HomeMy WebLinkAboutUC BERKELEY CHICANO LATINO ALUMNI ASSOCIATION-2018:9IRY 15 2018
CITY OF SANTA ANA
O: CMO ( i ) DONATION AGREEMENT WITH
Julie Castro -Cardenas UC BERKELEY CHICANO LATINO ALUMNI ASSOCIATION
1. PARTIES AND DATE
This Donation Agreement ("Agreement") is entered into on APRIL 17, 2018 by and between
the City of Santa Ana, a municipal corporation ("City") and UC BERKELEY CHICANO
LATINO ALUMNI ASSOCIATION, a California 501(c)(3) NON-PROFIT ORGANIZATION
("Recipient"). City and Recipient are sometimes individually referred to as "Party" and collectively
as "Parties" in this Agreement.
2. RECITALS
2.1 Community Benefit, The City wishes to provide Recipient with funding to assist
Recipient TO HOLD EVENTS FOR THE COMMUNITY IN ACHIEVING ACADEMIC
EQUITY FOR HIGHER EDUCATION ("Community Benefit"). The Parties wish to enter into
this Agreement to establish the terms and conditions under which the City will provide funding.
2.2 Public Purpose. The City, by recommendation of COUNCILMEMBER
SARMIENTO, believes there is a public purpose in supporting the Cormnunity Benefit because it
PROVIDES EVENTS FOR PROSPECTIVE HIGH SCHOOL AND COMMUNITY
COLLEGE STUDENTS AND TO ENGAGE ALUMNI FOR HIGHER EDUCATION. The
foregoing is a general description of the public purpose, and is not necessarily the only public
purpose to be gained from the Community Benefit.
3. TERMS AND CONDITIONS
3.1 Use of Funds. The City has chosen to provide Recipient with a one-time payment of
FIVE HUNDRED DOLLARS ($500), because the City has determined that there is a public
purpose to be served in supporting the Community Benefit. hi executing this Agreement and
receiving the funds, Recipient agrees to use the fiords only for the purpose described and subject to
the terms and conditions provided for in this Agreement. Should Recipient fail to use the funds for
such ,purpose or otherwise comply fully with the terms of this Agreement, City shall have the right to
terminate this Agreement and demand the return of the fiords pursuant to Section 3.2 below.
3.2 Term; Termination of Agreement. This Agreement shall take effect on the date first
above written and remain in effect through Recipient's full expenditure of the funds. The City has
the right to terminate this Agreement upon one day's notice, with or without cause. Should the City
terminate this Agreement, it shall also have the right to demand the immediate return of all funds
provide to Recipient pursuant to this Agreement, as well as interest at the rate of ten percent (10%)
per annum. Notwithstanding the foregoing, the indemnification provisions of this Agreement shall
survive any expiration or termination of this Agreement.
3.3 Waivers, Insurance or Other Obligations. For purposes of the City's protection, if the
City determines that the funds will be used for a purpose which may cause a significant risk of
EXHIBIT 6
injury, the City may, in its sole discretion, require Recipient to provide certain insurance and
participant waivor/release protections. This right shall be on-going and may be implemented by the
City at any time, and all insurance and waiver/release forms shall be provided on forms, in amounts
and with provisions acceptable to City.
3.4 No Oversight 1t by City. Nothing in this Agreement shall be implied or interpreted as
City establishing or providing oversight, control or approval of the Community Benefit or any
activities conducted by the Recipient.
3.5 Indemnification. Recipient understands, acknowledges and agrees that Recipient
shall assume all risks associated with the Community Benefit, including, but not limited to, the
possibility of death or serious trauma or injury. To this end, therefore, Recipient shall defend,
indemnify and hold City and its officials, officers, employees, agents and volunteers free and
barmless from and against any and all claims, demands, causes of action, costs, expenses, liabilities,
losses, damages or injuries, in law or equity, to property or persons, including wrongfiA death, in any
manner arising out of or incident to any and all acts, omissions, willful misconduct or other activities
of the Recipient or its officials, officers, employees, agents, guests, participants attendees, and
contractors, including the performance of the Community Benefit or this Agreement, including
without limitation the payment of all consequential damages and attorneys fees and other related
costs and expenses. The only exception to the Recipient's obligations hereunder shall be for claims,
demands, causes of action, costs, expenses, liabilities, losses, damages or injuries caused by the sole
negligence, sole willful misconduct or sole active negligence of the City. Recipient shall defend, at
Recipient's own cost, expense and risk, any and all such aforesaid suits, actions or other legal
proceedings of every kind that may be brought or instituted against the City, its officials, officers,
employees, agents, or volunteers. Recipient shall pay and satisfy any judgment, award or decree that
may be rendered against the City or its officials, officers, employees, agents, or volunteers, in any
such suit, action or other legal proceeding, Recipient shall reimburse City and its officials, officers,
employees, agents, and/or volunteers, for any and all legal expenses and costs incurred by each of
them in connection therewith or in enforcing the indemnity herein provided. Recipient's obligation
to indemnify shall not be restricted or limited by insivance proceeds, if any, received by the City, its
officials, officers, employers, agents or volunteers. The indemnification provisions of this
Agreement shall survive any expiration or termination of this Agreement. .
3.6 Entire Contract/M.odification. This Agreement contains the entire agreement of the
Parties with respect to the subject matter hereof, and supersedes all prior negotiations,
understandings or agreements. The terms and conditions of this Agreement may be altered, modified
or amended only by written agreement signed by both Parties.
3.7 Authority to Enter Agreement. The person executing below on behalf of Recipient
represents and warrants that the Recipient has all requisite power and authority to conduct its
business and to execute, deliver and perform this Agreement. Each Party warrants that the
individuals who have signed this Agreement have the legal power, right and authority to make this
Agreement bind each respective Party.
EXHIBIT 6
N-2018-061
CITY OF SANTA ANA
By
Rau Godinez
City Manager
Attest:
go
ngJA
'..
l MW
/Maria D.
6
Clerk 1theCouncil
Approved as to Form:
Sonia R. Carvalho
City Attorney
By A _
Jbhn M. Funk
Assistant City Attorney
UC BERKELEY CHICANO LATINO
ALUMNI ASSOCIATION, a 501(c)(3)
NON-PROFIT ORGANIZATION
r
By:
Signature
Name: y�AA J. � r��✓U�Z
Title:& Bk,Vl&x d'()&W
V 1-3 A�1_16 a4A
EXHIBIT 6
City Manage s omce- M-31
City of Santa Ana 20 CI* Center Plaza
}i Donation Request Santa�a„a, cg 92702
I'714j 647.5200
Name:
Roberto Figueroa for Brenda Rodriguez, ACH)
rtre;
Executive Direct or
ddreas:
2425 Channing Way, 8208
—Phone:
Tax•Exempt Status: Is your organization a non-profit or public tax-exempt organization as
defined under Section 501(c)(J) of the Internal Revenue Code?
city, state, zip:
Berkeley, CA.94704
619-254-9057 Ilf
Emag,
brodriguezaffordabfe-housing.org
Fax:
organization Information
Mail: City Manager's Office -M-31
20 Civic Center Plaza
P.O. Box 1988
Email: donation[equest@santaana.org
Fax: (714) 647.6954
UC Berkeley Chicano Latino Alumni Association on behalf of Affordable Clearrl�ig�
House
I OR -
Council Meeting Date: I APRIL 17, 2018
Tax•Exempt Status: Is your organization a non-profit or public tax-exempt organization as
defined under Section 501(c)(J) of the Internal Revenue Code?
elect One:
L. __I
®Y¢s
—
City Manager Signature:
I No
lPlyo, you will onlyqualify far a credit for City -related costs foryourrequest(i.e. permit fees,
taNttme,rerifalrate9farlaptitissorequipment,eta).CostsforCllyserviceswyaod8
IfYes,
[47-1688249pproved,
credit may ormay not cover toll cost of requested Cifyservices
ax ID d:
III
o.
City Services Credit
mount Requested: '-��d[---�-
�X-^—,e�
Date Needed: i
Mayor/Councilm¢mher. Sarmiento
Direct Payment Amount 500�Ev�entOajte
Rnesed
Ejv¢n4Time;
bm I
Ii
Event . City, tar
Address, City, State, Zlp
_
f
f—
C Icano Latino Alumni Association Chapter launch (Orange, County) -
Description of organize chapter to host yielding events for prospective high school a�
id commu
Event I Purpose: nity college students and to engage alumni• I
�I
Community Benefit:
ca emlo equity or un. errep resented stn ents,ln the Orange.Countyl
yea.
IAPPhoantSigrta`�e�, �, ,��)�sa,-r ar cr °w,�t '�i;'�`�4,' `Pate• ted`-"
.,�
Mail: City Manager's Office -M-31
20 Civic Center Plaza
P.O. Box 1988
Email: donation[equest@santaana.org
Fax: (714) 647.6954
EXHIBIT I
29A-5 levised 01/0512017
Donatian Request M:
I OR -
Council Meeting Date: I APRIL 17, 2018
Eligibility Met:
YES 1 NO YES
Approved • Amount: I $500
City Manager Signature:
— Date:
EXHIBIT I
29A-5 levised 01/0512017
Cat. No. 14231X Form W- (RSM. 12.2014)
Form ■IRS
Request for Taxpayer
Give
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(Rai. DSoembar2014a ry
Identification Number and .Certification
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I Name (as Shown on your income tax ratum). Name is required on We line: do not feava this Iles blank
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proprietor or Corporation [J S Corporation 0 partnership Trustlesiete
single-marrrUAr'LLC instructions on pa
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[]Limited liability company.. Enter the tar classification(t'aC corporation, S=5 corporation, P.partnership)► Exempt payee code
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Note. For a sinoWmember LLC that q disregarded, do not check LLC; check the appropriate box in the lin; sbova for Exemption from FA
reporting
the tax classification of the aingle-member owner.
Ottode {ro.cear,a
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Tax ver IdentHlcaiion Number IN
Enter your TIN in the appropriate box. The TW provided must match the name given on tine 1 to avoid ,
backup withholding. For Individuals, this Is generally your social Security number (SSN). Nowsvar, fora
n!n_
resident alien, sole Proprietor, or disregarded entity, seethe Fart I Instructions on page3. For other
entities, it is your employer identification number (EIN). if you do not have a number, see How to gat a
T1JJon peg; 3. or
Note, If the account Is In more then One name, $ae the instructions for line f and the chart on page 4 for Employer Identdf0amon numb
,
guidelines on whose number to enter.
4`'7
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Certification
Under penalties of perjury, I certify that:
1. The number shown on this form Is my correct taxpayer Identification number (or I am wafting for a number to be issued to me); and
2, 1 elm not subject to backup withholding because. (a) I am exempt from backup withholding, or (b) I have not been notified by the Inlay
tell Revenue
Service (IRS) that I am subject to backup withholding as A result of a failure to report ail Interest or dividends, or (o) the IRS has ncififif
d me that I am
no longer subject to backup withholding; and
3. f am a U,S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form if any) Indicating that I am exempt from FATCA reporting is correct.
Cerullo stion instructions, You must cross out item 2 above if you have been notified bylhe IRS that you ars currently subject W backu
-'withholding
because you have failed to report all interest and dividends on your tax return. For real estate transactions, Item 2 does not apply. Form
rtgage
Interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangemo
t(IRA), and
generally, payments other than Interest and dividend you are no u(red to sign the certification, but you must provide your correct T.
Instructions on page 3.
N. Sea the
Sign
Fiera
Signatupere of
U.S.U.s. parson r
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Generali Instructions = Form 1098 (home mortgage intereat},1098-E (student ban ante
st), I098 -T
(arttion)
Bsotlan U#WAnceS are to the Internal Revenue Code unless otherwise noted. . Form 1089.0 (oaneeled debt)
Future developments. Information about developments affecting form W-9 (such • Form 1499-A acqulsidw or abandonment of secured property)
as legislation enacted after we release it) is at www.lr^,.gnvlice.
Uae Form W-9 only ff you are a U.S. person 4ncluding a menden
Purpose of Form provide your correct TIN,
afion), to
An individual or entity (Form W -e requester) who Is required to file an Information lfyou do not return r'onr, W8 to fhs rsquesWurith a TPN, you 0
ghtbe subject
return with the IRB must obtain your correct taxpayer identification number (CIN) to backup withholding. Sea What is backup wXhholding? on page
.
which may be your social security number (SSW), individual taxpayer Identification By aiming the filled -out farm, You:
number (ITIN), adoption taxpayer identification number (ATIN), or employer
t. Gert' that the TIN
Identification number PN), to report on an information return the Amount paid to rfY You are giving is correct (o you are waif
for a number
you, or other amount reportable an an information return. Examples of information to be Issued),
returns include, but are not limited tc, me following: 2. CamNy that you are not subject to backup withholding, or
• Form 1496 -INT (Intoreat earned or pall) 3. Claim exemption from backup withholding H you aro a U.S. a
ampt payee. if
•• Form 1099 -DN (dividends, including those from stacks or mutual funds) applicable, you are also corfifying that as a U.S. person, your alisc
sple share of
• Form 1099-MIBC (various types of indOma, Wiz",, awards, loss any partnership income from a U.S, trade w business is not subject
proceeds) or
g P ) withholding tax on foreign paMsrs'share of effectively connected
to the
income, sad
• Form 1099-B (stook or mutual fund setas and certain other transactions by 4. CSorth, that FATCA coda(A) entered on this form (f arty) Indica
brokers)
Ing that you ora
exempt from the FATCA reporting, is correct. See What isFAMA
'ng?on
0 FOrm 1099.5 (proceeds from real estate Iramesfidns) page 2 for further information.
• Form 1498-K (merchant card and Hard party network transactions)
Cat. No. 14231X Form W- (RSM. 12.2014)