HomeMy WebLinkAboutC2017-508 - 12/19/2017 - Approved AMENDMENT NO. 1 TO THE SERVICE AGREEMENT FOR BROKER OF RECORD
SERVICES FOR PROPERTY INSURANCE
Whereas, on December 15, 2015, the Corpus Christi City Council authorized a Service
Agreement for Broker of Record Services for Property Insurance ("the Agreement") with Carlisle
Insurance ("Contractor");
Whereas, the parties desire to amend the Service Agreement to add additional Broker of Record
Services;
NOW, THEREFORE, THE PARTIES AGREE TO AMEND THE AGREEMENT AS FOLLOWS:
1. In addition to the Services specified in the original Agreement, Contractor agrees to provide
Broker of Record services for the following:
(1) Excess Workers' Compensation;
(2) Excess Liability Insurance; and
(3) Liability and Property Insurance comparable to the coverages currently provided to the City
by Texas Municipal League Risk Pool.
The City Risk Manager will coordinate with Contractor to develop required specifications. The
Contractor will solicit quotes for these insurance coverages and provide the quotes and coverages
to the City Risk Manager upon a mutually agreed upon schedule. The City agrees to pay
Contractor$60,000 per year for the additional services provided under this Amendment No. 1 for
services from April 151 of the upcoming year to April 1st of the subsequent year thereafter.
2. Required Disclosures of Interests. (a) Contractor agrees to comply with City of Corpus Christi
Ordinance No. 17112 and complete the Disclosure of Interests form as part of this Amendment
No. 1. (b) Contractor agrees to comply with Texas Government Code section 2252.908 and
complete Form 1295 Certificate of Interested Parties as part of this contract. For more
information, please review the information on the Texas Ethics Commission website at
https://www.ethics.state.tx.us. (c) Contractor agrees to comply with Chapter 176 of the Texas
Local Government Code and file Form CIQ with the City Secretary's Office, if required. For more
I information and to determine if you need to file a Form CIQ, please review the information on the
City Secretary's website at http://www.cctexas.com/government/city-secretary/conflict-
disclosure/index. (d) As required by House Bill 89 adopted during the 2017 regular session of the
Texas Legislature, the signatory executing this Amendment on behalf of Contractor verifies that
the Contractor does not boycott Israel and will not boycott Israel during the term of the Agreement.
3. All other terms and conditions of the previously executed Agreement between the parties
which are not inconsistent herewith shall continue in full force and effect.
4. This Amendment becomes effective on April 1, 2018. The Contractor's notification to
proceed will be issued to the Contractor by the Risk Manager.
0*-, QQ n
EXECUTED • :. - • i = - . • this � �/ day of UQC�mr 2017, by the authorized
representative of the parties.
2017-508
12/19/17
M2017-193
Carlisle Insurance
INDEXED
Contractor: Carlisle Insurance
By:
Name: 9 W a c L Cc r i
Title: (rG5 i plLrk -
Date: tI/1 / 17
City of Corpus Christi,Texas
By: ill*JIS1W
Name: M W C e - Rase> ATTEST:
Title: � 4P — RE:ECCA HUERTA
Date: /A.a4,/7 CITY SECRETARY
Approved as to legal form: 19_ ' )j 17
t J��jtiv--�cw
Lisa Aguilar,`, ssistant City Attorney
For the City Attorney
H2-D11 - !AUIMU ILL.
fy council... G
SFCRETARv
CERTIFICATE OF INTERESTED PARTIES FORM 1295
1 of 1
OFFICE USE ONLY
Complete Nos.1-4,and, 6there we interested no n parties.
Complete Nos.I,2,3.5,and 6 it there are no interested parties. CERTIFICATION OF FILING
1 Name et business entity tiling form,and the city,state and country of the business entity's place Certificate Number:
of business. 2017-289374
Carlisle Insurance Agency.Inc
Date Piled
Corpus Christi,TX United States 1.2/D1/20172 Name of governmental entity or state agency thaws a party to the contract for which the form is
being filed. Anovelfaged
City of Corpus Christi Date �\ Sed:
g Provide the Identification number used by the governmental entity or state agency to track or identity the contract,arL provide a
description of the services,goods,or other property to be provided under the contract.
111
Agreement
Nature at interest
4 Name of Interested Party City,State,Country(place of business) (check applicable)
Controlling I Intermediary
5 Check only if there is NO Interested Party. ❑K
6 AFFIDAVIT I swear,or affirm.under penalty of perjury,that the above disclosure is true and correct.
d Creek\ GLADYS ADDISONIC ��lNo P7g059-z
NTEry pTEX...%%% $TNTE Of TEAS Signature of aumorized agem d cenvacung business entitya14, My Comm.Ekp,04452021
AF J)C OtAl7V7.STAf4rr SEAL AGOSE" CL/c �.F {s
Sworn to and subscribed before me,by the said /a(rr3 hp"en ce/HeJ,sklhiz the /54 day of hecon4er
20 1'7 .to cent/wwhich,witness my hand and seal of office.
4arlby/12-4 V A6lise✓
Signature el officer administering oath Printed name of o titer administering oath Tide of officer administering oath
Forms provided by Texas Ethics Commission www.ethics.slate.tx.us Version V1.0.3337