HomeMy WebLinkAboutO.C. CONSERVATION CORPS 4AGREEMENT TERMINATION
Please complete this form when the attached agreement is no longer in effect.
Return form to the Deputy Clerk of the Council (M-30). Call 647-6520 if you have any
questions.
The agreement with
was completed on n , and final payment has been made.
X A-' ZW4 `G-' Department: _
--5 "0.--
Signature:
Date: L
City of Santa Ana
Revised 4-16-87 Clerk of the Council
INSURANCE ON PILE
WORK MAY PROCEED
UNTIL INSURANCE EXPIR S
/- a&
CLERK Or, VOUNc11,
DATE:
CONSULTANT AGREEMENT
A-2003-163
( CbA THIS AGREEMENT, made and entered into this o2)5r day of J�J L/ ,
2003 by and between Orange County Conservation Corps (hereinafter "Consultant'),
and the City of Santa Ana , a municipal corporation organized and existing under the
Fi Constitution and laws of the State of California (hereinafter "City").
RECITALS
A. The City desires to retain a consultant having special skill and knowledge in the
field of providing vocational/occupational training, employment strategies,
education and supportive services to individuals who reside in the Federal
Empowerment Zone.
B. Consultant represents that Consultant is able and willing to provide such
services to the City.
C. In undertaking the performance of this Agreement, Consultant represents that it
is knowledgeable in its field and that any services performed by Consultant
under this Agreement will be performed in compliance with such standards as
may reasonably be expected from a professional consulting firm in the field.
D. The City, through the Santa Ana Empowerment Corporation (SAEC), is the
recipient of Empowerment Zone ("FEZ") funds from the United States
Department of Housing and Urban Development ("HUD").
E. The City and Consultant have duly executed this Agreement for expenditure of
such funds.
NOW THEREFORE, in consideration of the mutual and respective promises, and
subject to the terms and conditions hereinafter set forth, the parties agree as follows:
SCOPE OF SERVICES
Consultant shall perform those services as set forth in Exhibit A to this
Agreement.
2. COMPENSATION
a. City agrees to pay, and Consultant agrees to accept as total payment for its
services, the rates and charges identified in Exhibit B. The total sum to be expended
under this Agreement, shall not exceed $99,865.00 during the term of this Agreement.
b. Payment by City shall be made within thirty (30) days following receipt of
proper invoice evidencing work performed, subject to City accounting procedures.
Pagel of 9
Payment need not be made for work which fails to meet the standards of performance
set forth in the Recitals which may reasonably be expected by City.
3. TERM
This Agreement shall commence on July 1, 2003 and terminate on June 30,
2004, unless terminated earlier in accordance with Section 12, below. The term of this
Agreement may be extended upon a writing executed by the Executive Director of the
Community Development Agency and the City Attorney.
4. INDEPENDENT CONTRACTOR
Consultant shall, during the entire term of this Agreement, be construed to be an
independent contractor and not an employee of the City. This Agreement is not
intended nor shall it be construed to create an employer -employee relationship, a joint
venture relationship, or to allow the City to exercise discretion or control over the
professional manner in which Consultant performs the services which are the subject
matter of this Agreement; however, the services to be provided by Consultant shall be
provided in a manner consistent with all applicable standards and regulations governing
such services. Consultant shall pay all salaries and wages, employer's social security
taxes, unemployment insurance and similar taxes relating to employees and shall be
responsible for all applicable withholding taxes.
5. INSURANCE
Prior to undertaking performance of work under this Agreement, Consultant shall
maintain and shall require its subcontractors, if any, to obtain and maintain insurance as
described below:
a. Commercial General Liability Insurance. Consultant shall maintain
commercial general liability insurance naming the City, its officers, employees, agents,
volunteers and representatives as additional insured(s) and shall include, but not be
limited to protection against claims arising from bodily and personal injury, including
death resulting therefrom and damage to property, resulting from any act or occurrence
arising out of Consultant's operations in the performance of this Agreement, including,
without limitation, acts involving vehicles. The amounts of insurance shall be not less
than the following: single limit coverage applying to bodily and personal injury, including
death resulting therefrom, and property damage, in the total amount of $1,000,000 per
occurrence. Consultant shall supply City with a fully executed additional insured
endorsement in substantially the form attached hereto as Exhibit F upon execution of
this Agreement and shall be approved in form by the City Attorney.
b. Business automobile liability insurance, or equivalent form, with a combined
single limit of not less than $1,000,000 per occurrence. Such insurance shall include
coverage for owned, hired and non -owned automobiles.
Page 2 of 9
c. Worker's Compensation Insurance. In accordance with the provisions of
Section 3300 of the Labor Code, Consultant, if Consultant has any employees, is
required to be insured against liability for worker's compensation or to undertake self-
insurance. Prior to commencing the performance of the work under this Agreement,
Consultant agrees to obtain and maintain any employer's liability insurance with limits
not less than $1,000,000 per accident.
d. The following requirements apply to the insurance to be provided by
Consultant pursuant to this section:
(i) Consultant shall maintain all insurance required above in full force
and effect for the entire period covered by this Agreement.
(ii) Certificates of insurance shall be furnished to the City upon
execution of this Agreement and shall be approved in form by the
City Attorney.
(iii) Certificates and policies shall state that the policies shall not be
canceled or reduced in coverage or changed in any other material
aspect without thirty (30) days prior written notice to the City.
e. If Consultant fails or refuses to produce or maintain the insurance required by
this section or fails or refuses to furnish the City with required proof that insurance has
been procured and is in force and paid for, the City shall have the right, at the City's
election, to forthwith terminate this Agreement. Such termination shall not effect
Consultant's right to be paid for its time and materials expended prior to notification of
termination. Consultant waives the right to receive compensation and agrees to
indemnify the City for any work performed prior to approval of insurance by the City.
6. INDEMNIFICATION
Consultant agrees to and shall indemnify and hold harmless the City, its officers,
agents, employees, consultants, special counsel, and representatives from liability: (1)
for personal injury, damages, just compensation, restitution, judicial or equitable relief
arising out of claims for personal injury, including health, and claims for property
damage, which may arise from the direct or indirect operations of the Consultant or its
contractors, subcontractors, agents, employees, or other persons acting on their behalf
which relates to the services described in section 1 of this Agreement; and (2) from any
claim that personal injury, damages, just compensation, restitution, judicial or equitable
relief is due by reason of the terms of or effects arising from this Agreement. This
indemnity and hold harmless agreement applies to all claims for damages, just
compensation, restitution, judicial or equitable relief suffered, or alleged to have been
suffered, by reason of the events referred to in this Section or by reason of the terms of,
or effects, arising from this Agreement. The Consultant further agrees to indemnify,
hold harmless, and pay all costs for the defense of the City, including fees and costs for
special counsel to be selected by the City, regarding any action by a third party
challenging the validity of this Agreement, or asserting that personal injury, damages,
just compensation, restitution, judicial or equitable relief due to personal or property
Page 3 of 9
rights arises by reason of the terms of, or effects arising from this Agreement. City may
make all reasonable decisions with respect to its representation in any legal proceeding.
CONFIDENTIALITY
If Consultant receives from the City information which due to the nature of such
information is reasonably understood to be confidential and/or proprietary, Consultant
agrees that it shall not use or disclose such information except in the performance of
this Agreement, and further agrees to exercise the same degree of care it uses to
protect its own information of like importance, but in no event less than reasonable care.
"Confidential Information" shall include all nonpublic information. Confidential
information includes not only written information, but also information transferred orally,
visually, electronically, or by other means. Confidential information disclosed to either
party by any subsidiary and/or agent of the other party is covered by this Agreement.
The foregoing obligations of non-use and nondisclosure shall not apply to any
information that (a) has been disclosed in publicly available sources; (b) is, through no
fault of the Consultant disclosed in a publicly available source; (c) is in rightful
possession of the Consultant without an obligation of confidentiality; (d) is required to be
disclosed by operation of law; or (e) is independently developed by the Consultant
without reference to information disclosed by the City.
CONFLICT OF INTEREST CLAUSE
Consultant covenants that it presently has no interests and shall not have
interests, direct or indirect, which would conflict in any manner with performance of
services specified under this Agreement.
SOURCE OF FUNDS
a. Consultant acknowledges that the FEZ funds being provided by City for
Consultant's services are received by City from HUD, and warrants that expenditures of
these funds shall comply with the laws, regulations and policies governing the use of
said funds as set forth in P.L. 106-74 (2000), 24 CFR 598.215 and Federal Register,
April 16, 1998.
b. Consultant has received and read a copy of the City's SUBRECIPIENT
Agreement with the Santa Ana Empowerment Corporation and agrees to be bound by
all of the terms and conditions of said SUBRECIPIENT Agreement, as set forth in
Exhibit C, Acknowledgement of Subrecipient Agreement, attached hereto and by this
reference incorporated herein.
10. CONSULTANT CERTIFICATIONS
a. Consultant has read and shall comply with any and all restrictions on lobbying
as set forth in the Certification Regarding Lobbying, attached hereto as Exhibit D and
incorporated herein by reference.
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b. Consultant shall maintain a drug free workplace as set forth in the
Certification regarding Drug Free Workplace Requirements, attached hereto as Exhibit
E, and incorporated herein by reference.
c. Consultant assures and certifies that it will not use any funds appropriated
under this agreement for religious activity or anti -religious activity, or to promote or
oppose any political candidate, party and/or belief.
d. Consultant assures and certifies that where applicable, classroom training
instructors are properly credentialed, and training curriculums comply with State
Education Codes.
e. Consultant assures and certifies that it is in good standing with the California
Secretary of State Franchise Tax Board and Internal Revenue Service.
f. Consultant agrees to cooperate with any monitoring, inspection, audit, or
investigations of activities related to this agreement as may be scheduled and
conducted by the Santa Ana WORK Center of the Santa Ana Empowerment
Corporation.
g. Consultant agrees to acknowledge the Santa Ana WORK Center and Santa
Ana Empowerment Corporation as the source of funds in all oral presentations, written
documents, publicity and advertisements regarding any activities that ensue from this
agreement.
11. NOTICE
Any notice, tender, demand, delivery, or other communication pursuant to this
Agreement shall be in writing and shall be deemed to be properly given if delivered in
person or mailed by first class or certified mail, postage prepaid, or sent by telefacsimile
or other telegraphic communication in the manner provided in this Section, to the
following persons:
To City:
Clerk of the City Council
City of Santa Ana
20 Civic Center Plaza (M-30)
P.O. Box 1988
Santa Ana, CA 92702-1988
telefacsimile (714) 647-6956
With courtesy copy to:
Santa Ana WORK Center
1000 E. Santa Ana Boulevard, Suite 200
Page 5 of 9
Santa Ana, California 92701
telefacsimile (714) 565-2602
To Consultant:
Orange County Conservation Corps
700 N. Valley Street
Anaheim, California 92801
A party may change its address by giving notice in writing to the other party.
Thereafter, any notice, tender, demand, delivery, or other communication shall be
addressed and transmitted to the new address. If sent by mail, any notice, tender,
demand, delivery, or other communication shall be effective or deemed to have been
given three (3) days after it has been deposited in the United States mail, duly
registered or certified, with postage prepaid, and addressed as set forth above. If sent
by telefacsimile, any notice, tender, demand, delivery, or other communication shall be
effective or deemed to have been given twenty-four (24) hours after the time set forth on
the transmission report issued by the transmitting facsimile machine, addressed as set
forth above. For purposes of calculating these time frames, weekends, federal, state,
County or City holidays shall be excluded.
12. EXCLUSIVITY AND AMENDMENT
This Agreement represents the complete and exclusive statement between the
City and Consultant, and supersedes any and all other agreements, oral or written,
between the parties. In the event of a conflict between the terms of this Agreement and
any attachments hereto, the terms of this Agreement shall prevail. This Agreement may
not be modified except by written instrument signed by the City and by an authorized
representative of Consultant. The parties agree that any terms or conditions of any
purchase order or other instrument that are inconsistent with, or in addition to, the terms
and conditions hereof, shall not bind or obligate Consultant nor the City. 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.
13. ASSIGNMENT
Inasmuch as this Agreement is intended to secure the specialized services of
Consultant, Consultant may not assign, transfer, delegate, or subcontract any interest
herein without the prior written consent of the City and any such assignment, transfer,
delegation or subcontract without the City's prior written consent shall be considered
null and void. Nothing in this Agreement shall be construed to limit the City's ability to
have any of the services which are the subject to this Agreement performed by City
personnel or by other consultants retained by City.
Page 6 of 9
14. TERMINATION
This Agreement may be terminated upon thirty (30) days written notice by either
party. In such event, Consultant shall be entitled to receive and the City shall pay
Consultant compensation for all services performed by Consultant prior to receipt of such
notice of termination, subject to the following conditions:
a. As a condition of such payment, the Executive Director may require Consultant
to deliver to the City all work product completed as of such date, and in such case such
work product shall be the property of the City unless prohibited by law, and Consultant
consents to the City's use thereof for such purposes as the City deems appropriate.
b. Payment need not be made for work which fails to meet the standard of
performance specified in the Recitals of this Agreement.
15. DISCRIMINATION
Consultant shall not discriminate because of race, color, creed, religion, sex,
marital status, sexual orientation, age, national origin, ancestry, or disability, as defined
and prohibited by applicable law, in the recruitment, selection, training, utilization,
promotion, termination or other employment related activities. Consultant affirms that it
is an equal opportunity employer and shall comply with all applicable federal, state and
local laws and regulations.
16. JURISDICTION - VENUE
This Agreement and all questions relating to its validity, interpretation,
performance, and enforcement shall be governed and construed in accordance with the
laws of the State of California. This Agreement has been executed and delivered in the
State of California and the validity, interpretation, performance, and enforcement of any
of the clauses of this Agreement shall be determined and governed by the laws of the
State of California. Both parties further agree that Orange County, California, shall be
the venue for any action or proceeding that may be brought or arise out of, in
connection with or by reason of this Agreement.
17. PROFESSIONAL LICENSES
Consultant shall, throughout the term of this Agreement, maintain all necessary
licenses, permits, approvals, waivers, and exemptions necessary for the provision of the
services hereunder and required by the laws and regulations of the United States, the
State of California, the City of Santa Ana and all other governmental agencies.
Consultant shall notify the City immediately and in writing of her inability to obtain or
maintain such permits, licenses, approvals, waivers, and exemptions. Said inability
shall be cause for termination of this Agreement.
Page 7 of 9
18. MISCELLANEOUS PROVISIONS
a. Each undersigned represents and warrants that its signature hereinbelow 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.
b. All Exhibits referenced herein and attached hereto shall be incorporated as if
fully set forth in the body of this Agreement.
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IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of
the last date and year written below.
DATED:
Clerk of the Council
DATED: % x, z
v 3
RECOMMENDED FOR APPROVAL
John . Reekstin, Executive Director
Comfnunity Development Agency
CITY OF SANTA Ana, a municipal
Corporation of the State of California
David N. Ream
City Manager
APPROVED AS TO FORM:
BEN KAUFMAN,
City General Counsel
CONTRACT R:
p /�fn/GE C�Duti�i 30nSeeii}'Tronl L'OZPS
16c-r4A44 I.-
c V-Ee trlue� �r2E'rr2
Federal Tax ID: .3.3 oS G3 7 /
Page 9 -{' 9
Orange County Conservation Corps
FEZ Daisy Wheel Network Program
Scope of Work
TERM
July 1, 2003 through June 30, 2004
II. PURPOSE
The FEZ Daisy Wheel Network Program will provide vocational/occupational training, employment
strategies, education, and supportive services to individuals who reside in the Federal Empowerment
Zone.
III. POPULATION TO BE SERVED
The population to be served are Federal Empowerment Zone residents 18 years and older.
Eligibility will be determined by age, address, and by Right to Work documentation.
IV. PROGRAM DESIGN, ELEMENTS, AND OUTCOMES FOR ORANGE COUNTY
CONSERVATION CORPS
A. Program Design:
a. Provide an intake assessment (for screening) of each FEZ resident that includes a review
of academic and occupational skills levels as well as service needs;
b. Develop an Individual Service Plan including notifying achievement objectives.
B. Program Elements:
a. The following program elements will be made available to eligible residents expected to
enroll in the FEZ Daisy Wheel Network Program for participation in activities aimed at
providing a comprehensive strategy that addresses employment and training needs:
i. vocational/occupational training,
ii. employment strategies,
iii. education, and
iv. supportive services
C. Performance Outcomes
a. 20 will be served
b. Of the 20 FEZ residents served, 20 will be placed in jobs, given work experience, receive
On -the -Job Training, receive retention services, attend English as a Second Language
classes, be provided with skill upgrades, and have access to paid internships.
c. Planned enrollments by Quarter:
1st
Qtr.
2�a
tr.
3.a
tr.
4m
Qtr.
7
3
7
3
V. SERVICES WILL BE PROVIDED AT:
Orange County Conservation Corps
700 N. Valley St., Suite B
Anaheim, CA 92801
EXHIBIT A
VI. WORK CENTER RESPONSIBILITIES
1. Develop contracts for partners
2. Provide orientation and training on eligibility, referral process, assessment, MIS tracking
system, joint policies and procedures, fiscal billing, documentation, etc.
3. Develop joint forms such as application, screening/intake tool, ISP, referral form, MIS
forms, etc.
4. Perform Program Monitoring
5. Perform Program Reporting
6. Provide partners with on -going technical assistance
7. Provide a quarterly FEZ newsletter
8. Facilitate monthly meetings
VII. ORANGE COUNTY CONSERVATION CORPS RESPONSIBILITIES
1. Orange County Conservation Corps will provide eligible FEZ residents with services
designed to meet the FEZ Board requirements. A participant will be provided with one or
more of the following services to assist them in obtaining unsubsidized employment and self-
sufficiency:
• Case management
• Comprehensive support services
• Job development
• Placement and retention services
• Job training / education
2. Evaluate participants for eligibility and assign those eligible for program services.
3. Perform client assessments. Assess education level of FEZ participants through TABE test
and using ISP form.
4. Report progress and job placements to WORK Center FEZ staff.
5. Incorporate all service navigator partners' information into each other's marketing materials.
6. Attend monthly partner meetings.
7. Provide WORK Center FEZ staff with monthly and quarterly progress reports.
8. Provide WORK Center FEZ staff with necessary information for conducting informal and
formal monitoring of program progress.
9. Meet performance measures. All staff and agencies participating in this project will be held
accountable for achieving their agency FEZ performance measures.
10. Submit Monthly Statistics Report documentation to FEZ Liaison staff by the 5th of every
month. Report should include new enrollments and a continuous Activity Enrollment Form.
11. Maintain a current and complete file (electronic as well as a hard copy) for each FEZ
participant: eligibility documentation; registration form; enrollment form; assessment;
Individual Service Plan (ISP); EEO/Grievance; case notes; supportive services
documentation; attendance records; training documentation; etc.
12. Comply with allowable expenses. To be allowable, costs must: a) be reasonable for the
performance of the program; b) conform to any limitations or exclusions set forth in the
program as to types or amount of cost items; c) be consistent with policies and procedures
that apply uniformly to both federally -financed and other activities of the organization; d) be
determined in accordance with generally accepted accounting principles (GAAP); e) not be
included as a cost or used to meet cost sharing or matching requirements of any other
federally -financed program in either the current or a prior period; and, i) be adequately
documented.
EXHIBIT A
13. Submit in triplicate, a monthly Invoice on City of Santa Ana, Federal Empowerment Zone
Program Subrecipient Request for Reimbursement, showing in detail the amount of money
already expended. Accounting records must be supported by source documentation such as
cancelled checks, paid bills, payrolls, and attendance records. Submit the above stated
documents to Osiel "Ozzie" Madrigal by the tenth (10`h) day of the month following the
month in which services are performed.
EXHIBIT A
ORANGE COUNTY CONSERVATION CORP
FEZ Daisy Wheel Proposal
PY 2003104
OCCC
Direct Program Expenses
FEZ
FEZ
OCCC Staff Wageaysalaries
Time %
Amount
Administrative Staff
Finance Manager -
R. Smith
40,934
9%
3,684
Director of Cms Development
C. Gonzalez
48,006
5%
2,400
Subtotal Admin Wages/Salanes
6,084
Employer Taxes
703
Workers Compensation
85
Benefits
252
Subtotal Admin TaxesrBenefrts
1,040
Total Administrative Staff Expenses
$ 7,124
Program Staff
FEZ Program Specialist
J. Betancourt
34,694
5%
$
1,735
FEZ Case Manager
R. Rodriguez
31,470
100%
31,470
Outreach Specialist
A Valline
33,051
5%
1,653
Transition Specialist
G. Nguyen
37,253
5%
1,863
Subtotal Program Wages/Salaries
$
36,720
Employer Taxes
4,446
Workers Compensation
514
Benefits
2 070
Subtotal Program Taxes/Benefits
$
7,031
Total Program Staff Expenses
$ 43,750
Corpsmember(Cms) Expenses
Average
Total Total
OCCC
FEZ
Cms Stipends
# o/ Cms
Hourly Rate
Hours Wages
Match 85%
Amount
Cms Wages
20
$ 7.25
$232,000
$ 197,200 $
34,800
Cms Hours/Paid Work Experience
32,000
Cms Bonus
1,430
Supportive Services/Training
20
$ 200
4,000
Subtotal Cms Expense
40,230
Program Expenses (page 2)
Project Transportation
3,316
Occupancy
5,444
Subtotal Program Expenses
$
8,760
Total Program Expenses
48,990
OCCC Cash & In Kind
OCCC Staff Salaries & Wages (pg 2)
In -kind
$
26,758
Employer Taxes
$ 3,412
Workers Compensation
375
Benefits
900
Subtotal Taxes & Benefits
$
4,687
OCCC Cms Paid Work Experience
Cash
$
197,200
OCCC Cms Bonus
Cash
$
8,101
OCCC Charter School
In -kind
$
15,000
OCCC Program Expenses (pg 2)
In -kind
$
130,878
Total OCCC Cash & In Kind
$ 382,624
EXHIBIT }3
Proposed
FEZ
FEZ
OCCC
Budget
%
Direct
In -kind
FY 03/04
R. Stroup
78,083
5%
-
3,904
M. Bravo
25,272
0%
-
-
R. Smith
40,934
9%
3,684
-
A. Duran
26,520
5%
-
1,326
C. Gonzalez
48,006
5%
2,400
-
J. Betancourt
34,694
5%
1,735
P. Rohen
31,470
0%
-
-
A. Valline
33,051
5%
1,653
-
G. Nguyen
37,253
5%
1,863
-
R. Rodriguez
31,470
100%
31,470
-
to be hired
27,040
0%
-
-
A. Totaro
44,452
10%
-
4,445
M. Nevel
42,336
10%
-
4,234
J. Drom
40,320
10%
-
4,032
H. Duran
21,778
10%
-
2,178
R. Von Gietzen
48,006
0%
-
-
G. Patin
36,691
5%
-
1,835
J. Volp
36,691
0%
-
-
C. Bartholomew
31,304
0%
-
-
S.Hemandez
26,478
0%
-
-
S.Jasso
28,392
0%
-
-
E. Moran
25,320
0%
-
-
C. King
25,230
0%
-
-
D. Nieto
28,392
0%
-
A. Dickson
24,024
0%
-
-
R. Jones
24,024
0%
-
-
R. Cetayan
24,024
10%
-
2,402
C. Goodness
24,024
10%
-
2,402
D. Smith
24,024
0%
969,303
42,804
26,758
Proposed
Budget
FEZ
FEZ
FEZ
OCCC
FY 03/04
%
Amount
Program 2.8%
In -kind
Note
-
0%
-
-
-
21,652
28.1%
6.078
6,078
Staff training/audit & legal fees
118,150
28.1%
33,165
3,316
29,848
Project gas/oil/vehicle maintenance
11,671
28.1%
3,276
-
3,276
Staff mileage
58,300
28.1%
16,365
16,365
Cms tools/safety supplies/uniforms
193,937
28.1%
54,439
5,444
48,995
Rent/utilities/phones
20,992
28.1%
5,892
-
5,892
Office supplies
38,993
28.1%
10,946
10,946
CPA/ IT / contracted services
9,481
28.1%
2,661
2,661
15,097
28.1%
4,238
4,238
Classroom supplies/books
9,189
28.1%
2,579
2,579
Sankfees
-
0.0%
-
-
497,462 8,760 130,878
32,000
114,000
28.1%
Page 2
EXHIBIT .8
ACKNOWLEDGEMENT OF
SUBRECIPIENT AGREEMENT
To: John P. Reekstin
Executive Director
Santa Ana Empowerment Corporation
From: Subcontractor/Assignee
Subcontractor/Assignee hereby stipulates that it has been provided with a copy, has read,
and is familiar with all of the terms of SUBRECIPIENT's Agreement with the Santa Ana
Empowerment Corporation.
Subcontractor/Assignee further agrees to be bound to all of the terms and provisions of
SUBRECIPIENT's Agreement with the Santa Ana Empowerment Corporation.
Executed this daffy of n Zc�3
BY:
k� u
Name: u A " . S77�e i
Title: G�eeccwt /��-v
EXHIBIT C
Certification Regarding Lobbying
Certification for Contracts, Grants, Loans, and Cooperative Agreements
The undersigned certifies, to the best of his or her knowledge and belief, that:
(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned,
to any person for influencing or attempting to influence an officer or employee of any agency, a
Member of Congress, an officer or employee of Congress, or an employee of a Member of
Congress in connection with the awarding of any Federal contract, the making of any Federal
grant, the making of any Federal loan, the entering into of any cooperative agreement, and the
extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan,
or cooperaive agreement.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any agency, a Member of
Congress, an officer or employee of Congress, or an employee of a Member of Congress in
connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall
complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance
with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award
documents for all subawards at all tiers (including subcontracts, 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.
Name of Certifying Officer Signature Date
EXHIBIT D
Part I
INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES
This disclosure form still be completed by the reporting entity, whether subawardee or prime Federal recipient, at the Initiation or receipt of a covered
Federal action, or a material change to a previous filling, pursuant to title 31 U.S.C. section 1352. The filling of a form be required for each payment or
agreement to make payment for any lobbying entity 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 a Federal Action. Used the SF-LLLrA
Continuation Sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filling and material
change report. Refer to the Implementing guidance published by the Office of Management and Budget for additional information.
1. Identify the type of covered Federal Action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal
action.
2. Identify the status of the covered Federal action.
3. Identify the appropriate classification of this report. If this is a followup report caused by a material change to the information previously reported,
enter the year and quarter in which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this
covered Federal action.
4. Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District, if known. Check the appropriate
classification of the reporting entity that designates if it is, or expects to be, a prime or subaward recipient. Identify the tier of the subawardee, e.g,
the first subawardee of the prime is the 1" tier. Seaboard include but are not limited to subcontracts, subcontracts, subgrants and contract awards
under grants.
5. If the organization filling the report in item 4 checks "subwardee" then enter the full name, address, city, state and zip code of the prime Federal
recipient. Include Congressional District, if known.
6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organizational level below agency name, if
known. For example, Department of Transportation, United States Coast Gaurd.
7. Enter the Federal program name or description for the covered Federal action (iteml). If known, enter the full Catalog of Federal Domestic
Assistance (CFDA) number for grants, cooperative agreements, loans, and loan commitments.
8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e.g.) Request for Proposal (RFP)
number; invitation for Bid (IFB) number; grant announcement number; the contract, grant, or loan award number; the application/proposal control
number assigned by the Federal agency). Include prefixes, e.g.'RFP-DE-90-001."
9. For a covered Federal action where these has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan
commitment for the prime entity identified in item 4 or 5.
10. (a) Enter the full name, address, city, state and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influence the
covered Federal action.
(b) Enter the full names of the individual(s) performing services, and include full address if different from 10 (a). Enter Last Name, First Name, and
Middle initial (MI).
11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting.entity (item 4) to the lobbying entity (item 10). Indicate
whether the payment has been made (actual) or will be made (planned). Check all boxes that apply, if this is a material change report, enter the
cumulative amount of payment made or planned to be made.
12. Check the appropriate box(es). Check all boxes that apply, if payment is made through an in -kind contribution, specify the nature and value of the
in -kind payment.
13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature.
14. Provide a specific and detailed description of the services that the lobbyist has performed, or will be expected to perform, and the date(s) for any
services rendered. Include all preparatory and related activity, not just time spent in actual contact with Federal officials. Identify the Federal
official(s) or employee(s) contacted or the officers), employee(s), or Member(s) of Congress that were contacted.
15. Check whether or not a SF-LLL-A Continuation Sheet(s) is attached.
16, The certifying official shall sign and date the form, print his/her name, title, and telephone number.
Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instructions
searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments
regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of
Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C.20503.
EXHIBIT D
Part II
Certification Regarding Drug -Free Workplace Requirements
The certification set out below is a material representation upon which reliance is placed by the
U.S. Department of Housing and Urban Development in awarding the grant. If it is later
determined that the contractor knowingly rendered a false certification, or otherwise violates the
requirements of the Drug -Free Workplace Act, the U.S. Department of Housing and Urban
Development, in addition to any other remedies available to the Federal Government, may take
action authorized under the Drug -Free Workplace Act.
CERTIFICATION
A. The contractor certifies that it will provide a drug -free workplace by:
(a) Publishing a statement notifying employees that the unlawful manufacture,
distribution, dispensing, possession or use of a controlled substance is prohibited
in the contractor's workplace and specifying the actions that will be taken against
employees for violation of such prohibition;
(b) Establishing a drug -free awareness program to inform employees about -
(1) The dangers of drug abuse in the workplace;
(2) The contractor's policy of maintaining a drug -free workplace;
(3) Any available drug counseling, rehabilitation, and employee assistance
program; and
(4) the penalties that may be imposed upon employees for drug abuse
violations occurring in the workplace;
(c) Making it a requirement that each employee who will be engaged in the
performance of the grant be given a copy of the statement required by paragraph
(a);
(d) Notifying the employee in the statement required by paragraph (a) that, as a
condition of employment under the contract, the employee will -
(1) Abide by the terms of the statement; and
(2) Notify the employer of any criminal drug statute conviction for a violation
occurring in the workplace no later than five days after such conviction.
(e) Notifying the U.S. Department of Housing and Urban Development within ten days
after receiving notice under subparagraph (d)(2) from an employee or otherwise
receiving actual notice of such conviction;
EXHIBIT 6
Pg. 2
(f) Taking one of the following actions, within 30 days of receiving notice under
subparagraph (d)(2), with respect to any employee who is so convicted -
(1) Taking appropriate personnel action against such an employee, up to and
including termination; or
(2) Requiring such employee to participate satisfactorily in a drug abuse
assistance or rehabilitation program approved for such purposes by a
Federal, State, or local health, law enforcement, or other appropriate
agency;
(g) Making a good faith effort to continue to maintain a drug -free workplace through
implementation of paragraphs (a), (b), (c), (d), (a) and (f).
B. The contractor shall insert in the space provided on the attached "Place of Performance"
form the site(s) for the performance of work to be carried out with the grant funds
(including street address, city, county, state, and zip code). the contractor further
certifies that, if it is subsequently determined that additional sites will be used for the
performance of work under the contract, it shall notify the U.S. Department of Housing
and Urban Development immediately upon the decision to use such additional sites by
submitting a revised "Place of Performance" form.
Dated: (/ I �0--,
Program Ope for
EXHIBIT F
DIVISION OF EMPLOYMENT SERVICES
PLACE OF PERFORMANCE
FOR CERTIFICATION REGARDING DRUG -FREE WORKPLACE REQUIREMENTS
Name:
Name of Contractor: ® #E 09 NG E L/I C H Nry el oRJSEl- V14 r-i0A.
Contractor Number:
Date: 9-53
The Contractor shall insert in the space provided below the site(s) expected
to be used for the performance of work under the contract convered by the
certification:
Place of Performance (include street address, city, county, state, zip code
for each site):
70L, Ad IAA Sr Si E- .6
EXHIBIT t
EXHIBIT F
ADDITIONAL INSURED ENDORSEMENT
FOR COMMERCIAL GENERAL LIABILITY POLICY
Insurance Company
This endorsement modifies such insurance as is afforded by the provisions of Policy
# relating to the following:
1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California
92701; its officers, employees, agents, volunteers and representatives are named as
additional insureds ("additional insureds") with regard to liability and defense of suits
arising from the operations and uses performed by or on behalf of the named insured.
2. With respect to claims arising out of the operations and uses performed by
or on behalf of the named insured, such insurance as is afforded by this policy is
primary and is not additional to or contributing with any other insurance carried by or for
the benefit of the additional insureds.
3. This insurance applies separately to each insured against whom claim is
made or suit is brought except with respect to the company's limits of liability. The
inclusion of any person or organization as an insured shall not affect any right which
such person or organization would have as a claimant if not so included.
4. With respect to the additional insureds, this insurance shall not be
cancelled, or materially reduced in coverage or limits except after thirty (30) days written
notice has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana,
California 92701.
(Completion of the following, including countersignature, is required to make this
endorsement effective.)
Effective
Policy # _
Issued to
this endorsement form as a part of
Named Insured
Countersigned by
Authorized Representative
Page 9 of 9
Ah
Ank
,'CORE? CERTIFICAN OF LIABILITY INSUR/WE
PRODUCER
Andreini & Company
300 Esplanade, Suite 100
oe�iiizoo3
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY NO RIGHTHE
HOLDER.NTHISONFERS CERTIFICATE DOES NOTOAMEND, EXTENDCATE OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Oxnard, CA 93030
COMPANIES AFFORDING COVERAGE
(805) 981-9585 F: (805) 981-0161
COMPANY
A PHILADELPHIA INDEMNITY INS CO
WSURND
COMPANY
ORANGE COUNTY CONSERVATION
B STTA.�� ��j"SAS}AT�4N.INS FUND
CORPS FAX NO. 1 (714)-956-1944
700 N. VALLEY STREET, STE. AS
COMPANY 1 f�: "*A • "' �'� S
C'-
ANAHEIM CA 92801
COMPANY
��ySl�c WINE �HOPE
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABDVE 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 POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY
HAVE BEEN REDUCED BY PAID CLAIMS.
CD
LTA
TYPE OF INSURANCE
POLICY NCMBER
POLICY EFFECrm
DATE (MWDDAN)
POLICY EXPIATION
DATE (MWOO/YYI
LDS
A
GENERAL
LASSITY
PHPK0007
07/20/03
07/20/04
GENERAL AGGREGATE
s
PRODUCTS - COWMP AGO
f
COMMERCIAL GENERAL LLLBLRY
CLAM RUDE ® OCCUR
PERSONAL f ADV INAIRY
$1,000,NO
EACH OCCURRENCE
$ODO.000
0M 3 A CONTRACTORS MOT
FIRE DAMAGE wl GM fire)
S 0-NO
MED DfP Wq my pv)
i
•
AUTOMONLE
LIABILITY
ANY AUTO
PHPK055497
07/20/03
07/20/04
COMBINED SINGLE LIMIT
s1,000,D00
BODILY INJURY
(P„ pef,m)
S
AL OWNED AUTOS
SCHEDULED AUTOS
ODDLY
ep
s
HsiED AUTOS
NON -OWED AUTOS
,Sfii�
D
roan
PROPF30Y DAMAGE
f
GARAGE LWBLITY
ANY AUTO
p�
Ptl,7 CItY Art
tney
AUTO ONLY • EA ACCIDENT
f
OAR THAN AUTO O'4Y:
`
EACH ACCIDENT
S
AGGREGATE
s
EXCESS LNABLRY
PHLIB021098
07/20/03
07/20/04
EACH OCCURMNCE
$
A
UMBRELLA FORM
AGGREGATE
i
S In
OTHER THAN VM69SAA FORM
Tj
WORKM5COMPENSAWNAND
EM►LOYEAS' LIABILITY
gB.p1205B-03
06/Ol/03
06/01/04
61s��
Ci FADI 4CCIOENT
3
THE PROMIETOHI WCL
PARTNEICIEFCU 's
EL DISEASE - POLICY LIMIT
7
EL DISEASE - EA EMPLOYEE
f
OFFICERS ARE EXCL
I
OTHER
A
AUTO PHYSICAL
PHPKD55497
07/20/03
07/20/04
DEDUCTIBLE 1,000 COMP
DAMAGE
DEDUCTIBLE 1,000 COLL
DESCRIPTION! OF OFEMTIONLT.00ATIONSNEMNILEf9PECIAL ITEMS
RE: GENERAL LIABILITY COVERAGE -THE
CERT HOLDER ITS OFFICERS, EMPLOYEES
AGENTS AND REPRESENTATIVES ARE NAMED AS ADDITIONAL INSUREDS WITH
RESPECT TO THE OPERATIONS OF THE NAMED INSURED. ADDITIONAL INSURED
ENDORSEMENT,ATTCHED.*10 DAY NOTICE
OF CANCEL FOR NON -PAY SHALL APPLY.
G 'flFfC
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCE111D BEFORE THE
CITY OF SANTA ANA
SUMMON DATE THEREOP, THE ISSUING COMPANY WLLXTgar0"XWXMAl
ATTN : ESTHER AKHAVAN/PARK PLANNING
_ 30 DAYS WNTTEN NOTICE TO THE CWT FKATE MOLDER HAM® TO THE LM,
888 W. SANTA ANA BLVD., STE 200
xBcac)EId90)f6C IIMGCSUCKMKTCEJGRMY za9sscxecT>aaxx
SANTA ANA CA 92701
XatXMn >GlawXkBLacxx xaaxaRSDscsTXTCXSc
AUTHOR ESENTAl1YE
[}'EFT y x Sf
AC.�J.T1Lf .FJ' 1' R �.0 q SE ,y '�:`r o k L } 4.�} ff/�Q f
.. ...... .5.. ...,.W3 v�J'3Y .df"a'F :. n.R n)ble,Y.iS. OiPYn .... F
#'i). ..+�u, A '. NA,,:111WOkI:
xa
•
me,�� 1• - i t q i•\. a in
Tnsuraflec Company _ Db a t oAet i h a r��o s
This endorsement modifios such insurartee as is afforded by the provisions of Policy
#it 05649, relating to thefbllowing:
1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701, its
officers, employees, agents, volunteen and Pepresentativos are reamed as additional insureds
("additional insureds') with regard to liability and defense of suits arising from the operations
and uses perfonucd by or on behalf of the named insured.
2. With respect to Claims arising out of the operations and uses performed by oT or,
behalf ofthe named insured, such insurance as is afforded by ibis policy is primaty and is sot
additional to or contributing with arty other Insurance carried by or for the benefit of the
additional'nsureds. Unless the city is gfiossly negligent.
3, This insurance applios separately to each insured against whom claim is made or
suit it brought cacept with xespect to the eempany's limits of liability. The inclusion of any
person or orgattizatton as an insured shall not affect any right whicb such person or organization
would have as a claimant If not so included.
4. With respect to the additional Insureds, this insurance shall not be cancelled, or
mattxWly reduced in coverage or limits except after thirty (30) days written notice has been
given to the City of Santa Ana, 20 Civic Center Plata, Santa Ana, California 92701,
(Completion of the following, Including countersignature, is required to tn*c this endorsement
effective)
l ffrctive —� Q this endorsement form as a part of
policy#. DHPYA§b487 �
Issued to
Named u
Cournersipned by �f�^ YLI�Wkz
Authorized Reps eniativee —
$PP RD A TO FORM
I INE LEE SMAW
Deputy City Attorney
;In ,,
POLICY NUMBER:PHPK055497
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
ATTN: ESTHER AKHAVAN/PARK PLANNING
888 W. SANTA ANA BLVD., STE 200
SANTA ANA, CA 92701
(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 Ilabli ty arising out of your operations or premises owned by or
rented to you.
CG 20 26 11 85 Copyright, Insurance Services Office, Inc., 1984
E
ANDREINI & COMPANY
Insurance / Risk Management / Employee Benefits
ACORD FORM 25-S - CONTINUED...
IT IS AGREED THAT ANY INSURANCE MAINTAINED BY THE CITY OF
SANTA ANA SHALL APPLY IN EXCESS OF, AND NOT CONTRIBUTE WITH,
INSURANCE PROVIDED BY THIS POLICY EXCEPT IN THE CASE OF SOLE
NEGLIGENCE OR WILLFUL MISCONDUCT BY THE CITY OF SANTA ANA.
D AS "0 Foy
STIN�SHAW
uty City Attorney
300 Esplanade, Suite 100, Oxnard, CA 93030 License 0208825 8051961-9585 FAX 805/981-0161
CERTHOLDER COPY
STATE P.O. BOX 420807, SAN FRANCISCO, CA 94142-0807
COMPENSATION
INSURANCE
FUN D CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
ISSUE DATE: 12-02-2003 GROUP: 000046
!,z POLICY NUMBER: 12055-2003
`,•_ av(-�� �3 CERTIFICATE ID: 4e
CERTIFICATE EXPIRES: 06-01-2004
06-01-2003/06-01-2004
CITY OF SANTA ANA
ATTN: KIM
20 CIXffC CENTER PLAZA
SANTA ANA CA 92701
JOB: ALL OPERATIONS
This is to certify that we have issued a valid Worker's Compensation insurance policy in a form approved by the California
Insurance Commissioner to the employer named below for the policy period indicated.
This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer.
We will also give you.30 days advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not an insurance policy and does not amend, extend or after the coverage afforded by the
policies listed herein_ Notwithstanding any requirement, term or condition of any contract or other document with
respect to which this certificate of insurance 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.
AUTHORIZED REPRESENTATNE
A(�,c.A4-
PRESIOEE
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE.
ENDORSEMENT #1586 - VOLUNTEER COVERED.
ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 06-01-2003 IS
ATTACHED TO AND FORMS A PART OF THIS POLICY.
G> 50-;� r
T 4
EMPLOYER APPROVED AS TO FORM
ORANGE COUNTY CONSERVATION CORP. (A NON PROFIT
CORP.) ., . _-.__.__..
700 N VALLEY ST STE B Laura Stw $ eedq
ANAHEIM CA 92801 asistant City AuorneY
SCIF 10262E Accept Nis scats s* H you see a Haim asteneark Nat reads -OFFICIAL STATE FUND DDCUMENr'
A1WN
PRIEE :12-02-2003
PAGE 1 OF 1