Loading...
2025-26 Bill Proctor & Assoc - Healthcare InfoMEMORANDUM .Ca Qa &a CALIFORNIA DATE: April 4, 2025------- TO: Christina Calderon, Community Services Deputy Director FROM: Caroline Doran, Senior Community Services Specialist RE: Volunteer Agreement with Bill Proctor & Associates, Insurance Services, Inc. - free health insurance information Please list the Contracting Party / Vendor Name, any change orders or amendments, and the type of services to be provided. Make sure to list any related Project No. and Project Name. Authority to execute this agreement is based upon: ❑ Approved by City Council on ❑ City Manager's signing authority provided under the City's Purchasing & Contracting Policy [Resolution No. 2023-008] for budget expenditures of $50,000 or less. ❑ City Manager's signing authority provided under the City's Personnel Policy Section 3.2 for temporary employment positions. ❑✓ Department Director's or Manager's signing authority provided under the City's Purchasing Policy [Resolution No. 2023-008] for budget expenditures of $15,000 and $5,000, respectively, or less. Procurement Method (one must aaDI ❑ Bid ❑ RFP ❑ RFQ ❑ 3 written informal bids ❑✓ Sole Source ❑ Select Source ❑ Cooperative Procurement Requesting department shall check and attach the items below as appropriate: ❑ Agreement payment will be charged to Account No.: _ ❑ Agreement term: Start Date February 25,2025 ✓❑ Amount of Agreement, Amendment, Change Order, etc End Date February 25, 2026 $ REMINDER: Signing authorities listed above are applicable on the a_g_pre_pate Agreement amount, not individual Amendments or Change Orders! ❑ Insurance certificates as required by the Agreement for Risk Manager approval Approved by: Oscar Mojica Date: 4/15/2025 ❑ Bonds (ori_ginals) as required by the Agreement (Performance, Payment, etc.) ❑ Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s) NOTE. Review the "Form 700 Disclosure for Consultants" guidance to determine if a Form 700 is required pursuant FPPC regulation 18701(2) ❑ Business License No. Expires: ❑ Requisition for a Purchase Order has been prepared (Agreements over $5,000) — — — — VOLUNTEER ORGANIZATION SERVICE AGREEMENT Our organization, Bill Proctor & Associates, Insurance Services, Inc. will provide volunteers to perform only the services as outlined in the attached scope of work for the City of La Quinta ("City"). We understand that we will not be compensated for our work and we will complete our organization volunteer duties in a responsible manner. If we decide to discontinue our organization volunteer services, our contact person Dayne Navarro, will notify Caroline Doran, City designee. We understand and agree that: • No one in the group is to appear for volunteer service under the influence of any drugs or alcohol. • Our organization will provide the City with a roster of individual participants including the names and hours worked. • Our organization will report any injuries sustained by participants during their volunteer activities to Caroline Doran, City designee immediately upon occurrence. • Our organization is responsible for directly supervising the activities of all the individuals in our group who will be doing volunteer work, and therefore, in consideration of our organization and members being permitted to perform services on City property, our organization agrees to defend, indemnify, and hold harmless the City and its officials, employees, and agents from any damage claim or lawsuit for injury, illness, (including exposure to communicable diseases, illnesses, or viruses), damage or other loss of any kind to anyone including members of our organization that might arise out of our activities or the actions of any individuals of our group, except for injuries or damages caused by the sole negligence of the City. • Our organization has commercial general liability insurance of at least $1M per occurrence / $2M general aggregate to cover our activities. A copy of the certificate of insurance, the additional insured endorsement, naming the City as an "additional insured," a Primary and Non -Contributory endorsement, and Waiver of Subrogation are attached. • The City may terminate this agreement at any time without cause, and we agree that we are volunteering our services at will and may be asked to discontinue such without prior notice or reason. This agreement will be in effect for the duration of our volunteer services or one year, whichever is less, beginning on this date. Dated this 25 day of February 1 20 25 Paqe 1 of 2 Doc ID:dbOa682ad8d54830deace5a887a3b45d88169a54 CITY OF LA QUINTA, a California Municipal Corporation CHRISTINA CALDERON, Community Services Deputy Director City of La Quinta, California Dated April 2, 2025 ATTEST: v MONIKA RADEVA, City Clerk La Quinta, California APPROVED AS TO FORM: WILLIAM IHRKE, ity Attorney City of La Quinta, California taQw�tra CALIFORNIA - BILL PROCTOR & ASSOCIATES Name of Organization -eG1'1t' �OG�Or Authorized Signature on behalf of Organization Jeremy Proctor Printed Name President Title 555 S. Sunrise Way, Ste 104 Address jeremy@proctorins.com dayne.navarro@proctorins.com Email Address 760-568-5348 Phone Number Paqe 2 of 2 Doc ID:dbOa682ad8d54830deace5a887a3b45d88169a54 SCOPE OF WORK Bill Proctor & Associates Insurance Services, Inc will offer FREE Medicare information to the community. Service Offered Free Information table and Free workshop/lecture on Medicare Health Insurance. Date/Times: Dates to be agreed upon by the representative of Bill Proctor & Associates and the City of La Quinta Wellness Center representative. Location Wellness Center Art & Leisure Room or Computer Lab with tables, and chairs available for the workshop. Look Who's in the Lobby - information provided by organization. The Wellness Center will provide the table and chair placed in the lobby. (Wellness Center Staff will assist set up tables and tear down tables) Doc ID:db0a682ad8d54830deace5a887a3b45d88169a54 X Dropbox Sign Audit trail Title City of LQ File name LQ.pdf Document ID dbOa682ad8d54830deace5a887a3b45d88169a54 Audit trail date format MM / DID / YYYY Status Signed Document History ® 02 / 25 / 2025 Sent for signature to Jeremy Proctor (Jeremy@proctorins.com) SENT 22:54:38 UTC from jeremy@proctorins.com I P: 72.132.192.231 C 02 / 25 / 2025 Viewed by Jeremy Proctor (jeremy@proctorins.com) VIEWED 22:56:59 UTC I P: 174.218.122.57 02 / 25 / 2025 Signed by Jeremy Proctor (jeremy@proctorins.com) SIGNED 22:59:53 UTC IP: 174.218.122.57 C✓ 02 / 25 / 2025 The document has been completed. COMPLETED 22:59:53 UTC Powered by N Dropbox Sign