_______________________________________________________________________
INDEPENDENT CONTRACTOR'S AGREEMENT
--Page 1 of 9 Pages --
AGREEMENT NO. ___________________
INDEPENDENT CONTRACTOR'S AGREEMENT
This INDEPENDENT CONTRACTOR’S AGREEMENT (“Agreement”) is made and entered into on _______________________, by and between the CITY OF BAKERSFIELD, a municipal corporation ("CITY" herein), and THE SEGAL COMPANY (WESTERN STATES), INC., D/B/A SEGAL CONSULTING ("CONTRACTOR" herein).
R E C I T A L S
WHEREAS, CONTRACTOR represents CONTRACTOR is experienced, well qualified, and a specialist in the field of Health Benefits Consulting; and
WHEREAS, CONTRACTOR has served as CITY’S health consultant since 2020 and performed well; and
WHEREAS, CONTRACTOR and CITY desire to enter into another contract for health consulting services.
NOW, THEREFORE, incorporating the foregoing recitals herein, CITY and CONTRACTOR mutually agree as follows:
1. SCOPE OF WORK. In exchange for the compensation outlined below, CONTRACTOR will do the following (“Scope of Work”): Provide the following consulting services for CITY in the following areas:
• Benefits Strategy & Cost Management
• Financial Management
• Renewal Management
• Compliance
• Vendor Marketing
• Vendor Management
Consulting would also include:
• Analyzing the current health care plans for cost saving opportunities and recommended changes.
• Analyzing alternative/additional health care options that would improve the benefit package and effectively manage cost. • Provide benefit recommendations in compliance with state and federal laws and regulations.
• Attendance and presentations at City Council meetings, Insurance Committee meetings, Personnel Committee meetings , and other meetings with CITY Staff as required.
• Effectively communicating with CITY Staff regarding benefit strategies and plan design changes.
Docusign Envelope ID: EEC03CE8-1CD1-4FC5-8CC0-57DB5C226F2E _______________________________________________________________________
INDEPENDENT CONTRACTOR'S AGREEMENT
--Page 2 of 9 Pages --
• Compiling and reporting on CITY ’s plan experience and vendor financial reports.
• Provide legal counsel, training, and communication to HR and/or other CITY Staff of state and/ or federal laws and regulation changes impacting CITY.
Consulting services will be for the following plans:
• All existing health and welfare plans, including: Medical, Dental, Vision, Prescription Drug, Life, Disability (LTD), FSA Accounts (medical and dependent care), COBRA, and other relative benefit plans.
The Scope of Work shall include all items and procedures necessary to properly complete the task CONTRACTOR has been hired to perform, whether specifically included in the scope of work or not.
2. COMPENSATION. Subject to the terms of this section, CITY will pay CONTRACTOR for performing the Scope of Work as follows (the “Compensation”): CITY will pay CONTRACTOR $108,000.00 per year for performing the Scope of Work from July 1, 2025 to December 31, 2027. If CITY elects to extend this Agreement for an additional one- year period pursuant to this Agreement, CITY will pay CONTRACTOR $114,000.00 for that extended year. The Compensation shall be the total compensation CITY will pay CONTRACTOR under this Agreement and includes, but is not limited to , all out-of-pocket costs and taxes. CITY shall pay only the compensation listed unless otherwise agreed to in writing by the parties.
3. PAYMENT PROCEDURE. CONTRACTOR shall be paid for services rendered after receipt of an itemized invoice for the work completed and approved by CITY in accordance with the terms of this Agreement. Payment by CITY to CONTRACTOR shall be made within thirty days after receipt and approval by CITY of CONTRACTOR's itemized invoice.
4. KEY PERSONNEL. CONTRACTOR shall name all key personnel to be assigned to the work set forth herein. All key personnel shall be properly licensed and have the experience to perform the work called for under this Agreement.
CONTRACTOR shall provide background for each of the key personnel including, without limitation, resumes and work experience in the type of work called for herein. CITY reserves the right to approve key personnel.
Once the key personnel are approved, CONTRACTOR shall not change such personnel without the written approval of CITY.
5. STARTING WORK. CONTRACTOR shall not begin work until authorized to do so in writing by CITY. No work will be authorized until the contract has been fully executed by CONTRACTOR and CITY.
6. INCLUDED DOCUMENTS. Any bid documents, including, without limitation, special provisions and standard specifications and any Request for Proposals, Docusign Envelope ID: EEC03CE8-1CD1-4FC5-8CC0-57DB5C226F2E _______________________________________________________________________
INDEPENDENT CONTRACTOR'S AGREEMENT
--Page 3 of 9 Pages --
Request for Qualifications and responses thereto relating to this Agreement are incorporated by reference as though fully set forth.
7. NO WAIVER OF DEFAULT. The failure of any party to enforce against another party any provision of this Agreement shall not constitute a waiver of that party's right to enforce such a provision at a later time, and shall not serve to vary the terms of this Agreement.
8. LICENSES. CONTRACTOR shall, at its sole cost and expense, keep in effect or obtain at all times during the term of this Agreement any licenses, permits and approvals which are legally required for CONTRACTOR to practice its profession. If a corporation, at least one officer or key employee shall hold the required licenses or professional degrees. If a partnership, at least one partner shall hold the required licensees or professional degrees.
9. STANDARD OF PERFORMANCE. All work shall be performed in conformity with all legal requirements and industry standards observed by a specialist of the profession in California.
10. MERGER AND MODIFICATION. This Agreement sets forth the entire agreement between the parties and supersedes all other oral or written representations.
This Agreement may be modified only in a writing approved by the City Council and signed by all the parties.
11. EXHIBITS. In the event of a conflict between the terms, conditions or specifications set forth in this Agreement and those in exhibits attached hereto, the terms, conditions, or specifications set forth in this Agreement shall prevail. All exhibits to which reference is made in this Agreement are deemed incorporated in this Agreement, whether or not actually attached.
12. TERM. Unless terminated sooner, as set forth herein, this Agreement shall terminate on December 31 , 20 27. CITY, in writing, and at its option, may extend this Agreement for one additional year under the terms and conditions outlined herein.
13. TERMINATION. Either party may terminate this Agreement after giving the other party written notice, as provided herein, thirty days before the termination is effective. If there is an early termination, CITY will only pay CONTRACTOR for the work CONTRACTOR satisfactorily completes up to the date of termination and delivers to CITY and CITY accepts.
14. COMPLIANCE WITH ALL LAWS. CONTRACTOR shall, at CONTRACTOR's sole cost, comply with all of the requirements of Municipal, State, and Federal authorities now in force, or which may hereafter be in force, pertaining to this Agreement, and shall faithfully observe in all activities r elating to or growing out of this Agreement all Municipal ordinances and State and Federal statutes, rules or regulations, and permitting requirements now in force or Docusign Envelope ID: EEC03CE8-1CD1-4FC5-8CC0-57DB5C226F2E _______________________________________________________________________
INDEPENDENT CONTRACTOR'S AGREEMENT
--Page 4 of 9 Pages --
which may hereafter be in force including, without limitation, obtaining a City of Bakersfield business tax certificate (Bakersfield Municipal Code Chapter
5.02) where required.
15. INDEPENDENT CONTRACTOR. This Agreement calls for the performance of the services of CONTRACTOR as an independent contractor. CONTRACTOR is not an agent or employee of CITY for any purpose and is not entitled to any of the benefits provided by CITY to its employees. This Agreement shall not be construed as forming a partnership or any other association with CONTRACTOR other than that of an independent contractor.
16. DIRECTION. CONTRACTOR retains the right to control or direct the manner in which the services described herein are performed.
17. EQUIPMENT. CONTRACTOR will supply all equipment, tools, materials and supplies necessary to perform the services under this Agreement.
18. INSURANCE.
18.1 Types and Limits of Insurance. In addition to any other insurance or security required under this Agreement, CONTRACTOR must procure and maintain, for the duration of this Agreement, the types and limits of insurance below ("Basic Insurance Requirements").
18.1.1 Automobile liability insurance, providing coverage for non- owned, and hired autos on an occurrence basis for bodily injury, including death, of one or more persons, property damage, and personal injury, with limits of not less than $1,000,000 per occurrence.
18.1.2 Commercial general liability insurance, unless otherwise approved by CITY’s Risk Manager, providing coverage on an occurrence basis for bodily injury, including death, of one or more persons, property damage, and personal injury, with limits of not less than $1,000,000 per occurrence. The policy must:
18.1.2.1 Provide contractual liability coverage for the terms of this Agreement;
18.1.2.2 Provide unlimited products and completed operations coverage;
18.1.2.3 Provide premises, operations, and mobile equipment coverage; and
18.1.2.4 Contain an additional insured endorsement in favor of CITY and its mayor, council, officers, agents,
employees, and designated volunteers.
Docusign Envelope ID: EEC03CE8-1CD1-4FC5-8CC0-57DB5C226F2E _______________________________________________________________________
INDEPENDENT CONTRACTOR'S AGREEMENT
--Page 5 of 9 Pages --
18.1.3 Workers' compensation insurance with limits of not less than $1,000,000 per occurrence. In accordance with the provisions of Labor Code Section 3700, every contractor will be required to secure the payment of compensation to his employees.
Pursuant to Labor Code Section 1861, CONTRACTOR must
submit to CITY the following certification before beginning any work under this Agreement:
I am aware of the provisions of Section 3700 of the
Labor Code which require 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 work of this contract.
By executing this Agreement, CONTRACTOR is submitting the certification required above.
The policy must contain a waiver of subrogation in favor of CITY and its mayor, council, officers, agents, employees, and designated volunteers.
18.2 General Provisions Applying to All Insurance Types.
18.2.1 All policies required of CONTRACTOR must be written on a first - dollar coverage basis, or contain a deductible provision.
Subject to advance approval by CITY, CONTRACTOR may utilize a self-insured retention in any or all of the policies provided, but the policy or policies may not contain language, whether added by endorsement or contained in the policy conditions, that prohibits satisfaction of any self -insured provision or requirement by anyone other than the named insured or by any means including other insurance or which is intended to defeat the intent or protection of an additional insured.
18.2.2 All policies required of CONTRACTOR must be primary insurance as to CITY and its mayor, council, officers, agents, employees, or designated volunteers and any insurance or self -insurance maintained by CITY and its mayor, council, officers, agents, employees, and designated volunteers must b e excess of CONTRACTOR’s insurance and must not contribute with it.
18.2.3 The insurance required above, except for workers’ compensation insurance, must be placed with insurers with a Best’s rating as approved by CITY’s Risk Manager, but in no event less than A-:VII. Any deductibles, self-insured retentions, or Docusign Envelope ID: EEC03CE8-1CD1-4FC5-8CC0-57DB5C226F2E _______________________________________________________________________
INDEPENDENT CONTRACTOR'S AGREEMENT
--Page 6 of 9 Pages --
insurance in lesser amounts, or lack of certain types of insurance otherwise required by this Agreement, or insurance rated below Best’s A -:VII, must be declared prior to execution of this Agreement and approved by CITY in writing.
18.2.4 CONTRACTOR shall provide CITY with a thirty-day written notice of cancellation or material change in policy language or terms.
All policies must provide that there will be continuing liability thereon, notwithstanding any recovery on any policy.
18.2.5 The insurance required hereunder must be maintained throughout the term of this Agreement.
18.2.6 When CONTRACTOR submits the executed Agreement to CITY, CONTRACTOR must furnish CITY’s Risk Manager with a certificate of insurance and required endorsements evidencing the
insurance required. The required certificates of insurance and endorsements are attached hereto as Exhibit A. CITY may withdraw its offer of contract or cancel this Agreement if certificates of insurance and endorsements are not provided when CONTRACTOR submits the executed Agreement to CITY.
18.2.7 Full compensation for all premiums which CONTRACTOR is required to pay on all the insurance described herein wi ll be considered as included in the prices paid for the various items of work to be performed under the Agreement, and no additional allowance will be made therefor or for additional premiums which may be required by extensions of the policies of
insurance.
18.2.8 It is further understood and agreed by CONTRACTOR that its liability to CITY will not in any way be limited to or affected by the amount of insurance obtained and carried by
CONTRACTOR in connection with this Agreement.
18.2.9 Unless otherwise approved by CITY, if any part of the work under this Agreement is subcontracted, the Basic Insurance
Requirements must be provided by, or on behalf of, all
subcontractors even if CITY has approved lesser insurance requirements for CONTRACTOR , and all subcontractors must agree in writing to be bound by the provisions of this section.
19. THIRD PARTY CLAIMS. In the case of public works contracts, CITY will timely notify CONTRACTOR of third party claims relating to this contract. CITY shall be allowed to recover from CONTRACTOR, and CONTRACTOR shall pay on demand, all costs of notification.
Docusign Envelope ID: EEC03CE8-1CD1-4FC5-8CC0-57DB5C226F2E _______________________________________________________________________
INDEPENDENT CONTRACTOR'S AGREEMENT
--Page 7 of 9 Pages --
20. INDEMNITY. CONTRACTOR shall indemnify, defend, and hold harmless CITY, and CITY’s officers, agents and employees against any and all liability, claims, actions, causes of action or demands whatsoever against them, or any of them, before administrative or judicial tribunals of any kind whatsoever, to the extent resulting from the negligence or willful misconduct of CONTRACTOR or CONTRACTOR's employees, agents, independent contractors, companies, or subcontractors in the performance of this Agreement whether or not caused in part by a party indemnified hereunder, except for CITY’s sole active negligence or willful misconduct.
21. EXECUTION. This Agreement is effective upon execution. It is the product of negotiation and all parties are equally responsible for authorship of this Agreement. Section 1654 of the California Civil Code shall not apply to the interpretation of this Agreement.
22. NOTICES. All notices relative to this Agreement shall be given in writing and shall be personally served or sent by certified or registered mail and be effective upon actual personal service or depositing in the United States mail.
The parties shall be addressed as follows, or at any other address designated by notice:
CITY: CITY OF BAKERSFIELD
CITY HALL
1600 Truxtun Avenue
Bakersfield, California 93301
CONTRACTOR: The Segal Company (Western States), Inc.
330 North Brand Blvd., Suite 1100
Glendale, CA 91203
COPY TO: The Segal Group, Inc.
Attn: General Counsel
333 West 34th Street
New York, NY 10001
[email protected]
23. GOVERNING LAW. The laws of the State of California will govern the validity, interpretation, and performance of this Agreement. Any litigation arising in any way from this Agreement shall be brought in Kern County, California.
24. FURTHER ASSURANCES. Each party shall execute and deliver such papers, documents, and instruments, and perform such acts as are necessary or appropriate, to implement the terms of this Agreement and the intent of the parties to this Agreement.
25. ASSIGNMENT. Neither this Agreement nor any rights, interests, duties, liabilities, obligations or responsibilities arising out of, concerning or related in Docusign Envelope ID: EEC03CE8-1CD1-4FC5-8CC0-57DB5C226F2E _______________________________________________________________________
INDEPENDENT CONTRACTOR'S AGREEMENT
--Page 8 of 9 Pages --
any way to this Agreement (including, but not limited to, accounts, actions, causes of action, claims, damages, demands, liabilities, losses, obligations, or reckonings of any kind or nature whatsoever, for compensatory or exemplary and punitive damages, or declaratory, equitable or injunctive relief, whether based on contract, equity, tort, or other theories of recovery provided for by the common or statutory law) may be assigned or transferred by any party. Any such assignment is prohibited, and shall be unenforceable and otherwise null and void without the need for further action by the non- assigning party or parties.
26. BINDING EFFECT. The rights and obligations of this Agreement shall inure to the benefit of, and be binding upon, the parties to the contract and their heirs, administrators, executors, personal representatives, successors and assigns, and whenever the context so requires, the masculine gender includes the feminine and neuter, and the singular number includes the plural. This Agreement may be executed in any number of counterparts, each of which shall be considered as an original and be effective as such.
27. OWNERSHIP OF DELIVERABLES. Except to the extent that they incorporate CONTRACTOR’s proprietary software, tools, know- how, techniques, methodologies and report formats (collectively, “CONTRACTOR’s Proprietary Information”), all documents, plans, and drawings, maps, photographs, and other papers, or copies thereof prepared by CONTRACTOR pursuant to the terms of this Agreement (collectively, the “Deliverables”) , shall, upon preparation, become the property of CITY, once paid for by the CITY. To the extent CONTRACTOR’s Proprietary Information is incorporated into such Deliverables, CITY shall have a perpetual, nonexclusive, worldwide, royalty - free license to use, copy, and modify CONTRACTOR’s Proprietary Information as part of the Deliverables internally and for their intended purpose.
28. ACCOUNTING RECORDS. CONTRACTOR shall maintain accurate accounting records and other written documentation pertaining to all costs incurred in performance of this Agreement. Such records and documentation shall be kept at CONTRACTOR's office during the term of this Agreement , and for a period of three years from the date of the final payment hereunder, and said records shall be made available to CITY representatives upon request at any time during regular business hours.
29. CORPORATE AUTHORITY. Each individual signing this Agreement on behalf of entities represents and warrants that they are, respectively, duly authorized to sign on behalf of the entities and to bind the entities fully to each and all of the obligations set forth in this Agreement.
30. TAX NUMBERS.
CONTRACTOR's Federal Tax ID Number: 94-1503999
CONTRACTOR is a corporation? Yes X No (Please check one.)
Docusign Envelope ID: EEC03CE8-1CD1-4FC5-8CC0-57DB5C226F2E _______________________________________________________________________
INDEPENDENT CONTRACTOR'S AGREEMENT
--Page 9 of 9 Pages --
31. NON-INTEREST. No officer or employee of CITY shall hold any interest in this Agreement (California Government Code section 1090).
32. RESOURCE ALLOCATION. All obligations of CITY under the terms of this Agreement are subject to the appropriation and allocation of resources by the City Council.
IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed, the day and year first-above written.
"CITY" “CONTRACTOR”
CITY OF BAKERSFIELD THE SEGAL COMPANY (WESTERN
STATES) INC.
By:________________________________ By:_________________________________
KAREN GOH RICHARD WARD
Mayor Senior Vice President
APPROVED AS TO CONTENT:
CITY MANAGER’S OFFICE
By:_______________________________
CHRISTIAN CLEGG
City Manager
APPROVED AS TO FORM:
VIRGINIA GENNARO
City Attorney
By:___________________________
VIRGINIA GENNARO
City Attorney
Insurance:____________
COUNTERSIGNED:
By:_______________________________
RANDY MCKEEGAN
Finance Director
Attachment: Exhibit A – Certificates of Insurance
S:\Manager\Agrs\24-25\Segal Agreement.docx
Docusign Envelope ID: EEC03CE8-1CD1-4FC5-8CC0-57DB5C226F2E
05/05/2025
Segal Select Insurance Services, Inc.
66 Hudson Blvd, E
20th Floor
New York NY 10001-2192
Susan Ginexi
(212) 251-5000
[email protected]
The Segal Company (Western States), Inc.
500 North Brand Blvd
Suite 1400
Glendale CA 91203
Federal Insurance Company 20281
Pacific Indemnity Company 20346
CL255502767
A Y 3603-81-14 02/28/2025 02/28/2026
1,000,000
1,000,000
10,000
1,000,000
2,000,000
Included
A Y 73596984 02/28/2025 02/28/2026
1,000,000
A
10,000
Y 7989-62-28 02/28/2025 02/28/2026
25,000,000
25,000,000
B N 7173-83-81 02/28/2025 02/28/2026
1,000,000
1,000,000
1,000,000
A
Crime
Y 82629525 04/30/2025 04/30/2026
Limit $5,000,000
Retention $50,000
City of Bakersfield, its mayor, council, officers, agents, employees, and volunteers is included as Additional Insured ATIMA where required by written contract.
City of Bakersfield
Finance Department
1600 Truxtun Ave
Bakersfield CA 93301
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
INSURER(S) AFFORDING COVERAGE
INSURER F :
INSURER E :
INSURER D :
INSURER C :
INSURER B :
INSURER A :
NAIC #
NAME:
CONTACT
(A/C, No):
FAX
E-MAIL
ADDRESS:
PRODUCER
(A/C, No, Ext):
PHONE
INSURED
REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES
IMPORTANT: If 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).
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.
OTHER:
(Per accident)
(Ea accident)
$
$
N / A
SUBR
WVD
ADDL
INSD
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. $
$
$
$PROPERTY DAMAGE
BODILY INJURY (Per accident)
BODILY INJURY (Per person)
COMBINED SINGLE LIMIT
AUTOS ONLY
AUTOSAUTOS ONLY
NON-OWNED
SCHEDULEDOWNED
ANY AUTO
AUTOMOBILE LIABILITY
Y / N
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
DESCRIPTION OF OPERATIONS below
If yes, describe under
ANY PROPRIETOR/PARTNER/EXECUTIVE
$
$
$
E.L. DISEASE - POLICY LIMIT
E.L. DISEASE - EA EMPLOYEE
E.L. EACH ACCIDENT
ER
OTH-
STATUTE
PER
LIMITS(MM/DD/YYYY)
POLICY EXP
(MM/DD/YYYY)
POLICY EFF
POLICY NUMBERTYPE OF INSURANCELTR
INSR
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
EXCESS LIAB
UMBRELLA LIAB $EACH OCCURRENCE
$AGGREGATE
$
OCCUR
CLAIMS-MADE
DED RETENTION $
$PRODUCTS - COMP/OP AGG
$GENERAL AGGREGATE
$PERSONAL & ADV INJURY
$MED EXP (Any one person)
$EACH OCCURRENCE
DAMAGE TO RENTED
$PREMISES (Ea occurrence)
COMMERCIAL GENERAL LIABILITY
CLAIMS-MADE OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO-
JECT LOC
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
CANCELLATION
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.
CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED
AUTOS ONLY
Docusign Envelope ID: EEC03CE8-1CD1-4FC5-8CC0-57DB5C226F2E Docusign Envelope ID: EEC03CE8-1CD1-4FC5-8CC0-57DB5C226F2E Docusign Envelope ID: EEC03CE8-1CD1-4FC5-8CC0-57DB5C226F2E Workers' Compensation and Employers' Liability Policy
Endorsement NumberNamed Insured
THE SEGAL COMPANY (EASTERN STATES), INC.
Policy Number
Symbol: Number: (26) 7173-83-81
Policy Period
02/28/2025 TO 02/28/2026
Effective Date of Endorsement
02/28/2025
Issued By (Name of Insurance Company)
Pacific Indemnity Company
Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy.
CALIFORNIA WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because California is shown in Item 3.A. of the Information Page.
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule, where you are required by a written contract to obtain this waiver from us.
You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule.
Schedule
1. ( )Specific Waiver
Name of person or organization
City of Bakersfield
Finance Department
1600 Truxtun Ave
Bakersfield, CA 93301
( )Blanket Waiver
Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver.
2. Operations:
3. Premium:
The premium charge for this endorsement shall be 0 percent of the California premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described.
4. Minimum Premium:
Authorized Representative
WC 90 03 75 (05/18)
Insured Copy
Docusign Envelope ID: EEC03CE8-1CD1-4FC5-8CC0-57DB5C226F2E Holder Identifier : 7777777707070700077763616065553330772737565024667507751025453734003071762765275333300725066671247773307746415136254574077044153122343100774243331061055407704611732070110077727252025773110777777707000707007 6666666606060600062606466204446200622200606206200006002004062260002062200042400422020622000606204200006022004240262222060222262420402200622220426020060006222244202462040066646062240664440666666606000606006 Certificate No : 570112401403
CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY )
05/05/2025
IMPORTANT: If 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).
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATI ON ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AM END, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE P OLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONST ITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AU THORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
PRODUCER
Aon Risk Services Northeast, Inc.
New York NY Office
One Liberty Plaza
165 Broadway, Suite 3201
New York NY 10006 USA
PHONE
(A/C. No. Ext):
E-MAIL
ADDRESS :
INSURER(S) AFFORDING COVERAGE NAIC #
(866) 283-7122
INSURED 22322 Greenwich Insurance Company INSURER A :
INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
FAX
(A/C. No .): (800) 363-0105
CONTACT
NAME:
The Segal Company (Western States), Inc.
500 North Brand Boulevard
Suite 1400
Glendale, CA 91203-3338 USA
COVERAGES CERTIFICATE NUMBER : 570112401403 REVISION NUMBER :
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE L ISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED A BOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH R ESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSUR ANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS S UBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES . LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS . Limits shown are as requested
POLICY EXP
(MM /DD /YYYY )
POLICY EFF
(MM /DD /YYYY )
SUBR
WVD
INSR
LTR
ADDL
INSD POLICY NUMBER TYPE OF INSURANCE LIMITS
COMMERCIAL GENERAL LIABILITY
CLAIMS-MADE OCCUR
POLICY LOC
EACH OCCURRENCE
DAMAGE TO RENTED
PREMISES (Ea occurrence )
MED EXP (Any one person )
PERSONAL & ADV INJURY
GENERAL AGGREGATE
PRODUCTS - COMP /OP AGG
GEN 'L AGGREGATE LIMIT APPLIES PER :
PRO-
JECT
OTHER :
AUTOMOBILE LIABILITY
ANY AUTO
OWNED
AUTOS ONLY
SCHEDULED
AUTOS
HIRED AUTOS
ONLY
NON-OWNED
AUTOS ONLY
BODILY INJURY ( Per person)
PROPERTY DAMAGE
(Per accident)
BODILY INJURY (Per accident)
COMBINED SINGLE LIMIT
(Ea accident)
EXCESS LIAB
OCCUR
CLAIMS-MADE AGGREGATE
EACH OCCURRENCE
DED
UMBRELLA LIAB
RETENTION
E.L. DISEASE-EA EMPLOYEE
E.L. DISEASE-POLICY LIMIT
E.L. EACH ACCIDENT
OTH-
ER
PER STATUTE
Y / N
(Mandatory in NH)
ANY PROPRIETOR / PARTNER / EXECUTIVE
OFFICER/MEMBER EXCLUDED? N / A
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
If yes, describe under
DESCRIPTION OF OPERATIONS below
Limit (1) MPP002214319 01/30/2025 01/30/2026 Consultants Liability A $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Limit (1) $2,000,000 per claim / $2,000,000 Aggregate.
Evidence of Insurance
CANCELLATION CERTIFICATE HOLDER
AUTHORIZED REPRESENTATIVE
CITY OF BAKERSFIELD
FINANCE DEPARTMENT
1600 Truxtun Avenue
Bakersfield, CA 93301 USA
ACORD 25 (2016/03)
©1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCE LLED BEFORE THE
EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS .
Docusign Envelope ID: EEC03CE8-1CD1-4FC5-8CC0-57DB5C226F2E Certificate Of Completion
Envelope Id: EEC03CE8-1CD1-4FC5-8CC0-57DB5C226F2E
Status: Completed
Subject: Complete with Docusign: Segal Agreement_Insurance Docs_Final.pdf Source Envelope:
Document Pages: 14
Signatures: 2
Envelope Originator:
Certificate Pages: 5
Initials: 1
City Clerk's Office
AutoNav: Enabled
EnvelopeId Stamping: Enabled
Time Zone: (UTC-08:00) Pacific Time (US & Canada)
[email protected]
IP Address: 174.46.226.5
Record Tracking
Status: Original
5/19/2025 4:23:55 PM
Holder: City Clerk's Office
[email protected]
Location: DocuSign
Security Appliance Status: Connected
Pool: StateLocal
Storage Appliance Status: Connected
Pool: City of Bakersfield
Location: Docusign
Signer Events
Signature
Timestamp
Richard Ward
[email protected]
Sr. Vice President
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 208.87.233.201
Sent: 5/19/2025 4:34:34 PM
Viewed: 5/20/2025 12:13:57 AM
Signed: 5/30/2025 7:25:29 AM
Electronic Record and Signature Disclosure:
Accepted: 5/20/2025 12:13:57 AM
ID: e3adc002-5d56-4473-a5d6-caab9bbf035b
Christian Clegg
[email protected]
City Manager
City of Bakersfield
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 75.113.167.51
Sent: 5/30/2025 7:25:30 AM
Viewed: 5/30/2025 9:06:25 AM
Signed: 5/30/2025 9:11:45 AM
Electronic Record and Signature Disclosure:
Accepted: 5/30/2025 9:06:25 AM
ID: ae9f374f-3a2b-41f5-bb6d-f17e6336726e
Jena Covey
[email protected]
RISK MANAGER
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 174.46.226.5
Sent: 5/30/2025 9:11:47 AM
Viewed: 6/3/2025 2:19:37 PM
Signed: 6/3/2025 2:19:58 PM
Electronic Record and Signature Disclosure:
Accepted: 6/3/2025 2:19:37 PM
ID: 08f14a54-4b7c-4c61-b6da-bc590d1c82a7
In Person Signer Events
Signature
Timestamp
Editor Delivery Events
Status
Timestamp
Agent Delivery Events
Status
Timestamp
Intermediary Delivery Events
Status
Timestamp
Certified Delivery Events
Status
Timestamp
Carbon Copy Events
Status
Timestamp
Witness Events
Signature
Timestamp
Notary Events
Signature
Timestamp
Envelope Summary Events
Status
Timestamps
Envelope Sent
Hashed/Encrypted
5/19/2025 4:34:34 PM
Certified Delivered
Security Checked
6/3/2025 2:19:37 PM
Signing Complete
Security Checked
6/3/2025 2:19:58 PM
Completed
Security Checked
6/3/2025 2:19:58 PM
Payment Events
Status
Timestamps
Electronic Record and Signature Disclosure
ELECTRONIC RECORD AND SIGNATURE DISCLOSURE
From time to time, City of Bakersfield (we, us or Company) may be required by law to provide to you certain written notices or disclosures. Described below are the terms and conditions for providing to you such notices and disclosures electronically through the DocuSign system.
Please read the information below carefully and thoroughly, and if you can access this information electronically to your satisfaction and agree to this Electronic Record and Signature Disclosure (ERSD), please confirm your agreement by selecting the check-box next to ‘I agree to use electronic records and signatures’ before clicking ‘CONTINUE’ within the DocuSign system.
Getting paper copies
At any time, you may request from us a paper copy of any record provided or made available electronically to you by us. You will have the ability to download and print documents we send to you through the DocuSign system during and immediately after the signing session and, if you elect to create a DocuSign account, you may access the documents for a limited period of time (usually 30 days) after such documents are first sent to you. After such time, if you wish for us to send you paper copies of any such documents from our office to you, you will be charged a $0.00 per-page fee. You may request delivery of such paper copies from us by following the procedure described below.
Withdrawing your consent
If you decide to receive notices and disclosures from us electronically, you may at any time change your mind and tell us that thereafter you want to receive required notices and disclosures only in paper format. How you must inform us of your decision to receive future notices and disclosure in paper format and withdraw your consent to receive notices and disclosures electronically is described below.
Consequences of changing your mind
If you elect to receive required notices and disclosures only in paper format, it will slow the speed at which we can complete certain steps in transactions with you and delivering services to you because we will need first to send the required notices or disclosures to you in paper format, and then wait until we receive back from you your acknowledgment of your receipt of such paper notices or disclosures. Further, you will no longer be able to use the DocuSign system to receive required notices and consents electronically from us or to sign electronically documents from us.
All notices and disclosures will be sent to you electronically Electronic Record and Signature Disclosure created on: 6/28/2022 10:51:05 AM Parties agreed to: Richard Ward, Christian Clegg, Jena Covey Unless you tell us otherwise in accordance with the procedures described herein, we will provide electronically to you through the DocuSign system all required notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you during the course of our relationship with you. To reduce the chance of you inadvertently not receiving any notice or disclosure, we prefer to provide all of the required notices and disclosures to you by the same method and to the same address that you have given us. Thus, you can receive all the disclosures and notices electronically or in paper format through the paper mail delivery system. If you do not agree with this process, please let us know as described below. Please also see the paragraph immediately above that describes the consequences of your electing not to receive delivery of the notices and disclosures electronically from us.
How to contact City of Bakersfield:
You may contact us to let us know of your changes as to how we may contact you electronically, to request paper copies of certain information from us, and to withdraw your prior consent to receive notices and disclosures electronically as follows:
To contact us by email send messages to: [email protected]
To advise City of Bakersfield of your new email address To let us know of a change in your email address where we should send notices and disclosures electronically to you, you must send an email message to us at [email protected] and in the body of such request you must state: your previous email address, your new email address. We do not require any other information from you to change your email address.
If you created a DocuSign account, you may update it with your new email address through your account preferences.
To request paper copies from City of Bakersfield
To request delivery from us of paper copies of the notices and disclosures previously provided by us to you electronically, you must send us an email to [email protected] and in the body of such request you must state your email address, full name, mailing address, and telephone number. We will bill you for any fees at that time, if any.
To withdraw your consent with City of Bakersfield
To inform us that you no longer wish to receive future notices and disclosures in electronic format you may:
i. decline to sign a document from within your signing session, and on the subsequent page, select the check-box indicating you wish to withdraw your consent, or you may; ii. send us an email to [email protected] and in the body of such request you must state your email, full name, mailing address, and telephone number. We do not need any other information from you to withdraw consent.. The consequences of your withdrawing consent for online documents will be that transactions may take a longer time to process..
Required hardware and software
The minimum system requirements for using the DocuSign system may change over time. The current system requirements are found here: https://support.docusign.com/guides/signer-guide- signing-system-requirements.
Acknowledging your access and consent to receive and sign documents electronically To confirm to us that you can access this information electronically, which will be similar to other electronic notices and disclosures that we will provide to you, please confirm that you have read this ERSD, and (i) that you are able to print on paper or electronically save this ERSD for your future reference and access; or (ii) that you are able to email this ERSD to an email address where you will be able to print on paper or save it for your future reference and access. Further, if you consent to receiving notices and disclosures exclusively in electronic format as described herein, then select the check-box next to ‘I agree to use electronic records and signatures’ before clicking ‘CONTINUE’ within the DocuSign system.
By selecting the check-box next to ‘I agree to use electronic records and signatures’, you confirm that:
You can access and read this Electronic Record and Signature Disclosure; and You can print on paper this Electronic Record and Signature Disclosure, or save or send this Electronic Record and Disclosure to a location where you can print it, for future reference and access; and
Until or unless you notify City of Bakersfield as described above, you consent to receive exclusively through electronic means all notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you by City of Bakersfield during the course of your relationship with City of Bakersfield.