HomeMy WebLinkAboutHABITAT FOR HUMANITY OF OCCity of Santa Ana
Clerk of the Council '1 I �fn cLER I
AGREEMENT TERMINATION FORM JA
Please complete this form in its entirety when the attached agreement and all
amendments (if any) are no longer in effect.
Note: If your agreement is grant related, please ensure that all grant retention requirements
have been satisfied prior to signing the termination form. J
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Return form to the Clerk of the Council Office (M-30).
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Date: 11 /m (2/7
INSURANCE ON FILE A-2021-068-08
WnQK MAY PROCEED
UNTIL INSURAN E EXPIRES
JUL 1 3 Z021 Ok /al Z022
CLERK OF COUNCIL
DATE:
AREEMENT BETWEEN THE CITY OF SANTA ANA AND
HABITAT FOR HUMANTPY FOR USE OF
OA
n OMMUNITY DEVELOPMENT BLOCK GRANT FUNDS
awtoLThis Agreement is hereby made and entered into this 6th day of July 2021, by and between the City
of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and
laws of the State of California ("CITY"), and Habitat for Humanity of Orange County, Inc., a California
religious nonprofit corporation ("SUBRECIPIENT").
RECITALS:
A. The CITY, as an entitlement recipient and grantee of the United States Department of Housing and
Urban Development ("HUD') Community Development Block Grant ("CDBG") Entitlement Program,
Catalog of Federal Domestic Assistance (CFDA) Number 14118, and Federal Award Identification Number
(FAIN) B-21 MC-06-0508, desires to enter into this Agreement with the SUBRECIPIENT for the
expenditure of CDBG funds in accordance with Title 24, Part 570 of Code of Federal Regulations 24 CFR
570.000, et seq. ("CDBG REGS").
B. CITY has applied for and received CDBG funds from HUD pursuant to Title I of the Housing and
Community Development Act of 1974, Public Law 93-383, as amended ("ACT").
C. The SUBRECIPMNT is a private nonprofit corporation that has been selected by the CITY to
receive CDBG funds and administer such financial assistance; and to provide the services described in
Exhibit A, in accordance with the Schedule of Performance included therein, hereinafter referred to as "said
program". SUBRECIPTIENT represents that it is qualified and willing to operate said program and certifies
that the activities carried out with funds provided under this Agreement will meet one or more of the CDBG
program'sNational Objectives (24 CFR Part 5M208).
D. SUBRECIPIENT agrees that it will adhere to the performance measurements and outcomes as
indicated on Exhibit A (Schedule of Performance). Failure to follow the measurements and meet the
stated outcomes may constitute breach of contract that could result in termination of this Agreement or
serve as reason for the City to recapture the grant funds awarded to SUBRECIPIENT pursuant to this
Agreement.
WHEREFORE, it is agreed by and between the parties that the foregoing Recitals are a substantive
part of this Agreement and the following terms and conditions are approved and together with all exhibits and
attachments hereto, shall constitute the entire Agreement between the CITY and SUBRECIPIENT:
A. Nonprofit Status - Representations and Warranties
(a) Authority. SUBRECIPIENT is a duly organized and existing nonprofit corporation in good
standing and authorized to do business under the laws of the State of California. SUBRECIPMM has
full right, power and lawful authority to accept the funding hereunder and to undertake all obligations as
provided herein and the execution, performance and delivery of this Agreement by SUBRECIPMNT has
been fully authorized by all requisite actions on the part of SUBRECIPIENT.
(b) Experience. SUBRECIPIENT is a qualified provider of the services to be provided
hereunder.
(c) Familiarity With Services Required. By executing this Agreement, SUBRECIPIENT
warrants that (i) it has thoroughly investigated and considered the services to be performed and provided
hereunder, (ii) it has carefully considered how the services should be performed, and (iii) it fully
understands the facilities, difficulties and restrictions attending performance of the services under this
Agreement.
(d) No Conflict. To the best of SUBRECIPIENT'S knowledge, SUBRECIPIENT'S execution,
delivery and performance of its obligations under this Agreement will not constitute a default or a breach
under any contract, agreement or order to which SUBRECIPIENT is a party or by which it is bound.
(a) No Bankruptcy. SUBRECIPIENT is not the subject of any current or threatened bankruptcy
proceeding.
(f) No Pending Legal Proceedings. SUBRECIPIENT is not the subject of a current or
threatened litigation that would or may materially affect SUBRECIPIENT'S performance under this
Agreement,
(g) Application Veracity. All provisions of and information provided in SUBRECIPIENT'S
application for funding submitted to CITY, including any exhibits, are true and correct in all material
respects.
(h) No Pending Investigation. SUBRECIPIENT has no knowledge that it is the subject of any
current or threatened criminal or civil action investigation by any public agency, including without
limitation a police agency or prosecuting authority, that would relate to or affect performance of the
Agreement or provision of services hereunder,
B. Amount of Grant/Temi and Monthly Disbursement. The amount granted to
SUBRECIPIENT is $545,532 ("CDBG FUNDS"), for a one-year term from July 6, 2021 through June
30, 2022 for the program named: Residential Rehabilitation Program (RRP). Such funds shall be
expended by SUBRECIPIRNT on or before June 30, 2022. The Term of this Agreement may be
extended by a writing executed by the City Manager, or his or her designee, and the City Attorney. The
CDBG FUNDS shall be disbursed by CITY to SUBRECIPIENT on a monthly basis subject to and upon
receipt and approval of a complete monthly activity report from SUBRECIPIENT, with the final
payment subject to the satisfaction of the condition precedent of submittal of complete reporting
information due on or before July 15 of the applicable funding year, as hereinafter more fully set forth.
SUBRECIPIENT shall be obligated to perform such duties as would normally extend beyond tine term,
including, but not limited to, obligations with respect to indemnification, audits, reporting,
data retention/reporting, and accounting. Failure to provide any of the required documentation and
reporting will cause CITY to withhold all or a portion of a request for reimbursement, or return the entire
reimbursement package to SUBRECIPIENT, until such documentation and reporting has been received
and approved by CITY.
The CITY reserves the right to reduce the amount of CDBG FUNDS to SUBRECIPIENT, or to
completely terminate this Agreement, in the CITY's sole discretion, if there is a reduction in CDBG
FUNDS provided to the CITY for program year 2021-2022.
The CITY reserves the right to reduce the grant application if the CITY's fiscal monitoring indicates
that SUBRECIPIENT's rate of expenditure will result in unspent funds at the end of the program years.
Amendments in the grant allocation will be made after consultation with SUBRECIPIENT.
C. Use of Funds. SUBRECIPIENT agrees to use all federal funds provided by CITY to
SUBRECIPIENT pursuant to this Agreement to operate said program, as set forth in "Exhibit t1," attached
hereto and by this reference incorporated herein, SUBRECIPIENT'S failure to perform as required may, in
addition to other remedies set forth in this Agreement, result in readjustment of the amount of funds CITY is
otherwise obligated to pay to SUBRECIPIENT hereunder.
D. Allowable Costs. SUBRECIPIENT agrees to complete said program on or before June 30,
2022, and to use said funds to pay for necessary and reasonable costs allowable under the federal law and
regulations to operate said program. Said amounts shall include, but not be limited to, wages, administrative
costs, and employee benefits comparable to other similarly situated employees, and indirect costs. other
allowable program costs are detailed in the budget, as set forth in "Exhibit B," attached hereto and by this
reference incorporated herein. SU13RECIPWNT shall use all income received from said funds only for the
same purposes for which said funds may be expended pursuant to the terms and conditions of this
Agreement, SUBRECIPIENT has the ability to adjust line item amounts in the budget with the written
approval of the CITY's Executive Director of the Commimity Development Agency, or designee, so long as
the total budget amount does not increase.
Pursuant to 2 CFR §200331(a)(4), the Indirect Cost Rate for the SUBRECIPIENT's award shall
be an approved federally recognized indirect cost rate negotiated between the SUBRECIPIENI' and the
Federal government, or, if no such rate exists, the de minimis indirect cost rate as defined in 2 CFR
§200.414(b) indirect (F&A) costs.
For this agreement, the de minimis indirect cost rate of 10% will apply,
E. Licensing. SUBRECIPIENT agrees to obtain and maintain all required licenses,
registrations, accreditation and inspections firm all agencies governing its operations. SUBRECIPIENT
shall ensure that its staff shall also obtain and maintain all required licenses, registrations, accreditation and
inspections from all agencies governing SUBRECIPIENT's operations hereunder. Such licensing
requirements include obtaining a City business license, as applicable.
F. Zonin . SUBRECIPIENT agrees that any facility/property used in furtherance of said
program shall be specifically zoned and permitted for such use(s) and activity(ies). Should SUBRECIPIENT
fail to have the required land entitlement and/or permits, thus violating any local, state or federal rules and
regulations relating thereto, SUBRECIPIENT shall hnmediately make good -faith efforts to gain compliance
with local, state or federal rules and regulations following written notification of said violation(s) from the
CITY or other authorized citing agency. SUBRECIPIENT shall notify CITY immediately of any pending
violations. Failure to notify CITY of pending violations, or to remedy such known violation(s) shall result in
termination of grant funding hereunder. SUBRECIPIENT must make all corrections required to bring the
facility/property into compliance with the law within sixty (60) days of notification of the violation(s); failure
to gain compliance within such time shall result in termination of grant funding hereunder.
G. Separation of Accounts. All funds received by SUBRECIPIENT from CITY pursuant to this
Agreement shall be maintained in an account in a federally insured banking or savings and loan institution
with record keeping of such accounts maintained pursuant to applicable 2 CFR 200302 requirements.
SUBRECIPIENT is not required to maintain separate depository accounts for CDBG FUNDS; provided
however, the SUBRECIPIENT must be able to account for receipt, obligation and expenditure of CDBG
FUNDS pursuant to applicable 2 CFR 200.302 requirements.
H. Audit Report Recuirements. SUBRECIPIENT agrees that if SUBRECIPIENT expends
Seven Hundred Fifty Thousand Dollars ($,750,000) or more in federal finds, SUBRECIPIENT shall have an
annual audit conducted by a certified public accountant in accordance with the standards as set forth and
published by the United States Office of Management and Budget. SUBRECIPIENT shall provide CITY
with a copy of said audit by April 1 of the year following the program year in which this Agreement is
executed.
I. Record Keepin /g Reporting. SUBRECI TENT shall keep and maintain complete and
adequate records and reports on program participants to determine their initial and continuing eligibility for
the program services being provided to assist CITY in meeting and maintaining its record keeping
responsibilities under the CDBG BEGS, including the following:
(1) Records
a. Documentation evidencing program income requirements in conformity with 24 CFR
570.504(b((2)(i), (ii) and 24 CFR 570.503(b)(3) and 24 CFR 570.208(a)(2)(B) of the income level
of persons and/or families participating in or benefiting by the SUBRECIPIENT program,
b, Documentation of the number of persons and/or families participating in or benefiting
by the SUBRECIPIENT program.
c. Household information shall include number of persons, identification of head of
household, raceladmicity, and income verification of all household members ages 18 and over,
d. Documentation of all CDBG FUNDS received from CITY.
e. Documentation of expenses as identified in the Budget Proposal, including evidence of
incurring the expense, invoices for goods or services, copies of any and all contracts or
documentation pertaining to costs for subcontractors, plus all other invoices and proof of payment for
which CDBG FUNDS were expended, and any payments therefor.
£ Any such other related records as CITY shall reasonably require or as required to be
maintained pursuant to the CDBG REGS.
(2) Reports
a. Payment Request, Concurrently with the submittal of each monthly report, on or before
the 15th day of October, January, April and July, SUBRECIPJENT shall submit both: an original
invoice/request for reimbursement and true copies of invoices, receipts, canceled checks, bank
statements, credit card statements, procurement documentation for goods or services, timesheets,
payroll records, benefit statements, agreements, contracts or documentation pertaining to costs for
subcontractors, and/or other documentation supporting and evidencing how the CDBG FUNDS
have been expended during the applicable quarter.
b. Monthly Progress Report. SUBRECIPIENT agrees to keep records of all ethnic and
racial statistics of persons and families benefited by SUBRECIPIENT in the performance of its
obligations under this Agreement, including, but not limited to, the number of low and moderate
income persons and households assisted in accordance with federal income limits, the number of
female heads of households assisted, new program information and year-to-date program
statistics on expenditures, caseload and activities. Failure to provide any of the required
documentation and reporting will cause CrTY to withhold all or a portion of a request for
reimbursement, or return the entire reimbursement package to SUBRECIPIENT, until such
documentation and reporting has been received and approved by CITY.
I. Access to Records. CITY and the United States Government and their representatives or
auditors shall have access for purposes of monitoring, auditing, and examining SUBRECIPIENT's
activities and performance, to books, documents and papers, and the right to examine recordsof
SUBRECIPIENT's subcontractors, bookkeepers and accountants, employees and participants in regard to
said program. CITY and the United States Government and their representatives or auditors shall also
schedule on -site monitoring at their discretion. Monitoring activities may also include, but are not limited
to, questioning employees and participants in said program and entering any premises or any site in which
any of the services or activities fimded hereunder is conducted or in which any of the records of
SUBRECIPIENT are kept. Nothing herein shall be construed to require access to any privileged or
confidential information as set forth in federal or state law.
K. Location of Records/Requued Length of Record Keeping. All accounting records, reports,
and evidence pertaining to all costs, expenses and the CDBG FUNDS of SUBRECIPIENT and all
documents related to this Agreement shall be maintained and kept available at SUBRECIPI ENT'S office
or place of business for the duration of the Agreement and thereafter for five (5) years from the date of
fmal payment under this Agreement. Records which relate to (a) complaints, claims, administrative
proceedings or litigation arising out of the performance of this Agreement, or (b) costs and expenses of
this Agreement to which CITY or any other governmental agency takes exception, shall be retained
beyond the five (5) years until complete resolution or disposition of such appeals, litigation claims, or
exceptions, In the event SUBRECIPIENT does not make the above -referenced documents available within
the city of Santa Ana, California, SUBRECIPIENT agrees to pay all necessary and reasonable expenses
incurred by CITY in conducting any audit at the location where said records and books of account are
maintained.
L. Compliance with Lanffin am Income. SUBRECIPIENT acknowledges that the funds
being provided by CITY for said program are received by CITY pursuant to the ACT as amended and that
expenditures of these funds shall be in accordance with the ACT and all pertinent regulations issued by
agencies of the federal government, including, but not limited to, all regulations found at Title 24 of the Code
of Federal Regulations. Program income received by SUBRECIPIENT shall be returned to CITY unless
otherwise provided for in this Agreement. SUBRECIPIENT agrees to comply fully with all federal, state and
local laws and court orders applicable to its operation whether or not referred to in this Agreement.
M. Debarment. To protect the public interest and ensure the integrity of Federal programs,
CITY may only conduct business with responsible persons and may not make any award or permit any
award to any party which is debarred or suspended or is otherwise excluded from or ineligible for
participation in Federal assistance programs under Executive Order 12549, "Debarment and Suspension".
See also 24 CFR 570.609, SUBRECIPIENT must review and sign Exhibit C "Debarment", which is
attached hereto and incorporated herein by this .reference. SUBRECIPIENT shall be in good standing,
without suspension by the California Secretary of State, Franchise Tax Board and Internal Revenue Service,
Any change in the corporate status or suspension of SUBRECIPIENT shall be reported immediately to
CITY.
N. Confidentiality, Without prejudice to any other provisions of this Agreement,
SUBRBCIPIEN i' shall, where applicable, maintain the confidential nature of information provided to it
concerning participants in accordance with the requirements of federal and state law. However,
SUBRECIPIENT shall submit to CITY and or HUD or its representatives, all records requested, including
audit, examinations, monitoring and verifications of reports submitted by SUBRECIPIENT, costs incurred
and services rendered hereunder.
O. Independent Contractor. SUBRECIPIENT agrees that the performance of obligations
hereunder is rendered in its capacity as an independent contractor and that it is in no way an agency of CITY.
P. Violation of Terms and Conditions, SUBRECIPIENT agrees that if SUBRECIPIENT
violates any of the terms and conditions of this Agreement or any prior Agreement whereby CDBG funds
were received by SUBRECIPIENT, or if SUBRECIPIENT reports inaccurately, or if on audit there is a
disallowance of certain expenditures, SUBRECIPIENT agrees to remedy the acts or omissions causing the
disallowance and repay CITY all amounts spent in violation thereof. If SUBRECIPIENT engaged in
fraudulent activity to obtain and/or justify .expenditure of the CDBG funds granted hereunder,
SUBRECIPIENT shall be required to reimburse the CITY of all such funds that were obtained and/or spent
under fraudulent circumstances,
Q. Equi ment. SUBRECIPIENT agrees to maintain a record for each item of non -expendable
personal property acquired undenthe terms of this Agreement. Said record shall be made available to CITY
upon request. The term "non -expendable personal property" shall include leased and purchased equipment.
R. Prohibited Use, "RECIPIENT hereby certifies and agrees that it will not use funds
provided through this Agreement to pay for entertainment, meals or gifts, or other prohibited uses.
S. Lobbvine. SUBRECIPIENT certifies that it will comply with federal law (31 U.S.C. 1352)
and regulations found at 24 CFR Part 87, which provide that no appropriated funds may be expended by the
recipient of a federal contract, grant, loan or cooperative agreement to pay any person for influencing or
attempting to influence an officer or employee of any agency, Member of Congress, or an officer or
employee of a Member of Congress in connection with awarding of any federal contract, the making of any
federal grant or loan, entering into any cooperative agreement and the extension, renewal, amendment or
modification of any federal contract, grant, loan or cooperative agreement. SUBRECIPIENT shall sign a
certification to that effect in a form as set forth in "Exhibit D," attached hereto and by this reference
incorporated herein. SUBRECIPIENT shall submit said signed certification to CITY prior to performing any
of its obligations under this Agreement and prior to any obligation arising on the part of CITY to pay any
sums to SUBRECIPIENT under the terns and conditions of this Agreement.
If any funds other than Federal appropriated funds have been paid or will be paid to any
person for influencing or attempting to influence an officer or employee of any agency, a Member of
Congress, an officer or employee of Congress, or an employee of a Member of Congress in.connection with
this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit a
"Disclosure Form to Report Lobbying," in accordance with its instructions (Exhibit D)..
SUBRECIPIENT shall require that the language of this certification be included in the
award documents for all sub -awards at all tiers (including subcontractors, sub -grants, and contracts under
grants, loans, and cooperative agreements),and agrees to take all actions necessary to ensure that all
subrecipients shall similarly certify and disclose accordingly.
T. Financial Interest. SUBRECIPIENT agrees that except for the use of CDBG funds to pay
salaries and other related administrative or personnel costs, no persons who exercise or have exercised
any function with respect to CDBG activities assisted under the terms of this Agreement, or who are in a
position to participate in a decision -making process or gain inside information with regard to such
activities, may obtain a financial interest or benefit from a CDBG-assisted activity of SUBRECIPIENT,
either for themselves or those with whom they have family or business ties; dining their tenure or for one
year thereafter. This prohibition applies to any person who is an employee, agent, consultant, officer, or
elected or appointed official of CITY, or of any designated public agency, or the SUBRECIPIENT.
U. Labor Standards. The SUBRECIPIENT agrees to comply with the requirements of the
Secretary of Labor in accordance with the Davis -Bacon Act as amended, the provisions of Contract Work
Hours and Safety Standards Act (40 U.S.C. 327 at seq.) and all other applicable Federal, state and local
laws and regulations pertaining to labor standards insofar as those acts apply to the performance of this
Agreement. The SUBRECIPIENT agrees to comply with the Copeland Anti -Kick Back Act (18 U,S.C.
974 at seq.) and its implementing regulations of the U.S. Department of Labor at 29 CFR Part 5. The
SUBRECIPIENT shall maintain documentation that demonstrates compliance with hour and wage
requirements of this part. Such documentation shall be made available to the CITY for review upon
request.
SUBRECIPIENT agrees that, except with respect to the rehabilitation or construction of
residential property containing less than eight (8) units, all contractors engaged under contracts in excess
of $2,000.00 for construction, renovation or repair work financed in whole or in part with assistance
provided under this contract, shall comply with Federal requirements adopted by the CITY pertaining to
such contracts and with the applicable requirements of the regulations of the Department of Labor, under
29 CFR Parts 1, 3, 5 and 7 governing the payment of wages and ratio of apprentices and trainees to
journey workers; provided that, if wage rates higher than those required under the regulations are imposed
by state or local law, nothing hereunder is intended to relieve the SUBRECIPIENT of its obligation, if
any, to require payment of the higher wage. The SUBRECIPIENT shall cause or require to be inserted in
full, in all such contracts subject to such regulations, provisions meeting the requirements of this
paragraph.
V. Section 3 of the Housing and Urban Development Act of 1968. SUBRECIPIENT will make
every effort to provide training opportunities for low -and moderato4ncome persons residing within the
community where the construction project is located and contracts awarded to local businesses therein to the
greatest extent feasible as required under the provisions of Section 3 of the Housing and Urban Development
Act of 1968, the regulations set forth in 24 CFR 135, and all applicable rules and orders issued hereunder
prior to the execution of this Agreement. Compliance with the foregoing requirements shall be a condition of
the federal financial assistance provided under this Agreement and binding on the SUBRECIPIENT. Failure
to fulfill these requirements shall subject the SUBRECIPIENT, its successors and designees, to those
sanctions specified by the Agreement through which federal assistance is provided. The SUBRECIPIENT
certifies and agrees that no contractual or other disability exists which would prevent compliance with these
requirements. SUBRECIPIENT shall make every effort to ensure that all projects fimded wholly or in part
by CDBG funds shall provide equal employment opportunities for minorities and women.
W. Drug Free Workplace, SU13RPCIPIENT agrees to provide a drug -free work place and to
execute a certification as set forth in "Exhibit E" attached hereto and incorporated herein by this reference.
X. Uniform Administrative Requirements, Cost Principles and Audit Rouuirements for Federal
Awards. The following requirements and standards must be complied with: 2 CFR Part 200 at al,
SUBRECIPIENT shall procure all materials, property, or services in accordance with the requirements of
2 CFR 200.318-326,
Y. Subpart K of 24 CFR 570. SUBRECIPIENT will carry out its activities in compliance with the
requirements of Subpart K of 24 CFR 570. However, SUBRECIPIENT does not assume the CITY's
environmental responsibilities or the responsibility for initiating the environmental review process under 24
CFR Part 52.
Z. Women- and Minority -Owned Businesses (W/MBE). SUBRECIPIENT will use its best
efforts to afford small businesses, minority business enterprises, and women's business enterprises the
maximum practicable opportunity to participate in the performance of this Agreement in accordance with
the requirements of 2 CFR 200.321 "Contracting with small and minority businesses, women's business
enterprises, and labor surplus area firms". As used in this Agreement, the term "small business" means a
business that meets the criteria set forth in section 3(a) of the Small Business Act, as amended (15 U.S.C.
632), and "minority and women's business enterprise" means a business at least fifty-one percent (5101,)
owned and controlled by minority group members or women. For the purpose of this definition,
"minority group members" are African -Americans, Spanish-speaking, Spanish surnamed or Spanish -
heritage Americans, Asian -Americans, and American Indians. SUBRECIPIENT may rely on written
representations by businesses regarding their status as minority and female business enterprises in lieu of
an independent investigation.
MIEW9_110ATITIMATERV$L
A. Payment of Funds. On February 25, 2021, the CITY was allocated $5,558,720 for fiscal year
2021-2022 from the United States Department of Housing and Urban Development ("HUD') Community
Development Block Grant ("CDBG") Entitlement Program, Subject to the terms of this Agreement, and
contingent on CITY receiving at least the same amount of CDBG funds from HUD for the 2021-2022
program year, CITY agrees to pay to SUBRECIPIENT when, if and to the extent federal finds are received a
sum not to exceed Five Hundred Forty Five Thousand, Five Hundred Thirty Two Dollars ($545,532) for
SUBRECIPIENT'S performance in accordance with the Budget attached hereto as "Exhibit B" during the
two-year period of this Agreement, Payments shall be made to SUBRECIPIENT through the submission of
invoices/reimbursement requests.
CITY shall pay such invoices/reimbursement requests within thirty (30) days after receipt thereof
provided CITY is satisfied that such expenses have been incurred and documented within the scope and
provisions of this Agreement and that SUBRECIPIENT is in compliance with the terms and conditions of
this Agreement. Failure to provide any of the required documentation and reporting will cause CITY to
withhold all or a portion of a request for reimbursement, or return the entire reimbursement package to
SUBRECIPIENT, until such documentation and reporting has been received and approved by CITY.
Documentation may include, but is not limited to, true copies of invoices, receipts, canceled checks, bank
statements, credit card statements, procurement documentation for goods or services, timesheets, payroll
records, benefit statements, agreements, contracts or documentation pertaining to costs for subcontractors,
and/or other documentation supporting and evidencing how the CDBG FUNDS have been expended
during the applicable quarter.
B. Audit of Account. CITY shall include an audit of the account maintained by
SUBRECIPIENT in CITY's annual audit of all CDBG FUNDS in accordance with Title 24 of the Code of
Federal Regulations and other applicable federal laws and regulations.
C. Common Rule: Pursuant to 2 CFR 200,328(a), the CITY manages the day-to-day operations of
each grant and subgrant supported activities. CITY staff has detailed knowledge of the grant program
requirements and monitors grant and subgrant supported activities to assure compliance with Federal
requirements. Such monitoring covers each program, function and activity and performance goals are
reviewed periodically.
D, Environmental Review: In accordance with 24 CM, 58, the CITY is responsible for
undertaking environmental review and maintaining environmental review records for each applicable
project.
E. Performance Monitoring: CITY shall monitor the performance of SUBRECIPIENT against
goals and performance standards required herein. The SUBRECIPIENT shall be responsible to
accomplish the levels of performance as set forth in Exhibit A and report such measures monthly to the
CITY. If the SUBRECIPIENT estimates such goals will not be met, the SUBRECIPIENT is to contact
the CITY, at wh ch time the CITY will determine if any adjustments to the grant award is appropriate.
Substandard performance as detennined by the CITY will constitute non-compliance with this
Agreement. Should the CITY determine that the SUBRECIPIENT has not performed its obligations as
stated in this contract in a satisfactory manner, or if the CITY determines that insufficient supporting
information has been submitted, the CITY shall notify the SUBRECIPIENT in writing of its
determination specifying in full detail the objections which it has to the SUBRECIPIENT's performance.
If action to correct such substandard performance is not taken by the SUBRECIPIENT after being
notified by the CITY, within a reasonable period of time as stipulated in the written notification, contract
suspension or termination procedures will be initiated,
(M
A. SUBRMPIENT agrees to comply with Executive Order 11246 which requires that during the
performance of this Agreement, SUBRECIPIENT agrees not to discriminate against any employee or
applicant for employment because of race, religion, sex, color or national origin. 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. SUBRECIPIENT agrees to post in
conspicuous places, available to employees and applicants for employment, notices to be provided by the
SUBRECIPIENT setting forth the provisions of this nondiscrimination clause.
B. SUBRECIPIENT agrees to comply with Title VI of the Civil Rights Act of 1964 which indicates
that no person shall, on the ground of race, color or national origin, be excluded from participation in, be
denied the benefits of, or be subject to discrimination under any program of activity receiving federal
financial assistance.
C. No person shall, on the grounds of race, sex, creed, color, religion, marital status, national origin,
age, sexual orientation, or physical or mental handicap be excluded from participation in, be refused the
benefits of, or otherwise be subject to discrimination in any activities, programs or employment supported by
this Agreement. SUBRECIPIENT is prohibited from discrimination on the basis of age or with respect to an
otherwise qualified handicapped person as provided for under Section 109 of the Rousing and Community
Development Act of 1974, as amended.
D. SUBRECIPIENT agrees to comply with the Age Discrimination Act of 1975 which requires that
during the performance of this Agreement, SUBRECIPIENT agrees not to discriminate against any employee
or applicant for employment because of age: 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. SUBRECIPIENT agrees to post in conspicuous places, available to
employees and applicants for employment, notices to be provided by the SUBRECIPIENT setting forth the
provisions of this age discrimination clause.
E. SUBRECIPIENT agrees to comply with Section 504 of the Rehabilitation Act of 1973 which
requires that no otherwise qualified individual with a disability in the United States, shall, solely by reason of
his or her disability, be excluded from the participation in, be denied the benefits of, or be subjected to
discrimination under any program or activity receiving federal financial assistance or under any program or
activity conducted by any executive agency or bythe United States Postal Service,
IV. CONFLICT Of
Pursuant to the conflict of interest requirements set forth in 24 CFR 570,611 and 2 CFR 200,112,
SUBRECIPIENT certifies that no member, officer, employee, agent or assignee of CITY having direct or
indirect control of any CDBG monies granted to the CITY, inclusive of the subject CDBG FUNDS, shall
serve as an officer of SUBRECIPIENT. Further, any conflict or potential conflict of interest of any officer of
SUBRECIPIENT shall be fully disclosed in writing prior to the execution of this Agreement and said writing
shall be attached and deemed fully incorporated as a pant hereof. Notice shall be sent by SUBRECIPIENT to
CITY regarding any changes or modifications to its board of directors and list of officers.
0
If SUBRECIPIENT is a religious entity, SUBRECIPIENT hereby agrees that in connection with the
provision of the services SUBRECIPIENT shall provide with CDBG funds, in accordance with 24 CFR
570.2000):
A. SUBRECPIENT shall not discriminate against any employee or applicant for employment on
the basis of religion and shall not limit employment or give preference in employment to persons on the basis
ofreligion.
B. SUBRECIPMW shall not discriminate against any person applying for the .services
SUBRECIPIENT agrees to provide under the terms of this Agreement on the basis of religion and shall not
limit such services or give preference to applicants for such services on the basis ofreligion.
C, SUBRECIPIENT shall NOT provide religious instruction or counseling, conduct any religious
worship or services, or engage in any religious proselytizing, or exert any religious influence in the provision
of the services in said program. The parties agree that this covenant is intended to and shall be construed for
the limited purpose of assuring compliance with respect to the use of CITY funds by SUBRECIPIENT with
applicable constitutional limitations respecting the establishment of religion as set forth in the establishment
clause under the First Amendment of the United States Constitution and Article I, Section 4 of the California
Constitution, and is not in any manner intended to restrict other activities. of SUBRECIPIENT.
D. The portion of a facility used to provide public services assisted in whole or in part under this
Agreement shall contain no sectarian or religious symbols,
E. Where the services to be provided under said program are rendered on property owned by the
primarily religious entity SUBRECIPIENT, CDBG funds may also be used for minor repairs to such property
which are directly related to the cost of rendering the services Lander said program, where the cost constitutes
in dollar terms only an incidental portion of the CDBG expenditure for rendering the services under said
program.
►A t _aTI i IiT 1311 OGTO IM
SUBRECIPIENT agrees not to hire or penn t the hiring of any person to fill a position funded
through this Agreement if a member of that persons immediate family is employed in an administrative
capacity by SUBRECIPIENT. For the purposes of this section, the term "immediate family" means spouse,
child, mother, father, brother, sister, brother-in-law, sisterAn-law, father-in-law, mother-in-law, son-in-law,
daughter-in-law, aunt, uncle, niece, nephew, stepparent and stepchild. The term "administrative capacity"
means having selection, hiring, supervisor or management responsibilities.
VIL NOTICES
Notices to the parties shall, unless otherwise requested in writing, be sent by U.S. Mail, postage
prepaid, and addressed as follows:
10
TO CITY: City of Santa Ana
Community Development Agency (M-25)
20 Civic Center Plaza
P.O. Box 1988
Santa Ana, California 92702-1988
TO SUBRECIPIENT: Sharon Ellis
CEO / President
2200 Ritchey Street
Santa Ana, CA 92705
VM. ASSTGNABII.TTY
None of the duties of, or work to be performed by, SUBRECIPIENT under this Agreement shall be
subcontracted or assigned to any agency, consultant, or person without the prior written consent of CITY.
SUBRECIPIENT must submit all subcontracts and other agreements that relate to this Agreement to CITY,
No subcontract or assignment shall terminate or alter the legal obligations of SUBRECIPIENT pursuant to
this Agreement.
I fI r 1:tw
SU13RECIPMNT shall indemnify, defend and save harmless CITY, its officers, employees, agents,
representatives and volunteers from and against any and all damages to or for loss of use of property and for
injuries to or death of any person or persons, including property and employees or agents of CITY, and shall
defend, indemnify and save harmless CLTY, its officers, employees, agents, representatives and volunteers
from and against any and all claims, demands, suits, actions or proceedings of any kind or nature, including,
but not by way of limitation, workers compensation claims and including attorney fees and reasonable
expenses for litigation or settlement, resulting from or arising out of the negligent or wrongful acts, offers or
ondssions of SUBRECIPIENT, its officers, directors, employees, agents, subcontractors and suppliers arising
out of SUBRECIPIENT's performance of this Agreement.
X. 1NSURAN( E
1, Couunercial General Liability. SUBRECIPIENT agrees to obtain and keep in force
during the torm of this Agreement a policy of,comprehensive commercial public liability insurance
insuring the CITY, and SUBRECIPIENT against any liability for accident, injury or death arising out of
or in consequence of this Agreement. Such insurance shall be in an amount not less than One Million
Dollars ($1,000,000.00) for any injury to or death of any person or persons in any single accident or
occurrence. Said policy of comprehensive liability insurance shall be endorsed to provide to CITY at
least thirty (30) days written notice prior to cancellation; name CITY, its officers, agents, employees, and
volunteers, additional insured; and state that such coverage is primary to any other coverage or self-
insurance and CITY. Governmental entities may provide proof of self-insurance,
(a) Such insurance shall: (1) name the City of Santa Ana, its officers, agents,
representatives, employees and volunteers as additional insured's; (2) be primary with respect to
insurance or self-insurance programs maintained by the CITY; (3) contain standard separation of
insured's provisions; and (4) give to CITY prompt and timely notice of claim made or suit instituted
arising out of SUBRECIPIENT's operations hereunder.
(b) SUBRECIPIENT shall: (1) prior to exercising any right under this
Agreement, fiunish properly executed certificates of insurance and additional insured endorsement to the
I
CIPY which shall clearly evidence all coverages required above; (2) provide that such insurance shall not
be materially changed or terminated except on 30 days prior written notice to the CITY; (3) maintain such
insurance for the period covered by this Agreement; and (4) replace such certificates for policies expiring
prior to the expiration of this Agreement
2. Automobile Liability Coverage SUBRECIPIENT shall also obtain and maintain, during
the effective period of this Agreement, broad form automobile liability coverage with a $1,000,000 limit
unless reduced by CITY, which applies to both owned/leased and non -owned automobiles used by
SUBRECIPIENT employees or participants in performance of this Agreement, or, in the event that
SUBRECIPIENT will not utilize such owned/leased automobiles but intends to require employees,
participants or other agents to utilize their own automobiles in the performance of this Agreement,
SUBRECIPIENT shall secure and maintain on file from all such employees, participants, or agents as
self -certification of automobile insurance coverage. Governmental entities may provide proof of self.
insurance.
3. Workers' Compensation. If SUBRECIPIENT is an "employer", as set forth in California
Labor Code Section 3300 et seq., or utilizes participants as "employees," as set forth in California Labor
Code Section 3350 at seq., SUBRECIPIENT shall obtain and keep in force during the term of this
Agreement full Workers' Compensation insurance coverage for injuries suffered by participants. Said
insurance policy shall guarantee CITY at least thirty (30) days written notice of cancellation or
modification.
4. Equipment Coverage. SUBRECIPIENT shall purchase a policy or policies of insurance
covering loss or damage to any and all Equipment provided to or purchased by SUBRECIPIENT in
accordance with this Agreement. Said insurance shall be in the amount of the fill replacement value
thereof, providing protection against the classification of fire, extended coverage, vandalism, malicious
mischief, then, and special extended perils. Governmental entities may substitute a certificate of self-
insurance.
5. Proof of Insurance. Certificates and endorsements must be submitted and approved by
CITY prior to any work under this Agreement. SUBRECIPIENT understands that CITY will make no
payments under this Agreement until the required certificates and endorsements have been approved by
CITY.
Ga"�7 /�•fi7�C�T
A. Upon the expiration of this Agreement, SUBRECIPIENT shall transfer to CITY any CDBG
funds on hand at the time of the expiration of this Agreement as wall as any accounts receivable attributable
to the use of CDBG funds, (24 CFR 570.5036)(7)]
B. Any real property under SUBRECIPIENT's control that was acquired or improved in whole or in
part with CDBG funds in excess of $25,000.00 must either be;
1. Used, where CITY has given written approval, to meet one of the national
objectives stated in 24 CFR 570.208 until five (5) years after expiration of this Agreement, or for such longer
period of time as determined to be appropriate by CITY; or
2. If not used in accordance with subparagraph 1 above, SUBRECIPIENT shall pay to
CITY an amount equal to the current fair market value of the property less any portion of the value
attributable to the expenditure of non-CDBG funds for acquisition of, or improvement to, the property. Such
payment is program income to CITY.
12
C. Subject to the obligations set forth herein, title to equipment acquired under the terms of this
Agreement will vest upon acquisition in SUBRECIPIENT. When said equipment which has been acquired
in accordance with this Agreement and all applicable regulations is no longer needed for said program,
disposition of said equipment will be made as follows:
1. Items of.equipment with a current per unit fair market value of less than $S,OOO o
may be retained, sold or. otherwise disposed of with no further obligation to CITY,
2. Items of equipment with a current fair market per unit value of $5,000.60 or more
may be retained or sold and CITY shall have the right to an amount calculated by multiplying the current
market value or proceeds from the sale -by CITY's share of federal funds used to acquire the equipment, in
accordance with 2 CFR 200313(e)(2).
D. SUBRECIPIENT hereby agrees, upon the demand of CITY, to execute, acknowledge and
deliver, or cause any person or entity who may have any claim to rights hereunder or under any document,
instrument or agreement executed in furtherance of the services and activities to be performed hereunder, to
execute, acknowledge and deliver, to CITY amignment(s), quit claim deed(s) or such other and further
instruments, documents and agreements as may be necessary, in the sole and absolute discretion of CITY, to
vest in CITY all of SUBRECIPIENT's right, title and interest (if any it may have) in and to CITY, CD13G or
other federal, state and/or local accounts or program funds or allocation of funds to which CITY is or may be
entitled, either for its own account or as fiduciary or trustee for others„ which were obtained for the purpose of
the performance of this Agreement or any previous agreements relating to the same subject matter or
activities as this Agreement, together with any instruments, loans, grants or advances by SUBRECIPIENT on
behalf of CITY, in furtherance ofthe activities hereunder or thereof.
SUBRECIPIENT's obligations and responsibilities set forth in this paragraph "XI: REVERSION OF
ASSETS." and in paragraph "XII. TERMINATION" and other requirements pertaining to program income
shall not be affected by the termination of this Agreement and shall survive the date of termination of this
Agreement for such period of time as CITY and/or HUD deems necessary for the responsibilities, duties and
obligations to be performed and completed to the satisfaction of CITY and HUD.
XH. TERMINATION
A. This Agreement may be terminated on thirty (30) days' written notice by either party. In the
event of such termination, SUBRECIPIENT shall only be entitled to reimbursement for approved expenses
incurred to the effective date of termination.
B. This Agreement may be suspended or terminated by CITY upon five (5) days' written notice for
violation by SUBRECIPIENT of Federal Laws goveming the use of Community Development Block Giant
Funds. In the event of such suspension or termination, SUBRECIPIENT shall only be entitled to
reimbursement for approved expenses incurred up to the effective date of suspension or termination.
C. Pursuant to 2 CFR 200.340, in the event SUBRECIPIENT defaults by failing to fulfill all or any
of its obligations hereunder, CITY may declare a default and termination of this Agreement by written notice
to SUBRECIPIENT, which default and termination shall be effective on a date stated in the notice which is to
be not less than ten (10) days after certified mailing or personal service of such notice, unless such default is
cured before the effective date of termination stated in such notice. If terminated for cause, CITY shall be
relieved of further liability or responsibility under this Agreement, or as a result of the termination thereof,
including the payment of money, except for payment for approved expenses incurred for services
satisfactorily and timely performed prior to the mailing or service of the notice of termination, and except for
13
reimbursement of (1) any payments made for services not subsequently performed in a timely and
satisfactory manner, and (2) costs incurred by CITY in obtaining substitute performance.
D. The grant of funds under this Agreement may be terminated for convenience by either the CITY
or SUBRECIPIENT, in whole or in part, by setting forth the reasons for such temaination, the effective date,
and, in the case of portion termination, their portion to be terminated. However, if in the case of a partial
termination, the CITY determines that the remaining portion of the award will not accomplish the purpose for
with the award was made, the CITY may terminate the award in its entirety,
E. The grant of funds under this Agreement may be termminated due to the non-performance of
SUBRECIPMNT and/or failure of SUBRECIPENT to perform the work described in Exhibits A and B or
failure to meet the performance standards and program goals set forth therein,
F. The grant of funds under this Agreement may be terminated due to the failure of the CITY to
receive sufficient or anticipated funding from HUD for the CDBG program for any year term subject to this
Agreement.
G. In the event this Agreement is terminated as set forth in subparagraphs XII.A, through XII.F.,
inclusive, SUBRECIPIENT agrees to immediately return to CITY upon CITY's demand and prior to any
adjudication of SUBRECIPIENT's rights, any and all funds not used, and to comply with paragraph "XI,
REVERSION OF ASSETS" of this Agreement.
1 ..Iu, _ a__IL1► f. Alo
The United States of America, through HUD, may in the future place programmatic or fiscal
limitations on the use of CDBG funds which limitations are not presently anticipated. Accordingly, CITY
reserves the right to revise this Agreement in order to take account of actions affecting HUD program
funding. In the event of funding reduction, CITY may, in its sole and absolute discretion, reduce the budget
of this Agreement as a whole or as to costs category, may limit the rate of SUBRECIPIENT's authority to
commit and spend funds, or may restrict SUBRECIPIENT's use of both its uncommitted and its unspent
fiords. Where HUD has directed or requested CITY to implement a reduction in fimding, in whole or as to a
cost category, with respect to funding for this Agreement, CITY's City Manager or delegate is authorized to
act for CITY in implementing and effecting such a reduction and in revising, modifying, or amending the
Agreement for such purposes. If such a reduction in funding occurs, SUBRECIPIENT shall be permitted to
de -scope accordingly, Where CITY has reasonable grounds to question SUBRECIPIENT's fiscal
accountability, financial soundness, or compliance with this Agreement, CITY may suspend the operation of
this Agreement for up to sixty (60) days upon five (5) days written notice to SUBRECIPIENT of its intention
to so act, pending an audit or other resolution of such questions. In no event, however, shall any revisions
made by CITY affect expenditures and legally binding commitments made by SUBRECIPIENT before it
received notice of such revision, provided that such amounts have been committed in good faith and are
otherwise allowable and that such commitments are consistent with HUD cash withdrawal guidelines.
51,0111MINTRIM Ma
This Agreement supersedes any and all other agreements, either oral or in writing, between the
parties hereto with respect to the use of CITY's CDBG fiords by SUBREC1pMNT and contains all the
covenants and agreements between the parties with respect to such employment in any manner whatsoever.
Each party to this Agreement acknowledges that no representations, inducements, promises or agreements,
orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which are not
embodied herein, and that no other agreement or amendment hereto shall be effective unless executed in
writing and signed by both CITY and SUBRECIPIENT.
14
PAW
This Agreement shall be governed by and construed in accordance with the laws of the State of
California, and all applicable federal laws and regulations,
XVI. CAS TIT
The SUBRECIPIENT agrees to comply with the closeout procedures detailed in 2 CFR §200.343,
including the following:
1. SUBRECIPIENT must submit, no later than ninety (90) calendar days after the end
date of the period of performance, all financial, performance, and other reports as required by the
terms and conditions of the Federal award;
2. Unless the CITY authorizes an extension, SUBRECIPIENT must liquidate all
obligations incurred under the Federal award not later than ninety (90) calendar days after the
end date of the period of performance as specified in the terms and conditions of the Federal
award;
3. SUBRECIPIENT must promptly refund any balances of unobligated cash that the
CITY paid in advance or paid and that is not authorized to be retained by SUBRECIPIENT for
use in other projects (See OMB Circular A-129 and 2 CFR §200.345);
4. SUBRECIPIENT must account for any real and personal property acquired with
Federal funds or received from the Federal government in accordance with 2 CFR §§200.310-
200.316 and 200.329; and,
5; The CITY should complete all closeout actions for the Federal award no later than one
year after receipt and acceptance of all required final reports.
XM. VA14M YANDST,VERASiL1TY
The invalidity in whole or in part of any provision of this Agreement shall not void or affect the
validity of any other provision of this Agreement. Whenever possible, each provision of this
AGREEMENT shall be interpreted in such manner as to be effective and valid under applicable
law, but if any provision of this AGREEMENT is held to be prohibited by or invalid under
applicable law, such provision shall be ineffective only to the extent of such prohibition or
invalidity, without invalidating the remainder of such provisions of this AGREEMENT.
XVM. WAIVE R
No delay or omission by either party hereto to exercise any right or power accruing upon any
noncompliance or default by the other party with respect to any of the terms of this Agreement shall
impair any such right or power or be construed to be a waiver thereof. A waiver by either of the parties
hereto of any of the covenants, conditions, or agreements to be performed by the other shall not be
construed to be a waiver of any succeeding breach thereof or of any other covenant, condition or
agreement herein contained.
15
a. Each undersigned represents and warrants that its signature herein below has the power, authority
and right to bind their respective parties to each of the terms of this Agreement, and shall inderra fy ClrY
fully, including reasonable costs and attorney's fees, for any injuries or damages to CITY in the event that
such authority or power is not, in fact, held by the signatory or is withdrawn.
b. All Exhibits and Attachments referenced herein and attached hereto shall be incorporated as if
fully set forth in the body of this Agreement.
(Signatures on follovingpage)
IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the last date and year
written below.
IDSA
Councilk of the
APPROVED AS TO FORM:
SONIA R. CARVALHO
City Attorney
- 12�L
By: RYO. ODGE
Assistant City Attorney
RECONINIENDED FOR APPROVAL:
STEVENMENDOZA
Executive Director
17
CITY OF SANTA ANA
E
City Manager
SUBRECIPIENT:
— A9 -
Sharon Pitis
CEO/ President
Tax ID: 33-0311059
DUNS #: 363569096
City of Santa Ana CDBG Scope of Work
Program Year 2021.2022 (July 1, 2021 - June 30, 2022)
Name of Organization Habitat for Humanity of Orange Count
Name of Funded Program City of Santa Ana Residential Rehabilitation Progam
Annual Accomplishment Goal
dated to be served during the 12-month contract period. _
Santa Ana Participants 1110% 251 Low Income Particloants� 1pp%
Schedule of Performance
Unduplicated Estimated
(estimated)
July
August
September
October
November
December
January
February
March
April
May
June
25
Program and Funding Description
$ 545,532.00
Through CDBG funding, the City of Santa Ana is partnering with Habltatfor Humanity of Orange County to offer
low Income homeowners in Santa Ana grants up to $25,000 for critical home repair.
The grant is intended to improve families long term living conditions by focusing on code related issues, as well as
health, safety, and accesibility items.
EXHIBIT A
Santa Ana Residential Rehabilitation Project
FISCAL YEAR 2021-2022
PROGRAM BUDGET
Organization Name Habitat for Humanity of Orange County
Program Name City of Santa Ana Residential Rehabilitation Progam
EXPENDITURES
Enter budget categories and Drofected expenditures for the nrnnnsaA nrnnram-
Category
Expenditures
Funded By
Santa Ana
CDBG
Expenditures
Funded By
Other Sources
Program
Budget
Total
Organization
Budget
Administrative staff Salaries
$14,238
$ 48,708
$62,946
$ 162,360
Program Staff Salaries
$61,700
$ 280,883
$342,583
7T .335,641
Contractual/Professional Services
$0
Construction Materials
$210,000
$ 460,803
$670,803
$ 451,523
Tub Contractors (Includes sub supplied materials)
$210,000
$ 611,518
$821,518
$. 801,861
Management/Fund Development
$0
$0
$ " 762,929
Restore
$0
$0
$ 2,131,655
Misc. Rental Expenses
$0
$0
$ 4,911
New Construction
$0
$0
$ 3,172;008
Special Events
$0
$0
$ 123,755
TOTAL Direct Costs
$495,938
$1,401,912
$1,897,850
$7;946,543
Indirect Costs 10%
$49,594
$140,191.17
$189,785
TOTAL BUDGET
$545,532
$1,542,103
$2,087,6351
$7,946,643
* Indirect cost rate: 10% Non -Federal entity without federaly recognized negotiated indirect
cost rate, will charge a de minimis rate of 10%of modified total direct
costs.
PROGRAM RESOURCES
LIST ALL OTHER PROGRAM RESOURCES FOR 2021-2022
Funding Source Total must equal Program Budget Total listed above.
FUNDING SOURCE
AMOUNT
Santa Ana CDBG
$480,000
Veteran Home_RepairProgram
$45,000
Newport Beach 6.H.A.R.P
$364,902
Anaheim RRP
$808,374
RSM Minor Home Repair Program
$12,781
Laguna Beach Senior Home Repal
$95,046
Garden Grove Minor Home Repair
1$216,000
TOTAL 1
$ 2,022,103
EXHIBIT 6
2021-2022 CDBG BUDGET LINE ITEMS
ADMINISTRATIVE STAFF
Position Title
Annual Salary
&Benefits
CDBG Funds
Requested
Description
Accountant
$ 63,960
$ 8,320
13%
Controller
$ 98,400
1 $ 5,91816%
PROGRAM STAFF
Position Title
Annual Salary
& Benefits
CDBG Funds
Requested
Description
Home Repair Manager
$ 96,571
$ .21,700
22%
Home Repair Technician
$ 36;400
$ , 10,000
27%
Home Repair Technician
$ 36,400
$ 10,000
27%
Home Repair Site Supervisor
$ 47,542
$ 11,000
23%
Home Repair Program Spec.
$ 63,970
$ 9,000,14%
CONTRACTUAL/PROFESSIONAL SERVICES
Type of Service
Contract
Amount
CDBG Funds
Requested
Description
OTHER LINE ITEMS
Line Item
Program
Amount
CDBG Funds
Requested
Description
Sub Contm4tors(including sub supplied materials)
$ 611,518
$ 210,000
Work contracted out to sub contractors
Construction materials
$ 460,803
$ 210,000
Materials used in home repairs
EXHIBIT B-1
Certification Revardine
Debarment. Suspension, Ineligibility and VoluntaryExclusion
Lou er Tier C'o%cred Transactions
This certification is required by the regulations implementing Executive Order 12549, Debarment and
Suspension, 29 CFR Pail 98, Section 95.510. Participants' responsibilities. The regulations were published
as Part VII of the May'_6. 191g Federal Reeister ( pages 19160-19211).
(BEFORE COMPLETING CERTIFICATION, READ INSTRUCTIONS POR CERTIFICATION
Attached)
(1) The prospective recipient of rederal assistance funds certifies, by submission of this proposal, that
neither it nor its principals are presently debarred, suspended. proposed for debarment, declared
ineligible, or voluntarity excluded from participation in this transaction by any federal department or
agency.
(2) Where the Prospective recipient of federal assistance funds is unable to certify to arty of the
statements in this certification, such prospective participant shall attach an explanation to this
proposal.
nflcie.tQQ
tCs1
Name and Title of Authorized Representative
Date
EXHIBIT C
Page 1 of 2
INSTRUCTIONS FOR CERTIFICATION
1. By signing and submitting this proposal, the prospective recipient of federal assistance funds is
providing the certification as set out below.
2. The certification in this clause is a material representation of fact upon which reliance was placed
when this transaction was entered into. If it is later determined that the prospective recipient of
federal assistance funds knowingly rendered an erroneous certification, in addition to other remedies
available to the Federal Government, the Department of Labor (DOL) may pursue available
remedies, including suspension and/or debarment.
3. The prospective recipient of federal assistance funds shall provide immediate written notice to the
person to which this proposal is submitted if at any time the prospective recipient of federal
assistance funds learns that its certification was erroneous when submitted or has become erroneous
byreason of changed circumstances.
4. The terms 'covered transaction," "debarred," "suspended," "ineligible," "lower tier covered
transaction," "participant," "person," "primary covered transaction," "principal," "proposal," and
"voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and
Coverage sections of rules implementing Executive Order 12549, You may contact the porson to
which this proposal is submitted for assistance in obtaining a copy of those regulations,
5. The prospective recipient of federal assistance funds agrees by submitting this proposal that, should
the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier
covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily
excluded from participation in this covered transaction, unless authorized by the DOL.
6. The prospective recipient of federal assistance funds further agrees by submitting this proposal that
it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and
voluntary exclusion - Lower Tier Covered Transactions," without modification, in all lower tier
covered transactions and in all solicitations for lower tier covered transactions.
A participant in a covered transaction may rely upon a certification of a prospective participant in a
lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded
from the covered transaction, unless it knows that the certification is erroneous. A participant may
decide the method and frequency by which it deterrines the eligibility of its principals. Each
participant may, but is not required to check the List of Parties Excluded from Procurement or Non -
Procurement Programs
8. Nothing contained in the foregoing shall be construed to require establishment of a system of
records in order to render in good faith the certification required by this clause. The knowledge and
information of a participant is not required to exceed that which is normally possessed by a prudent
person in the ordinary course of business dealings.
9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a
covered transaction knowingly enters into a lower tier covered transaction with a person who is
suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in
addition to other remedies available to the Federal Government, the DOL may pursue available
remedies, including suspension and/or debarment.
EXHIBIT C
Page 2 of 2
C'eni6cttion Regsrdin¢ Lobbying
Certification for Contracts. Grants, Loans. and CouueratkeAuic•m°nt'
The Undersigned certifies, to the best of his or her knowledge and belief, that
(1) No Federal appropriated Funds hate been paid or will be paid, by or on behalf of the
undersigned, to any person for influencing or attempting to influence an officer or
employee orany agency. a Member of Congress, an officer or employee of Coiigres;, or
an employee or a Member of Congress in connection with the im arding, of any Federal
contract, tin making of any cooperatice agreement. and the extension, continuation,
renencal, amendment. or modification of ally Federal contact, grant, loan or cooperative
aucentent.
(2) Iranfunds otherthan Federal appropriated Fund; have been paid or will be paid to
anc person for influencing or ❑rtennpting to influence an officer or employee of any
sn_encv. a Member of Congress. all officer or employee of Congress, or an employee of a
Member of Congress in connection with this Federal contract, tram, loan, nr cooperatice
agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclasure
Fm'm to Report Lobbying." in accordance a ith its instructions.
(,) fhe Undersigned shall require thm the langua_ec of this certification be uncluded in the
aM:lyd documents for all suhawards at all tier, (including .subcontract. suburants, and
contract, uniler grant:, loans. and cooperative agreements) and that all subrecipients shall
cartifv and discloie accordingly.
This certification is a material representation of fact upon which reliance gas placed
%hell this transaction %Uas made or entered into. Submission ofthis certification is a
prerequisite for making or entering into this transaction imposed by Section l3i2, "Rifle
31, U. S. Code. .Am person who fails to file the required certification Mull be Subject to
I cis it penalty of not less than S 10.000 and not more than SI00,000 for each SUCK failure.
{ lc �Ltitt�S' 041t� l(�ct1f 1
Grantee Contactor Org:mitation
Program lie
Name of Cc•rtift•ins Officer Signature Date
FAIIIBIf D
Pact I of
SUBRECIPIENT warrants the following:
1. SUBRECIPIENT will comply with Public Law 88-352, Title VI of the Civil Rights
Act of 1964 (42 U. S. C. section 2000 et seq.) and implementing regulation in 24 CFR
Part 1.
2. No person in the United States shall on the ground ofrace, color, religion, national
origin, or sex, be excluded. from participation in, or be denied the benefits of, or be
subj cored to discrimination under any program or activity funded in whole or in part with
community development fiends made available pursuant to the ACT.
3. All laborers and mechanics, employed by contractors or subcontractors in the
performance of construction work financed in whole or in part with community
development funds shall be paid wages at rates not less than those prevailing on similar
construction in the locality as determined in accordance with the Davis -Bacon Act, as
amended, 40 U. S. C. Sections 276 a 1-5, except for individuals who perform services for
which they volunteered; do not receive compensation for such services; or are paid
expenses, reasonable benefits, or a nominal fee for such services; and are not otherwise
employed at any time in construction work,
4. SUBRECIPIENT will comply with all Federal statutes applicable to projects funded
with community development funds, except that (a) SUBRECIPIENT does not assume
CITY'S environmental responsibilities described at 24 CFR 570.604; and (b)
SUBRECIPIENT does not assume CITY'$ responsibility for initiating the review process
under Executive Order 12372.
EXHIBIT D
Page 2 of 2
Certification Regarding Drua-Free Workplace Requirements
The certification set out below is a material representation upon which reliance is placed
by the U.S. Department of Housing and Urban Development in awarding the grant. If it
is later determined that the contractor knowingly rendered a false certification, or
otherwise violates the requirements of the Drug -Free Workplace Act, the U.S.
Department of Housing and Urban Development, in addition to any other remedies
available to the Federal Government, may take action authorized under the Drug Free
Workplace Act.
CERTIFICATION
A. The contractor certifies that it will provide a drug -free workplace by:
(a) Publishing a statement notifying employees that the unlawful manufacture,
distribution, dispensing, possession or use of a controlled substance is
prohibited in the contractor's workplace and specifying the actions that will
be taken against employees for violation of such prohibition;
(b) Establishing a drug -free awareness program to inform employees about-
(1) The dangers of drug abuse in the workplace;
(2) The contractor's policy of maintaining a drug -free workplace;
(3) Any available drug counseling, rehabilitation, and employee
assistance program; and
(4) The penalties that may be imposed upon employees for drug abuse
violations occurring in the workplace;
(c) Making It a requirement that each employee who will be engaged in the
performance of the grant be given a copy of the statement required by
paragraph (a);
(d) Notifying the employee In the statement required by paragraph -(a) that,
as a condition of employment under the contract, the employee will -
(1) Abide by the terms of the statement; and
(2) Notify the employer of any criminal drug statute conviction for a
violation occurring in the workplace no later than five days after
such conviction.
(a) Notifying the U.S. Department of Housing and Urban Development within
ten days after receiving notice under subparagraph (d)(2) from an
employee or otherwise receiving actual notice of such conviction;
EXHIBIT E
Page 1 of 3
(f) Taking one of the following actions, within 30 days of receiving notice
under subparagraph (d)(2), with respect to any employee who is so
convicted -
( 1) Taking appropriate personnel action against such an employee, up
to and including termination; or
(2) Requiring such employee to participate satisfactorily in a drug
abuse assistance or rehabilitation program approved for such
purposes by a Federal, State, or local health, law enforcement, or
other appropriate agency;
(g) Making a good faith effort to continue to maintain a drug -free workplace
through implementation of paragraphs (a), (b), (c), (d), (e) and (f).
B. The contractor shall insert in the space provided on the attached "Place of
Performance" form the site(s) for the performance of work to be carried out with
the grant funds (including street address, city, county, state, and zip code) .the
contractor further certifies that, if it is subsequently determined that additional
sites will be used for the performance of work under the contract, it shall notify
the U.S. Department of Housing and Urban Development immediately upon the
decision to use such additional sites by submitting a revised "Place of
Pfrf-O'rmance" form.
4a 1 1tu _ cfoco=Ocv(
Organ ation
eofJ )Id
uthorjzed Si1�nature Date
LL
EXHIBIT E
Page 2of 3
PLACE OF PERFORMANCE
FOR CERTIFICATION REGARDING DRUG -FREE
WORKPLACE REQUIREMENTS
Name: l ' la. e (jxI_�
Date: 9
The Contractor shall insert in the space provided below the site(s) expected to be used
for the performance of work under the contract covered by the certification:
Place of Performance (include street address, city, county, state, zip code for each site):
EXHIBIT E
Page 3of 3
CERTIFICATE OF LIABILITY INSURANCE
DATEIMMIDDIYYYY)
O6/30/2021
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.
THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR. NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
POLICIES
BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER,
IMPORTANT; If the certificate holder is an ADDITIONAL INSURED, 'no policy(IOS) must be. endorsed. If SUBROGATION IS WAIVED, subject to
the terms and condlffons of the policy, certain policies may require an endorsement, A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER
NAME: Loakton Affinity, LLC
Lockton Affinity, LLC
0 6 •988-553-9002 FANo; 913-652-3967
P. 0. Box 873401
on lLss:
Ransae City, NO 64107-3401
INSURERS AFFORDINO COVERA9 E
NA10#
INSURERA:aae AmexlCen laaaxenga Cn.
22667
INSURED
HaBdkat f*v fturraad.tLy of Orange County,
INSVRERD:Ars nzo ort and Casualty
an60S
INSURERO:
23 C,
2200 S. Ritchey Street
INE D:
Santa Ana, CA 92705
INSURERS:
INSURER
- .."I.aV,V INVIVICUMKI
Tt115 IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BE HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE
POLICY PERIOp
INDICATED. NOTWITHSTANDINO ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBIECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
--
CTR
TYPEOFINSURANOE
D
......___
POLICYNUMBER
CNYY
M1VP E
-_.-_.._-_
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
y
OL1064465-21
04/01/2021
04/GZ/2022
EACHOCCURRENCE
_
51,OOO,AOa
CLAIM&MADE 2 OCOVR
DAMAOETO-RVINW—TVL7
'-'-
'R,�,S�„1E; gxurrencol
rl, ODO�ODD
X
airad and Non -Owned
MEb EXP(Any gnapareo
SO
---.-
Auto Liability
PERSONAL& ADV INJURY
11, 000 ODD
AGGREGATE pp LIMIT APPLIES PER:
POLICY 0
OEN14
X
GENERAL AOtlREOATE
$2,000,000
PRODUCTS. COMP,VPAGG
62 000 o00
jzi 400
OTHER:
8
AUTOMOBILE
DABINTY
FAD e6 d DO I IT
/BODILY
S
ANYAUTO
INXRY(Par F.aurc
6
ALLOMED SCHEDULED
SOCILYINJURY(PerowIdeM)
S
AUT05 AUTOA E
HIREDALTOS AUTO$
PeCeERent PM
S
S
B
X
UMBRELLA %
OCCUR
UN1069465-21
04/01/2021
04/01/2022
EACH OCCURRENCE
1,000,000
E%OBS.'i LWB
CLAIMB•MAOE
EC
AOGRATE
$1, 000, Oo0
-
DED X EN000
S
WORKERS COMPENSATIONON
AND EMPLOYERS LIABILITY YIN
_ ST i ER_
ANY PROPr11ETORIPARTNER/FXECUTIVE
OFFICERIMEMBCREXCI.UDEOR
N!A
_
E.4_EACHACCIDENT
_.-_-
(mandatory In NH)
E.L. DISEASE• EA EMPLOYE
S
E.L; DISEASE•POUCY LIMIT
S
DESCRIPTION OF OPHihTIONs below
DESCRIPTION OF OPERATIONS! LOCATIONS! VEHICLES (ACORD 101. Addltbnal Remark¢ echodule, may be altaghod It more space is requlmd)
City of Santa Ma, officers, agents, employees, and volunteers ara named no additionally
insured on this policy pursuant to written oontraet, agreement, or memorandum of
understanding. Such insuranom no is afforded by this policy shall be primary, and any
insurance carried by City shall ba sensors, and nonooa
initiated by the company - for Non Payment; 10 nays; four Other r Reasoner 30 ncellation
ayno Natiae ®£
Non-IDenewal initiated by the c an : 10 Days. Pailure. to
Y Y provide notice will not
invaIidxtn the oano911ation or non-eanewal.
1064465 -_--
City of Santa Ma SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Rie?6 LrManayat®nt Division ACCORDANCE WITH THE POLICY PROVISIONS.
20 Civio Center Plaza
Santa Ma, CA 92702 AUTHOR. PRESENTATN E
aREVIEW D & APPA
01958 2014 ACORD CORPO - e
ACORD 23 (2014101) The ACORD name and logo are registered marks of ACORD )9
38154276 1064465 T 02 20bd
M, LAMBERT
A� f> CERTIFICATE OF LIABILITY INSURANCE DATE(MMlao/YYyy
8130/2021
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED EY THE POLICIES
BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE .ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the car floats holder is an ADDITIONAL INSURED, the r I: M!, (ies) must have ADDITIONAL INSURED prbvlsions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of a ich endorsoment(s).
PRODUCER
Arthur J. Gallagher & Co,
Insurance Brokers of CA, Inc. LIC #0726293
Market Street, Suits 2100
O TpDT
P a
e P
m,JiMI1 C Nn L,,,,_„„,.
MAIL........._�_._..._-....._......_ ,-_..._
San
San Francisco CA 94106
,aG_ ..............._.•....'.—....'....—......—...•—..
„__,,,,,,,-1NSU, RER1g1 AFFDRbING CDVERAGE .,,,,
NNCR
INsuRER A: NonProOts' United Ins Vehicle Pool
INSURED
Habitat for Humanity of Orange County (2100)
2200 Ritchey Street
Santa Ana, CA 92705
----
INSURER pJ......__..-..._..........._ ... ..-
INSURER C:
NBURERD:
IN6UREREI
NSURER F:
INMVIDIUIv IMU1V1=11;
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INBR
TYPE OF INSURANCE
JilautPOUCYNUMBER
POMtlY EFF
MMI W
POLO EXP
M
LIMITS
COMMERCIALGENERAL LIABILITY
CLAIMSMADE OCCUR
EACH OCCURRENCE
P SETD oea,nence
S
S
MEDEXPIM one area,
PERSONAL& NOV INJURY
5
GENL
AGGREGATE LIMIT APPLIES PER:
POLICY ❑ J C0. ❑ LOC
bENERALAGGRELWTE
5
PRODUCTS - COMPIOP AGO
S
OTHER:
5
A
AUTOMOMIJILIABILITY
X
OWNED
OWNEDNY 'O SCHEDULED
AUTOS ONLY AUTOS
HIRED RON•OWNEO
AUTOSONLY AUTOS ONLY
Y
NPU1000-2i
7/1/2021
711=22
C McelAenIEINGL IT
BODILY INJURY IPdr Person)
S2�OU4,Dll0
s
BODILYINJURY(Par attldned)
- -
_.,._..��
S
PROPERTY AMAGEnewo ""
e-._.w...._
...--_...
S
UMBRELLALIAR
EXCESS LIAR
OCCUR
CtAIM3•MAOE
"EACH OCCURRENCE
--•
$
AGGREGATE
OEU I RETENTION$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANYPRbPRIE70RMARTNEtYEXECIfriVE
ORMOERIMEMBEREXCLUDCDI
Imandolory in NH)
U es, dasMbe under
b Una.
OF OPERATIONS below
NIA
_ -
STATIff ,f,,,,,,•.. ERH"
•••
$
E.L. EACH ACCIDENT
$
e.L. DISEASE -EA BMPLOYE
i
EA, DISEASE -POLICY LIMIT
S
DESCRIPTION OF OPERATIONS ILOCATIONS I VEHICLES (ACORD 101, Addlaonal Remark. Ballodula, may 6o aUaehod II more spoon In mqulrod)
Any Auto means any covered auto under the NPU Vehicle Insurance Program,
City of Santa Ana, officers, agents, employees, and volunteers are named as additionally Insured on this policy pursuant to written contract, agreement, or
memorandum of understanding. Such insurance as Is afforded by this policy shall be primary, and any Insurance carded by City shall be excess and
noncontributory
The Producer will endeavor to mall 30 days written notice to the Ceruffeate Holder named on the certificate If any policy listed on the certificate is cancelled prior
to the exishalion date, Failure to do so shall Impose no obligation or liability of any kind upon the Producer or otherwise alter the policy terms.
h G•CTICIh ATG ,lei, r11_Yi T^^ _ _. _. _
SHOULD ANY OF THE A80VE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City Of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS.
R 11 'emagarnentDivision
20 CIVIC Center Plaza AU HORIZEDREPRESENTATIVE
Santa Ana CA 92702 yry
dYty7 I-ko)
V rVT DIVI.
M 1588.2019 ACORD CORPO AtTIO.�All rights reserved,
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD yo q
J� b U
M
COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY,
NonProfits' United Vehicle Insurance Pool
Automobile Liability Coverage
ADDITIONAL COVERED PARTY ENDORSEMENT
This endorsement modifies Insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless
modified by the endorsement,
The "Who is an Insured" section of your Automobile Liability Insurance Is changed by adding the
following;
Who is covered includes any person or organization from whom you have leased an auto, from
which you have received funding for your operations, or for who you provide services. These
persons or organization are protected, if they require to be named, and you agree to name them,
as an additional Insured, if Indicated on the attached Certificate of Coverage, but only with respect
to liability arising out of the ownership, use, maintenance, loading or unloading of a covered auto,
Cancellation:
Should any of the above described policies be cancelled before the expiration date thereof, the issuing
insurer will endeavor to mail 30 days written notice to the certificate holder named on the certificate, but
failure to do so shall Impose no obligation or liability of any kind upon the insurer, its agents or
representatives,
Premium Payments:
Those persons or organizations are not responsible for paying premiums for your coverage,
Insured:
Policy Number:
Effective Date:
Authorized Representative:
NPU-VIP
As shown on the Certificate of Insurance attached,
NPU1000-21
July 1, 2021 to July 1, 2022 (or otherwise indicated)
202L-2022
& APPROVED
�gEMENT DIVISION
93
11VIT
COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY,
NonProflts' United Vehicle Insurance Pool
Automobile Liability Coverage
PRIMARY & NON-CONTRIBUTORY
This endorsement modifies Insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless
modified by the endorsement.
The "Who is Covered" section of your Automobile Liability Insurance is changed by adding the
following:
Who is Covered section of the Memorandum of Coverage provided under this endorsement is
Primary and insurance maintained by additional covered party is Non -Contributory, Coverage
provided under this endorsement Is limited to the Limits of Liability stated on the Memorandum of
Coverage Declarations.
Cancellation:
Should any of the above described policies be cancelled before the expiration date thereof, the issuing
insurer will endeavor to mall 30 days written notice to the certificate holder named on the certificate, but
failure to do so shall impose no obligation or liability of any kind upon the insurer, its agents or
representatives,
Premium Payments:
Those persons or organizations are not responsible for paying premiums for your coverage,
Insured: As shown on the Certificate of Insurance attached,
Policy Number: NPU1000.21
Effective Date: July 1, 2021 to July 1, 2022 (or otherwise indicated)
pri� ram'—�.:-- /
Authorized Representative:
KEW ED & APPROVED
By RiS tiIANAGEMEN'r IDIVISION
NPU-VIA 2021-2022 of C 2 1
MA A M, LAMBERfi
CERTIFICATE OF WORKERS' COMPENSATION COVERAGE lna7 E
2021
PRODUCER
NonPmfits' United Workers' Compensation Group
610 Fulton Avenue, Sulte2W
Sacmmonto, CA 95825
THIS CERTIFICATE IS ISSUED AS MATTER OF INFORMATION ONLY
AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
Phone: (916) 868.6231 CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
Fax: (916) 880.5251 COVERAGE AFFORDED BY THE POLICIES BELOW.
ArthurJ. Gallagher & Co Insurance Brokers of California, Inc
1255 Battery 4
SauFraociscD,12A
OA 94111
INSURERS AFFORDING COVERAGE
INSURED
-
INSURERA; NonProfits' United Workers' Compensation Group
Habitat for Humanity Of Orange County
Ritchey Street
INSURER B: SafB National Casualty Corp2200
f! INAIIGYf15105]
Santo Ana, CA 92705
INSURER D: Response Indemnity Company of California [NAJC II tO970]
INSURER D: -
-
INSURER E
COVERAGES This Cerilloate is not intended to s Gul all endorsoments, covers es, terms, conditions and excluslona ofYhe olicies shown,
THE POLICIES OF COVERAGE LISTED BELOW HAVE BEEN ISSOEOTOTHE AFFILIATE MEMBER NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWIT18TANDINGANY
REQUIREMENT, TERM, OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE
COVERAGE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TOALL THE TERMS, EXCLUSIONS ANO CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS
SHOWN. MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INBR
LTR
TYPE OF COVeRAGE
POLICY NUMBER
PODCY
EFFECTIVE PATE
POLICY
EXPIRATION
LIMBS
GENERAL LIABILITY
EACHOCCURRENCE
COMMERCIAL GENERAL LN81LrrY
FIRE DAMAGE (Any one lire)
CLAIMS MADE I JOCCUR
MEP EXPENSE (Any one
`-
GENERAL AGGREGATE LIMIT APPLIES PER:
PERSONAL &ACV INJURY
$
POLICY PROJECT LOC
._e......__.....
GENERAL AGGREGATE
$
PRODUCTS-COMPAJPAGG
$
._
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMB
(Each eeetdw)
$�
..
ALLOWNEDAUTOS
BODILY
NJ BODILY INJURY
er NJ
$
SCHEDULEDAUTOS
HIRED AUTOS
BODILY INJURY
(Per axldw)
�
$
NON-OWNEDAUTOS
N
PROPERTY DAMAGE
erealdent
A
WORKERS' COMPENSATION
AND
EMPLOYERS LIABILITY
NPU-WCG001-2021
1/l/2021
I/l/2022
W PER
AA STATUTE
0
T
E,L EACH ACCIDENT
$ 500,000
EL. DISEASE-EA.EMPLOYEE
$ 500,000
ISEASE-COVERAGE
LIMIT
$500,900
DTHRM
C
B
XSWC-Bufer Layer
XSWC
ABLIOOOO13-00
SP4064079
1/1/2021
1/1/2021
1/1/2022
1/1/2022
XS of $500,D0o
xSof$750,000
XS of $750,000
$250,000 (EL & WC)
$2,000,000(EL)
Statutory (WC)
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAUPROVISIONS
Waiver of Subrogation provided by Endomcment No. NPL)WCG-7HHOC-05R
CERTIFICATE HOLDER
CANCELLATION
NPUWCO-I4HOC-OSR
City of Santa Ana
Risk Management Division
SHOULD ANY OF THE ABOVE DESCRIBE[) POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF NOTICE WILL BE DELIVERED
IN ACCORDANCE WITH THE POLICY PROVISIONS.
20 Civic Center Plaza
APPR
Santa Ana, CA 92702
VEt
t3 ANA - T
VISIOf
Based on ACORD 25 (2016/03)
'
tr�� 2021
�2
IwIPsI!!;
PLEASE CAREFULLY
WAIVER TRANSFER
A OF
OF
OTHERSRECOVERY AGAINST TO
US
Nonprofits' United Workers' Compensation Group
Memorandum of Coverage: NPU-WCG 001-2021
This endorsement modifies the coverage provided under the following:
Memorandum of Coverage: PART ONE: WORKERS' COMPENSATION
COVERAGE Paragraph H. RECOVERY FROM OTHERS is amended with respect to the following: Name
and Address of Person or Organization:
City of Santa Ana
Risk Management Division
20 Civic Center Plaza
Santa Ana, CA 92702
DESCRIPTION OF OPERATIONS/LOCATIONS ADDED BY ENDORSEMENT:
-City of Santa Ana, its officers, officials, employees, and agents as regards contract with the named insured.
NPU-WCG waives any right of recovery it may have against the person or organization shown above
because of payments made by NPU-WCG for injury or damage arising out of the Members' operations
done under a contract with that person or organization shown above and Included in the coverage
provided by the Memorandum of Coverage. This waiver applies only to the person or organization
shown on the Schedule Above.
This endorsement is part of the Memorandum of Coverage and Is effective on the date shown below.
All other terms and conditions remain unchanged.
Effective Da D 1 Expiration
D e: Janua 22
e er: Habitat for Humanity of Orange County
Endorsement No: NPUWCG-HHO%05R Dated,pd- Inn7 Inil
U
Authorized Representativ'v�or NP - CG
Page 1
VED & APPROVED
MANACENIENT DiViSION
City of Santa Ana CDBG Scope of Work
Program Year 2021.2022 (July 1, 2021 June 30, 2022)
Name of Organization Habitat for Humanity of Orange County
Name of Funded Program City of Santa Ana Residential Rehabilitation Pro am
Annual Accomplishment Goal
Schedule of Performance
(estimated)
July
August
September
October
November
December
January
February
March
April
May
June
25
rrogmm ano runamg
to be served durin the 12-month contract period.
Ana Participants 1 100%1 1 25 1 Low Income Participants 100°/
Unduplicated Estimated
$ 545,532.00
Through CDBG funding, the City of Santa Ana Is partnering with Habltatfor Humanity of Orange County to offer
low income homeowners in Santa Ana grants up to $25,000 for critical home repair.
The grant is intended to improve families long term living conditions by focusing on code related issues, as well as
health, safety, and accesibility items.
EXHIBIT A
Santa Ana Residential Rehabilitation Project
FISCAL YEAR 2021-2022
PROGRAM BUDGET
Organization Name Habitat for Humanity of Orange County
Program Name City of Santa Ana Residential Rehabilitation Progam
EXPENDITURES
Enter budget cateeories and orolected exnenditurac fnr tho nrnnncnrl nrnnrn, ,
Category
Expenditures
Funded By
Santa Ana
CDBG
Expenditures
Funded By
Other Sources
Program
Budget
Total
Organization
Budget
Administrative Staff Salaries
$14,238
$ 48,708
$62,946
$ 162,360
Program Staff Salaries
$61,700
$ 280,883
$342,583
$ 335,641
Contractual/Professional Services
$0
Construction Materials
$210,000
$ 460,803
$670,803
$ 451,523
Sub Contractors (includes sub supplledmateriais)
$210,000
$ 611,518
$821,518
$. 8011,861
Management/Fund Development
$p
$0
T 762,929
Restore
$0
$0
$ 2,131,6.55
Misc. Rental Expenses
$0
$0
$ 4,911
New Construction
$0
$0
$ 3,172,008
Special Events
$0
$0
$ 123,755
TOTAL Direct Costs
$495,938
$1,401,912
$1,897,850
$7,946,643
Indirect Costs 10%
$49,594
$140,191.17
$189,785
TOTAL BUDGET
$545,532
$1,542,103
$2,087,635
$7,946,643
* Indirect cost rate: 10% Non -Federal entity without federaly recognized negotiated indirect
cost rate, will charge a de minimis rate of 10% of modified total direct
costs.
PROGRAM RESOURCES
LISTALL OTHER PROGRAM RESOURCES FOR 2021-2022
Funding Source Total must equal Program Budget Total listed ahnve.
FUNDING SOURCE
AMOUNT
Santa Ana CDBG
$480,000
Veteran Home Repair Program
$45,000
Newport Beach S.H.A.R.P
$364,902
Anaheim RRP
$808,374
RSM Minor Home Repair Program
$12,781
l aguna Beach Senior Home Repaig
$95,046
Garden Grove Minor Home Repair
$216,000
TOTAL
$ 2,022,103
EXHIBIT B
2021-2022 CDBG BUDGET LINE ITEMS
ADMINISTRATIVE STAFF
Position Title
Annual salary
& Benefits
CDBG Funds
Requested
Description
Accountant
$ 63;960
$ 8,320
13%
Controller
$ 98,400
$ 5,918
6%
PROGRAM STAFF
Position Title
Annual Salary
& Benefits
CDBG Funds
Requested
Description
Home Repair Manager
$ 96,571
$ 21,700
22ya
Home Repair Technician
$ 36,400
$ . 10,000
27%
Hoe Repair Technician
$ 36,400
$ 10,000
27%
Home Repair Site Supervisor
$ .47,542
$ 11,000
23y
Home Repair Program Spec.
$ 63,970
$ 9,000
140Yo
CONTRACTUAL/PROFESSIONAL SERVICES
Type of Service
Contract
Amount
CDBG Funds
Requested
Description
OTHER LINE ITEMS
Line Item
Program
Amount
CDBG Funds
Requested
Description
Sub Contractars(Including sub supplied materlals)
$ 611,518
$ 210,000
Work contracted out to sub contractors
Construction materials
$ 460,803
$ .210,000
Materials used in home repairs
EXHIBIT B-1
Certification Reuardine
Dehanmeut. Suspension, Ineligihili y and Voluntan Exclusion
Loit er Tier Coi Bred Transactions
This certification is required by the regulations implementing ExeCLltlle Order 12549, Debarment and
Suspension, 29 CFR Part 98, Section 98.510. Participants' responsibilities . The regulations were published
as Part V II of the May 26, 19S8Fedcral Reuister (pages 19160-19211).
(BEFORE COMPLETING CERTIFICATION, READ INSTRUCTIONS FOR CERTIFICATION -
Attached)
(1) The prospective recipient of federal assistance funds certifies, by submission of this proposal, that
neither it nor its principals are presently debarred, suspended, proposed for debarment, declared
ineligible, or %oluntarily excluded from participation in this transaction by any federal department or
agency.
(2) Where the prospective recipient of federal assistance funds is Unable to certify to am of the
statements in this certification, Such prospeetfye participant shall attach an explanation to this
proposal.
� C
j CL.c.
Name and Title of Authorized Representative
Date
EXHIBIT C
Page 1 of 2
INSTRUCTIONS FOR CERTIFICATIOiN
1. By signing and submitting this proposal, the prospective recipient of federal assistance funds is
providing the certification as set out below.
2. The certification in this clause is a material representation of fact upon which reliance was placed
when this transaction was entered into. If it is later determined that the prospective recipient of
federal assistance funds knowingly rendered an erroneous certification, in addition to other remedies
available to the Federal Government, the Department of Labor (DOL) may pursue available
remedies, including suspension and/or debarment.
3. The prospective recipient of federal assistance funds shall provide immediate written notice to the
person to which this proposal is submitted if at any time the prospective recipient of federal
assistance funds learns that its certification was erroneous when submitted or has become erroneous
byreason of changed circumstances.
4. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered
transaction," "participant," "person," "primary covered transaction," "principal," "proposal," and
"voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and
Coverage sections of rules implementing Executive Order 12549. You may contact the person to
which this proposal is submitted for assistance in obtaining a copy of those regulations.
5. The prospective recipient of federal assistance funds agrees by submitting this proposal that, should
the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier
covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily
excluded from participation in this covered transaction, unless authorized by the DOL.
6. The prospective recipient of federal assistance funds further agrees by submitting this proposal that
it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and
voluntary exclusion - Lower Tier Covered Transactions," without modification, in all lower tier
covered transactions and in all solicitations for lower tier covered transactions,
7. A participant in a covered transaction may rely upon a certification of a prospective participant in a
lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded
from the covered transaction, unless it knows that the certification is erroneous. A participant may
decide the method and frequency by which it determines the eligibility of its principals. Each
participant may, but is not required to check the List of Parties Excluded from Procurement or Non -
Procurement Programs,
8. Nothing contained in the foregoing shall be construed to require establishment of a system of
records in order to render in good faith the certification required by this clause. The knowledge and
information of a participant is not required to exceed that which is normally possessed by a prudent
person in the ordinary course of business dealings.
9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a
covered transaction knowingly enters into a lower tier covered transaction with a person who is
suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in
addition to other remedies available to the Federal Government, the DOL may pursue available
remedies, including suspension and/or debarment.
EXHIBIT C
Page 2 of 2
Certification Regarding Lobbying
Certification for Contracts Grants Loans and Cooperative Aureem`nt-
The undersigned certi fies, to the best of his or her knowledge and belier, that:
1 I ) No Federal appropriated funds have been paid or will be paid, by or on behalf of the
undersigned, to any person for influencin11 or attempting to influence an officer or
employee or any agency, a Member of Congress, an officer or employee of Congress, or
all employee of a Member of Congress in connection with the awarding of any Federal
contract, the making of any cooperative agreement, and the extension, continuation,
renewal, amendment. ur ul>dilication of any Federal contact, grant, loan or cooperative
agreement.
(2) If any funds other than Federal appropriated funds have been paid or %+ill be paid to
any person &n iulhienciog or attempting to influence an officer or employee of any
agency, a Member of Congress. an officer or employee of Congress, or an employee of a
Member of Congress in connection with this Federal contract, gant, loan, or cooperative
agreement, the undersigned shall complete and submit Standard Form-LLL. "Disclosure
Form to Report Lobbying." in accordance with its instructions.
(3) Rae undersigned shall require that the language of this certification be included in the
award documents for all subaw-ards at all tiers (including subcontract, sub -rants, and
contracts under grants, loans, and cooperative agreements) and that all subrecipients shall
certify and disclose accordingly.
This certification is a material representanon of fact upon which reliance nos placed
when this transaction was made or entered into. Submission of this certification is
prerequisite ror making or entering into this transaction imposed by Section 1351, `I itle
31, U. S. Code. .Any person who fails to file the required certification shall be subject to
a civil penalty of not less than M,000 and not more than SI00,000 for each such failure.
GranteeContactor
/
Conta%ctor Organization r Pnrem ra�tle
Name orC'ertifying Officer Siumatura Date
EXHIBI f D
Page I of 2
SUBRECIPIENT warrants the following:
1. SUBRECIPIENT will comply with Public Law 88-352, Title VI of the Civil Rights
Act of 1964 (42 U, S. C. section 2000 et seq.) and implementing regulation in 24 CFR
Part 1.
2. No person in the United States shall on the ground ofrace, color, religion, national
origin; or sex, be excluded from participation in, or be denied the benefits of, or be
subjected to discrimination under any program or activity funded in whole or in part with
community development fiends made available pursuant to the ACT.
3. All laborers and mechanics, employed by contractors or subcontractors in the
performance of constriction work financed in whole or in part with community
development funds shall be paid wages at rates not less than those prevailing on similar
construction in the locality as determined in accordance with the Davis -Bacon Act, as
amended, 40 U. S. C. Sections 276 a 1-5, except for individuals who perform services for
which they volunteered; do not receive compensation for such services; or are paid
expenses, reasonable benefits, or a nominal fee for such services; and are not otherwise
employed at any time in constriction work.
4. SUBRECIPIENT will comply with all Federal statutes applicable to projects funded
with community development funds, except that (a) SU13RECIPIENT does not assume
CITY'S environmental responsibilities described at 24 CFR 570,604; and (b)
SUBRECIPIENT does not assume CITY'S responsibility for initiating the review process
under Executive Order 12372.
EXHIBIT D
Page 2 of 2
Certification Regarding Drug -Free Workplace Reguirements
The certification set out below is a material representation upon which reliance is placed
by the U,S, Department of Housing and Urban Development in awarding the grant. If it
Is later determined that the contractor knowingly rendered a false certification, or
otherwise violates the requirements of the Drug -Free Workplace Act, the U.S.
Department of Housing and Urban Development, in addition to any other remedies
available to the Federal Government, may take action authorized under the Drug -Free
Workplace Act.
CERTIFICATION
A. The contractor certifies that it will provide a drug -free workplace by:
(a) Publishing a statement notifying employees that the unlawful manufacture,
distribution, dispensing, possession or use of a controlled substance is
prohibited in the contractor's workplace and specifying the actions that will
be taken against employees for violation of such prohibition;
(b) Establishing a drug -free awareness program to inform employees about-
(1) The dangers of drug abuse in the workplace;
(2) The contractor's policy of maintaining a drug -free workplace;
(3) Any available drug counseling, rehabilitation, and employee
assistance program; and
(4) The penalties that may be imposed upon employees for drug abuse
violations occurring in the workplace;
(c) Making it a requirement that each employee who will be engaged in the
performance of the grant be given a copy of the statement required by
paragraph (a);
(d) Notifying the employee In the statement required by paragraph -(a) that,
as a condition of employment under the contract, the employee will -
(1) Abide by the terms of the statement; and
(2) Notify the employer of any criminal drug statute conviction for a
violation occurring in the workplace no later than five days after
such conviction.
(a) Notifying the U.S. Department of Housing and Urban Development within
ten days after receiving notice under subparagraph (d)(2) from an
employee or otherwise receiving actual notice of such conviction;
EXHIBIT E
Page 1 of 3
(f) Taking one of the following actions, within 30 days of receiving notice
under subparagraph (d)(2), with respect to any employee who is so
convicted -
( 1) Taking appropriate personnel action against such an employee, up
to and including termination, or
(2) Requiring such employee to participate satisfactorily in a drug
abuse assistance or rehabilitation program approved for such
purposes by a Federal, State, or local health, law enforcement, or
other appropriate agency;
(g) Making a good faith effort to continue to maintain a drug -free workplace
through implementation of paragraphs (a), (b), (c), (d), (a) and (f).
B. The contractor shall insert in the space provided on the attached "Place of
Performance" form the site(s) for the performance of work to be carried out with
the grant funds (including street address, city, county, state, and zip code) .the
contractor further certifies that, if it is subsequently determined that additional
sites will be used for the performance of work under the contract, it shall notify
the U.S. Department of Housing and Urban Development immediately upon the
decision to use such additional sites by submitting a revised "Place of
Pfrf-O'rmance" form.
4a 1 1u Cf 0C6=0Cv(
Organ' ation
eofJ;<<I
uthorzed Sionature Date
EXHIBIT E
Page 2of 3
PLACE OF PERFORMANCE
FOR CERTIFICATION REGARDING DRUG -FREE
WORKPLACE REQUIREMENTS
Name: �2 k�( �t13 �_r� � l leo '
Date: o ni
The Contractor shall insert in the space provided below the site(s) expected to be used
for the performance of work under the contract covered by the certification:
Place of Performance (include street address, city, county, state, zip code for each site):
EXHIBIT E
Page 3of 3