POS FY 08 Substance Abuse Service CenterTHE CITY OF
DUB E
Masterpiece on the Mississippi
MEMORANDUM
June 13, 2007
TO: The Honorable Mayor and City Council Members
FROM: Michael C. Van Milligen, City Manager
SUBJECT: Purchase of Service Agreement -
Substance Abuse Services Center
During the Fiscal Year 2008 budget process, the Mayor and City Council provided
$13,605 for a Purchase of Services Agreement with the Substance Abuse Services
Center.
Budget Director Jennifer Larson is recommending execution of the attached agreement
with Substance Abuse Services Center to provide funding for the operation of a
program which provides for a substance abuse counselor to work with youth in the City
who are referred to any of their high risk youth programs.
I concur with the recommendation and respectfully request Mayor and City Council
approval.
~~ ~y
~,.~ '1;~ ~'"
Mic~iael C. Van Milligen
MCVM/jml
Attachment
cc: Barry Lindahl, City Attorney
Cindy Steinhauser, Assistant City Manager
Jenny Larson, Budget Director
THE CITY OF
DUB E
Masterpiece on the Mississippi
MEMORANDUM
June 13, 2007
TO: Michael C. Van Milligen, City Manager
FROM: Jennifer Larson, Budget Director ~~
SUBJECT: Purchase of Service Agreement -
Substance Abuse Services Center
Attached for City Council approval is the Purchase of Services Agreement with
Substance Abuse Services Center for the City's financial support for Fiscal Year 2008.
The adopted Fiscal Year 2008 operating budget provides a payment of $13,605 to help
fund the Substance Abuse Services Center. The City's contribution funds ahalf-time
substance abuse counselor to work with youth in the City who are then referred to any
of the Center's high risk youth programs. The agency provides a number of services
including early outpatient substance abuse treatment for troubled adolescents and their
parents.
It is my recommendation that the City Council approves the attached purchase of
services agreement with Substance Abuse Services Center and authorizes the Mayor
to execute the contract on behalf of the City.
JML
Attachment
AGREEMENT
BETWEEN
CITY OF DUBUQUE, IOWA,
AND
SUBSTANCE ABUSE SERVICES CENTER
THIS AGREEMENT, dated for reference purposes the 1 st day of July 2007, is made
and entered into by and between the City of Dubuque, Iowa (City) and Substance Abuse
Services Center (Agency).
WHEREAS, Agency represents itself as technically and professionally qualified to
provide early substance abuse outpatient treatment to troubled adolescents and their
parents; and
WHEREAS, City has deemed it to be in the best interest to provide financial
assistance for ahalf-time adolescent specialist to work in the City of Dubuque.
NOW THEREFORE, the parties hereto agree as follows:
Scope of Service
Agency shall provide an early intervention program and outpatient treatment for
troubled adolescents in the area of substance abuse within the City of Dubuque.
2. Time of Performance
The term of this Agreement shall be from July 1, 2007, through June 30, 2008.
3. Compensation
City shall pay Agency $13,605.00 as compensation for the services provided by
Agency, which payment shall constitute full and complete compensation for such
services. The compensation shall be paid by City to Agency in four equal installments
of $3,401.25, payable September 29, 2007, December 29, 2007, March 30, 2008, and
June 29, 2008 after execution of this agreement by both parties and upon receipt by
City of a requisition for such sum from Agency.
4. Audit and Evaluation
Inasmuch as the funds to be provided Agency by City are public funds, Agency agrees
that it will maintain books of account in accordance with generally accepted
accounting standards together with necessary documentation to support all
expenditures.
Agency shall provide City quarterly written reports detailing its activities beginning for
the quarter ending September 30, 2007. Such report shall be due ten days after the
end of each quarter. Accompanying each quarterly report shall be copies of any
r
studies, brochures, or other non-confidential documents, which Agency has produced
during the relevant quarter.
5. Discrimination
In carrying out the services of this Agreement, Agency shall not discriminate against
any employee or applicant for employment because of race, creed, color, sex, age,
national origin, religion, sexual orientation, or disability. Agency shall take affirmative
action to ensure that applicants for employment are employed and that employees are
treated during employment without regard to race, creed, color, sex, age, national
origin, religion, sexual orientation, or disability.
Such action shall include, but not be limited to, the following: employment, upgrading,
demotion or transfer; rates of pay or other forms of compensation; and selection for
training, including apprenticeship.
Agency agrees and will undertake whatever affirmative measures are necessary so
that no person shall be excluded from participation in, be denied the benefits of, or be
subjected to discrimination under any program or activities funded in whole or in part
with any of the funds made available to Agency under the terms of this Agreement
because of race, creed, color, sex, age, national origin, religion, sexual orientation, or
disability.
6. Interest of Members. Officers. or Employees of the City of Dubuque Members of the
Dubuque City Council; or Other Public Officials
No member, officer, or employee of City or their designees or agents; no member of
the Dubuque City Council; and no other public official of City who exercises any
function or responsibilities with respect to the program during such person's tenure
shall have any interest, direct or indirect, in this contract or the proceeds thereof for
work to be performed in connection with the program assisted under this Agreement.
7. Termination of Contract
This contract may be terminated by either party by giving the other party a written,
ninety (90) day notice of such termination or upon such other terms as may be
mutually acceptable.
If, through any cause, Agency shall fail to fulfill in a timely and proper manner its
obligations under this Agreement or if Agency shall violate any of the covenants,
agreements, or stipulations of this Agreement, City shall have the right to terminate
this Agreement by giving written notice to Agency of such termination at least five (5)
days before the effective date of such termination.
2
• 8. Assignability
Agency shall not assign any interest in this Agreement without prior written approval
of City.
9. Insurance
At the time of execution of this Agreement by Agency, Agency shall provide City
copies of Agency's insurance certificates showing general liability, automobile liability,
and workers compensation insurance coverage to the satisfaction of City for the term
of this Agreement.
WITNESSED:
CITY OF DCJBUQUE
~ ~ r ~ ~~-*
eann F. chneider, City Clerk Roy uol, Mayor
~~ O~
Date ate
SUBSTANCE ABUSE
SERVICES CENTER
Dian K _T ~ rr~s, ecutive Director
Date
3
December 9, 2006
~I~OLYI~~IEAU~
I N S U R A N C E
d FiNANC1A~ SERVICES
FOR
Substance Abuse Service Center
Nesler Centre
799 Main Street
Dubuque, IA 52001
Prepared by:
Donald J. Blough, CPCU
Molyneaux Insurance, Inc.
100 Kirkwood Boulevard, P.O. Box 939
Davenport, Iowa 52805-0939
(563) 324-1011 Phone
(563) 324-7909 Fax
(800) 713-6930 Toll Free Phone
(877) 324-7909 Toll Free Fax
www. molyneaux. com
This is a synopsis of coverage for your information only and does not constitute a change or waiver of
policy terms or conditions. Please refer to your actual policy(ies) for coverage terms and conditions.
57479
Commercial Property ................................................................................................ 5
Electronic Data Processing ....................................................................................... 6
Crime ....................................................................................................................... 7
Commercial General Liability ................................................................................... 8
Professional Liability ................................................................................................ 9
Hired and Non-Owned Automobile Liability .............................................................10
Directors and Officers Liability .......................................... ........11
..............................
Workers' Compensation ..........................................................................................12
Commercial Umbrella .............................................................................................13
Premium Summary .................................................................................................14
CSR24 - 24 Hour Customer Service .........................................................................15
Benefits Client Community .....................................................................................16
i~~
X
Table of Contents
Insuriag Company
Limits of Coverage
Philadelphia Indemnity Insurance Co
Location l: 799 Main Street, Dubuque, IA 52001
urnce _ Personal Property $80,000 $500 80
Office Business Income $10,000 $0
With Extra
_ ___ Expense ',
Location 2: 907 W. Main, Manchester, IA
Office ___ Personal Property $30,000 $500 80
Office Business Income $10,000 $0
With Extra
Location 4: 218 N. Franklin St., Manchester, IA 52057
Storage __ _ _ Personal Propert~___ _ __ $10,000 _ $500 80
Covered Losses
Loss Adjustment Basis
Business Income
Risks of Direct Physical Loss
except as excluded or
limited
Replacement Cost if repaired
or replaced
1 / 3 monthly limitation
~~%~~
~~
Page 5 of 16
Insuring Company
Limits of Insurance
Philadelphia Indemnity
Hardware $ 84,500
Media and Data $ 10,500
While in Transit $ 10,000
Transfer between Premises $ 10,000
Temporarily within other Premises $ 10,000
Covered Losses
Deductible
Loss Adjustment Basis
Risks of Loss except as
excluded or limited
$ 500
Replacement Cost if repaired or
replaced
i~~
NIA. ~ X~'X
Pale 6 of 16
Employee Dishonesty
Limit of Insurance
Limit per loss
$ 100,000
Employees Covered Blanket All Employees
Deductible $ 1,000
Theft, Disappearance 8s Destruction
Limit of Insurance
On Premises $ 5,000
Away From Premises $ 5,000
Deductible $ 500
Page 7 of 16
Insuring Company: Philadelphia Indemnity Insurance Co
Limits of Liability
Each Occurrence Limit $ 1,000,000
Fire Damage Limit -one fire $ 100,000
Medical Expenses Limit -one person $ 5,000
Personal 8s Advertising Injury Limit $ 1,000,000
General Aggregate Limit $ 3,000,000
Products/Completed Operations Aggregate Limit $ 3,000,000
Premium Basis
44440 NF Profit -Health Care Facilities - Area 7,400
outpatient only ~
799 Main St, Dubuque, IA _ _ _
r.___.
44440 NF Profit -Health Care Facilities - Area 1,200
' outpatient only
909 W. Main St, Ste 1, Manchester, IA _ _ _ __
44440 NF Profit -Health Care Facilities - Area 1,500
outpatient only '
135 W. 17~ St, Dubuque, IA
*This location will be deleted January,
2007
i~~
M°~'~X
Page 8 of 16
Insuring Company: Philadelphia Indemnity Insurance Co
CLAIMS MADE
Limits of Liability
Each Professional Incident $ 1,000,000
Aggregate $ 3,000,000
Retroactive Date 12-9-1990
~~%~~
Page 9 of 16
Insuring Company
Limit of Liability
Philadelphia Indemnity Insurance Co
Bodily Injury and/or Property Damage $ 1,000,000
Covers liability arising out of the operation of hired or non-owned autos only.
x
Page 10 of 16
Insuring Company: Philadelphia Indemnity Insurance Co
Limit of Liability
Directors 8s Officers Liability $ 1,000,000
Employment Practices Liability $ 1,000,000
Aggregate $ 1,000,000
Retention
Directors 8v Officers Liability $ 2,500
Employment Practices Liability $ 5,000
Retroactive Date 12-9-1997
Prior 8s Pending Claim/Litigation Date None
~x
Page 11 of 16
Insuring Company:
Limits of Liability
First Comp Insurance
Medical Statutory
Disability Income Statutory
Employer's Liability
Bodily Injury by Accident $ 100,000
Bodily Injury by Disease-Policy Limit $ 500,000
Bodily Injury by Disease-Each Employee $ 100,000
Experience Modification 1.2600
State: IA
Premium Basis:
-Class Description _~ Poll ~~ ''
8861 Charitable Organization: Professional 8s $954 810 'I
Clerical
i~~
M°L''X
Page 12 of 16
Insuring Company: Philadelphia Indemnity Insurance Co
Limits of Liability
General Aggregate Limit $ 1,000,000
Products/Completed Operations $ 1,000,000
Personal Injury 8s Advertising Injury Limit $ 1,000,000
Each Occurrence Limit $ 1,000,000
Self Insured Retention $ 10,000
~~%i~
~+x.Yrr~u~
Page 13 of 16
Policy Period: December 9, 2006/December 9, 2007
Property
Electronic Data Processing
Crime
General Liability
Professional Liability
Hired 8v Non-Owned Auto Liability
Workers Compensation
Umbrella Liability
Directors 8~ Officers Liability
Total Annual Premium
Higher Liability limits may be available
$ 1,193
$ 542
$ 598
$ 1,046
$ 2,297
$ 191
$ 18,430
$ 1,245
$ 1,877
$ 27,419
i~~
11~I°L.t'X
Page 14 of 16
Molyneaux Insurance is pleased to offer their clients a new 24 hour service.. Our goal
is to meet and exceed our client's expectations and it is our hope that we can improve
our service to you by partnering with CSR24.
Outside of normal working hours you can call the CSR24 call center at 866-230-9185
or log onto a secured website and have access to your account information. Whether
you access CSR24 via phone or the Internet you will be able to review account
information, report a loss, print a Certificate of Insurance or Auto ID Card.
CSR 24 Highlights
Access Active Policy Information
Print an Auto ID Card for all active vehicles
Print Certificates of Insurance
Reach a Molyneaux Agent after Regular Working Hours
Please remember you have to speak with a Molyneaux Insurance agent in order to
bind or alter coverage. If you need an agent when the office is closed the CSR24
representative will contact a Molyneaux agent who can call you back outside of
normal working hours.
You can begin using the call center number today. If you would like to access your
account via the Internet please call Anne Molyneaux at (563) 324-1011 or e-mail
anne@molyneaux.com We will create your user ID and password and either mail or
e-mail it to you. If you prefer, we will call you and provide the user ID and password
over the phone.
Business customers who wish to issue Certificates of Insurance should also contact
Anne so the necessary forms can be created and made available. Anne is also
available to perform training at your work site.
i~~
,:.,.:.
Page 15 of 16
Client Community is an online portal we created exclusively for you. Through this
portal you and your HR staff can access comprehensive research tools, information
and news that will help you manage your benefits programs. In addition, we can use
Client Community as a "Workspace" to send and receive messages and documents to
each other in an efficient, secure way.
Highlights:
• The next time you need to educate yourself on a benefits or HR issue start with
the Resources in Client Community. With these tools, you can conduct on-
demand research on a world of benefits issues.
• Benefits Essentials - a unique resource that explains and simplifies
complicated information about a host of key benefits and HR areas.
• HIPAA Privacy Manual for Employers -developed by HIPAA Solutions Rx, this
manual gives you unlimited, free access to an online reference that covers the
extensive world of the HIPAA Privacy Rule and preferred pricing on additional
training and tools.
• Many Other Resources -including recent and proposed legislations, Webzine
articles that educate you about topics that touch every part of your life and
much more.
• News - In the News section you can view up-to-date news from our firm. In
addition Client Community will automatically include frequently updated HR
industry news from Employee Benefits News, an authoritative publisher.
We offer Client Community as a value-added service for your HR team. You can
perform extensive research and find valuable information about our services and
much more. Talk to your agent about how you can qualify for this benefit.
~x
Page 16 of 16
POLICY CHANGE DOCUMENT
POLICY NO.: PHPK199007
Philadelphia Indemnity Insurance Company 2975 MOLYNEAUX INSURANCE
NAMED INSURED SUBSTANCE ABUSE SERVICES CENTER
MAILING ADDRESS 799 Main St
Dubuque, IA 52001-6844
POLICY PERIOD: FROM 12/09/2006 TO 12/09/2007 at
12:01 A.M. Standard Time at your mailing address shown above.
CHANGE EFFECTIVE 01/05/2007 CHANGE # 1 y
DESCRIPTION
In consideration of the premium reflected, the policy is amended as indicated below
Deleted:
Loc. 3 Bldg. 1, 135 W 17th St., Dubuque, IA 52001, in its entirety
Path ID 2154537
Total Annual
Additional/Return Premium $
COUNTERSIGNED
Total Prorate
-155.00 Additional/Return Premium $ -144.00
RETURN RETURN
BY
(Date) d R r tiv
Insured Copy Page i of 1