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HomeMy WebLinkAboutO.C. CHILDREN'S THERAPEUTIC 4t~s~~ AGREEMENT TERMINATION m~ I"!t" -fi ~,~~ c3~ 59 Please complete this form when the attached agreement is no longer i~reffect: Return form to the Sr. Deputy Clerk of the Council (M-34). Call 64~k,~,~38 if you have arty questions. ~' ` The agreement with U//~ Cti,l~lrc~ 5 ~~,: ~~f. c /~~Is Bch}c~, No. H - ~.o(US' - ~ 3 S" was completed on CO ~~~ ~ ~ ,and final payment has been made. Department: ~ .~~ -~ ~~ ~ ~ J Signature: ~~ Date: ~~ ~ . ~/ City of Santa Ana Revised 8-7-03 Clerk of the Council INSURANCE ON FILE WORK MAY PROCEED UNtIL INSURANCE EXPIRES ~.'~ ~_„ lN' CLERK OF COONCIL DATE: J~ ~ y .~ U 6 Contract No. ~ - ~ o a 5' ~ 13 5 AGREEMENT UNDER TAE V~~ORKFORCE II~'~'ESTMENT ACT THIS AGREEMENT, made and entered into this 1st day of October. 2005, by and between the City of Santa Ana, a charter city and municipal corporation duly organized and existing under the Constitution and laws of the State of Califomia ("CITY") and O.C. Children's Therapeutic Arts Center ("CONTRACTOR"). R'-I-T-N-E-S-S-E-T-H Recitals: A. CITY has been designated a Local Workforce Investment Area (L~iriA) under the Workforce Investment Act of ] 998, Public Law 105-220 ("the Act"). B. The State of Califomia has created the LWIA to administer the Act programs operated by the State of California pursuant to the Act. C. As a LWIA, CITY is entitled to receive federal funds to establish programs to prepare economically disadvantaged youths for entry into the labor market and to provide basic skills development to those individuals who are economically disadvantaged or otherwise face serious barriers to succeeding in life. One goal of California's Workforce Investment System is to provide youth with the opportunities to achieve career goals that will allow them to successfully compete in the labor mazket and prepare them for higher education. D. CONTRACTOR is experienced in operating education, occupational development and emplo}'anent programs for economically disadvantaged youths for entn~ into the labor mazket ("said program"). E. CONTRACTOR is willing to operate said program pursuant to the Act and Califomia law. WHEREFORE, for and in consideration of the respective and mutual covenants and promises hereinafter contained and made, and subject to a]] the terms and conditions hereof, the parties hereto do hereby agree as follows: I. CONTRACTOR'S OBLIGATIONS Page I of 14 A. CONTRACTOR agrees to provide the following sen~ices pursuant to said program, as more specifically set forth in CONTRACTOR'S program narrative contained in "Exhibit A" and in the Statement of Work (Exhibit B), attached hereto and by this reference incorporated herein: CONTRACTOR'S failure to provide said services may be grounds for CITY to readjust the level of payment to CONTRACTOR otherwise provided for hereinafter. B. CONTRACTOR agrees to provide benefits to individuals who participate in the activities and services funded by this Agreement ("participants") in accordance with the standards and requirements set forth in Workforce Investment Act of 1998, Public Law 105-220. C. CONTRACTOR agrees to perform the services set forth herein in a professional. timely and diligent manner. D. CONTRACTOR shall provide wages and benefits to individuals who pazticipate in the activities and services funded by this Agreement ("participants") in accordance with the standads and requirements of the Act, including Section 181 of the Act. E. CONTRACTOR shall adhere to the Labor Standazds described in the Act including Section 181 of the Act. F. CONTRACTOR agrees to comply with the "Complaint Handling Procedures under the WIA", attached hereto as "Exhibit C" and incorporated herein as though fully set forth in 20 CFR §66?.200, Subpart F. CONTRACTOR shall advise participants of their rights to file complaints under the Act and the procedures for resolution of any complaints. CITY's procedures for handling complaints alleging a ~dolation of the Act, regulations, grants, or other agreements under the Act shall be followed and any decision of CITY, the State or the federal government relating to the complaint shall be binding and followed by CONTRACTOR. CONTRACTORS who are employers shall operate a grievance system that incorporates CITY's procedures for resolution of complaints relating to the terms and conditions of employment; these procedures shall be approved in writing by CITY. G. As a condition of this award of financial assistance under the Act to CONTRACTOR from CITY, CONTRACTOR assures, with respect to operation of all programs or activities funded with funds pro~~ided pursuant to the Act, and all agreements or arrangements to carry out such programs or activities, that it will comply fully with the nondiscrimination and equal opportunity provisions of the Act (Section 188); the Nontraditional Employment for Women Act of 1991; Title VI of the Civil Rights Act of 1964, as amended; section 504 of the Rehabilitation Act of 1973, as amended; the Age Discrimination Act of 1975, as amended; the Americans with Disabilities Act of 1990; and with all applicable requirements imposed by or pursuant to regulations implementing those laws, including, bui not limited to, 29 CFR part 37. The United States, the State of California and CITY have the right to seek judicial enforcement of this assurance. H. CONTRACTOR agrees that no participant(s) shall commence training prior to the approval of funding pursuant to Section 123 of the Act. Page 2 of 14 L CONTRACTOR agrees to maintain such records and submit such reports, data and information, on the form and containing such information, at such times as CITY may request or require regazding the performance of CONTRACTOR'S services or activities, costs or other data, including but not limited to, participants' attendance, payroll records and job duty statements. CONTRACTOR agrees to forward to the Santa Ana Work Center Administrative Office, 1000 East Santa Ana Blvd., Suite 200, Santa Ana, Califomia 92701 a completed Workforce Investment Act Application form (WIA EWIR) and supporting documents within 60 days of application date; a complete Workforce Investment Act Enrollment/Registration form (~'IA EWIE) and 1w'orkforce Investment Act Goals form (WIA ER~IG) must be submitted along with the Vr'IA EWIR; any subsequent updates to ERIE and /or EWIG must be completed within 10 days of the begin date of activity or end date of an activity; Workforce Investment Act Exit form (VJIA EWIT) within I S days of completion/termination of active enrollment of trainee; and the Workforce Investment Act Follow-Up Contact Information form (WIA EWIF) within 21 days following 30, 60, 90,180, 270, and 360 days of exit. CITY, the State of California and the United States government andior their representatives shall. have access for purposes of monitoring, auditing and examining of CONTRACTOR'S activities, performance, books, documents, papers, and records of CONTRACTOR subcontractors, bookkeepers and accountants, and employees and participants related to this Agreement. Such agencies or representatives shall also schedule on-site monitoring in their discretion. Monitoring activities may also include, but aze not limited to, questioning employees and participants and entering any premises or onto any site in which any of the services or activities funded hereunder are conducted or in which any of the records of CONTRACTOR aze kept. Nothing herein shall be construed to require access to any privileged or confidential information as set forth in federal or state law. In the event CONTRACTOR does not make the above-referenced documents available within the City of Santa Ana, California, CONTRACTOR agrees to pay al] necessary and reasonable expenses incurred by CITY in conducting any audit at the location where said records and books of account are maintained. All accounting records and evidence pertaining to all costs of CONTRACTOR and all documents related to this Agreement shall be kept available at the location where CONTRACTOR conducted the program, as well as in the County of Orange, for the duration of this Agreement and thereafter for three (3) years after completion of an audit. 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, the State of California or the United States Government take exception, shall be retained beyond the three (3) years until resolution of disposition of such appeals. litigation, claims, or exceptions. J. Without prejudice to any other section of this Agreement, CONTRACTOR shall, where applicable, maintain the confidential nature of information provided to it concerning participants in accordance with the requirements of federal and state law. Notwithstanding the foregoing, CONTRACTOR agrees to submit to CITY, the State of California and/or the United States Government or their representatives, all records requested for administrative purposes, including audits, examinations, monitoring and verification of records submitted by CONTRACTOR, costs incurred and services rendered hereunder. K. CONTRACTOR agrees to complete in triplicate, a monthly Invoice,'Voucher on CITY's Invoice/Voucher form, showing in detail the amount of money already expended by Page 3 of ] 4 CONTRACTOR hereunder, as this is a cash reimbursement contract. Accounting records must be supported by such source documentation such as cancelled checks, paid bills, payrolls, time and attendance records, contract and subgrant award documents [29 CFR-Subpart C, Section 97.20 (b)(6)]. CONTRACTOR agrees to submit the above-stated documents to the WIB Administrative Office, 1000 Fast Santa Ana Blvd.. Suite 200, Santa Ana, California, 92701, by the tenth (10th) day of the month following the month in which CONTRACTOR'S services aze performed. Should CONTRACTOR fail to deliver said documents to CITY. CITY shall have the option to cancel this Agreement by giving CONTRACTOR ten (10) days written notice thereof. CONTRACTOR shall either return to the CITY excess revenues over costs or use such excess revenues as progam income by utilizing such program income for additional training activities authorized under the Act. L. CONTRACTOR agrees to expend all funds in accordance with all applicable federal, state and local laws and regulations. CONTRACTOR also agrees to provide at CONTRACTOR'S own expense supplies and other costs of said PROGRAM. M. CONTRACTOR shall arrange independently for an audit that includes WIA funds received from CITY, in accordance with the Act, 20 CFR Section 667.200 and OMB Circulaz A- I33. CONTRACTOR shall submit one original of each required audit report to CITY within (30) days after the date received by CONTRACTOR. Should CONTRACTOR fail to comply with these requirements. CITY may at its option withhold payment of funds, or disallow funds or suspend additional grant funds. N. CONTRACTOR shall not expend funds pursuant to this Agreement to provide services to any participant where costs of training aze paid for by any other person or entity. O. CONTRACTOR shall comply with the provisions of Circular A-102 of the U.S. Office of Management and Budget (OMB) and the related "Common Rule" entitled "Uniform Administrative Requirements for Grants and Cooperative Agreements to State and Local Government", Subpart C, paragraphs 37 and 42, Circular A-128, and all other applicable federal statutes and executive orders and their implementing regulations, including regulations at 29 CFR Part 97. P. CONTRACTOR shall comply with the requirements of federal regulations found at 29 CFR 93 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 awazding 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 ageement. CONTRACTOR shall sign a certification to that effect in a form as set forth in "Exhibit D," attached hereto and by this reference incorporated herein. CONTRACTOR 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 CONTRACTOR under the terms and conditions of this Agreement. Q. CONTRACTOR agees to provide adrug-free work place and to execute a certification as set forth in "Exhibit E" attached hereto and incorporated herein by this reference. R. CONTRACTOR, in accordance with the Child Support Compliance Act, recognizes and acknowledges the importance of child and family support obligations and shall fully comply with all state and federal laws relating to child and family support enforcement, including, but not limited to: disclosure of information and compliance with earnings assignment orders, as provided Page 4 of 14 in Chapter 8 (commencing with Section 5200} of Part 5 of Division 9 of the state Family Code; and, to the best of its knowledge is fully complying with the earnings assignment orders of all employees and is providing the names of all new employees to the New Employee Registry maintained by the California Employment Development Department (EDD). S. CONTRACTOR agrees to comply with al] applicable provisions of the ACT and the federal regulations, including but not limited to the regulations found at 20 CFR part 629. II. CITY'S OBLIGATIONS A. CITY agrees to pay to CONTRACTOR when, if and to the extent federal funds aze received under the provisions of the Act a sum not to exceed seventeen thousand, eieht hundred and twenty-six Dollars (517, 826} for CONTRACTOR'S performance in accordance with the pay~xnent schedule attached hereto as "Exhibit F" during the period of this Agreement. Said sum shall be paid after CITY receives invoices submitted by CONTRACTOR as pro~~ided hereinabove. B. CITY agrees to provide for on-site monitoring reviews of said program operation at least twice annually. In addition, monthly desk-top reviews of pertinent information will be conducted. C. CITY has the right to de-obligate the funds hereunder and take such funding back from CONTRACTOR due to any of the following reasons: (a) lack of performance by CONTRACTOR; (b) lack of fiscal accountability of CONTRACTOR; or (c) decrease in available funding. III. TIME PERIOD OF AGREEMENT This Agreement shall commence on October 1, 2005 and all duties arising under this Agreement shall have been performed by June 30. 2006 .The term of this Agreement may be extended by a writing executed by the Executive Director of the Community Development Agency and the City Attorney. IY. INDEPENDENT CONTRACTOR Consultant shall, during the entire term of this Agreement, be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create anemployer-employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Consultant performs the services which are the subject matter of this Agreement; however, the services to be provided by Consultant shall be provided in a manner consistent with all applicable standards and regulations governing such services. Consultant shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. Page 5 of 14 v. WORKER'S COMPENSATION AND EMPLOYER'S RIGHTS A. CONTRACTOR shall use appropriate funds received from CITY to provide workers' compensation to all chose hired by CONTRACTOR under this Agreement. B. CONTRACTOR shall have the right to hire, dismiss, or promote its employees or contract personnel hired under this Agreement so long as its hiring or dismissal policy or standard does not violate Title VII of the Civil Rights Act of 1964, Fair Labor Standards Act of 1938, or any other applicable law, and CONTRACTOR maintains itself as an Equal Opportunity employer, VI. APPLICABLE GUIDELINES A. The parties hereto agree that CONTRACTOR shall comply with all applicable federal and state laws and regulations, including, but not limited to the Performance Standards (Exhibit B) and general program requirements described in Sections 106 and 141 of the Act (29 USC Sections 1516 and 1551) and applicable regulations, and the U.S. Department of Labor guidelines and regulations, including amendments or revisions made during the terms of this Agreement. Said applicable laws are hereby incorporated by reference and made as part of this Agreement as though fully set forth herein. B. CONTRACTOR also assures and certifies that: 1. CONTRACTOR shall comply with Title VII of the Civil Rights Act of 1964 (P.L. 83-354) and in accordance with Title VII of the Act, no person shalt, on the grounds of race, color. religion, sex, age, handicap or national origin be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under this Agreement. 2. CONTRACTOR shall comply with any and all federal laws limiting the political activity of employees hired under this Agreement. 3. CONTRACTOR shall comply with the requirements that no program under the Act shall involve political activities. 4. RECORD INSPECTION. CONTRACTOR shall provide the U.S. Department of Labor and the Controller General, by and through any authorized representative, as well as the WIB Administrative Office, access to and the right to examine all records, books, papers or documents relating to the accounting and use of funds under this Agreement for athree-year period from and after the effective date of this Agreement. 5. No person with responsibilities in the operation of any program under the Act shall discriminate with respect to any program participant or any application for participation in such program because of race, creed, color, national origin, sex, political affiliation or beliefs. 6. CONTRACTOR shall maintain appropriate standazds for health and safety in work and training situations. CONTRACTOR shall comply with general provisions; assurances, and Page 6 of 14 certifications attached hereto as "Exhibit G" and incorporated herein. 8. EQUAL OPPORTUNITY. Any literature distributed by CONTRACTOR for the purpose of apprising businesses, participants; or the general public of its programs under this Agreement shall state that its programs are supported by the City of Santa Ana and the Santa Ana Workforce Investment Board, and shall state that the program is an "equal opportunity employer;'program" and that "aaxilian~ aids and services aze available upon request to indi~-iduals with disabilities." 9. Based on the population eligible to be served, or likely to be directly affected by the W1A program or activity, the sen~ices or information may need to be pro~rided in a language other than English in order to allow such population to be effectively informed about or able to participate in the program or activity. Pursuant to 29 CFR 37.35, the Contractor must take reasonable steps to provide services and information in appropriate languages after considering the scope of the program or acfivity, and the size and concentration of the population that needs serc~ices or information in a language other than English. 10. CONTRACTOR certifies that all property, finished or unfinished documents, data, studies and reports prepared or purchased under this Agreement, will be disposed of in accordance with the direction of the CITY. In addition, any tools and/or equipment famished to the CONTRACTOR by the CITY and/or purchased by the CONTRACTOR with funds pursuant to this Agreement, will be limited to use within the activities outlined in this agreement and will remain the property of the United States Government and/or CITY'. Upon termination of this Agreement, CONTRACTOR will immediately return such tools and/or equipment to the CITY or dispose of them in accordance with the direction of the CITY. 11. CONTRACTOR certifies that this Agreement does not provide for the advancement or aid to any religious sect, church or creed, or sectarian purpose nor does it help to suppon or sustain any school, college, university, hospital or other institution controlled by any religious creed, church, or sectarian denomination, as specified by Article XY~I, Section 5, of the Constitution of the State of California, regarding separation of church and state. 12. PATENT, COPYRIGHTS AND RIGHTS IN DATA. The CONTRACTOR will disclose to the CITY any invention, written product, computer program developed or data assembled as a result of performance of work under this Agreement v,~ithin seventy four (74) days of invention, development or assembly. The CITY, State of California, and U.S. Department of Labor will have the right to patent any invention and copyright any written product or computer program or data generated by CONTRACTOR. Upon written request, CONTRACTOR will transfer all pertinent information, specifications and right, title and interest to the designated agency. 13. INVENTIONS, PATENTS AND COPYRIGHTS. A. Reporting Procedure. If any project produces patentable items; patent rights, processes, or inventions in the course of work under a U.S. Department of Labor (DOL) grant or agreement, the CONTRACTOR shall report the fact promptly and fully to the CITY. The CITY shall report the fact to the Grant Officer, at the DOL. Unless there is a prior agreement between the CITY and the DOL and its representative on these matters, the DOL shall determine whether to seek protection on the invention or discovery. The DOL and its representative shall determine how the rights Page 7 of 14 in the invention or discovery, including rights under any patent issued thereon, will be allocated and administered in order to protect the public interest consistent with the "Governmental Patent Policy" (President's Memorandum for Heads of Executive Departments and Agencies, August 23, 1971, and Statement of Government Patent Policy as printed in 36 FR 16889). B. Copyright Policy. ] . Unless otherwise provided in the terms of the grant or agreement, when copyright-able material is developed in the course of or under a DOL Grant or agreement, the author and the CITY which developed the work is free to copyright material or to permit others to do so. The CONTRACTOR and the Workforce Investment Board (WIB) shall have aroyalty-free, nonexclusive and irrevocable license to reproduce, publish, use and to authorize others to use all copyrighted material. 2. The DOL reserves aroyalty-free, nonexclusive, and irrevocable license to reproduce, publish or otherwise use, and to authorize others to use, for Federal Government purposes: (a) The copyright in any work developed under any grant, sub-grant, or contract under a grant or subgrant; (b) Any right of copyright to which a grantee, subgrantee or a CONTRACTOR purchases ownership with grant support; and (c) CONTRACTOR shall comply with the requirements of 29 CFR Part 97.34. C. Rights to Data. The DOL and the CITY shall have unlimited rights to any data first procured or delivered under this Agreement. 14. CLEAN AIR /CLEAN WATER ACT. If the grant hereunder exceeds $100,000, CONTRACTOR must comply with Section 306 of the Clean Air Act [(42 USC 1875(h)]; Section 508 of the Clean Water Act (33 USC 1368); Executive Order ] ] 738 and Environmental Protection Agency ("EPA") regulations (40 CFR Part 15) as any may now exist or be hereafter amended. Under these laws and regulations, the CONTRACTOR assures that: (a) No facility to be utilized in the performance of the proposed grant has been listed on the EPA List of Violating Facilities; (b) It will notify CITY prior to award of the receipt of any communication from the Director, Office of Federal Activities, U.S. EPA, indicating that a facility to be utilized for the grant is under consideration to be listed on the EPA List of Violating Facilities; (c) It will notify the CITY and the EPA about any known violation of the above laws and regulations. C. CONTRACTOR agrees to adhere to the following STANDARDS OF CONDUCT: 1. Genera] Assurance. Every reasonable course of action will betaken by CONTRACTOR in order to maintain the integrity of this expenditure of public funds and to avoid favoritism. This Agreement will be administered in an impartial manner, free from errors to gain personal, financial political gain. CONTRACTOR, its officers and employees, in administering this Agreement, will avoid situations which give rise to a suggestion that any decision was influenced by prejudice, bias, special interest or desire for personal gain. 2. Em l~loyment of Former State or CITY Employees. CONTRACTOR will ensure that any of its employees who were formerly employed by the State of California or CITY, in a position that Page 8 of 14 could have enabled such individuals to impact policy regarding or implementation of programs covered by this Agreement, will not be assigned to any part or phase of the activities conducted pursuant to this Agreement for a period of not less than two years following the termination of such employment, 3. Conducting Business Involving Relatives No relative by blood, adoption or marriage of any executive or employee of CONTRACTOR will receive favorable treatment when considered for enrollment in programs provided by, or employment with, CONTRACTOR. 4. Conducting Business Involvin Cg lose personal Friends and Associates. Executives and employees of CONTRACTOR will be particularly aware of the varying degrees of influence that can be exerted by personal friends and associates and, in administering this Agreement, will exercise due diligence to avoid situations which give rise to an assertion that favorable treatment is being granted to friends and associates. When it is in the public interest for CONTRACTOR to conduct business with a friend or associate of an executive or employee of CONTRACTOR, an elected official in the area or a voting or non-voting member of the Workforce Investment Board {WIB), a permanent record of the transaction will be retained. 5. Avoidance of Conflict of Economic Interest. No executive or employee of CONTRACTOR elected official in the area, or voting or non-voting member of a Vr~IB, will solicit or accept money or any other consideration from a third person, for the performance of an act reimbursed in whole or part by CONTRACTOR or CITY. Supplies, materials, equipment or services purchased with Agreement funds will be used solely for purposes asserted or allowed under this Agreement. No voting member of the WIB will cast a vote on the provision of serc~ices or vote on any matter which would provide direct fmancial benefit to that member or any business or organization which the member directly represents. ~'II. HOLD HARMLESS A. CONTRACTOR shall indemnify and save harmless CITY, its officers. agents and employees, from and against any and all damages to property or injuries to or death of any person or persons, including proper[} and employees or agents of CITY, and shall defend, indemnify and save harmless CITY, its officers, agents and employees, from any and all claims, demands, suits, actions or proceedings of any kind or nature, including, but not by way of limitation, workers' compensation claims, resulting from or arising out of the negligent acts, errors or omission of CONTRACTOR, its employees or subcontractors. B. CONTRACTOR shall indemnify and save harmless CITY, its officers, agents and employees, 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 and employees, from and against any and all claims, demands, suits, actions or proceedings therefore, resulting from or arising out of the intentional or malicious acts of CONTRACTOR, its employees or subcontractors. VIII. INSURANCE Page 9 of I4 1. Commercial General Liability. CONTRACTOR agrees to obtain and keep in force during the teen of this Agreement a policy of comprehensive corrunercial public liability insurance insuring the State of California, CITY, and CONTRACTOR against any liability for accident, injury or death arising out of or in consequence of this Agreement. Such insurance shall be in an amount not ]ess than One Million Dollars ($1,000,000.00) for any injury to or death of any person or persons in any single accident or occurrence. Said policy of comprehensive public liability insurance shall be endorsed to provide to CITY and to the State of California, Employment Development Department, at least thirty (30) days written notice prior to cancellation; name CITY, its officers. agents, employees, and volunteers, and the State of Califomia, its officers, employees, and volunteers as additional insured; and state that such coverage is primary to any other coverage or self-insurance of the State of California and CITY. Goverrunental entities may substitute a certificate of self-insurance. 2. Automobile Liability Coverage. CONTRACTOR shall also obtain and maintain, during the effective period of this Agreement. broad form automobile liability coverage with a $1,000,000 limit unless reduced by CITY, which applies to both owned,'leased and non-owned automobiles used by CONTRACTOR employees or participants in performance of this Agreement, or, in the event that CITY will not utilize such owned/leased automobiles but intends to require employees, participants or other agents to utilize their own automobiles in the performance of this Agreement, CONTRACTOR shall secure and maintain on file from all such employees, participants, or agents as self-certification of automobile insurance coverage. Govenunental entities may substitute a certificate ofself-insurance. 3. Workers' Compensation. If CONTRACTOR is an "employer", as set forth in California Labor Code Section 3300 et seq., or utilizes participants as "employees," as set forth in Califomia Labor Code Section 3350 et seq., CONTRACTOR shall obtain and keep in force during the term of this Agreement full Workers' Compensafion insurance coverage for injuries suffered by participants. Said insurance policy shall guarantee CITY at least thirty (30) days written notice of cancellation or modification. CONTRACTOR shall carry medical and accident insurance for those participants not qualifying as "employees" for R%orker's Compensation Coverage, pursuant to California Labor Code Section 3350, et seq. 4. Equipment Coverage. CONTRACTOR shall purchase a policy or policies of insurance covering loss or damage to any and all Equipment provided to or purchased by CONTRACTOR in accordance with this Agreement. Said insurance shall be in the amount of the full replacement value thereof, providing protection against the classification of fire, extended coverage, vandalism, malicious mischief, theft, and special extended perils. Governmental entities may substitute a certificate of self-insurance. 5. Proof of Insurance. Certificates and endorsements must be submitted and approved by CITY prior to any work under this Agreement. CONTRACTOR understands that CITY will make no payments under this Agreement until the required certificates and endorsements have been approved by CITY. IX. CORPORATE STATUS All corporate CONTRACTORS shall be in good standing, without suspension by the California Secretary of State, Franchise Tax Board and Internal Revenue Sen~ice. Any change in corporate status or suspension shall be reported immediately to CITY. X. Page 10 of 14 ASSIGNABILITY None of the duties of, or work to be performed by, CONTRACTOR under this Agreement shall be subcontracted or assigned to any agency, consultant, or person without the prior written consent of CITY. CONTRACTOR 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 CONTRACTOR pursuant to this Agreement. XI. LAWS GOVERNING TI3IS AGREEMENT In its performance under this Ageement, CONTRACTOR shall fully comply with the requirements of the following, whether or not otherwise referred to in this Ageement: 1. The Act and all applicable federal statutes; regulations, policies, procedures and directives, including but not limited to, 20 C.F.R. Parts 6~2 and 660 through 671. Z. All applicable State statutes, regulations, policies, procedures and directives; 3. All applicable CITI' policies.. procedures and directives; 4. All applicable Local ordinances and requirements, including use permits and licensing; 5. Court orders applicable to its operation; and, 6. The terms and conditions of this Ageement. If any of the foregoing is enacted, amended, or revised, CONTRACTOR will comply with such or will notify CITY afrer enactment or modification that it cannot so comply. CITY may thereupon terminate this Agreement, if necessary. XII. ERCLUSIVITY ANA AMENDMENT OF AGREEMENT This Agreement supersedes any and all other ageements, either oral or in writing, between the parties hereto with respect to the employment of CONTRACTOR by CITY, and contains all the covenants and ageements between the parties with respect to such employment. 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 CONTRACTOR. XTII. FRAUD CONTRACTOR shall immediately report to CITY all instances and facts concerning possible fraud, abuse or criminal activity relating to expenditure or receipt of funds under this Ageement. XIV. CONTINGENCY OF FUNDS Page 11 of 14 CONTRACTOR acknowledges that approval of and funding for this Agreement is contingent upon State approval, and funds received or obligated from the State of California to CITY. If such approval of funds is not forthcoming, or is otherwise limited, CITY shall immediately notify CONTRACTOR. R'ithin twenty (20) days of receipt of such notice, CONTRACTOR shall modify or cease operations as directed by CITY and negotiate necessary modification to this Agreement andior reimbursement of costs incurred hereunder. X'V. TERMINATION This Agreement may be terminated by either party at its sole discretion, upon thirty {30) days written notice to the other party. Notice shall be deemed served on the date of mailing. However, CONTRACTOR may not terminate this Agreement if undue hardship will result to any participant. XVI. DISPUTES Except as otherwise provided in this Agreement, any dispute concerning any question arising under this Agreement shall be decided by CITY. ht such a case CITY shall reduce its decision to writing and mail or otherwise furnish a copy thereof to CONTRACTOR. The decision of the City shall be fmal and conclusive unless within thirty (30) calendar days from the mailing or delivery of such copy, CITY receives from CONTRACTOR written request to appeal said decision. Procedures governing the appeal shall be prescribed by CITY and/or the State of Califomia in accordance with the Act and all corresponding regulations and OMB circulars. Pending final disposition of the appeal, CONTRACTOR shall act in accordance with CITY's decision unless the dispute involves a change order. XVII. BREACH -SANCTIONS If, through any cause, CONTRACTOR violates any of the terms and conditions of this Agreement, and/or prior agreements whereby grant funds were received by CONTRACTOR pursuant to this Agreement, or if CONTRACTOR reports inaccurately or if any Audit Report makes disallowances, CONTRACTOR shall promptly remedy its acts or omissions and/or repay CITY all amounts due CITY as a result of CONTRACTOR's violation. For any such failures or violations, CITY shall also have the right at its sole discretion to either. (1) discontinue program support until such time as CONTRACTOR fulfills its obligations or remedies all violations of this agreement or prior agreements; and~or (2) collect outstanding amounts as determined by CITY due CITY by offsetting or debiting from current claims or invoices, if after thirty (30) days' written notice CONTRACTOR has failed to repay same or a repayment schedule has not been made; and/or (3) terminate this Agreement by giving written notice to CONTRACTOR of such termination in accordance the notice provision in Pazagraph XVIII herein below. Page 12 of 14 XVIII. NOTICES All notices, reports and correspondence between the parties hereto respecting this Agreement shall be in writing and deposited in the United States Mail, postage prepaid, addressed as follows: CITY: City of Santa Ana Manager, WIB Administrative Office 1000 Santa Ana Blvd., Suite 200 Santa Ana, CA 92701 and, CLERK: Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 Telefacsimile (714) 647-6956 CO?~TTRACTOR: O.C. Children's Therapeutic Arts Center 208 N. Broadway Santa Ana, CA 92701 (714)547-5468 Telefacsimile (714) 564-9690 XIX. MERGER This Agreement, together with the attachments hereto, expresses the total understanding of the parties. There are no oral understandings of the parties or terms and conditions other than as stated herein. ~. 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 Ageement. XXI. 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 Page 13 of 14 indemnify City fully, including reasonable costs and attorney's fees, for any injuries or damages to CITY in the event that such authority or power is not, in fact; held by the signatory or is withdrawn. b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the bod}~ of this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Ageement the date and year first above-written. ATTEST: CITY OF SAh?TA ANA, a municipal corporation of the State of California "CITY" ~.~> Patricia E. Healv Clerk of the Council APPROVED AS TO FORM: BY: ~ Joseph .Fletcher City Attorney RECOMMEND FOR APPROVAL: i ~-~'J Patricia C. cer Executive Director c- ~C+t-G( Da~rid N. Ream City Manager "CONTRACTOR" BY: l M-cr ~`-~+ Name: Dr. Ana Jimen~-Hami Title: Executive Director Tax ID #: 3 3 _ pq 3 o$q 1 Page 14 of 14 Exhibit A I 1"~ Santa Ana V'Fur4aorcc [nvcstment 13aaard9Yauth Council The Yauth Scn•ice Provider Network 1S~FP 2(!4512006 Orange Count' Children's Therapeuriic Arts Center PROPOSAL NARRA'I'~VE Abo®t the Program 1Jxee.utive Summary The tOrange county Children's Therapeutic Arts Center (OCCTAaC) will recruit and serve a total of 50 (25) tn-School and (25) Out-of-School Santa Ana at-risk and disabled youth between the ages of 14-18 yrs. eligible to qualify for WIA Title 1 B youth services. OCCT.4~C will collaborate with the Santa Ana UniSred School District and the County of Orange to recmit and Qefer potential WIA participants to the Sant:: Ana W/Oi Rr'K Center for eligibility dete.mination through, the offices of Pupil Services, Student Discupline Services, and the Pupil Placement Committee from referrals to alternative schools and/or programs. OCCTAC will address the following WLA elements Mated on page 6 of the proposal appliication: 1, 3, 4, 6, and 8. WIA participants will engage in am `.integrated program that offers stud~vrtts a strong artistic, literacy, and technology program thart will empower youth by enhancing their pelf-esteem, teach responsibility, technical and mentoring<skills, and accelerate their learning. Students will train 3 days per week during after-school hours, and/or weekends, two hours per day durur-•g a period of one year, WIA participants will receive a miinimum of 1 hr. of basic skills (structured one-one one literacy tutoring and small group instruction} each day they attend the program, and 1 hour of artistic and/or technology training. Afters period of 6 months of training, all VJ1A participants will be provided an opportunity to transition unto a "mentor-ing job". OCCTAC will train ;and supervise WIA participants into paid/unpaid positions contingent upon participants' literacy develiopment, and performance levels as stated in their individual educational plans. R'hich R'IA pupulation will the program recruit and serve? OCCT AC will recruit and serve In-School and Out-of-School Santa Ana at-risk and disabled youth between the ages of 14-18 vrs., from limited educational and financial resources, history of academic probt~ems, suspended or expelled, and living in "high risk" areas tin Santa Ana; as well as o_ they eligibility criteria to qualify for WIA Title 1B youth services. lndieate hors many participants to be served. Our ~rog~ram proposes to serve approximately 50 narticipants: Twenty-five Santa Ana Unified School Dls-tr~Ct (SAUSD) students enrolled in Alternative School prog~.ums, and twenty-five Santa Ana students that have been expulsed from the district and/or parents have requested Alternative County programs. Desc-ibe your recruitment plan. OCC'TAC will collaborate with the Santa Ana Unified Schoen! Dtistrict and the County of Orange to recruiii and refer potential WIA participants to the Santa Aria WilO/R/K Center for eligibility deter ;~ination. OCCTAC will work with the SAUSD'S Director of Pupil Services, the Office of Student Discipline Services, and the Pupil Placement Cotnmiittee to recruit in-school youth from alternative schools, as well as youth to be expulsed by the Faipil 1Paacement Cormnittee, and placed in Out~~f School programs. In addition, because of our strong &aartmership with the Deparhnent of Special Education, OCCTAC can also recruit students with 1P,atnLng disabilities at these sites. The recruntntent process will also include pronidi~7g i~ajormation ['i~ia broclun~es, Elvers) to school admi:~nistrators, parents, and prospective students in the communut}~ of Santa Ana to encourage participation in our afler-school program. The Santa Ana Worli'orce Investment 13a:ardlYouth Council The Youth Service Provider Network RFP 2005/2006 Orange County Children's Theraneurtic Arts Center [ndi~eate which of the 10 ~§~IA elements the program will adidress. Our program will address the following WIA elements as stated; on page 6 of the proposal.: I, 3, 4, 6, and ~. 1) Tutoring study skills training and instruction leading_to comtpletion of secondary school including drop~:~ut prevention strategies. OCCTAC' has a strong After-sc}nool Arts Enrichment program that prov7des a wide variety of Art, Music, Dance, Technology classes and Community Service. Recently, OCCTAC was granted State Cer[ificatien by the Department of Education to provide Supplementary Educational Services to Santa Ana youth during after-school hmura. OCCTAC will use HOST Aca~emic Curriculum to provide students academic support, inalividualize students academic needs, and Jrepares them via one on one structured tutoring, small gromp instruction and homework support. 3) As appropriate, paid and unpaid work experiences including~internships and lob shadowing- 000'TAC aril] provide both paid and unpaid work experience tai youth interested in the education field. Parti._ ipants that excel artistically and academically will have thce opportunity to mentor other younger chil~ren and receive a mentor stipend for their efforts! 4) S~tnmer employment opportunities that aze directly linked to academic and occupational learning Menk:.oring positions at our OCCTAC Learning Academies are aiirectly linked to academic learning! 6) Leadership development opportunities. which may_include cmmmunity service and peer-centered actin-ties encourasing responsibility and other positive social beihaviors during non-school hours as a~Rropriate. OCCTAC is a community-based organization that prioritizes on community service, men_:aring programs, and leadership opportunities for both youths and adults/parents in our community, We s'songly believe that our After-school (Arts, Literacy, Technology) and mentoring programs will help participants learn responsible and positive social behaviors rthat are necessary to succeed in life. Furtt~~rmore, this training will develop leadership skills necessary to empower our Santa Ana youth, and wild higher levels ofself-esteem. 8) Ault Mentoring for the period of participation and a subsegiuent period, for a total of not less than 12 months. OCCTAC has a partnership with the Santa Ana Colllege, Chapman University and Cal State ru[lerton to provide mentoring programs to our youth. OC'.CTAC has been providing these men-:.ring services for approximately 3 years. Plnr- F:cd Orrtrumcs: a..-1r -i.rtic Skills: participants Team a new skill in a particular f ead of interest (music, art, dance}, and enh•,~~ce their levels ofself-expression and overall emotional weal-being. b. Tr:_ lmical/Educational Skills: participants will ]earn technolet~y skills (graphic arts, web-design, vide:: production) which are great technical skills that youth can use for job skills in the future! c. Acnd~micLileraey Skills: participants will increase their acadeemic! literacy skiffs as measured by pre R pc-~t tests, and criterion-referenced assessments connected to .the academic curriculum. d. blrntorin~ Skills: pariicipants will learn mentoring skills nee:aed for the educational "mentoring job'-- This training will have~a tremendous impact on student's lervel of responsibility, and foster their self-~-steem. Desr~ibe the basic program approach. (workshoplelassrooan~ 5n the cummunih~) The ^~rog*ram wrill take place in our community-based center, amt: the paidlunpaid mentorine job will take place in several designated elementary classrooms in the Sarnta Ana Unified School District. The Santa Ana Workforce Investment Bo:ard/Youlh Council The Youth Service Provider Network IILFP 2005/2006 Orange County Children's TherapeuGfic Arts Center Maim Purnose of Program R'haR is the organization's Mission Statement? _ The grange County Children's Therapeutic Arts Center (OCTA~C) utilizes the arts as a vehicle to hell, and empower at-risk youth and children with special needs from cultwally diverse backgrounds of limited resources. OCCTAC provides youth with access to the aims, literacy and technology training to enhance their self=esteem, accelerate student learning, building leadership skills, and divert youth from negative activity and influences to positive experiences that can bring about positive changes in their Life. 3ttd further their education and training. lndic:ate what~will the program accomplish. OCC'TAC participants will learn artistic, technology, literacy aped mentoring skills that will help them acqunre job skills. Most importantly, this program will empowe-youth by enhancing their self-esteem, teach responsibility, leadership, and accelerate their learning skulls. V1'ha-~ is the length of the program? 1 Year How. often will the WI_A participant need to attend the prog~-am7 (daily/weekly/month)}~) Weeltly: three days per week. V'`'h~: is the frequency of staff interaction with WIA particin:ant:' OCCTAC staff will interact with parriuipants every day/week they attend the program via individival and small group instruction. Goats 1 Obiectives and Performance Levels How many W]A youth will the program serve this year' SC participants \'t hi~ch W'IA program element will you offer'' Ow program will address the following WIA elements stated previously: ] , 3, 4, 6, and 8. (See pages I and 2). Ho« r+~ill service(s) he deemed necessary? All interested youth_ from in-school or out-school settings that are deficient in basic skills, have consistently failed in tradinional learning environments, and/or are interested in the field of arts or technology can qualify for thte program. 1}n}s will recruitment be coordinated with program aetiviti:e ': OCCTAC will coordinate efforts ~~ itL he SALiSD •altd the County of Orange to recruit and re Per ~notential RRA participants to the Santa Ana +~~/0/R/K Center for eligibility determination. Once stude:nrs have registered with OCCTAC, a pn,~.:=ss of evaluation and student interviews will take place imrmediately to determine the individual pn~_ atnmatic needs of each youth invoh~ed in our programs. ll~,~ will current scr~ices meet the needs of the tiy'IA perfor•nr.:nee standards'? L'peo entering ow program, each youth will be assessed in order- to determine the basic skill goals/ ohje~_~tives for each individual participant. These performance ~~~::als will be monitored continuously to en;u c success. Participants wilt also be trained to be educational mentors and paid a regular stipend to mc^ :ir younger children when they have acquired the educatio:r,al and mentoring skills. \~ ilr the participant receive x certificate of completion or accomplishment for participation'? Yes1 Ham will continuous improvement be conducted? }'art~cipants progress will be monitored on a regular basis via cr. iterion-referenced assessments that meL:ure students academic development of basic skills, and through one-on one structwed mentoring to ensure success. _ The Santa Ana Workforce Investment Bu~ard/Youth Council The Youth Service Provider Network 3tFP 2005/2006 Orange County Children's Therapemtic Arts Center Program Description Ues,~ribc the overall sen~iccs that will he made available to~rtuc WIA participant. WI:~. participants will engage in an integrated program that offc;rs students a strong artistic, literacy, and aechnology program. Students will train 3 days per week duaring after-school hours, and/or weerends, two hours per day during a period of one year. WL 4 participants will receive a minimum of 1 hr. of basic skills (structured one-one one literacy tutoring and small group instruction] each day they attend the program, and 1 hour of artistic and/or technolog}y training. After a period of 6 months of training, all WIA participants will be provided an opportunir.~. to transition into a "mentoringjob". OCC'TAC will train and supervise WIA participants into paid/umpaid positions contingent upon partucipants' literacy development, and performance levels as sttated in their individual educational plan:_s. Illu.~arate how the organization Hill interface with the Santa Ana W/O/R/K Center. OCCTAC will collaborate with the Santa Ana Unified School District and the County of Orange to recnait and refer potential WIA participants to the Santa Ana W ~O/R/K Center for eligibility determination. Describe how the participant flow will occur. Parr~cipants will be invited to participate three days per week (~urith a minimum of 2 days attendance per -,~~~eek}. Attendance days/times will vary according to the acatdemic/basic needs of the students, class preference, personal interests, availability,. and assessment .results. R'L~ participants will attend the p?rogram d days per week 2 hours each day. For example: y~/iondays, Wednesdays, and Fridays (4:.+:- 6: ,0) or Tuesday, Thursdays (4:30 - 630) and Saturda~~~s (1:00 - 3:OOp.m.). 11'IA participants will engage in an integated program that offers students classes. in the arts, literacy, technology, and menroring in educational settings. WIA participants will receive- a minimum of I hr. of basic skills (strux_tured one-one one literacy tutoring and small group insttvuaion) each day they attend the proms am, and 1 hour of artistic and/or technology training. After a period of 6 months of training, all WL^. panicipants will be provided an opportunity to transition lotto a "mentoring.job". OCCTAC will trair_ and supervise WIA participants into paid/unpaid positions contingent upon participants' literacy deve;~opment, and performance levels as staled in their individuatl educational plans. FaciiVities Frn~r ~chcre will program see-t~iccs he dclir~cred'? Zee -grogram services will be delivered at both OCCTAC facilir~ and the SAUSD. OCCTAC'S facility is 1~~_sated at the OCCTAC at 208 North F3roadway in downtown Santa Ana. The hours of operation at OCC' i .AC are: 8:30 a.m. - 8:30 p.m. during the week and 8:00 :r..m. - 6:U0 p.m. on Saturdays. The mere:~rinti' job training will be delivered at both the OCCTAC ~acilit}' and at the SAUSD facilities. tth:r: arc c~~ur hours of operation° 83~'- a.m. - 830 p.m. Mondays through Fridays; and 8:00 a.m.- 0:00 p.m. on Saturdays. I1~~~~- has the nr~aniration assured That the location is a same and ~ Huth fricndh~ em'ironment° The :K'C'l AC'S location is both s safe and friendly environme=nt. The Center is located in downtown Sanr_ .Ana, across the street from the Artist's Village, Grand Central Arts--California State University, Fully 'non and several local businesses that support the efforts of the Center. The parents at the Center also .assist in ensuring a safe environment. There are staff membeers available on site at all times mono axing the operational activities, including safety concerns and the Santa Ana Police Department works wi4r the Center as a community partner. Furthermore, Ot~CTAC has also been granted cett;= cation by the State Department of [education to provide aftter-school supplementary services to Sanr~ .Ana youth with extremely limited educational and limited resources. The facility accommodates The Santa Ana Workforce Investment Bo;ardn'outh Council The Youth Sen°ice Provider Network 3tFP 2005/2006 Orange County Children's Therapeurtic Arts Center for cne educational„artistic and technology training. of our youth, in a safe and nurtwing community envuronment that inspires creativity and learning. Abc,ut Your Organization Description of the Proposer Hour loot; has your organisation been scr-ving Santa Ana vou;th'? OCCTAC has been serving Santa Ana youth close to 5 yeats. OCCTAC'S mission fulfills a high meed in the community of Santa Ana by inter ating parents, children and youth with and without disabiliities in a nurturing community-based environment that teaches respect, cultural diversity, disability azwareness, and inclusion. Six days per week we offer a wide variety of classes (arts, literacy, technology, parenting & counseling) in the mornings, after-school and evenings to enhance the educational .levels of ow students, and provide a vehicae for self-empowerment. Of critical importance to ow mission is to provide youth with access to the ants, literacy and technology training to enhance their self-esteem, accelerate student learning, building leadership skills, and divert youth from negative activitry and influences to positive experiences that can bring about positive changes in their life, arnd further their education and training. \~'h:mt kind of impact has your services made to the youth in the communit}'? Our =Host important accomplishment with youth has been expaneding the level of services we provide to then". and their family in the Santa Ana community, Having expmnded tremendously in four years, OCC'TAC can now serve close to 400 families on a weekly basiis (six days per week)1 OCCTAC provides services to many families of extremely limited resowc~s (including educational and financial resc~!rces). Our families value the opportunities to engage their wouth in our after-school classes becazuse it provides youth a nurttirittg and safe environment for rtnem to learn, enhance their creative skill::.. and support their academic and emotional development. iYVlost of our families can't afford to pay for t~aese sen~ices or have limited access. Without an access to tflrese programs the potential for each your_r's development is limited. Access to these programs is essential to strengthening our communities at-risk. By providing our underprivileged families: access to after-school programs we enable youth to probe their individual potential, gain their conficdence to enter a healthy environment, and prevent youth from engaging in negative activity that is self-destructive. OCCTAC fulfills to ow up rust capacity the foundation's priorities in youth education atnd human services. Finally, of critical impc~-lance to ow mission is to also partner with youth in these :afforts, by exploring the challenges fact.-:_ young people in our community, valuing their contributiams, exploring solutions together, and pro., ,ding youth with access to the arts, literacy and technology ra bring about social changes in their com;_-nunity. Hn~•. du cuu track your outcomes" We track outcomes in a vm-iety of wa_~~s. Program outcomes are me~:ared through quantitative and qualitative information that'„s collected from teachers, parents and stud~~~ts. OCCTAC staff monitors students progress across time: and assessments is always ongoing! !s4os:: programs are assessed through criterion-referenced assessments that are connected to the specific clz~~s:~s andr'or curriculum. Same student outcomes are measured through pre-post tests, and others are base' nn qualitative information gathered through questionnairca_ parent surveys, student literacy and% or~~-- journals, and others. The Santa Ana Wnrkforec lm~estment Bosard/Youth Council The Ycruth Scrvicc Provider Network erFtFP 2005/20h6 Orange County' Children's Therapeuriic Arts Center Experience 6ricfty outline all youth programs Chat your agency has operated during the last 2 years. Six d::ys per week we offer a wide variety of classes (arts, literac~_v, technology, parenting, and family counseling). All of our programs aim at accelerating student learrning, empowering families of limited resources, helping youth build sell=esteem and develop leadership skills in our community. Every semesrer we offer approximately 50 classes during our Afier-schcnol program six days per week. During the pa_~t four and a half years of operation, a lot of time has been spent in acquiring some communication and technology resources. We established a new multimedia arts lab with high speed Internet access for our you*.h, and now have Internet access for the, staff, an email address for the center, and a ^ew Website! This technology has made the organization tiunction more effectively and has served to demonstrate the steady growth and sustainabilit}~ of the Centi;r. In addition, OCCTAC has forged strong, long-term relationships and contracts with commumity partners such as: Santa Ana Unified School District (for music therapy); the Santa Ana Colle_;e (for pazenting classes), the County of Orange, Social Services department for family coumseling and parenting classes; and Chapn?an University, the Santa Ana College and Cal State Fulleaton for homework support. y~ hi~b have been most succevsfhl? All of our programs are successful! O The f._dlowing is a remarkable case study of an at-risk youth that has been involved in our after-school programs for close to 5 years at the OCCTAC. These activities wave given her a great sense of accomplishment, enhanced her self-esteem and confidence, boos=ted her academic development. and most mportantly, kept her away from negative activity or influences, such as teen pregnancy. drugs, etc. ki. Came to our Center approximately 5 years ago when GC'CTAC opened its doors to the community. M. was identified as an at-risk youth because of the nigh risk factors that were observed in her family (domestic violence and drug abuse). M_ enrolled in se~.veral classes (choir, dance, art, piano and flute} during the first year at our Center, and we also provided her with tutors during the week for homework and literacy. She excelled in al] classes, and by the e_ud of the fast year at OCCTAC she had b._en the most accomplished student at our Center. At our .:arv 1st Holiday Concert she performed Flute and Piano Solos for the families at the Center. We were alt very proud of her accomplishments in such ~ short period of time. Most importantly, her mother commented on how her academic grades had improved so drastically, as well as her self-confidence. During ~ ~~°ars two and three at our Center M. learnr.:d to play other new instruments (guitar, violin and harp S. ::~ she continued to ]ean~ her previous ones piano, and flute). This past summer M. graduated with hmnors and was the received a Valeuctorian Medal, including honors in math, science and music!!! Furthermore, she auditioned to enter ,nio the Orange County High School of the Arts, and was T~cently accepted. M. is one of OCCTAC stars and we are very proud to have been part of her'-tire. M. and her family continue to come to the Center to receive music instruction, family eounsziiurg &. parenting classes. y',hat hind of experience du cuu have in incorporating paren~_s into your prugranu'? (?ur agency has been very successful in providing community outreach and ,rarent involvement. We have estab~shed a community network that helps foster our missi on_ -and provide opportunities to serve mangy families. Parent involvement_ participation and education s a critical aspect of our mission. The Center has five }'ears of experience in working with the p~re~nis and their children. We have an active parenting committee, and a parent representative on the &r>ard of Directors! 1v`ha- is your success based nn'? Academic and artistic aecompriishments of the students; leadership skills -of students and parents; growth of our organization; and. the quality and level of services that we c~~ provide our community. The Santa Ana Workforce Investment Bosard/Youth Council The Youth Scrvicc Provider Network 92FP 2005/2006 Orange Counil' Children's Therapeuttic Arts Center List positions and qualillcations of'staff assigned to Phis prol~ect. 1) Pnoeram CnordinatoriLead Teacher reports to the Executive Director. The Lead Teacher is responsible for testing and diagnosing students to assess their instructional needs and to develop indiv-idua] plans for each student. This person will also provide 'leadership in the training and recognition of mentors. The Lead Teacher will be responsible fmr collecting and maintaining data for student records. Primary Responsibilities include: 1. Participate in the Program Implementation workshop; 2. Testing and diagnosing students' specific needs usiing the program assessment tools 3. upda-ing student records and resource information; 4. Develop individual plans for each student; 5. Prov*~de leadership in mentor training; 6. Assist with in-service -raining for staff; 7. Participate in the program Evaluation process; 8. Assist in planning and executins a program for volunteer recognition; 9. Amend periodic Administrator meetings and trainings; 10. Convmunicate student progress to pazents and school personnel. ?) Th^ Literary Teacher reports to the program coordinator; lead teacher, and is responsible for identifying students in need of assistance, providing continual feedback on rthe progress of these students, and suggLsting learning objectives that should be reinforced. They wrill understand the HOSTS Program and provide guidance to the Paraprofessionals and Mentors. The Teacher's main role is to support the student's participation m the after-school Learning Academy. 3) Thee Arrr & Technoloev teachers reports to the program coorminator/lead teacher, and aze respe+nsible for developing their lesson plans according to the sptecific eumculum, and for conducting classes on a weekly basis. Fiscall Capacite Describe the process used to capture and report fiscal data`' After each check run. the expenditures aze separated, categorizetd and entered into the accounting sys[e`n general ledger. A check-copy is attached to the corresponding document (bill, invoice or receipt), store d and filed by month for every entry made to the a!.°neral ledger. Revenues are categorized into specific program funds or general funds, and entered into the system from the source documentation with attached deposit slip. All revenue back up diocumentation and deposit slips aze stored and filed by month. Submit most recent financial statements or audit reports. Sn:e attachment. Star: procurement policy and procedures. Procurement Policy &s Procedures The ri+llowing procurement procedures will be applied to all transactions that involve the execution of sen~ioes or the delivery of goods in excess of $5.000. In additicm_ OCCTAC will apph~ these procedures to an.' transaction involving or requiring adherence rto standards of practice or compliance vtiith laws governing the related operating activities of OCCTAC. OCCTAC will make every effort to ensure compliance with all requirements and regulations related to the services or goods to be provided in the given contact or agreement OCCTAC will obtain in writing, all requirements, obligartions and governing laws pertaining to the goods or services} involved. In the case of transactions that can be provided by more rthan one party, OCC"I'AC will obtain written bids from three or more parties to ensure the bes. value for money relative to Che given market If only two parties are available, than OCCTAC will accept bids from both parties. The Santa Ana Workforce. investment Bmard/1'outh Council The Youth Service Provider Network ~tFP 2(105/20(16 Orange County Children's Therapeuriic Arts Centcr • OCCTAC wilt obtain an appropriate and reasonable demionstration of value for money. • Al] Procurement transactions require board approval primr to acceptance. N'hat s}°stems arc used to ensure fiscal accountability and appropriate expenditures, and planm~ed costs° OCC'TAC is currently implementing an updated non-profit accouunting softwaze system that accurately tracl~~ and accounts for all the various aspects of non-profit rep6~rting. With the implementation of this new oftware, OCCTAC will combine the current accounting pmlicies and procedures that provide proper review of expenditures as well as complete and accurate Reporting. OCC'TAC prepazes and regulazly utilizes detailed budget reports: that aid in the process of planning, reviewring and authorizing expenditures for each month of the fiscal yeaz. y~F'ili ahe organization have trouble invoicing for services provided on a monthly basis? Describe invoicing process. The aenier can provide invoicing on a monthly basis and will gLztdly accommodate any specifications or dzail to be included with the invoicing. When new customer services are to be provided, OCCTAC creates a customer account and adds the customer information unto the accounting system, along with any saecific contract data {rate per unit of service). The billable .units aze recorded upon completion of the service. At the end oi'each billing cycle, OCCTAC generate=s an invoice from the accounting systems which is mailed to the customer for payment. 5ubr:>ntractiu~ , The cAnly subcontractor that we are using is an IT professional. ~;ee Budget for details. Financial Reports: Attached are conies of the current profit and loss report with the detailed report of revenue sources to date. Our fiscal year begins nn September Is' and ends on August 3I". Included is OCCTAC's last year end financial statements as filed with the IRS (form J90). ~v . p ~ ° y ., ° x ~ ~ ~°'~ m n .,, ~ rn ~ i~, ~t ~ $ m ~ ^~ 2 ~ n ~ ' m ~ ~ ~'~ m p, a ~ o d w ~~ ~ m ~ S o ~ ~• ~o ~~ cm 0 ~ ~ a O o ~~ C y O O ~ rt N ~o ~ '~ o b„c ~ ~ ~ ~ rt ~ :. ~ a o a o ~ rt ,.. ° ~ ~ o ~ ~ ~ ~ 9 n ~ n ~ n n n ~ N N N N N ~` O ~ ~ p ~ ~ `~ O O r ~ p ~ v+ p ~ V~ ~n ~ - Q+ ' ~ 6 ~ W W p O p ~ _ O ~ ~ ~ O Q+ W O T 0 d o ~ o ~ ~m ~. ~ ~~ 9 ~ b `~ C1 ~, p o ~'~`"., a 2~ o m r o b:l r ~ ~ 9' ~P cf~ O ~ C~ ~ y N w ~ r y p ~ ~ b d R~ ~ ~ v+ ~ rn ~. a :: r N K ~ "f ' b ate ~.y ' .-, a n y ~ 17 n a . ~ ~' L. E ~" T ~ `~' c .c b ~ y x ~' • n ~ ~. p b ~" O 0. b0 ~.. .~ ~ O" .~ ~ O ~ t 9 ~ ~ o . < ~ a. ~~ti~ ono ~ ~ ~ ~ ~ ~`'• . 'a o w i, _ry~. ~ O p " cp o' ,y C m R Ui ~"3 ~ K ~. ~ O n ~ 0 ~' ~ ~ ~ o .. 7 o a ~ ~ : o. o. 'rf ~ ~' n ~, ~o @~~ ~ `$ ~ $ ~ ~ o S. ~ . _ . n C ti ~ y G~/1 R. ~ ~ ` ` Q y ~. ~ w.o c o ~ tro a ~, o w ~ a. ~ a` ' sL ~ c b m c'~o a" a ~ ~• O p v' p ~. ~ a n O n 0 n m' N O ~ O _ _ O ~ ~ ~ O O ~"' w w ~ ~ O ~ O ~ Exhibit C COMPLAINT HANDLING UNDER THE WORF4FORCE INVESTMENT ACT SANTA ANA WIA Santa Ana Local Workforce Investment Area July 1, 2001 Table of Contents I. Information Regarding Complaints ............................................................................................ 2 A. Nondiscrimination and Equal Opportunity Complaints .......................................................... 2 1. Policy Statement ................................................................................................................ 2 2. Civil Rights ......................................................................................................................... 3 3. Nondiscrimination Laws under WIA ................................................................................... 4 4. How to File Your Complaint ............................................................................................... 5 B. Criminal Complaints .............................................................................................................. 6 II. General Procedures for Handling Non-Criminal Violations of the Act ....................................... 6 III. Procedures for Handling Complaints at the SDA Level ............................................................. 8 IV. Procedures for Handling Complaints at the State Level .......................................................... 13 V. Procedures for Handling Discrimination Complaints by Participants ....................................... 15 VI. Procedures for Handling Handicap Complaints by Participants .............................................. 16 GLOSSARY OF WIA TERMS ........................................................................................................ 18 1 Information Regarding Complaints A. Nondiscrimination and Equal Opportunity Complaints Policv Statement In carrying out the purpose of the Workforce Investment Act (WIA), the City of Santa Ana Local Workforce Investment Area {LWIA) will establish programs to prepare youth and unskilled adults for entry into the labor force and to afford job training to those individuals facing serious barriers to employment. Every effort will be made to provide services necessary for eligible individuals to obtain productive employment. In implementing WIA, all contractors in the Santa Ana LWIA will foster equal opportunity and non-discrimination, as provided in State and Federal equal opportunity and non-discrimination laws including, but not limited to: • Title VI of the Civil Rights Act of 1964 • Title VII of the Civil Rights Act of 1964 • The Age Discrimination Act of 1975, as amended • Section 503 of the Rehabilitation Act of 1973 • Section 504 of the Rehabilitation Act of 1973 • Title IX of the Education Amendments of 1972 • Section 188 of the Workforce Investment Act of 1998 In keeping with our commitment, no individual shall be excluded from participation in, denied benefits of, subjected to discrimination under, or denied employment, in the administration or of in connection with any WiA funded program because of race, color, religion, sex, national origin, age, handicap, or political affiliation or belief. Participation in programs and activities financially assisted in whole or in part under WIA shall be open to citizens and nationals of the United States, lawfully admitted permanent resident aliens, lawfully admitted refugee, parolees, and other individuals authorized by the Attorney General to work in the United States. No individual will be intimidated, threatened, coerced, or discriminated against because of filing a complaint, furnishing information, or assisting or participating in any manner in an investigation, compliance review, hearing, or any other activity related to the administration of WIA. 2 Administration responsibility for this Equal Opportunity/Affirmative Action (EO/AA) Program is delegated to the Equal Employment Opportunity (EEO) Officer for the Santa Ana Local Workforce Investment Area. Equal opportunity and non-discrimination, however, will only be achieved through leadership and implementation of a viable Affirmative Action Equal Opportunity Program. 2. Civil Rights No one applying for or enrolled in the Workforce Investment Act (WIA} Programs may be discriminated against because of race, color, creed, handicap, national origin, sex, age, political affiliation, or beliefs. This means that -for any of the characteristics listed above: You may not be denied the opportunity to enrol! in WIA. No benefits or services may be denied you for discriminatory reasons. You may not be segregated or treated any differently from other applicants or participants, while you are being registered, interviewed, counseled or tested; or while you are working or attending classes as part of the program. You must be provided an equal chance to use all facilities available in the program. Fair employment practices must be provided to all staff with regard to recruiting, hiring, transferring, promotions, training, compensation, benefits, layoff, and termination. You have the right to make a complaint if you fee! you have been denied any of the above opportunities. You cannot in any way be penalized for filing a complaint. Your WlA sponsor has established a mechanism for handling complaints or grievances. Your complaint must be filed within 180 days. All complaints will be handled confidentially. 3. Nondiscrimination Laws under WIA Title VI of the Civil Rights Act of 1964 Prohibits discrimination on the basis of race, color, national origin, or religion. The Age Discrimination Act of 1975 Prohibits arbitrary discrimination against persons age 40-70. The Rehabilitation Act off 1973 Prohibits discrimination based on handicap. Title IX of the Education Amendments of 1972 Prohibits discrimination in any education or training program or activity receiving federal financial assistance. OTHER CIVIL RIGHTS LAWS: Title VII of the Civil Riahts Act of 1964 Prohibits discrimination in employment based on race, color, religion, sex, or national origin in all terms and conditions of employment and establishes the Equal Employment Opportunity Commission as the administrative agency. White House Executive Order No. 11246 as Amended by Executive Order No. 11375 Creates the office of Federal Contract Compliance and prohibits discrimination based on race, color, sex, religion, or national origin. Department of Labor Secretary's Order no. 4-73 Prohibits discrimination based on sex. dual Pay Act of 1963 Prohibits pay differential solely because of sex. 4 Emergency Employment Act of 1971 Prohibits discrimination based on race, creed, national origin, political affiliation, or beliefs. 4. How to File Your Complaint a. Put your complaint in writing. b. Have it sworn to before a notary public, if possible. c. Provides details that tell what happened, where it happened, and when it happened. d. Give the name and addresses of all persons who were present o.r who had anything to do with the matter. ...Complaints on the basis of race, color, or national origin, age, sex, religion, political affiliation or belief, retaliation and citizenship, must be filed within 180 days of the alleged occurrence directly with; Director Civil Rights Center U.S. Department of Labor, Room N-4123 200 Constitution Ave., NW Washington, D.C. 20210 Complaints on the basis of handicap must be filed within 180 days of the alleged occurrence. These complaints must be filed directly with the WIA administrative entity. The WIA administrative entity shall issue a written decision within 30 days of the filing of the complaint. If the complaint is still unresolved, an appeal may be made to the Chief of State Workforce Investment Division Office. The Department of Labor, the Civii Service Commission, the Equal Employment Opportunity Commission, and many other offices and agencies are committed to assuring equal employment opportunities for all persons. They wilt protect you. A case may be taken to court if the other processes do not yield satisfactory results. You may hire your own lawyer, or if you cannot afford one, the court may appoint one for you, 5 It is unlawful for an employer, union, or employment agency to punish you or any witness for attempting to present the facts in a case. YOUR CIVIL RIGHTS UNDER THE WORKFORCE INVESTMENT ACT Santa Ana Local Workforce Investment Area 1000 E. Santa Ana Blvd., Suite 200 Santa Ana, CA 92701 (714)565-2600 B. Criminal Complaints )n accordance with the WIA (P.L. 105-200) and the implementing code of Federal section 667.600.... Federal handling of criminal complaints and report of fraud, abuse and other criminal activity. "All information and complaints involving fraud, abuse or other criminal activity shall be reported directly and immediately to the City of Santa Ana and the Secretary of Labor." il. General Procedures for Handling Non-Criminal Violations of the Act The following procedure is promulgated to meet the requirements of Title 20, of the Code of Federal Regulations, Section 667.600 through 667.640 of the WIA regulations, and Section 181(c) of the Act (Public Law 105.200: 29 U.S. Code Sec. 2931 et seq.) at the State and LWIA level for the receipt, investigation, hearing, and resolution of complaints by WIA participants, subrecipients, applicants for participation, or financial assistance, labor unions, community based organizations, or any other persons. These procedures provide for resolution of non-criminal complaints arising from the operation of the Santa Ana LWIA. A complaint is defined here as a written expression by a party alleging a violation of the Act, regulations promulgated under the Act, recipient grants, subagreements, or other specific agreements under the Act, including terms and conditions of employment of such participants in employment training programs. All complaints, amendments and withdrawals shall be in writing. These procedures are intended to resolve matters which concern policies, procedures or action(s) arising in connection with WIA programs operated by each LWIA grant recipient and subrecipient under the Act. These procedures shall not be construed as affecting any other available legal remedy outside of the WIA complaint process (i.e., disputes regarding terms and conditions of employment of any employee who is not a participant), either separately or simultaneously, that a person may wish to pursue in the resolution of a non-WIA complaint. Also, these procedures do not restrict the LWIA grant recipient staff in carrying out informal discussion 6 procedures do not restrict the LWIA grant recipient staff in carrying out informal discussion and resolution of any problems outside of and without resort to the formal complaint procedure. A. The following principles and rules apply to all complaints at all steps of the complaint procedures: 1. All complaints must be made in writing within 180 days of the alleged occurrence, except complaints alleging fraud or criminal activity. 2. All persons filing a complaint shall be free from restraint, coercion, reprisal, or discrimination. Good faith efforts shall be made to informally resolve the complaint prior to the scheduled hearing. Complainants have the right to withdraw their complaints (in writing) at any time prior to the hearing. A complainant may amend his/her complaint to correct technical deficiencies but not to add issues. Complainants shall have the right to be represented at their own expense by person(s) of their choosing at all levels of the complaint process. 4. Upon enrollment into employment or training, participants shall be provided with a written description of these procedures, including notification of their right to file complaints and instructions for filing. An employer of participants, including private-for-profct employers of participants, may use this or other complaint resolution procedures so long as the participant is informed of the complaint resolution procedure they are to follow and the time frames governing review of complaints are met. A "participant", within the meaning of these procedures, is an individual who receives employment-training services under a program funded by Santa Ana LWIA. The Complaint Resolution Procedures contained herein (or the alternative procedures which an employer may use) shall be available to participants to resolve disputes regarding items and conditions of employment of such participants in employment training programs. However, such procedures shall not be used to resolve disputes regarding terms and conditions of employment of any employee who is not a participant, as defined herein. 5. If a complaint does not receive a decision at the LWIA grant recipient level within 60 days of filing the complaint or receives an unsatisfactory decision, the complainant then has a right to request a review of the complaint by the Governor. Complainants must initially file and exhaust LWIA grant recipient hearing procedures prior to appealing to the State except where the State determines that the LWIA grant recipient's procedures are not in compliance with the State's procedures. III. Procedures for Handling Complaints at the LWIA Level A. Receipt of Complaints Pursuant to the WIA regulations found at 20 CFR, Section 667.600, the LWIA administrative entities have the responsibility to conduct hearings and resolve complaints made by individuals about the administration of programs in the LWIA. "LWIA level" encompasses LWIA administrative entity and employers to which the administrative entity has delegated the complaint resolution process. The following comprise the guidelines for resolving issues arising in connection with WIA programs operated by the Santa Ana LWIA including resolutions of complaints arising from actions, such as audit disallowances or the imposition of sanctions taken by the Governor with respect to audit findings, investigations or monitoring reports. Form and Filing of Complaint Official filing date of the complaint is the date fhe written complaint is received. The filing of the complaint with the Santa Ana LWIA Equal Employment Opportunity Officer shat( be considered as a request for hearing and a decision must be issued within 60 days. The complaint must be in writing and must be signed and dated. The complaint should also contain the following information: Full name, telephone number, if any, and mailing address of the complainant; Ful! name, telephone number, and mailing address of the agency involved (respondent); c. Clear and concise statement of facts including dates constituting alleged violation; What provisions under the Act, regulations, grant or other agreements under the Act, are believed to have been violated; e. Remedy sought by the complainant; and If the complainant is a private or public entity or corporation, and not a natural person, the filing of the complaint must be duly authorized by the governing body of such entity or corporation. 8 The absence of any of the requested information shall not be a basis for dismissing the complaint. A copy of the complaint must be sent to the respondent and both parties notified of the opportunity for an informal resolution. At each step of the complaint process, the complainant must be notified in writing of the next procedural step. 2. Informal Conference Informal conferences will be utilized by the Santa Ana LWIA to resolve complaints; however, such informal conferences shall not extend the time within which a decision must be issued after receipt of a complaint. Attempts at informal resolution will commence with two (2) weeks of the date of filing of the complaint. The EEO Officer will review the case and ascertain facts prior to the conference so that appropriate resolution can take place at the time of this meeting whenever possible. b. Although the complaintant should be encouraged to attend this conference, his/her failure to do so should not preclude his/her right to request a hearing on the matter. c. )f mutually satisfactory resolution results and the Santa Ana LWIA concurs, the EEO Officer will write a brief report for the file stating the issues and resolution. The matter shall then be considered closed. d. If resolution does not result, the complainant shall be provided the necessary information and assistance to request a hearing if he/she so desires. 3. Request for Hearing a. As in the case of the complaint, the request for a hearing should be put in writing and be filed in person or by mail. A governing board resolution of authorization to appeal should also be submitted when appropriate. The request should be filed with' Lydia H. Morgan EEO Officer Santa Ana Local Workforce Investment Area 1000 E. Santa Ana Blvd., Suite 200 Santa Ana, GA 92701 A hearing will be scheduled by the EEO Officer within thirty (30) days of the date of filing of the complaint. 4. Notice of Hearing Upon receipt of the request for hearing, the complainant and the respondent will be notified in writing of the hearing ten (10) calendar days prior to the date of the hearing. The ten-day notice may be shortened with the written consent of the parties. A decision will be issued by the Santa Ana LWIA within sixty (60) days of the date of filing of the complaint. The hearing notice shall be in writing and contain the following information: a. The date of notice, name of the complainant, and the name of the party against whom the complaint is filed. b. The date, time, and place of hearing before an impartial hearing officer. A statement(s) of the alleged violation(s) Advise as to where information or assistance may be obtained, and the name, address, and telephone number of the Santa Ana LWIA Equal Employment Opportunities (EEO) Officer who can answer inquiries. B. Conduct of Hearing The hearing shall be conducted in an informal manner with strict rules of evidence not applicable. Unnecessary technicalities should be avoided. It should provide the flexibility to enable adjustment to the circumstances presented. The hearing officer shall have complete independence to obtain facts and make decisions. The hearing officer shall be in a position to render impartial decisions and thus should not be subordinate to the Santa Ana LWIA or its subrecipients. The hearing officer will be selected from a list of names on file with the EEO Officer. 2. Full regard must be given to the requirements of due process to insure a fair and impartial hearing. 3. The hearing office designated by the EEO Officer to function in a quasi judicial capacity should begin the hearing by summarizing the record and the issue and should explain the manner in which the hearing will be conducted, making sure that everyone involved understands the proceedings. Such explanations should be adapted to the needs of the specific situation. The hearing officer might take testimony under oath or affirmation to give some assurance of veracity to the hearing. 10 4. The burden of proof should be reasonable and flexible, dependent upon the circumstances of the case involved. The hearing officer determines the order of proof. Generally, the party making the complaint has the obligation of establishing his or her case and should be examined first. 5. The party involved should have the right to be represented (at their own expense) if he/he so desires. Other he/she is limited to his/her own abilities and those of the hearing officer in obtaining testimony in the case. It is important that the hearing officer obtain the fullest information for the record. If the parties involved, or their representatives, do not know how to ask the right or pertinent questions in pursuing their right to due process, it shall be necessary for the hearing officer to step into have all the materials and relevant facts elicited. 7. The practice in informal hearings is generally not to apply strict rules of evidence in obtaining facts. However, the quantity of evidence required to support a decision on an issue should be sufficiently credible that the state (or other appropriate agency), upon reviewing the decision, would conclude that the decision is supported by substantial evidence. 8. The hearing officer should attempt to negotiate a resolution of the issue at any time prior to the conclusion of the hearing. 9. Within ten (10} days of the conclusion of the hearing, the hearing officer will issue a recommended decision to the LWIA for final determination. The recommended decision shall be in writing and may be accepted, rejected or modified by the Santa Ana Workforce Investment Board. C. Issuance of Decision Within sixty (60) calendar days of filing of the complaint, the Santa Ana LWIA shall issue a written decision to all parties by first class mail. The final decision shall contain the following information: 1. The name of the parties invoived. 2. A statement of the alleged violation and issues related to the alleged violation. 3. A statement of the facts. 4. The decision and the reasons for the decision. 5. A statement of corrective action, if any, to be taken. 6. Notice of the right to request, within ten (10) calendar days of receipt of the decision, a review of the decision by the State Review Panel. 11 D. Record of Hearing An administrative file containing support documents on the complaint resolution process hearing conducted will be retained by the Santa Ana LWIA. The purpose of a record is to serve as substantiation of the process followed by the Santa Ana LWIA on the resolution of the issues and the results. This information would then be available for subsequent review in the event the matter is raised with the State. Such records must be retained for athree-year period after the grant has been officially closed out. The Santa Ana LWIA's written decision will be included in the record. Evidence received at the hearing, notes by the hearing officer, stenographer's notes and tape recordings may also be used. E. Establishment of Complaint Procedures In accordance with Section 667.600, each employing agency including private-for- profit employers of participants under the Act is required to establish a complaint procedure for resolving matters relating to the terms and conditions of employment. Employers may operate their own grievance system or may utilize the Santa Ana LWIA's established procedures under Section 667.600. At a minimum these procedures must include: Written notice, upon enrollment into employment training services, of the scope and availability of such procedures. Employer's grievance procedures shall be set forth in a written document and must meet the regulation mandate that a complaint will be resolved with sixty (60) days from the date the complaint was filed. A copy of employer's grievance procedure shall be provided to each participant upon enrollment in employment training. Written notice, at the time the grievance is filed, of,the procedures under which the grievance will be processed. Written notification of the disposition of the grievance and a written decision shall be issued within thirty (30}days of the filing of the grievance unless a present and long established grievance specifically provides other limits; and 4. Written notification of the participant's right to request a review of the employer's decision by the Santa Ana LWIA and the State Review Panel in accordance with Section 667.600. 12 iV. Procedures for Handling Complaints at the State Level Section 181 (c) of the Act and the WIA regulations at 20 CFR, Section 667.600(d) requires the Governor to establish a State Review process of complaints filed at the LWIA grant recipient level and of complaints initially filed at the State level. Appeals of decisions issued at the LWIA level including audit disallowances and sanctions shall be reviewed by the State Review Panel. The State Review Panel shall review the record established at the LWIA level and shall issue a decision based on the information contained therein. Complaints which may be initially filed at the State level will be heard by an independent hearing officer designated by the State Workforce Investment Division (WID). The hearing officer shall conduct a hearing and issue a recommended decision to the State Panel. The recommended decision shall be in writing and may be accepted, rejected or modified by the State Review Panel. A. Form and Filing of Complaint. Request for State Review of LWIA Level Decisions On receipt of a complainant's request for review because of an unsatisfactory decision, the State shall provide for an independent state review. 2. Filing of Requests for State Review The State Review Panel shall review all LWIA level decisions when a request for review is filed within 10 days of receipt of the adverse decision. Such requests must be filed in writing with the Chief of the WID Office. The request for review should contain the following information: a. Full name, address, telephone number of the party requesting the review b. Full name, address, telephone number of the other party A copy of the decision Brief statement of reasons for review or the section of the LWIA decision to be reviewed including regulatory and statutory citations A statement of the relief sought. 13 3. Complaintant Responsibility It is the responsibility of the complainant to include in the request for review a written statement setting forth the facts presented at the LWIA hearing which support the requested relief. The Chief, WID, shall mail a copy of the request for review to the other party and to the LWIA. It shall be the responsibility of the LWIA to submit the complete record including a typed record of the hearing to the Chief, WID, within ten (10) days. B. Conduct of Hearings. Request for Hearing at the State Level If no decision has been issued at the LWIA level or the State has determined an audit disallowance or imposed sanctions, the complainant may request a hearing. The hearing officer will then issue a recommended decision to the State's Review Panel for final determination. 2. Filing for Request for Review The request for a State hearing shall be filed within ten (10) days after LWIA should have issued a decision or ten (10) days after the issuance of the audit disallowance or sanction. The request shall be filed directly with the Chief of the WID in writing and should include the following: a. Full name, address, and telephone number of the party requesting the review b. Name, address, and telephone number'of the LWIA c. Copies of complaints made at LWIA level from which no decisions were issued or sanctions imposed d. A statement of basis for the request for hearing. Evidentiary Hearing Upon receipt of the request for a State level hearing, a hearing before a designated hearing officer will be scheduled. 14 The hearing will be recorded mechanically or by court reporter. Both parties concerned will have the opportunity to present oral and written testimony under oath, to call and question witnesses in support of his/her position, to present oral andlor written arguments, to examine records and documents relevant to the issue(s), and to be represented. The hearing officer shall issue a written decision, which shall be forwarded to the State Review Panel for final determination. The State Review Panel may accept, reject or modify this recommendation. The decision of the State Review Panel is final except for audit disallowances, which must be approved by the Secretary of Labor. C. State Review Panel The State Review Panel will consist of a panel of three representatives from the Employment Development Department: one from the Legal Offices, one from the WID, and one from the Director's office. The panel will issue a written decision, which will be sent to the appropriate parties within thirty (30) days of receipt of the request for State review. Decisions issued by this panel, under the authority of the Governor, are final. D. Issuance of State Review Decision. The State review will be limited to violations of the WIA, implementing WIA regulations or the grant agreement. This review shall be limited to the record established at the LWIA hearing. V. Procedures for Handling Discrimination Complaints by Participants A. Complaints on the basis of race, color, or national origin, age, sex, religion, political affiliation or belief, retaliation, and citizenship, where appropriate, must be filed within 180 days of the alleged occurrence. It is the responsibility of the Santa Ana LWIA's Equal Employment Opportunity (EEO) Officer to determine jurisdiction and to make the complainant aware of and provide assistance in filing a complaint in accordance with the Santa Ana LWIA's procedure under Section li (A). 15 No later than 180 days of alleged _ discrimination Handling of complaints filed at LWIA ]eve] arising in connection with WIA programs operated by LWZAs Informal Resolution Process Wifhin 10 days of receipt of unsatisfactory decision or 10 days from date LWIA decision shoula' have beenissaed Filing of Complaint /Request for Hearing Notice of Hearing issued by LWIA w 0 a 0 C f4 Hearing Conducted LW'IA Decision within 60 days Unsatisfactory Decision or LW'IA Decision not issued within 60 davs Request for State Review Governor's Decision issued by State Review Panel If no decision issued by State Review Panel w c b a Appeal to DOL 2. In cases where areas of authority overlap, it is the responsibility of the EEO Officer to advise the complainant of the existence of State, Federal and other proper action agencies, which may also have a bearing. 3. Complainants alleging discrimination under this part will be made aware of their right to file directly with the Office of Civil Rights {OCR), U.S. Department of Labor and applicable procedures. 4. Complainants must file their complaint directly with: Lydia H. Morgan EEO Officer Santa Ana Local Workforce Investment Area 1000 E.-Santa Ana Blvd., Suite 200 Santa Ana, Ca 92701 VI. Procedures for Handling Handicap Complaints by Participants Complaints alleging discrimination on the basis of handicap will be filed and processed under the Department of Labor regulations implementing Section 504 of the Rehabilitation Act of 1973 at 29 Code of Federal Regulations Section 32. Complaints must exhaust the Santa Ana LWIA's informal resolution procedures before filing their complaint with OCR. 2. Complainants will be made aware of the 180 days requirement in which to file his/her complaint. A. Procedures at the LWIA Level The complainant shall file his/her complaint directly with the Santa Ana LWIA. Upon receipt of the complaint, the EEO Officer shall investigate and gather information concerning the complaint. An informal conference will be held with the parties concerned in an effort to resolve the issue(s). The complainant has the right to be present and may be represented during the conference. 3. The Santa Ana LWIA shat! issue in writing its decision to the complainant no later than thirty (30} days after the filing of the complaint. 16 B. Procedures at the State Level The complainant may appeal to the State if he/she is nat satisfied with the decision of the Santa Ana LWIA. 2. The Complainant must file his/her appeal as a request for review directly with the Chief WID within ten (10} calendar days after the receipt of the Santa Ana LWIA's decision. 3. The Chief-WID, shall issue a decision no later than thirty (30) calendar days after receipt of the request for review. After the complainant has received a decision or no decision has been received from the Director of Employment Development Department (on behalf of the Governor), the complainant has the right to appeal his/her complaint within thirty (3D} calendar days to the Office of Civil Rights (OCR} with the Department of Labor. 17 No later than ]80 davs of alleged Filing of complaint on the basis Day 1 discriminatior7 Of Handicap with LWIA I Informal Resolution I If no resolution reached Request for Hearing ~ Notice of Hearing ~ Hearing Conducted LVJIA Decision Unsatisfactory Decision or No Decision State Review Governor's Decision Filed within 30 days of LWIA/State Decision or 90 days from date of initial filing of complaints Appeal to Assistant Secretary Department of Labor Dayi45 Day 60 Days GLOSSARY OF WlA TERMS AGE DISCRIMINATIdN ACT - A law passed by Congress in 1975 which prohibits discrimination on the basis of age by any program or activity receiving Federal funds. APPLICANT - An individual who applies to a subrecipient or contract for services provided under WIA and who has no yet transitioned to the status of participant. ASSESSMENT -Services designed to determine each participant's employability, aptitudes, abilities and interests and to develcp a plan to achieve the participant's employment and related goals; also to identify the available employment and training activities appropriate for the participant. Testing and counseling may also be used during the assessment process. CHARGING PARTY (CP}, COMPLAINANT, GRIEVANT, OR AGGRIEVED PERSON -The person who charges that he/she has been discriminated against under Department of Justice nondiscrimination and civil rights regulations and/or guidelines. DISCRIMINATION - in general, a failure to treat all equally, whether intentional or unintentional; the effect of an action, policy or practice which selects an individual or class of persons to receive unequal treatment. ELIGIBLE NON-CITIZEN -Lawfully admitted permanent resident, aliens, lawfully admitted refugees, and parolees and other individuals authorized by the Attorney Genera! to work in the United States. EMPLOYER - An employer subject to the provisions of the Civil Rights Act of 1964, as amended, including state and local governments and any Federal agency subject to the provisions of Section 717 of the Civil Rights Act, as amended; and any Federal contractor or subcontractor covered by Executive Order 11246, as amended. GRIEVANCE - An allegation that something imposes an illegal obligation or burden or denies some equitable or legal right, or causes injustice. HANDICAPPED INDIVIDUAL -Any individual who has a physical or mental disability that constitutes or results in a substantial handicap to employment. 18 INTAKE -Includes screening to determine eligibility; to select from eligible applicants those individuals who are most in need and can benefit from program services; to complete procedural requirements necessary to enroll an individual into the program and to refer those not enrolled to other programs. JOINT COMPLAINT - A complaint of employment discrimination covered by Title VII or the Equal Pay Act and by Title VI or Title IX. Individual "joint complaints" are normally investigated by EEOC unless OCR has a compelling reason to investigate. "Joint complaints" alleging discrimination in employment and other practices and pattern or practice "joint complaints" are normally investigated by OCR. JURISDICTION -Authority to investigate and resolve complaints against an institution subject to a law or statute which has been assigned to OCR for enforcement, i.e., Titie VI, Title 1X, etc. PARTICIPANT -Any applicant who has: (1) Been determined eligible for participation upon intake; and (2) Who is receiving subsidized employment, training or services (except post-termination services) funded under the Act, following intake, except for an individual who receives only outreach and/or intake and assessment services. 19 Exhibit D 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 an agency, a IUlember of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contracts, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment or modification of any Federal contract, grant, loan or cooperative agreement, 21 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 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 31 U.S.C. 1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than S 10,000 and not mare that S 100,000 for each such failure. Grantee/Contractor Organization Program Title C G. Cb.tldrer'S ~~..n~~ e.fk~c Y~r~s s~_-~~ -~ ~_ C1~iwte., ~ ~ r.~V ~l ~~~, Name of Certifying Official Signature Certification Re~ardin-~ Debarment, Suspension, Ineligibility and `Voluntan~ -Exclusion Lower Tier Covered Transactions t This certification is required by the regulations implementing Executi~~e Order 12549, Debarment and Suspension, 29 CFR Part 98, Section 98.510, Participants' Responsibilities. The regulations were published as Part Vll of the May 16, '1988, Federal Register (Pages 79160-19311). F'Before completing certification, read instructions which ara an integral part of certification) 1. The prospective primary participant.. (i.e. grantee) certifiies to the best of its knowledge ;and belief, that it and its principals: a. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any federal department or agency; b. Have not within athree-year period preceding thiis proposal been convicted or had a civil judgment rendered against them for comrmission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state or local} transaction or contract under a public transaction; violation of federal or state antitrust statues or commission of-Embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property. c. Are not presently indicted for or otherwise criminally or civilly charged by a govenunent entity (federal, state or local} with commlission of anv of the offenses enumerated in paragraph (1)(b) of this certification: _and d. Have not within athree-year period preceding thus application%proposal had one or more public transactions (federal. state or local) tc rminated for cause or default. _. Vlhere the prospective primarti' participant is unable to c mortify to am of the statements in _nis certiilcation. such prospective participant shall attach atn explanation to this proposal. ~~ ~ ~iY1C~0I LV1~ to ~ V'n yl C !/K'~a ~u~G ~ ~ ~j~1~~(' <_,t~l(eeyE ontractor O gamzation game and Title of • trial Authori t ~ Ccrtif~~ Cm Behalf of the Grantee ~ ~ as'~Z~os mate Exhibit E Certification Regarding Drug-Free Workplace Requirements The certification set out below is a material representation upon which reliance is placed by the U.S. Department of Housing and Urban Development in awarding the grant. If it is later determined that the contractor knowingly rendered a false certification, or otherwise violates the requirements of the Drug-Free Workplace Act, the U.S. Department of Housing and Urban Development, in addition to any other remedies available to the Federal Government, may take action authorized under the Drug-Free Workplace Act. CERTIFICATION A. The contractor certifies that it will provide adrug-free workplace by: (a) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the contractor's workplace and specifying the actions that will be taken against employees for violation of such prohibition; (bi Establishing adrug-tree awareness program to inform employees about - (1) The dangers of drug abuse in the workplace; (2) The contractor's policy of maintaining adrug-free workplace; (31 Any available drug counseling, rehabilitation, and employee assistance program; and (41 The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace; (c} Making it a requirement that each employee who will be engaged in the performance of the grant be given a copy of the statement required by paragraph (al; (d1 Notifying the employee in the statement required by paragraph -(a) that, as a condition of employment under the contract, the employee will - (1 } Abide by the terms of the statement; and (2) Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five days after such conviction. Pg . 2 (e) Notifying the U.S. Department of Housing and Urban Development within ten days after receiving notice under subparagraph (d)(21 from an employee or otherwise receiving actual notice of such conviction; (f) Taking one of the following actions, within 30 days of receiving notice under subparagraph (d)(2), with respect to any employee who is so convicted - ( 7) Taking appropriate personnel action against such an employee, up to and including termination; or (2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency; {g) Making a good faith effort to continue to maintain adrug-free workplace through implementation of paragraphs (a), (b), (c), (d), (e) and (f). B. The contractor shall insert in the space provided on the attached "Place of Performance" form the site(s) for the performance of work to be carried out with the grant funds (including street address, city, county, state, and zip code) .the contractor further certifies that, it it is subsequently determined that additional sites will be used for the performance of work under the contract, it shat( notify the U.S. Department of Housing and Urban Development immediately upon the decision to use such additional sites by submitting a revised "Place of Performance" form. Dated: 1'3" Flo (_.~'"~'`~C~ Program Operator DIVISION OF EMPLOYMENT SERVICES PLACE OF PERFORMANCE FOR CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS Name: ~~r= J~wK,r~c. -Nuw.~ Name of Contractor: O~z (~vv.lT Ckildve~'s Tllevr ae~~i~ A/fs Lr.1-cr Contractor Number: Date: t- 3 - ab The Contractor shall insert in the space provided below the site(s) expected to be used for the performance of work under the contract covered by the certification: Place of Performance (include street address, city, county, state, zip code for each site): a~ N• f3YO~~~~ 5~.~..~~ C-e-~u cv~ aa> o I - , GC~'~ Q^'~-~ Exhibit F BUDGET FORM Administrative Pro ram Total147A Match/In Kind Personnel Salaries: (List titles and FTEs)* 0 $9,000.00 (Case Manager & Mentor ' Coordinawr) $6,732.00 (Graphic Arts) $4,000.00 Literacy Educator $9,000.00 {Case manager & Mentor coordinator) $6,732.00 (Graphic Arts) $4,000.00 (Literacy Educator) Benefits* Total Personnel 0 $19,732.00 $9,000.00 $10 732.00 O eratin E enses Rent or userfee* S826.00 S826.00 $1,783.00 UtiliCies Phones Internet fees Parkin fees Securit Maintenance Insurance E ui mentrentalfees* Vehicle lease charges (vehicles may not be urchased Office expenses consttmables Accountin Services Le al services Auditin services Indirect costs (attach indirect cost rate lan** Staff trainin Staff travel/rnilea e Partici ant Wa es* Su ort services* Profit for rofits onl Other list * $8,000.00 $6,600.00 Total O eratin Ex enses $826.00 $8,826.00 8,383.00 GRAND TOTAL (Total Personnel + Total Operating_Ex enses $826.00 $19,732.00 $17,826.00 19,115.00 BUDGET SUMMARY" Other: $8000.00 $800.00 per student will be dedicated towards mentor stipend. Approximately $133 per month at $8.33 per hour for 4 training sessions per week. Exhibit G Assurances & Certifications Selected providers will be required to sign and submit "acnual" assurances and certificates as required by the City of Santa Ana and the Workforce Investment Board on all contracts. 1 recognize that I must give assurances for each item belon° . If I cannot, this proposal Will he automatically rejected. Please initia7Qach box. 1 am authorized by my Board of Directors, Trustees, other le~lly qualified officer, or as the owner of this agency or business to submit [his proposal. ~? I We are not currently on any Federal, Slate of California, or local Debarment list. We will provide records w show that we are fiscally solvent. iti needed. We have, or will have, all ofthe fiscal control and accountine procedures needed to ensure that W1,4 funds twill be used as required by law and contract. W'e have additional funding sources and will nol be dependem- on R'lA funds alone. W'e will meet the applicable Federal, State, and local compliance re=quirements. These include, but are no[ Limited to: Records accurately reflect actual performance. Maintain record confidentiality, as required. ~~jReporing financial, participant, and performance data; as requitred. Comply with State and Federal fiscal and program activit}' audits- ~'jComplying with Federal and State non-discrimination provisionrs:. - ~Meeting requirements of Section 504 of the Rehabilitation Act cnf 19T. Meeting requirements of the American's with Disabilities Act ot';1999. (submit completed survey) Meeting all applicable labor law, including Child Labor Law sttnndards. ®Agree to provide a drug free workplace. Agree [o insure the Ciq~ of Santa Ana through Genera] Liabilin~ ]nsurance and Automobile Liabili~ coverage in [he amount oC$ I,D00,000.00 policy. Agree to provide all participants with Grievance Procedures. Agree to insure proposer's employ°ees Chrough Workers Compeansation htsw'ance iincluding part-time employees} We will not: iPlace a you0t in a position that will displace a cun-ent emplo}t__ lise b1'lA money to assist, promote.. or deter union organizing- ~1Jse Funds to emplo} or train of persons in sectarian activities- ~Ose funds for youth in the construction, operation, or maintenanme of any pan of a facility to be used for sectarian instruction or religious worship. Use WIA funds for activities that would interfere with or replac- regular academic requirements for eligible youth who are not dropouts. Use W1A funds [o carry out programs funded under the School-to-Work Opportunities Act of 1994 unless the program(s1 are only for youth eligible to participate under WIA. hereby assure that alt o! the above are true. SEPit BY: LAKE SNSURANCE AGENCY; 7148387568; SEP-B-nF 10:11 AM; PAGE 1/2 ~BL~„ CERTIFICATE OF LIABILITY INSURANCE o9ioz~2oo5 FROONCER (714)E38-1912 FAX (714) i38-7568 Lake Insurance Agency 13891 Newport Ave. , Suite 285 THIS CERTIFICATE IS ISSUED AB AMATTER OF NtfORMATR7N ONLY AND COMPERE NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Lic 10747473 CA 927b0 Tustin DINOCOVERAGE 1NSURERSAFFOR NAIC1 , N$URED Orange County dren's Therapeutic Art Cente ~,I INSURER A: ChaiY~kleStern Heritage Ins. Co , 208 North Broadway tr+sulD:R e: Santa Ana, CA 92701 IN5U~R G: - INSURER D _ N$URER E: !`l~VFQAf.FR THE POLICIES QF INSURANCE USTED BELOW HAVE BEEN ISSUED 70 THE INSURED NAMED ABOVE FOR THE Pvucr rewuu rnulr~n~ cu. •.~, ••„ ~~ ~..,.~.~•~ TERM OR GONDInON OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TD YYHICH THIS CERTIFICATE MAYBE ISSUED OR T , ANY REQUIREMEN ED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL 7F1E TERMS. EXCLUSIONS AND GONDIT10Na OF SUCH R D MAY PERTAIN, lME INSURANCE AFFO POLICIES. AGGREGATE LIMTTS SNONM MAY HAVE BEEN REDUCED BY PAID CLAIMS. , , , ~ ~ TYPE OF IN$LmANCE POLICY NUNBmI POLIC'f EFFECIIYE l1WRATgN 1aa1 7 DENSRAL wailTY SCPD573t31 08/02/2005 08/02/2006 EACH occuRRENGE s 1 ODD ~ CDNMERCIAL GENERLL LIABILRY DAMAGE TO RENIED SES iF i _SO , CLNMS MADE ~ CCLLR MED EXP (Arv/ aN DElim) i _ S OO A PERSONALaADV INJURY i 1 OOO OO GENERAL AOOREOATE 3 21 DOD, DO GE NL AGGREWTE UMRAPPLJE9 PER- PRODUCTS-COMP/OP AGG x Include PDUCr _ ~~ LOC AUT OMOBILE IMBILffY COMBINED SINGLE LINK S - IEe eiPxNnl ANYAUfO -~- ,.... ALLW+NEDAUTO$ BODILY INJURY S SCHEDULED AUIOti (hrPNEPn) HIRED AVTDS BODILY N,JURV S NON-0WHEO AUTOS IFar acdda+) PROPERTY DAMAGE i --- , IPx awlwRl fTY AUTO ONLY-EA ACCIDENT 7 ,,.,.. GA RAGE LMYL EA ACC R TNAN GTHF _ ! ANY AUTO . . AU700NLY. AGG 5. .._ BIELL4l11BILR1• EACH OCCURRENCE S E%CF59NN R ~CLMMS MAC OLGI AGGREGATE 1 _ . f _.. I i '- CTIBLE OEDL C4S ~ ~ rv~g~l f RETENTION $ , V1C STATLL 0714 PENSATION AND CO WORKER! M pIMAYER$'WNOTY E.L. EACH ACCIDENT S ANY PROPRIETOR~PMTNERIFXECVTIVE OFFICERIMEMeER EXClUDE07 ~ ~ , _ edy E.L. DEiEASE-EA EMPLOYE d R w aRaeR UNr S Laura Sti e E.L. DISEASE • POLICY OMIT S SPECIAL PROVISIONS CNOR OTNER A. >lSiaa mDN OP OPEMTIDN$! LOCATIONS I VEXL7.E$ l E1fCWNDM$ADDED BY ENOpRCEMENr1 VEtlAL MD ~yPoOf Santa Bna is Mamed as additiwial insured per FDrm attar Original Signed form attached T Subject to 30 days notice of cancellation for non-payBlent of premiwn. THE CITY OF SANTA ANA Community Development Agency Attn: Frank Hernando PO 8071 1988 Santa Ana, CA 92702 • PlN01N 7i I9AM MRl FAX: Sm7MD ANY OF THE ABOVE pE$CR16ED POLN:IPE BE CANCELLED aEFORE THE EXPmATION PATE THERE, THE 168UING INSURER WILL 71o9D(ibE186 W11L 30 DAYS wRlTTlN NOTICE 70 TTE CENIIFICATE HOLDER IUMEO TG THE LEFT. XX CORPORATION 1888 /~ _ 4. .l /. /~~ . SENT BY: LAKE INSl1RANCE AGENCY; 7148367558; SEP-G-~5 10:11A~1; T-iTb P.061f003 D8-08-OS -o,4DAN FROf~R.E. Chain i Ascoc A<~'11pNAL INSUR~A ~NI~RBEAAENT in911rence C~ortlparly rav_eTyrgB~ i~T~g~ ZNSt71W1C8 COMpAliY This egdagertlait modifaw such Mup~s ~ q stlardeid by IIM ptovbWns of Policy p -~~fln `~~ i ~ ~ to the fopoVVlnp: i. The city of Sertia Me, ~D CMio Center Pgirr, ~ Arw. C;aIMDmia 82701; t!s allbers, etrtplbyasa, egenk-, rohnibsrr~ and rvpreeetgetlVee rite nefned es eddpbnel lnourods ("eddplerial innrnt0ey Mdtll rpMd t0 M~pgr dttd dabnse of suRe arkirip f-orn tM opereMorp end u+ee perfbatted bir gran behatFaf tlp named insured, or an behalf ~tlie~nattNd k~ftNSd ~tnsureraae~r~eflbMad by PAY ~ R~ty and b not addtfbrid la Or o4nbitxrlMrp wMh any of}rer insunenoa card by ar ror a+. t-.min of the M3ditliatMl fnaurada. a 1'trb trsurerra epppas sfeperalely ~ each krured epskret wham awgn b nrede a suit 1a brouan) esx~ept ~ teepeet to Nw camparryU pnlRs at IIebINy. the indusisn of argr parson w eroanhattlort ~ tln lnRiMad dMM nd tMhiot any right which such person ar organltatlon would lpn+e tit: w dMmtint ff r-N sa tnt4nded. 4. V~AtlI respect m 11ra edditiond M->«i-eda. thb Nteirlmee chap not be tteen~DhmtClly ~A~, ~A Civic OenPlw, Santa Ceprornfe 1327Di, tCompletbn a[ rho faAawq+la, ~ud~ ruwitersipngbrre, is rogigred w rnaks this endatsernent eMectlve,) eve ~_oe joz/anus .Ihk Mda-sement farm as a pa-t of Issrradio~unace couiyTSr GxII,DREPS TgIiRAP$UTIC ART CTb1T8R Counberelgned by A Represeni~ive _ _Y~~_ ~_ 1r~. ___ .aura Stitt Slieedy ~k>>atanr Ciiy Attorr~e~ PAGE 212 F-030 JUL-29-2005 09:BBR FROM: 'Q: 17146476549 P.2 l'7~292005 07:47 fJ~.439 D002 SP POLICYHOLDER COPY STATE P.O. BOX 420607. SAN a=RANCrSCO,C1+ 94142-OB07 couaews.-rloN ru5UaANCE FUND cEaTIFICATE of WORI~RS' canlwenisAroni tNSU~aNC~ SSSOE PATE: 07-28-4005 GFlOYP. POLICY MAr6ER 7711151-9005 CERTIFICATE 6T ~ Ct3tT1FlCATp E%PVtE5:04'14'2006 a- t4-:oosla-t4-4oti5 THIS CEA71fICATE SUt•ER5EDE8 A!O COIbtECrS CERTIfIGTE ^ 9 bATEb 07-41-4005 CITY Of SANTA At14 :t0 CIVIC CLIREaI -LAZ~ SANTA ArttA G~ 1lTO! 6P This b b wrHfV lfut va4 hwe IaH+ed a valid W0rk4ra' CeRWnaat{OA htaurMKe pe6ry M a form aOprWW M era CaN}omh InsurMta GarsMaden4r m the atttPbver rraened 6altm a0r the poles P4rlod 1rxSOat4d Thn policy la rot lublaot m canoM4e0n sY tM Fred except upon t0 days advare4 wrltun notlco m the emplOPen Wa wiN also slue Ve0 t0 dM advanu naou eh0rad this poky be eannlled PrIOr m hs rxrrrtul 4xPdrklert This aerditaeb of UK{l411p is rot h irwarce pokey an0 rhea not amartQ extend Or M1er the G0v4ra0e attrxded by the po1oY pstad Iwain MOMfitlntwdtr~p arN reOuirMnsnt. term ar eeardidOrr of mY e0n1'a0t rx otMr doeanmM wRh rapes m vdtleh ih& certlfkata of Yravanca mry he isausd Or fo wNCh it Mal Pertaftt tde arstranee siforded bV era P06cY daserliad hrein k suE~eet m dl dre bans exeksiona. +d eand76ons of srreh p01i0V• ~~/~,oz-- ,dam- C . 6,~4... AU1LdtN11FD REPR63fNTATIVE PNESCENt EMPLOY11t'1 LIAtILfTY LIMIT IAGWDINB bEFl7a1E Lb5T5: 11,000,000 pER ppt;{IpIpICS. ~. _ R,~V:iia iW .~ T Y~'s~" TOROK LISA E• S Attorney ~' Assistant City EhehLOYFIt ORAaIIti GOLIJYY CHiLOREMrS 17iCRAPEUTC ARTS 401 N 51bDA0YAY SANTA ANl1 /:A 12701 .SP (MGS,CrTj -RiatTEO r lYt-29-2005 aiLN.YOq