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HomeMy WebLinkAboutCOMMUNITY HEALTH INITIATIVE OF ORANGE COUNTY (2)t uN FILE PROCEED SEP 2 8 2021 itA CE EXPIRES COUNCIL A-2020-157-04 FIRST AMENDMENT TO THE COMMUNITY DEVELOPMENT BLOCK GRANT SU13RECIPIENT AGREEMENT BETWEEN THE CITY OF SANTA ANA AND � COMMUNITY HEALTH INITIATIVE OF ORANGE COUNTY O'. C0R COX�unS (24 CFR Parts 570) THIS FIRST AMENDMENT TO THE COMMUNITY DEVELOPMENT BLOCK GRANT AGREEMENT is entered into this 16m day of September 2021, by and between the City of Santa Ana, a charter city and municipal corporation of the State of California (°`City"), and Community Health Initiative of Orange County, a California nonprofit organization ("Subrecipient"). (24 CFR Parts 570) RECITALS A. On July 1, 2020, the City entered into Community Development Block Grant ("CDBG") Subrecipient Agreement #A-2020-043-05 with Subrecipient to provide CDBG Funds from the United States Department of Housing and Urban Development ("HUD") to be used in the operation of a public service program for the youth of the City of Santa Ana ("said Agreement"). B. In accordance with the terms and conditions of said Agreement, the parties desire to amend said Agreement to report the current Catalog of Federal Domestic Assistance ("CFDA") Number and Federal Award Identification Number ("FAIN") for Subrecipient, and to report the current federal award date and amount of the award as required for pass -through entities. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions of said Agreement, except as herein modified, the parties agree as follows: I. Recital A shall be amended to update the City's current CFDA Number to 14.218 and FAIN to B-21-MC-06-0508 in accordance with the requirements for pass -through entities outlined in 24 CFR 200.332. 2. Article II, Section A, shall be amended to report the current federal award date of July 1, 2021, and update the amount of the award to be $5,640,635 in accordance with the requirements for pass -through entities outlined in 24 CFR 200.332. 3. Except as hereinabove modified, the terms and conditions of said Agreement remain unchanged and in full force and effect. A-2020-157-04 N IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to said Agreement the date and year first above written. ATTEST: DAISY GOMEZ `Clerk of the Council APPROVED AS TO FORM: RECOMMENDED FOR APPROVAL: STEVEN MENDOZA Executive Director Community Development Agency CITY OF SANTA ANA KRISTINE IDR GE City Manager SUBRECIPIENT: Na e: r 'na aldonado Tit : Ex tive Director Tax ID# 47-26711013 DUNS# 080155867 Digltally signed by Francine R. Francine R. Villareal Villareal Date. 2021 03 o313sssn-(Alm ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE(MMNJD/YYYY) 02/26/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND 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, the policy(ies) must have ADDITIONAL INSURED provisions 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 such endorsement(s). PRODUCER NAME: CONTACT Certificate Issuance Team Comprehensive Insurance Services PHDNE "" 709-8800 FAX (949) 709-1668 A/C No Ext : A/C. No 26429 Rancho Parkway South A.DUliess:jeremy@thecomprehensiveinsurance.com Suite 120 INSURERS) AFFORDING COVERAGE NAIC N Lake Forest CA 92630 INSURERA: Nonprofits Insurance Alliance of California 10023 INSURED INSURER B: Community Health Initiative of Orange County INSURER C: 1505 E. 171h Street, Suite 121 INSURER D: INSURER E : Santa Ana CA 92705 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2082704831 REVISION NUMBER: 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF MMIDO/YYVV al P MMIODIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY � OCCUR EACHOCCURRENCE $ 1,000,000 UAWGLIOKENIECLAIMS-MADE cc PREMISES Eaou anca $ 500,000 MED EXP(Any one person) $ 20,000 PERSONAL &ADV INJURY $ 1,000,000 A Y 2020-44927. 10/1512020 10/15/2021 GEN'L AGGREGATE LIMIT APPLI ES PER: POLICY ❑ PRO FX LOG ECT GENERAL -AGGREGATE $ 2,000,000 PRODUCTS-COMP/OPAGG $ 2.000,000 OTHER: - $0 Deductible $ LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ ANYAUTO AOWNED POMOBILE SCHEDULED AUTOS ONLY AUTOS 2020-44927 10/1512020 10/15/2021 BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY PROPERTY DAMAGE Peraccldent $ $0 Deductible $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY YIN PER OTH- STATUTE ER E.L. EACH ACCIDENT $ ANY PROPRIETOWPARTNEWEXECUTIVE El OFFICER(MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ (Mandatory In NH) (ryes, describe under E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS be. Social Service Professional $1,000,000/1,000,000 Aggregate/Occ A Improper Sexual Conduct 2020-44927 1011512020 1D115/2021 $1,000,000/1,000,000 Aggregate/Occ $0 Deductible DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more apace Is required) City of Santa Ana, officers, agents, employees, and volunteers are Included as additionally Insured on this policy pursuant to written contract or written agreement per attached endorsement NIAC E61. Such Insurance as Is afforded by this policy shall be primary, and any insurance Carried by City shall be excess and noncontributory per attached endorsement NIAC E61. 30 day notice of cancellation with 10 day notice of cancellation for non-payment of premium per policy provision. City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE @ 1988-2015 ACORO ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD ysu M &ManagementDivision 8 �#�3 REVIEWED 6 APPROVED BY: aaat�c n a P. v �� RISk ManagerrrerR/VTBlysk NONPROFITS INSURANCE �ff ALLIANCE, Or CALIFORNIA A Head Jor Iasurarrra. A Heart for Nonprofits. POLICY NUMBER: 2020-44927 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED PRIMARY AND NON-CONTRIBUTORY ENDORSEMENT FOR PUBLIC ENTITIES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: A. SECTION II — WHO IS AN INSURED is amended to include: 4. Any public entity as an additional insured, and the officers, officials, employees, agents and/or volunteers of that public entity, as applicable, who may be named in the Schedule above, when you have agreed in a written contract or written agreement presently in effect or becoming effective during the term of this policy, that such public entity and/or its officers, officials, employees, agents and/or volunteers be added as an additional insured(s) on your policy, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: a. Your negligent acts or omissions; or b. The negligent acts or omissions of those acting on your behalf; in the performance of your ongoing operations. No such public entity or individual is an additional insured for liability arising out of the sole negligence by that public entity or its designated individuals. The additional insured status will not be afforded with respect to liability arising out of or related to your activities as a real estate manager for that person or organization. B. SECTION III — LIMITS OF INSURANCE is amended to include: 8. The limits of insurance applicable to the public entity and applicable individuals identified as an additional insured(s) pursuant to Provision A.4. above, are those specified in the written contract between you and that public entity, or the limits available under this policy, whichever are less. These limits are part of and not in addition to the limits of insurance under this policy. C. With respect to the insurance provided to the additional insured(s), Condition 4. Other Insurance of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS is replaced by the following: 4. Other Insurance a. Primary Insurance This insurance is primary if you have agreed in a written contract or written agreement: (1) That this insurance be primary. If other insurance is also primary, we will share with all that other insurance as described in c. below; or NIAC-E61 02 19 �c wakknter�,,„antnt>�w,r g REUEWED&APPROVED Br, f P. VAa ram' RisR MandrlNmentHnalyst NONPROFITS INSURANCE ALLIANCE. OF CALIFORNIA A Head for Insurance. A Heart far Nonprofits. POLICY NUMBER: 2020-44927 (2) The coverage afforded by this insurance is primary and non-contributory with the additional insured(s)' own insurance. Paragraphs (1) and (2) do not apply to other insurance to which the additional insured(s) has been added as an additional insured or to other insurance described in paragraph b. below. b. Excess Insurance This insurance is excess over: 1. Any of the other insurance, whether primary, excess, contingent or on any other basis: (a) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work", (b) That is fire, lightning, or explosion insurance for premises rented to you or temporarily occupied by you with permission of the owner; (c) That is insurance purchased by you to cover your liability as a tenant for "property damage" to premises temporarily occupied by you with permission of the owner; or (d) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of SECTION I - COVERAGE A- BODILY INJURY AND PROPERTY DAMAGE. (a) Any other insurance available to an additional insured(s) under this Endorsement covering liability for damages which are subject to this endorsement and for which the additional insured(s) has been added as an additional insured by that other insurance. (1) When this insurance is excess, we will have no duty under Coverages A or B to defend the additional insured(s) against any "suit" if any other insurer has a duty to defend the additional insured(s) against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the additional insured(s)' rights against all those other insurers. (2) When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (a) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (b) The total of all deductible and self -insured amounts under all that other insurance. (3) We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. C. Methods of Sharing If all of the other insurance available to the additional insured(s) permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any other the other insurance available to the additional insured(s) does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. NIAC-E61 02 19 sn. Wsk tD[vlaion °. AP "F RenEWEDM&APP2avEDBY: � Rtcl<Managerrmnt Analyst s=e CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDP/YYY) 12/18/2020 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, the policy(ies) must have ADDITIONAL INSURED provisions 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 such endomement(s). PRODUCER CONTACT NAME: Paychex Insurance Agency Inc PAYCHEX INSURANCE AGENCY, INC. PHONE Biz-266-695o A/C No : 585-389-7428 150 SAWGRASS DRIVE E-MAIL ceds@paychex.com ADDRESS: ROCHESTER, NY 14620 INSURERS AFFORDING COVERAGE NAICp INSURERA: STATE COMPENSATION INSURANCE FUND INSURED INSURER B INSURER C: Community Health Initiative of Orange County INSURER D: 1505 E 17Th St Suite 121 INSURER Ei Santa Ana, CA, 92705 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. I LTR TYPE OF INSURANCE ADDL JUM SU D POLICY NUMBER MM/ODY� POLICY LIMITS COMMERCIAL GENERAL LABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ DAMAGES RE TED PREMISES(Ea occurrence $ MED EXP(Any oneperson) $ PERSONAL a ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY 0 PRO- JECT LOC OTHER: GENERALAGGREGATE $ PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NOM WNED AUTOS ONLY AUTOS ONLY COMBINED SINGLELIMIT Ea accident $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION YIN AND EMPLOYERS' LIABILITY ANYPROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 9289091 11/051202011/05/2021 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEAS E- POLICY LIMIT $ 1,000.000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES IACORD IO1, Additional Remarks Schedule, my be attached if more space is mqulmd) City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE f qff.Jjl0q V*. ©1988.2016 ACORD C ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD w,.� RWeMAnngem"`DMs1bn REVIEWED &APPROVED BY: Risk Mat agernent Andlyst