, and sub - contractors harmless from any and all claims,
demands, actions, suits, causes of action, arbitrations, mediations, proceedings, judgments, awards, injuries, damages,
liabilities, losses, fines, fees, penalties expenses, attorney's fees, costs, and /or litigation expenses to or by any and all
persons or entities, including without limitation, their respective agents, licensees, or representatives, arising from,
resulting from or connected with this Agreement to the extent solely caused by the negligent acts, errors, or omissions of
the City.
5.4 Survival. The provisions of this Section shall survive the expiration or termination of this Agreement with
respect to any event occurring prior to such expiration or termination.
PROFESSIONAL SERVICES AGREEMENT - 2 9/2016
CITY OF
'�....- Federa I Way
CITY HALL
33325 3th Avenue South
Federal Way, WA 98003 -6325
(253) 835 -7000
6. INSURANCE. The Contractor agrees to carry insurance for liability which may arise from or in connection with
the performance of the services or work by the Contractor, their agents, representatives, employees, or subcontractors for
the duration of the Agreement and thereafter with respect to any event occurring prior to such expiration or termination as
follows:
6.1. Minimum Limits. The Contractor agrees to carry as a minimum, the following insurance, in such forms
and with such carriers who have a rating that is satisfactory to the City:
a. Commercial general liability insurance covering liability arising from premises, operations,
independent contractors, products - completed operations, stopgap liability, personal injury, bodily injury, death, property
damage, products liability, advertising injury, and liability assumed under an insured contract with limits no less than
$1,000,000 for each occurrence and $2,000,000 general aggregate.
b. Workers' compensation and employer's liability insurance in amounts sufficient pursuant to the
laws of the State of Washington.
c. Automobile liability insurance covering all owned, non - owned, hired, and leased vehicles with a
minimum combined single limits in the minimum amounts required to drive under Washington State law per accident for
bodily injury, including personal injury or death, and property damage.
d. Professional liability insurance with limits no less than $1,000,000 per claim and $2,000,000
policy aggregate for damages sustained by reason of or in the course of operation under this Agreement, whether occurring
by reason of acts, errors or omissions of the Contractor.
6.2. No Limit of Liability. Contractor's maintenance of insurance as required by this Agreement shall not be
construed to limit the liability of the Contractor to the coverage provided by such insurance, or otherwise limit the City's
recourse to any remedy available at law or in equity. The Contractor's insurance coverage shall be primary insurance with
respect to the City. Any insurance, self - insurance, or insurance pool coverage maintained by the City shall be excess of the
Contractor's insurance and shall not contribute with Contractor's insurance.
6.3. Additional Insured, Verification. The City shall be named as additional insured on all commercial general
liability insurance policies. Concurrent with the execution of this Agreement, Contractor shall provide certificates of
insurance for all commercial general liability policies attached hereto as Exhibit C and incorporated by this reference. At
the City's request, Contractor shall furnish the City with copies of all insurance policies and with evidence of payment of
premiums or fees of such policies. If Contractor's insurance policies are "claims made," Contractor shall be required to
maintain tail coverage for a minimum period of three (3) years from the date this Agreement is terminated or upon project
completion and acceptance by the City.
6.4 Survival. The provisions of this Section shall survive the expiration or termination of this Agreement.
7. CONFIDENTIALITY. All information regarding the City obtained by Contractor in performance of this
Agreement shall be considered confidential and subject to applicable laws. Breach of confidentiality by the Contractor may
be grounds for immediate termination. All records submitted by the City to the Contractor will be safeguarded by the
Contractor. The Contractor will fully cooperate with the City in identifying, assembling, and providing records in case of
any public records request.
8. WORK PRODUCT. All originals and copies of work product, including plans, sketches, layouts, designs, design
specifications, records, files, computer disks, magnetic media, or material that may be produced or modified by Contractor
while performing the Services shall belong to the City upon delivery. The Contractor shall make such data, documents, and
files available to the City and shall deliver all needed or contracted for work product upon the City's request. At the
expiration or termination of this Agreement, all originals and copies of any such work product remaining in the possession
of Contractor shall be delivered to the City.
PROFESSIONAL SERVICES AGREEMENT
- 3 - 9/2016
CITY Of
4... Federal Way
CITY HALL
33325 3th Avenue South
Federal Way, WA 98003-6325
(253) 335 -7000
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9. BOOKS AND RECORDS. The Contractor agrees to maintain books, records, and documents which sufficiently
and properly reflect all direct and indirect costs related to the performance of the Services specified in this Agreement, and
maintain such accounting procedures and practices as may be deemed necessary by the City to assure proper accounting of
all funds paid pursuant to this Agreement. These records shall be subject, at all reasonable times, to inspection, review, or
audit by the City, its authorized representative, the State Auditor, or other governmental officials authorized by law to
monitor this Agreement.
10. INDEPENDENT CONTRACTOR. The Parties intend that the Contractor shall be an independent contractor and
that the Contractor has the ability to control and direct the performance and details of its work, the City being interested
only in the results obtained under this Agreement. The City shall be neither liable nor obligated to pay Contractor sick
leave, vacation pay, or any other benefit of employment, nor to pay any social security or other tax that may arise as an
incident of this Agreement. Contractor shall take all necessary precautions and shall be responsible for the safety of its
employees, agents, and subcontractors in the performance of the Services specified in this Agreement and shall utilize all
protection necessary for that purpose. All work shall be done at Contractor's own risk, and Contractor shall be responsible
for any loss of or damage to materials, tools, or other articles used or held for use in connection with the Services. The
Contractor shall pay all income and other taxes due except as specifically provided in Section 4 of this Agreement.
Industrial or any other insurance that is purchased for the benefit of the City, regardless of whether such may provide a
secondary or incidental benefit to the Contractor, shall not be deemed to convert this Agreement to an employment
contract. If the Contractor is a sole proprietorship or if this Agreement is with an individual, the Contractor agrees to notify
the City and complete any required form if the Contractor retired under a State of Washington retirement system and
agrees to indemnify any losses the City may sustain through the Contractor's failure to do so.
11. CONFLICT OF INTEREST. It is recognized that Contractor may or will be performing professional services
during the Term for other entities or persons; however, such performance of other services shall not conflict with or
interfere with Contractor's ability to perform the Services. Contractor agrees to resolve any such conflicts of interest in
favor of the City. Contractor confirms that Contractor does not have a business interest or a close family relationship with
any City officer or employee who was, is, or will be involved in the Contractor's selection, the negotiation, drafting,
signing, administration of this Agreement, or the evaluation of the Contractor's performance.
12. EQUAL OPPORTUNITY EMPLOYER. In all services, programs, activities, hiring, and employment made
possible by or resulting from this Agreement or any subcontract, there shall be no discrimination by Contractor or its
subcontractors of any level, or any of those entities' employees, agents, subcontractors, or representatives against any
person because of sex, age (except minimum age and retirement provisions), race, color, religion, creed, national origin,
marital status, honorably discharged veteran or military status, sexual orientation including gender expression or identity,
or the presence of any disability, including sensory, mental or physical handicaps, unless based upon a bona fide
occupational qualification in relationship to hiring and employment. This requirement shall apply, but not be limited to the
following: employment, advertising, layoff or termination, rates of pay or other forms of compensation, and selection for
training, including apprenticeship. Contractor shall comply with and shall not violate any of the terms of Chapter 49.60
RCW, Title VI of the Civil Rights Act of 1964, the Americans With Disabilities Act, Section 504 of the Rehabilitation Act
of 1973, 49 CFR Parts 21, 21.5, and 26, or any other applicable federal, state, or local law or regulation regarding non-
discrimination.
13. GENERAL PROVISIONS.
13.1 Interpretation and Modification. This Agreement, together with any attached Exhibits, contains all of the
agreements of the Partics with respect to any matter covered or mentioned in this Agreement and no prior statements or
agreements, whether oral or written, shall be effective for any purpose. Should any language in any Exhibits to this
Agreement conflict with any language in this Agreement, the terms of this Agreement shall prevail. The respective
captions of the Sections of this Agreement are inserted for convenience of reference only and shall not be deemed to
modify or otherwise affect any of the provisions of this Agreement. Any provision of this Agreement that is declared
invalid, inoperative, null and void, or illegal shall in no way affect or invalidate any other provision hereof and such other
provisions shall remain in full force and effect. Any act done by either Party prior to the effective date of the Agreement
PROFESSIONAL SERVICES AGREEMENT
- 4 - 9/2016
CITY O deral Way
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003 -6325
(253) 335 -7000
iY:hV cdyoftederalw7y!Cnrn
that is consistent with the authority of the Agreement and compliant with the terms of the Agreement, is hereby ratified as
having been performed under the Agreement. No provision of this Agreement, including this provision, may be amended,
waived, or modified except by written agreement signed by duly authorized representatives of the Parties.
13.2 Assignment and Beneficiaries. Neither the Contractor nor the City shall have the right to transfer or assign,
in whole or in part, any or all of its obligations and rights hereunder without the prior written consent of the other Party. If
the non- assigning party gives its consent to any assignment, the terms of this Agreement shall continue in full force and
effect and no further assignment shall be made without additional written consent. Subject to the foregoing, the rights and
obligations of the Parties shall inure to the benefit of and be binding upon their respective successors in interest, heirs and
assigns. This Agreement is made and entered into for the sole protection and benefit of the Parties hereto. No other person
or entity shall have any right of action or interest in this Agreement based on any provision set forth herein.
13.3 Compliance with Laws. The Contractor shall comply with and perform the Services in accordance with all
applicable federal, state, local, and city laws including, without limitation, all City codes, ordinances, resolutions,
regulations, rules, standards and policies, as now existing or hereafter amended, adopted, or made effective. If a violation
of the City's Ethics Resolution No. 91 -54, as amended, occurs as a result of the formation or performance of this
Agreement, this Agreement may be rendered null and void, at the City's option.
13.4 Enforcement. Time is of the essence of this Agreement and each and all of its provisions in which
performance is a factor. Adherence to completion dates set forth in the description of the Services is essential to the
Contractor's performance of this Agreement. Any notices required to be given by the Parties shall be delivered at the
addresses set forth at the beginning of this Agreement. Any notices may be delivered personally to the addressee of the
notice or may be deposited in the United States mail, postage prepaid, to the address set forth above. Any notice so posted
in the United States mail shall be deemed received three (3) days after the date of mailing. Any remedies provided for
under the terms of this Agreement are not intended to be exclusive, but shall be cumulative with all other remedies
available to the City at law, in equity, or by statute. The failure of the City to insist upon strict performance of any of the
covenants and agreements contained in this Agreement, or to exercise any option conferred by this Agreement in one or
more instances shall not be construed to be a waiver or relinquishment of those covenants, agreements or options, and the
same shall be and remain in full force and effect. Failure or delay of the City to declare any breach or default immediately
upon occurrence shall not waive such breach or default. Failure of the City to declare one breach or default does not act as
a waiver of the City's right to declare another breach or default. This Agreement shall be made in, governed by, and
interpreted in accordance with the laws of the State of Washington. If the Parties are unable to settle any dispute, difference
or claim arising from this Agreement, the exclusive means of resolving that dispute, difference, or claim, shall be by tiling
suit under the venue, rules, and jurisdiction of the King County Superior Court, King County, Washington, unless the
parties agree in writing to an alternative process. If the King County Superior Court does not have jurisdiction over such a
suit, then suit may be filed in any other appropriate court in King County, Washington. Each party consents to the personal
jurisdiction of the state and federal courts in King County, Washington and waives any objection that such courts are an
inconvenient forum. If either Party brings any claim or lawsuit arising from this Agreement, each Party shall pay all its
legal costs and attorney's fees and expenses incurred in defending or bringing such claim or lawsuit, including all appeals,
in addition to any other recovery or award provided by law; however, nothing in this paragraph shall be construed to limit
the Parties' rights to indemnification under Section 5 of this Agreement.
13.5 Execution. Each individual executing this Agreement on behalf of the City and Contractor represents and
warrants that such individual is duly authorized to execute and deliver this Agreement. This Agreement may be executed in
any number of counterparts, each of which shall be deemed an original and with the same effect asoifaxl4TP 9tigF4hereto had
signed the same document. All such counterparts shall be construed together and shall cosst' '� tscru." ,but in
making proof hereof, it shall only be necessary to produce one such counterpart. The signature ' 401 ffages
from such counterparts may be assembled together to form a single instrument comprised ,iii all" iageti �y this igkent
and a complete set of all signature and acknowledgment pages. The date upon which the. last of all oof tP# Patties Piave
executed a counterpart of this Agreement shall he the "date of mutual execution" hereof.
[Signature page follows] *fir # i # °`.A.
PROFESSIONAL SERVICES AGREEMENT - 5 - 9/2016
CITY OF
Federal Way
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003 -6325
(253) 835 -7000
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IN WITNESS, the Parties execute this Agreement below, effective the last date written below.
CITY OF _ DERAL WAY
Jim ' - el , ayor
DATE: / /7,//
C
R.L.
By:
Printed Name:
Title:
DATE:
STATE OF WASHINGTON )
) ss.
COUNTY OF I��•�
On his day personally appeared before me DOtA 1G 5 -6:460A5 , to me known to be the
CS At of _R_� . EUGtv\ CO , that executed the foregoing
instrument, and acknowledged the said instrument to be the free and voluntary act and deed of said corporation,
for the uses and purposes therein mentioned, and on oath stated that he /she was authorized to execute said
instrument and that the seal affixed, if any, is the corporate seal of said corporation.
GIVEN my hand and official seal this //I day of OC,f-T1e✓ , 204
ATTEST:
41 JAI
`5. ph.nie Courtney, CMC, Clerk
APPROVED AS TO FORM:
City Attorney, Acting J. Ryan Call
tttttltUHNU, Notary's signature
���* 3. AAid.•//, Notary's printed na
..` !,.*11M far, ;4e% �p',,�� Notary Public in and for the State of Washington.
• ': s My commission expires 101 ' 1
s
J;• OCT ! 1��e C °
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PROF 'SS OVAL SERVICES AGREEMENT 6
9/2016
CITY Of
'�.. Federal Way
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 835 -7000
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EXHIBIT A
SERVICES
The Contractor shall do or provide the following additional services which are representative of the basic
services with respect to the City's health insurance programs:
1. Plan Review
• Review in -force contracts, plans, benefit design
• Review funding agreements
• Review claims data and plan benefit design
• Assist with renewal contract negotiations
2. Bidding the In -Force Lines of Coverage (when requested).
• Prepare bid specifications for underwriters
• Research insurance markets on City's (Plan Sponsor's) behalf
• Evaluate current /prospective insurers and third party administrators (TPA) (self - funding)
• Analyze proposals and make recommendations
3. Plan Administration
• Assist with billing and eligibility problems
• Assist with plan installation
• Monitor insurer or TPA for compliance with contract terms
• Receive and maintain detailed claims register from insurer or TPA; provide to a HIPAA designated
member at the City as requested
4. Benefit Communication
• Plan and organize employee meetings
• Develop benefit summaries
• Assist with preparation of Summary Plan Descriptions
5. Assist the City in compliance with State and Federal Laws Impacting Benefit Plans
6. Other Services
• Act as an advocate of the employees and City in resolving difficult claims and administrative problems
• Review and analyze claims data and make recommendations
• Present information to Stakeholders (Council, Executive Staff. Employees)
• Review industry trends and advise the City
• Assist the City in strategic benefit planning
• Pursuant to WAC 200 - 110 - 120(5) work with the City to hire outside company to audit plan at least once
every three years
• Advise the City on the employee wellness program and assist with vendor performance and contracting
PROFESSIONAL SERVICES AGREEMENT - 7 1/2015
CITY OF
Federal Way
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003 -6325
(253) 335 -7000
SYIYbk: eltvoffederofway coo
EXHIBIT B
COMPENSATION
1. Method of Compensation: In return for the Services, the City shall pay the Contractor a fee based on
the number of enrolled employees. This fee will be as follows;
Year
Fee
2017
Fifteen and 00 /100 dollars per employee per month (PEPM) ($15.00 PEPM)
2018
Fifteen and 75/100 dollars (PEPM) ($15.75 PEPM)
2019
Sixteen and 50/100 dollars (PEPM) ($16.50 PEPM)
This fee will be billed by the Carrier as part of the monthly premium or administrative billing. A Carrier
includes an insurance company, a health service corporation, health maintenance organization, third party
administrator, or other entity providing or administering a plan of health insurance or health benefits. The City
reserves the right to pay the fee directly to the Contractor if it is determined that it is beneficial to do so.*
For services requested by the City, that are outside the services noted in Exhibit A of this agreement, the City
shall pay the Contractor for actual services performed at the hourly rate of Two Hundred Seventy -Five and
00 /100 dollars ($275.00) not to exceed Five Thousand and 00 /100 dollars ($5,000.00) annually. Prior to
beginning any such work, the Contractor will inform the City in writing that the requested service is outside of
the services listed in Exhibit A and will not proceed with work in question until written authorization by the City
is provided.
* The City recognizes that the Contractor may qualify for contingency bonuses from insurance companies with whom the Contractor conducts
business. As these amounts are not guaranteed and are typically earned based on factors that are not client - specific, any such payments received
by Contractor will not be offset against the fees noted above. Upon request Contractor will provide a detail listing of all contingency
commissions received for the prior year.
PROFESSIONAL SERVICES AGREEMENT
-8- 1/2015
AC RO D
CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDD(YYYY)
10/19/2016
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: tf the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
INSURED
R.L. Evans Company, Inc.
3535 Factoria Blvd SE, Ste 120
Bellevue, WA 98006
R.L. Evans Company
3535 Factoria Blvd SE Ste 120
Bellevue, WA 98006
CONTACT
NAME: Doug B. Harwood
.PHONE L ,10.1 f);..A425)455_0501 _laic, No): t425 }467 -5264
E-MAIL doU h devansco com
INSURER(S) AFFORDING COVERAGE...___.
INSURERA: The Hartford
INSURER B. Fireman's Fund Insurance Company
INSURER C :
INSURER D :
INSURER E
INSURER F :
NAIC
COVERAGES
CERTIFICATE NUMBER: 00000000- 221976
REVISION NUMBER: 4
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSfi - -� TYPE OF INSURANCE -- - •ADDLSUBR - -- - - - - -- - -- POLICYEFF • POLICY EXP LIMITS
LTR • IN^) wv POLICY NUMBER INIWOOFYYYY) (MMIDD/YYYY)
A X COMMERCIAL GENERAL LIABILITY Y • 52SBATZ7827
CLAIMS -MADE X OCCUR
_ -. --
GENT AGGREGATE LIMIT APPLIES PER:
PRO -
POLICY JECT _ .. LOC
OTHER.
12/01/2016
12101(2017 EACH OCCURRENCE S 2,000,000
• PREMISES(RENTED S 2,000,000
PREMISES (Ea occurrence).
..
- MED EXP (Any one person) ..... s 10,p00
PERSONAL & AM/ INJURY S 2,000,000
GENERAL AGGREGATE $ 4,000,000
PRODUCTS - COMP/OP AGG S 4,000,000
Bus Pers Prop- REPL 5 209,000
A AUTOMOBILE LIABILITY
. - - -,_
I 1 ANY AUTO
r---I OWNED ---
1 I AUTOS ONLY -__
` HIRED
i - X,I AUTOS ONLY . X . _
i
52SBATZ7827
-
SCHEDULED -
AUTOS
NON -OWNED
AUTOS ONLY
12!01!2016
COMBINED SINGLE LIMIT S
12101!2017 . {Eaaccdent) 2,000,000
BODILY INJURY (Per person) 5
N. P_.. - ... .
BODILY INJURY (Per acadenE} 5
PROPERTY DAMAGE
(Per accident) - S
-5
UMBRELLA LIAR I OCCUR
• EXCESS LIAB CLAWS-MADE
I 1 DED ; RETENTIONS
EACH OCCURRENCE
AGGREGATE
$
O
A AND EMPLOYERS' LIABILITY - 52SBATZ7827
ANY PROPRiETORfPARTNEIVEXECUTIVE Y 1 N
OFFICERIMEMBER EXCLUDED? NfA
(Mandatory in NH)
0 yes. describe under
DESCRIPTION OF OPERATIONS below
12!0112016
12/01/2017 STATUTE -, . OTH-
ER
E.L. EACH ACCIDENT : S 1,000,000
- - --
E.L. DISEASE - EA EMPLOYEE S 1,000,000
. . ._... . __. _ ................ _
E.L. DISEASE - POLICY LIMIT 5 1,000,000
B Errors & Omissions ME7363654
03!31!2016
• / /
03131/2017 2,000,000 each claim
/ / 2,000,000 aggregate
DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Certificate Holder is Additional Insured per attached 111 12 00 85
CERTIFICATE HOLDER
CANCELLATION
City of Federal Way
33325- 8th Ave So
Federal Way, WA 98063
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
i
ACORD 25 (2016103)
l t (DBH)
(5198M015-ACORD CORPORAL ION. All rights reserved.
The ACORD name and logo arp'registered marks of ACORD
Printed by DBH on October 19, 2016 at 01:39PM
