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HomeMy WebLinkAboutLATINO HEALTH ACCESS (4)DocuSign Envelope ID: 098D4B61-B495-429F-BABC-oAF46D368454 A-2022-069-09 INSURANCE ON FILL WORK MAY PROCEED UNTIL INSURANCE EXPIRES �•5 •22 CLERK OF COUNCIL AGREEMENT BETWEEN THE CITY OF SANTA ANA AND DATE: LATINO HEALTH ACCESS FOR USE OF AMERICAN RESCUE PLAN ACT (ARPA) FUNDS 6 �•PRCSACFfUs/1G�SLO hiC��1.. This Agreement is hereby made and entered into this 3rd day of May, 2022, by and between the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California ("CITY"), and Latino Health Access, a California domestic nonprofit corporation ("SUBRECIPIENT" or "CONTRACTOR"). RECITALS: A. The American Rescue Plan Act ("ARPA") was signed into law in March 2021. ARPA provides funding for a number of different programs, including the Coronavirus State and Local Fiscal Recovery Fund ("SLFRF"), to provide monetary support to local governments to respond to, mitigate, and recover from the COVID-19 public health emergency. B. On July 20, 2021, the Santa Ana City Council authorized the City Manager to utilize ARPA SLFRF funding from the United States Department of Treasury for the Revive Santa Ana Spending Plan, which includes five spending categories: recovery from the pandemic, direct assistance programs, public health and safety, critical infrastructure, and city fiscal health. C. SUBRECIPIENT has been selected by the CITY to receive ARPA SLFRF Funds in order to provide youth programs, including: early childhood support; head start; day care; after school tutoring; athletic; and, youth violence prevention, 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 ARPA's objectives to respond to, mitigate, and recover from this historic COVID-19 public health crisis. D. SUBRECIPIENT agrees that it will adhere to the tasks and services as indicated in Exhibit A for said program. 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 ARPA PROGRAM PROVISIONS A. Scone 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 tasks and services as described in the Scope of Work attached hereto as Exhibit A. SUBRECIPIENT's failure DocuSign Envelope ID: 098D4B61-B495-429F-BABC-OAF46D368454 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. ement. Term of A eement. The term of said Agreement shall commence on July 1st, 2022, and continue through June 30, 2023 ("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 ARPA SURF Funds were awarded to the CITY. Additionally, the Term of this Agreement may be extended by a writing executed by the City Manager, or designee, and the City Attorney. C. Amount of Grant Funding. The total amount of funds provided for said program shall not exceed One Hundred Twenty -Five Thousand Dollars and Zero Cents ($125,000) ("ARPA SURF Funds") during the Term of the Agreement. SUBRECIPIENT agrees to use said ARPA SURF Funds to administer said program as outlined in Exhibit A. D. Disbursement of Funds. Said ARPA SURF Funds shall be disbursed by CITY to SUBRECIPIENT pursuant to the terms found in the Fee Payment Schedule 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 ARPA SURF Funds, or return the entire request to SUBRECIPIENT, until such documentation and reporting has been received and approved by CITY. (1) Reduction in ARPA SLFRF Funding. The CITY reserves the right to reduce the amount of ARPA SURF Funds to SUBRECIPIENT, or to completely terminate this Agreement, in the CITY's sole discretion, if there is a reduction in ARPA SURF 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 utilized during the Term of this Agreement, and that any and all funds remaining as of the end of the Term, which have not been utilized, shall be returned by 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. 2 DocuSign Envelope ID: 096D4B61-B495-429F-BABC-OAF46D368454 E. Grant Program Requirements. (1) SUBRECIPIENT acknowledges that the source of funding for said program is the federal ARPA, and that payments from the ARPA SURF Funds are only to be used to make necessary expenditures incurred due to the public health emergency with respect to COVID-19. (2) SUBRECIPIENT acknowledges that ARPA provisions allow the use of ARPA SURF Funds to respond to, mitigate, and recover from the COVID-19 public health emergency, and will not use these finds for any other uses. (3) SUBRECIPIENT shall follow the process and determination of eligibility for participants in said program as outlined in Exhibit A. F. Performance Monitoring. (1) SUBRECIPIENT shall submit program performance information as often as requested by CITY, but no less than the submission of monthly reports and a final report to CITY with the information requested by and in the format acceptable to CITY. Each monthly report is due within thirty (30) days of completion of work for each month. 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 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 terms 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. DocuSign Envelope ID: 098D4B61-B495-429F-BABC-OAF460368454 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 ARPA regulations. (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 ARPA SLFRF 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 ARPA SLFRF 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 4 DocuSlgn Envelope ID: 096D4B61-B495-429F-BABC-OAF46D366454 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. I. Close -Out. SUBRECIPIENT agrees to comply with the closeout procedures detailed in 2 CFR §200.343, including the following: (1) SUBRECIPIENT must submit, no later than ninety (90) calendar days after the end date of the period of performance, all financial, performance, and other reports as required by the terms and conditions of 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 Federal award no later than one year after receipt and acceptance of all required final reports. II. SUBRECIPIENT'S OBLIGATIONS A. Representations and Warranties. (1) Authority. SUBRECIPIENT is a duly organized and existing domestic nonprofit corporation 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. DocuSign Envelope ID: 098D4B61-B495-429F-BABC-OAF46D368454 (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 proposal submitted to CITY, including any exhibits, are true and correct in all material respects. (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. 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 ARPA SLFRF Funds; provided however, the SUBRECIPIENT must be able to account for receipt, obligation, distribution and expenditure of ARPA SLFRF 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 I of the year following the program year in which this Agreement is executed. 6 DocuSign Envelope ID: 098D4B61-B495429F-BABC-OAF46D368454 F. Compliance with Law/Program Income. SUBRECIPIENT acknowledges that the funds being provided by CITY for said program are received by CITY pursuant to ARPA, and that distribution and expenditure of these ARPA SURF Funds shall be in accordance with ARPA and all pertinent regulations issued by agencies of the federal government, including, but not limited to, all regulations found at Title 24 of the Code of Federal Regulations. Any program income received by SUBRECIPIENT shall be returned to CITY, unless otherwise provided for in this Agreement. SUBRECIPIENT agrees to comply fully with all federal, state and local laws and court orders applicable to its operation and administration of said program, whether or not referred to in this 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 D "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. J. Violation of Terms and Conditions. SUBRECIPIENT agrees that if SUBRECIPIENT violates any of the terms and conditions of this Agreement or any prior Agreement whereby ARPA SURF 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 ARPA SURF 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. SUBRECMENT shall immediately report all suspected or known instances and facts concerning possible fraud, abuse or criminal activity related to said program for the ARPA SURF Funds under this Agreement. 7 DocuSlgn Envelope ID: 098D4B61-B495-429F-BABC-OAF46D368454 L. Prohibited Use. SUBRECIPIENT hereby certifies and agrees that it will not use ARPA SLFRF Funds provided through this Agreement to pay for entertainment, meals or gills, or other prohibited uses. M. Lobbvina. SUBRECIPIENT certifies that it will comply with federal law (31 U.S.C. 1352) and regulations found at 24 CFR Part 87, which provide that no appropriated funds may be expended by the recipient of a federal contract, grant, loan or cooperative agreement to pay any person for influencing or attempting to influence an officer or employee of any agency, Member of Congress, or an officer or employee of a Member of Congress in connection with awarding of any federal contract, the making of any federal grant or loan, entering into any cooperative agreement and the extension, renewal, amendment or modification of any federal contract, grant, loan or cooperative agreement. SUBRECIPIENT shall sign a certification to that effect in a form as set forth in Exhibit E, 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 E). 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. DocuSign Envelope ID: 098D4B61-B495-429F-BABC-OAF46D368454 P. Equal Em llooyment Opportunities. SUBRECIPIENT shall make every effort to ensure that all projects funded wholly or in part by ARPA SLFRF 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 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 F 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 ARPA SLFRF 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 E DocuSign Envelope ID; 098D4B61-B495-429F-BABC-OAF46D368454 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. 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 SUBRECIPIENT 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 subject to discrimination under any program of activity receiving federal financial assistance. 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. 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 10 DocuSign Envelope ID: 098D4B61-B495-429F-BABC-OAF46D368454 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 570.6t1 and 2 CFR 200.112, SUBRECIPIENT certifies that no member, officer, employee, agent or assignee of CITY having direct or indirect control of any ARPA SLFRF Funds granted to the CITY, inclusive of the subject ARPA SLFRF 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 ARPA SLFRF 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 SUBRECIPIENT agrees to provide under the terms of this Agreement on the basis of religion and shall not limit such services or give preference to applicants for such services on the basis 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, ARPA SLFRF 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 ARPA expenditure for rendering the services under said program. 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 SUBRECIPICNT. For the purposes of this 11 DocuSign Envelope ID: 098D4B61-B495-429F-BABC-OAF46D368454 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 Lisa Rudloff Executive Director Parks, Recreation and Community Services Agency 20 Civic Center Plaza TO SUBRECIPIENT: P.O. Box 1988 Santa Ana, California 92702-1988 Latino Health Access America Bracho Chief Executive Officer 450 W 41b St, Ste 130 Santa Ana, CA 92701-4562 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. Contractor shall procure and maintain for the duration of the contract insurance against claims for injuries to persons or damages to property which may arise from or in connection with 12 DocuSign Envelope ID: 098D4B61-B495-429F-BABC-OAF46D368454 the performance of the work hereunder and the results of that work by the Contractor, its agents, representatives, employees, or subcontractors. a. MINIMUM SCOPE AND LIMIT OF INSURANCE Coverage shall beat least as broad as: 1. Commercial General Liability (CGL): Insurance Services Office Form CG 00 O1 covering CGL on an "occurrence" basis, including products and completed operations, property damage, bodily injury and personal & advertising injury with limits no less than $2,000,000 per occurrence. If a general aggregate limit applies, either the general aggregate limit shall apply separately to this project/location (ISO CG 25 03 or 25 04) or the general aggregate limit shall be twice the required occurrence limit. 2. Automobile Liability: Insurance Services Office Form Number CA 0001 covering, Code 1 (any auto), or if Contractor has no owned autos, Code 8 (hired) and 9 (non -owned), with limit no less than $1,000,000 (if program services includes transportation of youth, the limit shall be no less than $5,000,000) per accident for bodily injury and property damage. (Not required if an automobile is not required to fulfill services.) 3. Workers' Compensation. insurance as required by the State of California, with Statutory Limits, and Employer's Liability Insurance with limit of no less than $1,000,000 per accident for bodily injury or disease. 4. Sexual Abuse or Molestation (SAM) Liability: If the CGL policy referenced above is not endorsed to include affirmative coverage for sexual abuse or molestation, Contractor shall obtain and maintain a policy covering Sexual Abuse and Molestation with a limit no less than $1,000,000 per occurrence or claim. 5. If the Contractor maintains broader coverage and/or higher limits than the minimums shown above, the City requires and shall be entitled to the broader coverage and/or the higher limits maintained by the Contractor. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to the City. b. Other Insurance Provisions — The insurance policies are to contain, or be endorsed to contain, the following provisions: 1. Additional Insured Status: The City, its officers, officials, employees, and volunteers are to be covered as additional insureds on the CGL policy with respect to liability arising out of work or operations performed by or on behalf of the Contractor including materials, parts, or equipment furnished in connection with such work or operations. General liability coverage can be provided in the form of an endorsement to the Contractor's insurance (at least as broad as ISO Form CG 20 10 1185 or if not available, through the addition of both CG 20 10, CG 20 26, CG 20 33, or CG 20 38; and CG 20 37 forms if a later edition is used). 13 DocuSign Envelope ID: 098D4B61-B495-429F-BABC-OAF46D368454 2. Primary Coverage: For any claims related to this contract, the Contractor's insurance coverage shall be primary coverage at least as broad as ISO CG 20 0104 13 as respects the City, its officers, officials, employees, and volunteers. Any insurance or self-insurance maintained by the City, its officers, officials, employees, or volunteers shall be excess of the Contractor's insurance and shall not contribute with it. 3. Notice of Cancellation: Each insurance policy required above shall state that coverage shall not be canceled, except with notice to the City. 4. Waiver of Subrogation: Contractor hereby grants to City a waiver of any right to subrogation which any insurer of said Contractor may acquire against the City by virtue of the payment of any loss under such insurance. Contractor agrees to obtain any endorsement that may be necessary to affect this waiver of subrogation, but this provision applies regardless of whether or not the City has received a waiver of subrogation endorsement from the insurer. 5. Self -Insured Retentions: Self -insured retentions must be declared to and approved by the City. The City may require the Contractor to purchase coverage with a lower retention or provide proof of ability to pay losses and related investigations, claim administration, and defense expenses within the retention. The policy language shall provide, or be endorsed to provide, that the self - insured retention may be satisfied by either the named insured or City. 6. Acceptability oflnsurers: Insurance is to be placed with insurers authorized to conduct business in the state with a current A.M. Best's rating of no less than ANII, unless otherwise acceptable to the City. 7. Claims Made Policies: If any of the required policies provide coverage on a claims -made basis: 1. The Retroactive Date must be shown and must be before the date of the contract or the beginning of contract work. 2. Insurance must be maintained and evidence of insurance must be provided for at least five (5) years after completion of the contract of work. 3. If coverage is canceled or non -renewed, and not replaced with another claims -made policy form with a Retroactive Date prior to the contract effective date, the Contractor must purchase "extended reporting" coverage for a minimum of five (5) years after completion of contract work. 8. Verification of Coverage: Contractor shall furnish the City with original Certificates of Insurance including all required amendatory endorsements (or copies of the applicable policy language effecting coverage required by this clause) and a copy of the Declarations and Endorsement Page of the CGL policy listing all policy endorsements to City before work begins. However, failure to obtain the required documents prior to the work beginning shall not waive the Contractor's obligation to provide them. City reserves the right to require 14 DocuSign Envelope ID: 09BD4B61-B495-429F-BABC-OAF46D368454 complete, certified copies of all required insurance policies, including endorsements required by these specifications, at any time. 9. Special Risks or Circumstances: City reserves the right to modify these requirements, including limits, based on the nature of the risk, prior experience, insurer, coverage, or other special circumstances. I. 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 Federal Laws governing the use of ARPA SURF Funds. In the event of such suspension or termination, SUBRECIPIENT shall only be entitled to reimbursement for approved expenses incurred up to the effective date of suspension or termination. 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. 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 ARPA program for any term subject to this Agreement. 7. In the event this Agreement is terminated as set forth in subparagraphs I(I) through I(6), inclusive, SUBRECIPIENT agrees to immediately return to CITY upon CITY's demand 15 DocuSlgn Envelope ID: 098D4B61-B495-429F-BABC-OAF46D368454 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 may in the future place programmatic or fiscal limitations on the use of ARPA SLFRF Funds, which limitations are not presently anticipated. Accordingly, CITY reserves the right to revise this Agreement in order to take account of actions affecting ARPA program funding. In the event of funding reduction, CITY may, in its sole and absolute discretion, reduce the budget of this Agreement, may limit the rate of SUBRECIPIENT's authority to utilize 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 ARPA SLFRF 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 ARPA SLFRF Funds by SUBRECIPIENT and contains all the covenants and agreements between the parties with respect to SUBRECrPlIENT's administration of said program. Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which are not embodied herein, and that no other agreement or amendment hereto shall be effective unless executed in writing and signed by both CITY and SUBRECIPIENT. L. Laws Governing this Agreement. 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 16 DocuSign Envelope ID; 098D4B61-B495-429F-BABC-OAF46D368454 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 ARPA, are included in Exhibit C attached hereto and incorporated herein by this reference. P. 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 terms of this Agreement, and shall indemnify CITY fully, including reasonable costs and attorney's fees, for any injuries or damages to CITY in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. 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} 17 DocuSign Envelope ID: 098D4B61-B495-429F-BABC-OAF46D368454 IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the date and year first written above. ATTEST: Y GOMEZ of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney y: DON SALVATIERRA Deputy City Attorney RECOMMENDED FOR APPROVAL: Exec''fitive Director Parks, Recreation and Community Services Agency 18 CITY OF SANTA ANA KRISTINE RIDGE City Manager SUBRECIPIENT: DocuBlgnetl by: 3E12MB431D94M— AMERICA BRACHO Chief Executive Officer DUNS #: 938164811 DocuSign Envelope ID: 098D4B61-B495-429F-BABC-OAF46D368454 E' YCHIBIT A SCOPE OF WORK 19 DocuSign Envelope ID: 098D4B61-B495429F-BABC-OAF46D368454 Exhibit A Latino Health Access Children and Youth Engagement for Violence Prevention RFP 21-116A REVIVE Santa Ana: Youth Programs SECTION 4: SCOPE OF WORK In response to the City of Santa Ana's REVIVE: Santa Ana Youth Programs RFP, Latino Health Access (LHA) proposes its Children and Youth Engagement for Violence Prevention program, a multi -layered approach to violence prevention that engages youth in interactive, age -appropriate activities that (1) build emotional wellness, coping strategies and resilience (2) activate youth as community leaders and enhances their ability to be civically engaged and (3) connects youth to supportive services and provides navigation support to ensure that youth are able to obtain preventive and harm -reduction services locally. Goal: The goal of Latino Health Access' Children and Youth Engagement for Violence Prevention (CYE) is to reduce youth violence through preventive programming that engages youth as leaders and provides positive outlets to address mental health, emotional wellness and their underlying causes. Objectives In the 12 -month grant period, Latino Health Access proposes to accomplish the following objectives: 1. 2. Engage a minimum of 1,200 youth in culturally concordant, age -appropriate "youth hangouts" or activities that serve as violence prevention and are co -designed with youth leaders to ensure relevance to our priority populations. 3. Reach 4,000 youth and their families with a youth -led violence prevention multi -media campaign that addresses topics that include but are not limited to: bullying, interpartner violence, hate crimes, among other relevant topics that youth identify. Outcomes In the 12-month grant period, Latino Health Access expects to accomplish the following objectives: 1. Increase engagement among a minimum of 75% of youth leaders as evidenced by participation in planning and/or facilitating of at least two community youth activities. 2. Increased access to violence prevention programming for low-income Santa Ana youth. 3. Increased public awareness of (1) various sources of violence impacting youth (2) root causes of violence and prevention methods and (3) resources to support violence prevention and to respond to incidences that may have occurred in the community. Our programming also leverages LHA's resources and additional programming in mental health and emotional wellness, chronic disease prevention, and community engagement and advocacy to support youth development as well as their families to ensure that existing needs are met through a comprehensive manner. 20 DocuSign Envelope ID: 098D4B61-B495-429F-BABC-OAF46D368454 Exhibit A Latino Health Access Children and Youth Engagement for Violence Prevention RCP 21-116A REVIVE Santa Ana: Youth Programs Activities Table I below outlines the proposed activities that will support our objectives and outcomes. Activity Description Outreach Latino Health Access will conduct outreach across its partners, including the Santa Ana Unified School District and its parent centers. LHA has an active MOU with SAUSD to provide a variety of services, including a mental health ambassadors program that trains youth to serve as emotional wellness ambassadors. LHA will activate participants of the program, as well as parents and teachers to promote CYE activities and programming. In addition, LHA will leverage its social media platforms as well as local, trusted sources of information such as a Radio Santa Ana Public Awareness Co -designed and co -led with youth, LHA will implement an annual Campaign public awareness campaign that aims to address the various types of violence impacting Santa Ana youth as well as provide resources for prevention and harm reduction. The campaign will leverage youth's creativity and talents to leverage multi -media such as TikTok, short videos, Podcasts, and direct outreach. Monthly Using the concept of "holding space" for youth, LHA and the CYE "Hangouts" youth will organize structured activities and events to elevate issues that are important to youth and are critical for violence prevention and harm -reduction. These can include DJ sets, collective song -writing, healing circles, workshops, and youth -led chats, among other activities that are co -designed by youth. Supportive Leveraging our promotor model, LHA will provide a range of Services supportive services to youth and their families for violence prevention and harm reduction. These may include but are not limited to: emotional wellness services, case management, referrals and linkages, individual and group therapy, connections to food, service navigation, coaching, among others. 4. Proposal shall include details of the target population Latino Health Access will prioritize working with Latinx youth in the 92701 Zip Codes through a neighborhood -based approach, although programming will be open to youth across Santa Ana, and it is our goal that as youth increase in leadership to co -implement the proposed programming, they will reach their peers in additional neighborhoods through a peer -engaged model. The youth in our prioritized neighborhoods live in households, which the U.S. Census identifies as having family members who are foreign -born (93%) and who have household incomes of less than $30,000 (88%). 21 DocuSign Envelope ID: 098D4B61-B495-429F-BABC-OAF46D368454 FEE PAYMENT SCHEDULE 22 DocuSign Envelope ID: 098D4B61-B495-429F-BABC-OAF46D368454 Exhibit B FISCAL YEAR 2022-2023 PROPOSED PROGRAM BUDGET Organization Name Latino Health Access Program Name Revive: Santa Ana Youth Programs Term: July 1, 2022 to June 30, 2023 EXPENDITURES Enter budeet cateeories and oroiected exnenditures: Category Funded By Funded By Budget Organization Administrative Staff Salaries $0 $0 Program Staff Salaries $105,724 $105,724 Contractual Services $0 $0 Other- $0 $0 $1,000 $1,000 $2,000 $2,000 $3,000 $3,000 $1,425 $1,425 $500 $500 $11,351 $11,351 TOTAL $125,000 $0 $125,000 $0 PROGRAM RESOURCES LIST ALL OTHER PROGRAM RESOURCES FOR 2022-2023 Funding Source Total must equal Program Budget Total listed above. FUNDING SOURCE AMOUNT Santa Ana REVIVE $ 125,000 TOTAL $ 125,000 23 DocuSign Envelope ID: 098D4B61-B495-429F-BABC-OAF46D368454 Exhibit B 2022-2023 REVIVE BUDGET LINE ITEMS ADMINISTRATIVE STAFF Position Title Annual Salary & Benefits REVIVE Funds Description PROGRAM STAFF Position Title Annual Salary &Benefits REVIVE Funds Description Oversees all LHA programs & ensures compliance Chief Program Officer 116992.5 5849.625 with contracts Will provide strategic oversight and direction to project team, and monitor progress towards Director of CYE 102214.5 10221.45 objectives WIII oversee day to day Implementation of project Program Coordinator 79407.12 7940.712 activities Will lead planning and implementation of outreach Outreach Coordinator 71722.56 7172,256 activities Senior level promotor- Deliver project outreach & engagement activities with youth and serve as Lead Promotor 51230.4 20492.16 guide/coach for other promotores during activities Deliver project outreach & engagement activities Promotor 46107.36 46107.36 with youth Enters data collected by program team Into project evaluation database to track progress towards Data Entry 46107.361 2305.3691 objectives Provides administrative, logistical, and clerical Program Associate 56353.44 5635.344support to prject team CONTRACTUAL/PROFESSIONAL SERVICES !Type of Service Contract Amount REVIVE Funds Description OTHER LINE ITEMS Line Item Program Amount REVIVE Funds Description Office Supplies 1000 General supplies (e.g., pens, easel pads, markers, notebooks, software subscriptions - zoom, hive Printing 2000 Printing paper, toner, copies Program Supplies 3000 Materials for youth planning and engagement activities (e.g., arts & crafts, macs & headphones, camera, snacks & refreshments, Incentives) Outreach Materials 1425 Outreach and educational awareness materials such as flyers, posters, stickers, shirts, backpacks, giveaways/swag Mileage 500 Transportation reimbursements for local project - related travel Indirect 11350.73 10%of Direct Expenses Attachment 1(b) 24 DocuSign Envelope ID; 098D4B61-B495-429F-BABC-OAF46D368454 EXHIBIT C FEDERAL AWARD IDENTIFICATION INFORMATION The General Program Requirements were designed to provide the framework where the CONTRACTOR will provide ARPA programs identified in this attachment. I. GOVERNANCE The CONTRACTOR agrees to comply, remain informed, and deliver services consistent with the provisions of ARPA. Where local policy has not been set, the CONTRACTOR agrees to adhere to state and/or federal policy, as appropriate. II. GOVERNANCE REFERENCES A. Additional state and federal agencies that provide funding to the CITY may be incorporated herein. B. Information Bulletins, Directives, and any other federal and state guidance documents pertaining to the ARPA SURF Funds. C. Actions, directives, and policy and procedures issued by the CITY. D. CITY policies, as applicable. III. CONTRACTOR/SUBRECIPIENT DETERMINATION: In accordance with the requirements of 2 CFR 200.330 (Subrecipient and Contractor determination) and for the purpose of this CONTRACT, SUBRECIPIENT is determined to be a CONTRACTOR. 25 Docu5lgn Envelope ID: 098D4B61-B496-429F-BABC-OAF46D368464 IV. FEDERAL AWARD IDENTIFICATION ,i a '*'NAIN;INFOIkMATION, S 5. P A. CONTRACTOR Name: LATINO HEALTH ACCESS B. CONTRACTOR'S Unique 938164811 Identifier (D-U-N-S): Federal Award C. Identification Number SLFRP1059 (FAIN): D. Federal Award Date: 5/19/2021 Subaward Period of E. Performance: 7/l/2022-6/30/2023 Total Amount of Federal F. Funds Obligated by the $125,000 Action: Total Amount of Federal G. Funds Obligated to the $125,000 CONTRACTOR: H. Total Amount of the $64,180,406.50 Federal Award: I Federal Award Project American Rescue Plan Act (ARPA) Description: J. Federal Awarding Agency: U.S. Department of the Treasury K. Name of PTE: City of Santa Ana L. Contact Information for the Kristine Ridge, City Manager Awarding Official: Phone Number: (714) 647-5200 E-mail Address: kridgegsanta-ana.org M. CFDA Number: 21.027 CFDA Name: Coronavirus State and Local Fiscal Recovery Funds N. Whether Award is R&D: No O Indirect Cost Rate for the de minimus or federally negotiated rate Federal Award: 26 DocuSign Envelope ID; 098D4B61-B495-429F-BABC-OAF46D368454 EXHIBIT D 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 Register (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. flancz.{ Wei iek , GP -e- Name and Title of Signature I ( I Date 27 Docu5lgn Envelope ID: 098D4B61-B495-429F-BABC-OAF46D368454 INSTRUCTIONS FOR CERTIFICATION 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. 28 Docu5lgn Envelope ID: 098D4B61-B495-429F-BABC-OAF46D368454 9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction lmowingly 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. 29 DocuSign Envelope ID: 098D4B61-B495-429F-BABC-OAF46D368454 EXHIBIT E LOBBYING Certification Regarding Lobbying Certification for Contracts, Grants, Loans, and Coonerative 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 foi influencing or attempting to influence au officer u, 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. Grantee/Contactor Organization Program Tide im Docu5lgn Envelope ID: 098D4B61-B495-429F-BABC-OAF46D368454 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. 31 DocuSign Envelope ID: 098D4B61-B495-429F-BABC-OAF46D368454 EXHIBIT F 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 32 DocuSign Envelope ID: 098D4B61-B495-429F-BABC-OAF46D368454 otherwise receiving actual notice of such conviction; (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. Organization Authorized SignaVure Date 33 DocuSlgn Envelope ID: 098D4B61-B495-429F-BABC-OAF46D368454 PLACE OF PERFORMANCE FOR CERTIFICATION REGARDING DRUG -FREE WORKPLACE REQUIREMENTS 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): 56 w A4e, Si � 13 D 34 - t �„T Ally CERTIFICATE O LIABILITY INSUF! A tasty03/04/2022 Y) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORM L ND NO RIGHI t T TE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVE A D, E LTER THE , TVE GE AFFORDED BY THE POLICIES JV BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE ONTRACT BETWE' N Ace AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. �VUU �VJ IMPORTANT: If the certificate holder is an ADDITIONAL INS D, [gyp pgggjjj{{{���yyy{{{LLLes) yyyggg[[[be r 1r�-Sb.'RROGATION IS WAIVED subject to the terms and conditions of the policy, certain policies may r �i t,n! .� /e 3 m t on 'Da te doe�022er n its 116 certificate holder in lieu of such endorsement(s). C C " .J v Dufour Insurance Services, LLC 5611 Littler Drive Huntington Beach, CA 92649 Stephanie Dufour INSURED Latino Center for Pre, and Action, dba Latino Health Access 450 W. Fourth Street Santa Ana, CA 92701 PHONI IAIC.N=Ea,,.7 '4-?J9-2998 I U.-tu� (TC.iNol U/ %JU 9411111TIq:&Tr.1 919KAI=1!11I171[.1=: :1A9691GRIII:� THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR rypE OFINSURANCE ADDL SUBft pOLICYNUMBER POLICYEFF POLICY EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 PREMISES E.....nonce $ 500,00 A X COMMERCWLGENERALLIABILITY CLAIMS -MADE Fx] OCCUR X X 2021-04261-NPO 07/05/2021 07/06/2022 MED EXP (Any one person) $ 20,00 PERSONAL a ADV INJURY $ 1,000,00 A X Professional 2021-04261- NPO 0710612021 07/05/2022 X Abuse GENERALAGGREGATE $ 3,000,00 A 2021.04261- NPO 07/06/2021 07/05/2022 GEN'LAGGREGATE LIMITAPPLIES PER: PRODUCTS-COMP/OP AGG $ 3,000,00 POucr PRO- X Loc Deductibl $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,00 BODILY INJURY (Par person) $ A X ANY AUTO 2021-04261-NPO 07/05/2021 07/0512022 ALLOWNED X SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE PER ACCIDEN $ NON -OWNED HIRED AUTOS AUTOS Deductible $ J( UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,00 AGGREGATE $ 5,000,00 A EXCESS UAB CLAIMS -MADE 2021-04261-UMB-NPO 07/05/2021 07/06/2022 DED I X I RETENTION $ 10,000 $ 6 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA SWC1374729 01/0112022 01/01/2023 X WC STALIMTU- OTH- E.L. EACH ACCIDENT $ 1;000,00 E.L. DISEASE -EA EMPLOYE $ 1,000,00 If yes, descnbe under DE SCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,00 O Cyber Liability PHSD1684193 12/12/2021 12/12/2022 Per Occ 1,000,00 A Liquor Liability 2021-04261- NPO 07/05/2021 07/06/2022 Aggregate 3,000,00 DESCRIPTION OFOPERATIONS/LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City of Santa Ana, its officers, officials, employees,& volunteers are to be covered as additional insureds & Waiver of Subro on the CGL respect to liability arising out of work or operations performed by or on behalf of the Contractor including materials, parts, or equipment furnished in connection with such work or operations Insurance is Primary ad Noncontributory City of Santa Ana ARPA funded food distribution Contractor 20 Civic Center Plaza Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZEDREPRESENTATIVE 1 { r'7LGlL © 1988-2010 ACOR ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD a fl emm��tOvaD A41P AM44 i®1 Risk Management Speoalist00 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 04-84) 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 5% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description The City of Santa Ana, its officers, employees, agents Funding Contract and volunteers. 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 1I112022 Policy No. SWC1374729 Endorsement No. 0 Insured Latino Health Access (a Corp) Premium $ 60,773 Insurance Company Security National Insurance Company Countersigned by„Qrp,u riEvEWED 6 APPRovm BY: (Ed. 04-84) WC 04 03A Aewuto Risk Management Speciallrt POLICY NUMBER: 2021-04261- NPO COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person or Organization: City of Santa Ana ARPA funded food distribution contractor (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule as an insured but only with respect to liability arising out of your operations or premises owned by or rented to you. g Risk MotagenadDhUbn k� REvtexm 6 APPRW® 8r. cl'.No�IM1 �. t� A4f4 Aa= Risk Management Speciallst POLICY # 2021-04261- NPO PI-GL-005 (07/12) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED PRIMARY AND NON-CONTRIBUTORY INSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization (Additional Insured): The City of Santa Ana, its officers, officials, employees,& volunteers Effective Date: 07/05/21 SECTION II — WHO IS AN INSURED is amended to include as an additional insured the person(s) or organization(s) shown in the endorsement Schedule, but only with respect to liability for "bodily injury," "property damage" or "personal and advertising injury' arising out of or relating to your negligence in the performance of "your work" for such person(s) or organization(s) that occurs on or after the effective date shown in the endorsement Schedule. This insurance is primary to and non-contributory with any other insurance maintained by the person or organization (Additional Insured), except for loss resulting from the sole negligence of that person or organization. This condition applies even if other valid and collectible insurance is available to the Additional Insured for a loss or "occurrence" we cover for this Additional Insured. The Additional Insured's limits of insurance do not increase our limits of insurance, as described in SECTION III — LIMITS OF INSURANCE. All other terms, conditions, and exclusions under the policy are applicable to this endorsement and remain unchanged. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. x+. X�R_= RWe Mgwgznwt Wsivn •" REve&m&APPRWIDBY: A+.j�4 Aetv4 Risk Management Specialist of =�INONPROFITS POLICY NUMBER:2021-04261 FORM: NIAC-E2611 17 INSURANCE NAMED INSURED: Latino Center for Prevention & Action in Health & Welfare* ALLIANCE OF CALIFORNIA A Head far Insurance. A Heartfor Nonprofits. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SOCIAL SERVICE PROFESSIONAL LIABILITY COVERAGE FORM SCHEDULE Name of Person or Organization: City of Santa Ana, its officers, employees, agents and volunteers Where you are so required in a written contract or agreement currently in effect or becoming effective during the term of this policy, we waive any right of recovery we may have against that person or organization, who may be named in the schedule above, because of payments we make for injury or damage. NIAC-E26 11 17 03n osxg 1:�IliYIRRRgCnI01i))IWIOM1 Cr REMemmfi APPRMED8Y. Ruk Management Specialist 1 l cf ''`�aY� CERTIFICATE O LIABILITY INSUPI � 03104/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORM L ND NO RIGHT 1 T TE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATNE A D, E LTER THE . 1VE GE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE ONTRACT BETWE' IN '1jI[ Ie�c,I�l1�C2 ANSLIbr(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. _ /"�L,C V ea �J IMPORTANT: If the certificate holder is an ADDITIONAL INSLj%D, the terms and conditions of the policy, certain policies may r I certificate holder In lieu of such endomement(s). Drive Services, LLC , CA 92649 INSURED Latino Center for Prevention and Action, dba Latino Health Access 460 W. Fourth Street Santa Ana, CA 92701 tephan': Dufour 7;4-7i9-2998 National OUVCftAGCS GtK I IML;AIt NUMHEK: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INTR TYPE OF INSURANCE ADDL SUB POLICYNUMBER POLICY EFF PODCYEXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 PREMISES Ea occurrence $ 500,00 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X X 2021-04261-NPO 07/05/2021 07/0612022 MED EXP(Anyone person) $ 20,00 A X Professional 2021-04261-NPO 07/05/2021 07/0512022 PERSONAL &ADV INJURY $ 1,000,00 X Abuse GENERAL AGGREGATE $ 3,000,00 A 2021-04261-NPO 07/05/2021 07/0612022 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO $ 3,000,00 17 POLICY PIFCT RO X LOC Deductibi $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Eaaccident 1,000,00 X BODILY INJURY (Per person) $ A ANY AUTO 2021-04261-NPO 07/05/2021 07106I72 ALLOWNED X SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) I $ NON,OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE PERACCIDEN $ Deductible $ J( UMBRELLA OAB X OCCUR EACH OCCURRENCE $ 6,000,00 AGGREGATE $ 5,000,00 A EXCESS UAB CLAIMS -MADE 2021-04261-UMB-NPO 07/05/2021 07/05/2022 DEO I X I RETENTION $ 10 000 $ 1 B WORKERSCOMPENSATION ANDEMPLOYERS' LIABILITYIMT OFFICERIME BEER IXCLUDE07 CUTIVE Y/❑N (Mandatoryin NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA SWC1374729 01/01/2022 01/0112023 X WC STATU- OTH- E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE EA EMPLOYE $ 1,000,00 E.L. DISEASE POLICY LIMIT $ 1,000,00 C Cyber Liability PHSD1684193 12112/2021 12/1212022 Per CDC 1,000,00 A Liquor Liability 2021-04261- NPO 07/05/2021 07/0512022 Aggregate 3,000,00 DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City of Santa Ana, its officers, officials, employees,& volunteers are to be covered as additional insureds & Waiver of Subro on the CGL respect to liability arising out of work or operations performed by or on behalf of the Contractor including materials, parts, or equipment furnished in connection with such work or operations Insurance is Primary ad NonContributory City of Santa Ana ARPA funded food distribution Contractor 20 Civic Center Plaza Santa Ana, CA 92701 ACORD 25 (2010/05) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. © 1988-2010 ACORD The ACORD name and logo are registered marks of ACORD aot WekMuMgarladDlvWdn REvPwEC&APPRov®BY: - �' Ar.�:rAuvrda Risk Management Specialistor WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 04-84) 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 5% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description The City of Santa Ana, its officers, employees, agents Funding Contract and volunteers. 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 Insured Insurance Company WC 04 03 06 (Ed. 04-84) 1/1/2022 Policy No. SWC1374729 Latino Health Access (a Corp) Security National Insurance Company Countersigned by Endorsement No. 0 Premium $ 60,773 ten.,,, 1tWeMnugarwdDMelan .5 P. REVIEWED6APPRovec BY: `II g• Risk Management SpetlaOst POLICY NUMBER: 2021-04261- NPO COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person or Organization: City of Santa Ana ARPA funded food distribution contractor (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule as an insured but only with respect to liability arising out of your operations or premises owned by or rented to you. xuknanage,no toter ReneWEo6Apprtwmer.r. a" A+ fe Aawute Risk Management Speaalist POLICY # 2021-04261- N PO PI-GL-005 (07/12) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, ADDITIONAL INSURED PRIMARY AND NON-CONTRIBUTORY INSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization (Additional Insured): The City of Santa Ana, its officers, officials, employees,& volunteers Effective Date: 07/05/21 SECTION II — WHO IS AN INSURED is amended to include as an additional insured the person(s) or organization(s) shown in the endorsement Schedule, but only with respect to liability for "bodily injury," ..property damage" or "personal and advertising injury" arising out of or relating to your negligence in the performance of "your work" for such person(s) or organization(s) that occurs on or after the effective date shown in the endorsement Schedule. This insurance is primary to and non-contributory with any other insurance maintained by the person or organization (Additional Insured), except for loss resulting from the sole negligence of that person or organization. This condition applies even if other valid and collectible insurance is available to the Additional Insured for a loss or "occurrence" we cover for this Additional Insured. The Additional Insured's limits of insurance do not increase our limits of insurance, as described in SECTION III — LIMITS OF INSURANCE. All other terms, conditions, and exclusions under the policy are applicable to this endorsement and remain unchanged. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. RhkMmngemoan[we� y., ;Y REVIEWED&Mraw®ar: A+f, AW44 �' Risk Management SpeaAnt NONPROFITS POLICY NUMBER: 2021-04261 FORM: NIAC-E26 11 17 INSURANCE NAMED INSURED: Latino Center for Prevention & Action in Health & Welfare* ALLIANCE OF CALIFORNIA A Head for Insurance. A Heart for Nonpraf ts. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SOCIAL SERVICE PROFESSIONAL LIABILITY COVERAGE FORM SCHEDULE Name of Person or Organization: City of Santa Ana, its officers, employees, agents and volunteers Where you are so required in a written contract or agreement currently in effect or becoming effective during the term of this policy, we waive any right of recovery we may have against that person or organization, who may be named in the schedule above, because of payments we make for injury or damage. NIAC-E26 11 17 ogdmg. wekMougonmtDMs[an REmEwED 6 APPKNED S : Ruk Management Specialist Of Ejhjubmmz!tjhofe! cz!Bohjf! Bohjf! Bdfwfep! Ebuf;!3133/18/3:! Bdfwfep 25;47;46!.18(11( QPMJDZ!DIBOHF UIJT!FOEPSTFNFOU!DIBOHFT!UIF!QPMJDZ/!QMFBTF!SFBE!JU!DBSFGVMMZ/ )15372* DPNQBOZ;Opoqspgjut!Jotvsbodf!Bmmjbodf!pg!Dbmjgpsojb QPMJDZ!OVNCFS;3133.15372 OBNFE!JOTVSFE;Mbujop!Dfoufs!gps!Qsfwfoujpo!'!Bdujpo!jo!Ifbmui!'!Xfmgbsf+ QPMJDZ!DIBOHF!FGGFDUJWF;1801603133 DPWFSBHF!QBSU!BGGFDUFE;DPNNFSDJBM!HFOFSBM!MJBCJMJUZ QPMJDZ!DIBOHF$;Qbhf22 Uif!gpmmpxjoh!beejujpobm!jotvsfe)t*!jt0bsf!ifsfcz!beefe!up!uif!qpmjdz; OJBD.F37!!!!!!!!Mpdbujpot!.!O0B %1 Djuz!pg!Tboub!Bob-!jut!pggjdfst-!fnqmpzfft-!bhfout-!boe!wpmvouffst 31!Djwjd!Dfoufs!Qmb{b/ Tboub!Bob-!DB!:3812 Bmm!puifs!ufsnt-!mjnjut!boe!dpoejujpot!sfnbjo!uif!tbnf/ %1 BEEJUJPOBM!QSFNJVN; %1 SFUVSO!QSFNJVN; %1 UPUBM!QSFNJVN; 1802903133 QPMJDZ!OVNCFS;!3133.15372GPSN;!OJBD.F37!22!28! OBNFE!JOTVSFE;!Mbujop!Dfoufs!gps!Qsfwfoujpo!'!Bdujpo!jo!Ifbmui!'!Xfmgbsf+ UIJT!FOEPSTFNFOU!DIBOHFT!UIF!QPMJDZ/!!QMFBTF!SFBE!JU!DBSFGVMMZ/ XBJWFS!PG!USBOTGFS!PG!SJHIUT!PG!SFDPWFSZ BHBJOTU!PUIFST!)XBJWFS!PG!TVCSPHBUJPO* Uijt!foepstfnfou!npejgjft!jotvsbodf!qspwjefe!voefs!uif!gpmmpxjoh; DPNNFSDJBM!HFOFSBM!MJBCJMJUZ!DPWFSBHF!QBSU TPDJBM!TFSWJDF!QSPGFTTJPOBM!MJBCJMJUZ!DPWFSBHF!GPSN TDIFEVMF Obnf!pg!Qfstpo!ps!Pshboj{bujpo; Djuz!pg!Tboub!Bob-!jut!pggjdfst-!fnqmpzfft-!bhfout-!boe!wpmvouffst Xifsf!zpv!bsf!tp!sfrvjsfe!jo!b!xsjuufo!dpousbdu!ps!bhsffnfou!dvssfoumz!jo!fggfdu!ps!cfdpnjoh!fggfdujwf!evsjoh!uif! ufsn!pg!uijt!qpmjdz-!xf!xbjwf!boz!sjhiu!pg!sfdpwfsz!xf!nbz!ibwf!bhbjotu!uibu!qfstpo!ps!pshboj{bujpo-!xip!nbz!cf! obnfe!jo!uif!tdifevmf!bcpwf-!cfdbvtf!pg!qbznfout!xf!nblf!gps!jokvsz!ps!ebnbhf/ OJBD.F37!22!28Qbhf!2!pg!2 NOTICE OF COMPLIANCE CITY STAFF: PRINT THIS PAGE AND INCLUDE WITH AGREEMENT TO THE CLERK OF THE COUNCIL Contractor Latino Center for Prevention and Action Name: Project A-2022-069-09 Number: Project Agreement Between The City Of Santa Ana And Latino Health Name: Access For Use Of American Rescue Plan Act (ARPA) Funds The Certificate of Insurance (COI) submitted indicates that the coverages are in compliance with the insurance requirements. No further action is required at this time. The compliant coverage(s) are: EXPIRATION TYPE OF INSURANCE POLICY NUMBER COI DATE FILE NAME DATE Latino Health Access AUTOMOBILE LIABILITY 202204261NPO 07/05/2023 06/28/2022 COI 2023.pdf Latino Health Access GENERAL LIABILITY 202204261UMBNPO 07/05/2023 06/28/2022 COI 2023.pdf Latino Health Access GENERAL LIABILITY 202204261NPO 07/05/2023 06/28/2022 COI 2023.pdf SEXUAL ABUSE 202204261NPO 07/05/2023 07/28/2022 Latino Health Access WORKERS COMPENSATION AND SWC1374729 01/01/2023 03/04/2022 COI Exp 7-5-22 EMPLOYERS' LIABILITY RMD04012022.pdf Thank you, City of Santa Ana Risk Management Division in partnership with CTrax Plus Services Team 12/13/2022 2:54 PM