Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
FAMILIES FORWARD (9)
INSURANCE ON FL - WORK MAY PR^C UNTIL INSUP li :. 7-i- CLERK OF COUNCIL DATE. A-2021-238-07 O. WP,(!D) AGREEMENT BETWEEN THE CITY OF SANTA ANA AND (pp vtd fta5i FAMILIES FORWARD FOR USE OF g: STATE RENTAL ASSISTANCE PROGRAM — ROUND 2 (SRA2) FUNDS This Agreement is hereby made and entered into this I' day of March, 2022, by and between C%a the City of Santa Ana, a charter city and municipal corporation organized and existing under the NConstitution and laws of the State of California ("CITY"), and Families Forward, a California nonprofit corporation ("SUBRECIPIENT" or "CONTRACTOR"). RECITALS: a �6 A. On March 11, 2021, the federal American Rescue Plan Act of 2021 (Pub. L. No. 117-2) ("ARPA") was signed into law. Section 3201 of Subtitle B of Title III of ARPA established the federal Emergency Rental Assistance Program ("ERA2'), and authorized the direct allocation of emergency rental assistance funds to states, units of local governments, territories, and high -need grantees. The ERA2 funds are intended to assist households that are unable to pay rent or utilities during or due to the COVID-19 pandemic. B. California Assembly Bill No. 832 (Chapter 27, Statutes of 2021) ("AB 832") established Round 2 of the State of California's program for administering its share of ERA2 funds (the "State Rental Assistance Program — Round 2" or "SRA2" or "SRA2 Funds"). Health and Safety Code section 50897.1, subdivision (a)(1) authorized the Department of Housing and Community Development ("HCD") to administer the SRA2 Funds in accordance with state and federal law. C. CITY desires to obligate and disburse an allocation of SRA2 Funds pursuant to Health and Safety Code section 50897.2.1, subdivision (a)(1) or (2). Accordingly, HCD and the CITY entered into STD 213 Standard Agreement #21-ERAP-20081 ("State Agreement") under the authority and in furtherance of the State Rental Assistance Program — Round 2, attached hereto as Exhibit H and incorporated herein by reference. D. CITY intends to use its SRA2 funds to make subawards to other entities, including non-profit organizations, to administer an SRA2 program on behalf of the CITY. The SRA2 funds will be used for direct financial assistance, including rent, rental arrears, utilities and home energy costs, utilities and home energy costs arrears, and other expenses related to housing. Remaining funds are available for administrative costs. E. SUBRECIPIENT has been selected by the CITY to receive SRA2 Funds in order to administer the CITY's CARES for Tenants Program, in accordance with the Scope of Work attached hereto as Exhibit A and incorporated herein by reference ("said program"). SUBRECIPIENT represents that it is qualified and willing to operate said program and certifies that the administration of said program carried out with funds provided under this Agreement will meet the SRA2 objectives to respond to this historic COVID-19 public health crisis. F. SUBRECIPIENT agrees that it will adhere to the eligibility requirements, required documentation, and project expectations as indicated in Exhibit A for said program and in 1 Document Ref. 0YPYR-0VGST-QPWKA-EGGA9 Page 1 of 48 compliance with: Section 3201(a) of the American Rescue Plan Act of 2021 and related federal guidance, and as such federal law may be subsequently amended; the Department of Treasury's Frequently Asked Questions (FAQs), and as such FAQs may be subsequently amended; AB 832, as enacted on June 28, 2021, and as such state law may be subsequently amended; HCD's State Rental Assistance Program Guidelines — Emergency Rental Assistance (ERA) Rounds 1 and 2 Implementation, dated September 27, 2021, and as such Guidelines may be subsequently amended; the Santa Ana Program Guidelines and Frequently Asked Questions established for said program, and as such Guidelines and FAQs may be subsequently amended; and all other applicable law. Failure to follow the requirements and meet the stated expectations 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: L SRA2 PROVISIONS A. Scope of Work. SUBRECIPIENT shall be responsible for the specific tasks and services of said program, and agrees to administer said program in compliance with the size of the grant, the eligibility requirements, the eligible expenses for said program, the disbursement of funds, the required information/documents to qualify for grant award, and the project expectations as described in the Scope of Work attached hereto as Exhibit A. 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 for said program or termination of this Agreement. B. Term of Agreement. The term of said Agreement shall commence on the date first written above and continue through August 31, 2022 ("Term"), unless terminated earlier pursuant to the terms of this Agreement. This Agreement shall also cover any and all services provided by the SUBRECIPIENT to the CITY since the date the CITY allocation of SRA2 Funds was awarded to the CITY. Additionally, the Term of this Agreement may be extended by a writing executed by the City Manager, or her designee, and the City Attorney. C. Amount of Grant Funding. SUBRECIPIENT is one of several entities selected to approve the distribution of SRA2 Funds. CITY neither warrants nor guarantees any minimum or maximum amount of SRA2 Funds for SUBRECIPIENT to approve. The total amount of SRA2 Funds provided for said program shall not exceed Eight Million, One Hundred Ten Thousand, One Hundred Twenty -Six Dollars and Ninety -Eight Cents ($8,110,126.98), which includes both Direct Financial Assistance and Administrative Funds, during the Term of the Agreement. CITY will allow SUBRECIPIENT to approve some portion of this maximum amount ofERA2 Funds, subject to the availability of funds. SUBRECIPIENT agrees to administer said program as outlined in Exhibit A, and within the terms of this Agreement, and to use said SRA2 Funds to administer said program pursuant to the regulations in Exhibit B attached hereto and incorporated herein by reference. 2 Document Ref: 0YPYR-0UG5T-QPWKA-EGGA9 Page 2 of 48 (1) Direct Financial Assistance. SUBRECIPIENT will potentially be responsible to approve the payment of direct financial assistance for up to an amount not to exceed Eight Million, Seventeen Thousand, Four Hundred Thirty -Nine Dollars and Eighty -Two Cents ($8,017,439.82), subject to the availability of funds, to be used for grants to eligible participants in said program in accordance with Exhibit A. The direct financial assistance will be disbursed by Orange County United Way as a third party on behalf of the SUBRECIPIENT and CITY under a separate Agreement. The responsibility to approve the payment of direct financial assistance is shared with other SUBRECIPIENTS. Additionally, SUBRECIPIENT may expend up to Eight Hundred One Thousand, Seven Hundred Forty -Three Dollars and Ninety -Eight Cents ($801,743.98) of the Direct Financial Assistance for housing stability services to include, among other things: case management, legal support to prevent eviction, tenant -landlord mediation services, housing counseling, housing placement, housing navigators/promoters that help households access ERAP funds, housing -related services for survivors of domestic abuse or human trafficking, and specialized services for seniors or individuals with disabilities. The responsibility to conduct housing stability services and expend these funds is shared with other SUBRECIPIENTS. The housing stability services may only be provided with written pre -approval by the CITY after the Agreement is fully executed. (2) Administrative Funds. CITY shall make administrative fee payment(s) to SUBRECIPIENT in an amount not to exceed Ninety -Two Thousand, Six Hundred Eighty -Seven Dollars and Seventeen Cents ($92,687.17), pursuant to the terms detailed in Exhibit B. D. Disbursement of Funds. Said Administrative Funds shall be disbursed by CITY to the SUBRECIPIENT pursuant to the terms found in the Compensation/Payment attached hereto as Exhibit B, with payments subject to the submittal of invoices and other reporting requirements, as hereinafter more fully set forth. SUBRECIPIENT shall be obligated to perform such duties as would normally extend beyond the 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 SRA2 Funds, or return the entire request to SUBRECIPIENT, until such documentation and reporting has been received and approved by CITY. (1) Reduction in SRA2 Funding. The CITY reserves the right to reduce the amount of SRA2 Funds to SUBRECIPIENT, or to completely terminate this Agreement, in the CITY's sole discretion, if there is a reduction in SRA2 Funds provided to the CITY. (2) Reduced Distribution of Funds. 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 term. Amendments in the grant allocation will be made after consultation with SUBRECIPIENT. (3) Reversion of Assets. SUBRECIPIENT agrees that any and all funds received under this Agreement shall be disbursed during the Term of this Agreement, and that any and all funds remaining as of the end of the Term, which have not been disbursed, shall be returned by Document Ref: 0YPYR-0VGST-QPWKA-EGGA9 Page 3 of 48 SUBRECIPIENT to the CITY within thirty (30) days of the expiration or earlier termination of the Agreement. No expense of SUBRECIPIENT will be reimbursed by CITY if incurred after the end of the Term of the Agreement. (4) Interest on Funds. SRA2 Funds made by HCD to local governments, Tribes, and TDHEs are not subject to the requirement of 2 CFR 200.305(b)(8)-(9) to maintain balances in an interest -bearing account and remit payments to HCD. E. Grant Program Requirements. (1) SUBRECIPIENT acknowledges that the source of funding for said program is the state SRA2 Funds, as part of the federal ERA2 program, and that payments from the SRA2 Funds are only to be used to make necessary expenditures incurred due to the public health emergency with respect to COVID-19 in compliance with: Section 3201(a) of the American Rescue Plan Act of 2021 and related federal guidance, and as such federal law may be subsequently amended; the Department of Treasury's Frequently Asked Questions (FAQs), and as such FAQs may be subsequently amended; AB 832, as enacted on June 28, 2021, and as such state law may be subsequently amended; HCD's State Rental Assistance Program Guidelines — Emergency Rental Assistance (ERA) Rounds 1 and 2 Implementation, dated September 27, 2021, and as such Guidelines may be subsequently amended; the Santa Ana Program Guidelines and Frequently Asked Questions established for said program, and as such Guidelines and FAQs may be subsequently amended; and all other applicable law. (2) SUBRECIPIENT acknowledges that SRA2 Funds provisions allow the use of SRA2 Funds for expenses associated with the provision of rental assistance in connection with the COVID-19 public health emergency, and will not use these funds for any other uses (3) SUBRECIPIENT shall follow the process and determination of eligibility for participants in said program as outlined in Exhibit A and the following: Section 3201(a) of the American Rescue Plan Act of 2021 and related federal guidance, and as such federal law may be subsequently amended; the Department of Treasury's Frequently Asked Questions (FAQs), and as such FAQs may be subsequently amended; AB 832, as enacted on June 28, 2021, and as such state law may be subsequently amended; HCD's State Rental Assistance Program Guidelines — Emergency Rental Assistance (ERA) Rounds 1 and 2 Implementation, dated September 27, 2021, and as such Guidelines may be subsequently amended; the Santa Ana Program Guidelines and Frequently Asked Questions established for said program, and as such Guidelines and FAQs may be subsequently amended; and all other applicable law. (4) CITY and HCD entered into STD 213 Standard Agreement #21-ERAP-20081 ("State Agreement") under the authority and in furtherance of the State Rental Assistance Program — Round 2, receiving and recognizing the CITY Allocation of SRA2 Funds to be used by CITY to provide rental assistance. A true and correct copy of the State Agreement is attached hereto as Exhibit H and incorporated herein by this reference. Subrecipient has been made aware of the State Agreement and agrees to comply with all the conditions of the State Agreement and the applicable requirements governing the use of SRA2 Funds, including amendments or addendums to said State Agreement, if any. City will provide notice of any such amendments or addendums to said State 0 Document Ref: OYPYR-OVGST-QPWKA-EGGA9 Page 4 of 48 Agreement to Subrecipient, and such notice will be sufficient to incorporate such amendment or addendum into this Agreement. F. Performance Monitoring. (1) The Subrecipient monitoring and management requirements set forth in 2 CFR 200.331-200.333 will apply to SUBRECIPIENT. SUBRECIPIENT shall submit program performance information as often as requested by CITY, but no less than the submission of weekly reports and a final report to CITY with the information requested by and in the format acceptable to CITY. Each weekly report is due within three (3) business days of completion of work for each week. The final report is due within thirty (30) days after the termination or expiration of this Agreement. (2) CITY will evaluate SUBRECIPIENT's management and operation of said program on factors, including but not limited to grant volume, disbursed funds, management, reporting and strategic results with respect to the project expectations as described in Exhibit A. (3) CITY will review the audit of the SUBRECIPIENT to ensure that grant funds are used for authorized purposes in compliance with laws, regulations, and the provisions of contracts or grant agreements under this Agreement, including attachments and exhibits. (4) If action to correct any substandard performance is not taken by the SUBRECIPIENT within a reasonable period after being notified by CITY, suspension or termination procedures may be initiated by CITY. (5) All performance shall be subject to review by the CITY or other regulatory agencies at all times. SUBRECIPIENT shall provide adequate cooperation to any inspector or other CITY representative to permit the same to determine SUBRECIPIENT's conformity with the terms of this Agreement. If any services performed by SUBRECIPIENT are not in conformance with the terms of this Agreement, the CITY shall have the right to require SUBRECIPIENT to perform the services in conformance with the terns of the Agreement at no additional cost. The CITY may also terminate this Agreement for default and charge SUBRECIPIENT for any costs incurred by the CITY because of SUBRECIPIENT's failure to perform. (6) SUBRECIPIENT shall establish adequate procedures for self -monitoring and quality control and assurance to ensure proper performance under this Agreement; and shall permit a CITY representative or other regulatory official to monitor, assess, or evaluate SUBRECIPIENT's performance under this Agreement at any time, upon reasonable notice to SUBRECIPIENT. G. Audit. (1) SUBRECIPIENT shall maintain complete and accurate records and supporting documentation to facilitate financial and/or program audits by CITY. This requirement shall apply to any records and documentation CITY shall reasonably require or as required to be maintained pursuant to the SRA2 regulations. Document Ref; OYPYR-OYGST-QPWKA-EGGA9 Page 5 of 48 (2) The books and accounts, files, and other records of SUBRECIPIENT, which are applicable to this Agreement, shall be available for inspection, review, and audit during normal business hours by CITY to determine the proper application and use of all SRA2 Funds provided to or for the account or benefit of SUBRECIPIENT. (3) SUBRECIPIENT assumes responsibility for reimbursement to CITY a sum of money equivalent to the amount of any expenditures disallowed should the CITY, or an authorized agency, rule through audit, exception, or some other appropriate means, that expenditures from funds allocated to SUBRECIPIENT for direct and/or administrative costs were not made in compliance with the applicable cost principles, regulations, or the provisions of this Agreement. (4) SUBRECIPIENT agrees to comply with the requirements of OMB Uniform Guidance 2 CFR Part 200. SUBRECIPIENT further agrees to provide CITY with a copy of completed independent auditors' report within thirty (30) days of CITY's request for such report. If the report contains instances of non-compliance with federal laws and regulations that bear directly on the performance or administration of this Agreement, SUBRECIPIENT shall provide CITY copies of responses to auditors' reports, a plan for corrective action, and auditors' response that the noncompliance has been resolved. All reports prepared in accord with the requirements of OMB Uniform Guidance 2 CFR Part 200 shall be available for inspection by representatives of CITY or the federal government during normal business hours. (5) All accounting records, reports, and evidence pertaining to all costs, expenses and the SRA2 Funds of SUBRECIPIENT and all documents related to this Agreement shall be maintained and kept available at SUBRECIPIENT'S office or place of business for the duration of the Agreement and thereafter for five (5) years from the date of final 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. H. Ownership/Use of Materials. SUBRECIPIENT agrees that all materials, reports or products in any form, including electronic, created by SUBRECIPIENT for which SUBRECIPIENT has been compensated pursuant to this Agreement shall be the sole property of the CITY. The material, reports, or products may be used by the CITY for any purpose that the CITY deems to be appropriate, including, but not limit to, duplication and/or distribution within the CITY or to third parties. SUBRECIPIENT agrees not to release or circulate in whole or part such materials, reports, or products without prior written authorization of the CITY. 1. Close -Out. SUBRECIPIENT agrees to comply with the closeout procedures detailed in 2 CFR §200.343, including the following: (1) S UBRECIPIENT must submit, no later than ninety (90) calendar days after the 0 Document Ref: OYPYR-OVGST-QPWKA-EGGA9 Page 6 of 48 end date of the period of performance, all financial, performance, and other reports as required by the terms and conditions of this Agreement; (2) 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); and, (3) CITY should complete all closeout actions for the award no later than one year after receipt and acceptance of all required final reports. IL SUBRECIPIENT'S OBLIGATIONS A. Renresentations and Warranties. (1) Authority. SUBRECIPIENT is a duly organized and existing nonprofit organization in good standing and authorized to do business under the laws of the State of California. SUBRECIPIENT 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 SUBRECIPIENT has been fully authorized by all requisite actions on the part of SUBRECIPIENT. (2) Experience. SUBRECIPIENT is qualified to provide the administrator services for said program detailed herein. (3) Familiarity With Services Required. By executing this Agreement, SUBRECIPIENT warrants that: (i) it has thoroughly investigated and considered the administrator services to be performed and provided for said program as detailed in Exhibit A; (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. (4) 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. (5) No Bankruptcy. SUBRECIPIENT is not the subject of any current or threatened bankruptcy proceeding. (6) 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. (7) Proposal Veracity. All provisions of and information provided in SUBRECIPIENT's management proposal submitted to CITY, including any exhibits, are true and correct in all material respects. Document Ref: OYPYR-OVGST-QPWKA-EGGA9 Page 7 of48 (8) 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, which would relate to or affect performance of the Agreement or provision of services hereunder. B. Licensing. SUBRECIPIENT agrees to obtain and maintain all required licenses, registrations, accreditation and inspections from 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. CITY shall provide a license to the application software used for the CARES for Tenants Program. C. Zoning. SUBRECIPIENT agrees that any facility/property used in furtherance of said program shall be specifically zoned and permitted for such use(s) and activities. 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 immediately 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. D. 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 200.302 requirements. SUBRECIPIENT is not required to maintain separate depository accounts for SRA2 Funds; provided however, the SUBRECIPIENT must be able to account for receipt, obligation, distribution and expenditure of SRA2 Funds pursuant to applicable 2 CFR 200.302 requirements. E. Audit Report Requirements. SUBRECIPIENT agrees that if SUBRECIPIENT expends Seven Hundred Fifty Thousand Dollars ($750,000) or more in federal funds, 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. F. Compliance with Law/Program Income. SUBRECIPIENT acknowledges that the funds being provided by CITY for said program are received by CITY pursuant to the SRA2, and that distribution and expenditure of these SRA2 Funds shall be in accordance with the SRA2 and all pertinent regulations issued by agencies of the state and federal government, including, but not limited to, all regulations found at Title 24 of the Code of Federal Regulations. Any program income received by SUBRECINENT 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 and administration of said program, whether or not referred to in this F Document Ref: 0YPYR-0VGST-QPWKA-EGGA9 Page 8 of 48 Agreement. G. 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 E "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 or Internal Revenue Service. Any change in the corporate status or suspension of SUBRECIPIENT shall be reported immediately to CITY. H. Confidentiality. Without prejudice to any other provisions of this Agreement, SUBRECIPIENT 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 or its representatives, all records requested, including audit, examinations, monitoring and verifications of reports submitted by SUBRECIPIENT, costs incurred and services rendered hereunder. I. 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 agent of CITY. I. Violation ofTerms and Conditions. SUBRECIPIENT agrees that if SUBRECIPIENT violates any of the terms and conditions of this Agreement or any prior Agreement whereby SRA2 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 distribution or expenditure of the SRA2 Funds granted hereunder, SUBRECIPIENT shall be required to reimburse the CITY of all such funds that were obtained, distributed and/or spent under fraudulent circumstances. K. Fraud. SUBRECIPIENT shall immediately report all suspected or known instances and facts concerning possible fraud, abuse or criminal activity related to the CITY and the Department of Treasury Office of Inspector General for the SRA2 Funds under this Agreement. L. Prohibited Use. SUBRECIPIENT hereby certifies and agrees that it will not use SRA2 Funds provided through this Agreement to pay for entertainment, meals or gifts, or other prohibited uses. M. Lobbyina. 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 Document Ref: OYPYR-OVGST-QPW KA-EGGA9 Page 0 of 48 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 F, 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 terms 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 F). N. Financial Interest. SUBRECIPIENT agrees that except for the use of administrative fees to pay salaries and other related administrative or personnel costs, no persons who exercise or have exercised any function with respect to administering said program 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 the administration of said program, may obtain a financial interest or benefit from said program, either for themselves or those with whom they have family or business ties, during 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. O. 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 et 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. 874 et 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. P. Equal Employment Opportunities. SUBRECIPIENT shall make every effort to ensure that all projects funded wholly or in part by SRA2 Funds shall provide equal employment opportunities for minorities and women. Q. 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 (51 %) owned and controlled by minority 10 Document Ref: OYPYR-OVGST-QPWKA-EGGA9 Page 10 of 48 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. R. Drug Free Workplace. SUBRECIPIENT agrees to provide a drug -free workplace and to execute a certification as set forth in Exhibit G attached hereto and incorporated herein by this reference. S. Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. The following requirements and standards must be complied with: 2 CFR Part 200 et al. SUBRECIPIENT shall procure all materials, property, or services in accordance with the requirements of 2 CFR 200.318-326. III. CITY'S OBLIGATIONS A. Audit of Account. CITY shall include an audit of the account maintained by SUBRECIPIENT in CITY's audit of all SRA2 Funds in accordance with Title 24 of the Code of Federal Regulations and other applicable federal laws and regulations. B. 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. C. Project Expectations: CITY shall monitor the performance of SUBRECIPIENT against goals and performance standards required herein. The SUBRECIPIENT shall be responsible to accomplish the project expectations as set forth in Exhibit A, and report such results to the CITY. If the SUBRECIPIENT estimates such goals will not be met, the SUBRECIPIENT is to contact the CITY, at which time the CITY will determine if any adjustments to the grant award is appropriate. Substandard performance as determined 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 that 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. IV. GENERAL PROVISIONS A. Non -Discrimination. 11 Document Ref: OYPYR-OVGST-QPWKA-EGGA9 Page 11 of 48 1. SUBRECIPIENT 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 SUBRECIMENT setting forth the provisions of this nondiscrimination clause. 2. 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 subj ect to discrimination under any program of activity receiving federal financial assistance. SUBRECIPIENT agrees to incorporate the following language in every contract or agreement subject to Title VI and its regulations between SUBRECIPIENT and SUBRECIPIENT's sub -grantees, contractors, subcontractors, successors, transferees, and assignees: The sub -grantee, contractor, subcontractor, successor, transferee, and assignee shall comply with Title VI of the Civil Rights Act of 1964, which prohibits recipients offederal financial assistance from excluding from a program or activity, denying benefits of, or otherwise discriminating against a person on the basis of race, color, or national origin (42 U.S.C. § 2000d et seq), as implemented by the Department of the Treasury's Title VI regulations, 31 CFR Part 22, which are herein incorporated by reference and made apart of this contract (or agreement). Title VI also includes protection to persons with "Limited English Proficiency" in any program or activity receiving federal financial assistance, 42 U.S.C. § 2000d et seq., as implemented by the Department of the Treasury's Title VI regulations, 31 CFR Part 22, and herein incorporated by reference and made a part of this contract or agreement. 3. 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 Housing and Community Development Act of 1974, as amended. 4. 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. 12 Document Ref: 0YPYR-0VGST-QPWKA-EGGA9 Page 12 of 48 5. 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 by the United States Postal Service. B. Conflict of Interest. 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 SRA2 Funds granted to the CITY, inclusive of the subject SRA2 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 part hereof. Notice shall be sent by SUBRECIPIENT to CITY regarding any changes or modifications to its board of directors and list of officers. C. Special Certification for Religious Entities. If SUBRECIPIENT is a religious entity, SUBRECIPIENT hereby agrees that in connection with the provision of the services SUBRECIPIENT shall provide with SRA2 Funds, in accordance with 24 CFR 570.2000): 1. SUBRECIPIENT 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 of religion. 2. SUBRECIPIENT shall not discriminate against any person applying for the services S UBRECIPIENT 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 of religion. 3. 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. 4. 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. 5. Where the services to be provided under said program are rendered on property owned by the primarily religious entity SUBRECIPIENT, SRA2 Funds may also be used for minor repairs to such property, which are directly related to the cost of rendering the services under said program, where the cost constitutes in dollar terms only an incidental portion of the SRA2 expenditure for rendering the services under said program. 13 Document Ref: 0VPYR-0VG8T-QPWKA-EGGA9 Page 13 of48 D. Prohibition of Nepotism. SUBRECIPIENT agrees not to hire or permit the hiring of any person to fill a position funded through this Agreement if a member of that person's 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, sister-in-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. E. Notices. Notices to the parties shall, unless otherwise requested in writing, be sent by U.S. Mail, postage prepaid, and addressed as follows: TO CITY: City of Santa Ana Steven Mendoza Executive Director Community Development Agency 20 Civic Center Plaza P.O. Box 1988 Santa Ana, California 92702-1988 TO SUBRECIPIENT: Families Forward 8 Thomas Irvine, CA 92618 Tel: (949) 552-2727 F. Assignability. 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. G. Indemnification/Hold Harmless. SUBRECIPIENT 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 CITY, 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, errors or omissions of SUBRECIPIENT, its officers, directors, employees, agents, subcontractors and suppliers arising out of SUBRECIPIENT's performance of this Agreement. H. Insurance. 1. Commercial General Liability. SUBRECIPIENT agrees to obtain and keep in force during the term of this Agreement a policy of comprehensive commercial public liability 14 Document Ref: OYPYR-OVGST-QPWKA-EGGA9 Page 14 of 48 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, furnish properly executed certificates of insurance and additional insured endorsement to the CITY 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. (i) Certificates shall list the City as a Certificate Holder as follows: City of Santa Ana Risk Management Division 20 Civic Center Plaza, 4th Floor Santa Ana, CA 92701 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 et 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. 15 Document Ref: 0YPYR-0VG8T-QPW KA-EGGA9 Page 15 of 48 4. 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. Termination. 1. 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. 2. This Agreement may be suspended or terminated by CITY upon five (5) days' written notice for violation by SUBRECIPIENT of any laws governing the use of SRA2 Funds. hi 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. 3. 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 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. 4. 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 termination, 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 which the award was made; the CITY may terminate the award in its entirety. 5. The grant of funds under this Agreement may be terminated due to the non- performance of SUBRECIPIENT and/or failure of SUBRECIPENT to perform the work described in Exhibit A or failure to meet the project expectations set forth in Exhibit A. 6. The grant of funds under this Agreement may be terminated due to the failure of the CITY to receive sufficient or anticipated funding for the SRA2 program for any term subject to this Agreement. 7. In the event this Agreement is terminated as set forth in subparagraphs I(1) through I(6), inclusive, SUBRECIPIENT agrees to immediately return to CITY upon CITY's demand 16 Document Ref: OYPYR-OVGST-QPWKA-EGGA9 Page 16 of 48 and prior to any adjudication of SUBRECIPIENT's rights, any and all funds not used, and to comply with the Reversion of Assets requirements in this Agreement. J. Limitation of Funds. The United States of America or State of California may in the future place programmatic or fiscal limitations on the use of SRA2 Funds, which limitations are not presently anticipated. Accordingly, CITY reserves the right to revise this Agreement in order to take account of actions affecting SRA2 funding. In the event of funding reduction, CITY may, in its sole and absolute discretion, reduce the budget ofthis Agreement, may limit the rate of SUBRECIPIENT's authority to disburse funds, or may restrict SUBRECIPIENT's use of uncommitted funds. Where CITY has been directed to implement a reduction in funding, 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 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 SRA2 Funds withdrawal guidelines. K. Exclusivity and Amendment of Agreement. 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 SRA2 Funds by SUBRECIPIENT and contains all the covenants and agreements between the parties with respect to SUBRECIPIIENT's administration of said program. Each party to this Agreement aclmowledges 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. L. Laws Governingthis his Ag er ement. 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. M. Validity and Severability. 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. N. Waiver. 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 17 Document Ref: OYPYR-OVGST-QPWKA-EGGA9 Page 17 of 48 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. O. Federal Award Identification Information. SUBRECIPIENT's pertinent Federal Award Identification Information, including DUNS Number and Federal Award Identification Number (FAIN), as well as the applicable information for the SRA2, are included in Exhibit D attached hereto and incorporated herein by this reference. Miscellaneous Provisions, 1. 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 terns of this Agreement, and shall indemnify CITY frilly, 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. 2. All Exhibits and Attachments referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. 3. This Agreement must be signed below and may be signed in counterpart and delivered by fax, email as a PDF (Portable Document Format) file attachment, or by other means that displays the original or a copy of the signatures. Any subsequent amendments may be signed and delivered in the same manner. {Signatures on following page} m Document Ref: OVPVR-OVGST-QPWKA-EGGA9 Page 18 of 48 A-2021-238-07 IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the last date and year written below. ATTEST: i AISY GOMEZ Clerk of the Council APPROVED AS TO FORM: FOR APPROVAL: STEVEN MENDOZA Executive Director Community Development Agency 19 CITY OF SANTA ANA STINE RIDGE City Manager SUBRECIPIENT: Af6?4( AAf *r *&re Madelynn Himeise Chief Executive Officer DUNS #: 61-00-93825 Document Ref: OYPYR-OVGST-QPWKA-EGGA9 Page 19 of 48 EXHIBIT A SCOPE OF WORK 20 Document Ref: 0YPYR-0VG6T-QPWKA-EGGA9 Page 20 of 48 City of Santa Ana State ERA2 Scope of Work March 1, 2022 - August 31, 2022 Name of Organization Families Forward Name of Funded Program CARES for Tenants Performance Goal Unduplicated Partici ants antici ated to be served Burin the 10-month Schedule of Performance. 1,603 TOTAL 1,603 Santa Ana Participants I 1 1 1,603 Low Income Participants 100°k Schedule of Performance (estimated) Month 1: MAR 1 - MAR 31 Month 2: APR 1 - APR 30 Month 3: MAY 1 - MAY 31 Month 4: JUN 1 - JUN 30 Month 5: JUL 1 - JUL 31 Month 6: AUG 1 - AUG 31 and Reporting Details: Unduplicated Participants 267 267 267 267 267 267 1,603 Administrative Costs $ 15,447.86 $ 15,447.86 $ 15,447.86 $ 15,447.86 $ 15,447.86 $ 15,447.86 $ 92,687.17 Low-income Santa Ana renters impacted by the Coronavirus may apply online to receive assistance with rental arrears and prospective rent owed to their landlord on or after April 1, 2020. -Families Forward will administer up to $8,017,439.82 in direct financial assistance for approximately 1,603 families. The workload will be shared by five other contractors. The number of 1,603 families to be assisted assumes that the average rental assistance per family equals $5,000 per household, but the total number of families assisted will vary according to the total amount of rental assistance approved per household. -Direct assistance may only be approved in compliance with Section 3201(a) of the American Rescue Plan Act of 2021 and related federal guidance, and as such federal law may be subsequently amended; the Department of Treasury's Frequently Asked Questions (FAQs), and as such FAOs may be subsequently amended; AB 832, as enacted on June 28, 2021, and as such state law may be subsequently amended; HCD's State Rental Assistance Program Guidelines— Emergency Rental Assistance (ERA) Rounds 1 and 2 Implementation, dated September 27, 2021, and as such Guidelines may be subsequently amended; the Santa Ana Program Guidelines and Frequently Asked Questions established for said program, and as such Guidelines and FAQs may be subsequently amended; and all other applicable law. Program Details: -Residents will apply online via the Neighborly Software application portal available on the City of Santa Ana's website following the Santa Ana Program Guidelines and Frequently Asked Questions. -Families Forward will be assigned applications to process by the City. -Families Forward will determine the eligibility of applicants for the program, including: application review; eligibility verification; collection of required supporting documentation; communication/coordination with the applicant; coordination with the applicant's landlord for the tenant's lease/sublease agreement, past due rent amount, prospective rental assistance, and rent ledger; general determination of eligibility of the applicant. Families Forward will re -certify the eligibility of applicants for prospective rental assistance following this same process. -Families Forward is responsible to ensure that each tenant is qualified and determined eligible in compliance with with Section 3201(a) of the American Rescue Plan Act of 2021 and related federal guidance, and as such federal law may be subsequently amended; the Department of Treasurys Frequently Asked Questions (FAQs), and as such FAQs may be subsequently amended; AB 832, as enacted on June 28, 2021, and as such state law may be subsequently amended; HCD's State Rental Assistance Program Guidelines —Emergency Rental Assistance (ERA) Rounds 1 and 2Implementation, dated September 27, 2021, and as such Guidelines may be subsequently amended; the Santa Ana Program Guidelines and Frequently Asked Questions established for said Droeram. and as such Guidelines and FAQs may be subsequently amended: EXHIBIT A Document Ref: OYPYR-OVGST-QPWKA-EGGA9 Page 21 of 48 .. _y_....... ........_-._.................................... ........ r..,o......, ,...,. ,,,,.,,...._.................-........., ......_...... y..... .., ................ and all other applicable law. -After the family is determined eligible, Families Forward will approve the applicant for rental assistance in the Neighborly Software application portal. The City will send the approved application information to the United Way of Orange County who will act as the payor and make payment to the tenant's landlord on behalf of the tenant after all required landlord documentation/information is received. The Orange County United Way will make payment to the tenant if the landlord refuses to participate in the program. -Families Forward will submit invoices for reimbursement of administrative expenses on a monthly basis -ERAP funding will be used for the administrative expenses for Families Forward to determine the eligibility of tenants for up to $8,017,439.82 in direct financial assistance. Reporting Details: -Families Forward will provide weekly updates (performance reports) to the City and will ensure that all applicant information is correct, complete and curent for all applications assigned to them in Neighborly Software. -Families Forward will monitor the payment approvals such that no more than $8,017,439.82 in direct financial assistance is approved for eligible tenants. Any additional payments approved by Families Forward beyond $8,017,439.82 in direct financial assistance will be charged back to Families Forward as an administrative expense. EXHIBIT A Document Ref: OYPYR-OVGST-QPWKA-EGGA9 Page 22 of 48 EXHIBIT B COMPENSATION/PAYMENT 21 Document Ref OYPYR-OVGST-QPWKA-EGGA9 Pago 23 of 48 Organization Name Families Forward Program Name CARES for Tenants PROGRAM BUDGET EXPENDITURES Enter budget categories and projected expenditures for the proposed program: Expenditures Funded By Expenditures Total Santa Ana Funded By Program Organization Category ERAP Other Sources Budget Budget Administrative costs attributable to providing Direct Financial Assistance $92,687 $92,687 $ 92,687 $0 $ $0 $ $0 $ $0 $ $ $0 $ TOTAL BUDGET $92,687 $0 $92,687 $92,687 PROGRAM RESOURCES LIST ALL OTHER PROGRAM RESOURCES Funding Source Total must equal Program Budget Total listed above. FUNDING SOURCE AMOUNT Santa Ana ERAP $ 92,687 TOTAL $ 92,687 EXHIBIT B Document Ref: OYPYR-OVGST-QPWKA-EGGA9 Page 24 of 48 STATE ERA2 BUDGET LINE ITEMS ADMINISTRATIVE STAFF Position Title Annual Salary & Benefits ERAP Funds Requested Description Application review; eligibility verification; collection of required supporting documentation; communication/coordination with the applicant; Administrative costs coordination with the applicant's landlord forthe attributable to approving $ 92'687 tenant's lease/sublease agreement, past due rent families for Direct Financial amount, and rent ledger; general determination of Assistance eligibility of the applicant; and administrative fee to staff the program. The same process will be used to re -certify the eligibility of applicants for prospective rental assiitance. PROGRAM STAFF Position Title Annual Salary &Benefits ERAP Funds Requested Description CONTRACTUAL/PROFESSIONAL SERVICES Type of Service Contract Amount ERAP Funds Requested Description OTHER LINE ITEMS Line Item Program Amount ERAP Funds Requested F Description EXHIBIT B-1 Document Ref: 0VPVR-0VGST-OPWKA-EGGA9 Page 25 of 48 EXHIBIT C PROJECT SCHEDULE (estimated) Month 1: MAR 1 - MAR 31 Month 2: APR 1 - APR 30 Month 3: MAY 1 - MAY 31 Month 4: JUN 1 - JUN 30 Month 5: JUL 1 - JUL 31 Month 6: AUG 1 - AUG 31 Unduplicated Participants 267 267 267 267 267 267 1,603 22 Document Ref: 0YPYR-0VGS7-OPWKA-EGGA9 Page 26 of 48 EXHIBIT D FAIN INFORMATION A. CONTRACTOR Name: Families Forward B. CONTRACTOR'S Unique 61-00-93825 Identifier (D-U-N-S): Federal Award C. Identification Number (FAIN): D. Federal Award Date: February 3, 2022 E. Subaward Period of March 1, 2022 — August 31, 2022 Performance: Total Amount of Federal F. Funds Obligated by the $8,110,126.98 Action: Total Amount of Federal G. Funds Obligated to the $8,110,126.98 CONTRACTOR: H. Total Amount of the $9,268,716.55 Federal Award: I Federal Award Project Department of Treasury Emergency Rental Assistance Description: Program J. Federal Awarding Agency: U.S. Department of the Treasury and State of California Department of Housing and Community Development K. Name of PTE: L. Contact Information for the Judson Brown, Housing Division Manager Awarding Official: Phone Number: (714) 667-2241 E-mail Address: jbrownAsanta-ana.or¢ M. CFDA Number: 21.023 CFDA Name: Department of Treasury Emergency Rental Assistance Program N. Whether Award is R&D: No 0' Indirect Cost Rate for the N/A Federal Award: 23 Document Ref: 0VPYR-0VGST-OPWKA-EGGA9 Page 27 of 48 EXHIBIT E DEBARMENT Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion Lower Tier Covered Transactions This certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, 29 CFR Part 98, Section 98.510, Participants' responsibilities. The regulations were published as Part VII of the May 26,1988 Federal Re ig ster (pages 19160-19211). (BEFORE COMPLETING CERTIFICATION, READ INSTRUCTIONS FOR CERTIFICATION - Attached) (1) The prospective recipient of federal assistance funds certifies, by submission of this proposal, that neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency. (2) Where the prospective recipient of federal assistance funds is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. Madelynn Hirneise, Chief Executive Officer, Families Forward Name and Title of Authorized Representative l�'tG�GiP.�6fk �F/Yi7tP,Gf'� 03 / 08 / 2022 Date 24 Document Ref: OYPYR-OVG$T-QPWKA-EGGA9 Page 28 of 48 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 by reason 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. 25 Document Ref: 0YPYR-0VG$T-QPWKA-EGGA9 Page 29 of 48 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. 26 Document Ref: GYPYR-GVGST-OPWKA-EGGAO Page 30 of 48 EXHIBIT F LOBBYING Certification Regarding Lobbying Certification for Contracts, Grants, Loans, and Cooperative Agreements The undersigned certifies, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have 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 of any agency, a Member of Congress, an officer or employee of Congress, or an 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, or modification of any Federal contact, grant, loan or cooperative agreement. (2) 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 Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontract, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U. S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Families Forward CARES for Tenants Program (SRA2) Grantee/Contactor Organization Program Title l�radelyaaci�ceGre Madelynn Hirneise 03 / 08 / 2022 Name of Certifying Officer Signature 27 Date Document Ref. 0YPYR-0VGST-QPWKA-EGGA9 Page 31 of 48 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 of race, 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 funds 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'S responsibility for initiating the review process under Executive Order 12372. HIj Document Ref: OYPYR-OVGST-QPWKA-EGGA9 Page 32 of 48 EXHIBIT G DRUG -FREE WORKPLACE Certification Regarding Drug -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. (e) 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; wo Document Ref. 0YPYR-0VGST-QPWKA-EGGA9 Page 33 of48 (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 Performance" form. Families Forward Organization !'7d�1%uu �Grtele 03 / 08 / 2022 Authorized Signature Date 30 Document Ref: OYPYR OVGST-QPWKA-EGGA9 Page 34 of 48 PLACE OF PERFORMANCE FOR CERTIFICATION REGARDING DRUG -FREE WORKPLACE REQUIREMENTS Families Forward 3/8/2022 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): 8 Thomas, Irvine, Orange, CA 92618 2030 N. East 1st Street, Santa Ana, Orange, CA 92705 31 Document Ref. OYPYR-OVGST-QPWKA-EGGA9 Page 35 of 0 EXHIBIT H STATE OF CALIFORNIA STD 213 STANDARD AGREEMENT #21-ERAP-20081 STATE RENTAL ASSISTANCE PROGRAM - ROUND 2 (SRA2) 32 Document Ref: OYPYR-OVGST-QPWKA-EGGA9 Page 36 of 48 'CDA U 1 Return FULLY EXECUTED A-2021-238-01 (-ILdi3+uw✓1) Reset Form Print —Form SCOID: copy toCOTC,M-30 STATE OF CAUJFORNLA-DEPARTMENTOFGENERALSEFM STANDARDAGREEMENT AGR�liNUMBER PURCHASINGAUTHORnYNUMBER(HApp&aNe) STD213(Rev.09@020) 2 IV 1 HPL:1 M AL&N'r rWWit the California Department of Housing and Community Development IKAUIUKIWiMt of Santa Ana z 1 ne term or MIS Agreement Is: START DATE Upon the date of the Department representative's signature THROUGH END DATE Five years from the Start Date 3. The maximum amount of this Agreement is: $3,707.486.62 4. The parties agree to comply with the terms and conditions of the following exhibits, which are by this reference made a part of the Agreement. Exhibits Title Pages Exhibit A Authority, Purpose and Scope of Work 5 Exhibit B Budget Detail and Payment Provisions 1 Exhibit C ' State of California General Terms and Conditions 04f2017 Exhibit D State Rental Assistance Program - Round 2 - General Terms and Conditions 3 Exhibit E Special Terms and Conditions 1 Items shown with an asterisk (`), are hereby incorporated by reference and made part of this agreement as if attached hereto. CONTRACTOR CONTRACTOR NAME (if other than an individual, slate whether a corporation, partnership, etc.) City of Santa Ana CONTRACTOR BUSINESS ADDRESS CITY STATE IZIP 20 Civic Center Plaza I Santa Ana I CA 192702 PRINTED NAME OF PERSON SIGNING TITLE Kristine Ridge I City Manager CONTRACTOR AUTHORIZED SIGNATURE Appgved as to form: O. Hodge Assistant City Attorney ATTEST: � By:C��' City Clerk Document Ref. OYP1R-OVGST-OPWKA-EGGA9 Pagelof2 Page 37 of 48 ResetFann PrntForm SCOID: STATE OF C.AUFORNIA-DEPARTMINTOFGENERALSERACES- STANDARDAGREEMENT jxuEENw A-2021-238-01 CONTRACUNGAGENCYNAME - The California Department of Housing and Community Development CONTRACTING AGENCY ADDRESS CITY STATE ZIP 2020 West El Camino Avenue Sacramento CA 95833 PRINTED NAME OF PERSON SIGNING - TITLE Steven Del Rio Chief, Business and Contract Services Branch OONTRAC7nNGAGENCYAUR,1C ZEDSIGRkTLIRE DATE SIGNED Albl� (� 4{ --- 2/3/22 CALIFORNIA DEPARTMENT OF OENERAL SERVICES APPROVAL ExEMPTION(IfAppFcable) Exempt -per, SCM Vol. 1 4.04.A.3 (DGS memo dated 06/12/1981) Document Ref: 0YPYR-0VGST-QPWKA-EGGA9 Page2of2 Page 38 of 48 EXHIBIT A AUTHORITY, PURPOSE AND SCOPE OF WORK Authority City of Santa Ana 21-ERAP-20081 Page 1 of 5, On March 11, 2021, the American Rescue Plan Act of 2021 (Pub.L. No. 117-2) ("ARPA') was signed into law. Section 3201 of Subtitle B of Title III of ARPA established the federal Emergency Rental Assistance Program ("ERA2"), and authorized the direct allocation of emergency rental assistance funds to states, units of local governments, territories, and high -need grantees. The ERA2 funds are intended to assist households that are unable to pay rent and utilities during or due to the novel coronavirus disease (COVIDA9) pandemic. California Assembly Bill No. 832 (Chapter 27, Statutes of 2021) ("AB $32") established Round 2 of the State of California's program for administering its share of ERA2 funds (the "State Rental Assistance Program — Round 2," "SRA2," or "SRA2 Funds"). AB 832 amended Sections 50897, 50897.1, 50897.2, 50897.3, and 50897.4 of, and added Sections 50897.2.1 and 50897.3.1 to, the Health and Safety Code. Health and Safety Code section 50897.1, subdivision (a)(1) authorizes the Department of Housing and Community Development (the "Department") to administer the SRA2 Funds in accordance with state and federal law. The Department and the City of Santa Ana ("Locality") enter into this STD 213, Standard Agreement ("Agreement") under the authority and in furtherance of the State Rental Assistance Program — Round 2. This Agreement is governed by the following laws (collectively, the "Program Requirements"), and each of the following laws is hereby incorporated by reference and made a part hereof: A. AB 832, as enacted on June 28, 2021, and as such law may be subsequently amended; B, The Departments State Rental Assistance Program Guidelines — Emergency Rental Assistance (ERA) Rounds 1 and 2 Implementation, dated September 27, 2021 (the "Guidelines"), and as such Guidelines may be subsequently amended; C. ARPA and related federal guidance, and as such laws may be subsequently amended; and D. All other applicable law. State Rental Assistance Program — Round 2 Locality Allocation -Locality Administration (Option B) Locality: City of Santa Ana Approved:9130/2021 Prep Date: 12/3/2021 Document Ref: OYPYR-OVGST-QPWKA-EGGA9 Page 39 of 48 EXHIBIT A 2. Purpose City of Santa Ana 21-ERAP-20081 Page 2 of 5 The State Rental Assistance Program — Round 2 is an extension of the ERA2 and, as such, it is intended to provide Rental Assistance (as defined below) to eligible households. ' Pursuant to Section 3201 of Subtitle B of Title III of ARPA, the Locality received an allocation of ERA2 funds from the U.S. Department of the Treasury ("Treasury")•(this amount, and any and all additional trenches thereof, the Locality's "Direct Federal Allocation — 2"). Locality plans to administer its Direct Federal Allocation — 2 and acknowledges that the Direct Federal' Allocation — 2 is subject to the requirements of ARPA and Treasury interpretive guidance and to all such requirements as may be subsequently amended, Locality desires to receive an allocation of SRA2 Funds pursuant to Health and Safety Code section 50897.2.1, subdivision (a)(1) or (2) (this amount, and any and all additional tranches thereof, the Locality's "Block Grant Award —,2"). As authorized by Health and Safety Code section 50897.2.1, subdivision (a)(2), the Department may verify the Locality's operational readiness and capacity prior to and during Locality's utilization of the Block Grant Award — 2. If there are outstanding verification items, they are set forth at Exhibit E of this Agreement, and they must be addressed or satisfied, to the Department's reasonable satisfaction, before disbursements of the Block Grant Award — 2. By entering into this Agreement, Locality agrees to utilize its Direct Federal Allocation — 2 in compliance with the Program Requirements. Locality's failure to comply with this requirement may result in the Department recouping the Block Grant Award — 2 from the Locality. By entering into this Agreement, the Locality agrees to utilize its Block Grant Award — 2 in compliance'with the Program Requirements and the terms and conditions of this Agreement. Locality further agrees that it wilt distribute the Block Grant Award - 2 equitably and consistent with demonstrated need within its jurisdiction. Locality further agrees that it will not institute additional programmatic requirements that may inhibit participation in its program of Rental Assistance (as defined below). By entering into this Agreement, Locality agrees that it is solely responsible for compliance with all applicable management, implementation, and reporting requirements established under state and federal law. State Rental Assistance Program — Round 2 Locality Allocation -Locality Administration (Option 8) Locality: City of Santa Ana Approved: 9/30/2021 Prep Date: 12/312021 Document Ref: OYPYR-OVGST-OPWKA-EGGA9 Page 40 of 48 EXHIBIT A 3. . Definitions City of Santa Ana 21-ERAP-20081 Page 3 of 5 .Any terms that are not defined in this Agreement shall have the definitions set forth in the Program Requirements. In the event of any conflict, the definitions set forth in ARPA shall be controlling. A. "Department' means the Department of Housing and Community Development. B. "Locality" means the entity entering into this Agreement with the Department under the authority and in furtherance of the State Rental Assistance Program - Round 2. The Locality is also identified as "Contractor" on the form STD 213 portion of this Agreement. Furthermore, all obligations applicable to the. Contractor as set forth in Exhibit C hereof shall apply to Locality. C. "Rental Assistance" means payments of rental arrears; prospective rent payments; utilities, including arrears and prospective payments; and any other expenses related to housing, as defined by the Secretary of the Treasury. 4. Scone of Work A. Locality shall.administer its Direct Federal Allocation - 2 and Its Block Grant Award - 2 in accordance with the Program Requirements. B. Locality shall use its best efforts to prevent incidents of fraud and duplication of benefits during its administration of the Block Grant Award - 2. C. Locality shall apply the Block Grant Award - 2.funds towards the eligible uses and compensation requirements specified at Health and Safety Code section 50897.1 and, upon approval by the Department, the other eligible uses provided in Section 3201(d)(1)(D) of Subtitle B of Title III of ARPA. Locality shall use its best efforts to ensure that only eligible applicants receive Rental Assistance under this Agreement. Locality shall prioritize payments of Rental Assistance in accordance with the Program Requirements. D. Locality may use up to 10 percent of the Block Grant Award - 2 for housing. stability services (e.g., case management): provided that such use complies with the Program Requirements. E. Locality may use up to 13.5 percent of the Block Grant Award - 2 for administrative costs attributable to providing financial assistance, housing stability services, and other affordable rental housing and eviction prevention activities (e.g., data State Rental Assistance Program - Round 2 Locality Allocation -Locality Administration (Option B) Locality: City of Santa Ana Approved: 9/30/2021 Prep Date: 12/3/2021 Document Ref: QYPYR-QVGST-QP WKA-EGGA9 Page 41 of 48 City of Santa Ana 21-ERAP-20081 Page 4 of 5 EXHIBIT A collection and reporting requirements related to such funds). The funds may be used to cover both direct and Indirect administrative costs, F. Locality shall track its separate expenditures of its Direct Federal Allocation — 2 and its Block Grant Award —,2, and it shall maintain a clear accounting of same. G. Locality shall contractually obligate at least 75 percent of the first tranche of its Block Grant Award — 2 by October 31, 2021. Locality shalt contractually obligate 50 percent of ts'total Block Grant Award — 2 by January 31, 2022. If Locality flails to meet an obligation deadline, Locality shall repay to the Department the amount of the Block Grant Award — 2 that has not been contractually obligated or expended by that deadline. However, the Department may waive this repayment requirement if Locality demonstrates, to the Department's satisfaction, that Locality will contractually obligate and expend any unused Block Grant Award — 2 funds within the timeframes specified in federal law. K All Block Grant Award — 2 funds shall be expended timely and consistent with the Program Requirements, or the funds may be recaptured by the Department and reallocated to other jurisdictions, as authorized. All Block Grant Award — 2 funds are subject to the same reporting and. verification requirements specified at Section 501(g) of Subtitle A of Title Vof Division N of the federal Consolidated Appropriations Act, 2021 (Pub.L. No. 116-260). Locality shall, in addition, provide any other information that the Department deems necessary for purposes of the State Rental Assistance Program — Round 2, including, but not limited to, quarterly activity reports and weekly financial reports. Such reports shall be in form and substance satisfactory to the Department. J. Locality shall maintain records (e.g., work plans, operational documents, financial documents) sufficient to support compliance with the Program Requirements. The Department, the Treasury Office of Inspector General, and the Government Accountability Office, or their authorized representatives, shall have the right of access to such records (electronic and otherwise) in order to conduct audits or other investigations. Locality shall maintain such records for a period of five (5) years after the expiration of this Agreement. 5. State Rental Assistance Program — Round 2. Contract Management A. Department's Contract Coordinator. The Department's Contract Coordinator for this Agreement is the Program Manager of the State Rental Assistance Program — Round 2 in the Department's Division of Federal Financial Assistance, or that person's designee. Locality shall mail any notice, report, or other communication State Rental Assistance Program — Round 2 Locality Allocation -Locality Administration (Option 6) Locality: City of Santa Ana Approved: 9/30/2021 Prep Date: 1202021 Document Ref; 0YPYR-0VG$T-OPWKA-EGGA9 Page 42 of 48 City of Santa Ana 21-ERAP-20081 Page 5 of 5 EXHIBIT A required under this Agreement by First -Class Mail, through a commercial courier, or via electronic transmittal to the Department's Contract Coordinator at the addresses specified below. All other communication regarding this Agreement shall be directed to the Department's Contract Coordinator as appropriate. State Rental Assistance Program — Round 2 Attention: Contract Coordinator Division of Federal Financial Assistance Department of Housing and Community Development 2020 W. El Camino Avenue, 95833 R.O. Box 952054 Sacramento, CA 94252-2054 erap(a hcd.ca.gov B. Locality's Contract Coordinator. Locality's Contract Coordinator for this Agreement is identified below. Unless otherwise informed, the Department shall mail any notice, report, or other communication required under this Agreement by First -Class Mail, through a commercial courier, or via electronic transmittal to the Locality's Contract Coordinator at the addresses specified below. The Department will direct all other communication regarding this Agreement to the Locality's Contract Coordinator as appropriate. Judson Brown, Housing Division Manager Community Development Agency 20 Civic Center Plaza (M-26) Santa Ana, CA 92702 (714) 667-2241 jbrown @santa-ana,org State Rental Assistance Program — Round 2 Locality Allocation -Locality Administration (Option 6) Locality: City of Santa Ana Approved:9/30/2021 Prep Date: 12/3/2021 Document Ref: OYPYR-OVGST•QPWKA-EGGA9 Page 43 of 48 EXHIBIT B BUDGET DETAIL AND PAYMENT PROVISIONS .1. Budget Detail City of Santa Ana 21-ERAP-20081 Page 1 of 1 Locality has been awarded a Direct Federal Allocation - 2 and a Block Grant Award — 2 In the amounts specified at Exhibit E of this Agreement.. These amounts may be increased to the extent the Treasury makes additional tranches of funding available. The Department and the Locality ghall amend this -Agreement, as appropriate, to reflect . any increase in the Block Grant Award — 2. Upon satisfaction of the below Conditions of Performance, as well as any relevant conditions specified at Exhibit E of this Agreement, the Department shall make the Block Grant Award — 2 to the Locality by issuing a warrant payable to the Locality within 30 days of the execution date of this Agreement. The parties may agree in writing that, In lieu of a warrant, the Locality may, receive the Block Grant Award — 2 through an electronic funds transfer. 2. Conditions of Performance The Department will make the Block Grant Award — 2 to the Locality after this Agreement has been fully executed, and after the Department receives an authorizing resolution from the Locality that, in the Department's reasonable determination, -materially comports with the Program Requirements. 3. Reallocation of Unexpended Funds The Locality shall, consistent with Program Requirements, provide the Department a written accounting of its obligation and expenditure of all Block Grant Award -- 2 funds. The form, substance, and timing of this written accounting shall be determined by the Department in its reasonable discretion. The Locality shall thereafter cooperate with the Department's recapture and reallocation.of any unused funds, as authorized. State Rental Assistance Program — Round 2 Locality Allocation -Locality Administration (Option B) Locality: City of Santa Ana Approved: 9/30/2021 Prep Date: 12/312021 Document Ref: OYPYR-OVGST-QPWKA-EGGA9 Page 44 of 48 City of Santa Ana 21-ERAP-20081 Page 1 of 3 EXHIBIT D STATE RENTAL ASSISTANCE PROGRAM — ROUND 2 GENERAL TERMS AND CONDITIONS Effective Date, Term of Agreement, and Timing A. This Agreement, when fully executed by the Department and the Locality, is effective upon the date of the Department representative's signature on the STD 213, Standard Agreement (such date, the "Effective Date"). B. This Agreement shall terminate five (5) years after the Effective Date (such date, the "Expiration Date"). C. Locality shall make its best efforts to meet the obligation deadlines specified by this Agreement and the Program Requirements, to avoid the Department's recapture and reallocation of unobligated or unused funds, as authorized. D. All Block Grant Award — 2 funds shall be expended timely and. consistent with the Program Requirements, or the funds may be recaptured by the Department and reallocated to other jurisdictions, as authorized. 2. Termination for Cause The Department or the Locality may terminate this Agreement for cause at any time by giving at least fourteen (14) calendar days' advance written notice to the other party. Locality shall return any unexpended Block Grant Award — 2 funds plus all accrued interest to the Department within fourteen (14) calendar days of the date on the written notice of termination, unless (1) the parties have agreed upon an alternate arrangement in advance and in writing; or (ii) an alternate arrangement is necessary for one or both parties to remain in compliance with the ERA2, or applicable law. Cause shall consist of either party's violation of the Program Requirements, material breach of the Agreement, or failure to satisfy any of the terms or conditions of this Agreement. 3. Cancellation A. It is mutually understood between the parties that this Agreement may have been written for the mutual benefit of both parties before ascertaining the availability of congressional appropriation of funds to avoid program and fiscal delays that would occur if this Agreement were executed after that determination was made. State Rental Assistance Program — Round 2 Locality Allocation -Locality Administration (Option B) Locality: City of Santa Ana Approved: 9130/2021 Prep Date: 12l312021 Document Ref., 0YPYR-0VGST-QPWKA-EGGA9 Page 46 of 48 City of Santa Ana 21-ERAP-20081 Page 2 of 3 EXHIBIT D B. This Agreement. is valid and enforceable only if sufficient funds are made available to the State of California by the United States Government for fiscal years 2021-2022 through 2025-2026 for the purpose of emergency rental assistance. In addition, this Agreement is subject to any additional restrictions, limitations, or conditions enacted, by the Congress or to any statute enacted by the Congress that may affect the provisions, terms, orfunding of this Agreement in any manner. C. The parties mutually agree that if the Congress does not appropriate sufficient funds for the ERA2, this Agreement shall be amended to reflect any subsequent reduction in SRA2 funds. D. The Department may cancel this Agreement, in whole or in part, if (i) sufficient funds are not made available by the United States Government; (11) Congress enacts.any restrictions, limitations, or conditions that impact this Agreement or the funding of this Agreement; or (iii) cancellation is otherwise permitted under state contracting law. E. To cancel this Agreement pursuant to this paragraph, the Department shall give thirty (30) calendar days' advance written notice to the Locality. The Locality shall return any undisbursed portion of its Block Grant Award -• 2 to the Department within thirty (30) calendar days from the date on the Department's written notice of termination, unfess (1) the parties have agreed upon an alternate arrangement in advance and in writing; or (ii) an alternate arrangement is necessary for one or both parties to remain in compliance with the ERA2, the SRA2, or applicable law. 4. Termination Without Cause The Department may terminate this Agreement at any time, without cause, by providing thirty (30) calendar days' advance written notice to Locality. Locality shall return any unexpended Block Grant Award -- 2 funds to the Department within thirty (30) calendar days from the date on the Department's written notice of termination, unless (i) the parties have agreed upon an alternate arrangement in advance and in writing; or (11) an alternate arrangement is necessary for one or both parties to remain in compliance with the ERA2, the SRA2, or applicable law. 5. Entire Agreement; Severabillity This Agreement constitutes the entire agreement between the Department and the Locality. All prior representations, statements, negotiations and undertakings with regard to the subject matter hereof are superseded hereby. In the event any term or provision of this Agreement is deemed to be in violation of law, null and void, or otherwise of no force or effect, the remaining terms and provisions of this Agreement shall remain in full force and effect. State Rental Assistance Program — Round 2 Locality Allocation -Locality Administration (Option B) Locality: City of Santa Ana Approved: 9/3012021 Prep Date: 121312021 Document. Ref: OYPYR-OVGST-OP WKA-EGGA9 Page 46 of 48 6. Waivers 7. City of Santa Ana 21-ERAP-20081 Page 3 of 3 EXHIBIT D No waiver of any breach, violation of, or default under this Agreement shall be deemed to be a waiver of any other or subsequent breach or violation thereof or default thereunder. This Agreement is subject to the administrative requirements, cost principles, and audit requirements for federal awards to non—federal entities, which are set forth at 2 Code of Federal Regulations part 200. 11 8. Compliance with State and Federal Law The Department, the Locality, and their respective appointees, employees, contractors, and agents shall comply with all state and federal laws, statutes, regulations, guidelines, guidance, and executive orders in their performance under this Agreement. 9. Defense and Indemnification Locality acknowledges that it is an essential term of this Agreement that the Locality use its best efforts to prevent incidents of fraud and duplication of benefits during its administration of the Block Grant Award — 2. Locality agrees to indemnify, defend and save harmless the State of California, the Department, and their respective appointees, officers, agents, and employees from any and all claims and losses accruing or resulting from illegitimate or duplicative payments of Rental Assistance, whether resulting from the negligence, willful misconduct, intentional misrepresentation, negligent misrepresentation, or deceit of the applicants for the Rental Assistance, the Locality (or any of its appointees, officers, agents, and - employees), or any other third party. The foregoing obligations shall not apply to any " instance where the State of California, the Department, or their respective appointees, officers, agents, or employees commit the negligence, willful misconduct, Intentional misrepresentation, negligent misrepresentation, or deceit. State Rental Assistance Program — Round 2 Locality Allocation -Locality Administration (Option B) Locality: City of Santa Ana Approved: 9/30/2021 Prep Date: 12/3/2021 Document Rat OYPYR-OVGST-QPWKA-EGGA9 Page 47 of 48 City of Santa Ana 21-ERAP-20081 Page 1 of 1 EXHIBIT E SPECIAL TERMS AND CONDITIONS 1. Locality's Direct Federal Allocation — 2 and Block Grant Award — 2 Locality has received a Direct Federal Allocation — 2 in the amount $14,028,593.90. This amount is subject to increase if Treasury makes additional trenches. of ERA2 funds available. The Department is making a Block Grant Award — 2 to Locality in the amount of $3,707,486.62. This amount is subject to increase if Treasury makes additional tranches of ERA2 funds available, or if the Department reallocates funds as authorized. 2. The Locality and any of its contractors, subcontractors, successors, transferees, and assignees shall comply with Title VI of the Civil Rights Act of 1964, which prohibits recipients of federal financial assistance from excluding from a program or activity, denying benefits of, or otherwise discriminating against a person on the basis of race, color, br national origin (42 U.S.C. § 2000d et seq.), as implemented by the Treasury's Title VI regulations, 31 CFR Part 22, which are herein incorporated by reference and made a part bf this Agreement. Title VI also includes protection to persons with "Limited English Proficiency' in any program or activity receiving federal financial assistance, 42 U.S.C, § 2000d' et seq., as implemented by the Treasury's Title VI regulations, 31 CFR Part 22, and herein incorporated by reference and made.a part of this Agreement. 3. Additional statutes and regulations prohibiting discrimination are applicable to this Agreement and include, without limitation, the following: a. Title VI of the Civil Rights Act of 1964 (42 U.S.C. § 2000d et seq.) and Treasury's implementing regulations at 31 CFR Part 22; b. The Fair Housing Act, Title VII[ of the Civil Rights Act of 1968 (42 U.S.C. § 3601 et seq.); c. Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. § 794); d. The Age Discrimination Act of 1975, as amended (42 U.S.C. § 6101 et seq.); e. Title Il of the Americans with Disabilities Act of 1990, as amended (42 U.S.C. § 12101 et seq.); and f. The State of California nondiscrimination statutes, regulations, and standards set forth and identified at Exhibit C of this Agreement. State Rental Assistance Program — Round 2 Locality Allocation -Locality Administration (Option B) Locality: City of Santa Ana Approved: 10115/2021 Prep Date: 12/2112021 Document Ref: OYPYR-OVGST-QPWKA-EGGA9 Page 48 of 48 Signature Certificate Reference number OYPYR-OVGST-QPWKA-EGGA9 Signer Madelynn Himeise - Email: mhirneise@families-fbmard.org Sent: Viewed: Signed: Document completed by all parties on 09 Mar 2022 01:58:28. UTC Page 1 of 1 Timestamp 09 Mar 2022 01:33:09 UTC 09 Mar 2022 01:58:02 UTC 09 Mar 2022 01:58:28 UTC Signed with PandaDoc PandaDoc is a document workflow and certified eSignature solution trusted by 30,000+ companies worldwide. Signature Mafia �rizcerrre IP address: 70.187.177.79 Location: Laguna Niguel, United States Dlgblly signed by F,andne R. Francine R. Vlllare8}y(la m oak: 2021.07a2 1CA3S' oral• FAMIFOR-01 RTONG CERTIFICATE OF LIABILITY INSURANCE DAT 6/30/2021 V) 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, 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 endorsements . PRODUCER License# OM10410 Armstrong/Robitaille/Riegle Business and Insurance Solutions 830 Roosevelt, Suite 200 Irvine, CA 92620 CONTA AMENCT 'AIC No, Ext: (949) 381.7700 FAX, No :(949) 487-6151 EDORIES, arrinfo@aleragroup.com INSURERISI AFFORDING COVERAGE - NAIC H INSURER A: Phlladell2hla Indemnity Ins Co 18058 INSURED INSURER B:Com West Insurance Company 12177 INSURER C : Families Fomard INSURER D 8 Thomas - Irvine, CA 92618 ' INSURER E INSURERF: 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 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. ILTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ® OCCUR X PHPK2293752 71112021 711/2022 EACH OCCURRENCE $ 1,000,000 DAMAGETO RENTEDPREMISS d occurrence) $ 100 ggg MED EXP An one erson 20,000 PERSONAL& ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY❑ 3IR�OT [X] LOG GENERAL AGGREGATE $ 3,000,000 GENT - PRODUCTS - COMP/OP AGO $ 3/000/000 SEXUALABUSE 1,000,000 OTHER A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Bf.riff$ 1,000,000 BODILY INJURY Perperson) $ X ANY AUTO PHPK2293752 711/2021 71112022 OWNED SCHEDULED AUTOS ONLY AUTOS BODILYBOODILY INJURY Per accident $ X AUT030NLY X AUUTOS ONLY f-0accldea AMADE $ A UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 F1 AGGREGATE $ 4,000,000 X EXCESS L CLAIMS -MADE PHUB774554 711/2021 71112022 LED I X RETENTION$ 10,000 B WORKERS COMPENSATION ANDEMPLOVERS'LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE ❑ FFFICCEqq(MEMBER EXCLUDED? �Mantlatory In NH) Ifna, describe under DESCRIPTION OF OPERATIONS below NIA WCV550516100 711/2021 7/112022 X PER OTH- ER E. L. EACH ACCIDENT 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 A Professional (E&O) PHPK2293752 71112021 71112022 Occurrence 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If mote space Is Decal red) The City of Santa Ana, its officers, employees, agents, and representatives are named as Additional Insured on Primary and Non-C ontri bory basis with respect to General Liability coverage per attached forms as requlred In a written contract, agreement, or memorandum of understanding. 30 Days Cancellation Notice unless 10 Days for Non -Payment. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Risk Management Division ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVE .I s , N WeltMa&APPR2OVED .„�,� fienEvrEn&APPIt(DVED S 1'a1c4•a?` ACORD 25 (2016/03) ©1988-2015 ACORD C r - The ACORD name and logo are registered marks of ACORD - Blsk MalkgotncnEFlnll Policy Number: PHPK2293752 PI-GLD-HS (10/11) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY DELUXE ENDORSEMENT: HUMAN SERVICES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE It is understood and agreed that the following extensions only apply in the event that no other specific coverage for the indicated loss exposure is provided under this policy. If such specific coverage applies, the terms, conditions and limits of that coverage are the sole and exclusive coverage applicable under this policy, unless otherwise noted on this endorsement. The following is a summary of the Limits of Insurance and additional coverages provided by this endorsement. For complete details on specific coverages, consult the policy contract wording. Coverage Applicable Limit of Insurance Page # Extended Property Damage Included 2 Limited Rental Lease Agreement Contractual Liability $50,000 limit 2 Non -Owned Watercraft Less than 58 feet 2 Damage to Property You Own, Rent, or Occupy $30,000 limit 2 Damage to Premises Rented to You $1,000,000 3 HIPAA - Clarification 4 Medical Payments $20,000 5 Medical Payments — Extended Reporting Period 3 years 5 Athletic Activities Amended 5 Supplementary Payments — Bail Bonds $5,000 5 Supplementary Payment — Loss of Earnings $1,000 per day 5 Employee Indemnification Defense Coverage $25,000 5 Key and Lock Replacement —Janitorial Services Client Coverage $10,000limit 6 Additional Insured — Newly Acquired Time Period Amended 6 Additional Insured — Medical Directors and Administrators Included 7 Additional Insured — Managers and Supervisors (with Fellow Employee Coverage) Included 7 Additional Insured — Broadened Named Insured Included 7 Additional Insured — Funding Source Included 7 Additional Insured — Home Care Providers Included 7 Additional Insured —Managers, Landlords, or Lessors of Premises Included 7 Additional Insured — Lessor of Leased Equipment Included 7 Additional Insured — Grantor of Permits Included 8 Additional Insured — Vendor Included 8 Additional Insured — Franchisor Included 9 Additional Insured —When Required by Contract Included 9 Additional Insured — Owners, Lessees, or Contractors Included 9 Additional Insured — State or Political Subdivisions Included 10 Page 1 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its pe R6k piv6b © 2011 Philadelphia Indemnity Insurance Company kf, P1MeWo&�AvrxovW0Y. rtxk IH,artac},�ment etn atyst. PI-GLD-HS (10/11) Duties in the Event of Occurrence, Claim or Suit Included 10 Unintentional Failure to Disclose Hazards Included 10 Transfer of Rights of Recovery Against Others To Us Clarification 10 Liberalization Included 11 Bodily Injury — includes Mental Anguish .. Included 11 Personal and Advertising Injury — Includes Abuse of Process, Discrimination Included 11 A. Extended Property Damage SECTION I — COVERAGES, COVERAGE BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph a. is deleted in its entirety and replaced by the following: a. Expected or Intended Injury "Bodily injury" or property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. B. Limited Rental Lease Agreement.Contractual Liability SECTION I — COVERAGES, COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph b. Contractual Liability is amended to include the following: (3) Based on the named insured's request at the time of claim, we agree to indemnify the named insured for their liability assumed in a contract or agreement regarding the rental or lease of a premises on behalf of their client, up to $50,000. This coverage extension only applies to rental lease agreements. This coverage is excess over any renter's liability insurance of the client. C. Non -Owned Watercraft SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph g. (2) is deleted in its entirety and replaced by the following: (2) A watercraft you do not own that is: (a) Less than 58 feet long; and (b) Not being used to carry persons or property for a charge; This provision applies to any person, who with your consent, either uses or is responsible for the use of a watercraft. This insurance is excess over any other valid and collectible insurance available to the insured whether primary, excess or contingent. D. Damage to Property You Own, Rent or Occupy SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE Page 2 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its pei © 2011 Philadelphia Indemnity Insurance Company ftk AeVi'vreo�xrnt .. 8.� s e.lExnrx( ask bier�c�gemgrR.ynnV,{it.. _ PI-GLD-HS (10/11) LIABILITY, Subsection 2. Exclusions, Paragraph j. Damage to Property, Item (1) is deleted in its entirety and replaced with the following: (1) Property you own, rent, or occupy, including any costs or expenses incurred by you, or any other person, organization or entity, for repair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to another's property, unless the damage to property is caused by your client, up to a $30,000 limit. A client is defined as a person under your direct care and supervision. E. Damage to Premises Rented to You 1. If damage by fire to premises rented to you is not otherwise excluded from this Coverage Part, the word "fire" is changed to "fire, lightning, explosion, smoke, or leakage from automatic fire protective systems" where it appears in: a. The last paragraph of SECTION I —COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions; is deleted in its entirety and replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in SECTION III —LIMITS OF INSURANCE. b. SECTION III — LIMITS OF INSURANCE, Paragraph 6. is deleted in its entirety and replaced by the following: Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems while rented to you or temporarily occupied by you with permission of the owner. c. SECTION V — DEFINITIONS, Paragraph 9.a., is deleted in its entirety and replaced by the following: A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract"; 2. SECTION IV— COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. Other Insurance, Paragraph b. Excess Insurance, (1) (a) (ii) is deleted in its entirety and replaced by the following: That Is insurance for fire, lightning, explosion, smoke, or leakage from automatic fire protective systems for premises rented to you or temporarily occupied by you with permission of the owner; 3. The Damage To Premises Rented To You Limit section of the Declarations is amended to the greater of: Page 3 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its pe 2 gpttielimmagzmmiDMston ©2011 Philadelphia Indemnity Insurance Company REVIEWED& APPROVER BY:: Rhk�azm�yeiro�nrtlualyst- PI-GLD-HS (10/11) a. $1,000,000; or b. The amount shown in the Declarations as the Damage to Premises Rented to You Limit. This is the most we will pay for all damage proximately caused by the same event, whether such damage results from fire, lightning, explosion, smoke, or leaks from automatic fire protective systems or any combination thereof. F. HIPAA SECTION I — COVERAGES, COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY is amended as follows: 1. Paragraph 1. Insuring Agreement is amended to include the following: We will pay those sums that the insured becomes legally obligated to pay as damages because of a "violation(s)" of the Health Insurance Portability and Accountability Act (HIPAA). We have the right and the duty to defend the insured against any "suit," "investigation," or "civil proceeding" seeking these damages. However, we will have no duty to defend the insured against any "suit' seeking damages, "investigation," or "civil proceeding" to which this insurance does not apply. 2. Paragraph 2. Exclusions is amended to include the Following additional exclusions: This insurance does not apply to: a. Intentional, Willful, or Deliberate Violations Any willful, intentional, or deliberate "violation(s)" by any insured. b. Criminal Acts Any "violation" which results in any criminal penalties under the HIPAA. c. Other Remedies Any remedy other than monetary damages for penalties assessed. d. Compliance Reviews or Audits Any compliance reviews by the Department of Health and Human Services. 3. SECTION V — DEFINITIONS is amended to include the following additional definitions: a. "Civil proceeding" means an action by the Department of Health and Human Services (HHS) arising out of "violations." b. "Investigation" means an examination of an actual or alleged "violation(s)" by HHS. However, "investigation" does not include a Compliance Review. c. "Violation" means the actual or alleged failure to comply with the regulations included in the HIPAA. Page 4 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its pe "M*Wganentmisim © 2011 Philadelphia Indemnity Insurance Company }gREMeNeo&APppP.ROVEDeY: RiSRCSQi1rld�JW�T1&0[Fj11eYkXSI. PI-GLD-HS (10/11) G. Medical Payments — Limit Increased to $20,000, Extended Reporting Period If COVERAGE C MEDICAL PAYMENTS is not otherwise excluded from this Coverage Part: 1. The Medical Expense Limit is changed subject to all of the terms of SECTION III - LIMITS OF INSURANCE to the greater of: a. $20,000; or b. The Medical Expense Limit shown in the Declarations of this Coverage Part. 2. SECTION I — COVERAGE, COVERAGE C MEDICAL PAYMENTS, Subsection 1. Insuring Agreement, a. (3) (b) is deleted in its entirety and replaced by the following: (b) The expenses are incurred and reported to us within three years of the date of the accident. H. Athletic Activities SECTION I — COVERAGES, COVERAGE C MEDICAL PAYMENTS, Subsection 2. Exclusions, Paragraph e. Athletic Activities is deleted in its entirety and replaced with the following: e. Athletic Activities To a person injured while taking part in athletics. I. Supplementary Payments SECTION I — COVERAGES, SUPPLEMENTARY PAYMENTS - COVERAGE A AND B are amended as follows: 1. b. is deleted in its entirety and replaced by the following: 1. b. Up to $5000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these. 1.d. is deleted in its entirety and replaced by the following: 1. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit', including actual loss of earnings up to $1,000 a day because of time off from work. J. Employee Indemnification Defense Coverage SECTION I — COVERAGES, SUPPLEMENTARY PAYMENTS — COVERAGES A AND B the following is added: We will pay, on your behalf, defense costs incurred by an "employee" in a criminal proceeding occurring in the course of employment. The most we will pay for any "employee" who is alleged to be directly involved in a criminal proceeding is $25,000 regardless of the numbers of "employees," claims or "suits" brought or persons or organizations making claims or bringing "suits. Page 5 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its peil luak �q, © 2011 Philadelphia Indemnity Insurance Company REwEwEMD&AP ovEQu BY. tiRSR�iitkl4etnGttt F1n71xtf. PI-GLD-HS (10/11) K. Key and Lock Replacement — Janitorial Services Client Coverage SECTION I — COVERAGES, SUPPLEMENTARY PAYMENTS — COVERAGES A AND B is amended to include the following: We will pay for the cost to replace keys and locks at the "clients" premises due to theft or other loss to keys entrusted to you by your "client," up to a $10,000 limit per occurrence and $10,000 policy aggregate. We will not pay for loss or damage resulting from theft or any other dishonest or criminal act that you or any of your partners, members, officers, "employees", "managers", directors, trustees, authorized representatives or any one to whom you entrust the keys of a "client" for any purpose commit, whether acting alone or in collusion with other persons. The following, when used on this coverage, are defined as follows: a. "Client" means an individual, company or organization with whom you have a written contract or work order for your services for a described premises and have billed for your services. b. "Employee" means: (1) Any natural person: (a) While in your service or for 30 days after termination of service; (b) Who you compensate directly by salary, wages or commissions; and (c) Who you have the right to direct and control while performing services for you; or (2) Any natural person who is furnished temporarily to you: (a) To substitute for a permanent "employee" as defined in Paragraph (1) above, who is on leave; or (b) To meet seasonal or short-term workload conditions; while that person is subject to your direction and control and performing services for you. (3) "Employee" does not mean: (a) Any agent, broker, person leased to you by a labor leasing firm, factor, commission merchant, consignee, independent contractor or representative of the same general character; or (b) Any "manager," director or trustee except while performing acts coming within the scope of the usual duties of an "employee." c. "Manager" means a person serving in a directorial capacity for a limited liability company. L. Additional Insureds SECTION II — WHO IS AN INSURED is amended as follows: 1. If coverage for newly acquired or formed organizations is not otherwise excluded from this Page 6 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its pal Ri9kMmWmal0wim © 2011 Philadelphia Indemnity Insurance Company ��, p8enerEo&Arreova>Bv; Nirlc Miou19Q mer,c €t7lkyst. PI-GLD-HS (10/11) Coverage Part, Paragraph 3.a. is deleted in its entirely and replaced by the following: a. Coverage under this provision is afforded until the end of the policy period. 2. Each of the following is also an insured: a. Medical Directors and Administrators — Your medical directors and administrators, but only while acting within the scope of and during the course of their duties as such. Such duties do not include the furnishing or failure to furnish professional services of any physician or psychiatrist in the treatment of a patient. b. Managers and Supervisors — Your managers and supervisors are also insureds, but only with respect to their duties as your managers and supervisors. Managers and . supervisors who are your "employees" are also insureds for "bodily injury" to a co - "employee" while in the course of his or her employment by you or performing duties related to the conduct of your business. This provision does not change Item 2.a.(1)(a) as it applies to managers of a limited liability company. c. Broadened Named Insured — Any organization and subsidiary thereof which you control and actively manage on the effective date of this Coverage Part. However, coverage does not apply to any organization or subsidiary not named in the Declarations as Named Insured, if they are also insured under another similar policy, but for its termination or the exhaustion of its limits of insurance. d. Funding Source —Any person or organization with respect to their liability arising out of: (1) Their financial control of you; or (2) Premises they own, maintain or control while you lease or occupy these premises. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. a. Home Care Providers — At the first Named Insured's option, any person or organization under your direct supervision and control while providing for you private home respite or foster home care for the developmentally disabled. f. Managers, Landlords, or Lessors of Premises — Any person or organization with respect to their liability arising out of the ownership, maintenance or use of that part of the premises leased or rented to you subject to the following additional exclusions: This insurance does not apply to: (1) Any "occurrence" which takes place after you cease to be a tenant in that premises; or (2) Structural alterations, new construction or demolition operations performed by or on behalf of that person or organization. g. Lessor of Leased Equipment— Automatic Status When Required in Lease Agreement With You —Any person or organization from whom you lease equipment when you and such person or organization have agreed in writing in a contract or agreement that such person or organization is to be added as an additional insured on your policy. Such person or Page 7 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its pe RmkMwagxnentDtvismn © 2011 Philadelphia Indemnity Insurance Company i Reme"osAPexovmsP; PI-GLD-HS (10/11) organization is an insured only with respect to liability for "bodily injury," "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person or organization. A person's or organization's status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. h. Grantors of Permits — Any state or political subdivision granting you a permit in connection with your premises subject to the following additional provision: (1) This insurance applies only with respect to the following hazards for which the state or political subdivision has issued a permit in connection with the premises you own, rent or control and to which this insurance applies: (a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners or decorations and similar exposures; (b) The construction, erection, or removal of elevators; or (c) The ownership, maintenance, or use of any elevators covered by this insurance. I. Vendors — Only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business, subject to the following additional exclusions: (1) The insurance afforded the vendor does not apply to: (a) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; (b) Any express warranty unauthorized by you; (c) Any physical or chemical change in the product made intentionally by the vendor; (d) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; (a) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; (f) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; Page 8 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its pei © 2011 Philadelphia Indemnity Insurance Company s RteloMmagamaDh'lslon. � r p& Re Mu & APPR0vM 8Y: - RkR WSafl�gell�gaSRnA[gs1,. PI-GLD-HS (10/11) (g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or (h) 'Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (1) The exceptions contained in Sub -paragraphs (d) or (f); or (i1) Such inspections, adjustments, tests or servicing as the vendor has agreed to. make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. (2) This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing. j. Franchisor — Any person or organization with respect to their liability as the grantor of a franchise to you. k. As Required by Contract — Any person or organization where required by a written contract executed prior to the occurrence of a loss. Such person or organization is an additional insured for "bodily injury," "property damage" or "personal and advertising injury" but only for liability arising out of the negligence of the named insured. The limits of insurance applicable to these additional insureds are the lesser of the policy limits or those limits specified in a contract or agreement. These limits are included within and not in addition to the limits of insurance shown in the Declarations I. Owners, Lessees or Contractors — Any person or organization, but only with respect to liability for "bodily injury," "property damage" or "personal and advertising injury" caused, in whole or in part, by: (1) Your acts or omissions; or (2) The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured when required by a contract. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: (a) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (b) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. Page 9 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its peAM © 2011 Philadelphia Indemnity Insurance Company PI-GLD-HS (10111) m. State or Political Subdivisions — Any state or political subdivision as required, subject to the following provisions: (1) This insurance applies only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit, and is required by contract. (2) This insurance does not apply to: (a) "Bodily injury," "property damage" or "personal and advertising injury" arising out of operations performed for the state or municipality; or (b) "Bodily injury" or "property damage" included within the "products -completed operations hazard." M. Duties in the Event of Occurrence, Claim or Suit SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 2. is amended as follows: a. is amended to include: This condition applies only when the "occurrence" or offense is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; or (3) An executive officer or insurance manager, if you are a corporation. b. is amended to include: This condition will not be considered breached unless the breach occurs after such claim or "suit" is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; or (3) An executive officer or insurance manager, if you are a corporation. N. Unintentional Failure To Disclose Hazards SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, 6. Representations is amended to include the following: It is agreed that; based on our reliance on your representations as to existing hazards, if you should unintentionally fail to disclose all such hazards prior to the beginning of the policy period of this Coverage Part, we shall not deny coverage under this Coverage Part because of such failure. O. Transfer of Rights of Recovery Against Others To Us SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, 8. Transfer of Rights of Page 10 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its pe , " rsskMmegmwtoWswn © 2011 Philadelphia Indemnity Insurance Company ri Rens\"a&pAPern�rrvEOft ' RRkMartafkaMMtAvriyit. PI-GLD-HS (10/11) Recovery Against Others To Us is deleted in its entirety and replaced by the following: If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. Therefore, the insured can waive the insurer's rights of recovery prior to the occurrence of a loss, provided the waiver is made in a written contract. P. Liberalization SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, is amended to include the following: If we revise this endorsement to provide more coverage without additional premium charge, we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state. Q. BodilyInjury— MentalAnguish SECTION V — DEFINITIONS, Paragraph 3. Is deleted in its entirety and replaced by the following: "Bodily injury" means: a. Bodily injury, sickness or disease sustained by a person, and includes mental anguish resulting from any of these; and b. Except for mental anguish, includes death resulting from the foregoing (Item a. above) at any time. R. Personal and Advertising Injury — Abuse of Process, Discrimination If COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY COVERAGE is not otherwise excluded from this Coverage Part, the definition of "personal and advertising injury" is amended as follows: 1. SECTION V — DEFINITIONS, Paragraph 14.b. is deleted in its entirety and replaced by the following: b. Malicious prosecution or abuse of process; 2. SECTION V— DEFINITIONS, Paragraph 14. is amended by adding the following: Discrimination based on race, color, religion, sex, age or national origin, except when: a. Done intentionally by or at the direction of, or with the knowledge or consent of: (1) Any insured; or (2) Any executive officer, director, stockholder, partner or member of the insured; b. Directly or indirectly related to the employment, former or prospective employment, termination of employment, or application for employment of any person or persons by an insured; Page 11 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its Pei, RtekM DMIs2m © 2011 Philadelphia Indemnity Insurance Company, RensWEo&�ov¢r9'r:: � Fi 1"rlE ganentAfk iyU PI-GLD-HS (10/11) c. Directly or indirectly related to the sale, rental, lease or sublease or prospective sales, rental, lease or sub -lease of any room, dwelling or premises by or at the direction of any insured; or d. Insurance for such discrimination is prohibited by or held in violation of law, public policy, legislation, court decision or administrative ruling. The above does not apply to fines or penalties imposed because of discrimination. Page 12 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its pe Rlekldanagmentuvtelon © 2011 Philadelphia Indemnity Insurance Company s\; REms"D&APPRovsoft, Rtsx teraaa�cmans An�trys( Policy Number: PHPK2293752 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. CG 20 01 0413 © Insurance Services Office, Inc., 2012 RtekManxgrnmEDtviatmi REVEWE66/tPPRQVfL76r: IT rye P, k" Rule Ma ruz�em�t7 [Ana�^�t WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 03 13 C (Ed. 7-09) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT — CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be $ 500 Schedule Any person or organization that you perform work for that is liable for an injury, covered by this policy, that prior to the injury has written contract requiring a waiver of our right to recover from them. Person or Organization Job Description This endorsement changes the policy to which It is attached and is effective on the date Issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 07/01/2021 Policy No.WCV 5505161 Endorsement No. 000 Insured FAMILIES FORWARD, INC. Insurance Company COMPWEST INSURANCE COMPANY Countersigned by WC 99 03 13 C Ig�ht` lEd.WC 7-09) Policy Number: PHPK2293752 PI-CA-004 10/14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON-CONTRIBUTORY CLAUSE ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM The following is added to SECTION IV -BUSINESS AUTO CONDITIONS, B. General Conditions, 5. Otherinsurance: The insurance provided by this policy for any additional insured endorsement attached to this policy is primary when primary coverage is required in a written contract. In addition, we will not seek contribution from any insurer when insurance on a non-contributing basis is required in a written contract for any additional insured endorsement attached to this policy. For coverage to apply, the written contract must have been executed prior to the occurrence of "loss. This endorsement supersedes anything to the contrary. Page 1 of 1 ©2014 Philadelphia Consolidated Holding Corp. ,� .„� iitukManagemsnttllvtcimt REAEmD&APPROVEDBY:oe Rrxk htanas��m�F�[.nn�4yst