HomeMy WebLinkAbout27 - On-Call PSA for EMS Quality Improvement ServicesQ �EwPpRT
CITY OF
s NEWPORT BEACH
`q44:09 City Council Staff Report
August 26, 2025
Agenda Item No. 27
TO: HONORABLE MAYOR AND MEMBERS OF THE CITY COUNCIL
FROM: Jeff Boyles, Fire Chief - 949-644-3101, jboyles@nbfd.net
PREPARED BY: Raymund Reyes, Administrative Manager - 949-644-3352,
rreyes@nbfd.net
TITLE: Approval of On -Call Professional Services Agreement with
Paramedrix, LLC for EMS Quality Improvement Services
ABSTRACT:
The Fire Department's Emergency Management Services (EMS) Division manages all
state and county required skills and education for emergency medical technician (EMT)
and paramedic licensing and accreditations. Nurse educators are contracted to support
these training and certification efforts. Following a prior Request for Proposals (RFP)
selection process, staff recommends approving an on -call agreement with
Paramedrix, LLC for EMS Quality Improvement Services.
RECOMMENDATIONS:
a) Determine this action is exempt from the California Environmental Quality Act (CEQA)
pursuant to Sections 15060(c)(2) and 15060(c)(3) of the CEQA Guidelines because
this action will not result in a physical change to the environment, directly or indirectly;
and
b) Approve an On -Call Professional Services Agreement with Paramedrix, LLC to
provide Emergency Management Services Quality Improvement Services for a
three-year term and a total amount not -to -exceed $180,000 and authorize the Mayor
and City Clerk to execute the agreement.
DISCUSSION:
The Fire Department is a state -approved EMT Certifying Entity and Continuing Education
(CE) Provider, offering annual EMS trainings on duty, and EMT recertifications in-house.
The department contracts with a nurse educator and a medical director to support Fire
and Lifeguard EMT and paramedic EMS training efforts to ensure personnel are provided
with up-to-date, high -quality education and skills training. Additionally, the department's
EMS Division is also responsible for the quality assurance (QA) of the care delivered to
all patients, which is reflective of key EMS clinical performance indicators and skills.
Contracted nurse educators assist in providing continuing education program services
and work closely with the EMS division chief to develop, coordinate, conduct and evaluate
EMS -related education, programs, curriculum and materials. Additionally, they may also
be tasked with QA and Continuous Quality Improvement (CQI) reviews.
27-1
Approval of On -Call Professional Services Agreement with
Paramedrix, LLC for EMS Quality Improvement Services
August 26, 2025
Page 2
On November 19, 2024, following an RFP process, the City Council approved on -call
agreements for Nurse Educator and Continuous Quality Improvement Services with two
of the top three ranked individuals. The staff report also indicated that staff would return
to the Council for approval of an agreement with a third individual, Brandon Grinstead.
Name
Rank
Brandon B. Grinstead Consulting
1
Jodi Mannino EMS Consultant
2
Norm Nedell aka Liberty First Response Training)
3
Julia Fields
4
Rapid Reliable Testing CA, LLC dba DocGo, Inc.
5
Brandon Grinstead was the top ranked proposer from the RFP and is a retired
Orange County Fire Authority EMS training and administrative captain. However, due to
a possible conflict with post -retirement employment, the City Attorney's Office originally
recommended that the City of Newport Beach not award an agreement until any conflicts
were resolved. The conflicts have been resolved, and an approved as to form agreement
is now ready. As Mr. Grinstead is now incorporated as Paramedtrix, LLC, staff
recommends City Council approval of an on -call professional services agreement with
Paramedtrix, LLC for EMS Quality Improvement Services. Paramedtrix, LLC will provide
various quality assurance reviews on patient care reports and assist the EMS division
chief in the development of Quality Assurance and Improvement curriculum.
FISCAL IMPACT:
The adopted budget includes sufficient funding for these services. It will be expensed to
the contract services account in the EMS Division of the Fire Department,
01040404-811017.
ENVIRONMENTAL REVIEW:
Staff recommends the City Council find this action is not subject to the California
Environmental Quality Act (CEQA) pursuant to Sections 15060(c)(2) (the activity will not
result in a direct or reasonably foreseeable indirect physical change in the environment)
and 15060(c)(3) (the activity is not a project as defined in Section 15378) of the CEQA
Guidelines, California Code of Regulations, Title 14, Chapter 3, because it has no
potential for resulting in physical change to the environment, directly or indirectly.
NOTICING:
The agenda item has been noticed according to the Brown Act (72 hours in advance of
the meeting at which the City Council considers the item).
ATTACHMENT:
Attachment A — On -Call Professional Services Agreement with Paramedtrix, LLC
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ATTACHMENT A
PROFESSIONAL SERVICES AGREEMENT
BY AND BETWEEN PARAMEDTRIX LLC, AND
THE CITY OF NEWPORT BEACH FOR
EMS QUALITY IMPROVEMENT SERVICES
THIS PROFESSIONAL SERVICES AGREEMENT .("Agreement") is made and
entered into as of this 26th day of August,.2025 ("Effective Date"), by and between the City
of Newport Beach, a California municipal corporation and charter city ("City"), and
Paramedtrix LLC, a California limited liability company ("Consultant"), whose address is
21821 Constancia, Mission Viejo, CA 92692, each referred to herein as a "Party" or collectively
the "Parties," and is made with reference to the following:
RECITALS
A. City is a municipal corporation duly organized and validly existing under the laws
of the State of California with the power to cant' on its business as it is now being
conducted under the statutes of the State of California and the Charter of City.
B. City desires to engage Consultant to provide consulting services with respect to
Emergency Medical Services (EMS) Quality Improvement Services for the Fire
Department of the City ("Project").
C. Consultant possesses the skill, experience, ability, background, certification and
. knowledge to provide the professional services described in this Agreement.
D. City has solicited and received a detailed proposal from Consultant, has reviewed
the previous experience and evaluated the expertise of Consultant, and desires to
retain Consultant to render independent professional services under the terms and
conditions set forth in this Agreement.
NOW, THEREFORE, it is mutually agreed by and between the undersigned Parties
as follows:
1. TERM
The term of this Agreement shall commence on the Effective Date, and shall
terminate on August 25, 2028, unless terminated earlier as set forth herein.
2. SERVICES TO BE PERFORMED
Consultant shall diligently perform all the services described in the Scope of
Services, at the noted costs, attached hereto as Exhibit A and incorporated herein by this
reference ("Services" or "Work"). City may, with thirty (30) days prior written notice, elect
to delete certain Services within the Scope of Services at its sole discretion. The Work
shall be performed by Brandon Grinstead, the founder and owner of Consultant. Upon
ten (10) days prior written notice and in accordance with this agreement, Consultant may
use additional qualified Consultant personnel in the performance of Services hereunder.
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3. TIME OF PERFORMANCE
3.1 Time is of the essence in the performance of Services underthis Agreement
and Consultant shall perform the Services in a diligent and timely manner. The Parties
may establish a time schedule for the performance of Services hereunder, and such
schedule shall form an integral part of this Agreement.
3.2 Notwithstanding the foregoing, Consultant shall not be responsible for
delays due to causes beyond Consultant's reasonable control. However, in the case of
any such delay in the Services provided for the Project, each Party hereby agrees to
provide notice within five (5) calendar days of the occurrence causing the delay to the
other Party so that all delays can be addressed.
3.3 Consultant shall submit any requests for extensions of time for performance
in writing to the Project Administrator as defined herein not later than ten (10) calendar
days after the start of a condition that purportedly causes a delay. The Project
Administrator shall review all such requests and may grant reasonable time extensions
for unforeseeable delays that are beyond Consultant's control.
3.4 For all time periods not specifically set forth herein, Consultant shall respond
in an expedient and appropriate manner under the circumstances.
4. COMPENSATION TO CONSULTANT
4.1 City shall pay Consultant for the Services as provided in Exhibit A attached
hereto. Consultant's compensation for all Work performed in accordance with this
Agreement, including all reimbursable items, if any, shall not exceed One Hundred
Eighty Thousand Dollars and 00/100 ($180,000), without prior written authorization
from City. A billing rate increase of 2% will occur on July 11t of each year. No additional billing
rate changes shall be made during the term of this Agreement without the prior written approval
of City. In this regard, all costs, e.g., fixed costs (e.g., infrastructure, reporting tools,
administrative support, consultant labor, analysis) are included within the Services provided
herein. Each invoice shall include:
4.1.1 The number of 12-Point Random Patient Care Report Reviews
performed.
4.1.2 The number of 360 reviews performed.
4.1.3 Any additional Quality Improvement Services provided.
4.1.4 For Quality Improvement Projects:
Twenty-five percent (25%) shall be billed at the
completion of Step 1,
Twenty-five percent (25%) shall be billed at the
completion of Step 4.
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Twenty-five percent (25%) shall be billed at the
completion of Step 7.
Twenty-five percent (25%) shall be billed at the
completion of Step 9.
4.1.5 Quality Assurance and Improvement curriculum shall be billed after
completion of development.
4.1.6 Quality Assurance and Improvement curriculum shall be billed after
completion of delivery.
4.2 Consultant shall submit monthly invoices to City describing the Work
performed the preceding month. Consultant's bills shall include the name of the person(s)
who performed the Work, a brief description of the Services performed and/or the specific
task in the Scope of Services to which it relates. City shall pay Consultant no later than
thirty (30) calendar days after approval of the monthly invoice by City staff.
4.3 Consultant shall not receive any compensation for Extra Work performed
without the prior written authorization of City. As used herein, "Extra Work" means any
Work that is determined by City to be necessary for the proper completion of the Project,
but which is not included within the Scope of Services and which the Parties did not
reasonably anticipate would be necessary at the execution of this Agreement.
Compensation for any authorized Extra Work shall be paid in accordance with the
Schedule of Billing Rates as set forth in Exhibit A.
5. PROJECT MANAGER
5.1 Consultant shall designate a Project Manager, who shall coordinate all
phases of the Project. Consultant has designated Brandon Grinstead to be its Project
Manager.
5.2 Consultant, may remove from the Project any of its personnel assigned to
the performance of Services upon written request of City. Consultant warrants that it will
furnish the necessary personnel to complete the Project on a timely basis as
contemplated by this Agreement.
6. ADMINISTRATION
This Agreement will be administered by the Project Manager, and on behalf of
the City, by the Project Administrator. City's Emergency Medical Services Chief or
designee shall be the Project Administrator and shall have the authority to act for City
under this Agreement. The Project Administrator shall represent City in all matters
pertaining to the Services to be rendered by the Project Manager pursuant to this
Agreement.
7. CITY'S RESPONSIBILITIES
To assist Consultant in the execution of its responsibilities under this Agreement,
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City agrees to provide access to and upon request of Consultant, one copy of all existing
relevant information on file at City. City will provide all such materials in a timely manner
so as not to cause delays in Consultant's Work schedule.
8. STANDARD OF CARE
8.1 All of the Services shall be performed by Consultant or under Consultant's
supervision. Consultant represents that it possesses the independent professional and
technical personnel required to perform the Services required by this Agreement, and that
it will perform all Services in a manner commensurate with community professional
standards and with the ordinary degree of skill and care that would be used by other
reasonably competent practitioners of the same consulting discipline under similar
circumstances. All Services shall be performed by qualified and experienced personnel
who are not employed by City. By delivery of completed Work, Consultant certifies, to the
best of its knowledge, that the Work conforms to the requirements of this Agreement, all
applicable federal, state and local laws, and legally recognized professional standards.
8.2 Consultant represents and warrants to City that it has, shall obtain, and shall
keep in full force and effect during the term hereof, at its sole cost and expense, all
licenses, permits, qualifications, insurance and approvals of whatsoever nature that is
legally required of Consultant,to practice its profession. Consultant represents that it shall
maintain a City of Newport Beach business license during the term of this Agreement.
8.3 Consultant shall not be responsible for delay, nor shall Consultant be
responsible for damages or be in default or deemed to be in default by reason of strikes,
lockouts, accidents, acts of God, or the failure of City to furnish timely information or to
approve or disapprove Consultant's Work promptly, or delay or faulty performance by
City, contractors, or governmental agencies.
9. HOLD HARMLESS
9.1 To the fullest extent reasonably permitted by law, Consultant shall
indemnify, defend and hold harmless City, its City Council, boards and commissions,
officers, agents, volunteers, employees (collectively, the "Indemnified Parties") from and
against any and all claims (including, without limitation, claims for bodily injury, death or
damage to property), demands, obligations, damages, actions, causes of action, suits,
losses, judgments, fines, penalties, liabilities, costs and expenses (including, without
limitation, attorneys' fees, disbursements and court costs) of every kind and nature
whatsoever (individually, a Claim; collectively, "Claims"), which r relate (directly or
indirectly) to the performance of this Agreement by Consultant, any breach of the terms
and conditions of this Agreement by Consultant, or negligence, recklessness, or willful
misconduct of the Consultant, its principals, -officers, agents, employees, vendors,
suppliers, subconsultants, subcontractors, anyone employed directly or indirectly by any
of them or for whose acts they may be liable, or any or all of them.
9.2 Notwithstanding the foregoing, nothing herein shall be construed to require
Consultant to indemnify the Indemnified Parties from any Claim arising from the
negligence, recklessness or willful misconduct of the Indemnified Parties. Nothing in this
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indemnity shall be construed as authorizing any award of attorneys' fees in any action on
or to enforce the terms of this Agreement. This indemnity shall apply to all claims and
liability regardless of whether any insurance policies are applicable. The policy limits do
not act as a limitation upon the amount of indemnification to be provided by the
Consultant.
10. INDEPENDENT CONTRACTOR
10.1 It is understood that City retains Consultant solely on an independent
contractor basis and Consultant is not an agent or employee of City. The manner and
means of conducting the Work are under the control and discretion of Consultant, except
to the extent they are limited by statute, rule or the terms of this contract. Consultant is
solely responsible for providing the tools, devices and other instruments needed for
completing the Project. No civil service status or other right of employment shall accrue
to Consultant or its employees. Nothing in this Agreement shall be deemed to constitute
approval for Consultant or any of Consultant's employees or agents, to be the agents or
employees of City. Consultant shall have the responsibility for and control overthe means
of performing the Work consistent with the terms of this Agreement. Anything in this
Agreement that may appear to give City the right to direct Consultant as to the details of
the performance of the Work or to exercise a measure of control over Consultant shall
mean only that Consultant shall consider the desires of City with respect to the results of
the Services.
11. COOPERATION
Consultant agrees to work closely with and reasonably cooperate fully with City's
designated Project Administrator and any other agencies that may have jurisdiction or
interest in the Work to be performed. City agrees to cooperate with the Consultant on the
Project.
12. CITY POLICY
Consultant shall discuss and review matters relating to the Project direction with
City's Project Administrator in advance of all critical decision points in order to ensure the
Project proceeds in a manner consistent with City goals and policies.
13. PROGRESS
Consultant shall keep the Project Administrator reasonably. informed of the Project,
activities, plans and performance.
14. INSURANCE
Without limiting Consultant's indemnification of City, and prior to commencement
of Work, Consultant shall obtain, provide and maintain at its own expense during the term
of this Agreement or for other periods as specified in this Agreement, policies of insurance
of the type, amounts, terms and conditions described in the Insurance Requirements
attached hereto as Exhibit B, and incorporated herein by reference.
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15. PROHIBITION AGAINST ASSIGNMENTS AND TRANSFERS
Except as specifically authorized under this Agreement, the Services to be
provided under this Agreement shall, not be assigned, transferred contracted' or
subcontracted out without the prior written approval of City. Any of the following shall be
construed as an assignment: The sale, assignment, transfer or other disposition of any
of the issued and outstanding capital stock of Consultant, or of the interest of any general
partner or joint venturer or syndicate member or cotenant if Consultant is a partnership or
joint -venture or syndicate or co -tenancy, which shall result in changing the control of
Consultant. Control means fifty percent (50%) or more of the voting power or twenty-five
percent (25%) or more of the assets of the corporation, partnership or joint -venture.
16. SUBCONTRACTING
The subcontractors authorized by City, if any, to perform Work on this Project
are identified in Exhibit A. Consultant shall be fully responsible to City for all acts and
omissions of any subcontractor. Nothing in this Agreement shall create any contractual
relationship between City and any subcontractor nor shall it create any obligation on the
part of City to pay or to see to the payment of any monies due to any such subcontractor
other than as otherwise required by law. City is an intended beneficiary of any Work
performed by the subcontractor for purposes of establishing a duty of care between the
subcontractor and City. Except as specifically authorized herein, the Services to be
provided under this Agreement shall not be otherwise assigned, transferred, contracted
or subcontracted out without the prior written approval of City.
17. OWNERSHIP OF DOCUMENTS
17.1 Each report, plan, or curriculum (hereinafter "Documents") prepared by
Consultant, its officers, employees, agents and subcontractors, and provided to City in
the course of implementing this Agreement, shall become the property of City, and City
shall have the sole right to use such materials in its discretion without further
compensation to Consultant or any other Party, provided, however, that Consultant may
maintain and a copy of all such Documents for internal and archival purposes. All other
documentation created by Consultant in or related to the performance of Services shall
be the sole and exclusive property of Consultant, provided that no such documentation
shall contain protected patient health information, including but not limited to, information
subject to the Health Insurance Portability and Accountability Act or the Confidentiality of
Medical Information Act.
17.2 Documents, including drawings and specifications, prepared by Consultant
pursuant to this Agreement are not intended or represented to be suitable for reuse by
City or others on any other project. Any use of completed Documents for other projects
and any use of incomplete Documents without specific written authorization from
Consultant will be at City's sole risk and without liability to Consultant. Further, any and
all liability arising out of changes made to Consultant's deliverables under this Agreement
by City or persons other than Consultant is waived against Consultant, and City assumes
full responsibility for such changes unless City has given Consultant prior notice and has
received from Consultant written consent for such changes.
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17.3 All written documents shall be transmitted to City in formats compatible with
Microsoft Office and/or viewable with Adobe Acrobat.
18. CONFIDENTIALITY
18.1 All Documents, including drafts, preliminary drawings or plans, notes and
communications that result from the Services in this Agreement, shall be kept confidential
between the Parties unless City expressly authorizes in writing the release of information
for public dissemination. Consultant and City agree to enter into a Business Associate
Agreement (BAA) that complies with the requirements of the Health Insurance Portability
and Accountability Act (HIPPA) and its implementing regulations (45CFR Parts 160 and
164) and California law.
18.2 Consultant, its officers, employees, agents and subcontractors may be
required to and pass a criminal background investigation by providing a complete set of
fingerprints to City prior to commencing or performing Services or Work with Protected
Health Information. Consultant is required to submit any fees for the criminal background
investigation according to the City's most current administrative fee schedule or
successor document. Fingerprints may be required to be updated every five (5) years.
19. INTELLECTUAL PROPERTY INDEMNITY
Consultant shall defend and indemnify City, its agents, officers, representatives
and employees against any and all liability, including costs, for infringement or alleged
infringement of any United States' letters patent, trademark, or copyright, including costs,
contained in Consultant's Documents provided under this Agreement.
20. RECORDS
Consultant shall keep records and invoices in connection with the Services to be
performed under this Agreement. Consultant shall maintain complete and accurate
records with respect to the costs incurred under this Agreement and any Services,
expenditures and disbursements charged to City, for a minimum period of three (3) years,
or for any longer period required by law, from the date of final payment to Consultant
under this Agreement. All such records and invoices shall be clearly identifiable.
Consultant shall reasonably allow a representative of City to examine, audit and make
transcripts or copies of such records and invoices during regular business hours.
Consultant shall allow inspection of all Work, data, Documents, proceedings and activities
related to the Agreement for a period of three (3) years from the date of final payment to
Consultant under this Agreement.
21. WITHHOLDINGS
City may withhold payment to Consultant of any disputed sums until the reasonable
resolution of the dispute with respect to such payment. Such withholding shall not be
deemed to constitute a failure to pay according to the terms of this Agreement. Consultant
shall not discontinue Work as a result of such withholding. Consultant shall have. an
immediate right to appeal to the City Manager or designee with respect to such disputed
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sums. Consultant shall be entitled to receive interest on any withheld sums at the rate of
return that City earned on its investments during the time period, from the date of
withholding of any amounts found to have been improperly withheld.
22. CITY'S RIGHT TO UTILIZE OTHER CONSULTANTS
City reserves the right to contract with additional Consultants in connection with
the Project.
23. CONFLICTS OF INTEREST
23.1 Consultant or its employees may be subject to the provisions of the
California Political Reform Act of 1974 (the "Act") and/or Government Code §§ 1090 et
seq., which (1) require such persons to disclose any financial interest that may
foreseeably be materially affected by the Work performed under this Agreement, and (2)
prohibit such persons from making, or participating in making, decisions that will
foreseeably financially affect such interest.
23.2 If subject to the Act and/or Government Code §§ 1090 et seq., Consultant
shall conform to all reasonable requirements therein. Failure to do so may result in a
material breach and may constitute grounds for termination of this Agreement by City.
Consultant shall indemnify and hold harmless City for any and all claims for damages
resulting from Consultant's violation of this Section.
24. NOTICES
24.1 All notices, demands, requests or approvals, including any change in
mailing address, to be given under the terms of this Agreement shall be given in writing,
and conclusively shall be deemed served when delivered personally, or on the third
business day after the deposit thereof in the United States mail, postage prepaid, first-
class mail, addressed as hereinafter provided.
24.2 All notices, demands, requests or approvals from Consultant to City shall
be addressed to City at:
Attn: Kristin Thompson
Division Chief, Emergency Medical Services
City of Newport Beach
100 Civic Center Drive
Newport Beach, CA 92660
24.3 All notices, demands, requests or approvals from City to Consultant shall
be addressed to Consultant at:
Attn: Brandon Grinstead
Paramedtix LLC
21821 Constancia
Mission Viejo, CA 92692
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25. CLAIMS
Unless a shorter time is specified elsewhere in this Agreement, before making its
request for final payment under this Agreement, Consultant shall submit to City, in writing,
any and all claims for compensation, if any, under or arising out of this Agreement.
Consultant's acceptance of the final payment shall constitute a waiver of all claims for
further compensation under or arising out of this Agreement except those previously
made in writing and identified by Consultant in writing as unsettled at the time of its final
request for payment. Consultant and City expressly agree that in addition to any claims
filing requirements set forth in the Agreement, Consultant shall be required to file any
claim Consultant may have against City in strict conformance with the Government Claims
Act (Government Code sections 900 et seq.).
26. TERMINATION
26.1 In the event that either Party materially fails or refuses to perform any of the
provisions of this Agreement at the time and in the manner required, that Party shall be
deemed in default in the performance of this Agreement. If such default is not cured within
a period of ten (10) calendar days, or if more than ten (10) calendar days are reasonably
required to cure the default, and the defaulting Party fails to give adequate assurance of
due performance within ten (10) calendar days after receipt of written notice of default,
specifying the nature of such default and the steps necessary to cure such default, and
thereafter diligently take steps to cure the default, the non -defaulting Party may terminate
the Agreement forthwith by giving to the defaulting Party written notice thereof.
26.2 Notwithstanding the above provisions, both parties shall have the right, at
their sole and absolute discretion and without cause, of terminating this Agreement at any
time by giving no less than sixty (60) calendar days' prior written notice to the other party.
In the event of termination under this Section, City shall pay Consultant for Services
satisfactorily performed up to the effective date of termination for which Consultant has not
been previously paid. On the effective date of termination, Consultant shall deliver to City
all Documents developed in the performance of this Agreement.
27. STANDARD PROVISIONS
27.1 Recitals. City and Consultant acknowledge that the above Recitals are true
and correct and are hereby incorporated by reference into this Agreement.
27.2 Compliance with all Laws. Consultant shall, at its own cost and expense,
comply with all statutes, ordinances, regulations and requirements of all governmental
entities, including federal, state, county or municipal, whether now in force or hereinafter
enacted that reasonably relate to its performance under this Agreement.
27.3 Waiver. A waiver by either Party of any breach, of any term, covenant or
condition contained herein shall not be deemed to be a waiver of any subsequent breach
of the same or any other term, covenant or condition contained herein, whether of the
same or a different character.
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27.4 Integrated Contract. This Agreement represents the full and complete
understanding of every kind or nature whatsoever between the Parties hereto, and all
preliminary negotiations and agreements of whatsoever kind or nature are merged herein.
No verbal agreement or implied covenant shall be held to vary the provisions herein.
27.5 Conflicts or Inconsistencies. In the event there are any conflicts or
inconsistencies between this Agreement and the Scope of Services or any other
attachments attached hereto, the terms of this Agreement shall govern.
27.6 Interpretation. The terms of this Agreement shall be construed in
accordance with the meaning of the language used and shall not be construed for or
against either Party by reason of the authorship of the Agreement or any other rule of
construction which might otherwise apply.
27.7 Amendments. This Agreement may be modified or amended only by a
written document executed by both Consultant and City and approved as to form by the
City Attorney.
27.8 Severability. If any term or portion of this Agreement is held to be invalid,
illegal, or otherwise unenforceable by a court of competent jurisdiction, the remaining
provisions of this Agreement shall continue in full force and effect.
27.9 Controlling Law and Venue. The laws of the State of California shall govern
this Agreement and all matters relating to it and any action brought relating to this
Agreement shall be adjudicated in a court of competent jurisdiction in the County of
Orange, State of California.
27.10 Equal Opportunity Employment. Consultant represents that it is an equal
opportunity employer and it shall not discriminate against any subcontractor, employee
or applicant for employment because race, religious creed, color, national origin,
ancestry, physical handicap, medical condition, marital status, sex, sexual orientation,
age or any other impermissible basis under law.
27.11 No Attorneys' Fees. In the event of any dispute or legal action arising under
this Agreement, the prevailing Party shall not be entitled to attorneys' fees.
27.12 Counterparts. This Agreement may be executed in two (2) or more
counterparts, each of which shall be deemed an original and all of which together shall
constitute one (1) and the same instrument.
[SIGNATURES ON NEXT PAGE]
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IN WITNESS WHEREOF, the Parties have caused this Agreement to be executed
on the dates written below.
APPROVED AS TO FORM:
CITY ATTORNEY'S OFFICE
Date: 7/ Z
B: 0 B
Y —, Y:
Aar'k-a on C. Harp
City Attorney Aq
ATTEST:
Date:
CITY OF NEWPORT BEACH,
a California municipal corporation
Date:
Joe Stapleton
Mayor
CONSULTANT: Paramedtrix LLC, a
California limited liability company
Date:
By: By:
Molly Perry, Brandon B. Grinstead,
Interim City Clerk Owner
Attachments
Paramedtrix LLC
(END OF SIGNATURES]
Exhibit A — Scope of Services and Fees
Exhibit B Insurance Requirements
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EXHIBIT A
SCOPE OF SERVICES and BILLING RATES
Emergency Medical Services (EMS) Continuous Quality Improvement Services
(SEE ATTACHMENT)
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EXHIBIT A
SCOPE OF SERVICES & BILLING RATES
Emergency Medical Services (EMS) Continuous Quality Improvement Services
Qualifications:
• Consultant shall have or held and maintain an EMT License or EMT-P License
• Consultant shall have a minimum of 3 years providing EMS Quality Improvement Services
The consultant shall perform EMS Quality Improvement Services for the City of Newport Beach
Fire Department, as outlined in the Paramedtrix proposal below:
Paramedtri*x
Ef115 QUALITY IMPROVEMENT EEDUCATION
13-Point Random CQI Review
Introduction
Paramedtrix LLC will conduct an independent 3"d party systematic and comprehensive Quality Assurance
review of patient care reports (PCRs). Our 13-point review ensures compliance with standards, enhances
documentation quality, and ultimately improves patient care outcomes.
Scope of Work
Paramedtrix LLC will conduct a random review of PCRs based on the following 13 critical criteria:
1. Appropriate Assessment Performed: Evaluation of whether the patient assessment meets
clinical standards and situational requirements.
2. Treatment Correlates with Patient Assessment: Ensuring treatments provided align with the
clinical findings.
3. Two Sets of Vital Signs: Verification that at least two complete sets of vital signs were obtained
and documented.
4. Abnormal Vital Signs Addressed and Reassessed: Ensuring that abnormal values were
appropriately managed and rechecked.
5. Blood Sugar Obtained When Indicated: Confirming blood glucose levels were measured in
relevant cases.
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6. Patient Medications Documented: Verification that the patient's medications were either listed
or appropriately attached to the PCR.
7. Pulse Oximetry: Ensuring its use is documented when clinically indicated.
8. Capnography: Verification of the use and documentation of nasal or in -line capnography where
indicated.
9. 12-Lead ECG: Ensuring it was performed, documented, and followed protocol when clinically
indicated.
10. Narrative Quality: Review whether the narrative accurately and sufficiently describes the events
surrounding the patient encounter.
11. Transport Level: Ensuring the transport level is appropriate based on the patient's condition.
12. Overall Documentation Rating: Providing a holistic score for the quality of documentation.
13. Policy/Procedural Compliance: Local Core Measures and OCEMS Policy/Procedure
compliance has been met.
Deliverables
Findings Report: Each reviewed PCR will include detailed feedback that utilizes the Paramedtrix 13-point
evaluation system, including specific strengths, areas for improvement, and recommendations for a more
in-depth 360 Incident Review.
a. Detailed Review Reports: Each reviewed PCR will include detailed findings, strengths, areas
for improvement, and actionable recommendations.
b. Patient Outcome Data: Outcome data (when available) will be shared with the agency and
EMS providers to provide a feedback loop for quality assurance.
c. Quarterly Summary Report: A trend analysis report summarizing findings, key observations,
data reporting, and recommendations for targeted Quality Improvement (QI) initiatives and
education will be provided quarterly for reviewed incident trends.
Critical patient safety trends will prompt immediate reporting.
Cost Structure
Cost Per Incident: $13.30
Annual Review Estimate: Approximately 10% of annual PCRs, equating to 1,500 incidents annually for a
projected total cost of $19,950 annually. Actual amounts are to be determined by the city in consultation
with Consultant.
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360 Incident Review
Introduction
Paramedtrix LLC will provide and perform a 3'd party comprehensive 360 Incident Review process to
evaluate high -risk Emergency Medical Service (EMS) incidents requiring a more detailed examination
than standard quality assurance services. Paramedtrix's analysis integrates multiple data points to
assess response quality, documentation accuracy, and patient outcomes.
The 360 Incident Review process ensures an objective and transparent evaluation of EMS responses.
By identifying strengths and addressing areas for improvement, the process supports operational
efficiency, enhances provider performance, and ultimately improves patient outcomes.
Scope of Work
Paramedtrix LLC will conduct an in-depth independent review of each city -selected incident, requiring a
3rd party comprehensive formal written review using the following data points:
1. Agency Patient Care Report: Evaluating provider documentation for accuracy, completeness,
and adherence to protocols.
2. Outside Agency Patient Care Report: Assessing interagency collaboration and documentation
consistency.
3. Base Hospital Report: Analysis to assess the communication, treatment orders, and destination
determination process.
4. Patient Outcome Information: Clinical outcomes to evaluate the efficacy and impact of
prehospital care.
5. Computer -Aided Dispatch (CAD): Assessment of dispatch information, timing, and resource
allocation.
6. Staffing Information: Review of the responding crew, certification, and fatigue level, relevant to
the incident.
7. National Incident Fire Reporting System (NFIRS): Examination of fire department incident data
for EMS -related responses.
8. EKG/Defibrillator Data: Analysis of cardiac monitoring and defibrillation data for adherence to
clinical protocols and timing.
9. Chest Compression Device Data: Review of mechanical CPR device performance and usage.
10. EMS System Policies and Protocols: Verification of adherence to established system -wide
guidelines.
11. Departmental Standard Operating Procedures (SOPs): Review of agency -specific operational
protocols for compliance.
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12.911 Audio: Evaluation of initial emergency communications for context, clarity, and
appropriateness.
13. Tactical Audio: Analysis of on -scene radio communications for coordination and situational
awareness.
14. Base Hospital Audio: Review of medical direction and hospital communication during the
incident.
15. Agency -Specific Applications: Analysis of application usage, such as Handtevy or other tools,
to ensure optimal application of resources.
Findings Report: Each reviewed incident will include a comprehensive report covering all available data
points. The report will highlight:
Specific strengths in performance and protocol adherence.
Areas for improvement in documentation, communication, and patient care.
Actionable recommendations for continuous quality improvement.
Cost Structure
Cost Per Incident: $640.00
Annual Estimate: Approximately 12 incidents annually, for a total projected cost of $7,680 per year.
Continuous Qualitv Improvement Proiect
Paramedtrix LLC is a leader in EMS quality improvement services, specializing in utilizing the Healthcare
Improvement Model (also known as the Model for Improvement). The Healthcare Improvement Model is
widely used in healthcare settings, including Emergency Medical Services (EMS), to drive quality
improvement. Paramedtrix partners with EMS agencies to identify performance gaps, analyze trends
using data -driven approaches, and implement targeted interventions that improve patient outcomes and
operational efficiency. Through structured methodologies such as Plan -Do -Study -Act (PDSA) cycles,
Paramedtrix ensures the development and deployment of effective solutions tailored to each
organization's unique needs. Our expertise includes enhancing protocol compliance and monitoring
systems for continuous performance tracking. With a commitment to evidence -based practices and
collaborative engagement with stakeholders, Paramedtrix delivers sustainable improvements that
elevate the standard of care in emergency medical services.
Paramedtrix, LLC will utilize the Healthcare Improvement Model. The Healthcare Improvement Model will
drive focused Emergency Medical Services (EMS) quality improvement. We will identify performance
gaps, analyze trends using data -driven approaches, and recommend targeted interventions that improve
patient outcomes and operational efficiency. Below is a step-by-step outline for the deliverables of an
EMS Quality Improvement (Ql) project using this model:
Step 1: Identify the Problem
• The initial stage is identified in the Quality Assurance process.
o Review existing data (e.g., patient care reports, response times, NEMSIS data).
• Engage stakeholders (EMS staff, medical directors, patients, and community members) to gather
input on perceived problems.
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Define the specific issues to address (e.g., excessive scene times, medication errors, protocol
non-compliance).
Step 2: Formulate the Aim
• Develop a clear and specific aim statement:
o What are you trying to accomplish?
o Example: "Reduce EMS pediatric medication errors by 20% within six months."
o Ensure the aim is SMART (Specific, Measurable, Achievable, Relevant, Time -bound).
Step 3: Establish Metrics and Collect Baseline Data
• Identify Key Performance Indicators (KPIs):
o Outcome measures: Patient survival rates, pain management effectiveness.
o Process measures: Protocol adherence, response time consistency.
o Balancing measures: Impact on other parts of the system (e.g., Budget, EMS availability for
non -critical calls).
o Collect baseline data to establish a starting point for improvement.
Step 4: Develop Change Ideas
• Brainstorm potential interventions with the City's team based on the identified problem.
• Utilize evidence -based practices or lessons from similar organizations.
• Examples of change ideas:
o Introducing real-time monitoring.
o Implementing training on specific protocols.
- Paramedtrix can develop a new educational curriculum
- Paramedtrix can adopt a nationally recognized curriculum to meet the project needs
- Paramedtrix can review the established agency curriculum and adapt changes to
meet the quality improvement project needs.
o Streamlining handoff processes at receiving facilities.
Step 5: Plan -Do -Study -Act (PDSA) Cycles
The PDSA cycle is the core of the Healthcare Improvement Model. Conduct iterative tests of change to
refine interventions.
Plan:
g.
Design the intervention and predict its impact.
Define roles, responsibilities, and success criteria.
• Present the intervention on a small scale.
Document observations and challenges during implementation.
Study:
• Analyze results using your pre -defined metrics.
• Compare results against predictions.
Act:
• Refine the intervention based on findings or decide whether to scale it up.
• If successful, plan broader implementation; if not, return to the Plan phase with adjustments.
Step 6: Implement Successful Changes
• Scale -up interventions that demonstrated effectiveness in PDSA cycles.
• Provide training for staff to ensure consistent implementation.
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Step 7: Monitor and Sustain Improvements
• Develop dashboards or regular reporting systems to track metrics over time.
• Schedule periodic reviews to ensure sustained compliance with the new practices.
• Address resistance to change by reinforcing the benefits of improvements and involving staff in
ongoing discussions.
Step 8: Communicate Results
• Share outcomes with stakeholders, including staff, medical directors, and community partners.
• Use visuals (graphs, charts) to illustrate improvements.
• Celebrate successes to build momentum for future QI projects.
Step 9: Reflect and Plan for Future Improvements
• Conduct a formal project review to identify lessons learned.
• Document processes and results for future reference.
• Plan for additional QI projects based on other identified areas of need.
This structured approach ensures a data -driven, systematic improvement process, aligning with the
principles of the Healthcare Improvement Model.
Cost Structure
National EMS Quality Alliance CA Core Measures $6,400 consultant project management fees for Image
Trend report development. This fee excludes education development and delivery fees as outlined in
this proposal.
1. Paramedtrix will develop NEMSIS-compliant reporting aligned with the National EMS Quality
Alliance (NEMSQA) metrics and California EMS Core Measures.
2. As each measure is established, these reporting tools will be seamless[y integrated into the
City's quality assurance program, enabling monitoring and evaluation of key performance
indicators.
3. Paramedtrix will identify trends, assess compliance, and highlight areas for improvement
these measures serve as actionable drivers for targeted quality improvement projects.
Annual Estimate: Approximately 1-2 quality improvement projects annually, starting after the 15t quarter
of quality assurance projects. Continuous Quality Improvement Project $6,400 for consultant project
management fees.
Curriculum Development
Service Description
Proposal Outline for EMS Curriculum Development and Continuing Education (CE) Services to meet
EMS Quality Improvement project needs.
Objective: To develop and deliver engaging, evidence -based EMS education programs, including a 2-3-
hour curriculum, a 1-hour online course, and preparation resources for instructors, alongside live CE
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offerings with accreditation to meet quality improvement project AIM statement and quality measures
developed during the improvement project. Ensure the curriculum aligns with state and national EMS
standards.
Scope of Work
• Development of a 2-3-Hour EMS Curriculum:
o Topic selection based on project needs (e.g., advanced airway management, trauma care
updates, or pediatric emergencies).
o Inclusion of interactive content (case studies, simulations, group discussions).
Creation of a 1-Hour Online Curriculum:
o Development of a concise, focused online module on topics like protocol updates or
medication administration.
o Integration of multimedia elements (videos, quizzes, downloadable resources).
o Ensure compatibility with major LMS platforms for ease of delivery.
2. Course Familiarization, Modification, and Preparation:
o Review existing curriculum such as the instructor manual and familiarization videos for
instructors, highlighting key content areas.
o Make modifications to curriculum to meet project and EMS agency standards
customization options to meet specific organizational needs.
o Prepare all necessary items to administer the course.
• Live CEU Fee -Based Offerings:
0 2-Hour Live CEU:
■ The curriculum focused on a specialized topic(s) to meet quality improvement
project needs.
■ Delivered in -person with real-time interaction and Q&A.
0 3-Hour Live CEU:
■ Expanded curriculum to meet quality improvement project needs.
■ In-depth case -based learning and hands-on practice (if applicable).
2. Methodology
• Needs Analysis:
o As determined through the quarterly quality assurance and quality improvement project
processes
• Curriculum Design:
o Develop content using instructional design principles.
o Align content with national, state, and OCEMS CE standards and requirements.
• Content Delivery:
o Online module hosted on an accessible LMS.
o Live CEU courses offered in flexible formats (onsite, virtual, hybrid)
• Assessment and Feedback:
o Active engagement activities to reinforce activities.
o Hands-on simulation scenarios to apply learning
o Written tests as required by the course curriculum.
o Surveys to evaluate course effectiveness and gather suggestions.
3. Deliverables
• Comprehensive instructor guide for 2-3-hour curriculum.
• Two live CE programs with accreditation (2-hour and 3-hour formats).
• Interactive, SCORM-compliant 1-hour online course module.
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• Train the Trainer - Instructor familiarization resources, including videos, and checklists.
• 2-3 hour course instruction
This plan is a comprehensive approach to developing high -quality EMS training programs that address
potential gaps in professional knowledge and skills while meeting CE standards.
Cost Structure
1. Continuous Quality Improvement Project $6,400 for consultant project management fees.
a. This fee excludes Quality Improvement Project education development and delivery
fees.
b. Annual Estimate: Approximately 1-2 quality improvement projects annually starting
after the 1 st quarter of quality assurance projects.
2. Quality Assurance C Improvement Curriculum Development and Delivery. Actual
recommended quantities are to be determined by the quality assurance program and quality
improvement project recommendations.
a. 1-Hour Online CE Course Development $1,600
b. 2-3 Hour Live CE Course Development $3,200
c. 2-Hour Live CE Course Delivery $240
d. 3-Hour Live CE Course Delivery $320
e. 2-Hour Train -the -Trainer $240
f. 3-Hour Train -the -Trainer $320
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EXHIBIT B
INSURANCE REQUIREMENTS — PROFESSIONAL SERVICES
Provision of Insurance. Without limiting Consultant's indemnification of City, and
prior to commencement of Work, Consultant shall obtain, provide and maintain at
its own expense during the term of this Agreement, policies of insurance of the
type and amounts described below and in a form reasonably satisfactory to City.
Consultant agrees to provide insurance in accordance with the requirements set
forth here. If Consultant uses existing coverage to comply and that coverage does
not meet these requirements, Consultant agrees to amend, supplement or endorse
the existing coverage.
2. Acceptable Insurers. All insurance policies shall be issued by an insurance
company currently authorized by the Insurance Commissioner to transact business
of insurance in the State of California, with an assigned policyholders' Rating of A -
(or higher) and Financial Size Category Class VI I (or larger) in accordance with the
latest edition of Best's Key Rating Guide, unless otherwise approved by the City's
Risk Manager.
3. Coverage Requirements.
A. Workers' Compensation Insurance. Consultant shall maintain Workers'
Compensation Insurance, statutory limits, and Employers Liability
Insurance with limits of at least one million dollars ($1,000,000) each
accident for bodily injury by accident and each employee for bodily injury by
disease in accordance with the laws of the State of California, Section 3700
of the Labor Code.
Consultant shall submit to City, along with the certificate of insurance, a
Waiver of Subrogation endorsement in favor of City, its City Council, boards
and commissions, officers, agents, volunteers, employees.
B. General Liability Insurance. Consultant shall maintain commercial general
liability insurance, and if necessary umbrella liability insurance, with
coverage at least as broad as provided by Insurance Services Office form
CG 00 01, in an amount not less than one million dollars ($1,000,000) per
occurrence, two million dollars ($2,000,000) general aggregate. The policy
shall cover liability arising from premises, operations, personal and
advertising injury, and liability assumed under an insured contract (including
the tort liability of another assumed in a business contract).
C. Automobile Liability Insurance. Consultant shall maintain automobile
insurance at least as broad as Insurance Services Office form CA 00 01
covering bodily injury and property damage for all activities of Consultant
arising out of or in connection with Work to be performed under this
Agreement, including coverage for any owned, hired, non -owned or rented
vehicles, in an amount not less than one million dollars ($1,000,000)
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combined single limit each accident.
D. Professional Liability Errors & Omissionst Insurance. Consultant shall
maintain professional liability insurance that covers the Services to be
performed in connection with this Agreement, in the minimum amount of
one million dollars ($1,000,000) per claim and two million dollars
($2,000,000) in the aggregate. Any policy inception date, continuity date, or
retroactive date must be before the Effective Date of this Agreement and
Consultant agrees to maintain continuous coverage through a period no
less than three years after completion of the Services required by this
Agreement.
4. Other Insurance Requirements. The policies are to contain, or be endorsed to
contain, the following provisions:
A. Waiver of Subrogation. All insurance coverage maintained or procured
pursuant to this Agreement shall be endorsed to waive subrogation against
City, its City Council, boards and commissions, officers, agents, volunteers,
and employees or shall specifically allow Consultant or others providing
insurance evidence in compliance with these requirements to waive their
right of recovery prior to a loss. Consultant hereby waives its own right of
recovery against City, and shall require similar written express waivers from
each of its subconsultants.
B. Additional Insured Status. All liability policies including general liability,
excess liability and automobile liability, but not including professional
liability, shall provide or be endorsed to provide that City, its City Council,
boards and commissions, officers, agents, volunteers, employees shall be
included as insureds under such policies.
C. Waiver of Subrogation. All insurance coverage maintained or procured
pursuant to this Agreement shall be endorsed to waive subrogation against
City, its City Council, boards and commissions, officers, agents, volunteers
and employees or shall specifically allow Consultant or others providing
insurance evidence in compliance with these requirements to waive their
right of recovery prior to a loss. Consultant hereby waives its own right of
recovery against City, and shall require similar written express waivers from
each of its subconsultants.
D. Additional Insured Status. All liability policies including general liability,
excess liability and automobile liability, but not including professional
liability, shall provide or be endorsed to provide that City, its City Council,
boards and commissions, officers, agents, volunteers and employees shall
be included as insureds under such policies.
E. Primary and Non Contributory. All liability coverage shall apply on a primary
basis and shall not require contribution from any insurance or self-insurance
maintained by City.
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F. Notice of Cancellation. All policies shall provide City with thirty (30) calendar
days' notice of cancellation (except for nonpayment for which ten (10)
calendar days' notice is required) or nonrenewal of coverage for each required
coverage.
5. Additional Agreements Between the Parties. The Parties hereby agree to the
following:
A. Evidence of Insurance. Consultant shall provide certificates of insurance to
City as evidence of the insurance coverage required herein, along with a
waiver of subrogation endorsement for workers' compensation and other
endorsements as specified herein for each coverage. Insurance certificates
and endorsement must be approved by City's Risk Manager prior to
commencement of the Work. Current certification of insurance shall be kept
on file with City at all times during the term of this Agreement. The
certificates and endorsements for each insurance policy shall be signed by
a person authorized by that insurer to bind coverage on its behalf. At least
fifteen (15) days prior to the expiration of any such policy, evidence of
insurance showing that such insurance coverage has been renewed or
extended shall be filed with the City. If such coverage is cancelled or
reduced, Consultant shall, within fifteen (15) days after receipt of written
notice of such cancellation or reduction of coverage, file with the City
evidence of insurance showing that the required insurance has been
reinstated or has been provided through another insurance company or
companies. City reserves the right to require complete, certified copies of
all required insurance policies, at any time.
B. City's Right to Revise Requirements. City reserves the right at any time
during the term of the Agreement to change the amounts and types of
insurance required by giving Consultant sixty (60) calendar days' advance
written notice of such change. If such change results in substantial
additional cost to Consultant, City and Consultant may renegotiate
Consultant's compensation.
C. Insurance for Subcontracts. Consultant shall require and verify that all
subcontractors maintain insurance meeting all the requirements stated
herein, and Consultant shall ensure that City is an additional insured on
insurance required from subcontractors. For CGL coverage, subcontractors
shall provide coverage with a format at least as broad as CG 20 38 04 13.
D. Enforcement of Agreement Provisions. Consultant acknowledges and
agrees that any actual or alleged failure on the part of City to inform
Consultant of non-compliance with any requirement imposes no additional
obligations on City nor does it waive any rights hereunder.
E. Requirements not Limiting. Requirements of specific coverage features or
limits contained in this Section are not intended as a limitation on coverage,
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limits or other requirements, or a waiver of any coverage normally provided
by any insurance. Specific reference to a given coverage feature is for
purposes of clarification only as it pertains to a given issue and is not
intended by any Party or insured to be all inclusive, or to the exclusion of
other coverage, or a waiver of any type. If the Consultant maintains higher
limits than the minimums shown above, the City requires and shall be
entitled to coverage for higher limits maintained by the Consultant. Any
available insurance proceeds in excess of the specified minimum limits of
insurance and coverage shall be available to the City.
F. Self -insured Retentions. Any self -insured retentions must be declared to
and approved by City. City reserves the right to require that self -insured
retentions be eliminated, lowered, or replaced by a deductible. Self-
insurance will not be considered to comply with these requirements unless
approved by City.
G. City Remedies for Non -Compliance. If Consultant or any subconsultant fails
to provide and maintain insurance as required herein, then City shall have
the right but not the obligation, to purchase such insurance, to terminate this
Agreement, or to suspend Consultant's right to proceed until proper
evidence of insurance is provided. Any amounts paid by City shall, at City's
sole option, be deducted from amounts payable to Consultant or reimbursed
by Consultant upon demand.
H. Timely Notice of Claims. Consultant shall give City prompt and timely notice,
in confidence, of claims made or suits instituted that arise out of or result from
Consultant's performance under this Agreement, and that involve or may
involve coverage under any of the required liability policies. City assumes
no obligation or liability by such notice, but has the right (but not the duty)
to monitorthe handling of any such claim or claims if they are likely to involve
City.
Consultant's Insurance. Consultant shall also procure and maintain, at its
own cost and expense, any additional kinds of insurance, which in its own
judgment may be necessary for its proper protection and prosecution of the
Work.
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