HomeMy WebLinkAboutO.C. TEEN CHALLENGE 3c2�o�
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AGREEMENT 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Please complete this form when the attached agreement is no longer in effect.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-2005-078-032
INSURANCE NO�d� ON ��.E
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CLERK OF COUNCIL
DATE:8/1812005 AGREEMENT BETWEEN THE CITY OF SANTA ANA AND
TEEN CHALLENGE OF SOUTHERN CALIFORNIA FOR USE OF
COMMUNITY DEVELOPMENT BLOCK GRANT FUNDS
This Agreement, is hereby made and entered into this loth day of June, 2005, by and
between the City of Santa Ana, a charter city and municipal corporation of the State of California
("CITY") and Teen Challenge of Southern California, a California nonprofit corporation
("SUBRECIPIENT").
WITNESSETH
Recitals:
A. The CITY, as an entitlement recipient and grantee of the United States Department of
Housing and Urban Development ("HUD") Community Development Block Grant ("CDBG")
Program, desires to enter this Agreement with the SUBRECIPIENT for the expenditure of CDBG
funds in accordance with Title 24, Part 570 of Code of Federal Regulations 24 CFR 570.000, et seq.
("CDBG REGS"); and
B. CITY has applied for and received CDBG funds from HUD pursuant to Title I of the
Housing and Community Development Act of 1974, Public Law 93-383, as amended ("ACT'); and
C. The SUBRECIPIENT is a private nonprofit agency that has been selected by the CITY
to receive CDBG funds and administer such financial assistance; and to provide the services
described in Exhibit A, in accordance with the schedule of performance included therein, hereinafter
referred to as "said program". SUBRECIPIENT represents that it is qualified and willing to operate
said program and certifies that the activities carried out with funds provided under this Agreement
will meet one or more of the CDBG program's National Objectives (24 CFR Part 570.208).
D. SUBRECIPIENT agrees that it will adhere to the performance measurements and
outcomes as indicated on Exhibit B (Scope of Work). Failure to follow the measurements and
meet the stated outcomes may constitute breach of contract that could result in termination of
this Agreement or serve as reason for the City to recapture the grant funds awarded to
SUBRECIPIENT pursuant to this Agreement.
E. 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
substantive part of this Agreement and the following terms and conditions are approved and
together with all exhibits and attachments hereto, shall constitute the entire Agreement between the
CITY and SUBRECIPIENT:
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A. Non -Profit Status - Reuresentations and Warranties.
(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
performance of the services under this Agreement.
(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.
(e) No Bankruptcy. SUBRECIPIENT is not the subject of any current or threatened
bankruptcy proceeding.
(i) No Pending Legal Proceedings. SUBRECIPIENT is not the subject of a current or
threatened litigation that would or may materially affect SUBRECIPIENT'S performance under
this Agreement.
(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.
B. Amount of Grant and Quarterly Disbursement. The amount granted to
SUBRECIPIENT is $ 9,500("CDBG FUNDS"), and such funds shall be expended by
SUBRECIPIENT on or before June 30, 2006. The CDBG FUNDS shall be disbursed by CITY
to SUBRECIPIENT on a quarterly basis (October, January, April and July) subject to and upon
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receipt and approval of a complete quarterly activity report from SUBRECIPIENT, with the final
payment subject to the satisfaction of the condition precedent 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.
C. Use of Funds. SUBRECIPIENT agrees to use all federal funds provided by CITY to
SUBRECIPIENT pursuant to this Agreement to operate said program, as set forth in "Exhibit A,"
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 hereunder.
D. Allowable Costs. SUBRECIPIENT agrees to complete said program on or before
June 30, 2006 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, but not be limited
to, wages, administrative costs, and employee benefits comparable to other similarly situated
employees. 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. Licensing. SUBRECIPIENT agrees to obtain and maintain all required licenses,
registrations, accreditation and inspections from all agencies governing its operations.
SUBRECIPIENT shall ensure that its staff shall also obtain and maintain all required licenses,
registrations, accreditation and inspections from all agencies governing SUBRECIPIENT's
operations hereunder. Such licensing requirements include obtaining a City business license, as
applicable.
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 in an account in a federally insured banking or
savings and loan institution with record keeping of such accounts maintained pursuant to applicable
OMB Circular A-110 requirements. SUBRECIPIENT is not required to maintain separate
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depository accounts for CDBG FUNDS; provided however, the SUBRECIPIENT must be able to
account for receipt, obligation and expenditure of CDBG FUNDS pursuant to applicable OMB
Circular A-110 requirements.
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.
1. Record Keeping/Reporting. SUBRECIPIENT shall keep and maintain complete and
adequate records and reports to assist CITY in meeting and maintaining its record keeping
responsibilities under the CDBG REGS, including the following:
(1) Records
a. Documentation evidencing program income requirements in
conformity with 24 CFR 570.504(b((2)(i), (ii) and 24 CFR 570.503(b)(3) and 24
CFR 570.208(a)(2)(B) of the income level of persons and/or families participating
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, and income verification.
d. Documentation of all CDBG FUNDS received from CITY.
e. Documentation of expenses as identified in the Budget Proposal,
including 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 CDBG FUNDS were expended, and any payments
therefor.
f. Any such other related records as CITY shall reasonably require or as
required to be maintained pursuant to the CDBG REGS.
(2) Reports
(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, copies
of any and all contracts or documentation pertaining to costs for
subcontractors or other documentation supporting and
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evidencing how the CDBG FUNDS have been expended during
the applicable quarter.
(ii) Quarterly Activity Report: SUBRECIPIENT agrees to keep monthly
records of all ethnic and racial statistics of persons and families benefited by
SUBRECIPIENT in the performance of its obligations under this Agreement,
including, but not limited to, the number of low and moderate income persons
and households assisted in accordance with federal income limits, the number
of female heads of households assisted, new program information and year-to-
date program statistics on expenditures, caseload and activities.
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 is 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 CDBG 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 CDBG REGS's.
Records which relate to (a) complaints, claims, administrative proceedings or litigation arising
out of the performance of this Agreement, or (b) costs and expenses of this Agreement to which
CITY or any other governmental agency takes exception, shall be retained beyond the five (5)
years until complete resolution or disposition of such appeals, litigation claims, or exceptions. In
the event SUBRECIPIENT does not make the above -referenced documents available within the city
of Santa Ana, California, SUBRECIPIENT agrees to pay all necessary and reasonable expenses
incurred by CITY in conducting any audit at the location where said records and books of account
are maintained.
L. Compliance with Law/Program Income. SUBRECIPIENT acknowledges that the funds
being provided by CITY for said program are received by CITY pursuant to the ACT as amended
and that expenditures of these funds shall be in accordance with the ACT and all pertinent
regulations issued by agencies of the federal government, including, but not limited to, all
regulations found at Title 24 of the Code of Federal Regulations. Program income received by
SUBRECIPIENT shall be returned to CITY unless otherwise provided for in this Agreement.
SUBRECIPIENT agrees to comply fully with all federal, state and local laws and court orders
applicable to its operation whether or not referred to in this Agreement.
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M. Standine. 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 provided
to it concerning participants in accordance with the requirements of federal and state law. 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 incurred and services rendered hereunder.
O. Independent Contractor. SUBRECIPIENT agrees that the performance of
obligations hereunder is rendered in its capacity as an independent contractor and that it is in no way
an 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 CDBG 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 CDBG funds granted hereunder, SUBRECIPIENT shall be required to reimburse
the CITY of all such funds that were obtained/spent under fraudulent circumstances.
Q. Equipment. SUBRECIPIENT agrees to maintain a record for each item of non -
expendable personal property acquired under the terms of this Agreement. 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. Lobbyine. 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.
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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 CDBG funds
to pay salaries and other related administrative or personnel costs, no persons who exercise or have
exercised any function with respect to CDBG 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 CDBG-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.
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. Drug Free Workplace. SUBRECIPIENT certifies that it has established the following
drug -free workplace policy:
1. The unlawful manufacture, distribution, dispensing, possession or use of a
controlled 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
employees of SUBRECIPIENT will be required to:
a) Abide by the terns above in statement 1.
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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 State 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.
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.
IL CITY'S OBLIGATIONS
A. Payment of Funds. Upon execution of this Agreement by SUBRECIPIENT, CITY shall
pay to SUBRECIPIENT from CDBG funds, when, if and to the extent received from HUD, for
CITY's 2005-2006 CDBG program year amounts expended by SUBRECIPIENT in carrying out
said program for fiscal year 2005-2006 pursuant to this Agreement up to a maximum aggregate
payment of Nine Thousand Five Hundred Dollars (S 9,500) in installments determined by CITY.
Payments shall be made to SUBRECIPIENT through the submission of invoices on a quarterly
basis (October, 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 and documented within the scope and provisions of this
Agreement and that SUBRECIPIENT is in compliance with the terms and conditions of this
Agreement.
B. Audit of Account. CITY shall include an audit of the account maintained by
SUBRECIPIENT in CITY's annual audit of all CDBG FUNDS in accordance with Title 24 of
the Code of Federal Regulations and other applicable 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
applicable project.
E. Performance Monitorine: CITY shall monitor the performance of the
SUBRECIPIENT against goals and performance standards required herein. Substandard
performance as determined by the CITY will constitute non-compliance with this Agreement. If
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action to correct such substandard performance is not taken by the SUBRECIPIENT within a
reasonable period of time after being notified by the CITY, contract suspension or termination
procedures will be initiated.
III. NONDISCRIMINATION
SUBRECIPIENT agrees that no person on the ground of race, age, color, national origin,
religion 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 CDBG funds.
IV. CONFLICT OF INTEREST
Pursuant to the conflict of interest requirements set forth in 24 CFR 576.57 and OMB
Circulars 1-102 and A-110, SUBRECIPIENT agrees that no officer, employee, agent or assignee of
CITY having direct or indirect control of any CDBG monies granted to the CITY, inclusive of the
subject CDBG FUNDS, shall serve as an officer of SUBRECIPIENT. Further, any conflict or
potential conflict of interest of any officer of SUBRECIPIENT shall be fully disclosed in writing
prior to the execution of this Agreement and said writing shall be attached and deemed fully
incorporated as a part hereof. Notice shall be sent by SUBRECIPIENT to CITY regarding any
changes or modifications to its board of directors and list of officers.
V. SPECIAL CERTIFICATION FOR RELIGIOUS ENTITIES
If SUBRECIPIENT is a religious entity, SUBRECIPIENT hereby agrees that in connection
with the provision of the services SUBRECIPIENT shall provide with CDBG funds, in accordance
with 24 CFR 570.2000):
A. SUBRECIPIENT shall not discriminate against any employee or applicant for
employment on the basis of religion and shall not limit employment or give preference in
employment to persons on the basis of religion.
B. SUBRECIPIENT shall not discriminate against any person applying for the services
SUBRECIPIENT agrees to provide under the terms of this Agreement on the basis of religion and
shall not limit such services or give preference to applicants for such services on the basis of
religion.
C. SUBRECIPIENT shall NOT provide religious instruction or counseling, conduct
any religious worship or services, or engage in any religious proselytizing, or exert any religious
influence in the provision of the services in said program. The parties agree that this covenant is
intended to and shall be construed for the limited purpose of assuring compliance with respect to the
use of CITY funds by SUBRECIPIENT with applicable constitutional limitations respecting the
establishment of religion as set forth in the establishment clause under the First Amendment of the
United States Constitution and Article I, Section 4 of the California Constitution, and is not in any
manner intended to restrict other activities of SUBRECIPIENT.
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D. Where the services to be provided under said program are rendered on property
owned by the primarily religious entity SUBRECIPIENT, CDBG funds may also be used for minor
repairs to such property which are directly related to the cost of rendering the services under said
program, where the cost constitutes in dollar terns only an incidental portion of the CDBG
expenditure for rendering the services under said program.
VI.
SUBRECIPIENT agrees not to hire or permit the hiring of any person to fill a position
funded through this Agreement if a member of that person's immediate family is employed in an
administrative capacity by SUBRECIPIENT. For the purposes of this section, the term "immediate
family" means spouse, child, mother, father, brother, sister, brother-in-law, sister-in-law, father-in-
law, mother-in-law, son-in-law, daughter-in-law, aunt, uncle, niece, nephew, stepparent and
stepchild. The term "administrative capacity" means having selection, hiring, supervisor or
management responsibilities.
V1I. 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, California 92702-1988
TO SUBRECIPIENT: Teen Challenge of Southern California
C/o Orange County Teen Challenge
418 S. Main St.
Santa Ana, CA 92701
VIII. ASSIGNABILITY
None of the duties of, or work to be performed by, SUBRECIPIENT under this Agreement
shall be subcontracted or assigned to any agency, consultant, or person without the prior written
consent of CITY. SUBRECIPIENT must submit all subcontracts and other agreements that relate
to this Agreement to CITY. No subcontract or assignment shall terminate or alter the legal
obligations of SUBRECIPIENT pursuant to this Agreement.
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IX. HOLD HARMLESS
SUBRECIPIENT shall indemnify, defend and save harmless CITY, its officers, employees,
agents, representatives and volunteers from and against any and all damages to or for loss of use of
property and for injuries to or death of any person or persons, including property and employees or
agents of CITY, and shall defend, indemnify and save harmless CITY, its officers, employees,
agents, representatives and volunteers from and against any and all claims, demands, suits, actions
or proceedings of any kind or nature, including, but not by way of limitation, workers compensation
claims and including attorney fees and reasonable expenses for litigation or settlement, resulting
from or arising out of the negligent or wrongful acts, errors or omissions of SUBRECIPIENT, its
officers, directors, employees, agents, subcontractors and suppliers arising out of
SUBRECIPIENT's performance of this Agreement.
X. INSURANCE
A. In accordance with the provisions of Section 3300 of the Labor Code, if
SUBRECIPIENT has any employees it is required to be insured against liability for worker's
compensation or to undertake self-insurance. Prior to commencing performance of this
Agreement, SUBRECIPIENT agrees to obtain and maintain employer's liability insurance with
limits not less than $1,000,000 per accident. If SUBRECIPIENT has no employees, nor
workers' compensation coverage, it must execute a Declaration available from the CITY, and
update as is necessary.
B. SUBRECIPIENT shall undertake self-insurance, or shall obtain, at its sole cost, a
policy or policies of commercial general liability insurance, or equivalent form, with a combined
single limit of not less than $1,000,000 per occurrence.
Such insurance shall: (1) name the City of Santa Ana, its officers, agents,
representatives, employees and volunteers as additional insured's; (2) be primary with respect to
insurance or self-insurance programs maintained by the CITY; (3) contain standard separation of
insured's provisions; and (4) give to CITY prompt and timely notice of claim made or suit
instituted arising out of SUBRECIPIENT's operations hereunder.
SUBRECIPIENT shall: (a) 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; (b) provide that such insurance
shall not be materially changed or terminated except on 30 days prior written notice to the CITY;
(c) 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.
XI. REVERSION OF ASSETS
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A. Upon the expiration of this Agreement, SUBRECIPIENT shall transfer to CITY any
CDBG funds on hand at the time of the expiration of this Agreement as well as any accounts
receivable attributable to the use of CDBG funds. [24 CFR 570.503(b)(8).]
B. Any real property under SUBRECIPIENT's control that was acquired or improved
in whole or in part with CDBG funds in excess of $25,000.00 must either be:
1. Used, where CITY has given written approval, to meet one of the national
objectives stated in 24 CFR 570.208 until five (5) years after expiration of this Agreement, or for
such longer period of time as determined to be appropriate by CITY; or
2. If not used in accordance with subparagraph A above, SUBRECIPIENT
shall pay to CITY an amount equal to the current fair market value of the property less any portion
of the value attributable to the expenditure of non-CDBG funds for acquisition of, or improvement
to, the property. Such payment is program income to CITY.
C. Subject to the obligations set forth herein, title to equipment acquired under the
terms of this Agreement will vest upon acquisition in SUBRECIPIENT. When said equipment
which has been acquired in accordance with this Agreement and all applicable regulations is no
longer needed for said program, disposition of said equipment will be made as follows:
1. Items of equipment with a current per unit fair market value of less than
$5,000.00 maybe retained, sold or otherwise disposed of with no further obligation to CITY.
2. Items of equipment with a current fair market per unit value of $5,000.00 or
more may be retained or sold and CITY shall have the right to an amount calculated by multiplying
the current market value or proceeds from the sale by CITY's share of federal funds used to acquire
the equipment, in accordance with 24 CFR 85.32(e)(2).
D. SUBRECIPIENT hereby agrees, upon the demand of CITY, to execute,
acknowledge and deliver, or cause any person or entity who may have any claim to rights hereunder
or under any document, instrument or agreement executed in furtherance of the services and
activities to be performed hereunder, to execute, acknowledge and deliver, to CITY assignment(s),
quit claim deed(s) or such other and further instruments, documents and agreements as may be
necessary, in the sole and absolute discretion of CITY, to vest in CITY all of SUBRECIPIENT's
right, title and interest (if any it may have) in and to CITY, CDBG or other federal, state and/or
local accounts or program funds or allocation of funds to which CITY is or may be entitled, either
for its own account or as fiduciary or trustee for others, which were obtained for the purpose of the
performance of this Agreement or any previous agreements relating to the same subject matter or
activities as this Agreement, together with any instruments, loans, grants or advances by
SUBRECIPIENT on behalf of CITY, in furtherance of the activities hereunder or thereof.
SUBRECIPIENT's obligations and responsibilities set forth in this paragraph "XI.
REVERSION OF ASSETS," and in paragraph "XII. TERMINATION" and other requirements
pertaining to program income shall not be affected by the termination of this Agreement and shall
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survive the date of termination of this Agreement for such period of time as CITY and/or HUD
deems necessary for the responsibilities, duties and obligations to be performed and completed to
the satisfaction of CITY and HUD.
XII. TERMINATION
A. This Agreement may be terminated on thirty (30) days' written notice by either
party. In the event of such termination, SUBRECIPIENT shall only be entitled to reimbursement
for approved expenses incurred to the effective date of termination.
B. This Agreement may be suspended or terminated by CITY upon five (5) days'
written notice for violation by SUBRECIPIENT of Federal Laws governing the use of Community
Development Block Grant Funds. In the event of such suspension or termination, SUBRECIPIENT
shall only be entitled to reimbursement for approved expenses incurred up to the effective date of
suspension or termination.
C. Pursuant to 24 CFR 85.43, in the event SUBRECIPIENT defaults by failing to fulfill
all or any of its obligations hereunder, CITY may declare a default and termination of this
Agreement by written notice to SUBRECIPIENT, which default and termination shall be effective
on a date stated in the notice which is to be not less than ten (10) days after certified mailing or
personal service of such notice, unless such default is cured before the effective date of termination
stated in such notice. If terminated for cause, CITY shall be relieved of further liability or
responsibility under this Agreement, or as a result of the termination thereof, including the payment
of money, except for payment for approved expenses incurred for services satisfactorily and timely
performed prior to the mailing or service of the notice of termination, and except for reimbursement
of (1) any payments made for services not subsequently performed in a timely and satisfactory
manner, and (2) costs incurred by CITY in obtaining substitute performance.
D. The grant of funds under this Agreement may be terminated for convenience in
accordance with 24 CFR 85.44.
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 described
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 subparagraphs XII.A.
through XII.E., inclusive, 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, and
to comply with paragraph "XI. REVERSION OF ASSETS" of this Agreement.
XIII. LIMITATION OF FUNDS
13
5105
The United States of America, through HUD, may in the future place programmatic or fiscal
limitations on the use of CDBG funds which limitations are not presently anticipated. Accordingly,
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 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 permitted to de -scope
accordingly. Where CITY has reasonable grounds to question SUBRECIPIENT'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 legally binding
commitments made by SUBRECIPIENT before it received notice of such revision, provided that
such amounts have been committed in good faith and are otherwise allowable and that such
commitments are consistent with HUD cash withdrawal guidelines.
XIV. EXCLUSIVITY AND AMENDMENT OF AGREEMENT
This Agreement supersedes any and all other agreements, either oral or in writing, between
the parties hereto with respect to the use of CITY's CDBG 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,
inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone
acting on behalf of any party, which are not embodied herein, and that no other agreement or
amendment hereto shall be effective unless executed in writing and signed by both CITY and
SUBRECIPIENT.
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 affect
the validity of any other provision of this Agreement.
XVIL MISCELLANEOUS PROVISIONS
14
5105
a. Each undersigned represents and warrants that its signature herein below has the power,
authority and right to bind their respective parties to each of the terms of this Agreement, and shall
indemnify CITY fully, including reasonable costs and attorney's fees, for any injuries or damages to
CITY in the event that such authority or power is not, in fact, held by the signatory or is withdrawn.
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.
15
5/05
IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the last date and
year written below.
ATTEST:
PATRICIA E. HEAL'
Y
Clerk of the Council
APPROVED AS TO FORM:
JOSEPH W.FLETCHER
City Attorney
Z22 -- � �IC-1-
By: LISA E. STORCK
Assistant City Attorney
DATE:
16
CITY OF SANTA ANA/Z
aze'z�
DAVID N. REAM
City Manager
SUBRECIPIENT:
(\ s
Name: DennisjGoffi
Title: EXeciAWe Director
Tax ID: 95-2683852
Sent By: Teen Challenge; 951682357; Jun-23-05 1:16PM; Page 2
30ab t4 11. -C1 148858825 Tr ENC'dAL.I.40ELC - Sll rriry
fi?n ev; Teen Cpalle ripe.!
951682357, May. 05 9: a0at.l; r-ae
CITY OF SANA ANA
Cummunity Aevelopment Block Gran[
Scope of Fork
Annual AccImplishmnnt Goal
1. rotal n imber of clients anticipated to be,, served during 12-month conimct
1>er od�S1_,_ ^_ PERSONS
U. Nurnhel( nfunduplic,ted Santa AnA. residents to be served with grant funds during Inc, I
mnntb dune act period PERSONS
that the sub -recipient
will be irackimg with :1
III. tndicate
below ntte City per#btntunce outcome
check rAark
in the appropriate box.
COMMUNIA
MTORM T43PEDS: Pubtie Servke.FYeath Servlcm
Otalcotllc Trackln •-
Goal
I, for eduu�tioa-based ptngrarns.
Ar[Wf /1`rogr
�Yourh Stavices
m
1. Track iruprowmcru in Pre-ta?i,
poswom soon .
improve pre -test pose -test scores bs
Track number a f individuals
2. Provide opporhmioes fi r cxpnyw;
t— J
exposed to the fine arts.
to the fine arts.
!
3 Track childmn/tmuth seeking
3. 90% of chil47eu/youlh ecokmg
.I
rafepale that were linked to the
refennls will he linked rr� 1'u ne r+_�,..�•
oerviccs vrw ht
P
50r�g1U _,._ _ __
Law and Mode`ate.fnean+e
_
Truck program Pmjvipamys that were
90-x of pro Gram pAmi ipanra wdl be
SU�/16F� j
linked to 4Lrtt ei 90LIghL
linked to Re"ices aouglht.
ion of Woik - in space below. describe the program to be ftuarlcd during the I
Iv. Descrip
month ontract period including, services to be provided. program
goalS, client
charactlristics, b't how grant will be utilized.
Iflmds
C"
`4m. 0,,,d ate c�JO oi�C"S "YD
C .g 1 r KSe 1�f1r, l,o�n ,,AIL +yr�rP r `-I f"'44C�_c,
t
I' � �"\ `1.i�p�° i o.SKY`•t- T. �Y�Acln�, � i P. '+°.srna �� Q�htiS,a�'t
Ir�MvlYr-Cc cA
(x4�.Cot` e �
Sent By: Teen Challenge; 951682357;
05/25/2005 14.47 FAX 7148358825 TEENCHALLENSLUC
Jun-23-05 1:16PM;
Huhn
sent By: Teen Challenge;
I -
931882357;
May," 05 9:40AM;
'ehedule o er nrmanre the l2-month
Estimrce the wimher of unduplic ated Santa Ana ccsidents to he served dunnp_,
wntract peri per quarter,
Quar er 1: July 1 — September 30_ _ Persons
Quar er 2: October 1 —December 31 persons
9 Parson.
Quar�er .4: Jatruary 1 —March 3T �._ PCX-Su11S
Quar1Jl -r 4: April 1 - June 30 - -9 ' persons
Total �—
P:gge 3'5
Paro+e ,7�5
v
ount of grant funds to be requested during the 12-mnnth contr Wt pariud on U
1: July 1 - Scptonaber 30 $2t2: Cktoher l- December 313: January 1 March 31 $ r v b D
Quar er 4: April I Junc 30 $b
Total :F�y�
EXHIBIT A
Sent By: Teen Challenge; 951682357; Jun-23-05 1:16PM; gage d 5
05,25/2005 14 47 FAX 7148358825 ittnt•nnt_��nucuu •�.,,,.,. -
Attachment 4(a)
PROGRAM YEAR 2005-2006 (Projected)
PUBLIC SERVICE PROGRAM BUDGET PROPOSAL
Organization Name: Orange County Tgcn Chailen4e
Program Name: AfterSchooi earnlnq Center
CAtEGORY
Services
Other (Pieaao Specit
1. Transportation
2. ConferenceslMtgs
$30,000
52,500
5,750
10,200
2,520
2,100
0
300
8 9,500 5161,950
PROGRAM RESOURCES
TOTAL PROGRAM
BUDGET
$ 30.000
52,500
15,750
10,200
2,520
�2,100 1
0
800
2,006
1,000
$ 117,020
SOURCE
AMOUNT
CDBG (Projected)
$ 9,500
Foundational Giving (Projected)
$ 27,000
Misc. individual and Church Donations (Projected)
S 80,520
TOTAL
$117,020 ,...�
Cx
11
Certification Regarding Lobbying
Certification for Contracts Grants Loans, and Cooperative Agreements
The undersigned certifies, to the best of his or her knowledge and belief, that
(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the
undersigned, to any person for influencing or attempting to influence an officer or
employee of any agency, a Member of Congress, an officer or employee of Congress, or
an employee of a Member of Congress in connection with the awarding of any Federal
contract, the making of any cooperative agreement, and the extension, continuation,
renewal, amendment, or modification of any Federal contact, grant, loan or cooperative
agreement.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to
any person for influencing or attempting to influence an officer or employee of any
agency, a Member of Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection with this Federal contract, grant, loan, or cooperative
agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure
Form to Report Lobbying," in accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the
award documents for all subawards at all tiers (including subcontract, subgrants, and
contracts under grants, loans, and cooperative agreements) and that all subrecipients shall
certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed
when this transaction was made or entered into. Submission of this certification is a
prerequisite for making or entering into this transaction imposed by Section 1352, Title
31, U. S. Code. Any person who fails to file the required certification shall be subject to
a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
Rrange Country Teen Challenge After -School Learning Center
Grantee/Contactor Organization Program Title
Name of Certifying Officer
EXHIBIT C
Page 1 of 2
SUBRECIPIENT warrants the following:
1. SUBRECIPIENT will comply with Public Law 88-352, Title VI of the Civil Rights
Act of 1964 (42 U. S. C. section 2000 et seq.) and implementing regulation in 24 CFR
Part 1.
2. No person in the United States shall on the ground of race, color, religion, national
origin, or sex, be excluded from participation in, or be denied the benefits of, or be
subjected to discrimination under any program or activity funded in whole or in part with
community development funds made available pursuant to the ACT.
3. All laborers and mechanics, employed by contractors or subcontractors in the
performance of construction work financed in whole or in part with community
development funds shall be paid wages at rates not less than those prevailing on similar
construction in the locality as determined in accordance with the Davis -Bacon Act, as
amended, 40 U. S. C. Sections 276 a 1-5, except for individuals who perform services for
which they volunteered; do not receive compensation for such services; or are paid
expenses, reasonable benefits, or a nominal fee for such services; and are not otherwise
employed at any time in construction work.
4. SUBRECIPIENT will comply with all Federal statutes applicable to projects funded
with community development funds, except that (a) SUBRECIPIENT does not assume
CITY'S environmental responsibilities described at 24 CFR 570.604; and (b)
SUBRECIPIENT does not assume CITY'S responsibility for initiating the review process
under Executive Order 12372.
EXHIBIT C
Page 2 of 2
TEEN CHALLENGE
INTE.RNAT] 0NA1,
The Proven Cure For The Drug Epidemic
SO. CALIFORNIA HEADQUARTERS
www.teenchallenge.com
Dennis Griffith
July 6, 2005
Southern California
Director
Mr. Frank Hernandez
5445 Chicago Avenue
Riverside, CA 92507
City of Santa Ana
8990
Community Development A enM
FAX'9s1#382 3754
E-Mail. infoh)Lenchallenge.com
P.O. Box 1988
Kern County Santa Ana, CA 92702
P.O. Box 1011
Bakersfield CA 93302-1011
Dear Frank,
661/399-2273
FAX 661 /399-2354
E-Mail. teenchallenge@sbcglobalnet
Enclosed are the three signed copies of the sub -recipient agreement between Orange County
Las County
Teen Challenge and the City of Santa Ana for the use of the Community Development
01539
Box 015
0. Box
Loa Angeles, CA 90001
Block Grant (CDBG) funds for our Orange County After -School Learning Center for the
44
Program Year 2005-2006.
FAX 310/644-21so
E-MailtclaAcarnuink net
Orange County Teen Challenge looks forward to working with your office throughout the year. if you have
PO Box 236 any questions or concerns, please feel free to contact either myself or Regina Fournier, our
Santa 714/8 Ana cas27o2
714/8358822 grants coordinator, at (951) y 682-8990 at antime.
FAX 710358825
E-Mail. octcsantaanac&eerihl ink net
Singly, /
San DiegoPO
637
Sao Box
San CA /f
Diego
CA , 92175-5637
619/2650337
FAX 619/2650059 Dennis Griffith
E-Mau sdtcrapacbell net Executive Director
Tri-County Teen Challenge of Southern California
PO. Box 1064
Ventura, CA 93002
805/648-3295
FAX 805/652 0405
E-Mail. vtctc@earthlinknet
Ministry Institute
PO Box 739
South Gate, CA 90280
323/569-2818
FAX 323/569-7128
E-Mail. tcmi®pacbell.net
Thrift Store Operations
10131 Long Beach Blvd.
Lynwood. CA 90262
323/357-6990
FAX 323/564-7093
ECFA
A higher smMord
A higherpurpoie.
REQUEST FOR 40
COUNCIL ACTION
CITY COUNCIL MEETING DATE:
MARCH 7, 2005
TITLE:
PUBLIC HEARING — COMMUNITY
DEVELOPMENT BLOCK GRANT PROGRAM
FISCAL YEAR 2005-2006
CITY MANAGER
RECOMMENDED ACTION
CLERK OF COUNCIL USE ONLY:
APPROVED
As Recommended
❑ As Amended
❑ Ordinance on 1" Reading
❑ Ordinance on 2n0 Reading
❑ Implementing Resolution
❑ Set Public Hearing For
CONTINUED TO 4 �—O fj
FILE NUMBER A-2005-078-032
1. Approve the proposed fiscal year 2005-2006 Community Development
Block Grant Program.
2. Authorize the City Manager to submit the approved program to the
United States Department of Housing and Urban Development for the
City's fiscal year 2005-2006 allocation of Community Development
Block Grant funds, and execute the grant agreement with the United
States Department of Housing and Urban Development.
3. Direct the City Attorney to prepare and authorize the City Manager
and the Clerk of the Council to execute agreements with nonprofit
agencies and/or subrecipients awarded funds as part of the approved
program.
HUMAN RELATIONS COMMISSION RECOMMENDATION
Direct staff to transmit the Human Relations Commission's funding
recommendations for fiscal year 2005-2006 Community Development Block
Grant Social Services Programs to the City Council.
By a vote of 9:0 at its Regular Meeting of February 14, 2005.
DISCUSSION
Since fiscal year 1974-1975, Santa Ana has received annual Community
Development Block Grant (CDBG) funds to improve low- and moderate- income
neighborhoods, eliminate blight and create a more stable economic base.
These funds have been used for a diverse range of programs including
40
Public Hearing
March 7, 2005
Page 2
- CDBG Program FY 05-06
housing, street improvements, parks and public works improvements, social
services, historic preservation and community services. The City's
entitlement for fiscal year 2005-2006 will be $7,910,023. No more than 15
percent of this entitlement may be used for social service programs.
The proposed CDBG program and budget for fiscal year 2005-2006 reflect the
culmination of a process that solicited proposals from outside
organizations and City agencies for the use of the annual entitlement.
Invitations to apply for funds were distributed to 160 organizations in
September 2004. Staff then met with the Human Relations Commission (HRC)
in its capacity as the CDBG Citizen Advisory Board to review the
applications and conduct three public hearings held on January 18, 20, and
25, 2005 in the City Council Chambers.
Following the public hearings, staff met again with the HRC to draft a
recommended social service program and budget for City Council
consideration. The proposed fiscal year 2005-2006 CDBG program and budget
(Exhibit 1) consists of the Commission's recommendations for social
service funding and staff's funding recommendations for the remainder of
the program, including capital projects, code enforcement and program
administration. Exhibit 2 consists of the HRC ranking and funding
recommendations for the social service programs. The City Council public
hearing will provide another opportunity for public input and the
completion of the process necessary to submit our locally approved program
to HUD.
FISCAL IMPACT
Approval of the recommended action will authorize the City Manager to
submit the approved program to HUD and to execute a grant agreement, which
will result in the City's CDBG letter of credit being augmented by
$7,910,023. These funds will be available for the approved program
effective July 1, 2005.
Patricia C. Whitaker
Executive Director
Community Development Agency
PCT/NTE/mlr
H:\ACTIONS\2005 CC\PH - CDBGPrOgFY2005-2006 3-7-05.doc
APPROVED AS TO FUNDS AND ACCOUNTS:
Francisco Gutierrez
Executive Director
Finance & Management Services Agency/
J
CITY OF SANTA ANA
0006 HRC PUBLIC SERVICE GRANT RECOMMEND
BY TAB ORDER
SERVICE SERVICE 05-06 AMT. HRC
TAR APPLICANT NAME RECOMM'D
PROVIDED CATEGORY REQ.
GRANT
I
Academia Comm. Learning Center
Education
Youth
$20,000
0
2
Achievement Institute
Education
Youth
$8,600
0
3
AIDS Services Foundation
Medical
Adult 8 Family
$10,000
0
4
Assistance League of Santa Ana
Clothing
Youth
$25,000
17,000
5
Blind Children's Learning Center
counseling
Youth
$25,000
18,000
6
Bowers Museum
Education
Youth
$10,000
0
7
Boys & Girls Club of Santa Ana
Recreation
Youth
$45,000
29,000
8
California Elwyn
mplymnt.
Asst.
Adult & Family
$17,700
0
9
Cambodian Family
Education
Youth
$45,000
18,000
10
Camp Fire USA
volunteer.
Youth
$15,000
6,000
11
C.A.R.E. Counseling
omestic
Violence
Adult & Family
$15,000
0
12
Career Beginnings of O.C.
Education
Youth
$20,000
14,000
13
Casa de Salud Family Health Clinic
Nutrition
Adult 8 Family
$75,000
15,000
14
Centro Cultural de Mexico
Education
Youth
$22,500
0
15
Colette's Children's Home
Shelter
Housin /Shelter
$23,800
0
16
Community Service Programs(CSP)
Shelter
Youth
$25,000
0
17
Council on Aging - Linkages
Medical
Senior Citizens
$15.000
6,000
18
Dayle McIntosh Center
Emplymnt.
Asst.
Adult & Family
$15,707
14,000
19
Delhi Center
Recreation
Senior Citizens
$20,423
0
20
Betty Shabazz Delta Academy
Education
Youth
$6,500
0
21
Families Together of Orange County
Education
Adult & Family
$20,000
9,000
22
Feedback Foundation
Nutrition
Senior Citizens
$60,000
31,000
23
Hope Community Services, Inc.
counseling
Youth
$46,990
7,000
24
Hotline of Southern California
counselin
Adult & Familv
$5,000
5,000
25
Human Options
Uornestic
Violence
Youth
$20,000
18,000
26
Paul McNees Kidsingers
Recreation
Youth
$20,000
9,000
27
Latino Psychological & Soc. Swcs.
counseling
Youth
$72,950
0
28
Latino Youth Leadership Institute
counseling
Youth
$48,400
10,000
29
Legal Aid Society of Orange County
Legal
Adult & Family
$7,500
6,000
30
Lighthouse Learning Center
Education
Adult & Family
$20,000
16,000
31
Mariposa Women's Center
counseling
Adult & Family
$10,000
7,000
32
MOMS
rental
Adult & Family
$71,947
0
33
Mercy House Transitional Living Ctr - Joseph & Regina
Shelter
Housin /Shelter
$60,000
16,000
34
Mexican American Opportunity Fndtn.
Recreation
Youth
$20,714
10,000
35
National Council on Alcoholism & Drug (Drug Court)
counseling
Adult & Family
$22,158
15,000
36
National Heritage
Recreation
Youth
$25,000
0
37
Orange Coast Interfaith Shelter
Shelter
I Housin /Shelter
$25,000
0
Exhibit 1
1
CITY OF SANTA ANA
0006 HRC PUBLIC SERVICE GRANT RECOMMEND
BY TAB ORDER
SERVICE SERVICE 05-06 AMT. HRC
TAB APPLICANTNAME PROVIDED CATEGORY REQ, RECOMM'D
GRANT
38
Orange County Bar Foundation -Shortstop
counseling
Adult 8 Family
$20,000
13,000
39
Orange County Bar Foundation -Addiction
counseling
Adult & Family
$10,000
11,000
40
Orange County Children's Therapeutic Arts Center
Recreation
Youth
$25,000
12,000
41
Orange County Council, BSA (Learning for Life)
counseling
Youth
$50,000
0
42
Orange County Crazies
Recreation
Youth
$25,000
6,000
43
Orange County on Track
counseling
Youth
$20,000
0
44
Orange County Teen Challenge
Education
Youth
$9,500
9,000
45
Orange County Youth & Family Services
counseling
Youth
$60,398
0
46
Orange County Youth Commission
Recreation
Youth
$14,500
7,000
47
.Phoenix House Orange County, Inc.
Recreation
Youth
$13,803
9,000
48
PRCSA - McFadden Learning & Tech. Ctr.
Education
Youth
$141,102
90,000
49
PRCSA - Project Pride
Education
Youth
$215,434
198,000
50
Relampago del Cielo
Recreation
Youth
$8,000
0
51
Saint Joseph Ballet
Recreation
Youth
$50,000
41,000
52
Santa Ana Education Foundation
Education
Youth
$25,000
0
53
Santa Ana Friends for the Animals
Spay/Neuter
Animal
$9,500
0
54
Santa Ana Police Dept - Helicopter Program
Crime
Prevention
Adult & Family
$406,245
154,000
55
Share Our Selves
Medical
Adult & Family
$35,000
10,000
56
S. CA College of Optometry
Medical
Adult & Family
$53,100
15,000
57
Southwest Minority Economic Development Association
Homelessness
Adult & Family
$12,000
10,000
58
Taller San Jose
mp ymnt.
Asst.
Adult & Family
$55,150
34,000
59
Think Together
Education
Youth
$10,000
5,000
60
Thomas House Temporary Shelter
Shelter
Housin /Sheller
$30,000
15,000
61
TKO Boxing Club
Recreation
Youth
$15,000
13,000
tit
Vietnamese Community of Orange County
counseling
Youth
$67,091
15,000
63
Volunteer Center of Orange County
volunteer
Senior Citizens
$10,000
0
64
Williamson Institute
Shelter
Housing/Shelter
$35,000
14,000
65
WISE Place
Shelter
Housing/Shelter
$13,500
12,000
66
Women Helping Women
mp ymnt.
Asst.
Adult & Family
$10,000
5,000
67
Women's Transitional Living Center (WTLC)
Shelter
Housin /Shelter
$40,189
6,000
68
YMCA Orange County
counseling
Adult & Family
$10,000
0
$2,517,341 $1,000,000
Exhibit 1
2
PROPOS 05-06 COMMUNITY DEVELOPMENT K GRANT
NONS IAL SERVICE PROGRAM FUNDING RE UESTS
2004-05 2005-06 2005-06
STAFF
TAB
APPROPRIATION
REQUEST
RECOMMENDATION
Administration & Planning
69 Administration
$ 835,000
$ 785,000
$ 785,000
70 Fair Housing Council of Orange County
68,990
69,984
69,985
71 General Planning
100,000
235,000
235,000
Total Administration & Planning
$ 1,003,990
$ 1,089,984
$ 1,089,985
Obligations
72 Section 108 Loan Repayment --
Police Holding Facility
1,902,680
1,892,815
1,892,815
Total Obligations
$
1,902,680
$
1,892,815
$
1,892,815
Capital Improvements
73 Fire Equipment
$
1,368,200
$
777,000
$
777,000
Parks and Recreation --
74 Delhi Park Improvements
300,000
435,000
435,000
Public Works --
75 Delhi Neighborhood Street Improvements
400,000
535,000
535,000
Total Capital Improvements
$
2,068,200
$
1,747,000
$
1,747,000
Code Enforcement
76 Code Enforcement
$
1,995,260
$
1,795,260
$
1,795,260
Total Code Enforcement
$
1,995,260
$
1,795,260
$
1,795,260
Historic Preservation
77 Episcopal Church of the Messiah
$
-
$
35,000
$
35,000
Total Historic Preservation
$
-
$
35,000
$
35,000
Housing Rehabilitation
78 Rebuilding Together O.C.
$
15,000
$
26,000
$
26,000
79 Multi -Family Rehab Loans
123,470
323,963
323,963
Total Housing Rehabilitation
$
138,470
$
349,963
$
349,963
Total Nonsocial Services Request
$
6,910,022
TOTAL NONSOCIAL
SERVICE RECOMMENDED FUNDING
$
6,910,023
Social Service Requests
$
1,000,000
TOTAL 05/06 CDBG GRANT
$
7,910,023
Exhibit 1
3
CITY OF SANTA ANA
�006 HRC PUBLIC SERVICE GRANT RECOMMEND
BY RATING ORDER
IRC
HIRC
SERVICE
05-06 AMT.
SERVICE AVE
RECO M'D
TAB APPLICANT NAME
PROVIDED
CATEGORY REQ.
RATE
GRANT
40
Orange County Children's Therapeutic Arts
CenterRecreation
Youth
8.6
$25,000
12,000
24
Hotline of Southern California
counseiinq
Adult & Family
8.6
$5,000
5,000
38
Orange County Bar Foundation -Shortstop
counseling
Adult & Family
8.4
$20,000
13,000
39
Orange County Bar Foundation -Addiction
counseling
Adult & Family
8.4
$10,000
11,000
60
Thomas House Temporary Shelter
Shelter
Housing/Shelter
8.4
$30,000
15,000
30
Lighthouse Learning Center
Education
Adult & Family
8.4
$20,000
16,000
48
PRCSA - McFadden Learning & Tech. Ctr.
Education
Youth
8.3
$141,102
90,000
58
Taller San Jose
mp ymnt.
Asst.
Adult & Family
8.3
$55,150
34,000
9
Cambodian Family
Education
Youth
8.1
$45,000
18,000
1
Academia Comm. Learning Center
Education
Youth
8.0
$20,000
0
7
Boys & Girls Club of Santa Ana
Recreation
Youth
8.0
$45,000
29,000
29
Legal Aid Society of Orange County
Le al
Adult & Family
8.0
$7,500
6,000
44
Orange County Teen Challenge
Education
Youth
8.0
$9,500
9,000
49
PRCSA - Project Pride
Education
Youth
6.0
$215,434
198,000
75F
Saint Joseph Ballet
Recreation
Youth
8.0
$50,000
41,000
61
TKO Boxing Club
Recreation
Youth
8.0
$15,000
13,000
65
WISE Place
Shelter
Housin Shelter
8.0
$13,500
12,000
19
Dayle McIntosh Center
mplymnt.
Asst.
Adult & Family
7.9
$15,707
14,000
31
Mariposa Women's Center
counseling
Adult & Family
7.9
$10,000
7,000
47
Phoenix House Orange County, Inc.
Recreation
Youth
7.9
$13,803
9,000
4
Assistance League of Santa Ana
Clothin
Youth
7.9
$25,000
17,000
13
Casa de Salud Family Health Clinic
Nutrition
Adult & Family
7.8
$75,000
15,000
25
Human Options
omestic
Violence
Youth
7.7
$20,000
18,000
34
Mexican American Opportunity Fndtn.
Recreation
Youth
7.7
$20,714
10,000
62
Vietnamese Community of Orange County
counseling
Youth
7.6
$67,091
15,000
12
Career Beginnings of O.C.
Education
Youth
7.6
$20,000
14,000
20
Betty Shabazz Delta Academy
Education
Youth
7.6
$6,500
0
28
Latino Youth Leadership Institute
counseling
Youth
7.6
$48,400
10,000
22
Feedback Foundation
Nutrition
Senior Citizens
7.5
$60,000
31,000
55
Share Our Selves
Medical
Adult & Family
7.5
$35,000
10,000
56
S. CA College of Optometry
Medical
Adult & Family
7.4
$53,100
15,000
21
Families Together of Orange County
Education
Adult 8 Family
7.4
$20,000
9,000
57
Southwest Minority Economic Development
Association
Homelessness
Adult & Family
7.3
$12,000
10,000
2
Achievement Institute
Education
Youth
7.1
$8,600
0
42
Orange County Crazies
Recreation
Youth
7.1
$25.000
6,000
75
National Council on Alcoholism & Drug (Drug
counseling
Adult & Family
7.1
$22,158
15,000
17
Council on Aging - Linkages
Medical
Senior Citizens
7.0
$15,0001
6,000
E.nmu 2
1
CITY OF SANTA ANA
�D06 HRC PUBLIC SERVICE GRANT RECOMMEND
BY RATING ORDER
TAB APPLICANT NAME SERVICE SERVICE AVE. OS-Ob AMT' RECOMM'D
PROVIDED CATEGORY RATE REQ. GRANT
26
Paul McNeff Kidsingers
Recreation
Youth
7.0
$20,000
9,000
46
Orange County Youth Commission
Recreation
Youth
7.0
$14,500
7,000
64
Williamson Institute
Shelter
Housin /Shelter
7.0
$35,000
14,000
5
Blind Children's Learning Center
counseling
Youth
6.9
$25,000
18,000
50
Relampago del Cielo
Recreation
Youth
6.9
$8,000
0
23
Hope Community Services, Inc.
counseling
Youth
6.9
$48,990
7,000
59
Think Together
Education
Youth
6.8
$10,000
5,000
67
Women's Transitional Living Center (WTLC)
Shelter
Housin /Shelter
6.8
$40,189
6,000
66
Women Helping Women
Emplymnt.
Asst.
Adult & Family
6.6
$10,000
5,000
10
Camp Fire USA
volunteer
Youth
6.6
$15,000
6,000
33
Mercy House Transitional Living Ctr - Joseph &
Reaina
Shelter
Housin /Shelter
6.6
$60,000
16,000
53
Santa Ana Friends for the Animals
S a /Neuter
Animal
6.5
$9,500
0
6
Bowers Museum
Education
Youth
6.4
$10,000
0
16
Community Service Programs(CSP)
Shelter
Youth
6.4
$25,000
0
36
National Heritage
Recreation
Youth
6.4
$25,000
0
45
Orange County Youth & Family Services
counseling
Youth
6.4
$60,338
0
54
Santa Ana Police Dept - Helicopter Program
Cdme
Prevention
Adult & Family
6.4
$406,245
154,000
32
MOMS
rental
Adult & Family6.1
$71,947
0
11
C.A.R.E. Counseling
oIn I c
Violence
Adult & Family
6.0
$15,000
0
52
Santa Ana Education Foundation
Education
Youth
6.0
$25,000
0
68
YMCA Orange County
counseling
Adult & Family
6.0
$10,000
0
41
Orange County Council, BSA (Learning for Life)
counseling
Youth
5.9
$50,000
0
27
Latino Psychological & Soc. Srvcs.
counseling
Youth
5.8
$72,950
0
15
Colette's Children's Home
Shelter
Housing/Shelter
5.3
$23,800
0
43
Orange County on Track
counseling
Youth
5.1
$20,000
0
19
Delhi Center
Recreation
Senior Citizens
2.1
$20,423
0
63
Volunteer Center of Orange County
volunteer
Senior Citizens
1.5
$10,000
0
3
AIDS Services Foundation
Medical
Adult & Family
0.9
$10,000
0
37
Orange Coast Interfaith Shelter
Shelter
Housing/Shelter
0.9
$25,000
0
8
California Elwyn
mpymnt.
Asst.
Adult & Famil
0.0
$17,700
0
14
Centro Cultural de Mexico
Education
Youth
0.0
$22,500
0
$2,517,341 $1,000,000
E.hb,t 2
2
41
•
BUSINESS CALENDAR
NOES: None (0)
ABSTAIN: None (0)
ABSENT: None (0)
REPORTS
65.A. 4TH DISTRICT COURT OF APPEAL STATUS REPORT — City Manager
David Ream, City Manager, briefed the Council on the steps taken to
ensure that the 4th District Court of Appeal remains in the City of Santa
Ana.
PUBLIC HEARINGS
75.A. PUBLIC HEARING — COMMUNITY DEVELOPMENT BLOCK GRANT
PROGRAM FISCAL YEAR 2005-2006
Continued from the March 7, 2005 City Council Meeting by a vote of 7-0
Public hearing held and closed on March 7, 2005
Public hearing regarding the proposed Community Development Block
Grant (CDBG) Program and Budget for Fiscal Year 2005-2006
Legal Notice published in the Orange County Register, La Opinion, and
Nguoi Viet on February 21, 2005
Vivian Clecak representing Human Options; Larry Haynes representing
Mercy House Transitional Living Center; Peggy Weatherspoon and Suzie
Gulick representing Feedback Foundation; and, Stacey Physioc
representing Paul McNeff Singers spoke in support of funding for their
respective organizations.
Motion: 1. Approve the proposed fiscal year 2005-2006 Community
Development Block Grant Program.
i
1
Academia Comm. Learning Center
$0
$0
2
Achievement Institute
$0
$5,000 $5,000
3
AIDS Services Foundation
$0
$0
4
lAssistance League of Santa Ana
$17,000
$17,000
CITY COUNCIL MINUTES
12
APRIL 4, 2005
PUBLIC HEARINGS
5
Blind Children's Learning Center
$18,000
$18,000
6
Bowers Museum
$0
$5,000
$5,000
7
Boys & Girls Club of Santa Ana
$29,000
$29,000
8
California Elwyn
$0
$0
9
Cambodian Family
$18,000
$18,OOC
10
Camp Fire USA
$6,000
-$1,000
$5,OOC
11
C.A.R.E. Counseling
$0
$C
12
Career Beginnings of O.C.
$14,000
$14,OOC
13
Casa de Salud Family Health Clinic
$15,000
-$2,000
$13,OOC
14
Centro Cultural de Mexico
$0
$10,000
$10,OOC
15
Colette's Children's Home
$0
$C
16
Community Service Programs (CSP)
$0
$C
17
Council on Aging - Linkages
$6,000
$6,OOC
18
Dayle McIntosh Center
$14,000
$14,OOC
19
Delhi Center
$0
$5,000
$5,OOC
20
Betty Shabazz Delta Academy
$0
$C
21
Families Together of Orange County
$9,000
-$4,000
$5,OOC
22
Feedback Foundation
$31,000
$14,000
$45,00C
23
Hope Community Services, Inc.
$7,000
-$7,000
$(
24
Hotline of Southern California
$5,000
$5,00C
25
Human Options
$18,000
$2,000
$20,00C
26
Paul McNeff Kidsingers
$9,000
$1,000
$10,00C
27
Latino Psychological & Soc. Srvcs.
$0
$(
28
Latino Youth Leadership Institute
$10,000
$10,00(
29
Legal Aid Society of Orange County
$6,000
$6,00(
30
Lighthouse Learning Center
$16,000
$16,00(
31
Mariposa Women's Center
$7,000
-$1,000
$6,00(
32
MOMS
$0
$(
33
Mercy House Transitional Living Ctr
- Joseph & Regina
$16,000
$3,000
$19,00(
34
Mexican American Opportunity
Fndtn.
$10,000
-$1,000
$9,00(
35
National Council on Alcoholism &
Drug (Drug Court
$15,000
$5,000
$20,00(
36
National Heritage
$0
$5,000
$5,00(
37
Orange Coast Interfaith Shelter
$0
$(
CITY COUNCIL MINUTES 13 APRIL 4, 2005
PUBLIC HEARINGS
38
Orange County Bar Foundation -
Shortstop
$13,000
$13,000
39
Orange County Bar Foundation -
Addiction
$11,000
-$6,000
$5,000
40
Orange County Children's
Therapeutic Arts Center
$12,000
$12,000
41
Orange County Council, BSA
(Learning for Life
$0
$0
42
Orange County Crazies
$6,000
$4,000
$10,000
43
Orange County on Track
$0
$4,000
$4,000
44
Orange County Teen Challenge
$9,000
$500
$9,50
45
Orange County Youth & Family
Services
$0
$0
46
Orange County Youth Commission
$7,000
$7,000
47
Phoenix House Orange County, Inc.
$9,000
-$9,000
$0
48
PRCSA - McFadden Learning &
Tech. Ctr.
$90,000
-$9,000
$81,000
49
PRCSA - Project Pride
$198,000
$198,000
50
Relampago del Cielo
$0
$0
51
Saint Joseph Ballet
$41,000
$4,000
$45,000
52
Santa Ana Education Foundation
$0
$0
53
Santa Ana Friends for the Animals
$0
$0
54
Santa Ana Police Dept - Helicopter
Pro ram
$154,000
$50,875
$204,875
55
Share Our Selves
$10,000
$10,000
56
S. CA College of Optometry
$15,000
-$7,500
$7,500
57
Southwest Minority Economic
Development Association
$10,000
$10,000
58
Taller San Jose
$34,000
$34,000
59
Think Together
$5,000
$5,000
60
Thomas House Temporary Shelter
$15,000
$15,000
61
TKO Boxing Club
$13,000
$13,000
62
Vietnamese Community of Orange
Countv
$15,000
$15,000
63
Volunteer Center of Orange County
$0
$0
64
lWilliams Institute
$14,000
$6,000
$20,000
65
IWISE Place
$12,000
$5001
$12,500
CITY COUNCIL MINUTES 14 APRIL 4, 2005
•
PUBLIC HEARINGS
66 Women Helping Women $5,000 Z�S,000
67 Women's Transitional Living Center
WTLC $6,000 $1,000 $5,000
68 YMCA Orange County $0 $0
Total Social Services: $1.000.000 $76.375 $1.076.375
NON-SOCIAL SERVICE PROGRAMS
Total Administration&Planning: $1,089,985 $1,089,985
Total Obligations: $1,892,815 $1,892,815
Total Capital Improvements: $1,747,000-$76,375 $1,670,625
Total Code Enforcement: $1,795,260 $1,795,260
CITY COUNCIL MINUTES 15 APRIL 4, 2005
PUBLIC HEARINGS
Total Housing Rehabilitation: $384,963 $384,963
TOTAL NONSOCIAL SERVICE RECOMMENDED FUNDING $6,833,648
TOTAL SOCIAL SERVICE RECOMMENDED FUNDING $1,076,375
TOTAL CDBG PROGRAM BUDGET $7,910,023
2. Authorize the City Manager to submit the approved program to
the United States Department of Housing and Urban Development
for the City's fiscal year 2005-2006 allocation of Community
Development Block Grant funds, and execute the grant agreement
with the United States Department of Housing and Urban
Development.
3. Direct the City Attorney to prepare and authorize the City Manager
and the Clerk of the Council to execute agreements.
AGMT NO. 2005-078 - With nonprofit agencies and/or sub -recipients
awarded funds as part of the approved program.
MOTION: Christy SECOND: Bist
VOTE: AYES: Alvarez, Bustamante, Pulido, Bist, Christy,
Garcia, Solorio (7)
NOES: None (0)
ABSTAIN: None (0)
ABSENT: None (0)
75.13. ADELPHIA CABLEVISION OF SANTA ANA, LLC. FRANCHISE
RENEWAL
Legal notice published in the O.C. Reporter on March 18, 2005
Motion: Continue the item to April 18, 2005 at the request of staff.
CITY COUNCIL MINUTES
16
APRIL 4, 2005
DATE (MMIDDIYYYY)
Aco-Ta CERTIFICATr' 7F LIABILITY INSURANC - TEENCH M 07/28/05
Advanced Insurance Marketing
P.O. Box 4459
Orange CA 92863-4459
Phone:714-997-8100
INSURED
Teen Challenge of So. Ca. Inc.
Sandy Segrest
5445 Chicago Avenue
Riverside CA 92507
COVERAGES
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
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE NAIC #
INSURER A- Philadelphia Indemnity Ins co.
USURER B:
INSURER C.
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.
I
LTR
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE IMM/DD
POLICY
DATE MM/DO/Yl'
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
ATED——
DPREANMISESGETDR(Ea occurence)
E300,000_ ,
A
i
X COMMERCIAL GENERAL LIABILITY
PHPK130052
07/19/0$
07/19/06
MED EXP(Any one pars.,)
( CLAIMS MADE , OCCUR
$ 15, 000
PERSONAL 8 ADV INJURY
$ 1 , OOO , OOO
GENERALAGGREGATE
s2,000,000
GENL AGGREGATE LIMIT APPLIES PER.
PRODUCTS - COMP/OP AGG
$2,000,000
X POLICY PECOT LOC
Em Ben.
1,000,000
AUTOMOBILE LIABILITY
�
COMBINED SINGLE LIMB
$1,000, 000
A
I$iANY AUTO
PHPK130052
07/19/05
07/19/06
(Ea accident)
p
ALL OWNED AUTOS
BODILY INJURY
$
SCHEDULED AUTOS
(Per person)
HIRED AUTOS
BODILY
$
NON OWNED AUTOS
(Per accidcitlenU
ao t)
PROPERTY DAMAGE
- -- -----
$
(Per accident)
RAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
ANY AUTO
OTHEEAACC
$ _ _—
P
AUTO ONLY
AUTOONLY'. AGO
$
ESSIUMBRELLA LIABILITY
EACH OCCURRENCE
$9,000,000
A
OCCUR f CLAIMS MADE
PHUB048953
07/19/05
07/19/06
AGGREGATE
$
DEDUCTIBLE
$
X RETENTION $ 10 , 000
$
WORKERS COMPENSATION AND
TORY LIMITS Eft
EMPLOYERS' LIABILITY
---- —
— —
C.L. EACH ACCIDENT
ANY PROPRIETORAPARTNERIEXECUTIVE
AbO
F
Fr�
_-. A�
$
OFFICER/MEMBER FxClUDED'
Al
EL. DISEASE EA EMPLOYEE
$
I( yes, describe under
SPECIAL PROVISIONS below
E IFDISEASE - POLICY LIMIT
$
OTHER
L
ain Smt Shea
y
Assistant
City
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISI NS
10 day notice of cancellation for non-payment of premium. City of Santa Ana,
its officers, agents, employees and volunteers are named as Additional
Insured as respects their interests and connection with the named insured.
RE: Funding
City of Santa Ana CDBG M-25
Community Development Agency
P.O. Box 1988 M-25
Santa Ana, CA 92702
CITSAN•1' I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILLlNBMYWiiO MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
ACORD 25 (2001108)
rr•�.oraeni
INSURED: Teen Challenge of So. Ca. Inc.
POLICY NUMBER: PHPK130052
EFFECTIVE DATE: 07/19/05
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
ADDITIONAL INSURED -DESIGNATED PERSON OR ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART.
SCHEDULE
Name of Person or Organization:
CITY OF SANTA ANA CDBG M-25
COMMUNITY DEVELOPMENT AGENCY
PO BOX 1988 M-25, SANTA ANA, CA 92702
RE: FiiNDING
(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.
APPROVED AS TO FORM
Laura Stitt Sheedy
Assistant City Attoimw�
CG 20 26 11 85
Sent By:-Te�n Challenge; 951882357; May-24-05 4:16AM; Paq_e 3
15 2..' -005 1 ; ,7 STaTF Cu,,,' PIS FI.Jh4D 91'=51nR.-3754 11 . -' „_..,.r.,
STATE -
HOME OFFICE SAN FRANCI]GU i ANNUAL RATING ENOORSEMENI
I N S U N$ATION
I N $ U R A N CG IT IS AGREED THAT T'NF. CLASSIFICATIONS AND RATES PER $100 OF REMUNERATION APPEARING
FUND IN THL CONTINUOUS POLICY ISSUED TO THIS EMPLOYER ARF AMENDED AS SHOWN BELOW
4CRC ARE YOUR NEW RATES FOR THE. PERIOD INDICATFD IF YOUR NAME OR ADDRESS SHOUIn
BE CORRECTED OR IF INSURANCE IS NOT NEEDLE) FOR NEXT YEAR, PI CASE TELL LS,
IMPQRTANT THIS IS NOT A BILL CONTINUOUS POLICY 488-04
SEND ND MONEY URLIiSS STATEMENT i$ ENCLOSED CALIFORNIA COUNCIL OF COMMUNITY MENIAL
tiEALTa AGENCIES
THE RATIM6 PEPICD 4EGINS ANC PROS AT 12:07AM
PACIFIC STAMCARD TIME
TEEN CHALLENGE OF SO CA , INC RATING PERIOD 2-01-05 TO 2-01-06
PO BOX 5039 UNIT 62b
RIVF,RSIDE, CALTP 92517 DEPOSIT PREMIUM $17,301.00
MINIMUM PREMIUM $160.00
PREMIUM ADJUSTMENT PERIOD MONTHLY
REP 02 R SP
NAME OF EMPLOYFR- TEEN CHALLENGE OF SO CA INC
(A NON-PROFIT CORP.)
CODE N0. PRINCIPAL WORK AND RATES EFFECTIVE FROM 02-DL-US TO 02-07 06
INTERIM
PREMIUM aASE 3I1"1,1NG
BASIS RATE RATE*
DDU4 ALCOHOLIC AND DRUG RECOVERY HOMES --ALL 1186nnU 1U.53 S.4U
EMYLUYIE6.
8017 STORES--RETAIL--N.O_C_ 96400 10.70 11.36
8742 SALESPERSONS --OUTSIDE. 35940U 2.11 1.66
8804 SOCIAL REHABILITATION FACILITIES FOR 10,83 8.4E
ADUT-TS--ALL EMPLOYEES.
8810 CLERTCAL OFFICE EMPLOYEES--N.Q.C. 736000 1.94 1.52
EXPERIENCE MODIFICATION
2 D1 35 TO 2-01-06
7% x
--------BUREAU NOTE INFORMATION.*.x•...
FEIN 952683852 APPROVED
A5 7"O
Laura Stitt Shccd, —�
Assis(aut City 11I,,, Irt,
TO-1"AL ESTIMATED ANNUAL PREMIUM $90,400
COUNTERSIGNED AND ISSUED AT SAL`7 FRANCISCO FEBRIJARY 11, 2005 YUI,IC.Y L PACY1: Y OF
SCR CORM 10563(REY.5�051 IOVFR PIFASFI
Sect By: Teen Challenge; 951682357; May-24-05 9:17AM;
05.'25,2305 15:5'/ STIdTE LUMP INS FIND � 919516823754
Paqe 415
NGISCQT ANNUA: FA71NG ENDOR$FM ENT
STATE "DIME OFFICE SAN FRA
COMPENSATIONINSURANCE IT IS AGREED THAT THE CLASSIFICATIONS AND RATES PER $100 OF REMUNFRATION APNEA.HING
Ct 'Nn IN THE CONTINUOUS POLICY ISSUED TO THIS EMPLOYER ARE AM FNDFO AS SHOWN 130 OVl
HERE ARE YOUR NCW RATES FOR THE PERIOD INDICATED, IF YOUR NAME OR ADDRESS SHOULD
RE CORFECTEO OR IF INSURANCE IS NOT NEEDED FOR NEXT YEAR, PLEASE TELL US.
IMPORTANT THIS=NOTA CONTINUOUS POLICY 489-04
SEND NO HONEY UNLESS STATENE
THE RATING PERIOD BEGINS AND ENDS AT 12:01AM RATING k'ERIOD 2-U1-0cJ TO 2-UT-OG:
PACIFIC STANDARD TIFE
UNIT 626
* INTERIM BILLING RATES WILI. BE USED ON PAYROLL REPORTS. THEY -TAKE INTO ACCOUNT
RATING PLAN CREDITS (OR DEBITS) WHICH WILL APPLY AT FINAL BILLING AND AN
ESTIMATE OF YOUR PREMIUM DISCOUNT" AS DETAILED BELOW.
RATING PLAN CREDITS (DFBTTSI EFFECTIVE FROM 0zQI-051`0 02-01-n6
RATING PLAN MODIFIER 0-911Hn
ESTIMATED PREMIUM DISCOUNT MODIFIER H-Hsi11
COMPOSITE FACTOR APPLIED TO BASE PATES TO DERIVE
INTERIM BILLING RATES 0.70152
aiasaiiiarra..ir........ *...........
Y =
PREMIUM DISCOUNT SCHEDULE FFFECTTVE FROM 02--01-05 TO 02-01-06 _
ESTIMATFD MODIFIED PREMIUM IS DISCOUNTED ACCORDING TO THE FOLLOWING; SCHEDULE: _
FIRST ABOVE _
$5,000 $5,000 =
= 0.0% 15.0%L =
s a
fiiii=fiiii=iiiiaiiiiYiiiaaiiiiaaaaalaiiaiirraraiiaa.A.Rii............. ki!=iFt#
SHE ESTIMATED PRFATUM DISCOUNT IS BASED ON AN ESTIMATE OF YOUR PAYROLL- ACTUAL
PREMIUM DISCOUNT APPLIED AT FINAL BILLING WILL BE BASED ON THE ACTUAL PAYROLL
REPORTED ON YOUR POLICY AND SUBJECT TO AUDIT.
APPROVED AS Iv I
Lauri >IIu .,Wordy �-
l�SSISI.illi
COUNTERSIGNED AND ISSUED AT SAN FRANCISCO FE.ARUARY 11, 2005 POLICY L P_J E, 2 OF 3
SUP Fown 1050(Rtvs 3) (OVER PLEASE)
Senj By: Teen Challenge; 951682357; May-24-0F 9:17AM; Page 5/5
2757 STFITE , P INS 7UND — yL UlbdL' ',---j4 Nl i Ul_n_w
STATE HQME OFFICE SAN'FRANCISCo ANNUAL RATING ENDORSEMENT
I N 8 LII I A HI C u IT I$ AGREED CHAT THE CLASSIFICATIONS AND RATES PER 5100 OF REMUNERATION APPEARING
INSURANCi
Tau N IN THE CONTINUOUS POLICY ISSUED TO THIS EMPLOYER ARE AMEfmEO AS SHOWN BELOW.
CONTINUOUS POLICY488-0000626-04
IF YCU HAVE ANY OUESTIONS, PLEASE CONTACT YOUR IOCAI STATE FOND OFt ICF BELOW
SANTA ANA
17S0 Ed�:;T FOURTH STREET
SANTA ANA CA 9270S
(71,1) 565—S995
Nothing harein ctnteined shall be hold to vary, titer, waive or extend my of the terms. Condltions
agreements or limitations of the Policy other than as herein stated.
When countareipned by a duly authorised officer or repreaemative of tho State Ccmparsalicn Instirvrce
Furs{, these dacfaraWns shall be rand and form part of the Policy.
ALyHpAIYEb NkPHESENTATIVE
PgESIp
MR0V ED 'AS 'lli tv: ...
As>isLan[ lv� -so ;,
COUNTERSIGNED AND ISSUED AT SAN FRANCISCO FEBRUARY 11, 2005 POLICY L PAGE .] OF It