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RESOLUTION NO.
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RESOLUTION OF THE CI'l'Y OF SAN BERJIIARDINO AUTHORIZING THE
EXECUTJ:ON OF A ~JJlST AMENDM:IN'l' TO AGbl!:IIIIwr WITH WILLIAM EDWAR,D
n.BItt.,DBA "~HG , ASSOCJ:ATES, PROVIDING taRA COMPLETE AUDIT
OF 'ALL' ci.om ~R COMPENSATION FILES.
BE IT RESOLVED BY THE MAtOR AND COMMON COUNCIL OF THE CITY
. OF sAN BERJIIARDIHOAS FOLLOWS:
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I SECTION 1. The Mayor of the City of San Bernardino is
'hereby authorized and directed to execute on behalf of said City
a First Amendment to Agreement with William Edward Fleming, dba
Fleming & Associates, providing for a complete audit of aU, c10sed
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Worker Compensation files, a copy of which is attached hereto,
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marked Exhibit "Aft and incorporated herein by reference as
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fully as though set forth at length.
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I HEREBY CERTIFY that the foregoing resolution was duly
adopted by the Mayor and Common Council of the city of San
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Bernardino at a
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meeting thereof, held
, 1977, by the following
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on the /.P'~ day of
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vote, to wit:
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AYES:
Councilmen
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NAYS:
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ABSENT:
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hereby approve tlU.s :...?#
day
The foregoing resolution is
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, 1977.
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FIRST AMENDMENT TO AGREEMENT
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(consultant - workers' compensation audit and administration)
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THIS FIRST AMENDMENT TO AGREEMENT is made and entered into
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, 1977, by and between the
this
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CITY OF SAN BERNARDINO, a municipal corporation, hereinafter
called "City", and WILLIAM EDWARD FLEMING, dba Fleming &
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Associates, hereinafter called "Consultant".
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WIT N S SSE T H:
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WHEREAS, City and Consultant entered into an agreement
:on June 7, 1977 wherein Consultant was to perform certain
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services i~ connection with the City's program for administering
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its own workers' compensation claims; and
I WHEREAS, Consultant's audit of 228 open worker compensation
I: files revealed overpayments by ESIS to employees and for medical
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services; and
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WHEREAS, at City's request, Consultant made a spot audit
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of 84 closed files; and
WHEREAS, said spot audit revealed overpayments that
should be recovered; and
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WHEREAS, a complete audit of all closed files should be
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performed; and
I WHEREAS, City and Consultant now desire to amend said
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prior agreement to also provide for the audit of approximately
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24 1503 closed files and compensation therefor,
25 NOW, THEREFORE, it is mutually agreed as follows:
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1. section I, entitled Audit, of that certain agreement
27 between the parties hereto dated June 7, 1977, is hereby amended
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1 "I. Audit.
2 A. Consultant shall commence an audit of all of City's
3 open workers' compensation claims files and complete the audit
4 of all of said files within two weeks after the receipt of the
5 Ifiles from ESIS, the City's previous claims management agent.
6 Said audit shall encompass and include:
7 1. A complete review of all open files with
8 emphasis upon disability, medical and legal control. consultant
9 will note all relevant deficiencies and recommend appropriate
10 control measures.
11 2. A complete reconciliation of claims file
12 expenditures with those listed in the Loss Experience Report.
13 Consultant shall note and tabulate all discrepancies.
14 3. The adjustment and approval for payment of all
15 unpaid, reasonably incurred bills and accrued benefits.
16 4. A review of all reserves and the necessary ad-
17 justMeats to indicate a true and accurate value for each claim.
18 All changes to reserves shall be recorded and tabulated.
19 5. A list of all files requiring indemnity pay-
20 ments in the payment diar~ book. Diary entries shall be provided
21 for all files on the basis of priority for periodic technical
22 review.
23 6. The preparation and submission to City of a
24 comprehensive audit report which shall tabulate, summarize and
25 total all of the foregoing and which shall relate all relevant
26 information ascertained as a result of the audit to City.
27 B. Consultant shall commence an audit of all of City's
28 closed workers' compensation claims files previously administered
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1 by ESIS and shall complete said audit in accordance,- with a
2 sChedule established by City's Loss Prevention Coordinator.
3 Said audit shall encompass and include:
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1. A complete review of all closed files noting
5 all relevant deficiencies.
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2. A complete reconciliation of claims file
7 expenditures with those listed in the Loss Experience Report.
8 Consultant shall note and tabulate all discrepancies.
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3. The preparation and submission to City of a
10 comprehensive audit report which shall tabulate, summarize and
11 total all of the foregoing and which shall relate all relevant
12 information ascertained as a result of the audit to City.
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C. It is understood and agreed by the parties hereto
14 that this audit to be conducted by Consultant involves approxi-
15 mately 150 open indemnity files, approximately 1503 closed files,
16 and an unascertained number of- pending "Medical Only" ~laims.
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D. Consultan~'s total compensation for the work to
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be performed pursuant to this agreement shall be as follows:
1. Open File Audit. Consultant's total fee for
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the work to be performed in Subsection A of this section shall be
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the sum of fifteen hundred dollars ($1500.00), which. shall be
paid promptly by City upon receipt by City from Consultant of the
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audit report which is in a form satisfactory to City's Loss Pre-
vention Coordinator.
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2. Closed :File Audit. Consultant's total fee for
26 the work to be performed in Subsection B of this section shall be
27 at a rate of twenty dollars ($20.00) per hour up to a maximum of
28 twenty-five hundred dollars ($2500.00), which Shall be paid
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promptly by City upon receipt by City from Consultant of the
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audit report which is in a form satisfactory to City's Loss Pre-
vention Coordinator.
Consultant shall maintain adequate time records concerning
his work for which payment is made on an hourly basis for this
6 subsection. Said time records shall indicate the starting and
7 stopping time of all work under this subsection, shall specify
8 generally the task being performed, and shall be in a format
9 satisfactory to the City's Loss Prevention Coordinator. Con-
10 sultant's billing for his work performed under this subsection
11 shall also specify the actual time expended upon said work and
12 shall be certified under penalty of perjury to be true and correct
13 by Consultant. City shall have the right to inspect and audit
14 COnsultant's time records at all reasonable times and places.
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E. Time is of the essence with respect to Consultant's
16 performance hereunder. City agrees to direct ESIS to deliver all
17 files to Consultant and to cooperate with Consultant to enable
18 Consultant to obtain said files promptly."
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2. All other terms, conditions and covenants of said
20 agreement shall remain the same and be in full force and effect.
21 IN WITNESS WHEREOF, the parties hereto have executed this
22 First Amendment to Agreement on the date first hereinabove
23 written.
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ATTEST:
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