HomeMy WebLinkAboutINTERVAL HOUSE 9AGREEMENT TERMINATION
Please complete this form when the attached agreement is no longer in effect.
Return form to the Sr. Deputy Clerk of the Council (M-30)_ Call 647-5238 if you have any
questions.
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City of Santa Ana
Revised 8-7-03 Clerk of the Council
A-2004-039
INSURANCE ROT ON HLC
WORK MAY & PROCEED
CLERK OF COUNCIL
DATE: !C,`f4-Oq AGREEMENT BETWEEN THE CITY OF SANTA ANA
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AND INTERVAL HOUSE
FOR THE USE OF EMERGENCY SHELTER GRANT FUNDS
(With Provisions Relating to Compliance with Title X
and 24 CFR Part 35 Relating to Lead Based Paint)
THIS AGREEMENT, is hereby made and entered into this 3rd day of May, 2004, by and
between the City of Santa Ana, a charter city and municipal corporation of the State of California
("CITY") and INTERVAL HOUSE, a California nonprofit organization ("SUBRECIPIENT").
WITNESSETH
Recitals:
1. CITY is the recipient of Emergency Shelter Grant ("ESG") funds from the United
States Department of Housing and Urban Development ('HUD") pursuant to the Stewart B.
McKinney Homeless Assistance Act: Emergency Shelter Grants Program 42 USC 11331 et seq.
2. CITY has approved the provision of federal funds under the ESG to be used in the op-
eration of an emergency shelter program for the homeless of the City of Santa Ana ('said pro-
gram") as further described by a Scope of Work and Schedule of Performance in Exhibit A, at-
tached hereto and by this reference incorporated herein.
3. SUBRECIPIENT represents that it has expertise and experience in the provision of
emergency shelter programs for the homeless and is willing to use said federal funds to operate
said program.
4. SUBRECIPIENT agrees to assist homeless individuals and families in obtaining:
appropriate supportive services including, but not limited to, temporary and permanent housing,
medical health treatment, mental health treatment, counseling supervision and other services es-
sential for achieving independent living, as well as other federal, state, local and private assis-
tance available for such individuals.
5. Title X of the 1992 Housing and Community Development Act (Title X) established
requirements relating to lead based paint ("LBP") in housing receiving federal assistance,
with particular requirements relating to (i) notification (including pamphlet distribution, disclo-
sure to purchasers and lessees, notice of lead hazard presumption or results of evaluation, and/or
lead hazard reduction), (ii) lead hazard evaluation (including visual assessment, paint testing,
and/or risk assessment), (iii) lead hazard reduction (including paint stabilization, interim con-
trols, standard treatments, or abatement depending on the requirements for housing activity type),
(iv) ongoing maintenance, if required, and (v) response to children with environmental interven-
tion blood lead levels, as required; and
6. On September 15, 1999 HUD adopted implementing regulations to Title X that became
effective September 15, 2000 as set forth in 24 CFR Part 35, et seq. ("LBP Regs."), which estab-
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lish specific rules regarding notification to owners and occupants about the existence of LBP
hazards, identification of LBP hazards, and control of LBP hazards; and
7. Residential structures built after January 1, 1978 are exempt from lead -based paint re-
quirements as the use of lead -based paint was banned for use in residences after this date by
Congress (24 CFR Part 35.115). Therefore, the Title X requirements set forth herein shall not be
applicable if the structures involved were built after January 1, 1978.
8. Subpart K - Acquisition, Leasing, Support Services, and Operation of the LBP Regs, sets
forth specific requirements relating to housing providers, such as SUBRECIPIENT, who admin-
ister local programs that provide supportive housing for special needs populations and are funded
by HUD Office of Community Planning and Development ("CPD") programs, including
ESG funds, as provided to SUBRECIPIENT under this Agreement; and
9. In connection with the grant of funds under this Agreement, CITY requires that
SUBRECIPIENT comply and show evidence of compliance with all applicable requirements of
Title X and the LBP Regs, in particular Subpart K relating to acquisition, leasing, support ser-
vices, or operations, and Subpart J relating to rehabilitation, as and when applicable; and
10. In connection with the grant of funds under this Agreement, CITY requires that
SUBRECIPIENT comply and show evidence of compliance with all applicable requirements of
Title X and the LBP Regs, in particular Subpart M relating to tenant based rental assistance, as
and when applicable; and
11. Attached and hereby fully incorporated to this Agreement are the following notification
attachments: Attachment No. 1 entitled "Protect Your Family From Lead In Your Home",
EPA747-K-99-001, Attachment No. 2 entitled "Sample Disclosure Format for Target Housing
Sales, Disclosure of Information on Lead -Based Paint and Lead -Based Paint Hazards", and At-
tachment No. 3 entitled "Sample Summary Risk Assessment Notice Format'; provided however,
that such attachments are not intended to modify or limit SUBRECIPIENT'S obligation to fully
comply with all applicable provisions of Title X and the implementing regulations in the LBP
Regs; and
12. By this Agreement SUBRECIPIENT will accept assignment from the CITY of all re-
sponsibilities set forth in Subpart K of the LBP Regs; and
13. The CITY and SUBRECIPIENT have duly executed this Agreement for the expenditure
of such funds; and
WHEREFORE, it is agreed by and between the parties, that the foregoing Recitals are a sub-
stantive 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:
is
L SUBRECIPIENTS'S OBLIGATIONS
A. Non -Profit Status - Representations and Warranties
(1) SUBRECIPIENT acknowledges that its operations and the services it provides to
the community are subject to Subpart K, and, in some instance(s) Subpart J and/or Subpart M, of
the LBP Regs.
(2) SUBRECIPIENT acknowledges that its operations and the services it provides in-
clude: (a) acquisition, leasing, or ownership of residential property for the purpose of providing
affordable housing for persons with special needs, such as transitional housing, or (b) housing for
persons with special needs, such as the disabled, or (c) financial assistance to assist transitional
housing participants to move to permanent housing by paying for the first month's rent or secu-
rity deposit, or (d) tenant -based rental assistance to program participants who choose their own
housing units, and by provision of such services such housing is subject to the requirements of
the LBP Regs.
(3) Representations:
(a) Authority. SUBRECIPIENT is a duly organized and existing non-profit
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.
(b) Experience. SUBRECIPIENT is a qualified provider of the services to be
provided hereunder.
(c) Familiarity With Services Required. By executing this Agreement,
SUBRECIPIENT warrants that (i) it has thoroughly investigated and considered the services to
be performed and provided hereunder, (ii) it has carefully considered how the services should be
performed, and (iii) it fully understands the facilities, difficulties and restrictions attending per-
formance of the services under this Agreement, inclusive of compliance with the LBP REGS.
Should SUBRECIPIENT discover any latent or unknown conditions materially differing from
those inherent in the work or as represented by CITY, it shall immediately inform CITY of such
fact and shall not proceed except at SUBRECIPIENT'S risk until written instructions are re-
ceived from CITY'S representative.
(d) No Conflict. To the best of SUBRECIPIENT'S knowledge,
SUBRECIPIENT'S execution, delivery and performance of its obligations under this Agreement
will not constitute a default or a breach under any contract, agreement or order to which
SUBRECIPIENT is a party or by which it is bound.
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(e) No Bankruptcy. SUBRECIPIENT is not the subject of any current or threat-
ened bankruptcy proceeding.
(f) No Pending Legal Proceedings. SUBRECIPIENT is not the subject of a cur-
rent or threatened litigation that would or may materially affect SUBRECIPIENT'S performance
under this Agreement.
(g) Application Veracity. All provisions of and information provided in
SUBRECIPIENT'S application for funding submitted to CITY including any exhibits are true
and correct in all material respects.
(h) No Pending Investigation. SUBRECIPIENT is not aware that it is the
subject of any current or threatened criminal or civil action investigation by any public agency,
including without limitation a police agency or prosecuting authority, that would relate to affect
performance of the Agreement or provision of services hereunder.
(4) Compliance with Subpart K of LBP Rees. Subpart K — Acquisition, Leas-
ing, Support Services, or Operation
(a) SUBRECIPIENT acknowledges and agrees that it shall comply with and im-
plement the requirements set forth in Title X and the LBP Regs to eliminate, as far as practicable,
LBP hazards in all residential property that is under its ownership, possession, or control and/or
residential property occupied by persons or families that receive financial or other assistance
from SUBRECIPIENT.
(b) SUBRECIPIENT shall provide a notice to all residents/occupants of residen-
tial property that is under its ownership, possession, or control and/or residential property occu-
pied by persons or families that receive financial or other assistance from SUBRECIPIENT in
accordance with Section 35.125 of the LBP Regs.
(i) SUBRECIPIENT acknowledges that in connection therewith a
visual assessment is not considered an evaluation for purposes of the LBP
Regs.
(c) Notification (24 CFR 35.130). SUBRECIPIENT shall provide the LBP haz-
ard information pamphlet in accordance with Section 35.130 of the LBP Regs to all occupants,
owners, and purchasers of housing.
(i) The pamphlet shall be the EPA/HUD/Consumer Product Safety
Commission lead hazard information pamphlet or an EPA -approved equivalent.
The current form and version of the pamphlet is attached as Attachment No. 1
to this Agreement.
(ii) SUBRECIPIENT shall cause to be disclosed to all purchasers
and lessees available information and knowledge regarding the presence of LBP
and LBP hazards prior to selling or leasing a housing unit in accordance with 24
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CFR 35, Subpart A. The current form and version of such notice is attached as
Attachment No. 2 to this Agreement.
(iii) SUBRECIPIENT shall ensure that all occupants, owners, and
purchasers of housing be notified in writing of the results of the presumption of
LBP and/or LBP hazards, and results of any lead hazard evaluation, and any lead
hazard reduction work in accordance with 24 CFR 35, Subpart A. The current
form and version of such notice is attached as Attachment No. 3 to this Agree-
ment.
(d) Lead Hazard Evaluation (24 CFR 35.125). SUBRECIPIENT shall conduct
all activities described in Section 35.1015 relating to visual assessment, paint stabilization, risk
assessment, and maintenance with regard to all residential property that is under its ownership,
possession, or control and/or residential property occupied by persons or families that receive
financial or other assistance from SUBRECIPIENT, except for the exemptions described below
in section 4 (d)(i)(1).
(i) SUBRECIPIENT shall cause a visual assessment to identify de-
teriorated paint in all residential property that is under its ownership, possession, or control
and/or residential property occupied by persons or families that receive financial or other assis-
tance from SUBRECIPIENT.
(1)Section 35.115(a) provides exemptions from Subparts B
through R of the LBP Regs. including without limitation, (a) short term emergency assistance
lasting less than 100 days cumulatively is exempted from compliance with Subpart K as to such
short term rental assistance units, and (b) exemption for zero -bedroom units, including SRO
units, for which occupancy by a recipient of SUBRECIPIENT'S services is for less than 100
days, and (c) exemption for residential housing units constructed after January 1, 1978.
(ii) To the extent that the assistance provided by SUBRECIPIENT
to persons or households meets one or more of the exemptions set forth in the LBP Regs, then
compliance with the notification, evaluation, reduction, clearance and other requirements of the
LBP Regs is not required related to the subject housing unit due to such exemption.
(iii) SUBRECIPIENT shall comply with the applicable provisions
of both Subpart K and Subpart M (Tenant Based Rental Assistance) of the LBP Regs. as to all
tenant -based long term housing assistance, i.e., assistance to persons/households residing in
housing units cumulatively for more than 100 days. If SUBRECIPIENT has knowledge that an
assisted family or household will occupy a dwelling unit for more than 100 days, the LBP Regs
require evidence of compliance prior to occupancy. Funding to be provided hereunder is condi-
tioned upon evidence of compliance.
(1) Subpart M applies to all dwelling units occupied to be
occupied by families or households that have one or more children of less than 6 years of age, as
well as the common areas servicing such dwelling units, and exterior painted surfaces associated
with such dwelling units or common areas. LBP compliance requirements relating to such dwell-
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ing units includes, without limitation: notification, evaluation by visual assessment, paint stabi-
lization utilizing safe work practices, and clearance.
(2) CITY advises SUBRECIPIENT that in the event the
services provided hereunder include rental assistance payments, such as first and last month's
rent and/or security deposit, and the assisted tenant executes a lease for long term occupancy, in-
cluding occupancy in the same dwelling unit for more than 100 days, then the provisions of Sub-
part M (Tenant Based Rental Assistance), will apply (unless otherwise informed and directed by
HUD). In this regard, CITY advises SUBRECIPIENT that Subpart M requires HQS inspection
of each dwelling unit prior to occupancy and prior to compliance with applicable notification,
evaluation by visual assessment, reduction through paint stabilization utilizing safe work prac-
tices, and clearance requirements of the LBP BEGS.
(e) Lead Hazard Reduction Work. SUBRECIPIENT shall cause LBP hazard
reduction, such as paint stabilization, interim controls, standard treatments, or abatement of all
residential property that is under its ownership, possession, or control and/or residential property
occupied by persons or families that receive financial or other assistance from SUBRECIPIENT,
except as exempted as described in subsection 4(d)(i)(1) above.
(1) If paint stabilization occurs, SUBRECIPIENT shall cause paint stabi-
lization of each deteriorated surface and clearance of residential units pursuant to Section
35.1330(a) and (b) shall occur before occupancy of a vacant dwelling unit, or where a unit is
occupied, immediately after receipt of the ESG FUNDS hereunder.
(2) Safe Work Practices shall be used in all LBP hazard reduction work.
(3) Clearance shall be conducted to confirm that no LBP hazards remain
when LBP hazard reduction work is complete. Confirmation of clearance by written certification
of a qualified inspector is required on an annual basis in connection with submittal of the April
15 quarterly report.
(f) Ongoine Maintenance. SUBRECIPIENT shall incorporate ongoing LBP
maintenance activities into regular building operations in accordance with Section 35.1355(a) for
all residential property that is under its ownership, possession, or control and/or residential prop-
erty occupied by persons or families that receive financial or other assistance from
SUBRECIPIENT, except as exempted as described in subsection 4(d)(i)(1) above.
(1) Ongoing maintenance includes confirmation of clearance which shall
be conducted to confirm that no LBP hazards remain when LBP hazard reduction work is com-
plete.
(2) Ongoing maintenance also includes confirmation of clearance by writ-
ten certification of a qualified inspector on an annual basis in connection with submittal of the
April 15 quarterly report.
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(3) A part of such ongoing maintenance obligation includes notification of
the results of clearance confirmation and annual confirmation of clearance.
a. SUBRECIPIENT shall cause to be provided a notice to all oc-
cupants of all residential property that is under its ownership, possession, or control and/or resi-
dential property occupied by persons or families that receive financial or other assistance from
SUBRECIPIENT in accordance with Sections 35.125(b)(1) and (c), describing the results of the
clearance examination and the results of annual certification.
(g)_Units Cleared Prior to Date of Agreement Confirmation of Clearance.
In the event the requirements of the LBP REGS relating to lead hazard evaluation, lead hazard
reduction, and lead hazard clearance have been completed on the subject dwelling units prior to
the Date of Agreement, then the SUBRECIPIENT shall provide to the CITY with the April 15
quarterly report a certificate from a qualified inspector evidencing a recent inspection and con-
firmation of clearance of LBP and LBP hazards from the subject dwelling unit(s).
5. LBP Informational Summary. For purposes of information only and in no
respect intended to be a representation or warranty of the provisions of the LBP REGS, the CITY
has caused to be prepared an information summary relating to the LBP REGS and application to
dwelling units that may be occupied by recipients of services and/or funding from
SUBRECIPIENT under this Agreement. Attachment No. 4 to this Agreement, attached and
hereby fully incorporated by this reference, is such information summary. CITY staff will coop-
erate with and make themselves available to SUBRECIPIENT to assist in implementation of
compliance with the LBP REGS as to residential dwelling units to be assisted by
SUBRECIPIENT. The parties acknowledge and agree the CITY is and shall not be liable or re-
sponsible for the accuracy of such summary, and the SUBRECIPENT is directed to the LBP
REGS and implementing guidance published and provided by HUD relating to compliance with
such LBP REGS.
B. Amount of Grant; Quarterly Disbursement and Match Funds. The amount
granted to SUBRECIPIENT is $("35,000"), and such funds shall be expended by
SUBRECIPIENT on or before June 30, 2005. The ESG FUNDS shall be disbursed by CITY to
SUBRECIPIENT on a quarterly basis, subject to and upon receipt and approval of a complete
quarterly activity report, with the final payment subject to the satisfaction of the condition prece-
dent of submittal of complete reporting information due on or before July 15 of the applicable
funding year, as hereinafter more fully set forth. SUBRECIPIENT shall be obligated to perform
such duties as would normally extend beyond the term, including but not limited to obligations
with respect to indemnification, audits, reporting, data retention/reporting, and accounting.
In accordance with 42 USC 11375(a), SUBRECIPIENT agrees to match all federal funds
provided by CITY to SUBRECIPIENT with an equal amount of funds from sources other than
these or other ESG funds. SUBRECIPIENT cannot use ESG funds from other jurisdictions in
order to meet this match requirement. Match documentation showing new, previously unused
match dollars, must be provided with each quarterly report.
C. Use of Funds. SUBRECIPIENT agrees to use said funds pursuant to this
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Agreement to pay for necessary and reasonable costs allowable under the federal law and regula-
tions to operate said program only. Said amounts shall include and will be limited to, essential
services, homeless prevention, and/or operations costs. Allowable program costs are detailed in
the Budget, as set forth in "Exhibit B," attached hereto and by this reference incorporated herein.
SUBRECIPIENT'S failure to perform as required may, in addition to other remedies set forth in
this Agreement, result in readjustment of the amount of funds CITY is otherwise obligated to pay to
SUBRECIPIENT pursuant to the terms hereof. SUBRECIPIENT agrees that the homeless shelter
and services under said program shall be made available for the entire period during which said
funds are provided.
D. Allowable Costs. SUBRECIPIENT agrees to complete said program on or before
and to use said funds to pay for necessary and reasonable costs allowable under the federal law and
regulations to operate said program. Said amounts shall include essential services, homeless
prevention, and/or operations costs. Other allowable program costs are detailed in the Budget, as
set forth in "Exhibit B," attached hereto and by this reference incorporated herein.
SUBRECIPIENT shall use all income received from said funds only for the same purposes for
which said funds may be expended pursuant to the terms and conditions of this Agreement.
E. Licensine. 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.
F. Zoning. SUBRECIPIENT agrees that any facility/property used in furtherance of
said program shall be specifically zoned and permitted for such use(s) and activity(ies). Should
SUBRECIPIENT fail to have the required land entitlement and/or permits, thus violating any local,
state or federal rules and regulations relating thereto, SUBRECIPIENT shall 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.
G. Separation of Accounts. All funds received by SUBRECIPIENT from CITY
pursuant to this Agreement shall be maintained separate and apart from any other funds of
SUBRECIPIENT, or of any principal or member of SUBRECIPIENT, in an account in a federally
insured banking or savings and loan institution with record keeping of such accounts maintained
pursuant to applicable legal requirements. No monies shall be withdrawn from such account except
for expenditures relating to essential services, homeless prevention and/or operations costs, as
authorized hereunder.
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H. Audit Report Requirements. SUBRECIPIENT agrees that if SUBRECIPIENT
receives Three Hundred Thousand Dollars ($300,000.00) 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
October 1 of the year following the program year in which this Agreement is executed. Further,
SUBRECIPIENT shall comply and/or cause compliance with audit report(s) required by applicable
provisions of Title X and the LBP Regs.
I. Record Keepingaeporting. SUBRECIPIENT shall keep and maintain complete
and adequate records and reports to assist CITY in meeting and maintaining its record keeping
responsibilities under the ESG BEGS, Title X, and the LBP Regs, including the following:
(1) Records
a. Documentation evidencing income level of persons and/or families par-
ticipating in or benefiting by the SUBRECIPIENT program.
b. Documentation of the number of persons and/or families participating in
or benefiting by the SUBRECIPIENT program.
c. Household information shall include number of persons, identification
of head of household, race/ethnicity, age of children, seniors, income
verification.
d. Documentation of homelessness pursuant to 42 U.S.C. 11374(a)(4)
and 24 CFR 576.21.
e. Documentation of all ESG FUNDS received from CITY.
f Documentation of expenses as identified in the Budget Proposal, in-
cluding evidence of incurring the expense, invoices for goods or services, copies of
any and all contracts or documentation pertaining to costs for subcontractors, plus
all other invoices for which ESG FUNDS were expended, and payment therefor.
g. Any such other related records as CITY shall reasonably require or as
required to be maintained pursuant to the ESG BEGS.
h. Documentation evidencing compliance with all applicable provisions
of Title X and the LBP Regs, in particular Subpart K and, as applicable Subpart J
and/or Subpart M.
(i) Specific documentation, as required, evidencing compli-
ance with all applicable provisions of such LBP Regs includ-
ing: (i) notification, including distribution of the lead hazard
information pamphlet (Attachment No. 1), disclosure and no-
tices of hazard evaluation and reduction (Attachments No. 2
and 3); (ii) evaluation of lead hazard(s), including paint test-
ing and risk assessment; (iii) reduction of lead hazard(s), in-
cluding safe work practices and clearance, and confirmation
of clearance; and (iv) ongoing maintenance, as and if appli-
cable for multifamily properties.
(ii) In this regard SUBRECIPIENT shall track information on
all persons/households assisted and the housing units assisted
with the ESG FUNDS. Attachment No. 5 hereto is a sample
form for tracking persons/households and housing units as-
sisted with the ESG FUNDS. All categories of information set
forth in such tracking form shall be prepared and submitted to
the CITY with the April 15 quarterly report.
(iii) In the event that such information and reports are not com-
plete and reasonably satisfactory information submitted in order
for CITY staff to review and evaluate compliance with applica-
ble ESG REGS and LBP Regs, then the final quarterly dis-
bursement payment shall be withheld from the
SUBRECIPIENT.
(iv) Documentation of clearance confirmation as provided
herein.
(2) Report
(i) Payment Request. Concurrently with the submittal of each
quarterly report, on or before the 15th day of October, January,
April and July, SUBRECIPIENT shall submit both: an original
invoice and true copies of invoices, receipts, agreements or
other documentation supporting and evidencing how the ESG
FUNDS have been expended during the applicable quarter.
(ii) Quarterly Activity Report: Including in such reports
evidence of compliance with all applicable provisions of Title X
and the LBP Regs, in particular Subpart K and, as applicable
Subpart J, as further described in subsection (d) hereinafter, and
Subpart M, if SUBRECIPIENT provides long term tenant -based
rental assistance. SUBRECIPIENT agrees to provide CITY with
written cumulative (year-to-date) reports of its activities on or
before the 15th day of October, January, April and July for the
period beginning July 1, and through and including the previous
three-month reporting period setting forth the activities, program
accomplishments, new program information and year-to-date
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program statistics on expenditures, caseload and activities. When
appropriate, pictures should be included.
(iii) Quarterly certification of match, plus documentation of
match source.
(iv) Any such other reports as CITY (or HUD) shall reasonably
require and/or request, including but not limited to the following
information: monthly records of all ethnic and racial statistics of
persons and families benefited by SUBRECIPIENT in the per-
formance of its obligations under this Agreement, including, but
not limited to, the activities, program accomplishments, new pro-
gram information, match fund certification and current program
statistics on expenditures, caseload and activities. When appro-
priate, pictures/slides should be included.
(3) Recordkeeping of Ongoing Maintenance under the LBP Regs. If the services and
program activities provided by SUBRECIPIENT hereunder establish an ongoing relationship
with a property (such as long term tenant based rental assistance program [Subpart M] or transi-
tional or permanent housing operated or administered by the SUBRECIPIENT), then the
SUBRECIPIENT shall provide a report to the CITY evidencing that SUBRECIPIENT and/or the
property owner(s), as applicable, has performed ongoing maintenance of the subject property.
Ongoing maintenance shall include evidence of an annual clearance certification of the subject
residential property conducted by a DHS certified technician to ensure that LBP hazard reduction
measures are maintained. All maintenance activities shall be conducted to ensure the threat of
LBP hazards is minimized.
(4) Recordkeeping under the LBP Regs. The SUBRECIPIENT shall keep records of dis-
tribution of notifications, all visual assessment, evaluations, inspections, repairs, and any other
lead hazard evaluation, reduction, safe work practices, and clearance activities.
(a) The SUBRECIPIENT shall keep records evidencing distribution of all lead
hazard information pamphlet(s).
(b) The SUBRECIPIENT shall keep records evidencing each LBP evaluation re-
port, LBP hazard reduction documentations, (such as job specifications), and all clearance or
abatement report(s).
(c) The SUBRECIPIENT shall keep ongoing maintenance records and records of
relevant building operations for use during reevaluations of subject property for LBP and/or LBP
hazards.
1. Such records shall be maintained for not less than longer of
(A) four (4) years after the activities cease or (B) the period re-
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quired by applicable program regulations. Under the ESG REGS
records shall be retained for not less than five (5) years after the ac-
tivities cease.
2. The SUBRECIPIENT shall provide a copy of any of the
above records to the CITY or to HUD upon request of either or
both.
(d) Tracking Report. If the SUBRECIPIENT has provided, or is providing, rental
assistance payments directed to a housing unit or housing units for more than 100 days, or it is
anticipated that during the last quarter of funding that such rental assistance payment will be for
more than 100 days, then the April 15 quarterly report shall contain information and evidence of
compliance with the requirements herein relating to tracking of housing units, cumulative days of
rental assistance, proper notifications to occupants and owners, HQS inspection, visual assess-
ment, work write-up, stabilization and clearance of LBP and LBP hazards, if any. The proposed
form of such tracking information is attached hereto as Attachment No. 5 and fully incorporated
by this reference. In the event such April 15 quarterly report does not fully satisfy the reporting
requirements set forth herein and in the LBP Regs, then the final installment payment of the
ESG FUNDS shall be withheld from disbursement to SUBRECIPIENT.
J. Access to Records. CITY and the United State Government and/or their representatives
shall have access for purposes of monitoring, auditing, and examining SUBRECIPIENT's activities
and performance, to books, documents and papers, and the right to examine records of
SUBRECIPIENT's subcontractors, bookkeepers and accountants, employees and participants in
regard to said program. CITY and the United States Government and/or their representatives shall
also schedule on -site monitoring at their discretion. Monitoring activities may also include, but are
not limited to, questioning employees and participants in said program and entering any premises or
any site in which any of the services or activities funded hereunder are conducted or in which any of
the records of SUBRECIPIENT are kept. Nothing herein shall be construed to require access to any
privileged or confidential information as set forth in federal or state law.
K. Location of Records/Required Length of Record Keeping. All accounting records,
reports, and evidence pertaining to all costs, expenses and the ESG 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 after completion of an audit in conformity with the ESG REGS, except as
hereinafter provided relating to retention of any records or documentation existing, created, or
maintained in compliance with Title X or the LBP Regs. 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. All records relating to, or created or
maintained in compliance with, Title X and/or the LBP Regs shall be retained and maintained by
SUBRECIPIENT indefinitely, including without limitation, all inspection report(s), disclosure
statement(s), and clearance report(s). In the event SUBRECIPIENT does not make the above -
referenced documents available within the city of Santa Ana, California, SUBRECIPIENT agrees to
12
pay all necessary and reasonable expenses incurred by CITY in conducting any audit at the location
where said records and books of account are maintained.
L. Compliance with Law/Program Income. SUBRECIPIENT acknowledges that the
funds being provided by CITY for said program are received by CITY pursuant to applicable
ESG guidelines and that expenditures of these funds shall be in accordance with the ESG guide-
lines and all pertinent regulations issued by agencies of the federal government.
SUBRECIPIENT agrees to comply fully with all federal, state and local laws and court orders
applicable to its operation whether or not referred to in this Agreement, and all Program Re-
quirements. Program income received by SUBRECIPIENT shall be returned to CITY unless
otherwise provided for in this Agreement. SUBRECIPIENT agrees to comply fully with all fed-
eral, state and local laws and court orders applicable to its operation whether or not referred to in
this Agreement.
M. Standing. SUBRECIPIENT shall be in good standing, without suspension by the
California Secretary of State, Franchise Tax Board and Internal Revenue Service. Any change in
the corporate status or suspension of SUBRECIPIENT shall be reported immediately to CITY.
N. Confidentiality. Without prejudice to any other provisions of this Agreement,
SUBRECIPIENT shall, where applicable, maintain the confidential nature of information pro-
vided to it concerning participants in accordance with the requirements of federal and state law.
SUBRECIPIENT certifies that it will develop and implement procedures to ensure the confiden-
tiality of records pertaining to any individual provided family violence prevention or treatment
services under any project assisted under the Emergency Shelter Grants Program and that the ad-
dress or location of any family violence shelter project assisted under the Emergency Shelter
Grants Program will, except with written authorization of the person or persons responsible for
the operation of such shelter, not be made public (24 CFR 576,56). However, SUBRECIPIENT
shall submit to CITY and or HUD or its representatives, all records requested, including audit,
examinations, monitoring and verifications of reports submitted by SUBRECIPIENT, costs in-
curred and services rendered hereunder.
O. hndenendent Contractor. SUBRECIPIENT agrees that the performance of
obligations hereunder are rendered in its capacity as an independent contractor and that it is in no
- way an agency of CITY.
P. Violation of Terms and Conditions. SUBRECIPIENT agrees that if
SUBRECIPIENT violates any of the terms and conditions of this Agreement or any prior
Agreement whereby ESG funds were received by SUBRECIPIENT, or if SUBRECIPIENT reports
inaccurately, or if on audit there is a disallowance of certain expenditures, SUBRECIPIENT agrees
to remedy the acts or omissions causing the disallowance and repay CITY all amounts spent in
violation thereof. If SUBRECIPIENT engaged in fraudulent activity to obtain and/or justify
expenditure of the ESG funds granted hereunder, SUBRECIPIENT shall be required to reimburse
the CITY of all such funds that were obtained/spent under fraudulent circumstances.
1141
Q. Equipment. SUBRECIPIENT agrees to maintain a record for each item of non -
expendable personal property acquired under the terms of this Agreement in accordance with 24
CFR 85.32. Said record shall be made available to CITY upon request. The term "non -expendable
personal property" shall include leased and purchased equipment.
R. Prohibited Use. SUBRECIPIENT hereby certifies and agrees that it will not use
funds provided through this Agreement to pay for entertainment, meals or gifts.
S. Lobbvin¢. 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 C," 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 (see C-1).
T. Financial Interest. SUBRECIPIENT agrees that except for the use of ESG funds
to pay salaries and other related administrative or personnel costs, no persons who exercise or have
exercised any function with respect to ESG activities assisted under the terms of this Agreement, or
who are in a position to participate in a decision -making process or gain inside information with
- regard to such activities, may obtain a financial interest or benefit from a ESG-assisted activity of
SUBRECIPIENT, 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 agencies, or the SUBRECIPIENT.
U. Davis -Bacon Act. All laborers and mechanics employed by contractors or
subcontractors in the performance of construction work, including alterations and repairs, in excess
of $2,000.00, financed in whole or in part with federal 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 276a - 276a-5. Any such construction contract
shall include and comply with the required contract provisions and rules set forth in 29 C.F.R. §5.5.
14
Further, the payroll reports (along with the "Statement of Compliance') and basic records are
required to be maintained and submitted, or made available, pursuant to 29 C.F.R. §5.5(a)(3). No
payment, advance, grant, loan or guarantee of funds shall be approved by the federal agency unless
there is on file with the agency a certification by the contractor that the contractor and its
subcontractors have complied with the provisions of 29 C.F.R. §5.5. A breach of the contract
clauses in 29 C.F.R. §5.5 may be grounds for termination of the contract, and for debarment as a
contractor/subcontractor, as provided in 29 C.F.R. §5.12. Labor standards interviews/investigations
shall be made as necessary to assure compliance [29 C.F.R. §5.6(a)(3)].
V. Homeless Involvement. SUBRECIPIENT certifies that it will involve, to the
maximum extent practicable, homeless individuals and families in constructing, renovating,
maintaining, and operating facilities assisted under the ESG program, and in providing services for
occupants of these facilities [24 CFR 576.56(b); 42 USC 11375(d)].
W. Drug Free Workplace. SUBRECIPIENT certifies that it has established the fol-
lowing drug -free workplace policy:
1. The unlawful manufacture, distribution, dispensing, possession or use of a con-
trolled substance is prohibited in the workplace for any employee involved in a federally funded
program.
2. As an employee working in conjunction with a federally funded program, the em-
ployees of SUBRECIPIENT will be required to:
a) Abide by the terms above in statement 1.
b) Notify appropriate officials of SUBRECIPIENT and CITY officials of any
criminal drug statute conviction for a violation occurring in the workplace not later than five days
after such conviction.
3. The City and the United States Department of Housing and Urban Development
will be notified within ten days after receiving notice of any such violation.
4. Within 30 days of receiving such notice, appropriate personnel action will be
- taken against such employee, up to and including termination.
5. Each such employee shall be required 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.
X. Expenditure of Funds: SUBRECIPIENT must spend all of its grant amount within 24
months of the grant award (24 CFR 576.35). Any funds not obligated within said timeframe
shall be reallocated.
B61
II. CITY'S OBLIGATIONS
A. CITY shall pay to SUBRECIPIENT from funds received under the ESG when, if and
to the extent received from HUD, amounts expended by SUBRECIPIENT in carrying out said
program pursuant to this Agreement up to a maximum aggregate amount of THIRTY FIVE
THOUSAND ($ 35,000 ) in installments determined by CITY. Payments shall be made to
SUBRECIPIENT through the submission of quarterly invoices (on or before the 15th day of Oc-
tober, January, April and July) in a form prescribed by CITY, detailing such expenses. CITY shall
pay such invoices within thirty (30) days after receipt thereof, provided CITY is satisfied that
such expenses have been incurred within the scope of this Agreement and that SUBRECIPIENT
is in compliance with the terms and conditions of this Agreement.
Costs incurred prior to the effective date of this Agreement, accrued as of the first day of
July 1, for purposes identified herein will be allowable for reimbursement upon presentation of
evidence of and invoices for such expenditures.
B. Audit: CITY shall include an audit of the account maintained by SUBRECIPIENT in
CITY's annual audit of all funds pursuant to the Code of Federal Regulations and other applica-
ble federal laws and regulations.
C. Common Rule: Pursuant to CFR 85.40(a), the CITY manages the day-to-day operations
of each grant and subgrant supported activities. CITY staff has detailed knowledge of the grant
program requirements and monitors grant and subgrant supported activities to assure compliance
with Federal requirements. Such monitoring covers each program, function and activity and
performance goals are reviewed periodically.
D. Environmental Review: In accordance with 24 CFR 58, the CITY is responsible for
undertaking environmental review and maintaining environmental review records for each appli-
cable project.
16
E. Performance Monitoring: CITY shall monitor the performance of the
SUBRECIPIENT against goals and performance standards required herein. Substandard per-
formance as determined by the CITY will constitute non-compliance with this Agreement. If ac-
tion to correct such substandard performance is not taken by the SUBRECIPIENT within a rea-
sonable period of time after being notified by the CITY, contract suspension or termination pro-
cedures will be initiated.
III. NONDISCRIMINATION
SUBRECIPIENT agrees that no person on the ground of race, color, national origin, re-
ligion or sex will be excluded from participation in, be denied the benefits of, or be subjected to
discrimination under any program or activity funded in whole or in part with ESG funds.
IV. CONFLICT OF INTEREST
Pursuant to the conflict of interest requirements set forth in 24 CFR 576.57 and OMB Circu-
lars 1-102 and A-110, SUBRECIPIENT agrees that no officer, employee, agent or assignee of
CITY having direct or indirect control of any ESG monies granted to the CITY, inclusive of the
subject ESG FUNDS, shall serve as an officer of SUBRECIPIENT. Further, any conflict or poten-
tial 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 modi-
fications to its board of directors and list of officers
V. SPECIAL CERTIFICATION FOR RELIGIOUS ENTITIES
In addition to, and not in substitution for, other provisions of this Agreement regarding
said program using federal funds, SUBRECIPIENT:
A. Represents that it is, or may be deemed to be, a religious or denominational institution
or organization or an organization operated for religious purposes that is supervised or controlled
by or in connection with a religious or denominational institution or organization;
B. Agrees that, in connection with said program:
1. It will not discriminate against any employee or applicant for employment on the
basis of religion and will not limit employment or give preference in employment to persons on
the basis of religion;
2. It will not discriminate against any person applying for participation in said pro-
gram on the basis of religion and will not limit such participation or give preference to persons
on the basis of religion;
17
3. It will provide no religious instruction or counseling, conduct no religious worship
or services, engage in no religious proselytizing, and exert no other religious influence in said
program;
4. The funds received under this Agreement shall not be used to construct, rehabili-
tate, or restore any facility that is owned by SUBRECIPIENT and in which said program is to be
implemented; provided that, minor repairs may be made if such repairs (1) are directly related to
said program; (2) are located in a structure used exclusively for non -religious purposes and (3)
constitute in dollar terms only a minor portion of the federal fund expenditure for said program.
VI. CONDITIONS ON PROVISIONS OF DEVELOPMENT AND IMPLEMENTING
HOMELESS PREVENTION ACTIVITIES
In addition to, and not in substitution for, other provisions of this Agreement regarding
said program using federal funds, SUBRECIPIENT:
A. Represents that it is, or may be deemed to be, a Homeless Prevention Program [24
CFR 576.21(a)(4)j and will implement homeless prevention activities subject to the limitations
in 42 USC 11374(a)(4);
B. Agrees that, in connection with said program, if ESG funds are to be used to assist
families that have received eviction notices or notices of termination of utility services, the fol-
lowing conditions will be met:
1. The inability of the family to make the required payments must be the result of a
sudden reduction in income;
2. The assistance must be necessary to avoid eviction of the family or termination of
services to the family;
3. There must be a reasonable prospect that the family will be able to resume pay-
ments within a reasonable period of time; and
4. The assistance must not supplant funding for preexisting homeless prevention ac-
tivities from any other source.
VII. PROHIBITION OF NEPOTISM
SUBRECIPIENT agrees not to hire or permit the hiring of any person to fill a position
funded through this Agreement if a member of that person's immediate family is employed in an
administrative capacity by SUBRECIPIENT. For the purposes of this section, the term "immedi-
ate family" means spouse, child, mother, father, brother, sister, brother-in-law, sister-in-law, fa-
ther-in-law, mother-in-law, son-in-law, daughter-in-law, aunt, uncle, niece, nephew, stepparent
18
and stepchild. The term "administrative capacity" means having selection, hiring, supervisor or
management responsibilities.
VIII. 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
Community Development Agency (M-25)
20 Civic Center Plaza
P.O. Box 1988
Santa Ana CA 92702-1988
TO SUBRECIPIENT: Interval House Crisis
P.O. Box 3356
Seal Beach, CA 90740
IX. ASSIGNABILITY
None of the duties of, or work to be performed by, SUBRECIPIENT under this Agree-
ment 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.
X. HOLD HARMLESS
SUBRECIPIENT shall defend, indemnify and save harmless CITY, its officers, agents,
employees, representatives and volunteers from and against any and all damages to property or
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, agents, employees, rep-
resentatives and volunteers from and against any and all claims, demands, suits, actions or pro-
ceedings 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 SUBRECIPI-
ENT's performance of this Agreement.
XI. TERMINATION
This Agreement may be terminated in accordance with Federal Register 24 CFR Part 576
19
as follows:
A. This Agreement maybe terminated by CITY on thirty (30) days' written notice by ei-
ther party. In the event of such termination, SUBRECIPIENT shall only be entitled to reim-
bursement for approved expenses incurred to the effective date of termination.
B. This Agreement may be suspended or terminated by CITY upon five (5) days' written
notice for violation by SUBRECIPIENT of Federal, state and/or local laws governing the use of
Emergency Shelter Grant funds. Furthermore, the SUBRECIPIENT shall comply with the Con-
ditional Use permit requirements. For failure to comply with the aforementioned terms, suspen-
sion or termination shall result, and SUBRECIPIENT shall only be entitled to reimbursement for
approved expenses incurred up to the effective date of suspension or termination.
C. In the event SUBRECIPIENT defaults by failing to fulfill all or any of its obligations
hereunder, CITY may declare a default and termination of the 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 no-
tice, 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 pay-
ments made for services not subsequently performed in a timely and satisfactory manner, and (2)
costs incurred by CITY in obtaining substitute performance.
D. The grant of funds under this Agreement may be terminated for convenience.
E. 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 de-
scribed in Exhibits A and B or failure to meet the performance standards and program goals set
forth therein.
F. In the event this Agreement is terminated as set forth in Section X.A through X.E, in-
- elusive, SUBRECIPIENT agrees to immediately return to CITY, upon CITY's demand and prior
to any adjudication of SUBRECIPIENT's rights, any and all funds not used under this Agree-
ment.
XII. LIMITATION OF FUNDS
The United States of America, through HUD, may, in the future, place programmatic or
fiscal limitations on the use of ESG funds which limitations are not presently anticipated. Ac-
cordingly, CITY reserves the right to revise this Agreement in order to take account of actions
affecting HUD program funding. In the event of funding reduction, CITY may, in its sole and
absolute discretion, reduce the budget of this Agreement as a whole or as to costs category, may
limit the rate of SUBRECIPIENT's authority to commit and spend funds, or may restrict
20
SUBRECIPIENT's use of both its uncommitted and its unspent funds. Where HUD has directed
or requested CITY to implement a reduction in funding, in whole or as to a cost category, with
respect to funding for this Agreement, CITY's City Manager or delegate is authorized to act for
CITY in implementing and effecting such a reduction and in revising, modifying, or amending
the Agreement for such purposes. If such a reduction in funding occurs, SUBRECIPIENT shall
be allowed to de -scope accordingly. Where CITY has reasonable grounds to question SUBRE-
CIPIENT's fiscal accountability, financial soundness, or compliance with this Agreement, CITY
may suspend the operation of this Agreement for up to sixty (60) days upon five (5) days' written
notice to SUBRECIPIENT of its intention to so act pending an audit or other resolution of such
questions. In no event, however, shall any revisions made by CITY affect expenditures and le-
gally binding commitments made by SUBRECIPfENT before it received notice of such revision,
provided that such amounts have been committed in good faith and are otherwise allowable and
that such commitments are consistent with HUD cash withdrawal guidelines.
XIII. INSURANCE
A. SUBRECIPIENT shall famish CITY's Clerk of the Council with an insurance certifi-
cate from its workers' compensation insurance carrier certifying that it carries such insurance and
that the policy shall not be canceled nor the coverage reduced except upon thirty (30) days prior
notice to CITY.
B. SUBRECIPIENT shall undertake self-insurance, or shall obtain, at its sole cost, a pol-
icy or policies of commercial general liability insurance, or equivalent form, with a combined
single limit of not less than $1 Million Dollars per occurrence.
Such insurance shall: (1) name the City of Santa Ana, its officers, agents, employees and
volunteers as additional insureds; (2) be primary with respect to insurance or self-insurance pro-
grams maintained by the CITY; (3) contain standard separation of insureds provisions; and (4)
give to CITY prompt and timely notice of claim made or suit instituted arising out of SUBRE-
CIPIENT's operations hereunder.
SUBRECIPIENT shall: (i) prior to exercising any right under this Agreement, furnish
properly executed certificates of insurance and additional insured endorsement to the CITY
- which shall clearly evidence all coverages required above; (ii) provide that such insurance shall
not be materially changed or terminated except on thirty (30) days prior written notice to the
CITY; (iii) maintain such insurance for the period covered by this Agreement; and (d) replace
such certificates for policies expiring prior to the expiration of this Agreement.
XIV. EXCLUSIVITY AND AMENDMENT TO AGREEMENT
This Agreement supersedes any and all other agreements, either oral or in writing, be-
tween the parties hereto with respect to the use of CITY's ESG funds by SUBRECIPIENT and
contains all the covenants and agreements between the parties with respect to such employment
in any manner whatsoever. Each party to this Agreement acknowledges that no representations,
21
inducements, promises or Agreements, orally or otherwise, have been made by any party, or any-
one 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.
XV. 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.
XVI. VALIDITY
The invalidity in whole or in part of any provision of this Agreement shall not void or af-
fect the validity of any other provision of this Agreement.
XVII. 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 and Attachments referenced herein and attached hereto shall be incorporated
as if fully set forth in the body of this Agreement.
c. No delay or omission by either party hereto to exercise any right or power accruing
upon any noncompliance or default by the other party with respect to any of the terms of this
Agreement shall impair any such right or power or be construed to be a waiver thereof. A waiver
by either of the parties hereto of any of the covenants, conditions, or agreements to be performed
by the other shall not be construed to be a waiver of any succeeding breach thereof or of any
other covenant, condition or agreement herein contained.
22
IN WITNESS WHEREOF, the parties hereto have executed this Agreement on the date
and year first above written.
DATED:
ATTEST:
CITY OF SANTA ANA
a municipal corporation
DAVID N. REAM
City Manager
APPROVED AS TO FORM:
JOSEPH W.FLETCHER
City Attorney
PATRICIA E. HEALY By: LISA E. STORCK
Clerk of the Council Assistant City Attorney
DATED:
23
SUBRECIPIENT:
Signature
Christine Delabre
Administrative Director
EXHIBIT A
Scope of Work
Annual Accomplishment Goal
I. Number of unduplicated Santa Ana residents to be served with grant funds during the 12-
month contract period = 250 PERSONS I $ % Sete*a Ana C 1 i e ✓Its
II. Description of Work - in space below, describe the program to be funded during the 12-month contract
period including services to be provided, program goals, client characteristics, & how grant funds will be utilized.
Interval House will provide shelter, food, clothing, peer/counseling, individual counseling, crisis
hotline counseling, comprehensive medical services and legal assistance to Santa Ana women
who are victims of domestic violence and their children.
The goals are:
• To provide shelter, food and clothing to 50 women and children who are victims of
domestic violence residing in Santa Ana.
o Emergency and transitional shelter will be provided at our facilities.
o Three meals a day plus snacks will be provided by Interval House
o Clothes are provided through a cooperative arrangement with the "Bargain Box"
To provide emotional support and problem solving skills through individual counseling,
group counseling, and domestic violence education groups to 100 women and children
who are victims of domestic violence residing in Santa Ana.
o Individual and peer counseling services will be provided at our facility to women
in and out of shelter.
o Children in and out of shelter will receive a full range of services and activities to
address psychosocial, emotional and academic needs.
To provide 24 hour multi-lingual hotline counseling services to 100 callers from Santa
Ana.
o Interval House provides two published hotline numbers that will be answered by
trained multi-lingual domestic violence advocates. Forty different languages are
available. These services will be available 24 hrs. a day, 365 days a year.
Schedule of Performance
Estimate the number of unduplicated Santa Ana residents
to be served during the 12-month
contract period per quarter:
Quarter 1: July 1 — September 30
60
Persons
Quarter 2: October 1 — December 31
60
Persons
Quarter 3: January 1 — March 31
65
Persons
Quarter 4: April 1 — June 30
65
Persons
Total
250
Persons
EXHIBIT A
Invoicing Schedule
Estimate the amount of grant funds to be requested during the 12-month contract period on a
quarterly basis:
Quarter 1:
July 1 — September 30
$
9,000
Quarter 2:
October 1 — December 31
$
9,000
Quarter 3:
January 1 — March 31
$
8,500
Quarter 4:
April 1— June 30
$
8,500
Total
$
35,000
CITY OF SANTA ANA
EMERGENCY SHELTER GRANT
PROGRAM BUDGET
Organization Name: Interval House
Program Name: Interval House
Program Year: 2004-2005
EXPENDITURES
CATEGORY
SANTA ANA CDBG
OTHER
TOTALPROGRAM
GRANT
RESOURCES
BUDGET
Administrative Staff
$
$244,148.00
$244,148.00
Salaries & Benefits
Program Staff Salaries &
$
$1,975,383.00
$1,975,383.00
Benefits
Office Supplies
$ 4,000.00
$28,000.00
$32,000.00
Rent/Lease
$108,720.00
$108,720.00
Communications
$ 4,000.00
$ 47,530.00
$ 51,530.00
Utilities
$ 5,500.00
$ 18,500.00
$ 24,000.00
C o n t ra c t u a l l P ro f e s s i o n a l
Services
$313,000.00
$313,000.00
Please Specify)
Insurance
$3,000.00
$ 17,000.00
$ 20,000.00
Other (Please Specify)
Repair/Maintenance
$ 6,000.00
$ 37,000.00
$43,000.00
Food
$ 6,000.00
$ 27,000.00
$33,000.00
Program Supplies
$ 6,500.00
$ 53,500.00
$60,000.00
Other Costs:
0
$158,223.00
$158,223.00
TOTAL
$35,000.00
$3,028,004.00
$3,063,004.00
EXHIBIT B
OTHER PROGRAM RESOURCES
FUNDING SOURCE
AMOUNT
Federal / National Service Trust
$203,000.00
Federal / HUD
$241,421.00
STATE / OCJP
$373,690.00
STATE / DHS
$460,200.00
Orange County / HCD
$70,000.00
Orange County / CSA
$133,952.00
Orange County / Calwork's
$180,000.00
Cities ( Santa Ana not included)
$125,139.00
United Way OC
$98,212.00
Foundations
$240,000.00
FUNDRAISING
$250,000.00
OTHERS
$687,390.00
TOTAL
$3,063,004.00
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 under-
signed, 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 coopera-
tive 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 per-
son 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 con-
nection 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 mak-
ing 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
Name of Certifying Officer
EXHBIT C
Page 1 of 2
24
Program Title
Date
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 discrimina-
tion 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 envi-
ronmental responsibilities described at 24 CFR 570.604; and (b) SUBRECIPIENT does not as-
sume CITY'S responsibility for initiating the review process under Executive Order 12372.
EXHIBIT C
Page 2 of 2
25
ACORD CERTIFICATE OF LIABILITY INSURANCF
DATE (MMIDD/YYYY)
Chapman & Associates
License #0522024
P. O. Box 5455
Pasadena CA 91117-0455
Phone:626-405-8031 Fax:626-405-0585
INSURED
Interval House
P.O. Box 3356
Seal Beach CA 90740
bZ01T/=1:7_CH39
THIS CERTIFICATE IS I:. jD AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
INSURERS AFFORDING COVERAGE NAIC #
INSURER A: liveeport xneeranca Company
INSURER B: Ales. North America Ins Co
INSURER G
INSURER D:
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MM/DDIM
POLICY EXPIRATION
DATE (MWDDtM
LIMITS
GENERAL LIABILITY
EACH OCCRR UENCE
E1900000
A
X COMMERCIALGENERAL LABILITY
CLAIMS MADE FX ] OCCUR
RP0004364
10/01/03
10/01/04
PREMISES(Eaocuuenca)
f 100000
MED EXP(My one Person)
$ 5000
X Owner/Cont Prot.
PERSONAL$ ADV INJURY
$1000000
X
Prof'1 Liab/Abuse
GENERA -AGGREGATE
$3000000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OPAGG
$3000000
X POLICY PRO-
JECT LOC
Hm Ben.
10 QQQ QQ
AUTOMOBILE
LIABILITY
NY AUTO
ANYAUTO
BINED LIMB
(Ea
$
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per person)
$
HIRED AUTOS
NON -OWNED AUTOS
BODILY INJURY
(Per accitleni)
$
PROPERTY DAMAGE
(Per amiCent)
$
GARAGE LIABILITY
APPROVE
lJ
AS 7O FORM
1V1
AUTO ONLY - EA ACCIDENT
$
ANY AUTO
/01
OTHER THAN EA ACC
AUTO ONLY: AGG
S
$
E%CESSIUMBRELLA LIABILITY
OCCUR CLAIMS MADE
To S i."J)
eputy CiLy
EACH OCCURRENCE
$
k1tar,10
AGGREGATE
$
$
DEDUCTIBLE
a
RETENTION $
$
B
WORKERS COMPENSATION AND
EMPLOYERS'LIABILITY
ANY PROPMETOR/PARTNER/EXECUTIVE
OFFICER/NIEMBER EXCLUDED?
S yECIAL PROVIbe SIONS
SPECIAL PROVISIONS Eelow
IO
WC1002628
02/01/03
02/01/04
TWC LIMBS ER
E.L. EACH ACCIDENT
$1000000
E.L. DISEASE -EA EMPLOYEE
$ SOOOOOO
E.L. DISEASE -POLICY LIMIT
$ 100QQQQ
OTHER
A Crime Section RP0004364 10/01/03 10/01/04 Dishonest $110,000
DESCRIPTION OF OPERATIONS (LOCATIONS /VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS Forgery $110,000
The certificate holder is named as an additional insured as respects their
interest in the business operations of the named insured, with the exception
of workers' compensation. (CG 2026 Hndt attached) y
CTYSANT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
GATE THEREOF, THE ISSUING INSURER WILL a=1IX2I0==MAIL 30 DAYS WRITTEN
City of Santa Ana NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT
Comm Development Agency
M-25 OR
20 Civic Center Plaza
Santa Ana CA 92702 AUT EDREPRE ANVE
(2001/08) - --
Riverport
POLICY NUMBER: RP0004364
CL-261
(11-85)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CG 20 26 11 85
ADDITIONAL INSURED -DESIGNATED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following:
1
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
NAME OF PERSON OR ORGANIZATION:
City of Santa Ana
Community Development Agency (M-25)
20 Civic Center Plaza
Santa Ana, CA 92702
(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.
"Such Insurance as is afforded by the Endorsement for the Additional Insured's shall apply as primary
insurance. Any other insurance maintained by the district or its officers and employees shall be excess only
and not contributing with the coinsurance afforded by this endorsement".
Named Insured:
Interval House
P.O. Box 3356
Seal Beach, CA 90740
Authorized Representative/a-7 C /--
Date: 10/07/03
A '1- 'O ED AS TO FORIJ
Depury City Attorney
10/20/2004 01:47 FAX
U 002
GA09
ACORD_ CERTIFICATE OF LIABILITY INSURANCE
1Nxaa 5 28 4
PRODUCER
Chapman & Associates
License #0522024
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P . O. Box 5455
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Pasadena CA 91117-0455
Phone1626-405-8031 Pax=626-405-0585
INSURERS AFFORDING COVERAGE
NAICM
WSU;Hn
03�
INSURER M. RlwN.>•t in.urara. Co
INSURER it Alen North America Ins Cc
Aa�✓�
INSURER C:
Interval House
P.O. Box 3356
Seal Beach CA 90740
INSEIRER o:
RISI RER
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 THE CERTIFICATE ANY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED SY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES, AGGREGATE LIMITS SHOWN ANY NAVE BEEN REDUCED BY PAM CLAIMS.
LTR
TYPE OF INSURANCE
POLICY NVMBEq
DA
OA
Lana
GENERAL LIABILITY
EACH OCCURRENCE
$1000000
A
B: COMMERCIAL GENERAL LIABILITY
CLAIMS MADE xI OCCUR
RICO005372
10/01/04
10/01/05
PREMISES Evom
6100000
NED EXP(Ay GAIN Panora)
$ 5000
x Sex Abuse Liab.
PERSONAL LADVINJURY
$1000000
GENERAL AGGREGATE
33000000
GEN'LAGGREGATE LIMB APPLIES PER:
PRODUCTS -COMPIOP AGO
s3000000
PaICY JP"Ecor LOC
Prof Liab
lmil/3mil
AUTOMOBILE
LIASUTY
COMANYAUTO (Eaa cW SINGLE LIMIT
5
ALL OWNED AUTOS
SCHEDULEDAUTOS
GODLY INJURY
(PGA PGA )
$
HIRED AUTOS
NON -OWNED AlfT03
BOOZY INJURY
(PGA ectlden)
$
PROPERTY DAMAGE
(Per A"ident)
a
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
ANY AUTO
/JA
VV
OTHER THAN EA AGO
AUTO ONLY: AGO
S
$
EXCESBNMBRELIJA LIABILITY
OCCUR CLANS MADE
EACH OCCURRENCE
a
AGGREGATE
S
3
S
DEDUCTIBLE
RETENTION $
a
B
COMPEaATON LIABILITYTORYT
WOEMPLOYEW LIABILITY
ANY PROPRIETDIVPARTNERIFJECUIryE
OFFICEFUMEIABEREXCLUDED7
H yyeeaa OMaPoe urges
IAL PROVISIONS bd.
WC100262801
02/01/04
02/01/05
ESi
E.LEACHAccor
ET
$1000000
EL DISEASE -EAEPLO
$1000000
EL. DISEASE -POLICY LIMIT
il0000O0
OTHER
A Crime Section RIC0005372 10/01/04 10/01/05 8mpl Dish $110,000
DESCRIPTION OF OPERATIONS LOCATIONS / VEHCLm l EXCLUSIONS ADDED BY ENDORSEMENT I SPECIALPRONSIONs Dad. $1,000
Certificate holder is named as an additional insured with respect to the
operations of the named insured with the exception of Workers Compensation
coverage, evidence only. See attached endorsement
City of Santa Ana
Comity Development Agency
N-25
20 Civic Center Plaza
Santa Ana CA 92702-1988
SANTANA I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE BXPIRATIQF
DATETHEREOF,TNEISSUMOMURERWLUekENOa/DMML 30 DAYS WRITTEN
NOTIGI! TO THE CERTIFICATE HOLDER NAMED TO THE LEFT
lU/EO/2004 01:48 FAX lit003
RIVERPORT INSURANCE COMPANY OF CALIFORNIA
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
GENERAL LIABILITY BROADENINGF"ORSEMENT
This endorsement modifies the insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
Througbout this endorsement the words "you" and "your" refer to the Named Insured shown in the Declarations. The word "we,"
"us" and "our" refer to the Company providing this insurance.
The following is only arsuamiary of the additional coverages provided by this endorsement and'is provided only foryourreference
and convenience. For the Limits of Insurance and the additional coverages provided by this endorsement, read the provisions on
the following pages and the Coverage Form which this endorsement modifies.
SUBJECTS OF INSURANCE
Broadened Bodily Injury
Broadened Personal and Advertising Injury
Broadened Property Damage
Broadened Fire, Lightning, Explosion dt Sprinkler Leakage - $500,000
Broadened Medical Payments - S10,00o
Broadened Supplementary Benefits
a. Bail Bonds - $l,000
- - b. Expenses Incurred to Assist in Defense - $500 per Day
Broadened Newly -Acquired or Formed Organization
Broadened Non -Owned or Chartered Watercraft or Aircraft
Broadened Commercial General Liability Conditions
a. Duties in the Event of Occurrence, Offense, C iro or Suit
b. Liberalization a Automatic Coverage If We Adopt Broader Coverages
C. Notice to Company
Automatic Coverage for "Special Events"
Automatic Additional lasureds
_ a. Athletic Activity Participants
b. Contractual Obligations
c. Funding Sources
\ d. Manage or Lessor ofPremises
,v e. Owner, Manager, Operator or Lessor of "Special Event" Premises
f. Supervisors or Higher in Rank a Co -Employee Exclusion Removed
g. Volunteer Workers
Iti Limitation
Blanket Waiver of Subrogation
Priority of Application for Multiple Insureds
The coverages listed In this endorsement are provided as extensions or additiow to your insurance program '—
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1. BROADENED BODILY INJURY
SECTION V - DEFINITIONS
with: , Item 3. is replaced
3."Bodily inJUIT"meansphysical injury, sick=%
or disease sustained by a person, including
death resulting from any of these. "Bodily
injury" she means mental injury, mental
anguish,phumiliation or shock sustained by a
directly mWtimg from physical
injury, sickness or disease person sustained by that
2. BROADENED PERSONAL
ADVERTISING INJURY
LIABILITY EXCLUSIONS, Pan bs2s
2 243) are replaced with: lSTaP 4) and
(2) Arising out of oral, written, televised,
videotaped or eketranic publication of
material, if done by or at the direction of the
insured with knowledge of its falsity;
(3) Arising out of orsi, written, televised,
videotaped or electronic Publication of
material whose fast publication took place
before the beginning of the policy period;
AND 4. BROADENED PROPERTY DAMAGE
SECTION V - DEFINITIONS, Item 14. is replaced
with:
14. "Personal cod Advertising injury" means inj try,
including consequential "bodily injury" arising
out of one or more of the following offenses
during the policy period:
a. False arrest, detention or hnprisonment;
b. Malicious Prosecution or abuse ofprocess;
c. The wrongful eviction from, wrongful
entry Imo, or invasion of the right of
Private occupancy of a room, dwelling or
Premises that a person occupies by or on
e of its owner, landlord or lessor;
d.. Oral, written, televised, videotaped or
electronic publication of material that
slanders or libels a person or organization
or disparages a persons or
organizations goods, products or
services;
e• Oral, written, televised, videotaped or
electronic publication of material that
violates 9 personas tight of privacy or
L Misappropriation of advertising ideas or
style of doing business; or
g• Infringement of copyright, title or slogan.
h. Mental injury. mental anguish, humiliation
or shock, if directly resulting from items
14.a. through 14.g. above.
SECTION 1 - COVERAGES, COVERAGE B,
PERSONAL AND ADVERTISING INJURY
HSCG 00 0! 07 00
SECTION I - COVERAGES, COVERAGE A.
BODILY INJURY AND PROPERTY DAMAGE
LIABILIABILITY EXCLUSIONS, Paragraph 2.a. is
LITY with:
a. "Bodily injury" or "property damage"
expected or intended from the standpoint of
the insured. This exclusion does not apply to
damage -
resulting from the use of reasonable forcto
Protect Persons or property.
5. BROADENEDFIRE,LIGIITNING,EXPLOSION
AND SPRINKLER LEAKAGE
A. SECTION III - LIMITS OF INSURANCE,
Paragraph 6. is replaced with:
6. Subject to 5. above, the Damage to Premises
Rented to You Limit is the most we will pay
under Coverage A for damages because of
"Property damage,, to:
a• Any one Premises while rented to you or
temporarily occupied by you with
permission of the owner; or
b. Personal property of others in your care,
custody or control, while at premises
rented to you or temporarily occupied by
You with Permission of the owner
arising out of any one fire, lightr ing,
.explosion or sprinkler leakage occurrence.
In the case of fire, the Fire Damage Limit is
the greater of:
A. $500,000; or
b. The amount shown in the Declarations
for Fire Damage Limit
B. TheCOVERAGES,
�G� graph of SECTION I -
BODILY
INJURY AND P OR PERGTY DAMAGE
AMAGE
Includa eopytfghled materiel aj
lusufoac<S—iea oj/ica., with'is p ,ivba
Page 2 of 9
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LIABILITY, Paragraph 2. Exclusions is
replaced with; C. This above Medical Expense Limit does not aPPY
if COVERAGE C.IYDICAL PAYMENTS is
Exclusions a. through n. do not apply to dame excluded either by the Declaration to this
by fire, lighmirM explosion or sprinkler leakage ge Coverage Part or by an endorsement to this
to premises while rented to Coverage Part
occupied b You or temporarily
Pi Y you with permission of the owner, 7. BROADENED SUPPLEMENTARYPAYMENTS
A separate limit of insurance applies to this
coverage as described in LIMITS OF
INSURANCE (Section Ill). ---— User SECTIOX—I - SUPPLEMENTARY
PAYMENTS - COVERAGES A AND B,
C. SECTION IV - COMMERCIAL GENERAL
Paragraphs L(b) and 1.(d) are replaced with;
-----LIABILITY CONDITIONS, Paragraph 4.
Other Insurance, Item b.(1)(b) is rewith:placed
b. Up to S 1,000 for cost of bail bonds required
because of accidents or traffic law violations
arising out of the use of any vehicle to which
(b) That's Fire, Li
Lightning, Explosion or
Sprinkler
the Bodily Inju ryLiability Coverageapplies.
We do not have to famish these bonds.
Leakage insurance for
Premisesw ranted to You m �nPo�Y
occupied YYmhw'idnpermissionofthe
d. All reasonable expenses incurred b the
insured at our request to assist us in the
defense
D. SECTION V - DEFINITIONS, Item 9.a. is
mvestigation or of the claim or
"suit," including actual loss ofemmingsup to
replaced with:
$500 a day because of time off from work.
a. A contract for a Iease of premises.
however, that portion of the contract for a
lease of premises that inde®»fies any
Person or organization for damage by fire,
lightnurg, eexxpplosion m sprinkler leakage to
pretenses V a rented to you or temporarily
occupied by you with pemtismon of the
owner is not an "insured contact' ;
E. This Broadened Coverage is subject to all the
terms of SECTION $ - LIMITS OF
INSURANCE.
F. This Broadened Coverage does not apply if Fin
Damage Liability of COVERAGE A
(SECTION 1) is excluded either by the
Declaration to this Coverage Part or by an
endorsement to this Coverage Part _
6. BROADENED MEDICAL PAYMENTS
A. The following provision is added to Paragraph 7.
Of SECTION III — LIMITS OF
INSURANCE:
The Medical Expense Limit shall be the greater
Of.
b. S10,000; or
b. The amount shown in the Declarations for
Medical Expense Limit
This Medical Expense Limit is subject to all the
lemma of SECTION M - LIMITS OF
INSURANCE.
8" BROADENED NEWLY ACQUIRED OR
FORMED ORGANIZATION
A. SECTION II - WHO IS AN INSURED, Item
4.a. is replaced with:
A. Coverage under this provision is afforded
only uatiil the 120th day after you acquire or
foam the organization or the end of the policy
Period, whichever is earlier.
9. BROADENED NON -OWNED OR CHARTERED
WATERCRAFT OR AIRCRAFT
SECTION I - COVERAGES, COVERAGE A.
BODILY INJURY AND PROPERTY DAMAGE
LIABILITY, Paragraph 2.g. is replaced with
g. "Bodily injury" or "pmpertY damage" arising
out of the ownership, maintenance, use or
entmsaaent to others of any airman, "auto"
or watercraft owned or operated by, or rented
or loaned to, any insured. Use includes
Operation and "loading or unloading"
This eachhsion does not apply to:
(1) A watercraft while ashore on premises
you own or rent;
(2) A watercraft you do not own that is:
(2) Less than 51 feet long; and
(b) Not being used to carry persons or
Property for a charge;
(3) Parking an "auto" on, or on the ways
text to premises you own or rant,
provided the "auto" is not owned by or
HSCG 00 0107 00
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Insaraece Services Oren, wrtb itsPmairstea Page 3 of 9
:jai
10/20/2004 01:50 FAX
Q 006
"#t
rented or loaned to you or the insured;
(4) Liability assumed under any
"insured
(5) contracts for the ownership,
maintenance or use of watercraft.
or airctall; or
"Podily injury„ or "property damage"
arising out of the operation of any of
the equipment listed in paragraph Q2)
or L(3) of SECTION V_
DEFINITIONS, Paragraph II.,
"Mobile Equipment"; or
(6) An aircraft you do not own that is:
(a) Hired, chartered or loaned with a
crew; and
) Not owned in whole or in part by
any insured.
(7) This insurance does not apply, under
paragraph 9.0) and g.(2) above, if the
insured bas any other insurance for
which would�ala alsor o to loss coveered
raider this provision, whether the other
"'cc islatmery, excess, contingent
or on any other basis.
(8) This insurance is excess, under
paragraph gd6) above, over any other
insurance, whetbar the other insosaoce
is primary, excess, contingent or on any
other basis.
10. BROADENED COMMERCIAL GENERAL
LIABILITY CONDITIONS
A. SECTION IV _ COMMERCIAL GENERAL
LIABILITY CONDITIONS, Paragraph 2.
DutiesIn The Event of Occurrence, Offense,
Claim Or Suit is amended to add the following
provision
a. Your obligation to notify us as soon as
wO Practicable of an �"occurrence," or offeme \ under Paragraph 2.1. above, or a claim or
suit " or offense under paragraphs 2.a,
2.b, and 2.c. above, is satisfied if you send
us written notice as sees Is practicable after
any of your "executive officers,e directors,
Partners, insurance managers, or legal
representatives becomes aware of or should
have became aware of, such "occurrence,"
offense, claim or "suit"
10. Liberalization.
if we adopt any revision that would broaden
the coverage under this coverage part without
additional Premium within 30 days prior to or
during the policy period, the broadened
coverage will immediately apply to this
coverage part. ....
11. Notice To Company
If you report an "occurrence" or offense to
your Workers- Compensation insurer which
later becomes a claim under this Coverage
Part, failure to report such "occurrence" or
offense to us at the time of the `occurrence"
or offense will not be considered a violation
of the Duties In The Event Of Occurrence,
Offense, Claim Or Suit Condition, if you
-- notify us as soon as practicable when you
become aware that the 'occurrence" or
offense has become a liability claim
"'AUTOMATIC COVERAGE FOR 1.SPECI4,L
EVENTS.®
A. You are automatically covered for all "special
events" which you organize, promote, administer,
sponsor, or conduce during the term of thispoliey.
B. SECTION V _ DEFBVITIONS, is amended to
add the following paragraph:
22. "Special Event" means any event:
a. The purpose of which is to raise funds
for you; or
b. To recognize the accomplishments of
Your organization, your employees," or
Your volunteer workers; or
e. Which you, or an individual or
organization with whom you have
catered into a contract or agreement,
organize. Promote, admirostar, sponsor
or conduct for the purposes desrnbed in
Paragraphs A. or b. above; and
d. Which takes place on premises owned
by you, or on premises while rented or
leased to you, or to that organization
described in Paragraph c. above.
e. However, "special event" shall NOT —
include, and no insurance is afforded
under this Coverage Part, for:
B. The following Provisions are added to (1) my event at which you, your
SECTIONIV_COMMERCLALGENERAL "employees," or your volunteer
LIABD.I'TY CONDITIONS: workers sell alcoholic beverages or
sell tickets or coupons which may
be exchanged for alcoholic
beverages; or
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10/20/2004 01:50
U 007
(2) any event which involves:
(a) professional or semi-
professional athletie teams;
(b) fairs, rodeos, carnivals,
haunted houses, or street
parties;
(ej-pyfoteclum: displays;
(d) racing or timed events of all
loads, including but not
limited to, automobile or
watercraft ratio& airplane
racing or exhibitions, soap-
box derbies, bike -a -thous,
marathons, and walkathons;
or
(a) race tracks or stadiums
operated by you.
Coverage for the "special events" listed
under e.(1) and e.(2) above shall be
extended only by a specific endorsement
issued by us.
12. The following provisions are added to SECTION H
- WHO IS AN INSURED.
S. Automatic Additional Iusured(s)
a. Additional Insureds - Athletic Activity
Participants
(1) This policy is amended to include as an
insured any person(s) (bereioafter
called Additional Inswed(s)
representing you while participating in
amateur athletic activities that you
sponsor. However, no such person Is
an Insured for:
(a) "Medical expenses" under
COVERAGE C. MEDICAL
PAYMENTS.
(b) "Bodily Injury" to:
(i) a co-participadl, your
volunteer worker or your
"employee" while
Participating in amateur
athletic activities that you
sponsor, or
(If) you, or any partner or
Melchor, (if you are a
partnership or joint venue),
or any member (if you are a
limited Lability company); or
(c) "Property damage" to property
owned by, occupied or used by,
rented to, in &a care, custody, or
control of, or over which physical
control is being exercised for any
purpose by --
(I) a co-puticipani, your volunteer
worker, or your "employee;®.
or-- ---.
(ii) you, or anyparmu or member,
(if you are a partnership or
joint vendee), or any member
(if you are a limited liability
company).
b. Additional Insured - Contractual
Obligations
(1) This policy is amended to include as an
insured any person or organization
(hereinafter called Additional Insured)
that you are required by a written
"inured contact" to include as an
Insured, subject to all of the following
provisions:
(a) Coverage is limited to liability
arising out of
(I) your ongoing operations
performed for such Additional
Insured; or
(if) such Additional Insureds
financial control of you; or
pli) the maintenance, operation or
use by you of equdpmentleased
to you by such Additional
Insured; or
(Iv) a permit issued to you by a
state or political subdivision.
- -(b) Coverage does not apply to any
.occurrence" or offense:
(I) which took place before the
execution ot;orsubsequent to
the completion or expiration
Of, the written insured
contmct," or
(if) which takes place after you
cease to be a tenant in that
premises. --
(e) With respect to architects,
engineare, or surveyors, coverage
does not apply to "Bodily Injury,"
"Property Damage," Personal
Injury," or "Advertising Injury -
arising out of the rendering or the
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f tihme to reader any professional
than that customarily provided by
services by or for you including:
the policy forms specified in and
(1) the preparing, approving, or
required by the contract.
failing to approve or prepare
(e) in no event shall the coverages or
maps, drawings, opinions,
Limits of Insurance in this
reports, surveys, change
Coverage Form be increased by
orders, designs or
such contract.
specifications; and
(11) supervisory, inspection, or
(d) Coverage provided bercm shall be
considered excess over any other
engineering services,
valid and collectible insurance
(d) Covers
Coverage provided herein shall
available to the Additional Insured
whether that other insurance is
considered excess over any other
other
valid and collectible insurance
primary, excess, contingent, or on
available to the Additional Insured
any other basis unless a written
contractual arrangement specifically
whether that other imam ,.e is
requires this insurance to be
pritnaty, excess, contingent, or on
primary,
any other basis unless a written
contractual amangament
specifically requires this i aun=e
d. Additional Insured -Manager or Lessor of
Premises
to be primary.
(e) In the event that you are engaged
(1) This policy is amended to include as an
insured
in the manufacture or assembly of
any person or organization
(hereinafter called Additional insured)
any goods or products for the
benefit or at the direction
from whom you lease or rent your
of
another Party, Pursuant to a
premises and which requires you to add
such person or organization as an
contract or agreement with that
Additional Insured in this policy under:
party, this paragraph (d.) does not
extend coverage to that party as an
(a) A written contact or
Additional Insured. Coverage for
such a party will be extended only
by a specific endorsement issued
(b) An oral agreement or contact
where a Certificate ofhuurance has
by us and naming such party,
been issued showing that person or
c. Additional Insured-FundingSources
organization as an Additional
Insured;
(I) Thu policy is amended to include as an
but only if the written or oral agreement
insured any Funding Source
(hereinaRwaalled-Additional Insured)
is an "insured contract®
- - which requires you in a written contract
(i) cogently in effect or to become
to name such Additional Insured but
only with respect to liability arising our
effective during the term of this
g
.. of Your Premises or "your wont" for
. . policy; and
such Additional Insured, and only to
the extent set forth as follows:
(11) executed prior to the "bodily
injury® "Property damage,"
The Limits of Insurance applicable
_rsonal(a) or
"advertising injury-,, injur
to the Additional Insured are the
leaser of those specified in the
written contract or agreement or in
(2) With respect to the insurance afforded
the Declarations for this policy and
the Additional Insured identified in
subject to all the tens, conditions
paragraph d.(1) immediately above, the
and exclusions for this policy, The
fallowing additional provisions apply:
Limits of Insurance applicable to
the Additional Insured
(a) This insurance applies only to
are
s andnotinadditionto,
the
the Limits Insurance shown in
lability arising out of the
ownership, maintenance or use of
eclas ti
the Declarations.
that portion of the premises leased
to You:
(b) The coverage provided to the
Additional Insured is not greater
(b) The Limits of Insurance applicable
to the Additional hisured are the
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10/20/2004 01:52 FAX
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lesser of those specified in the
written contract or a
agreement or in
term of this policy,
P bey; and ,
the Declarations for this policy and
subject to all this policy's tertm,
(iq executed prior to the "bodily
`property
conditions and excisions. The
injury," damage,,•
injury,
Limits of Insurance applicable to
the Additional Insured
"personal or
advertising igjury."
are
inclusive of, not in additionto, the
Lim
its of Insurance shown in
(2) With respect to the insurance afforded
Dc
Declarations:
the Additional Insured identified in
paragraph e.(1) of this endorsement, the
(c) In no event shall the coverages or
following additional provisions apply:
Limits of Insurance in this
Coverage Fart be increased by
(a) This insurance applies only to
such contract or agreement.
liability arising out of the use of that
portion ofthe premises while leased .
(d) Coverage provided herein shall be
or rented to you for the specific ."�
"special
considered excess over any other
event;"
valid and collectible insurance
available to the Additional Insured
(b) The Limits of Insurance applicable
antehisrur
whether that other insurance is
to the Additional ae
excess, contingent at, or en
anypriOther
arty other basis unless a written
lesser of those d in the
contract or agreement pertaining to
contractual
specificallyrequiresthismamance
the use of the
the Premises is the
Declarations for this policy and
to be primary
subject to all of this policy=s terms,
conditions and exclusions. The
(3) This insurance does not apply to;
Limits of Insurance applicable to
the Additional Insured are inclusive
(a) Any "occurrence" or offense
of, not in addition to, the Limits of
which takes place after you cease
Insurance shown in the
to be a tenant in the premises
Declarations.
covered by this endorsement; or
(c) In no event shall the coverage or
(b) Structural alterations, new
Limits of Insurance in this
construction or demolition
Coverage Form be increased by
Operations perfomnsd by or on
such contract or agreement
behalf of the Additional Insured.
(d) Coverage provided berein shall be '
e. Additional Insured -naer
considered excess over any odic, ""
Operator or Lessor o Special Events^
"
valid and collectible insurance -
Premises
available to the Additional Insured
whether that other insurance is
(1) Tbis policy is amended to include as an
primary, excess, contingent, or on
insured any person or organisation
any other basis unless a written
(hereinafter called Additional Insured)
contractual anaogement specifically
from whom you lease, rem or occupy
the "special
requires this insurance to be
primary.
premises upon which a
event" is held, sponsored or conducted
by you, or on your behalf; under:
) This insurance i ces not apply to:
(a) A written contract; or
(a) Any `Occurrence" or offense which
[ekes place after you cease to be a
(b) An oral agreement or contact
terrwt, licensee or occupant in the "
where a Certificate of Insurance
premises covered by this
has been issued showing that
endorsement; or
Person or organiution as an
Additional Insured;
(b) Any acts or "occurrences" caused
by or attributable to the owner,
but only if the written or oral
7f1Hnager, operator or lessor of the
agreement is an "insured contract,"
Presses upon which the "special . w
(i) BUY in effect or to
event" is held. :say
L Additional Insureds - Supervisors or
become effective during the
I3igher in Rank
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(1) This policy is amended to include as an
CalledAdd�ti IWinsured an 1, Inure" � r
oral Insured) deli
Physical
ecised for any purpose
or �� orautho supervisor48 yout
y
you, any of your "employees o any
indirect supervision and control over
einPlOYM"
Partner or member (if you am a
and the manner in which
work is Performed, but only for acts
Partnership or joint venue), or any
member (if you are a limited
within the scope of their employment
liability company).
by you or while Performing duties
related to the conduct ofyour business.
However, none of these ,employees"
(2) SECT70N II - WHO IS AN
INSURED, Paragraph Is. is deleted.
designated as supervisor or higher in
rank, is an insured for. i•
Additional Insureds -Volunteer Workers
(a) "Bodily injury" or "Personal
(1) This policy is amended to include as an
injury":
insured any persons (hereinafter called
Additional Insured) who are volunteer
(i) to You, to your Partners or
workers for you, but only while acting at
members (if You are a
partnership or joint venture),
Your direction, and within the scope of
the duties which they perform for
or to your members (if you
are a limited liability
you.
However, none of these volunteer
workers are insured for:
company);
(if) for which there is
(a) "Bodily inimy" or "personal
injury":
any
obligation to share
with or repay someone then
(1) to You, to Your Partners or
who must Pay damages
because of the injury
members (if you ate a
Partnership or joint venture), to
described in paragraph (11)(1)
Your members (if you are a
above; or
limited liability company), to
(iH) arising out of his or her
Your other volunteer workers,
or to You "employees" arising
Providing or failing to provide
out of and in the course of their
Professional health care
duties for you;
services.
(b) "Personal Injury":
(ri) to the spouse, child, parent,
brother or
G) to
sister of you =
volunteer worker(s) or your
"employees"
a co -"employee" while in
the course of his or her
as a consequence
of paragraph (a)()) above; or
employment, or
(it) to the spouse, child parent;
(fit) for which there is any
obligation to share damages
brother or sister of that co-
"employee"
with or repay someone else
as a consequence
Of paragraph (b)(1) above;
who must pay damages
because of the injury described
M for which these is any
'
in
abovee or�P� (a)(!) or (U)
obligation to share damages
with or repay someone else
Who
(iv) arising out of the volunteer
becauset pay
yhe damages
workers) Providing or failing
to Provide professional health_
dearnbed in paragraph (b)(�
care services, _
or (li) about.
(c) "Property damage" to
(b) "Pry thnsge" to property:
Property:
(i) owned, occupied or used by;
(iJ owned, occupied or used by;
or
(11) rented to, in the care, custody,
rented to, in the care, custody
or control of, or over which
is being
or control of, or over which
exercised fcontrol
xy Purpose by;
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you, any of your other volunteer
worker(s), your "employees,® your
partners or members (if you are a
partnership or 'ant venture), or
any member (Wyou are a limited
liability company).
h. Additional Insureds - LUAITATIONS
(1) The persons, entities or organizations
to which coverage is extended under
paragraphs a. (Athletic Activity
Participants), b. (Contractual
Obligations), c. (Funding Sources), d.
(Matiagm orLeaso I ofpramises), and
e. (Owner, Manager, Operator or
Lessor of "Special Event" Premises)
an Additional Insureds, but only:
(a) With respect to each Additional
Insured-s vicarious liability for
"scnal damages" solely causedby
you or by "your work^ that is
ongoing for such Additional
Insured-s supervision of "your
work"; and
(b) If the Additional Insured did of
cause or contribute to the
"occurrence" or act resulting in
liability.
(2) If an Endorsement is attached to this
policy and specifically names a person
or organization as an Additional
Insured, then the coverage extended
under this paragraph S. AUTOMATIC
ADDITIONAL INSURED(S) does
not apply to that person, entity or
orgsnvation.
(3) SECTION V - DEFINITIONS, is
amended to add the following Item 23:
23. "Actual Damages" Is to have its
must and custornsryk:gai nearuutg
and excludes, without limitation,
punitive damages, restitution,
penalties, and formula damages
added to "actual damages" and any
other enhanced damages.
(4) All other terms and conditions of this
Coverage Part which am not
inconsistent with this paragraph b.
apply to coverage extended to the
above -referenced Additional Insureds
REGARDLESS OF WIIETHER OR
NOT A COPY OF THIS COVERAGE
PART AND/OR ITS
ENDORSEMENTS ARE
DELIVERED TO AN ADDITIONAL
INSURED,
13. BLANKET WAIVER OF SUBROGATION
SECTION IV - COMMERCIAL GENERAL
LIABILITY CONDITIONS, Item S. is replaced
with:
S. Transfer of Rights Of Recovery Against
Others To Us And Blanket Waiver Of
Subrogation
a. If an insured has rights to recover all or put
of any payment we have made under this
Coverage Part, those rights are transferred to may""
us. The insured mast do nothing after loss to
unpair them At our request, the insured will
bring "suit" or transfer time right to us and
help us enforce them
b. If required by a written "insured contract,"
we waive any right of recovery we may have
against any person or organizationbecauu of
payments we make for injury or damage
ansmg out of your ongoing operations or
"your work" done under a contract for that
person or organization and included in the
"products -completed operations hazard®
14. PRIORITY OF APPLICATION FOR MULTIPLE
INSUREDS
SECTION IN - LIMITS OF INSURANCE is
amended to add the following paragraph:
8. In the event a claim or "suit" is brought against
more than one insured, due to "bodily injury" or
"property damage" from the sarx "occurrence," a
or "personal injury' or "advertising injury" from i
the same offense, we will apply the Limit of
Insurance in the following order:
a. You;
Is. Your "executive officers;' directors,
"amployees"; and
c. Any other insureds in any order that we T
choose.
5 toil U
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