1 ( . . )
CITY OF STOCKTON
STANDARD AGREEMENT
1. This Agreement is entered into between the City of Stockton and Contractor to provide
as set forth in Exhibit A to this Agreement.
_____________________________________________________________________________
2. The term of this Agreement is as follows, unless amended as described in Exhibit A and Exhibit C section 8:
Commences on: Terminates on:
_____________________________________________________________________________
3. The maximum not to exceed amount to be paid to Contractor for the term of this Agreement, including if authorized, reimbursement of expenses, is: $
4. The complete Agreement consists of all the following Agreement documents which by reference are incorporated and made a part of this Agreement. The parties agree to comply with the terms and conditions of this Agreement.
____________________________________________________________________________ IN WITNESS WHEREOF, the authorized parties have executed this Agreement.
CONTRACTOR
______________________________________________________________________________________________ Name (if other than an individual, state whether a corporation, partnership, etc.):
______________________________________________________________________________________________ Authorized Signature Date
CITY OF STOCKTON
_________________________________________________________ ________________ City Manager Date
ATTEST:
____________________________________________________________________________ , City Clerk
APPROVED AS TO FORM:
, City Attorney
BY:
Agreement Number:
(a) Exhibit A Statement of Work
(b) Exhibit B Insurance
(c) Exhibit C General Terms Conditions
(d) Exhibit D
Exhibit E Compensation Schedule
(f) Exhibit F Timeline
George Hills Company, Inc. General Liability Administration 10/01/2025 10/01/2030
2,504,768.64
Professional Services Special Terms & Conditions
George Hills Company, Inc.
ATTACHMENT A
1 ______________________________________________________________________________________________John Chaquica, President Printed Name and Title of Person Signing
___________________________________________________________________________________________PO Box 278, Rancho Cordova, CA 95741; [email protected] Address
8/21/25
2.0 SCOPE OF SERVICES
The selected TPA (proponent) awarded the contract shall operate under the general direction of the City’s Risk Manager and consult with other City staff in developing effective procedures and practices
to successfully administer the City’s third-p arty property and liability claims along with administering the City’s first party property subrogation and restitution services to recover
costs from third parties. The TPA shall perform all services and related work necessary
for program administration, claims administration, subrogation, claims investigations, reporting to the City’s risk pool, Medicare reporting, reserving, settlements, litigated files
management, and all other related documentation. TPA services shall include the City’s major programs, but are not limited to: general, automobile, and property liability claims administration, investigations, research, analysis, recording, reporting, subrogation, litigation management, liability trust
account management and reconciliation,
and related support services. The City will retain management of litigated claims but may call upon TPA
to assist in these areas on a case-b y-case basis; a dedicated claims examiner is preferred.
The selected proponent
shall work with Public Risk Innovation, Solutions , and Management (PRISM) for the
entirety of the contract and adhere to their Addendum B Liability Claims Administration Standards found at the following link: https://www.prismrisk.gov/about- prism/prism-documents/claims/standards/addendum-b-liability/. i. Program Administration
The selected TPA shall:
1. Consult with the City and provide professional and technical staff to assist in developing the necessary procedures and practices to implement and administer the City's self-insured program, including administering all open and closed indemnity, subrogation, and restitution claims.
2. Convert the data from the data system of the present administrator to selected TPA’s data system as the City wishes to maintain and integrate all claims into its current statistical base. Please indicate if there is a charge to convert loss data for all incurred claims, both open and closed files and the amount of that charge.
3. Follow the Records Retention Policy established and approved by the City. All files, records, transcripts including loss run data base files and other materials related to the management and administration of City's General Liability Program
EXHIBIT A
STATEMENT OF WORK
ATTACHMENT A
2 are the exclusive property of the City of Stockton and must be relinquished in good order and condition upon termination of the Agreement with the selected TPA. Selected TPA shall make files available for review by the City anytime during regular business hours. Selected TPA shall provide copies of file correspondence and documentation as requested by the City.
4. Maintain a master file of claims administration policies, practices and guidelines, and any other material needed to properly administer claims in accordance with applicable state law and City instructions.
5. Provide City's General Liability Analyst and City Attorney’s Office with user connections (and software if applicable) on City's existing personal computer, to allow database inquiry access and e-mail capability to TPA's claim processing system. System should allow diary to be set by City’s Analyst to follow up on pending issues as needed.
6. Conduct or assist in onsite or offsite training as needed for City personnel involved directly or indirectly in the processing of general liability, subrogation or restitution cases. Inform the City of changes or proposed changes in statutes, rules, regulations, and case law affecting its general liability claims program.
7. Periodically update all form letters used in connection with claim processing.
The City of Stockton reserves the right to approve and disapprove all forms and form letters.
8. Represent City in all matters related to the set -up, investigation, adjustment, processing, negotiation, and resolution of liability claims against City.
9. Provide accur ate, appropriate claims handling in a timely manner, according to agreed upon performance standards and state requirements.
10. Provide the City with written information on changes or proposed changes in statu
tes, rules and regulations affecting the City's responsibility under a legally self-insured General Liability Program.
11. Inform the City of problem areas or trends, both potential and perceived, and provide recommendations and/or solutions to address problem areas or trends.
Matters of significance must be called to the City's attention at the earliest appropriate time (i.e., disgruntled employees, system problems, large overpayments, large reserve changes, etc.).
12. Attend client m eetings as requested by the City of Stockton . TPA's travel expenses in connection with client meetings or other matters relating to claims processing shall be paid by the TPA.
13. Attend appointments, including but not limited to meetings, conferences, court appearances,
and scene investigations at the request of the City.
14. Install and/or utilize any necessary automated claims administration systems. TPA shall have ability to integrate with external/third party system, including imports of claims financial data, transaction details, and adjusters’ notes from TPA and carriers, as well as exports of financial transaction data and imports to capture payment details from City’s Enterprise Resource Planning System (ERP) and/or Accounts Payable systems (e.g., Central Square HTE, Tyler, Klear.ai, etc.), among other data feeds.
15. Transfer records and systems to the succeeding Administrator at the termination of the contract with no additional cost or fee required.
16. Administrative fees should cover the cost of TPA’s staff; all office space; storage space for closed files; supplies; forms/posters/pamphlets; standard management reports; telephone expenses; postage; checks (if utilizing TPA’s own checking account); computer hardware/software; transcription services; and other equipment/supplies necessary for claims handling.
ATTACHMENT A
3 ii. Claims Adm
inistration
Selected TPA shall:
1. Only ut
ilize outside expert services or subcontractors with prior approval from the City. City reserves the right to approve, disapprove, or select all service providers and vendors selected by TPA.
2. Ensure every file contains a Plan of Action, quarterly litigation budgets and the steps to accomplish it. The Plan of Action should be updated during each diary review. Files should be clearly documented, with claim notes reflecting ongoing file activity. All conversations and issues should be documented.
3. Provide professional and courteous responses t o receipt of telephone calls, written or in person inquiries, complaints and questions from all sources within 48 hours of receipt. Such inquiries may include claim payment or benefit related questions from parties with authorized access to information, such as claimants, vendors, providers, legal counsel, the City of Stockton, etc.
4. Ensure all claims management adhere to the requirements of the California Governmen
t Code for accepting, denying, and rejecting claims.
5. At the direction of the City, contact claimants or their attorneys within five (5) business days of receipt of a claim and maintain appropriate contact with them until the claim is closed.
6. Review the status of claims and assist as directed with setting adequate reserves on all acti
ve cases at least every ninety (90) calendar days.
7. Review all claims for liability and provide first investigative report within thirty (30) calendar days of receipt of claim to City’s Risk Services Division.
8. Provide narrative reports when recommending rejection or settlement of a claim, w
hen going to trial, or other significant events occur. Reports must be clear and concise.
9. Negotiate settlements within authority limits provided by City. Funding for the payment of any settlement is specifically excluded from this agreement.
10. Report claims in compliance with Medicare, Medicaid, and SCHIP Extensi on Act
(MMSEA) Section 111. Notify the City when reports for the MMSEA Section 111 require signature.
11. Process payments within authority levels provided by City within fourteen (14) business day
s.
12. File all supporting documentation for payments made in the appropriate claim file
.
13. Provide monthly reports for the following open and closed liability claims; general liability, date excess sent, open litigated, and injury year detail by department.
14. Provide weekly reports for open and closed liability claims.
15. Provide weekly reserve change report.
16. Checking: follow the banking requirements of the City, such as establishing, maintaining, and reconciling an interest-bearing checking account with appropriate deposit and transfer procedures for the payment of claims; or if utilizing a City of Sto c kton checking account, provide monthly records of financial transactions to coordinate with City's computer or ERP system, or make other claims payment arrangements which are acceptable to the City. The TPA claims administrator will maintain check registers and provide a monthly check register to the City, along with a copy of all checks and vouchers.
ATTACHMENT A
4 17. Reserve Adequacy and Accuracy: Maintain reserves for each file to reflect the probable future liability of a claim as required by Title 8, California Code of Regulation, Section 15300. Reserve calculations should be accurate and adjusted as facts change. Detailed reserve worksheet calculations to be retained in claim file.
18. Provide any required federal or state financial or tax reports. Provide appropriate information, documentation and cooperation to the State of California or City of Stockton Auditor upon request.
19. Reconcile all claim file payments twice per year, and upon settlement and file closure. Proof of resolution should remain in claim file.
20. Overpayments/Errors: Any overpayments/incorrect payments should be reported to the City immediately, along with diligent efforts to collect all overpayment and resolve any other incorrect payments.
21. Diary dates shall be established to allow for timely completion of required activity and no less frequently than every sixty (60) calendar days. TPA shall monitor the timely completion of diary notes.
22. All correspondence shall be addressed within 48 hours of receipt unless an immediate response is required.
23. Written responses to requests that cannot be emailed shall be mailed within ten (10) business days of receipt, unless an immediate response is required.
24. Identify and notify co-defendants w
ithin thirty (30) calendar days of identification.
25. Have translators available to assist with non-English speaking claimants. iii. Subrogati
on
TPA shall:
1. Place the
tortfeasor on notice of the City’s subrogation rights; and
2. Work with the Risk Services division to draft legal documents to recover monies spent on claims.
3. Aggressively invest igate fraud and pursue restitution in all fraud cases. The City shall be notified of all claims involving potential fraud and initiation of fraud investigation activities.
4. Provide subrogation services to recover costs from third parties (responsible persons, agencies, insurers, and/or their agents) responsible for employees, volunteers, inmates, etc., injuries, up to the point necessitating legal counsel. The Administrator will give prompt notice to Risk Services for each case indicating a potential for subrogation.
5. Subrogation efforts on injuries in which there is also property loss to the City shall be coordinated by the Administrator. Subrogation notices and action against another party require advance authorization from the City. If subrogation action develops problems or unreasonable delays, the matter is to be referred to and reviewed by Risk Services for referral to City designated Counsel for legal action.
6. If the third party needs to be sent to collections, approval must be obtained from Risk Services.
7. Provide monthly and weekly open and closed reports on amounts recovered for subrogation and restitution.
8. Provide weekly subrogation reserve change report.
9. Pursue small claims actions. Litigation in civil court beyond small claims court requires specific authority from the City (this may be City Counsel, Risk Manager, etc.). Settlement authority for less than full amount claimed by TPA requires City’s
ATTACHMENT A
5 Analyst or Risk Manager’s prior approval.
iv. Claims Inves
tigation
TPA shall:
1. Within ten (10
) business days of receipt of claim, unless otherwise requested by City Risk Manager, take statement of facts from claimants when not represented by an attorney. Statements will be preserved by recording or taking hand- written signed statements.
2. Investigate claims where the initial review indicates that it is warranted. Further investigation may include, but is not limited to, on-sight investigation, photographs, interviewing witnesses and taking signed or recorded statements, verification of damage or loss, taking measurements, obtaining maps/diagrams from the City or other sources, obtaining medical releases, police reports, or other records as required.
3. Complete initial investigation answering questions such as who, what, where, when and why. Investigations shall be completed within forty-five (45) days of the Member’s knowledge of claim, including statements from participants and witnesses, appropriate official reports, investigative reports, site inspections, relevant documents and photos/videos.
4. Identify liability issues, including immunities, comparative negligence, joint tortfeasors and joint and several liability.
5. Initiate the development of information on damages including, but not limited to:
1. Property damage
2. Nature and extent of injuries
3. Medical costs (billed and paid)
4. Lost wages (past and future)
5. Other economic damages
6. Non-economic damages
6. Obtain and review relevant contracts and insurance documents, to determine whether there is any sharing or complete transfer of the risk.
1. Hold-harmless and/or indemnity agreements
2. Additional insured requirements
7. Ensure proper preservation of evidence.
8. Evaluate the need to utilize experts.
1. All bodily injury claims shall be initially reported to the Index Bureau and re-indexed on an as needed basis thereafter. ( PRISM maintains a membership with the Index Bureau that members can access).
9. Secure estimates or appraisals for damaged property.
10. All notices (pertaining to claim insufficiency, returning late claims, claims rejections, etc.) shall be done in accordance with the relevant Governmental Code provisions.
v. PRISM Report
ing Requirements
TPA shall:
1. First Report
The T
PA shall give PRISM immediate written notice for any claims or suits which the TPA becomes aware of that include injury of the following types:
ATTACHMENT A
6 • Death
• Paralysis, paraplegia, quadriplegia
• Loss of eye(s), or limbs
• Spinal cord or brain injury
• Dismemberment or amputation
• Sensory organ or nerve injury or neurological deficit • Serious burns
• Severe scarring
• Sexual assault or battery including but not limited to rape, molestation or sexual abuse
• Substantial disability or disfigurement
• Any class action
• Any claim or suit in which PRISM is named as a defendant; or • Any injury caused by lead.
Additional
ly, the TPA must report to PRISM any occurrence, offense, or wrongful act in which the amount incurred has reached $500,000.
Utiliz
e the current First Report Potential Excess Liability Claims form, available through PRISM’s website, and transmit to PRISM by email to [email protected]..
First report f
orms shall, at a minimum, include the following:
• Entity name
• Entity’s claim number
• Defense counsel’s name and firm name
• Lead Claimant’s first and last name
• Specific date of loss
• Brief description of the incident
• Established reserves for indemnity, litigation, and expense
2. Status Repor
ts
After the First Report to PRISM, status reports shall be provided by the TPA at a minimum of every ninety (90) days (more frequently if warranted). Status reports shall focus on changes in liability analysis, damages, and reserves.
3. Photos, diagrams, estimates, statements, contracts, medical, law enforcement and coroner's reports (where applicable), claim forms, lawsuits (including amended complaints), motions for summary judgment, demurrers, dismissals, appellate briefs and orders/rulings/judgments shall be in the claims file, and provided to PRISM, within ninety (90) days of receipt of the material.
4. Closure Reports
When a claim or suit that has been reported to PRISM is settled, dismissed or closed in any other fashion, PRISM shall be provided with the closing documents and an accounting of the final paid amounts on the exposure for indemnity, litigation, and expense within 90 days from the day the final defense bill is paid. vi. Medicare Repor
ting
ATTACHMENT A
7 1. Proper verification of a claimant’s status as to Medicare eligibility shall be completed and documented in every file involving a bodily injury. In those cases where the claimant does meet the eligibility requirements, mandatory reporting to the Center for Medicare and Medicaid Services (CMS) must be completed directly or through a reporting agent in compliance with State Children’s Health Insurance Program (SCHIP) Section 111 of the Medicare Medicaid and SCHIP Extension Act of 2007.
vii. Reserving
Each claim should be reviewed and evaluated according to the merits of the claim and based upon the most current and reliable information received, starting with the initial report of claim and continuing through final resolution. Delays result in understated reserves and, possibly, missed opportunities to settle.
1. An accurate and
appropriate initial indemnity reserve shall be established on all reportable claims based on facts known, upon completion of the initial investigative report or when suit is filed, whichever occurs first. In addition, separate legal and adjusting reserves shall be established.
Indemnity reser
ves shall reflect the most probable outcome plus exposure to plaintiff attorney’s fees and costs.
Most probable out
come is the potential total amount a plaintiff could expect to receive, either through settlement or verdict, after factoring in the Member’s percentage of liability. (This approach is neither the best or worst case outcome).
Factors to
consider when evaluating the potential total settlement or verdict a plaintiff could expect to receive include but are not limited to:
• Extent of injuries and/or damages
• Medical expenses
• Loss of income
• Any other related expenses
• Future anticipated expenses
• Total of both gross and out-of-pocket expenses
• Permanent injury
• Disfigurement/scarring
• Pain and suffering
• Any other intangible factors which may result in a higher or lower claim value such as jurisdiction, credibility of
parties/witnesses, etc.
Percentage of liability is determined by various factors that are discovered during an investigation. Reserves shall be adjusted accordingly, as facts are developed, to properly reflect the exposure. These factors include but are not limited to:
a. Facts of loss
b. Applicable laws
c. Defense Counsel evaluations
ATTACHMENT A
8 d. Jury Verdict evaluation
e. The extent of plaintiff's liability (comparative negligence) f. The number of co-defendants and their percentage of liability g. The ability of the co -defendants to respond financially to any settlement or verdict.
h. On cases occurring after June 3, 1986, Proposition 51 allows defendants to limit their liability on non-economic damages to their percentage of fault.
i. On cases involving uninsured motorist claimants the recovery is limited to economic damages in accordance with California Code of Civil Procedures sections 3333.3 and 3333.4 (Prop 213).
j. Any other mitigating factors
2. Reserves shall be set at the most probable outcome even if it exceeds the Member’s Self-Insured Retention. In all litigated Excess reportable cases, the Member shall set a meaningful indemnity reserve.
3. Reserves shall be evaluated for adequacy at least every ninety (90) days. All reserve changes shall be documented in a paper or electronic file providing explanation of the reason for the reserve change or notation that the current reserve is adequate and why. PRISM shall be notified of all reserve changes within thirty (30) days of the change being made.
viii. Documentat
ion
1. Each file shall contain information necessary to document the decisions made, including all demands, offers of settlement and settlement authority.
For those c
ases in which the (1) Bodily Injury claims reserved above twenty - five (25) percent of the S.I.R., (2) Property Damage claims reserved above twenty -five (25) percent of the S.I.R., and (3) All claims that meet PRISM’s excess reporting requirements regardless of reserves, the following information shall be contained in each file:
1. Claimant(s) Information
2. Date of Loss
3. Claim Number
4. Facts of accident or occurrence
5. Witness/Participant Statement
6. Reserve rationale
7. Assessment of liability
8. Damages/injuries, including medical costs, lost wages, dependency, property damage estimates, total loss evaluations, loss of use claims, and other damages
9. Index Bureau reporting
10. Coverage questions
11. Excess potential
12. Structured Settlement possibilities (where applicable)
13. Alternative Dispute Resolution
ATTACHMENT A
9 14. Subrogation potential (where applicable)
15. Governmental Code compliance and immunities
16. Future course of action
17. Next diary date
18. If litigated, identify counsel on both sides
19. Offsets or liens that may need to be considered
20. Medicare eligibility and reporting
21. Risk and insurance transfer
ix. Case Settl
ement Factors
1. Settlement evaluation and authority by the Member shall be documented. On cases exceeding the S.I.R., prior written settlement authority must be obtained from PRISM.
2. Ensure PRISM’s endorsement outlining the requirement for settlement within the City’s SIR is followed.
3. The settlement shall be reasonable in light of damages, injuries, liability, and any obligations to Medicare.
4. Settlements shall be effected in a timely manner, with consideration given to structures, statutory offers (Rule 68 or 998) where applicable, and/or alternative dispute resolution.
5. When settlements reach PRISM’s layer, the TPA examiner will make sure authority will be obtained prior to the settlement, working directly with the City and PRISM obtaining written authority from the City and PRISM.
6. Contributions from joint tortfeasors shall be considered.
7. Proper releases and dismissals shall be secured and copies provided to PRISM. x. Litigated Fi
les
The City of Stockton’s City Attorney (CA) shall retain the litigation management function.
The TPA shall as
sist in the implementation and conform to the procedures pursuant to the Litigation Management Program. The duties of the TPA shall include, but not be limited to:
1. Within 45 days following assignment, ensure defense counsel has submitted a preliminary evaluation of the lawsuit including a litigation plan and budget.
2. Ensure defense counsel submits status reports every 90 days to include new developments only. Routine submission of repetitive, non- substantive status reports is not acceptable.
3. Coordinate with defense counsel to properly follow up on investigation/discovery requests, obtaining expert witness, complete field investigation, notifying relevant employees and other parties regarding pending litigation, etc.
4. Ensure all defense expenses, including but not limited to, depositions, motions, and discovery have been approved by the City Attorney.
5. No later than 30 days before trial, confirm defense counsel has submitted a report which includes:
a. An assessment of the Member’s liability exposure.
b. An assessment of the plaintiff’s damages.
c. An assessment of the legal defenses and probability of prevailing, including significant arguments of each party and expected counter arguments. d. Unique characteristics of the jurisdiction, presiding judge and opposing counsel.
ATTACHMENT A
10 e. The verdict value assuming full liability.
f. Settlement value, considering defendant’s liability exposure and chances of prevailing.
g. Status of settlement discussions.
6. Attend mediation, ar
bitration, settlement conferences on behalf of the City when necessary.
7. Evaluate defense counsel with respect to each defense assignment.
8. Ensure all attorney fees are billed at the agreed hourly rate. All bills shall state with particularity the legal work performed, the hours expended to perform the work and the costs incurred.
9. Audit all bills to make certain the billing practices are in conformance with the City’s litigation guidelines
xi. Claims Management In
formation System (CMIS)
TPA shall:
1. Convert all open and closed cl
aims data and enter new claims data into the TPA’s CMIS.
2. Record all claims in a CMIS. Claims records must contain all pertinent claim information, including but not limited to claim number, date of loss, date of claim, claimant name and address, location of loss, description of incident, loss reserves, loss payments, and expense reserves.
3. TPA must create a review system to ensure accurate data will be entered into the CMIS.
All claims must be reviewed on a periodic basis, as determined by the City. The review system must include a check on all the financial documentation entered into the CMIS to ensure the financial integrity of the system. In addition, the review system must include appropriate claims handling and reserving procedures, and timely file closures.
4. TPA shall use electronic notes in the CMIS to record activity which shall be updated with new developments. All significant documents (e.g., email communications, status updates from counsel, etc.) will be scanned/saved into the database by TPA.
5. TPA shall provide CMIS training, support, and access for up to three (3) City Risk Services staff so that they may search for claim information and data, as required.
6. Provide specified standard loss reports as agreed upon.
7. Provide special reports as needed by the City.
8. Provide data transfer services to the City’s Risk Information Management System (RMIS).
xii. Term.
The term of this Contract shall begin on the execution date and continue for a period of five (5) years. This Contract may be extended up to two (2) additional years, for a maximum of seven (7) years. All Contract extensions must be agreed upon in writing by issuance of a Task Order.
ATTACHMENT A
11 Exhibit B:
Insurance Requirements for Professional Services
(Third-Party Claims Administrator)
Consultant
shall procure and maintain for the duration of the contract insurance against claims for injuries to persons or damages to property which may arise from or in connection with the performance of the work hereunder by the Consultant, its agents, representatives, or employees.
MINIMUM SCOPE A
ND LIMIT OF INSURANCE
Coverage
shall be at least as broad as:
1. Commercial General Liability (CGL): Insurance Services Office Form CG 00 01, or a form in common use in the insurance industry and which are acceptable to the City after review, covering CGL on an “occurrence” basis, i ncluding products and completed operations, property damage, bodily injur y and personal & advertising injury with limits no less than $2,000,000 per occurrence. If a general aggregate limit applies, either the general aggregate limit shall apply separately to thi s project/location (ISO CG 25 03 or 25 04, or a form in common use in the insurance industry and which are acceptable to the City after review.) or the general aggregate limit shall be twice the required occurrence limit.
2. Automobile Liability: Insurance Services Office Form Number CA 0001, or a form in common use in the insurance industry and which are acceptable to the City after review, covering Code 1 (any auto), or if Consultant has no owned autos, Code 8 (hired) and 9 (non-owned), with limit no l ess than $1,000,000 per accident for bodily injury and property damage.
3. Workers’ Compensation insurance as required by the State of California, with Statutory Limits, and Employer’s Liability Insurance with limit of no less than $1,000,000 per accident for bodily injur y or disease.
4. Professional Liability (Errors and Omissions) Insurance appropriates to the Consultant’s profession, wi th limit no l ess than $2,000,000 per occurrence or claim, $2,000,000 aggregate.
5. Crime/Fidelity Bond – Insurance no less than $1,000,000 per occurrence, covering all officers and employees, for loss o f proceeds caused by dishonesty.
Any avai lable insurance proceeds in excess of the specified minimum limits of insurance and coverage shal l be available to the City of Stockton by the Consultant.
ATTACHMENT A
12 REV 2025-06-04
Other Insurance Provisions
The insurance policies are to contain, or be endorsed to contain, the following provisions:
Additional Insured Status
The City of Stockton, its officers, officials, employees, and volunteers are to be covered as additional insureds on the CGL policy with respect to liability arising out of work or operations performed by or on behalf of the Consultant including materials, parts, or equipment furnished in connection with such work or operations. General liability coverage can be provided in the form of an endorsement to the Consultant’s insurance (at least as broad as ISO Form CG 20 10 11 85 or if not available, through the addition of both CG 20 10, CG 20 26, CG 20 33, or CG 20 38; and CG 20 37, or a form in common use in the insurance industry and which are acceptable to the City after review). Additional insured Name of Organization shall read “City of Stockton, its officers, officials, employees, and volunteers.” Policy shall cover City of Stockton, its officers, officials, employees, and volunteers for all locations work is done under this contract.
Primary Coverage
For any claims related to this contract, the Consultant’s insurance coverage shall be primary and non-contributory and at least as broad as ISO CG 20 01 12 19, or a form in common use in the insurance industry and which are acceptable to the City after review as respects the City of Stockton, its officers, officials, employees, and volunteers. Any insurance or self-insurance maintained by the City of Stockton, its officers, officials, employees, or volunteers shall be excess of the Consultant’s insurance and shall not contribute with it. This requirement shall also apply to any Excess or Umbrella liability policies. The City of Stockton does not accept endorsements limiting the Contractor’s insurance coverage to the sole negligence of the Named Insured.
Umbrella or Exce ss Policy
The Consultant may use Umbrella or Excess Policies to provide the liability limits as required in this agreement. The policies shall be provided on a true “following form” coverage basis, with coverage at least as broad as provided on the underlying Commercial General Liability insurance.
Notice of Cancellation
Each insurance policy required above shall provide that coverage shall not be canceled, except with notice to the City of Stockton. Consultant will provide notice to the City within five (5) business days of receipt by Consultant of any notice of cancellation pertaining to any insurance policy required by this contract.
ATTACHMENT A
13 REV 2025-06-04
Waiver of Subrogation
Consultant hereby grants to City of Stockton a waiver of any right to subrogation which any
insurer of said Consultant may acquire against the City of Stockton by virtue of the payment of any loss under such insurance. This applies to the Commercial General Liability, Commercial Auto Liability, and Workers’ Compensation policies.
Consultant agrees to obtain any endorsement that may be necessary to affect this waiver of subrogati
on, but this provision applies regardless of whether or not the Ci ty of Stockton has recei ved a waiver of subrogation endorsement from the insurer.
Self-Insured Retentions
Self-insured retentions must be declared to and approved by the City of Stockton. The City of Stockton may require the Consultant to purchase coverage with a lower retentio
n or provide proof of ability to pay losses and related expenses within the retention. The policy language shall provide, or be endorsed to provide, that the self- insured retention may be satisfied by either the named insured or City of Stockton.
Acceptability of Insurers
Insurance is to be placed with insurers authorized to conduct business in the state with a current A.M. Best’s rating of no less than an A-, unless otherwise acceptable to the City of Stockton.
Claims Made Policies (Professional & Pol lution only)
If any of the required policies provide claims-made coverage:
1. The Retroactive Date must be shown and must be before the date of the contract or the beginning of contract work.
2. Insurance must be maintained and evidence of insurance must be provided for at least five (5) years after completion of the contract of work .
3. If coverage is canceled or non-renewed, and not replaced with another claims -made policy form with a Retroactive Date prior to the contract effective date, the Consultant must purchase “extended reporting” coverage for a minimum of five (5) years after completion of work.
Verification of Coverage
Consultant shall furnish the City of Stockton with original certificates and amendatory endorsements or copies of the applicable policy language affecting coverage required by this clause All required documents are to be received and approved by the City of Stockton before work commences. However, failure to obtain the documents prior to the work beginning shall not waive the Consultant’s obligation to provide them. The City of Stockton reserves the right to require complete, certified copies of all required insurance policies, including endorsements, at any time.
Subcontractors
Consultant shall require and verify that all subcontractors maintain insurance meeting all the requirements stated herein, and Consultant shall ensure that City of Stockton is an additional insured on insurance required from subcontractors.
ATTACHMENT A
14 REV 2025-06-04
Duration of Coverage
CGL & Excess liability policies for any construction related work, including, but not limited to, maintenance, service, or repair work, shall continue coverage for a minimum of 5 years for Completed Operations liability coverage. Such Insurance must be maintained and evidence of insurance must be provided for at least five (5) years after completion of the contract of work .
Special Risks or Circumstances
City of Stockton reserves the right to modify these requirements, including limits, based on the nature of the risk, prior experience, insurer, coverage, or other special circumstances.
Certificate Holder Address
The address for mailing certificates, endorsements and notices shall be:
City of Stockton
Its Officers, Officials, Employees, and Volunteers
425 N El Dorado Street
Stockton, CA 95202
ATTACHMENT A
15 REV 2025-06-04
EXHIBIT C
GENERAL TERMS AND CONDITIONS
1. G
oods, Equipment and Services. Subject to the terms and conditions set forth in this Agreement, Contractor shall provide to City the services described in Exhibit A of the Agreement. Contractor shall provide said services at the time, place and in the manner specified in Exhibit A of the Agreement.
2. C
ity Assistance, Facilities, Equipment and Clerical Support. Except as set forth in Exhibit A, Contractor shall, at its sole cost and expense, furnish and maintain all facilities and equipment that may be required for furnishing services pursuant to this Agreement. If applicable, City shall furnish to Contractor only the facilities and equipment listed in Exhibit A to the Agreement.
3. C
ompensation. City shall pay Contractor for services rendered pursuant to this Agreement as described more particularly in Exhibit A and Exhibit E to the Agreement.
3.1 Invoices submitted by Contractor to City must contain a brief description of work performed, time spent and City reference number. Within thirty (30) days of receipt of Contractor’s invoice, City will review invoice, and if acceptable make payment on approved invoice.
3.2 Upon completion of work and acceptance by City, Contractor shall have sixty (60) days in which to submit final invoicing for payment. An extension may be granted by City upon receiving a written request thirty (30) days in advance of said time limitation. The City shall have no obligation or liability to pay any invoice for work performed which the Contractor fails or neglects to submit within sixty (60) days, or any extension thereof granted by the City, after the work is accepted by the City.
4. Sufficiency of Contractor’s Work . All Contractor services, work, and deliverables shall be performed in a good and workmanlike manner with due diligence in accordance with the degree of skill normally exercised by similar contractors supplying services and work of a similar nature, and in conformance with applicable laws, codes and professional standards. Contractor’s work shall be adequate and sufficient to meet the purposes of this Agreement.
5. Ownership of Work . All reports, work product, all other documents completed or partially completed by Contractor or its approved subcontractors, in performance of this Agreement, and if applicable, drawings, designs, and plan review comments shall become the property of the City. Any and all copyrightable subject matter in all materials is hereby assigned to the City and the Contractor and its approved subcontractors agree to execute 1 ATTACHMENT A
16 any additional documents that may be necessary to evidence such assignment. All materials shall be delivered to the City upon completion or termination of the work under this Agreement. If any materials are lost, damaged or destroyed before final delivery to the City, the Contractor shall replace them at its own expense. Contractor and its approved subcontractors shall keep materials confidential. Materials shall not be used for purposes other than performance of services under this Agreement and shall not be disclosed to anyone not connected with these services, unless the City provides prior written consent.
6. T
imeliness. Time is of the essence in this Agreement. Further, Contractor acknowledges that the failure of Contractor to comply with the time limits described in Exhibit A and Exhibit F may result in economic or other losses to the City.
7. C
hanges. Both parties to this Agreement understand that it may become desirable or necessary during the term of this Agreement for City to modify the scope of services provided for under this Agreement. Any material extension or change in the scope of work shall be discussed with City and the change and cost shall be memorialized in a written amendment to the original contract prior to the performance of the additional work. Until the amendment is so executed, City will not be responsible to pay any charges Contractor may incur in performing such additional services, and Contractor shall not be required to perform any such additional services.
8. A
mendment. No variation of the terms of this Agreement shall be valid unless an amendment is made in writing and signed by both parties.
9. C
ontractor’s Status.
9 .1 In performing the obligations set forth in this Agreement, Contractor shall have the status of an independent contractor and Contractor shall not be considered to be an employee of the City for any purpose. All persons working for or under the direction of Contractor are its agents and employees and are not agents or employees of City. Contractor by virtue of this Agreement, has no authority to bind or incur any obligation on behalf of City. Except as expressly provided in Exhibit A, Contractor has no authority or responsibility to exercise any rights or power vested in the City. No agent, officer or employee of the City is to be considered an employee of the Contractor. It is understood by both Contractor and City that this Agreement shall not be construed or considered under any circumstances to create an employer-employee relationship or a joint venture.
9.2 Contractor shall determine the method, details and means of performing the work and services to be provided by Contractor under this Agreement. Contractor shall be responsible to City only for the requirements and results specified in this Agreement and, except as expressly provided in this Agreement, shall not be subjected to City's control with 2 ATTACHMENT A
17 respect to the physical action or activities of Contractor in fulfillment of this Agreement.
Contractor has control over the manner and means of performing the services under this Agreement. If necessary, Contractor has the responsibility for employing other persons or firms to assist Contractor in fulfilling the terms and obligations under this Agreement.
9.3 If in the performance of this Agreement any third persons are employed by Contractor, such persons shall be entirely and exclusively under the direction, supervision and control of Contractor. All terms of employment including hours, wages, working conditions, discipline, hiring and discharging or any other term of employment or requirements of law shall be determined by the Contractor.
9.4 It is further understood and agreed that Contractor must issue W -2 forms or other forms as required by law for income and employment tax purposes for all of Contractor's assigned personnel under the terms and conditions of this Agreement.
10. Subcontractor.
10. 1 Subcontractors shall not be recognized as having any direct or contractual relationship with City. Contractor shall be responsible for the work of subcontractors, which shall be subject to the provisions of this Agreement. Subcontractors will be provided with a copy of the Agreement and be bound by its terms. Contractor is responsible to City for the acts and omissions of its subcontractors and persons directly or indirectly employed by them.
10.2 If in the performance of this Agreement any third persons are employed by Contractor, such persons shall be entirely and exclusively under the direction, supervision and control of Contractor. All terms of employment including hours, wages working conditions, discipline, hiring, and discharging or any other term of employment or requirement of law shall be determined by Contractor.
10.3 It is further understood and agreed that all Subcontractors must issue W-2 forms or other forms as required by law for income and employment tax purposes for all of Subcontractors personnel.
11. T
ermination.
11. 1 Termination for Convenience of City . The City may terminate this Agreement at any time by mailing a notice in writing to Contractor. The Agreement shall then be deemed terminated, and no further work shall be performed by Contractor. If the Agreement is so terminated, the Contractor shall be paid for the work actually completed at the time the notice of termination is received. 3 ATTACHMENT A
18 11.2 Termination for Convenience of Contractor . The Contractor may terminate this Agreement at any time by mailing a notice in writing to City. The Agreement shall then be deemed terminated, and no further work shall be performed by Contractor. If the Agreement is so terminated, the Contractor shall be paid for the work completed at the time the notice of termination is received.
11.3 Should either party default in the performance of this Agreement or materially breach any of its provisions, the other party, at that party’s option, may terminate this Agreement by giving written notification to the other party.
11.4 Funding- Non-Appropriation. It is mutually understood between the Parties that payment to the Contractor for performance shall be dependent upon the availability of appropriations by the City Council for the purposes of this Agreement. No legal liability on the part of the City for any payment may arise under this Agreement until funds are made available and until the Contractor has received funding availability, which will be confirmed in writing. If funding for any fiscal year is reduced or deleted, or if the City loses funding for any reason, the City, in its sole discretion, shall have the option to either (a) cause this Agreement to be canceled or terminated pursuant to applicable provisions of the Agreement; or (b) offer to amend the Agreement to reflect the reduced funding for this Agreement.
12. Non-Assignability. The Contractor shall not assign, sublet, or transfer this Agreement or any interest or obligation in the Agreement without the prior written consent of the City, and then only upon such terms and conditions as City may set forth in writing. Contractor shall be solely responsible for reimbursing subcontractors.
13. Indemnity and Mutual Hold Harmless. George Hills will defend, indemnify, and hold harmless the City of Stockton and its officers, officials, employees and volunteers from and against all claims, demands, actions, or causes of action arising directly or indirectly from the negligent action, conduct, or failure to act by George Hills' personnel (“Indemnity Event”), except that indemnity under this section does not apply with respect to any claim, demand, action, or cause of action arising out of the sole negligence or willful misconduct of the City. This right to indemnity shall not cover any claims in which there is a failure to give George Hills prompt and timely notice, within thirty (30) days of notice received by the City which implicates this provision, but only if and to the extent that such failure materially prejudices the defense of such claims. For an Indemnity Event, the maximum amount recoverable by City against George Hills for damages and costs (inclusive of attorneys’ fees) is limited to the insurance policy limits, of the policy which covers the Indemnity Event held by George Hills, in place at the time of the Indemnity Event.
4 ATTACHMENT A
19 City will defend, indemnify, and hold harmless GH, and/or employees of GH, from and against all claims, demands, actions, or causes of action, which may arise, from the action, conduct, or failure to act by City. In any cases subject to this indemnity provision, wherein GH, or any employee of GH, is named in a filed or verified complaint simply by virtue of the fact it is the claims administration firm, or an employee thereof, on a given claim, the City will defend GH, and/or its employees, at no cost to GH or its employees.
14. Insurance. During the term of this Agreement, Contractor shall maintain in full force and effect at its own cost and expense the insurance coverage as set forth in the attached Exhibit B to this Agreement and shall otherwise comply with the other provisions of Exhibit B to this Agreement.
15. Notices. All notices herein required shall be in writing and shall be sent by certified or registered mail, postage prepaid, addressed in Exhibit A to this Agreement.
16. Conformance to Applicable Laws . Contractor shall comply with all applicable Federal, State, and Municipal laws, rules, and ordinances. Contractor shall not discriminate in the employment of persons or in the provision of services under this Agreement on the basis of any legally protected classification, including race, color, national origin, ancestry, sex or religion of such person.
17. Licenses, Certifications and Permits. Prior to the City’s execution of this Agreement and prior to the Contractor’s engaging in any operation or activity set forth in this Agreement, Contractor shall obtain a City of Stockton business license, which must be kept in effect during the term of this Agreement. Contractor covenants that it has obtained all certificates, licenses, permits and the like required to perform the services under this Agreement. Such licenses, certificates and permits shall be maintained in full force and effect during the term of this Agreement.
18. Records and Audits . Contractor shall maintain all records regarding this Agreement and the services performed for a period of three (3) years from the date that final payment is made. At any time during normal business hours, the records shall be made available to the City to inspect and audit. To the extent Contractor renders services on a time and materials basis, Contractor shall maintain complete and accurate accounting records, in a form prescribed by City or, if not prescribed by City, in accordance with generally accepted accounting principles, such records to include, but not be limited to, payroll records, attendance cards, time sheets, and job summaries.
19. Confidentiality. Contractor shall exercise reasonable precautions to prevent the unauthorized disclosure and use of City reports, information or conclusions.
5 ATTACHMENT A
20 20. C
onflicts of Interest . Contractor covenants that other than this Agreement, Contractor has no financial interest with any official, employee or other representative of the City. Contractor and its principals do not have any financial interest in real property, sources of income or investment that would be affected in any manner of degree by the performance of Contractor’s services under this Agreement. If such an interest arises, Contractor shall immediately notify the City.
21. W
aiver. In the event either City or Contractor at any time waive any breach of this Agreement by the other, such waiver shall not constitute a waiver of any other or succeeding breach of this Agreement, whether of the same or of any other covenant, condition or obligation. No payment, partial payment, acceptance, or partial acceptance by City shall operate as a waiver on the part of City of any of its rights under this Agreement.
22. G
overning Law . California law shall govern any legal action pursuant to this Agreement with venue for all claims in the Superior Court of the County of San Joaquin, Stockton Branch or, where applicable, in the Federal District Court of California, Eastern District, Sacramento Division.
23. N
o Personal Liability . No official or employee of City shall be personally liable to Contractor in the event of any default or breach by the City or for any amount due Contractor.
24. S
everability. If any portion of this Agreement or application thereof to any person or circumstance shall be declared invalid by a court of competent jurisdiction or if it is found in contravention of any federal, state or city statue, ordinance or regulation the remaining provisions of this Agreement or the application thereof shall not be invalidated thereby and shall remain in full force and effect to the extent that the provisions of this Agreement are severable.
25. Non-Discrimination. During the performance of this Agreement, Contractor and its officers, employees, agents, representatives or subcontractors shall not unlawfully discriminate in violation of any federal, state, or local law, rule or regulation against any employee, applicant for employment or person receiving services under this Agreement because of race, religion, color, national origin, ancestry, physical or mental disability, medical condition (including genetic characteristics), marital status, age, political affiliation, gender identity, gender expression, sex or sexual orientation, family and medical care leave, pregnancy leave, or disability leave. Contractor and its officers, employees, agents, representative or subcontractors shall comply with all applicable Federal, State and local laws and regulations related to non- discrimination and equal opportunity, including without limitation the City’s nondiscrimination policy; the Fair Employment and Housing Act (Government Code sections 12990 (et seq.); California 6 ATTACHMENT A
21 Labor Code sections 1101, 1102 and 1102.1; the Federal Civil Rights Act of 1964 (P.L. 88-352), as amended; and all applicable regulations promulgated in the California Code of Regulation or Code of Federal Regulations. Title VI of the Civil Rights Act of 1964 requires that “no person in the United States shall, on the grounds of race, color, or national origin be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving federal financial assistance.”(42 USC Section 2000d). http://www.dol.gov/oasam/regs/statutes/titlevi.htm.
The City requires compliance with the requirements of Title VI in all of its programs and activities regardless of funding source.
26. Force Majeure. Neither party shall be responsible for delays or failures in performance resulting from acts of God, acts of civil or military authority, terrorism, fire, flood, strikes, war, epidemics, pandemics, shortage of power or other acts or causes reasonably beyond the control of that party. The party experiencing the force majeure event agrees to give the other party notice promptly following the occurrence of a force majeure event, and to use diligent efforts to re- commence performance as promptly as commercially practicable.
27. Taxes and Charges. Contractor shall be responsible for payment of all taxes, fees, contributions or charges applicable to the conduct of the Contractor’s business.
28. Cumulative Rights. Any specific right or remedy provided in this Agreement will not be exclusive but will be cumulative of all other rights and remedies to which may be legally entitled.
29. Advice of Attorney. Each party warrants and represents that in executing this Agreement, it has received independent legal advice from its attorneys or the opportunity to seek such advice.
30. Heading Not Controlling. Headings used in this Agreement are for reference purposes only and shall not be considered in construing this Agreement.
31. Entire Agreement, Integration, and Modification.
31.1 This Agreement represents the entire integrated agreement between Contractor and the City; supersedes all prior negotiations, representations, or agreements, either written or oral between the parties and may be amended only by a written Amendment signed by the Contractor and City Manager.
31.2 All Exhibits to this Agreement and this Agreement are intended to be construed as a single document.
7 ATTACHMENT A
22 32. Counterparts. This Agreement may be executed in one or more counterparts, each of which shall be deemed an original. All counterparts shall be construed together and shall constitute one agreement.
33. Authority. The individual(s) executing this Agreement represent and warrant that they have the legal capacity and authority to do so on behalf of their respective legal entities.
8 ATTACHMENT A
23 1
(Rev. 07.12.22)
EXHIBIT D
PROFESSIONAL SERVICES SPECIAL TERMS AND CONDITIONS
1. Definitions. The following words and phrases have the following meanings for purposes of this Agreement:
1.1 "Services" means, collectively, the services, duties and responsibilities described in Exhibit A of this Agreement and any and all work necessary to complete them or carry them out fully and to the standard of performance required in this Agreement.
1.2 “Deliverable” means quantifiable goods or services that will be provided upon completion of a project. A deliverable is any tangible material, work or thing delivered by one party to the other, including associated technical documentation. A deliverable can be tangible or intangible parts of the development process, and often are specified functions or characteristics of the project.
2. General. The following terms and conditions are applicable for the Professional Services only. The special conditions shall be read in conjunction with the Standard Agreement, General Terms and Conditions (“GTC”) Exhibit C, and all other Exhibits identified in the Standard Agreement.
2.1 Where any portion of the GTC is in conflict to or at variance with any provisions of the Special Conditions of the Agreement, then unless a different intention stated, the provision(s) of the Special Conditions of the Agreement shall be deemed to override the provision(s) of GTC only to the extent that such conflict or variations in the Special Conditions of the Agreement are not possible of being reconciled with the provisions of the GTC.
2.2 In the case of modification of a part or provision of the GTC, the unaltered part or provision, or both shall remain in effect. The Special Conditions shall relate to a particular project and be peculiar to that project but shall not weaken the character or intent of the GTC.
3. Time for Performance.
3.1 Contractor shall perform the services according to the schedule contained in Exhibit F.
3.2 Timeliness of Performance i) Contractor shall provide the S ervices, and Deliverables within the term and within the time limits required under this Agreement, pursuant to the provisions of Exhibit A and Exhibit F. ii) Neither Contractor nor Contractor’s agents, employees nor subcontractors are entitled to any damages from the City, nor is any party entitled to be reimbursed by the City, for damages, charges or other
ATTACHMENT A
24 2
(Rev. 07.12.22)
losses or expenses incurred by Contractor by reason of delays or hindrances in the performance of the Services, whether or not caused by the City.
4. Standard of Performance
In addition to Exhibit C, Section 4 and 17, Contractor agrees as follows:
4.1 Contractor’s S ervices shall be performed in accordance with generally accepted professional practices and principles and in a manner consistent with the level of care and skill ordinarily exercised by member s of Contractor’s profession currently practicing under similar conditions. Contractor shall comply with the profession’s standard of performance, applicable laws, regulations, and industry standards . By delivery of completed work, Contractor certifies that the work conforms to the requirements of this Agreement and all applicable federal, state and local laws. If Contractor is retained to perform services requiring a license, certification, registration or other similar requirement under California law, Contractor shall maintain that license, certification, registration or other similar requirement throughout the term of this Agreement.
4.2 Contractor acknowledges that it is entrusted with or has access to valuable and confidential information and records of the City and with respect to that information, Contractor agrees to be held to the standard of care of a fiduciary. Contractor shall assure that all services that require the exercise of professional skills or judgment are accomplished by professionals qualified and competent in the applicable discipline and appropriately licensed, if required by law. Contractor must provide copies of any such licenses. Contractor remains responsible for the professional and technical accuracy of all Services or Deliverables furnished, whether by Contractor or its s ubcontractors or others on its behalf. All Deliverables must be prepared in a form and content satisfactory to the Using Agency and delivered in a timely manner consistent with the requirements of this Agreement.
4.3 If Contractor fails to comply with the foregoing standards, Contractor must perform again, at its own expense, all Services required to be re-performed as a direct or indirect result of that failure. Any review, approval, acceptance or payment for any of the Services by the City does not relieve Contractor of its responsibility for the professional skill and care and technical accuracy of its Services and Deliverables. This provision in no way limits the City’s rights against Contractor either under this Agreement, at law or in equity.
5. Compensation
5.1 In addition to Section 3 Compensation in Exhibit C – GTC, the Contractor shall be compensated for the services provided under this Agreement as follows:
5.1.1 Contractor shall be compensated for services rendered and accepted under this Agreement and shall be paid monthly, in arrears on a not to exceed
ATTACHMENT A
25 3
(Rev. 07.12.22)
basis, based upon the rates set forth in Exhibit E attached hereto and made a part of this Agreement. Contractor may vary the compens ation for each task in Exhibit E provided that the total project compensation listed in Exhibit E and the Standard Agreement is not exceeded.
6. Personnel
6.1 None of the work or services covered by this Agreement shall be subcontracted without the prior written approval of the City. Any work or services subcontracted hereunder shall be specified by written agreement and shall be subject to each provision of this Agreement. Contractor shall provide subcontractor a copy of this fully executed Agreement.
6.2 Contractor agrees to assign only competent personnel according to the reasonable and customary standards of training and experience in the relevant field to perform services under this Agreement. Failure to assign such competent personnel shall constitute grounds fo r termination of this Agreement. The payment made to Contractor pursuant to this Agreement shall be the full and complete compensation to which Contractor and Contractor’s officers, employees, agents, and subcontractors are entitled for performance of any work under this Agreement. Neither Contractor nor Contractor’s officers or employees are entitled to any salary or wages, or retirement, health, leave or other fringe benefits applicable to employees of the City. The City will not make any federal or state tax withholdings on behalf of Contractor. The City shall not be required to pay any workers' compensation insurance on behalf of Contractor. Contractor shall pay, when and as due, any and all t axes incurred as a resul t of Contractor’s compensation hereunder, including estimated taxes, and shall provide City with proof of such payments upon request.
6.3 Key Personnel : Because of the special skills required to satisfy the requirements of this Agreement, Contractor shall not reassign or replace key p ersonnel without the written consent of the City, which consent the City wi ll not unreasonably withhold. "key p ersonnel" means those job titles and the persons assigned to those positions in accordance with the provisions of this Agreement. The City may at any time in writing notify Contractor that the City will no longer accept performance of Services under this Agreement by one or more Key Personnel listed. Upon that notice Contractor shall immediately suspend the services of the key person or persons and must replace him or them in accordance with the term s of this Agreement. A list of k ey personnel is found in Exhibit A, Scope of Services.
7. Reports and Information
Contractor shall at such times and in such forms as the City may require furnish the City such periodic reports as it may request pertaining to the work or services undertaken pursuant to this Agreement, the costs and obligations incurred or to be incurred in connection therewith, and any other matters are covered by this Agreement as specified in Exhibit A and Exhibit E.
ATTACHMENT A
26 4
(Rev. 07.12.22)
8. Findings Confidential
All of the reports, information, data, et cetera, prepared or assembled by the Contractor under this Agreement are confidential and the Contractor agrees that they shall not be made available to any individual or organization without the prior written approval of the City. Contractor shall not be required under the provisions of this paragraph to keep confidential any data or information which is or becomes publicly available, is required by applicable law or by proper legal or governmental authority, is already rightfully in the Contractor’s possession without obligation of confidentiality, is independently developed by Contractor outside the scope of this Agreement or is rightfully obtained from third parties. Contractor shall give City prompt notice of any such legal or governmental demand and reasonably cooperate with City in any effort to seek a protective order or otherwise to contest such required disclosure.
9. Copyright
No materials, including but not limited to reports, maps, or documents produced as a result of this Agreement, in whole or in part, shall be available to Contractor for copyright purposes. Any such materials produced as a result of this Agreement that might be subject to copyright shall be the property of the City and all such rights shall belong to the City, and the City shall be sole and exclusive entity who may exercise such rights.
10. Deliverables
Contractor shall prepare or provide to the City various Deliverables. "Deliverables" include work product, such as written reviews, recommendations, reports and analyses, produced by Contractor for the City. The City may reject Deliverables that do not include relevant information or data, or do not include all documents or other materials specified in this Agreement or reasonably necessary for the purpose for which the City made this Agreement or for which the City intends to use the Deliverables. If the C ity determines that Contractor has failed to comply with the foregoing standards, it has 30 days from the discovery to notify Contractor of its failure. If Contractor does not correct the failure, or if it is possible to do so, within 30 days after receipt of notice from the City specifying the failure, then the City, by written notice, may treat the failure as a default of this Agreement.
Partial or incomplete Deliverables may be accepted for review only when required for a specific and well-defined purpose and when consented to in advance by the City. Such Deliverables will not be considered as satisfying the requirements of this Agreement and partial or incomplete Deliverables in no way relieve Contractor of its commitments under this Agreement.
11. Applicable Laws
Deliverables must conform with all applicable federal, state, and local laws. Such conformity includes compliance with federal sanctions, and Contractor certifies that it has not and will not engage in prohibited transactions with sanctioned persons or entities.
ATTACHMENT A
27 EXHIBIT E
COMPENSATION SCHEDULE
The Contractor shall be compensated for the services identified in Exhibit A, Exhibit C, and Exhibit D to this Agreement as follows:
1. Project Price
1.1 The maximum the Contractor shal l be paid on this Agreement is $__2,504,768.64_ (hereafter the “not to exceed” amount ). The “not to exceed” amount includes all payments to be made pursuant to this Agreement, including City approved reimbursable expenses, if any. Nothing in this Agreement requires the City to pay for work that does not meet the Standard of Performance identified in Exhibit D section 4 or other requirements of this Agreement.
1.2 Standard Reimbursable Items : Only the reimbursable items identified in Exhibit A , C, and E ( Compensation), shall be compensated to the Contractor .
Reimbursable expenses will be reimbursed without markup. Fees plus reimbursable expenses shall not exceed the amount set forth in section 1.1 of this Exhibit and a copy of the original invoice for the items listed in i, ii or iii below shall be attached to the invoice submitted to the City for reimbursement. Payments shall be based upon work documents submitted by the Contractor to the City and accepted by the City as being satisfactory to City’s needs. The C ity shall not pay a markup on any of the items listed in i, ii or iii .
Additionally, items such a telephone, fax, postage or freight are already included in the billable hourly rate. Contractor shall be reimbursed the direct expenses, which are the actual cost of the following items that are reasonable, necessary and actually incurred, by the Contractor in connection with the services:
i. Expenses, fees or charges for printing, reproduction or binding of documents at actual costs with no markup added to the actual cost.
ii. Any filing fees, permit fees, or other fees paid or advanced by the Contractor at actual costs with no markup added to the actual cost.
iii. Travel expenses shall be reimbursed in accordance with the C ity’s travel policy, which is incorporated herein by reference.
Reimbursement shall be made at actual costs with no markup added to the actual cost.
1.3 The Contractor shall be entitled to receive payments for its work performed pursuant to the Agreement. The City will pay Contractor based on invoices for acceptable work performed and approved until the “not to exceed” amount is reached. Thereafter, Contractor must complete services based on the Agreement without additional compensation unless there is a material change to the Statement of Work and Scope by a written Amendment.
ATTACHMENT A
28 1.4 If work is completed before the “not to exceed” amount is reached, the Contractor’s compensation will be based on the Contractor ’s invoices previously submitted for acceptable work performed and approved.
1.5 Subcontractor Costs: Compensation for sub contractors shall be limited to the same restrictions imposed on the Contractor . Maximum markup Contractor may apply to subcontractor fees, minus reimbursable expenses, shall not exceed ______%. 1 .6 If any invoice remains unpaid after 90 days, Contractor reserves the right to cease all services. Contractor will provide written notice 10 days in advance of cessation of services. City acknowledges and agrees that cessation of all services will occur regardless of City consent and regardless of deadlines imposed by statute in connection with the handling of claims. Following receipt of any notice of cessation of services, City agrees that it will immediately make all necessary arrangements for the handlin g and administration of all claims.
2. Task Price.
2 .1 B elow is the maximum price for the services for claims and reimbursable expenses as described in ATTACHMENT A (see pricing sheet) of this Agreement.
Year Task Price
1 $453,300.00
2 $475,965.00
3 $499,763.25
4 $524,751.41
5 $550,988.98
Total $2,504,768.64
Fixed Fee and/or Annual Cap Recalculation: Contractor reviews and analyzes the claims frequency annually. Within 30 days of the end of each 12-month period from the date the work under the contract is initiated, Contractor will provide notice to the City of the actual number of claims received for the preceding 12 months. If the claims frequency exceeds the base number, which is the number of claims at the time of execution of this Contract, by greater than 10%, Contractor will provide a new Annual Fixed Fee and/or Annual Cap calculation based on the change in frequency. The new Annual Fixed Fee or Cap will begin on July 1st of the next year in the Contract term. If the frequency changes in an amount of 10% or less, there will be no change in the Annual Fixed Fee calculation.
Likewise, if the Annual Cap does not need adjustment to allow work to continue, the parties may agree that no adjustment is necessary. Any Annual Cap does not include any fees charged and collected by Consultant for First Party Subrogation services and fees.
2. 2 Litigated Claims : If the City requests that Contractor perform work on or in connection with litigated claims under Exhibit A, Section 2.0, Contractor will perform the requested services on a Time and Expense basis utilizing the rates identified in ATTACHMENT A under Option 1A. In the event such work is performed on a Time and Expense basis, the amounts billed for this work will be in addition to and will not serve to erode the maximum price listed above.
ATTACHMENT A
29 2. 3 First Party Subrogation Services and Fees : Consultant will perform first party recovery and subrogation services. The fee for these services is 30% of the gross recovery per claim. Since the fees are collected from third parties and not paid directly by the City, t he fees collected and paid for these services are not included in the Annual Fixed Fees identified above.
2. 3.1 Billing for Services and Payment to Contractor: The process to be used by Contractor is stated as follows:
a. Once recovery is agreed to between Contractor and the at -fault party and all documentation is executed including a release, the at- fault party will issue a check to Contractor for the full agreed upon amount.
b. Contractor shall deposit the gross recovered funds into the Contractor’s Client Trust Fund.
c. Within ten (10) days after deposit, Contractor will issue the net payment to the City consisting of the amount remaining after deduction of the fees and expenses to compensat e Contractor based on this Contract.
2.3.2 Costs and Expenses: All costs and expenses of litigation filed pursuant to this section, including attorney fees for outside counsel where necessary and approved, will be paid by the City. a. Where Contractor is requested to appear in small claims court to pursue the recovery of funds, each appearance will incur an additional fee of $250.
b. Where Contractor’s personnel appear in the same court on the same day for more than one claim, Contractor will charge a flat fee of $500 for half of a day or $1,000 for a full day, regardless of the number of claims handled on that day.
c. Contractor will be reimbursed for all miles traveled at the current IRS rate.
d. All costs and expenses allocated to any claim will be billed to the client which assigned to claim for handling.
2. 3.3 Compensation Upon Termination: Due to the nature of these services, in that compensation is contingent upon recovery, if the contract is terminated prior to recovery or other closure of any claim, the City shall pay Contractor for all expenses and time spent, to date, on any claims(s) currently open and recovery in process. Payment shall be based on the current hourly rate of Contractor of $115.00 per hour. Contractor will submit a final invoice within five business days of termination.
ATTACHMENT A
30 3. Additional Fees, Costs, and Expenses.
See ATTACHMENT A.
4. Invoice to Mailing Address or Email. Each invoice submitted shall identify the specific task(s) listed in Exhibit A and this Exhibit, and the completed work product/ deliverable for the agreed upon price listed in this Exhibit. Invoices shall be submitted to the below mailing address or email address:
City of Stockton
Attention: HR – Risk Services
Attention: Dawna Zarubin
425 N. El Dorado Street, 3rd Floor
Stockton, CA 95202
[email protected]
ATTACHMENT A
31 NARRATIVE
CITY OF STOCKTON
THIRD PARTY ADMINISTRATOR (TPA) TO
MANAGE CITY’S SELF -INSURED GENERAL
LIABILITY PROGRAM
RFP PUR 25 -042 ................................ ................................ ........ Submitted : July 17, 202 5 George Hills
PO Box 278, Rancho Cordova, CA 95741
Phone: (916) 859 -4800 , Fax: (916) 859 -4805
ATTACHMENT A
32 5. COVER LETTER
July 17, 2025
City of Stockton
Attn: Jason Farrow
RE: RFP for Third -Party Administrator (TPA) to Manage City’s Self -Insured General Liability Program
Dear Mr. Farrow,
As President of George Hills, I thank you for the opportunity to submit a proposal to provide Third Party Claims Administration Services to the City of Stockton (the City). Our team will provide exemplary services while increasing efficiencies and reducing the City’s total cost of risk. Our claims professionals are highly qualified and experienced with the unique nuances of California’s public entities.
George Hills provides third -party administration services to several of California’s cities and public entities of all sizes, including many special districts and nearly 20 JPAs (both primary and excess). We are knowledgeable in the specific exposures that California public entities face.
Responsiveness to the RFP: We are proud to know that we meet, and in some cases exceed the City’s requirements and evaluation criteria. George Hills is prepared and ready to fulfill the needs of the City.
Public Entity Experience: George Hills has an established record of consistent professional service and reputation within the industry, with specific emphasis on public entities and knowledge of public safety benefits, laws, and immunities.
High Quality References: Our clients are a testament to the quality of service we provide. We serve nearly 500 California public entities, including nearly 20 JPAs.
Staffing and Experience: George Hills selectively recruits and retains the industry’s best of the best claims professionals. Our team is dedicated to setting the standard for client satisfaction.
Cost Benefit Advantages: With our claims handling best practices to guide us, George Hills’ approach is focused on efficient, cost-effective, and strategic resolutions. As a boutique-style firm, we customize our services to fit your needs.
Core Values: George Hills is set apart from other candidates by our core values, which direct and maintain all that we do. George Hills fosters values of resilience, accountability, continuous improvement, stewardship, and collaboration.
Our claims handling success is focused on the protection of your assets. With over 70 years in business, George Hills has achieved a best -in-class reputation. As the president of George Hills, I promise that you will experience the difference in our approach and feel confident in your decision to work with us. Thank you for considering George Hills for this vital role.
Respectfully submitted,
John Chaquica, CPA, MBA, ARM
President, George Hills Company
Company Contacts: John Chaquica, President & Chris Shaffer, Chief Operating Officer Office: (916) 859-4824 & (916) 859-4826
Email: [email protected] & [email protected] Mailing Address: PO Box 278, Rancho Cordova, CA 95741
ATTACHMENT A
33 EXECUTIVE SUMMARY
1. Key Team Members
The key members of the proposed team include Shari Huff (Assistant Vice President, Supervisor), Kelley Winters (Senior Adjuster), Nick Chavez (Senior Property Adjuster), Nick Dotzler (Field Claims Representative), Kathleen Proctor (Client Services Manager), Tammy Hunt (Subrogation Manager), Chris Shaffer (Chief Operating Officer), and John Chaquica (President).
2. Main Contact
The main point of contact for the City is to be Kathleen Proctor, Client Services Manager.
3. Summary of Experience
George Hills has served California’s public entities, providing liability and property claims administration services for more than 70 years.
4. Addenda
There are no addenda pertaining to this RFP.
5. Proposal Validity
This proposal and all its contents, including the fee proposal, are valid for a period of 120 days.
ATTACHMENT A
34 TAB LE OF CONTENTS
5. COVER LETTER ................................ ................................ ................................ .............. 1 EXECUTIVE SUMMARY ................................ ................................ ................................ ............ 2
5.1 QUALIFICATIONS AND EXPERIENCE ................................ ................................ ................ 5
1. FIRM ORGANIZATION ................................ ................................ ................................ ......... 5
2. REFERENCES ................................ ................................ ................................ ..................... 15
3. FINANCIAL CAPACITY ................................ ................................ ................................ ....... 15
5.2 METHOD OF APPROACH ................................ ................................ ............................... 17
1. SCOPE OF WORK STATEMENT ................................ ................................ .......................... 17
2. SCOPE OF WORK ................................ ................................ ................................ .............. 17
3. BEST PRACTICES ................................ ................................ ................................ ............... 27
4. QUALITY ASSURANCE PRACTICES ................................ ................................ .................... 37 Section 8 Form – Proposal Documents ................................ ................................ .............. 39 Attachment B – Proponent’s Covenant ................................ ................................ ............. 40 Attachment C – Non -Collusion Affidavit ................................ ................................ ........... 41 Attachment D – Agency Reference List ................................ ................................ ............ 43 Attachment E – Certification of Financial Condition ................................ ......................... 44 Attachment F – Cost/Price Proposal ................................ ................................ .................. 45 Attachment G – Subcontractor List ................................ ................................ ................... 46 Attachment H – Exceptions ................................ ................................ ............................... 47 Amendments ................................ ................................ ................................ ...................... 50 Sample Reports ................................ ................................ ................................ .................. 51 Sample POA ................................ ................................ ................................ ....................... 55
ATTACHMENT A
35 5.1 QUALIFICATIONS
AND E XPERIENCE
ATTACHMENT A
36 5.1 QUALIFICATIONS AND EXPERIENCE
1. FIRM ORGANIZATION
George Hills Company was founded in 1954 and has provided liability and property claims administration services to the public sector for four decades. Since 2013, we have dedicated an entire department to Subrogation Recovery Services for public entities. Since its inception, George Hills has expanded, grown, and branched out in ways consistent with our value of continuous improvement.
In addition to third -party claims administration, we provide industry -leading litigation management services, subrogation recovery, investigative services, and JPA management. Today, we work with more public entities in California than any other TPA.
Public Entity Experience: George Hills has made public entity casualty claims adjusting its focus. We put forth considerable effort in recruiting, retaining, and training our employees. We partner with nearly 150 California cities – a significant percentage of the state’s counties both as stand-alone agencies and JPA members.
George Hills’ emphasis on high quality public entity adjusters and our reputation for excellent client services have led us to the forefront for California Public Entities property and liability claims management. For more than half a century, George Hills has specialized in California public entity multi -line claims adjusting (property and liability) while also providing litigation management and investigative services.
Firm Structure: Our claim division staffing structure ensures that the quality of work we provide will meet your exact expectations. We employ claim executives who have been in the business of serving public entities for most of their careers. We have a hierarchical structure of managers and supervisors who oversee and advise on the work produced by adjusters. Our adjusting staff consists of senior level adjusters, adjusters who are progressing in their careers toward senior level positions and claim processors who provide administrative support as well as key support duties. George Hills’ employees hold professional licenses, BA/BS/MA and JD degrees, and/or industry certifications/designations, including: Independent Insurance Adjuster; Associate in Risk Ma nagement (ARM); Registered Professional Adjuster (PRA); Casualty Claim Law Associate (CCLA); California Self -Insured Administrator (SIA); Certified Public Accountant (CPA); Charter Global Management Accountant (CGMA); Certified Litigation Management Profes sional (CLMP); Property/Casualty Agent; and the California State Bar.
Commitment: Our approach as a third -party administrator is based on our commitment to protect your assets. Our goal is to reduce the number of claims and claims paid amounts by identifying cost drivers, performance gaps, and opportunities for cost reduction. Our proje ct approach centers on transparency and frequent communication with internal and external stakeholders. At the onset, we seek to determine your expectations, which will refine our methodology. Our approach to fulfilling the City’s needs stems f rom our company’s experience, values, personnel, and our best practices approach to claims handling. Customer satisfaction is paramount and one of our core values – one which guides us in all we do. Our commitment to superior customer service is bolstered by our exceptional, highly qualified staff supported by our unparalleled training and certification program .
ATTACHMENT A
37 Organizational structure
George Hills is a values -based company. Our values are accountability, continuous improvement, collaboration, stewardship, and resiliency. These values influence everything we do.
Primary Office: George Hills operates in a hybrid environment with our corporate headquarters in Folsom, near Sacramento. We have adjusters statewide in California.
PERSONNEL
Personnel Role for the City
John Chaquica
CPA, MBA, ARM
President
Role: Executive Contact Contract liaison for the City’s total satisfaction with George Hills’ services and
steward of George Hills’ values through the
engagement.
Qualifications: With over 33 years of experience in risk and JPA management, Mr. Chaquica applies a virtually unmatched level of experience and talent. Mr. Chaquica holds an MBA from Golden Gate University and a BS in Accounting from California State University, Sacramento. In addition, he holds an Associate in Risk Management (ARM) designation from the Insurance Institute of America.
Chris Shaffer
ARM/P
Chief Operating Officer
Role: Oversees firm operations and provides
executive oversight as needed. His role includes
strategic efforts for growing the company and further
developing George Hills as the leading California TPA.
Qualifications: Mr. Shaffer has an exceptional 30 -year record of achievement in the management of corporate, risk management, business systems, and information systems operations. He earned 34 31
ATTACHMENT A
38 a Bachelor of Arts from the University of Utah. He holds and Associate in Risk Management (ARM) designation.
Shari Huff
AIC-M
Assistant Vice President
Role: Supervisor overseeing client relationships.
Qualifications: Ms. Huff has over 27 years of
management-level experience in the insurance claims
industry. She brings extensive public entity experience to the table – working in the public entity arena for the past 14 years. Ms. Huff earned her degree from the University of Santa Barbara. She holds an Associate in Claims – Management (AIC-M) designation.
Kathleen Proctor
WCCA, CFE
Client Services Manager
Role: Assures client satisfaction, including developing detailed Claims Handling Instructions tailored to the
City’s needs and scheduling regular and ongoing
meetings with the service team to address any service
needs or concerns.
Qualifications: Ms. Proctor holds a BS in Criminal Justice from California State University, Sacramento. She is experienced with public entity claims, public records, and business development. Ms.
Proctor has a decade of experience as a Risk Manager, and nearly a decade of operation management.
Nick Chavez
FCLS
Senior Property Claims
Adjuster
Role: Senior Claims Adjuster and secondary point of
contact for all claims-related matters for the City.
Qualifications: Mr. Chavez has an impressive 35-year
record of claims adjusting experience, with the majority of his time spent handling large, complex claims and property claims . Mr.
Chavez holds a Bachelor of Arts from California State University, Turlock.
Kelley Winters
Senior Claims Adjuster Role: Senior Claims Adjuster and secondary point of contact for all claims -related matters for the City.
Handles assigned litigated files.
Qualifications: Ms. Winters has more than 31 years of experience working in the industry with claims. She is experienced with conducting investigations, interviews, and handling litigated claims.
Nick Dotzler
Field Claims Representative Role: Handles claims for the City.
Qualifications: Mr. Dotzler specializes in field
investigations. His experience includes property
damage, potholes, small claims, and field/fatality investigations.
Mr. Dotzler possesses a CA POST Certificate.
27 35
20 1
32 ATTACHMENT A
39 Tammy Hunt
CCLS
Subrogation Manager
Role: Supervisor overseeing subrogation recovery
services.
Qualifications: Ms. Hunt has 27 years of experience
in the industry. She has been focused on subrogation recovery for public entities for more than 15 years. She received her Associate’s Degree in Liberal Arts, Bachelor’s Degree in Paralegal Studies, and Paralegal Certificate from Humphreys University (prev iously Humphreys College) in Stockton, California.
TBD
Claims Adjuster
Role: Handles claims for the City.
TBD
Claims Representative
Role: Handles claims for the City.
TBD
Claims Processor
Role: Responsible for support of the designated liability claims team. Enters all new claims into the CMIS and general claims processing. The Claims Processor is instrumental in our quality assurance reporting.
The proposed fixed fee is based on an anticipated staffing level equivalent to 2.5 full-time equivalents (FTEs) of adjuster time. This staffing level is calibrated to support the expected claim frequency and service scope as outlined in the RFP.
During the term of the contract, should claim volume increase materially, defined as greater than 10%, beyond the assumptions used to develop this pricing, the fixed fee will no longer be valid. In such cases, George Hills will work collaboratively with th e client to assess the increased workload and determine appropriate staffing adjustments. Any additional personnel required will be mutually agreed upon, and the fee structure will be revised accordingly to reflect the expanded service commitment.
This approach ensures transparency and flexibility while maintaining service quality and responsiveness.
27 ATTACHMENT A
40 TRAINING
At George Hills, training is more than just slideshows and seminars. We are committed to growth and continuous
improvement. We regularly provide training for our clients and employees on relevant and current topics from industry experts.
Most significantly , we provide access to George Hills Claims University (GHCU), where anyone can learn about the unique claims processes and considerations necessary for handling claims presented against public entities. The specialized educational resources provided throug h GHCU offer enhanced knowledge and skills to
claims and risk management professions.
The George Hills Subrogation Recovery Division provides all Division staff with continuous training on a daily basis, and an in-depth training session is provided monthly regarding various subjects relevant specifically to the subrogation recovery process. In addition, annual training is provided to all Division staff on a variety of topics as may be appropriate and necessary as laws change and industry requirements may dictate.
GEORGE HILLS CLAIMS UNIVERSITY
Our goal is to deliver a comprehensive and effective educational program that aligns with the vision, values, and goals of George Hills.
The genesis of GHCU was the reality that students were not going to college to seek a career in insurance claims adjusting, and even fewer in claims adjusting in the public sector. We felt an obligation to establish a sustainable education forum to continu e to cultivate knowledgeable and experienced public entity adjusters. By pooling resources, we have created GHCU to be cost-effective and to present relevant technical information from industry experts.
We offer multiple certifications through GHCU for anyone interfacing with the claims process:
Public Entity Claims Professional (PECP): The PECP is designed for adjusters and staff of public entities who are involved with their entity’s claims to build a strong foundational understanding of public entity claims in California. All George Hills claims staff complete the course work and earn the PECP designation, ensuring that every client has trained adjusters on their team. Advanced levels of the PECP offer a career-boosting spotlight on technical reforms in the claims process for experienced adjusters. The basic level of PECP can provide anyone with the tools and knowledge they need to begin a career in public entity claims.
Modules in the PECP certification course include:
• Public Entity Basics • Common Vs. Statutory Law
• The California Tort Claims Act • Recognizing Coverage • Liabilities, Immunities, and Defenses • The Settlement Process • Unique Exposures • Joint Powers Authorities & Pools
More information can be found at: https://georgehills.com/services/george-hills-claims-university/.
ATTACHMENT A
41 Public Entity Claims Foundations (PECF): The PECF is crafted for any public entity employee who touches any part of a claim presented to their entity. This would include personnel who interface with the claims process, including risk managers, department heads, management, board members, analysts, managers, and anyone else interested in expanding their knowledge. The PECF provides supporting knowledge for our clients and the public in a ‘Claims 101’ style program.
GHCU is entirely online, allowing you to earn your certification anytime, anyplace. We offer a robust resource and reference library of claims and risk management technical topics, as well as structured training courses and assessments. GHCU is hosted on a comprehensive online Learning Management System. Access your courses from a personalized dashboard, review technical materials in the content library, and put yourself to the test with entirely online assessments all in one place. Content and courses are continually improving and updating to maintain fresh, relevant learning materials to support you.
For our clients, access to GHCU and these resources is included in your services and entirely free for your staff to utilize. But learning isn’t limited to George Hills’ clients; anyone can access GHCU. Email [email protected] for more information.
Training Programs
George Hills provides training for employees and clients. These training options include:
• Training sessions facilitated by industry experts on current and emerging claims -related topics, such as legislative changes, new case laws, and claim trends. We also use this session to refresh our claims administration staff on industry and internal best practices. • An annual two -day event for all claims staff, targeted at technical training, overall staff development, and team building. This annual session includes in -depth training and panel discussions on claims technical topics, claim system utilization, and corporate issues. A recent sample event included discussion about AB 218, the recent legislation extending the statute of limitations for childhood sexual abuse and molestation claims. • Online resources and training through George Hills’ Learning Management System. This Learning Management System is a robust resource and reference library for a wide variety of claims and risk management technical topics, as well as structured training cou rses ranging from entry-level to advanced.
• Company-paid training courses leading to an Associate in Claims (AIC) and other pertinent professional designations.
• Active participation in industry associations, such as Public Agency Risk Management Association (PARMA), California Association of Joint Powers Authorities (CAJPA), the League of California Cities, California State Association of Counties, Association of Governmental Risk Pools, and the Claims and Litigation Management Alliance. George Hills encourages employee attendance at their annual conferences and other training events throughout the year.
ATTACHMENT A
42 RESUMES
John Chaquica
CPA, MBA, ARM
President
[email protected] | (916) 859-4824
George Hills Job Description
The Chief Executive Officer (CEO) establishes and lives by the corporate vision; develops and implements the George Hills’ Strategic Plan; provides leadership; and fosters the culture through our values to achieve plan objectives. As lead on George Hills’ Corporate Management Team (CMT), the CEO works with management to establish long -term goals, plans, and policies that align with organizational goals. The CEO provides coaching, guidance, and support to the team while setting professional development plans to assure all managers reach their full potential and deliver the highest standard of Division, cross-Divisional, and cross-Company teamwork and customer service.
Professional Experience
• George Hills, CEO / President
• Bickmore Risk Services, CEO
• Multiple Public Entity Self-Insurance Pools, Executive Director/Consultant • Gilbert Accountancy Corporation, Audit Partner and Industry Team Leader on Public Entity Self-Insured Groups
• Executive Director of: Independent Cities Risk Management Authority (ICRMA), Bay Cities Joint Powers Insurance Authority, Valley Insurance Program (VIP), Santa Cruz/San Benito JPA, North Valley Schools Insurance Group (NVSIG)
Professional Affiliations
• American Institute of Certified Public Accountants (AICPA) • California Society of Certified Public Accountants (CSCPA) • Court Appointed Special Advocates (CASA), Sacramento
Education
• Golden Gate University – MA, Business Administration/Finance • California State University, Sacramento – BS, Accounting • Insurance Institute of America – Associate in Risk Management (ARM)
ATTACHMENT A
43 Chris Shaffer
ARM/P
Chief Operating Officer
[email protected]
George Hills Job Description
Responsible for managing operations for the Claims Administration Division. Works with the CEO and other management to establish long -term goals, plans, and policies that align with organizational goals. Provides coaching, guidance, and support to the team while setting professional development plans to ensure all employees reach their full potential and deliver the highest standard of departmental, cross -departmental, and cross -Company teamwork and customer service.
Professional Experience
• George Hills, Vice President of Claims
• York Risk Services Group, Managing Vice President Client Services • York Risk Services Group, Vice President of Information Services & Chief Business Systems Officer
• Bragg & Associates, Vice President – Information Services Education
• University of Utah - BA
Shari Huff
AIC-M
Assistant Vice President of Claims Administration
[email protected]
George Hills Job Description
Serves as the primary account liaison to George Hills’ clients. Motivates, coaches, and assesses George Hills’ staff to successfully execute client goals. Ensures quality claims handling.
Summary of Professional Experience
• Carl Warren & Company, Litigation Manager/Claim Manager • Halo Claim Solutions, VP of Claims
• Permanent General Insurance, Claim Manager
Education
• University of Santa Barbara
• Associate in Claims – Management (AIC-M)
• Insurance Adjuster Licenses in CA, TX, NM, WA
ATTACHMENT A
44 Kathleen Proctor
WCCA, CFE
Client Services Manager
[email protected]
George Hills Job Description
The Client Services manager ensures that existing customers are retained, satisfied, and their needs are fulfilled. Builds relationships with customers and uses independent judgement and discretion to facilitate the resolution of problems, issues, and conc erns. Understands the balance, inter - relation, and nuances between operations, sales, and customer service. Works as a liaison between customers and George Hills to support the Company’s business operations.
Summary of Professional Experience
• Heringer Estates Winery, Sales Director
• George Hills, Quality Assurance Operations Manager
• City of Stockton, Risk Manager
Education
• California State University, Sacramento – Bachelor of Science, Criminal Justice • Insurance Educational Association – Workers’ Compensation Claims Administrator (WCCA) • Association of Certified Fraud Specialists – Certified Fraud Examiner (CFE)
Kelley Winters
Senior Claims Adjuster
[email protected]
George Hills Job Description - Classification
The Senior Claims Adjuster handles multi-line claims, including adjusting minor to complex property and liability claims for clients including municipalities, schools (public and charter), and private companies. Investigates, negotiates, and settles a vari ety of claim types, including general liability bodily injury and property damage, auto liability bodily injury and property damage, first party property claims, due process claims, and subrogation claims. Maintains timely contact with clients, including r eporting on claim files to clients and various excess carriers. Manages litigated files, monitors and directs defense counsel on litigation, and attends settlement conferences and mediations.
Summary of Professional Experience
• George Hills, Senior Claims Adjuster
• York Risk Services Group, Adjuster Property & Casualty Claims III • Esurance, Casualty Adjuster
• USAA, Casualty Claims Adjuster
• USAA, Senior Claims Representative
• USAA, Claims Representative
Education
• University of Santa Barbara
• Associate in Claims – Management (AIC-M)
• Insurance Adjuster Licenses in CA, TX, NM, WA
ATTACHMENT A
45 Nick Chavez
FCLS
Senior Claims Adjuster
[email protected]
George Hills Job Description - Classification
Handles multi -line claims, including investigating and adjusting minor to complex property and liability claims for clients including municipalities, schools (public and charter), and private companies. Investigates, negotiates, and settles a variety of cl aim types, including general liability bodily injury and property damage, auto liability bodily injury and property damage, first -party property claims, due process claims, and subrogation claims. Maintains timely contact with clients, including reporting on claim files to clients and excess carriers. Manages litigated files, monitors and directs defense counsel on litigation, and attends settlement conferences and mediations.
Summary of Professional Experience
• George Hills Company, Senior Claims Adjuster
• CSE Insurance, Senior Property Examiner
• Mercury Insurance, Property Claims Specialist Field II • Pacific Specialty Insurance, Property Field Adjuster – Large Loss • California Claims, Independent General Adjuster
Education
• California State University, Stanislaus – BA
• American Educational Institute – Fraud Claim Law Specialist (FCLS)
Nick Dotzler
Field Representative
[email protected]
George Hills Job Description
The field representative investigates claims on-site and assists claims staff with investigations.
Professional Experience
• George Hills, Field Representative
Education
• CA POST Certificate
• San Jose State University – Bachelor of Science, Pre-Law Justice Studies
ATTACHMENT A
46 2. REFERENCES
Client Contact Services Provided Dates
Public Risk
Innovation,
Solutions, and
Management
(PRISM)
Heather Fregeau
PRISM Chief Claims Officer
(916) 850-7329
[email protected]
TPA Services for
General Liability
and Medical
Malpractice Claims
1988 -
Present
City of Sacramento Patrick Flaherty
Risk Manager
(916) 808-8587
[email protected]
Subrogation
Recovery Services
2022 -
Present
County of San
Joaquin
Tanya Moreno
County Safety & Risk Manager
(209) 468-3274
[email protected]
TPA Services for
General Liability
and Medical
Malpractice Claims
2020 -
Present
3. FINANCIAL CAPACITY
George Hills Financials demonstrates a good record of performance and has sufficient financial resources to ensure we can satisfactorily provide the services required. George Hills is not involved in Bankruptcy, reorganization, liquidation, or dissolution.
Please see Attachment E of our Proposal Attachments for Certification of Financial Condition on page
44. ATTACHMENT A
47 5.2 METHOD OF
APPROACH
ATTACHMENT A
48 5.2 METHOD OF APPROACH
1. SCOPE OF WORK STATEMENT
George Hills understands the requirements of the Scope of Work.
2. SCOPE OF WORK
The selected TPA (proponent) awarde d the contract shall operate under the general direction of the City’s Risk Manager and consult with other City Staff in developing effective procedures and practices to successfully administer the City’s third-party property and liability claims along with administering the City’s first party property subrogation and restitution services to recover costs from third parties.
The TPA shall perform all services and related work necessary for program administration, claims administration, subrogation, claims investigations, reporting to the City ’s risk pool, Medicare reporting, reserving, settlements, litigated files management, and all other related documentation.
TPA services shall include the City’s major programs, but are not limited to: general ,automobile, and property liability claims administration, in vestigations, research , analysis, recording, reporting, subrogation, litigation management, liability trust account management and reconciliation, and related support services. The City will retain management of litigat ed claims but may call upon the TPA to assist in these areas on a case-by-case basis; a dedicated claims examiner is preferred.
The selected proponent shall work with Public Risk Innovation, Solutions, and Management (PRISM) for the e ntirety of the contract and adhere to their Addendum B Liability Claims Administration Standards.
George Hills acknowledges and agrees to comply with the terms stated above.
I. Program Administration
1. George Hills will c onsult with the City and provide professional and technical staff to assist in developing the necessary procedures and practices to implement and administer the City's self - insured program, including administering all open and closed indemnity, subrogation , and restitution claims.
2. George Hills will c onvert the data from the data system of the present administrator to George Hills‘ data system as the City wishes to maintain and integrate all claims into its current statistical base. The Conversion fee is intended to cover costs associated with data conversion, transition, and contract closeout. The data conversion fee is dependent on many factors which will need to be discussed. If George Hills is retained for five (5) years, we will entirely absor b the conversion fee. If George Hills is not retained for the full length of the proposed contract, then the client shall be subject to a fee of 20 percent each year not retained, not including shipping, storing, scanning, copying, or otherwise handling op en or closed paper claim files (this shall be a separate charge based on the Scope of Work). George Hills will charge for any agreed services related to conversion storage, copying, scanning, shipping, and disposal.
3. George Hills will follow the Records Retention Policy established and approved by the City. All files, records, transcripts including loss run data base files and other materials related to the management and administration of City's General Liability Program are the exclusive property of
ATTACHMENT A
49 the City of Stockton and will be relinquished in good order and condition upon termination of the Agreement with George Hills. George Hills shall make files available for review by the City anytime during regular business hours. George Hills shall provide copies of file correspondence and documentation as requested by the City.
4. George Hills will maintain a master file of claims administration policies, practices and guidelines, and any other material needed to properly administer claims in accordance with applicable state law and City instructions.
5. George Hills will p rovide City's General Liability Analyst and City Attorney’s Office with user connections (and software if applicable) on City's existing personal computer, to allow database inquiry access and e -mail capability to George Hills' claim processing system. System will allow diary to be set by City’s Analyst to follow up on pending issues as needed.
6. George Hills will conduct or assist in onsite or offsite training as needed for City personnel involved directly or indirectly in the processing of general liability, subrogation or restitution cases. George Hills will inform the City of changes or proposed changes in statutes, rules, regulations, and case law affecting its general liability claims program.
7. George Hills will periodically update all form letters used in connection with claim processing. The City of Stockton reserves the right to approve and disapprove all forms and form letters.
8. George Hills will r epresent City in all matters related to the set -up, investigation, adjustment, processing, negotiation, and resolution of liability claims against City.
9. George Hills will provide accurate, appropriate claims handling in a timely manner, according to agreed upon performance standards and state requirements.
10. George Hills will provide the City with written information on changes or proposed changes in statutes, rules and regulations affecting the City's responsibility under a legally self -insured General Liability Program.
11. George Hills will inform the City of problem areas or trends, both potential and perceived, and provide recommendations and/or solutions to address problem areas or trends. Matters of significance will be called to the City's attention at the earliest appropriate time (i.e., disgruntled employees, system problems, large overpayments, large reserve changes, etc.).
12. George Hills will attend client meetings as requested by the City of Stockton. George Hills’ travel expenses in connection with client meetings or other matters relating to claims processing shall be paid by George Hills.
13. George Hills will attend appointments, including but not limited to meetings, conferences, court appearances, and scene investigations at the request of the City.
14. George Hills will i nstall and/or utilize any necessary automated claims administration systems.
George Hills shall have ability to integrate with external/third party system, including imports of claims financial data, transaction details, and adjusters’ notes from George Hills and carriers, as well as exports of financial transaction data and imports to capture payment details from City’s
ATTACHMENT A
50 Enterprise Resource Planning System (ERP) and/or Accounts Payable systems (e.g., Central Square HTE, Tyler, Klear.ai, etc.), among other data feeds.
15. George Hills will transfer records and systems to the succeeding Administrator at the termination of the contract with no additional cost or fee required.
16. George Hills administrative fees will cover the cost of George Hills’ staff; all office space; storage space for closed files; supplies; forms/posters/pamphlets; standard management reports; telephone expenses; postage; checks (if utilizing TPA’s own checking account); computer hardware/software; transcription services; and other equipment/supplies necessary for claims handling.
II. Claims Administration
1. George Hills will only utilize outside expert services or subcontractors with prior approval from the City. City reserves the right to approve, disapprove, or select all service providers and vendors selected by George Hills.
2. George Hills will ensure every file contains a Plan of Action, quarterly litigation budgets and the steps to accomplish it. The Plan of Action will be updated during each diary review. Files will be clearly documented, with claim notes reflecting ongoing file activity. All conversations and issues will be documented.
3. George Hills will provide professional and courteous responses to receipt of telephone calls, written or in person inquiries, complaints and questions from all sources within 48 hours of receipt. Such inquiries may include claim payment or benefit related questions from part ies with authorized access to information, such as claimants, vendors, providers, legal counsel, the City of Stockton, etc.
4. George Hills will e nsure all claims management adhere to the requirements of the California Government Code for accepting, denying, and rejecting claims.
5. At the direction of the City, George Hills will contact claimants or their attorneys within five (5) business days of receipt of a claim and maintain appropriate contact with them until the claim is closed.
6. George Hills will review the status of claims and assist as directed with setting adequate reserves on all active cases at least every ninety (90) calendar days.
7. George Hills will review all claims for liability and provide first investigative report within thirty (30) calendar days of receipt of claim to City’s Risk Services Division.
8. George Hills will provide narrative reports when recommending rejection or settlement of a claim, when going to trial, or other significant events occur. Reports will be clear and concise.
9. George Hills will negotiate settlements within authority limits provided by City. Funding for the payment of any settlement is specifically excluded from this agreement.
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51 10. George Hills will report claims in compliance with Medicare, Medicaid, and SCHIP Extension Act (MMSEA) Section 111 . George Hills will notify the City when reports for the MMSEA Section 111 require signature.
11. George Hills will p rocess payments within authority levels provided by City within fourteen (14) business days.
12. George Hills will file all supporting documentation for payments made in the appropriate claim file.
13. George Hills will provide monthly reports for the following open and closed liability claims; general liability, date excess sent, open litigated, and injury year detail by department.
14. George Hills will provide weekly reports for open and closed liability claims.
15. George Hills will provide weekly reserve change report.
16. Checking: George Hills will follow the banking requirements of the City, such as establishing, maintaining, and reconciling an interest -bearing checking account with appropriate deposit and transfer procedures for the payment of claims; or if utilizing a City of Stockton checking acc ount, provide monthly records of financial transactions to coordinate with City's computer or ERP system, or make other claims payment arrangements which are acceptable to the City. George Hills’ claims administrator will mainta in check registers and provide a monthly check register to the City, along with a copy of all checks and vouchers.
17. Reserve Adequacy and Accuracy: George Hills will maintain reserves for each file to reflect the probable future liability of a claim as required by Title 8, California Code of Regulation, Section 15300. Reserve calculations will be accurate and adjusted as facts change. Detailed reserve worksheet calculations to be retained in claim file.
18. George Hills will provide any required federal or state financial or tax reports. George Hills will provide appropriate information, documentation and cooperation to the State of California or City of Stockton Auditor upon request.
19. George Hills will r econcile all claim file payments twice per year, and upon settlement and file closure. Proof of resolution will remain in claim file.
20. Overpayments/Errors: Any overpayments/incorrect payments will be reported to the City immediately, along with diligent efforts to collect all overpayment and resolve any other incorrect payments.
21. Diary dates shall be established to allow for timely completion of required activity and no less frequently than every sixty (60) calendar days. George Hills shall monitor the timely completion of diary notes.
22. All correspondence shall be addressed within 48 hours of receipt unless an immediate response is required.
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52 23. Written responses to requests that cannot be emailed shall be mailed within te n (10) business days of receipt, unless an immediate response is required.
24. George Hills will identify and notify co-defendants within thirty (30) calendar days of identification.
25. George Hills will have translators available to assist with non-English speaking claimants.
III. Subrogation
1. George Hills will place the tortfeasor on notice of the City’s subrogation rights; and
2. George Hills will work with the Risk Services division to draft legal documents to recover monies spent on claims.
3. George Hills will aggressively investigate fraud and pursue restitution in all fraud cases. The City shall be notified of all claims involving potential fraud and initiation of fraud investigation activities.
4. George Hills will p rovide subrogation services to recover costs from third parties (responsible persons, agencies, insurers, and/or their agents) responsible for employees, volunteers, inmates, etc., injuries, up to the point necessitating legal counsel. George Hills will give prompt notice to Risk Services for each case indicating a potential for subrogation.
5. Subrogation efforts on injuries in which there is also property loss to the City shall be coordinated by George Hills . Subrogation notices and action against another party require advance authorization from the City. If subrogation action develops problems or unreasonable delays, the matter is to be referred to and reviewed by Risk Services for referral to City designate d Counsel for legal action.
6. If the third party needs to be sent to collections, approval must be obtained from Risk Services.
7. George Hills will provide monthly and weekly open and closed reports on amounts recovered for subrogation and restitution.
8. George Hills will provide weekly subrogation reserve change report.
9. George Hills will pursue small claims actions. Litigation in civil court beyond small claims court requires specific authority from the City (this may be City Counsel, Risk Manager, etc.). Settlement authority for less than full amount claimed by George Hills requires City’s Analyst or Risk Manager’s prior approval.
IV. Claims Investigation
1. Within ten (10) business days of receipt of claim, unless otherwise requested by City Risk Manager, George Hills will take statement of facts from claimants when not represented by an attorney.
Statements will be preserved by recording or taking hand-written signed statements.
2. George Hills will investigate claims where the initial review indicates that it is warranted. Further investigation may include, but is not limited to, on -sight investigation, photographs, interviewing witnesses and taking signed or recorded statements, verification of damag e or loss, taking
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53 measurements, obtaining maps/diagrams from the City or other sources, obtaining medical releases, police reports, or other records as required.
3. George Hills will c omplete initial investigation answering questions such as who, what, where, when and why. Investigations shall be completed within forty -five (45) days of the Member’s knowledge of claim, including statements from participants and witnesses, appropriate offi cial reports, investigative reports, site inspections, relevant documents and photos/videos.
4. George Hills will i dentify liability issues, including immunities, comparative negligence, joint tortfeasors and joint and several liability.
5. George Hills will initiate the development of information on damages including, but not limited to:
a. Property damage
b. Nature and extent of injuries
c. Medical costs (billed and paid)
d. Lost wages (past and future)
e. Other economic damages
f. Non-economic damages
6. George Hills will obtain and review relevant contracts and insurance documents, to determine whether there is any sharing or complete transfer of the risk. a. Hold-harmless and/or indemnity agreements
b. Additional insured requirements
7. George Hills will ensure proper preservation of evidence.
8. George Hills will evaluate the need to utilize experts. a. All bodily injury claims shall be initially reported to the Index Bureau and re -indexed on an as needed basis thereafter. (PRISM maintains a membership with the Index Bureau that members can access).
9. George Hills will secure estimates or appraisals for damaged property.
10. All notices (pertaining to claim insufficiency, returning late claims, claims rejections, etc.) shall be done in accordance with the relevant Governmental Code provisions.
V. PRISM Reporting Requirements
1. First Report
George Hills shall give PRISM immediate written notice for any claims or suits which George Hills becomes aware of that include injury of the following types:
• Death
• Paralysis, paraplegia, quadriplegia
• Loss of eye(s), or limbs
• Spinal cord or brain injury
• Dismemberment or amputation
• Sensory organ or nerve injury or neurological deficit • Serious burns
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54 • Severe scarring
• Sexual assault or battery including but not limited to rape, molestation or sexual abuse • Substantial disability or disfigurement
• Any class action
• Any claim or suit in which PRISM is named as a defendant; or • Any injury caused by lead.
Additionally, George Hills will report to PRISM any occurrence, offense, or wrongful act in which the amount incurred has reached $500,000.
Utilize the current First Report Potential Excess Liability Claims form, available through PRISM’s website, and transmit to PRISM by email to [email protected].
First report forms shall, at a minimum, include the following:
• Entity name
• Entity’s claim number
• Defense counsel’s name and firm name
• Lead Claimant’s first and last name
• Specific date of loss
• Brief description of the incident
• Established reserves for indemnity, litigation, and expense
2. Status Reports: After the First Report to PRISM, status reports shall be provided by George Hills at a minimum of every ninety (90) days (more frequently if warranted). Status reports shall focus on changes in liability analysis, damages, and reserves.
3. Photos, diagrams, estimates, statements, contracts, medical, law enforcement and coroner's reports (where applicable), claim forms, lawsuits (including amended complaints), motions for summary judgment, demurrers, dismissals, appellate briefs and orders/ru lings/judgments shall be in the claims file, and provided to PRISM, within ninety (90) days of receipt of the material.
4. Closure Reports: When a claim or suit that has been reported to PRISM is settled, dismissed or closed in any other fashion, PRISM shall be provided with the closing documents and an accounting of the final paid amounts on the exposure for indemnity, litigation, and expense within 90 days from the day the final defense bill is paid.
VI. Medicare Reporting
1. Through George Hills, p roper verification of a claimant’s status as to Medicare eligibility shall be completed and documented in every file involving a bodily injury. In those cases where the claimant does meet the eligibility requirements, mandatory reporting to the Center for Medicare and Medicaid Services (CMS) must be completed directly or through a reporting agent in compliance with State Children’s Health Insurance Program (SCHIP) Section 111 of the Medicare Medicaid and SCHIP Extension Act of 2007.
VII. Reserving
Through George Hills, each claim will be reviewed and evaluated according to the merits of the claim and based upon the most current and reliable information received, starting with the initial report of claim and continuing through final resolution. Delays result in understated reserves and, possibly, missed opportunities to settle.
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55 1. Through George Hills, an accurate and appropriate initial indemnity reserve shall be established on all reportable claims based on facts known, upon completion of the initial investigative report or when suit is filed, whichever occurs first. In addition, separate legal and adju sting reserves shall be established. Indemnity reserves shall reflect the most probable outcome plus exposure to plaintiff attorney’s fees and costs.
Most probable outcome is the potential total amount a plaintiff could expect to receive, either through settlement or verdict, after factoring in the Member’s percentage of liability. (This approach is neither the best or worst case outcome).
Factors to consider when evaluating the potential total settlement or verdict a plaintiff could expect to receive include but are not limited to:
• Extent of injuries and/or damages
• Medical expenses
• Loss of income
• Any other related expenses
• Future anticipated expenses
• Total of both gross and out-of-pocket expenses
• Permanent injury
• Disfigurement/scarring
• Pain and suffering
• Any other intangible factors which may result in a higher or lower claim value such as jurisdiction, credibility of parties/witnesses, etc.
Percentage of liability is determined by various factors that are discovered during an investigation.
Reserves shall be adjusted accordingly, as facts are developed, to properly reflect the exposure. These factors include but are not limited to:
a. Facts of loss
b. Applicable laws
c. Defense Counsel evaluations
d. Jury Verdict evaluation
e. The extent of plaintiff's liability (comparative negligence) f. The number of co-defendants and their percentage of liability g. The ability of the co-defendants to respond financially to any settlement or verdict. h. On cases occurring after June 3, 1986, Proposition 51 allows defendants to limit their liability on non-economic damages to their percentage of fault. i. On cases involving uninsured motorist claimants the recovery is limited to economic damages in accordance with California Code of Civil Procedures sections 3333.3 and 3333.4 (Prop 213).
j. Any other mitigating factors
2. Reserves shall be set at the most probable outcome even if it exceeds the Member’s Self -Insured Retention. In all litigated Excess reportable cases, the Member shall set a meaningful indemnity reserve.
3. Reserves shall be evaluated for adequacy at least every ninety (90) days. All reserve changes shall be documented in a paper or electronic file providing explanation of the reason for the reserve change
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56 or notation that the current reserve is adequate and why. PRISM shall be notified of all reserve changes within thirty (30) days of the change being made.
VIII. Documentation
1. E ach file shall contain information necessary to document the decisions made, including all demands, offers of settlement and settlement authority.
For those cases in which the (1) Bodily Injury claims reserved above twenty - five (25) percent of the S.I.R., (2) Property Damage claims reserved above twenty -five (25) percent of the S.I.R., and (3) All claims that meet PRISM’s excess reporting requiremen ts regardless of reserves, the following information shall be contained in each file:
a. Claimant(s) Information
b. Date of Loss
c. Claim Number
d. Facts of accident or occurrence
e. Witness/Participant Statement
f. Reserve rationale
g. Assessment of liability
h. Damages/injuries, including medical costs, lost wages, dependency, property damage estimates, total loss evaluations, loss of use claims, and other damages i. Index Bureau reporting
j. Coverage questions
k. Excess potential
l. Structured Settlement possibilities (where applicable) m. Alternative Dispute Resolution
n. Subrogation potential (where applicable)
o. Governmental Code compliance and immunities
p. Future course of action
q. Next diary date
r. If litigated, identify counsel on both sides
s. Offsets or liens that may need to be considered
t. Medicare eligibility and reporting
u. Risk and insurance transfer
IX. Case Settlement Factors
1. Settlement evaluation and authority by the Member shall be documented by George Hills . On cases exceeding the S.I.R., prior written settlement authority must be obtained from PRISM.
2. George Hills will ensure PRISM’s endorsement outlining the requirement for settlement within the City’s SIR is followed.
3. The settlement shall be reasonable in light of damages, injuries, liability, and any obligations to Medicare.
4. Settlements shall be effected in a timely manner, with consideration given to structures, statutory offers (Rule 68 or 998) where applicable, and/or alternative dispute resolution.
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57 5. When settlements reach PRISM’s layer, George Hills’ examiner will make sure authority will be obtained prior to the settlement, working directly with the City and PRISM obtaining written authority from the City and PRISM.
6. Contributions from joint tortfeasors shall be considered.
7. Proper releases and dismissals shall be secured and copies provided to PRISM by George Hills.
X. Litigated Files
The City of Stockton’s City Attorney (CA) shall retain the litigation management function .
George Hills shall assist in the implementation and conform to the procedures pursuant to the Litigation Management Program. The duties of George Hills shall include, but not be limited to:
1. Within 45 days following assignment, ensure defense counsel has submitted a preliminary evaluation of the lawsuit including a litigation plan and budget.
2. Ensure defense counsel submits status reports every 90 days to include new developments only.
Routine submission of repetitive, non-substantive status reports is not acceptable.
3. Coordinate with defense counsel to properly follow up on investigation/discovery requests, obtaining expert witness, complete field investigation, notifying relevant employees and other parties regarding pending litigation, etc.
4. Ensure all defense expenses, including but not limited to, depositions, motions, and discovery have been approved by the City Attorney.
5. No later than 30 days before trial, confirm defense counsel has submitted a report which includes:
a. An assessment of the Member’s liability exposure.
b. An assessment of the plaintiff’s damages.
c. An assessment of the legal defenses and probability of prevailing, including significant arguments of each party and expected counter arguments. d. Unique characteristics of the jurisdiction, presiding judge and opposing counsel . e. The verdict value assuming full liability.
f. Settlement value, considering defendant’s liability exposure and chances of prevailing. g. Status of settlement discussions.
6. Attend mediation, arbitration, settlement conferences on behalf of the City when necessary.
7. Evaluate defense counsel with respect to each defense assignment.
8. Ensure all attorney fees are billed at the agreed hourly rate. All bills shall state with particularity the legal work performed, the hours expended to perform the work and the costs incurred.
9. Audit all bills to make certain the billing practices are in conformance with the City’s litigation guidelines
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58 XI. Claims Management Information System (CMIS)
1. George Hills will convert all open and closed claims data and enter new claims data into George Hills’ CMIS.
2. George Hills will r ecord all claims in a CMIS. Claims records will contain all pertinent claim information, including but not limited to claim number, date of loss, date of claim, claimant name and address, location of loss, description of incident, loss reserves, loss payments, and expense reserves.
3. George Hills will create a review system to ensure accurate data will be entered into the CMIS. All claims must be reviewed on a periodic basis, as determined by the City. The review system will include a check on all the financial documentation entered into the CMIS to ensure the financial integrity of the system. In addition, the review system will include appropriate claims handling and reserving procedures, and timely file closures.
4. George Hills shall use electronic notes in the CMIS to record activity which shall be updated with new developments. All significant documents (e.g., email communications, status updates from counsel, etc.) will be scanned/saved into the database by George Hills.
5. George Hills shall provide CMIS training, support, and access for up to three (3) City Risk Services staff so that they may search for claim information and data, as required.
6. George Hills will provide specified standard loss reports as agreed upon.
7. George Hills will provide special reports as needed by the City.
8. George Hills will provide data transfer services to the City’s Risk Information Management System (RMIS).
3. BEST PRACTICES
CLAIMS ADMINISTRATION
George Hills has developed best practices in claims management, and we believe our process and specific alignment with your needs and expectations collectively results in a reduction of claims expenses.
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59 Best Practices Claims Approach
George Hills’ Best Practices General Liability Claims Handling Manual and Best Practices General Liability Litigation Manual are followed by all George Hills claims processors, adjusters, and supervisors in addition to the specific rules, regulations, and requirements of each individual client.
These manuals support the scope of work, procedures, processes, and requests of the City. Our stated mission is always “to provide the highest level of quality, customer -focused claims service”. We accomplish this by assigning teams of experienced individuals who have managed similar accounts for many years.
Our best practice approach to claims management centers around early communication and transparency of information. Early communication with claimants leads to faster claim resolution, and the transparency of information provided to the City gives insight to the claims process from inception to close.
Best Practices Quality Control
Our processes, procedures, and methodologies center around adjuster accuracy and customer satisfaction. Quality control comes at the technological (automated) level, and at the human (adjuster/supervisor) level by George Hills’ Supervisors and Client Servi ces Managers.
Communication
Phone calls and emails will be returned within 24 hours. All other written communication will be responded to within three (3) business days.
Contact
• 24-hour emergency contact will be made within one (1) hour of assignment or phone call. • Initial contact will be made with the insured/client, claimant, and witness within one (1) business day of receipt of their information. If no contact is made with the claimant, two (2) subsequent contact attempts via telephone will be made within the first 48 hours after receipt of the claim. If we do not have contact information for the claimant, or have incorrect information, extra attempts will be made to secure correct contact information, such as a Google or online ‘white pages’ search. If the City’s protocols are such that a claimant is not to be contacted, this will be documented in the adjuster’s file notes. • An acknowledgement letter or email will be sent to all pertinent parties containing the adjuster’s contact information and claim number, unless instructed otherwise.
Adjuster Initial Review and Contacts
Upon notification of a new assignment, the adjuster will:
• Review the information in CMIS for accuracy
• Review all attached documents and notes in the file
• Review the tort claim for timeliness and sufficiency and take appropriate action, including recommendations for sending tort claims notices
• Set initial reserves
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60 • Make initial contact with the insured/client, claimant, and witness(es) within one (1) business day of receipt of their information. If no contact is made with the claimant, two (2) subsequent contact attempts via telephone will be made within the first 48 hours after receipt of the claim.
Investigation
An investigation plan is developed for each claim to assess the liability and damages exposure efficiently and effectively. Applying their experience and expertise, the adjuster tailors the scope of investigation to the nature and exposure of the claim. The investigation may include:
• Gathering all internal documents from the City, including reports, maintenance logs, photos, contracts, easements, certificates of insurance, etc.
• Conducting a scene inspection with photos and diagrams as warranted • Interviewing City staff
• Obtaining official reports
• Interviewing and obtaining statements from the claimant and witnesses • Obtaining damage estimates, invoices, and/or damage appraisals • Obtaining all pertinent medical records
George Hills will identify and engage an interpreter/translator that is acceptable to the City. When possible, we will utilize one of our bilingual employees to assist with translation. Where warranted, we will seek authority from the City to engage experts.
Risk Transfer and Indemnity Rights
During our investigation, we actively seek to identify all risk transfer and indemnity/defense rights owed to the City through contracts, agreements, additional insured statuses, easements, etc. With the City’s approval, we promptly and vigorously pursue t ender/cross-complaints on behalf of the City against all potentially responsible parties and/or their insurance carriers.
Reserving of Claims
The establishment of reserves is one of the most important tasks we perform for our clients – it impacts critical areas, such as funding levels and budgets. George Hills’ philosophy is to set reserves on a “most probable outcome” basis. Our best practice is to establish separate reserves for indemnity and expense; however, we will reserve according to the City’s policy. Adjusters are required to set initial file reserves for indemnity and expenses (legal and adjusting) within five (5) days of assignment.
Adjusters review claim reserves each time they interact with a file, and specifically on each diary date.
Reserves take into consideration liability as to the City and comparative fault of the claimant/plaintiff, type of injury, damages, prognosis, expenses (e.g., medical and wage), and any anticipated general damages. Litigated files include separate reserves for legal expenses based on a current litigation plan and budget.
Updating Clients on Major Reserve Changes
The City will receive monthly reports which include reserves and/or reserve changes. ClaimsXpress will send push notifications when the reserve change meets the threshold that George Hills and City have established. Our best practices dictate that all rese rve changes be entered as soon as the adjuster becomes aware of the need for a change.
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61 Supervisory Approval of Reserve Changes
Supervisors must approve all reserves set by an adjuster. The decision -making authority on revising the reserve is initially set at the level where the work is being done. However, large increases in reserves will be reported immediately to the supervisor and/or the City as required.
Notification and Updating of Excess Insurers
It is the responsibility of the adjuster to promptly report (within 30 days of receiving notice of a reportable claim) any case meeting the reporting requirements of the excess carrier, or as instructed by the City. The adjuster will also provide status re ports to the excess carrier/pool (including reports from defense counsel) at the required intervals.
George Hills will notify the City’s excess carrier(s) in any number of situations according to the requirements of the excess policy carrier’s stipulations. First, the excess carrier is notified no later than 30 days after receipt of a reportable claim. Se cond, notification is sent when reserves are set on any reportable claim or suit involving multiple claims or suits arising out of one occurrence, or any claims or reserves amounting to 50 percent or more of the retained limit. Third, excess carriers are n otified regarding Title 42 USC 1983 cases in which a complaint has been served and the plaintiff is represented by legal counsel or with reserves of 25 percent or more of the retained limit.
Lastly, regardless of the reserve, notification is sent on any claim involving the following:
• One or more fatalities
• Loss of a limb
• Loss of use of any sensory organ
• Quadriplegia or Paraplegia
• Third degree burns involving 10 percent or more of the body • Serious facial disfigurement
• Paralysis
• Closed Head injuries
Timeline of the Claims Handling Process
The following takes place from receipt of a new claim:
Within 24 Hours
• Index new correspondence and new claims for damages to determine if they belong to an existing claim
• Claims data entered into ClaimsXpress, our CMIS
• Acknowledgement of new assignment sent to the City
• Claimant/Claimant’s attorney is called, emailed, or both to acknowledge and provide claim and adjuster information
Within 2 Days
• Two-point contact made with claimant (or their attorney) and the City
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62 Within 5 Days
• Reserves Set
Within 30 Days
• Claim tendered (if appropriate)
• Liability determination
• Excess carriers notified
Monthly
• Monitor closing ratios
• Statistical report (all claims activity) provided to the City • Payment register provided to the City
• Plan of Action (POA) updated
• Watch list claims meetings
• Case reviews (90 days if waiting for activity by others, 180 days if waiting on expiration of a statute of limitations)
Cost Saving Methods
Through our efficient and thorough investigation, there is a two-point contact within one (1) business day of receipt of each claim. We ensure the liability investigation is completed early, and many claims are not pursued when they are denied or rejected early in the process. In these instances:
• Attorneys Will Likely Pass On The Case: Attorneys are less likely to take a case that has already been denied.
• Establishing Defense Early: By not establishing your defense position early, a claimant is often more likely to think they will receive a settlement. • Securing Witness And Claimant Statements Early : This action is essential, lest they forget critical details or revise the facts to help their position. • Indexing Claimants Pursuing Injury Claims: We verify if they have made similar claims in the past, and/or have prior injuries that are unrelated to our matter. • Secure Complete Medical Records: If there is liability and injuries are claimed, we secure complete medical records to check for pre-existing conditions.
We explore all tender possibilities based on the claimants’ allegations, because allegations trigger coverage regardless of liability. First party subrogation recovery services (see page 36) returns 100% of funds to our clients.
Litigation Management
Through our extensive experience managing claims for hundreds of different public agencies, George Hills has developed the expertise to adapt our litigation management services to fit a wide range of litigation management program structures. This ranges fr om full litigation management responsibility, including retention and direction of defense counsel and management of defense costs, to basic litigation support for the City’s in-house defense team.
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63 George Hills’ philosophy and guidelines for providing litigation management services are focused on achieving the best result for our client while aggressively managing costs. This is driven by our litigation best practices, which include:
• Securing the litigation budget within 45 days of assignment to defense counsel. Our adjusters review defense counsel bills in detail to ensure they are reasonable and in line with the litigation budget.
• Training our adjusters to perform a risk weighted analysis early in litigation to establish a target settlement number before incurring extensive defense costs, pursuant to the City’s risk protocols.
• Utilizing adjusters to complete tasks when possible, in lieu of an attorney. • Using statutory settlement offers, such as 998s, when appropriate to possibly recover costs if a favorable verdict is received.
When a claim becomes litigated, George Hills’ claims adjusters do not simply assign a file to defense counsel and vanish but operate as true litigation managers. We believe it is the responsibility of our claims adjusters to work closely with defense couns el until the case is resolved and the claim file is closed. A good early investigation, coupled with an experienced litigation manager, helps bring the case to an earlier resolution. We strategize early and often with the client and defense counsel and monitor the case to ensure counsel stays on track.
Our full litigation management services include the following:
• Within five (5) days of the assignment by the City, contact will be made by the lead claims adjuster and with any assigned defense counsel. An appropriate plan of action will be discussed, and initial case analysis will be reviewed to determine what course of discovery and motion/defense strategy to implement.
• Within 60 days following the assignment of a case, defense counsel will complete and return a complete case analysis to the City, the George Hills adjuster, and the claims supervisor. The case analysis will include a comprehensive evaluation of the case an d formalize the defense strategy crafted by the team.
• In addition to the initial case analysis, counsel will provide an accurate estimate of defense costs for all litigated cases as set forth in the exhibits. Defense counsel is expected to stay within the estimated case budget throughout the litigation and to report on fees expended in relation to the budget as requested.
• After the initial case analysis, defense counsel will provide mandatory written status reports at 60-day intervals, setting forth all substantive developments. The defense attorney handling the claim will prepare the status reports. Defense counsel will re port only on new developments since the last report, as it is not necessary to repeat case facts or information previously reported. Status reports will be as objective and straightforward as possible to allow the George Hills adjuster and claims superviso r to meaningfully analyze the case and determine the course of action to be taken.
• George Hills monitors defense counsel to ensure that counsel stays true to the plan of action and within the defense budget. This includes monitoring defense counsel procedures, mandating regular reporting by defense counsel, and reviewing legal bills for appropriateness
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64 as directed by the American Bar Association standards or by the City’s instructions to ensure the claim is resolved in the most cost-efficient manner. • George Hills has developed specific guidelines that include creating and monitoring a watch list of any claims that, because of allocated expenses, expense reserves, case reserves, or a combination thereof, may present a threat to pooled funds or have alre ady reached pooled funds. Though the City may wish to assign claims to their watch list for the Litigation Manager, George Hills’ watch list typically starts at the primary level. If chosen to provide third -party administration services, George Hills will continue to follow these guidelines to create a watch list of claims that have the potential to exceed the City’s SIRs and monitor those claims until the case resolves.
Reporting New Claims
Depending on the nature and urgency of an incident, new claims can be reported to George Hills in several ways:
• Routine, non-urgent tort claims can be sent via email through our dedicated intake portal, which is monitored by our claims support team to ensure timely setup in the claims system within one (1) business day.
• More urgent matters can be reported directly by phone through your designated adjuster, supervisor, or claims processor.
• After-Hours Critical Incident Response: The City will be provided with the after -hours contact information for your primary designated adjusters, who can usually respond to the scene of a critical incident within one (1) hour of contact.
File Setup
Within one (1) business day of receiving notification of a new claim – usually the same day – the claims processor will take the following steps:
1. Enter the data into CMIS, including assignment of the adjuster.
2. Attach any paperwork received with the claim to the CMIS.
3. Notify the assigned adjuster of the newly assigned claim. a. These actions trigger the CMIS to set an automatic diary for the adjuster and their supervisor.
4. Send an acknowledgement of new assignment to the City, including claim number and assigned adjuster information.
5. Make initial phone contact with the claimant or their attorney, if so instructed, with the claim number and contact information for the adjuster, including a follow -up acknowledgement letter.
Electronic File Management
Claims Progress Notes – All file activity is documented in the Notepad of the electronic claim file as it occurs. Dropdown boxes for notepad types allow the adjuster to be specific as to the type of activity (i.e., phone call, correspondence received or sent, claim filed). The su bject line allows for further specific yet brief information for an at-a-glance review in CMIS. Notepads are important to document
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65 phone conversations or receipt of materials; they serve as a chronological outline of what activity has taken place.
Claim Documents – All claim documents are attached to the electronic claims files as they are obtained. This includes text/PDF, spreadsheets, photos, audio and video files, in all electronic media formats. Each document is annotated with a description and a corresponding No tepad entry.
Diaries – Upon setup in CMIS, a file review diary is automatically set for the adjuster. Our best practices ensure that each assigned case is reviewed at least one every 30 days for active files, 90 days for extended diaries awaiting activity by others, and up to 18 0 days on files in which the adjuster is awaiting the expiration of the statute of limitations. All diaries are maintained through CMIS. All activity during the diary review is documented in the Notepad. No claim is re -diaried without specific indication why no further action was taken.
George Hills’ claim supervisor will maintain separate diaries and other audit controls necessary to review and ensure timeliness in handling, as well as ensuring other claims standards and reporting requirements are being met.
Plan of Action (POA) – The Plan of Action (POA) is a special Notepad document that provides the current summary of the claim, including current financials (payments and reserves), investigation findings, assessment of the exposure, status of litigation (if applicable), and the p lan for moving the claim to resolution. The POA is reviewed and regularly updated at each diary review, or whenever there are material changes in the claim. The POA has proven to be an effective tool for managing the file and a valua ble resource for our clients, auditors, and when conducting file reviews. The City will have online access to the POA entries in the claim summary view. A sample POA can be found on page
55. ClaimsXpress Claims
George Hills has used ClaimsXpress as our Claims Management Information System (CMIS) for 9 years.
ClaimsXpress (CXP) is a secure cloud browser-based software system that allows our claims adjusters to work anywhere, from the scene of an incident to our co rporate office. Similarly, the system being browser-based allows the City 24 -hour, read-only real-time access of its claims information. George Hills owns perpetual licenses to CXP and we contract with Spear Claims to provide the Microsoft Azure- based secure cloud, in which our clients’ data is housed.
Searching within CXP for specific claims data is simple, but to minimize the need to search, George Hills has developed dashlets within ClaimsXpress to allow the City and adjusters quick access to relevant claims information right on their homepage.
As part of the onboarding process, George Hills will hold a training session with all potential client - side ClaimsXpress users, ensuring that everyone has the desired level of access and understanding of the system.
ClaimsXpress is an entirely paperless system. All claim files are stored electronically in a secured Microsoft Azure cloud hosted by Spear Claims, available to any authorized user, using any browser, at any time.
ClaimsXpress is configured to enforce additional security measures when necessary. It can limit a user’s access to claim information by a client’s organization structure, for example allowing access to view claims for a single location or for the entire or ganization. CXP also includes identifiers for highly
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66 sensitive or confidential claims. When a claim is flagged as confidential, ClaimsXpress will limit access to that claim by individual User ID.
The use of ClaimsXpress increases our firm’s service capabilities for the City and enhances our service workflow efficiencies and custom reporting capabilities. The alignment of these technologies with George Hills’ services is of great value to the City b y providing real -time access to decision -making data, metrics, and trends. When it comes to read -only access, reporting, and modification abilities to meet the City’s needs, our technology offering is unmatched.
Client Portal
George Hills is thrilled to launch our self -service client portal. The City will have their own dedicated Portal for staff to access. We can tailor the Portal to directly complement the City’s preferred level of access. This new web -based platform provides our clients with exclusive access to the following features:
• Secure file sharing and document management
• Quick reporting and metrics on dashboard
Best Practice Claims Data and Information Management
George Hills’ ability to develop and maintain the City’s data metrics for decision -making as well as to provide accurate statistical reporting is due solely to our commitment to best practices in our Information Technology processes. Our Claims Management Information System (CMIS) provides George Hills and our clients with exceptional expert resources. We can rely on our system’s commitment to security to ensure your data is safe; to demonstrate this commitment, our team completes an annual disaster recovery exercise to safeguard against potential data loss.
Timely resolution of claims is another best practice we employ. Generally, the longer a file is open the costlier it is for our clients. Superfluous open reserves on a client’s book of business can negatively affect financial results. As such, one of the i tems reviewed by supervisors when they audit files is timeliness of closures. The supervisor will also review whether the adjuster is continuing to update the claim diary. Every time an adjuster interacts with a file, they should do everything necessary to move the file closer to resolution.
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67 1st Party Subrogation Recovery
George Hills provides subrogation recovery services to many of our clients. In 2013, George Hills created a dedicated Subrogation Recovery Unit to handle recovery opportunities for our clients who have requested or contracted with us for subrogation recove ry services.
George Hills has a dedicated team with extensive experience in the public entity environment who handle all 1st party subrogation matters for our clients who choose this service. Below are testimonials from a few of George Hills’ subrogation clients:
PUBLIC ENTITY TESTIMONIAL STATEMENT
Client of
Sacramento
Risk & Loss Control
“We have utilized the George Hills Subrogation unit for several years, and simply put - they get results. They have a wealth of knowledge and expertise. Our 1st and 3rd party claims are always handled promptly and professionally. Partnering with George Hills for subrogation has proven to be a wise decision for our Client.” City of Sacramento
Risk Management
“We are pleased to be partnering with George Hills for our subrogation recovery services. They provide quality staff and services.”
City of Oakley
Kevin Rohani, Public
Works Director/City
Engineer
“The City of Oakley has utilized the services of George Hills Subrogation Team for several years, and we have been very happy with this service and the professional approach that the George Hills Team brings towards the subrogation process. The knowledge and expertise of the George Hills Team has been invaluable for the City of Oakley, and we are very grateful for their great work in resolving our assortment of third -party claims and we are looking to many more years of successful collaboration with the George Hills Team.” City of Oakland
Human Resources
Management/Risk
Management Unit
“We have utilized the George Hills Subrogation unit for several years, and they get excellent results. They have a wealth of knowledge and expertise, and their professionalism and prompt attention to our needs is second to none. There’s no better service out there that can beat them, and the rates are below the typical rates offered by other vendors. Our third -party claims are always handled promptly and professionally. Our partnership has proven itself to be the best decision for our City.”
Quick Stats on George Hills’ Subrogation Recovery Results 2,272 - Average number of subrogation claims handled in 2024 91% - of claims handled result in a Recovery
83% - of claims result in a full recovery (including GH Fees) 84% - of amounts sought for our clients are recovered
Average recovery: $5,590.53/claim
George Hills’
subrogation recovery
unit has performed
spectacularly,
recovering several
million dollars on
behalf of our clients.
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68 Our standard subrogation fee is 30% of the amount collected, however George Hills has been successful more than 80% of the time collecting our fees, thus equating to recovery essentially free of charge. The minimum amount to be paid to George Hills will be $250 per claim.
Generally, no recovery shall be agreed to involving payment plans if the recovery is less than $5,000 and/or greater than a one-year term. Exceptions can be made on a case-by-case basis. If a recovery is agreed to above this amount, the subrogation fee sha ll be 45%. In the event a payment plan is authorized and entered, the subrogation fee will be based upon the total amount of the lien and will be invoiced to the City.
If authorized, small claims court appearances for recovery of funds will be priced at $ 250 per appearance. In the event of multiple appearances for the same court on the same day, a flat fee of $500 is priced for half a day, and $1,000 for a full day, regardless of the number of claims handled on that day.
The benefits of George Hills’ subrogation recovery:
• High-level expertise of subrogation recovery
• Recovery of damages to property, utilities, hazardous material cleanup • Small claims
• Preparation of proof of loss statements
• Claim reporting activity, demand letters, final demand to claimant with suspended license, closing and/or payment transmittal
• Settlements
• File retention
• Development of policy and procedures
• Provision of account manager and lead subrogation adjuster
4. QUALITY ASSURANCE PRACTICES
Our processes, procedures, and methodologies center around adjuster accuracy and customer satisfaction. Quality control comes at the technological (automated) level and at the human (adjuster/supervisor) level by George Hills’ Supervisors and Client Services Managers.
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69 APPENDIX
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70 Section 8 Form – Proposal Documents
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71 Attachment B – Propo nent’s Covenant
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72 Attac hment C – Non-Collusion Affidavit
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73 ATTACHMENT A
74 Attachment D – Agency Reference List
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75 Attachment E – Certification of Financial
Condition
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76 Attachment F – Cost/ Price Proposal
Please find Attachment F in the separate file PUR 25-042 TPA FOR GENERAL LIABILITY George Hills_Pricing.pdf.
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77 Attachment G – Subcontractor List
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78 Attachment H – Exceptions
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79 George Hills Company, Inc. hereby submits the f ollowing explanation and recommendation for exceptions, alterations, and/or modifications to the sample Exhibit C: General Terms and Conditions.
George Hills Company has reviewed the City of Stockton Sample Contract and is willing to submit to the terms and conditions therefore with the following changes.
Section 11: Termination
Original Text in Sample Contract:
Section 11.1: Termination for Convenience of City. The City may terminate this Agreement at any time by mailing a notice in writing to Contractor. The Agreement shall then be deemed terminated, and no further work shall be performed by Contractor. If the Agreement is so terminated, the Contractor shall be paid for the work actually completed at the time the notice of termination is received.
1) Explanation of Reason for Change:
While termination for convenience is an acceptable term, based on the type of services being performed George Hills requires 90 days notice of termination in order to properly unwind the relationship and preclude any detriment to the City in connection wit h the claims and lawsuits which are the subject of this contract.
2) Proposed Alternative Language:
Section 11.1: Termination for Convenience of City. The City may terminate this Agreement at any time by mailing a notice in writing to Contractor at least 90 days prior to the effective termination date. The Agreement shall then be deemed terminated on the effective date , and no further work shall be performed by Contractor after that date . If the Agreement is so terminated, the Contractor shall be paid for the work actually completed at the time the notice of termination is received through the termination effective date.
Section 13: Indemnity and Hold Harmless
Original Text in Sample Contract:
Section 13: Indemnity and Hold Harmless. To the fullest extent permitted by law, Contractor shall hold harmless, defend and indemnify City of Stockton and its officers, officials, employees and volunteers from and against any and all liability, loss, damage, expense, costs (including without limitation costs and fees of litigation) of every nature arising out of or in connection with Contractor’s performance of work hereunder or its failure to comply with any of its obligations contained in this agreement, except such loss or damage which was caused by the sole negligence or willful misconduct of the City of Stockton. This obligation is independent of, and shall not in any way be limited by, the minimum insurance obligations contained in this agreement. These obligations shall survive the completion or termination of this agreement.
1) Explanation of Reason for Change:
George Hills requires a mutual indemnification provision since the risk of George Hills be named as a defendant in a case solely because of its work on behalf of the City is equal to the risk of the City being sued because of the work of George Hills.
2) Proposed Alternative Language:
Section 13: Indemnity and Hold Harmless: GH will defend, indemnify, and hold harmless City from and against all claims, demands, actions, or causes of action arising directly or indirectly from the negligent action, conduct, or failure to act by GH personnel (“Indemnity Event”), except that indemnity under this section does not apply with respect to any claim, demand, action, or cause of action arising out of the sole negligence or willful misconduct of the City. This right to indemnity shall not cover any claims in which there is a failure to give GH prompt and timely notice, within thirty (30) days of notice
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80 received by the City which implicates this provision, but only if and to the extent that such failure materially prejudices the defense of such claims. For an Indemnity Event, the maximum amount recoverable by City against GH for damages and costs (inclusi ve of attorneys’ fees) is limited to the insurance policy limits, of the policy which covers the Indemnity Event held by GH, in place at the time of the Indemnity Event.
City will defend, indemnify, and hold harmless GH, and/or employees of GH, from and against all claims, demands, actions, or causes of action, which may arise, from the action, conduct, or failure to act by City. In any cases subject to this indemnity prov ision, wherein GH, or any employee of GH, is named in a filed or verified complaint simply by virtue of the fact it is the claims administration firm, or an employee thereof, on a given claim, the City will defend GH, and/or its employees, at no cost to GH or its employees.
Section 14: Insurance
Original Text in Exhibit 1 to the RFP which is anticipated to be attached to the Contract:
Minimum Scope and Limit of Insurance
Paragraphs 1 & 2 and all other references to any specific ISO form: Suggest removing reference to specific ISO forms. George Hills cannot control the forms utilized by carriers to establish coverage. It is usually recommended that we use language such as “….coverage written on forms in common use in the insurance industry and which are acceptable to the City after review…” “If the Contractor maintains broader coverage and/or higher limits than the minimums shown above, the City of Stockton requires and shall be entitled to the broader coverage and/or the higher limits maintained by the contractor.” It is recommended that we remove this section of the requirement. Many carriers are limiting coverage to only that coverage which is required by contract. Therefore, any limit above and beyond required would not apply. This coverage is already in place for George Hills and is not being newly obtained solely for the City of Stockton contract and as such, the ability to modify this coverage is limited.
Primary Coverage
“This requirement shall also apply to any Excess or Umbrella liability policies” Primary and non - contributory does not apply to an Umbrella policy. We suggest removing this requirement.
Notice of Cancellation
“Each insurance policy required above shall provide that coverage shall not be canceled, except with notice to the City of Stockton.” Suggest adding : “except with notice to the City of Stockton, within a reasonable amount of time”.
Waiver of Subrogation
A waiver of subrogation is only available under the Commercial General Liability, Auto, and Workers’ Compensation policies, and as such this requirement should be limited to only those coverages.
Self-Insured Retentions
“The City of Stockton may require the Contractor to purchase coverage with a lower retention or provide proof of ability to pay losses and related investigations, claim administration, and defense expenses within the retention." It is recommended that we r emove this portion of the requirement.
The City of Stockton cannot dictate the SIRs or Deductible levels for insurance which is already in place and providing coverage to multiple clients of George Hills.
Acceptability of Insurers
It is recommended that the City all inclusion of insurers that are rated “ A-“ rather than “A”. “A-“ is still a secured rating from A.M. Best. Gallagher has stringent guidelines for insurers that we do business with and “A -“ rated are acceptable. “A -“ gives us much more flexibility when placing GH’s insurance coverage should an “A” rated not be available at an acceptable price.
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81 Amendments
There are no amendments to the RFP.
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82 Sample Reports
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PRICING
CITY OF STOCKTON
THIRD PARTY ADMINISTRATOR (TPA) TO
MANAGE CITY’S SELF -INSURED GENERAL
LIABILITY PROGRAM
RFP PUR 25 -042 ................................ ................................ ......... Submitted : June 5 , 202 5
George Hills
PO Box 278, Rancho Cordova, CA 95741
Phone: (916) 859 -4800 , Fax: (916) 859 -4805
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5.3 PRICE SHEET
1. PRICING
FEE SECTION TERMS
One Time Startup Fee – George Hills is strongly interested in partnering with the City of Stockton, and as such, this fee has been waived for the City of Stockton.
The process of onboarding a new client covers many areas, from establishing expectations, policies, and procedures, to designing the infrastructure (process, people, and systems) to meet the needs of risk management, council, and department heads. It also involves time and effort in establishing the Trust Account or check writing, W -9, and all federal and state reporting requirements. Most importantly, this process involves the est ablishment of effective claims triage. Note that this is not time spent on the actual data conversion.
Annual Administration Fee – George Hills has determined it takes a company-wide effort to ensure we exceed the expectations of our clients. As such, we feel it transparent to separately identify and charge for those critical functions that are not directly tied to claims handling. W e include an annual administration fee, which covers the following activities:
• Executive attendance at any City Executive Committee Meeting or Board Meeting • Claims Management Information System (CMIS) services and reports • Access to CMIS and training
• Monthly listing of open claims, showing expense categories, reserves, and total incurred • Monthly claim summary reports
• Monthly hours and claims data detail for billing
• Providing loss run data and required reports
• Access to GH Client Portal
• Providing annual reports to outside agencies
• Filing of regulatory reports, such as 1099s, W-9s, etc. • Trust Account
• Establishment and maintenance of a trust account to pay indemnity and expenses that may be due on claims; the amount to be maintained in the trust account shall be determined by the City. If the trust account is set up with the GH preferred bank then George Hills covers the cost of Positive Pay and Payee Match.
o If the City prefers an alternate bank, there may be an additional setup fee, as other banks’ processes can be extraordinarily time consuming. • New bank account setup, including signature cards, test checks, online access, and setup of bank in CXP
• Discussion and agreement on the approval process
• Preparation of W-9s
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• Processing of checks weekly
• Submission of positive pay (if applicable) and monitoring of positive pay (review of daily emails from bank for exceptions)
• Maintenance of a copy of all checks drawn by George Hills to pay claims and claims -related expenses
• Monitoring of account balance, preparation of replenishment requests as needed (custom requests for each client’s needs)
• Monthly bank reconciliation (prepared and sent to the City) • Payment of invoices that are pass -throughs, such as invoices for medical record copies, ExamWorks, etc.
• Certificates of insurance as required by the Contract • Annual service
• Response to outside financial auditors
• Provision of reports to the City’s actuaries and claims auditors • Submission of GH SSAE 16 reports, or the current equivalent • Account Management
Mileage: Adjuster – Mileage is paid at the current IRS rate.
MMSEA – Both the one-time setup fee and the annual reporting feeds to offset fees paid directly to ExamWorks.
Adjuster Travel Expenses – For mediations, settlement conferences, trials, etc.; subject to prior approval and submitted with receipts.
CXP Access Fee – Included in the annual administration fee is the setup and management of five (5) user accounts through our CMIS: CXP.
iMetrics Report Fee – There will be no charge for our iMetrics business intelligence reports with executive in-person debriefs.
Custom Reports – Additional charged for custom reporting are defined as being client -specific and needing a third-party programmer for three (3) hours or more.
Conversion Fees – This fee is intended to cover costs associated with data conversion, transition, and contract closeout. The data conversion fee is dependent on many factors which will need to be discussed. If George Hills is retained for five (5) years, we will entirely absorb the conversion fee. If George Hills is not retained for the full length of the proposed contract, then the client shall be subject to a fee of 20 percent each year not retained, not including shipping, storing, scanning, copying, or otherwise handling open or closed paper claim files (this shall be a separate charge based on the Scope of Work).
George Hills will charge for any agreed services related to conversion storage, copying, scanning, shipping, and disposal.
Catastrophic Pricing – Applicable only to Fixed Fee and Time And Expense With A Cap Fee agreements. George Hills recognizes that in the event of a catastrophe, additional hours will need to be applied to the handling of such claims. As such, to preserve the quality and efficiency of service for
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which we are known, George Hills proposes that should a catastrophic event occur resulting in 10 or more claimants or claims from a single occurrence, the client shall be billed at the current hourly rate.
Annual Fee Escalator – The Annual Fixed Fee and all hourly rates shall be adjusted at the beginning of each of the remaining years of the term by the lesser of 5%, or in accordance with the changes in the Consumer Price Index (CPI -U) for all Urban Consumers for the Western Regi on using the most recently published annual percentage change, but in any event such increase shall not be less than 3%.
Termination Fee – In the event of contract termination, George Hills’ procedures and cost for run-off claims will be billed at the current hourly rate; no charge for historical loss summaries. George Hills believes that the successful transition of claims requires preparat ion, so we ask for 90 days’ notice if the contract is terminated without cause to facilitate the transition of claims management properly and efficiently.
General File – A general administrative file shall be established and maintained to track effort related to services necessary to fulfill our contractual obligations and not otherwise associated with a claim.
Storage – George Hills will charge for any services related to storage, retrieval, copying, scanning, shipping, and disposal of paper files.
ADJUSTING SERVICES FEES - OPTIONS
Option 1A: Time and Expense – George Hills believes, as in the legal field, services surrounding claims and potential litigation are best captured by directed effort. In this case, the client only pays for the services requested. In a time and expense environment, George Hills applies its best practice approach to all claims; unless the client adjusts, restricts, or expands such services. A general administrative file will be established and maintained to track effort related to services necessary to fulfill our contractual obligations not otherwise associated with a claim.
Time and Expense for Adjusting Services
Supervisor $135/hour
Senior Adjuster $115/hour
Adjuster $102/hour
Claims Processing $89/hour
All fee options are subject to the Annual Fee Escalator described above.
Please note that we are proposing Time and Expense for litigat ed matters.
Option A2: Time and Expense with a Cap – George Hills believes that this can be the best of both worlds. This pricing model allows for the realities of the unknown to dictate service results but retains some budget certainty. The cap will always be more than the fixed fee to protect the unknown, but often can result in less cost too. The cap is a movable target and should be adjusted annually until the services and relationship have settled.
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The above hourly rates by position are the same for both options A1 and A2. The only difference shall be that George Hills will commit to an annual maximum fee for adjusting services for option A2, in the amount of $475,000. Please note that the catastrophic pricing is applicable, and therefore outside of the annual maximum fee.
All fee options are subject to the Annual Fee Escalator described above.
Option B: Fixed Fee – George Hills believes this is a workable solution for public agencies seeking budget certainty. Unfortunately, it has its challenges. First, every other significant component of a claim (settlement and legal fees) is not predictable and as such, making the adjusting costs fixed will ensure that 100 percent of the time the fee will be wrong. Secondly, the result could be that the client is receiving far more resources than they are paying for, or the client is paying for far more resources than they are receiving in services on any one claim. Either outcome is wrong.
In this environment, George Hills makes every effort to be resource -sensitive in applying our best practices to ensure we balance the economics. No matter what, we put forth the right effort to resolve the claim. We do, however, adjust our clients’ fees that can and should be adjusted to meet our clients’ budget goals.
George Hills has developed a hybrid Fixed Fee Proposal. California Public Entities have seen dramatic increases in claims frequency in contrast to pandemic years. As such, we wanted to create a simple fee model that allows for fee adjustments down or up due to claims frequency, as hopefully frequency drops back down. Since claims activity is the main indicator for TPAs and the number of resources needed to perform quality services, it is important that adjustments can be made to resources provided and resulting costs for the benefit of the client and TPA.
Our model provides for an assessment of claims frequency twice a year – after six (6) and twelve (12) months. We have established the change must be at least 10% to trigger an adjustment and no more than 25%, as greater than that warrants a contract modifi cation. For the City’s proposal the model would result in an adjustment in the event claims frequency dropped below the current estimate of new claims per year. In the event claims dropped below or increased above this estimate, an adjustment would automatically occur during the 7th and/or 13th month. The claims base would be adjusted to this new level for future year calculations.
For the City, the financial result would be calculated based on the percentage increase or decrease ranging from 10 -25%. For example, if the increase/decrease was 10%, the fee would decrease from $427,500 to $470,250. Conversely, if there was a 10% increase the fee would increase from $ 427,500 to $384,750.
Fixed Fee
Fixed Fee—Claims Only $427,500
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GENERAL ADMINISTRATIVE FEES – ADDITIONAL TO ADJUSTING
FEES
Fixed Fee and Cap pricing will be based on the current average. Should the claim volume change more than 10% in severity or frequency in a year, we request a reevaluation of our pricing agreement. *All fee options are subject to the Annual Fee Escalator described above.
Subrogation Recovery Services
The fees for Subrogation Recovery services is 30% for each recovery obtained—if no recovery is made, there is no fee. The minimum amount to be paid to GH will be $250 per claim upon recovery. Please note, on most subrogation recovery claims sent to George Hills, we are successful in recovering our 30% fee, thus the net cost is zero.
General Administrative Fee Section – Applicable to each fee option.
One-Time Setup Fee $15,000 - Waived
Annual Administration Fee – billed yearly $25,000*
Mileage - Adjuster Current IRS Rate
MMSEA Annual Reporting Fee (paid to ExamWorks, billed
yearly)
One-Time Setup: $300
Annual Fee: $500
Adjuster travel expenses for mediations, settlement
conferences, trials; subject to prior approval.
Actual
CXP access fee (up to 5 users) Included
Custom reports, if exceeds three hours and is client
specific
$185/hour
Allocated File Expenses (see attached details) At cost
Catastrophic Pricing Current hourly rate
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ALLOCATED EXPENSES
Typically, allocated expenses are those expenses that are generated by a claim (by outside vendors other than George Hills) that cannot be foreseen nor included in this Contract. These expenses are generally allocated back to the specific claim file for wh ich the cost was incurred and then charged back to the entity whose claim incurred that cost. In most situations these are pass -through costs (with processing fees) for services and/or fees not directly generated by the TPA, but rather by a third- party consultant where the TPA has acted as an agent on behalf of the entity to necessarily outsource services to a third-party consultant and/or miscellaneous fees applicable to the specific claim applied by an outside entity, such as a court or copy services. Bel ow, George Hills has provided a non - exhaustive list of typical allocated expenses.
Paid to GH
• CMS reporting costs and fees (ExamWorks)
Paid to Others as Authorized by Client
• Fees of outside counsel for claims in suit, coverage opinions, and litigation, and for representation and hearings or pretrial conferences
• Fees of court reporters
• All court costs, court fees, and court expenses
• Fees for service of process
• Costs of undercover operatives and detectives (if initially paid by GH) • Costs for employing experts for the preparation of maps, professional photographs, accounting, chemical or physical analysis, or diagrams
• Costs for employing experts for the advice, opinions, or testimony concerning claims under investigation or in litigation for which a declaratory judgement is sought • Costs for independent medical examination or evaluation for rehabilitation • Costs of legal transcripts of testimony taken at coroner’s inquests, or criminal or civil proceeding
• Costs for copies of any public records or medical records • Costs of depositions and court reporting
• Costs and expenses of subrogation (if not George Hills) • Costs of engineers, handwriting experts, or any other type of expert used in the preparation of litigation or used in a one-time basis to resolve disputes • Witness fees and travel expenses
• Costs of photographers and photocopy services (if not George Hills; our costs for this are included in our rate)
• Costs of appraisal fees and expenses not included in flat fee or performed by others • Costs of indexing claimants
• Services performed outside the TPAs normal geographical regions
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• Costs associated with Medicare Set -Aside analysis and submission of Medicare Conditional Lien negotiation
• Investigation of possible fraud including SIU services and related expenses Any other similar cost, fee, or expense that is not otherwise included in the TPAs service fees that is reasonably chargeable to the investigation, negotiation, settlement, or defense of a claim or loss or to the protection or perfection of the subrogation rights of the entity, including travel related expenses.
Travel Related
Costs of travel related to claims including mileage drive, such as for attendance at inspections, mediations, and trial, shall be allocated to the specific claim and reimbursed to GH based on the actual cost incurred. Mileage shall be reimbursed at the current IRS rated at the time the mileage is traveled.
OPTIONAL SERVICES
Full In-House Litigation Management – Use of George Hills’ Attorneys Name and Title
Years of
Experience
Role for the Client
Neil Callahan, Esq.
Litigation Manager
25 Serves as a Litigation Manager for several
clients, monitoring counsel, and as a
resource to our claims staff.
Benjamin Oram, Esq.
General Counsel/Litigation
Manager
15 Serves as a Litigation Manager for several
clients, monitoring counsel, and as a
resource to our claims staff.
Cornelius (Neil) Callahan, Esq., Litigation Manager: Mr. Callahan has over 25 years of experience defending public entities on high profile claims in state and federal courts. Mr. Callahan commenced his career practicing law in New York, New Jersey, and Connecticut. In 1999 he began practicing law in California, where he served as lead trial counsel for public entities in the areas of civil rights, police practices, and dangerous condition defense. He has tried multiple cases to jury verdict in both state and federal court having been the lead defense attorney in 13 trials, with 12 defense verdicts. His emphasis has been on defending an d advising public entities involved in civil litigation. Past cases include officer -involved shootings, excessive force, unlawful seizure, dangerous condition, discrimination, and harassment. He is experienced in all aspects of litigation including discove ry, depositions, motion practice, arbitrations, administrative hearings, mediations, and trials.
Benjamin Oram, Esq., General Counsel/Litigation Manager: Ben serves as George Hills’ General Counsel/Litigation Manager. He currently serves as a Litigation Manager for several clients, monitoring counsel, and as a resource to our claims staff.
George Hills’ proactive approach is founded on our commitment to the preservation of the City’s assets. Early contact with all involved parties maintains lines of communication and rapport (not only with the insured but also with the claimant); hence, cost -saving opportunities to resolve claims efficiently are more plentiful.
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Here is an outline of their role and how it would work for the City:
1. Serve as Litigation Manager (Specifics of the role below) i. Actively manage all watchlist files (parameters of a watchlist to be agreed upon through subsequent discussions)
ii. Manage and supervise all litigated files – claims adjusters will track the nonserious and/or non-active litigated files, with the support of Claims Processors, and report to the City
iii. Accessible to the entire GH adjuster team to advise and instruct as needed
2. Serve as Outside General and Special Counsel – limited basis i. Work closely with the City with confidential analysis and problem-solving for managing risk and avoiding unnecessary litigation
ii. Provide immediate access to legal advice to the City, which includes analyzing coverage issues, Public Records Act requests, tort claim handling and strategy, conflicts of interest, oversight of outside litigation counsel, and providing legal opinions on potential and active litigation
iii. Advise on sensitive and political issues/claims
3. Coverage counsel consultation
i. Review and analysis of memorandums of coverage and excess/umbrella policies to address and offer advice and consultation regarding coverage issues ii. Advise on potential changes to all coverage documents iii. Assist City and George Hills staff in interpretation of coverage issues
4. Resource to a broker of record for coverage needs
5. Trial/Mediation/Board Meeting attendance
i. Attend board/executive/coverage/claims meetings (as necessary) ii. Attend trials, mediations, and other court hearings, including appearing before Courts of Appeal as needed
iii. Provide analysis and consultation before, during, and after these significant litigation events – to reduce exposure and maximize opportunities for resolution
6. Legal training and seminars
i. Provide customized seminars and training upon request – to City staff, brokers, members, and GH staff
ii. Subject areas include memorandums of coverage, all aspects of risk management, claims handling and litigation, employment law, and general liability claims iii. Courses are customized to address the client’s specific needs and to work closely with safety and loss staff, defense firms, and others
ATTACHMENT A
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Rates for Optional Legal Service
Litigation Management $225/hour
This rate is subject to the annual fee escalator.
Please note that George Hills can provide a monthly/annual fixed fee for the above services upon discussion and agreement on level of effort.
ATTACHMENT A
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Attachment F – Cost/ Price Proposal PUR 25 -042
ATTACHMENT A
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EXHIBIT F
TIMELINE
1. Contractor shall complete the requested services identified in Exhibit A as follows:
1.1 TIMELINE FOR COMPLETION OF WORK
1.1.1 Complete Contract Negotiations 08/25/2025
1.1.2 RMIS Interface Development Begin 08/18/2025 – Duration 30 Days
1.1.3 Pre-Contract Onboarding Begin with term notice – 30 Days
1.1.4 Ready for Claim Servicing 10/01/2025
1.1.5 Claim Files Ongoing
1.1.6 Property Subrogation Files Ongoing
1.1.7 Plan of Action Ongoing
1.1.8 Quarterly Litigation Budgets Ongoing
1.1.9 Investigative Reports As necessary
1.1.10 Narrative Reports As necessary
1.1.11 Check Register Due the 1st of each month
1.1.12 Loss Runs – Injury Year as Due the 1st of each month of Date-GL, Date Excess
Sent-GL, Open Litigated
Claims-GL, Injury Year Detail
by Department, and
Subrogation (Recovery and
Invoicing
1.1.13 Loss Runs – Opened-GL, Due weekly (on Saturday)
Closed-GL, Reserve
Change-GL, All claims-GL,
All claims-Fleet,
Opened-Subrogation,
Closed-Subrogation, Reserve
Change-Subrogation
1.1.14 Financial and/or Tax Reports Due May 1st (annually)
1.1.15 Standard Loss Reports As requested by City
1.1.16 Special Reports As requested by City
1.1.17 Reports for Federal, State Due May 1st (annually) & Local 1099 Information
1.1.18 Stewardship Meeting Annually
1.1.19 Review claims Meetings with Monthly (3rd Monday from 3:00 Risk and City Attorney pm – 4:00 pm
1 (Rev, 10.27.22)
ATTACHMENT A
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