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HomeMy WebLinkAboutTALLER SAN JOSE 15 - 2006 INSUR!\NCE ON rill WORK MAY PROCLED UNTIL INSUfiA!~C,: EXPIRES &; -~D' -(~I CLERK OF COUNCIL DATE, AUG 0 9 2006 A-?006-l89 6/10iOS1es :-,. Ct>~( ')1 l~~~As) AGREEMENT BETWEEN THE CITY OF SANTA ANA AND TALLER SAN JOSE FOR USE OF EMPOWERMENT ZONE FUNDS This Agreement, made and entered into this First (01) day of July, 2006, 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 California ("CITY"), and Taller San Jose ("CONTRACTOR"). W!IN~~~~IH Recitals: 1. The City of Santa Ana, through the Santa Ana Empowerment Corporation ("SAEC"), is the recipient of Federal Empowerment Zone ("FEZ") funds from the United States Department of Housing and Urban Development ("HUD"). 2. CITY desires to engage CONTRACTOR to provide the services at the cost set forth in Exhibit Aand for the services set forth Exhibit B, hereinafter referred to as "said program" and CONTRACTOR represents that it is qualified and willing to operate said program. WHEREFORE, for and in consideration of the respective and mutual covenants hereinafter contained and made, and subject to all the terms and conditions hereof, the parties hereby agree as follows: I. CONTRACTOR'S OBLIGATIONS A. CONTRACTOR agrees to use all federal funds provided by CITY to CONTRACTOR pursuant to this Agreement to operate said program, as set forth in "Exhibit B," attached hereto and by this reference incorporated herein. CONTRACTOR'S failure to perform as required may, in addition to other remedies set forth in this Agreement, result in readjustment of the amount of funds CITY is otherwise obligated to pay to CONTRACTOR under Paragraph II hereof. B. CONTRACTOR agrees to obtain and maintain all required licenses, registrations, accreditation and inspections from all agencies governing operation of its program. CONTRACTOR shall ensure that its staff shall also obtain and maintain all required licenses, registrations, accreditation and inspections from all agencies governing CONTRACTOR operations hereunder. C. CONTRACTOR agrees that any facility/property used in furtherance of said program shall be specifically zoned and permitted for such use(s) and activity(ies). Should CONTRACTOR fail to have the required land Page 1 of 14 6/10/06 les entitlement and/or permits, thus violating any local, state or federal rules and regulations relating thereto, CONTRACTOR shall immediately make good- faith efforts to gain compliance with local, state or federal rules and regulations following written notification of said violation(s) from the CITY or other authorized citing agency. CONTRACTOR shall notify CITY immediately of any pending violations. Failure to notify CITY of pending violations, or to remedy such known violation(s) shall result in termination of grant funding hereunder. CONTRACTOR must make all corrections required to bring the facility/property into compliance with the law within sixty (60) days of notification of the violation(s); failure to gain compliance within such time shall result in termination of grant funding hereunder. D. All funds received by CONTRACTOR from CITY pursuant to this Agreement shall be separately accounted for apart from any other funds of CONTRACTOR, or of any principal or member of CONTRACTOR. CONTRACTOR agrees that if CONTRACTOR receives $500,000 or more in any Federal funds, CONTRACTOR shall have an annual audit conducted by a certified public accountant in accordance with the standards as set forth and published by the United States Office of Management and Budget Circular A-133. CONTRACTOR shall provide CITY with a copy of said audit 30 days after receipt of the auditor's report(s), or nine months after the end of the audit period following the program year in which this Agreement is executed. E. CONTRACTOR shall keep records of all funds received from CITY under the terms and conditions of this Agreement in accordance with the procedures set forth in the "Agreement Accounting and Administrative Handbook", a copy of which shall be provided to CONTRACTOR by CITY. CONTRACTOR agrees to keep monthly records of all ethnic and racial statistics of persons and families benefited by CONTRACTOR in the performance of its obligations under this Agreement, including, but not limited to, the number of low and moderate income persons and households assisted in accordance with federal income limits, number of female heads of households, and number of senior citizens assisted. CONTRACTOR agrees to provide CITY with written cumulative (year-to- date) reports of its activities on or before the 15th day of July, October, January and April for the period beginning October 1, 2006 and through and including the previous three-month reporting period setting forth the activities, program accomplishments, new program information and year-to- date program statistics on expenditures, case load and activities. When appropriate, pictures should be included. This Agreement shall terminate on June 30, 2007, unless extended by mutual consent of the parties. Any extension shall be in writing, and executed by the Executive Director of the Community Development Agency and the City Attorney on behalf of CITY. Page 2 of 14 6/10/06 les CITY, SAEC and the United States Government and/or their representatives shall have access for purposes of monitoring, auditing, and examining CONTRACTOR's activities and performance, to books, documents and papers, and the right to examine records of CONTRACTOR's subcontractors, bookkeepers and accountants, employees and participants in regard to said program. CITY, SAEC and the United States Government and/or their representatives shall also schedule on-site monitoring at their discretion. Monitoring activities may also include, but are not limited to, questioning employees and participants in said program and entering any premises or any site in which any of the services or activities funded hereunder are conducted or in which any of the records of CONTRACTOR are 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 all necessary and reasonable expenses incurred by CITY in conducting any audit at the location where said records and books of account are maintained. F. 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 Orange County, California, for the duration of the Agreement and thereafter for five (5) 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 or any other governmental agency takes exception, shall be retained beyond the five (5) years until resolution or disposition of such appeals, litigation, claims, or exceptions. G. CONTRACTOR agrees to comply fully with all federal, state and local laws and court orders applicable to its operation whether or not referred to in this Agreement. CONTRACTOR agrees that ithas read, understood and shall adhere to the legal obligations referred in .E{<llipitQ.. H. CONTRACTOR shall be in good standing, without suspension by the California Secretary of State, Franchise Tax Board and Internal Revenue Service. Any change in the corporate status or suspension of CONTRACTOR shall be reported immediately to CITY. I. Subreceipient acknowledges and warrants that it shall at all times comply with the laws, regulations and policies governing the use of FEZ funds, including but not limited to, the limitations on use of FEZ funds set forth in P.L. 106-74 (2000), 24 CFR section 598.215 and Federal Register, April 16,1998. Page 3 of 14 6/10106 les J. Without prejudice to any other provisions 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. However, CONTRACTOR shall submit to CITY, SAEC and or HUD or its representatives, all records requested, including audit, examinations, monitoring and verifications of reports submitted by CONTRACTOR, costs incurred and services rendered hereunder. K. CONTRACTOR agrees that the performance of obligations hereunder are rendered in its capacity as an independent contractor and that it is in no way an agency of CITY. L. CONTRACTOR agrees that if CONTRACTOR violates any of the terms and conditions of this Agreement or any prior Agreement whereby FEZ funds were received by CONTRACTOR, or if CONTRACTOR reports inaccurately, or if on audit there is a disallowance of certain expenditures, CONTRACTOR agrees to remedy the acts or omissions causing the disallowance or repay CITY all amounts spent in violation thereof. M. CONTRACTOR agrees to maintain a record for each item of non- expendable personal property acquired under the terms of this Agreement. Said record shall be made available to CITY upon request. The term "non- expendable personal property" shall include leased and purchased equipment. N. CONTRACTOR hereby certifies and agrees that it will not use funds provided through this Agreement to pay for entertainment, meals or gifts. O. CONTRACTOR certifies that no appropriated funds may be expended by the recipient of a federal contract, grant, loan or cooperative agreement to pay any person for influencing or attempting to influence an officer or employee of any agency, Member of Congress, or an officer or employee of a Member of Congress in connection with awarding of any federal contract, the making of any federal grant or loan, entering into any cooperative agreement and the extension, renewal, amendment or modification of any federal contract, grant, loan or cooperative agreement. CONTRj\CT()R shall sign a certification to that effect in a form as set forth in "E;xfjipit.P;" 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. 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 Page 4 of 14 6/10/06 les Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit a "Disclosure Form to Report Lobbying," in accordance with its instructions. P. CONTRACTOR agrees that except for the use of FEZ funds to pay salaries and other related administrative or personnel costs, no persons who exercise or have exercised any function with respect to FEZ activities assisted under the terms of this Agreement, or who are in a position to participate in a decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a FEZ-assisted activity of CONTRACTOR, either for themselves or those with whom they have family or business ties, during their tenure or for one year thereafter. This prohibition applies to any person who is an employee, agent, consultant, officer, or elected or appointed official of CITY, or of any designated public agencies, or the CONTRACTOR. Q. CONTRACTOR acknowledges and warrants that prior to having any contractor perform work paid for by FEZ funds, that it shall be responsible (i) for providing such contractor with a copy of this Agreement, and (ii) ensuring that any such contractor executes and provides to the Executive Director of theCommunity Development Agency a letter in substantially the form of Ej(fflbltE$ hereto, agreeing to be bound by the terms of this Agreement. R. CONTRACTOR acknowledges and warrants that during the term of this Agreement it shall to the maximum extent feasible collaborate with other CONTRACTORS to ensure that duplication of services is avoided. Such collaboration shall include, but not be limited to, regular attendance (i.e., an attendance record exceeding 50%) and active participation in the appropriate committee or committees established pursuant to the Strategic Plan. S. CONTRACTOR agrees to pro"ide a drug-free work place and to execute a certification as set forth in ~!':xhTtlitr=!' attached hereto and incorporated herein by this reference. 1. CONTRACTOR shall comply withthe~eneral provisions, assurances, and certifications attached hereto as "!,:Xhibitl;3" and incorporated herein. II. CITY'S OBLIGATIONS Upon execution of this Agreement by CONTRACTOR, CITY shall pay to CONTRACTOR from FEZ funds, when, if and to the extent received from HUD, for CITY's 2006-07 FEZ program year amounts expended by CONTRACTOR in carrying out said program for fiscal year 2006-07 pursuant to this Agreement up to a maximum aggregate payment of seventy nine thousand seven hundred seventy Dollars ($79,770) for CONTRACTOR'S performance in accordance with the Page 5 of 14 6/101061e5 payment schedule attached hereto as "Exhibit A". Payments shall be made to CONTRACTOR through the submission of periodic invoices, in a form prescribed by CITY, detailing such expenses. CONTRACTOR agrees to submit the above-stated document to the FEZ Navigator Office, 1000 E. Santa Ana Blvd., Suite 200, Santa Ana, CA 92701. CITY shall pay such invoices within thirty (30) days after receipt thereof provided CITY is satisfied that such expenses have been incurred within the scope of this Agreement and that CONTRACTOR is in compliance with the terms and conditions of this Agreement. 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 first quarter performance by CONTRACTOR as outlined in the Scope of Work attached hereto as "Exhibit B" (c) lack of fiscal accountability of CONTRACTOR; or (d) decrease in available funding. III. PROGRAM INCOME A. For the purposes of this Article (III) "Program income," shall mean gross income received by the CONTRACTOR directly generated from the use of FEZ funds, except as provided below in Paragraph III.C. When such income is generated by an activity that is only partially assisted with FEZ funds, the income shall be prorated to reflect the percentage of FEZ funds used. B. Program income includes, but is not limited to each of the following: 1. Proceeds from the disposition by sale or long term lease of real property purchased or improved with FEZ funds; 2. Proceeds from the disposition of equipment purchased with FEZ funds. 3. Gross income from the use or rental of real or personal property acquired by the CONTRACTOR with FEZ funds, less the costs incidental to the generation of such income; 4. Gross income from the use or rental of real property owned by the CONTRACTOR that was constructed or improved with FEZ funds, less the costs incidental to the generation of such income; 5. Payments of principal and interest on loans made using FEZ funds; 6. Proceeds from the sale of loans made with FEZ funds; 7. Proceeds from the sale of obligations secured by loans made with FEZ funds; 8. Interest earned on funds held in a revolving fund account; 9. Funds collected through special assessments made against properties owned and occupied by households not of low and moderate income, where such assessments are used to recover all or part of the FEZ portion of a public improvement. C. Program income does not include income on grant advances from the U.S. Treasury. The following items of income earned on grant advances must be remitted to HUD for transmittal to the U.S. Treasury: Page 6 of 14 6/10/06 les 1. Interest earned from the investment of the initial proceeds of a grant advance by the U.S. Treasury; 2. Interest earned on loans or other forms of assistance provided with FEZ funds that are used for activities determined by HUD either to be ineligible or to fail to meet a national objective or other federal criteria. 3. Interest earned on the investment of amounts reimbursed to the FEZ program account prior to the use of the reimbursed funds for eligible purposes. D. The receipt of program income (as defined in Paragraph iliA hereinabove) by CONTRACTOR in the operation of said program shall be recorded by CONTRACTOR and reported to CITY. E. Program income received by CONTRACTOR shall be returned to CITY unless otherwise provided for in this Agreement. IV. NONDISCRIMINATION CONTRACTOR agrees that no person on the ground of race, color, national origin, religion or sex will be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity funded in whole or in part with FEZ funds. V. SPECIAL CERTIFICATION FOR RELIGIOUS ENTITIES If CONTRACTOR is a religious entity, CONTRACTOR hereby agrees that in connection with the provision of the seNices CONTRACTOR shall provide with FEZ funds: A. CONTRACTOR shall not discriminate against any employee or applicant for employment on the basis of religion and shall not limit employment or give preference in employment to persons on the basis of religion. B. CONTRACTOR shall not discriminate against any person applying for the services CONTRACTOR agrees to provide under the terms of this Agreement on the basis of religion and shall not limit such seNices or give preference to applicants for such seNices on the basis of religion. C. CONTRACTOR shall NOT provide religious instruction or counseling, conduct any religious worship or seNices, or engage in any religious proselytizing, or exert any religious influence in the provision of the seNices in said program. Page 7 of 14 6/10/06 les D. Where the services to be provided under said program are rendered on property owned by the primarily religious entity CONTRACTOR, FEZ funds may also be used for minor repairs to such property which are directly related to the cost of rendering the services under said program, where the cost constitutes in dollar terms only an incidental portion of the FEZ expenditure for rendering the services under said program. VI. PROHIBITION OF NEPOTISM CONTRACTOR agrees not to hire or permit the hiring of any person to fill a position funded through this Agreement if a member of that person's immediate family is employed in an administrative capacity by CONTRACTOR. For the purposes of this section, the term "immediate family" means spouse, child, mother, father, brother, sister, brother-in-law, sister-in-law, father-in-law, mother-in-law, son-in-law, daughter-in-law, aunt, uncle, niece, nephew, step-parent and stepchild. The term "administrative capacity" means having selection, hiring, supervisor or management responsibilities. VII. NOTICES Notices to the parties shall, unless otherwise requested in writing, be sent by U.S. Mail, postage prepaid, and addressed as follows: TO CITY: Santa Ana WORK Center WORK Center Director 1000 E. Santa Ana Blvd., Suite 200 Santa Ana, California 92701 Telefacsimile (714) 565-2602 TO CLERK: Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 82702-1988 Telefacsimile (714) 647-6956 TO CONTRACTOR: Taller San Jose Executive Director 801 Broadway Santa Ana, CA 92701 VIII. ASSIGNABILITY CONTRACTOR shall not assign nor transfer any interest in this Agreement, whether by assignment or novation, without the prior written consent of CITY; provided, however, that claims for money due or to become due CONTRACTOR from CITY under this Agreement may be assigned to a bank, trust company or other financial institution, or to a trustee in bankruptcy, without such approval. Page 8 of 14 6/10106 les Notice of any such assignment or transfer shall be promptly furnished to CITY. IX. HOLD HARMLESS CONTRACTOR shall indemnify and save harmless CITY, its officers, employees, agents, representatives and volunteers from and against any and all damages to or for loss of use of property and for injuries to or death of any person or persons, including property and employees or agents of CITY, and shall defend, indemnify and save harmless CITY, its officers, employees, agents, representatives and volunteers frorn and against any and all claims, demands, suits, actions or proceedings of any kind or nature, including, but not by way of limitation, workers compensation claims and including attorney fees and reasonable expenses for litigation or settlement, resulting from or arising out of the negligent or wrongful acts, errors or omissions of CONTRACTOR, its officers, directors, employees, agents, subcontractors and suppliers arising out of CONTRACTOR's performance of this Agreement. X. INSURANCE CONTRACTOR shall obtain and maintain for the entire term of this Agreement comprehensive general public liability insurance, in companies acceptable to the City, authorized to issue such insurance in the State of California. Said insurance shall consist of the following: A. Commercial General Liabilitv. CONTRACTOR agrees to obtain and keep in force during the term of this Agreement a policy of comprehensive commercial 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 less 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 California, 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. Governmental entities may substitute a certificate of self-insurance. B. Automobile Liabilitv Coveraqe. 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, Page 9 of 14 6/10106105 CONTRACTOR shall secure and maintain on file from all such employees, participants, or agents as self-certification of automobile insurance coverage. Governmental entities may substitute a certificate of self- insurance. C. 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 California Labor Code Section 3350 et seq., CONTRACTOR shall obtain and keep in force during the term of this Agreement full Workers' Compensation 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 Worker's Compensation Coverage, pursuant to California Labor Code Section 3350, et seq. D. Equipment Coveraqe. 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. E. Proof of Insurance. Certificates and endorsements (E:Xhj~jt'I'D 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. XI. REVERSION OF ASSETS A. Upon the expiration of this Agreement, CONTRACTOR shall transfer to CITY any FEZ funds on hand at the time of the expiration of this Agreement as well as any accounts receivable attributable to the use of FEZ funds. B. Any real property under CONTRACTOR's control that was acquired or improved in whole or in part with FEZ funds in excess of $25,000.00 must either be: 1. Used, where CITY has given written approval, to meet one of the national objectives stated under federal law until five (5) years after expiration of this Agreement, or for such longer period of time as determined to be appropriate by CITY; or 2. If not used in accordance with subparagraph A above, CONTRACTOR shall pay to CITY an amount equal to the current fair Page 10 of 14 6/10/06 les market value of the property less any portion of the value attributable to the expenditure of non-FEZ funds for acquisition of, or improvement to, the property. Such payment is program income to CITY. C. Subject to the obligations set forth herein, title to equipment acquired under the terms of this Agreement will vest upon acquisition in CONTRACTOR. When said equipment which has been acquired in accordance with this Agreement and all applicable regulations is no longer needed for said program, disposition of said equipment will be made as follows: 1. Items of equipment with a current per unit fair market value of less than $5,000.00 may be retained, sold or otherwise disposed of with no further obligation to CITY. 2. Items of equipment with a current fair market per unit value of $5,000.00 or more may be retained or sold and CITY shall have the right to an amount calculated by multiplying the current market value or proceeds from the sale by CITY's share of federal funds used to acquire the equipment. C. CONTRACTOR hereby agrees, upon the demand of CITY, to execute, acknowledge and deliver, or cause any person or entity who may have any claim to rights hereunder or under any document, instrument or agreement executed in furtherance of the services and activities to be performed hereunder, to execute, acknowledge and deliver, to CITY assignment(s), quit claim deed(s) or such other and further instruments, documents and agreements as may be necessary, in the sole and absolute discretion of CITY, to vest in CITY all of CONTRACTOR's right, title and interest (if any it may have) in and to CITY, SAEC, FEZ or other federal, state andlor local accounts or program funds or allocation of funds to which CITY is or may be entitled, either for its own account or as fiduciary or trustee for others, which were obtained for the purpose of the performance of this Agreement or any previous agreements relating to the same subject matter or activities as this Agreement, together with any instruments, loans, grants or advances by CONTRACTOR on behalf of CITY, in furtherance of the activities hereunder or thereof. CONTRACTOR's obligations and responsibilities set forth in this paragraph "XI. REVERSION OF ASSETS," and in paragraphs "XII. TERMINATION" and "III. PROGRAM INCOME" shall not be affected by the termination of this Agreement and shall survive the date of termination of this Agreement for such period of time as CITY and/or HUD deems necessary for the responsibilities, duties and obligations to be performed and completed to the satisfaction of CITY and HUD. Page 11 of 14 6/10106 les XII. TERMINATION A. This Agreement may be terminated on thirty (30) days' written notice by either party. In the event of such termination, CONTRACTOR shall only be entitled to reimbursement for approved expenses incurred to the effective date of termination. B. This Agreement may be suspended or terminated by CITY upon five (5) days' written notice for violation by CONTRACTOR of the terms and conditions of the this agreement or applicable State or Federal requirements. In the event of such suspension or termination, CONTRACTOR shall only be entitled to reimbursement for approved expenses incurred up to the effective date of suspension or termination. C. In the event CONTRACTOR defaults by failing to fulfill all or any of its obligations hereunder, CITY may declare a default and termination of this Agreement by written notice to CONTRACTOR, which default and termination shall be effective on a date stated in the notice which is to be not less than ten (10) days after certified mailing or personal service of such notice, unless such default is cured before the effective date of termination stated in such notice. If terminated for cause, CITY shall be relieved of further liability or responsibility under this Agreement, or as a result of the termination thereof, including the payment of money, except for payment for approved expenses incurred for services satisfactorily and timely performed prior to the mailing or service of the notice of termination, and except for reimbursement of (1) any payments made for services not subsequently performed in a timely and satisfactory manner, and (2) costs incurred by CITY in obtaining substitute performance. D. The grant of funds by CITY to CONTRACTOR pursuant to this Agreement may be terminated for convenience upon two weeks written notice to CONTRACTOR. E. In the event this Agreement is terminated as set forth in subparagraphs XII.A. through XII.D., inclusive, CONTRACTOR agrees to immediately return to CITY upon CITY's demand and prior to any adjudication of CONTRACTOR's rights, any and all funds not used, and to comply with paragraph "XI. REVERSION OF ASSETS" of this Agreement. XIII. LIMITATION OF FUNDS The United States of America, through HUD, may in the future place programmatic or fiscal limitations on the use of FEZ funds which limitations are not presently anticipated. Accordingly, CITY reserves the right to revise this Agreement in order to take account of actions affecting HUD program funding. In the event of funding reduction, CITY may, in its sole and absolute discretion, reduce the budget of this Agreement as a whole or as to costs category, may limit the rate of CONTRACTOR's authority to commit and spend funds, or may restrict Page 12 of 14 6/10/06 les CONTRACTOR's use of both its uncommitted and its unspent funds. Where HUD has directed or requested CITY to implement a reduction in funding, in whole or as to a cost category, with respect to funding for this Agreement, CITY's Executive Director or delegate is authorized to act for CITY in implementing and effecting such a reduction and in revising, modifying, or amending the Agreement for such purposes. Where CITY has reasonable grounds to question CONTRACTOR's fiscal accountability, financial soundness, or compliance with this Agreement, CITY may suspend the operation of this Agreement for up to sixty (60) days upon five (5) days written notice to CONTRACTOR of its intention to so act, pending an audit or other resolution of such questions. In no event, however, shall any revisions made by CITY affect expenditures and legally binding commitments made by CONTRACTOR before it received notice of such revision, provided that such amounts have been committed in good faith and are otherwise allowable and that such commitments are consistent with HUD cash withdrawal guidelines. XIV. EXCLUSIVITY AND AMENDMENT OF AGREEMENT This Agreement supersedes any and all other agreements, either oral or in writing, between the parties hereto with respect to the use of CITY's FEZ funds by CONTRACTOR and contains all the covenants and agreements between the parties with respect to such employment in any manner whatsoever. Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which are not embodied herein, and that no other agreement or amendment hereto shall be effective unless executed in writing and signed by both CITY and CONTRACTOR. XV. LAWS GOVERNING THIS AGREEMENT This Agreement shall be governed by and construed in accordance with the laws of the State of California, and all applicable federal laws and regulations. XVI. VALIDITY The invalidity in whole or in part of any provision of this Agreement shall not void or affect the validity of any other provision of this Agreement. Page 13 of 14 6/10/06Ies IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the date and year written hereinabove. ATTEST: .G2~-~ PATRICIA E. HEALY . Clerk of the Council CITY OF SANTA Ana, a municipal oo~ornti~t;r' DAVID N. REAM City Manager APPROVED AS TO FORM: JOSEPH W. FLETCHER City Attorney ~(.~ By: Lisa E. Storck Assistant City Attorney CONTRACTOR: /l~ 1~€~~ It v ~ !~e: Title: ~y:~-h...... D.....,......+-- Federal Tax ID: 59 -38;665fJ RECOMMENDED FOR APPROVAL ~~ t),u)eudo tylStephen G. H ding Deputy City Manager for Development Services Page 14 of 14 PROGRAM BUDGET Taller San Jose Program FY 2006-2007 Administrative ii!i'~ij~~!i!i!.\li.. Salaries $211,362 $35,770 $175,592 Benefits $15,500 $15,500 Student A rentices $48,448 $4,448 Total Personnel $275,310 Rent or user fee $113,250 $113,250 Utilities $8,000 $8,000 Telecommunications $10,000 $10,000 Parkin fees $500 $500 Securi $2,000 $2,000 Maintenance $7,600 $7,600 Marketin $1,000 $1,000 Office ex enses $12,000 $12,000 Accountin Services $35,000 $35,000 Auditin services $3,000 $3,000 Customer Trainin $20,250 $20,250 Su oct services $3,000 $3,000 Other Total Operating $0 $215,600 $0 $214,600 Ex enses GRAND TOTAL $0 $490,910 $79,770 $411,140 BUDGET NARRATIVE I Program Coordinator (.50) @ $20,000; Case Manager (.40) @ $15,770 210 construction apprentices (400 hrs @ $7.501hr + FICA) = $30,000 5 business technology students (400 hrs @ $7.001hr + FICA) = $14,000 3 In-Kind: Customer training expenses includes: instructional materials, training supplies, textbooks, exam/testing fees, uniforms, tools, transportation, and safety equipment Per student cost: Tech apprentices $1,150 each CNA students $300 each CareerTech $565 each EXHIBIT A Taller San Jose FEZ Daisy Wheel Network Program Scope of Work July 1, 2006- June 30, 2007 I. TERM July I, 2006 through June 30, 2007 II. PURPOSE The FEZ Daisy Wheel Network Program will provide vocationaVoccupational training, employment strategies, education, and supportive services to individuals who reside in the Federal Empowerment Zone. III. POPULATION TO BE SERVED The population to be served are Federal Empowerment Zone residents 18 years and older. Eligibility will be determined by age, address, and by Right to Work documentation. IV. PROGRAM DESIGN, ELEMENTS, AND OUTCOMES FOR Taller San Jose A. Program Design: I. Provide an intake assessment (for screening) of each FEZ resident that includes a review of academic and occupational skills levels as well as service needs; 2. Develop an Individual Service Plan including notifying achievement objectives. B. Program Elements: I. The following program elements will be made available to eligible residents expected to emoll in the FEZ Daisy Wheel Network Program for participation in activities aimed at providing a comprehensive strategy that addresses employment and training needs: i. vocationaVoccupational training, 11. employment strategies, Ill. education, and IV. sllpportive services C. Performance Outcomes 1. 15 FEZ residents will be served within 10 months. 2. Of the IS FEZ residents served, 8 (50%) will be provided additional services within 10 months. 3. Of the IS FEZ residents served, 6 (40%) will be provided with work experience, receive On-the-Job Training, receive retention services, attend English as a Second Language classes, be provided with skill upgrades, have access to paid intemships, etc. within 10 months. 4. Of the IS FEZ residents served, 5 (30%) will be placed in unsubsidized employment within 10 months. Cumulative Planned Enrollments: April I I July ~ Sept. I oct.; Dec. I Jan. - ~arch Cumulative Planned Additional Services: July - Sept. 3 Oct. - Dec. 2 Jan. - March 2 I A~ril I EXHIBIT B Cumulative Planned 40%: Jan. - March 2 April ] I July ~ Sept. I Oct. ~ Dec. Cumulative Planned Placements: July - Sept. ] Oct. - Dec. 2 Jan. - March 2 April o V. SERVICES WILL BE PROVIDED AT: Taller San Jose 801 Broadway Santa Ana, CA 92701 VI. WORK CENTER RESPONSIBILITIES I. Develop contracts for partners. 2. Provide orientation and training on eligibility, referral process, assessment, MIS tracking system, joint policies and procedures, fiscal billing, documentation, etc. 3. Develop joint forms such as application, screening/intake tool, ISP, referral form, MIS forms, etc. 4. Perform Program Monitoring 5. Perform Program Reporting 6. Provide partners with on-going technical assistance 7. Provide a quarterly FEZ newsletter 8. Facilitate monthly meetings 9. Provide job development / job placement enhancement services to partner agencies 10. Conduct a mid year progress review to access progranunatic performance and fiscal accountability VII. Taller San ,Jose RESPONSIBILITIES I. Taller San Jose will provide eligible FEZ residents with services designed to meet the FEZ Board requirements. A participant will be provided with one or more of the following services to assist them in obtaining unsubsidized employment and self-sufficiency: . Case management . Job readiness . Job development & job placement . Coordinate on-site recruitments . Community forums on job related services 2. Evaluate participants for eligibility and assign those eligible for program services. 3. Report progress and job placements to WORK Center FEZ staff. 4. Incorporate all service navigator partners' information into each other's marketing materials. 5. Attend monthly partner meetings. 6. Provide WORK Center FEZ staff with monthly and quarterly progress reports. 7. Provide WORK Center FEZ staff with necessary information for conducting informal and formal monitoring of program progress. 8. Meet performance measures. All staff and agencies participating in this project will be held accountable for achieving their agency FEZ performance measures. 9. Submit Monthly Statistics Report documentation to FEZ Liaison staff by the 5th of every month. Report should include new enrollments and a continuous Activity Enrollment Form 10. Maintain a current and complete file (electronic as well as a hard copy) for each FEZ participant: eligibility documentation; registration form; enrollment form; assessment; Individual Service Plan (ISP); EEO/Grievance; case notes; supportive services documentation; attendance records; training documentation; etc. EXHIBIT B II. Comply with allowable expenses. To be allowable, costs must: a.) be reasonable for the performance of the program; b) conform to any limitations or exclusions set forth in the program as to types or amount of cost items; c.) be consistent with policies and procedures that apply uniformly to both federally-financed and other activities of the organization; d.) be determined in accordance with generally accepted accounting principles (GAAP); e.) not be included as a cost or used to meet cost sharing or matching requirements of any other federally-financed program in either the current or a prior period; and, f.) be adequately documented. 12. Submit in triplicate, a monthly Invoice on City of Santa Ana, Federal Empowerment Zone Program Subrecipient Request for Reimbursement, showing in detail the amount of money already expended. Accounting records must be supported by source documentation such as cancelled checks, paid bills, payrolls, and attendance records. Submit the above stated documents to Bea Gonzalez by the tenth (10th) day of the month following the month in which services are performed. EXHffiIT B SUBRBCIPIENT warrants the following: 1. SUBRECIPIENT will comply with Public Law 88-352, title VI of the Civil Rights Act of 1964 (42 u.s.c. 92000 ET SEQ.) and implementing regulations in 24 CFR Part l. 2. No person in the United States shall on the ground of race, color, religion, national origin, or sex, be excluded from participation in, or be denied the benefits of, or be subjected to discrimination under, any program or activity funded in whole or in part with community development funds made available pursuant to the ACT. 3. All laborers and mechanics employed by contractors or subcontractors in the performance of construction work financed in whole or in part with community development funds shall be paid wages at rates not less than those prevailing on similar construction on the locality as determined in accordance with the Davis-Bacon Act, as amended, 40 U.S.c. 9 9276a-276a-5, except for individuals who perform services for which they volunteered; do not receive compensation for such services; or are paid expenses, reasonable benefits, or a nominal fee for such services; and are not otherwise employed at any time in construction work. 4. SUBRBCIPIENT will comply with all Federal statutes applicable to projects funded with community development funds, except that (a) SUBRBCIPIENT does not assume CITY's environmental responsibilities described at 24 CFR 570.604; and (b) SUBRBCIPIENT does not assume CITY's responsibility for initiating the review process under Executive Order 12372. EXHIBIT C Certification Regarding Lobbying Certification for Contracts. Grants. Loans. and Cooperative AlZreements The undersigned certifies, to the best of his or ber knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperaive agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, sub grants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $ I 0,000 and not more than $100,000 for each such failure. ::Ljj~ Sa...,.. -J 6>-e..-- Grantee/Contractor Organization "'5 z-..,. _ Program Title ~rti~e/lc-~ Signature t./U/ dt I Date EXHIBIT D Part I INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form still be completed by the reporting entity, whether subawardce or prime Federal recipient, at the Initiation or receipt of a covered Federal action, or a material change to a previous t1Iling, pursuant to title 31 u.s,c. section] 352. The filling ofa form be required for each payment or agreement to make payment for any lobbying entity for influencing or attempting to influence an officer or employee of any agency, a member of Congress an officer or employee of Congress, or an employee of a Member of Congress in connection with a Federal Action. Used the SF-LLL~A Continuation Sheet for additional infonnation if the space on the fonn is inadequate. Complete al] items that apply fOf both the initial fiJling and material change report. Refer to the Implementing guidance published by the Office of Management and Budget for additional information, I. Identify the type of covered Federal Action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action. 2. Identify thc status of the covered Federal action. 3. Identify the appropriate classification of this report. If this is a followup report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this covered Federal action. 4. Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District, if known. Check the appropriate classification of the reporting entity that designates if it is, or expects to be, a prime or subaward recipient. Identify the tier of the subawardee, e.g, the first subawardee of the prime is the 1 st tier. Seaboard include but are not limited to subcontracts, subcontracts, subgrants and contract awards under grants, 5. If the organization filling the report in item 4 checks "subwardee" then enter the full name, address, city, state and zip code of the prime Federal recipient. Inc]ude Congressional District, if known. 6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organizational level below agency name, if known. For example, Department of Transportation, United States Coast Gaun!. 7. Enter the Federal program name or description for the covered Federal action (item I). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans, and loan commitments. 8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e.g.) Request for Proposal (RFP) number; invitation for Bid (IFS) number; grant announcement number; the contract, grant, or loan award number; the application/proposal control number assigned by the Federa] agency). Include prefixes, e.g. "RFP-DE-90.001." 9. For a covered Federal action where these has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitment for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, state and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influence the covered Federa] action. (b) Enter the full names of the individual(s) performing services, and include full address if different from to (a). Enter Last Name, First Name, and Middle initial (MD. II. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply, if this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply, if payment is made through an in-kind contribution, specify the nature and value of the in-kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. 14. Provide a specific and detailed description of the services that the lobbyist has performed, or will be expected to perfonn, and the date(s) for any services rendered. Include all preparatory and related activity, not just time spent in actual contact with Federal officials. IdentifY the Federal official(s) or employee(s) contacted or the officer(s), employee(s), or Member(s) of Congress that were contacted. 15. Check whether or not a SF-LLL-A Continuation Sheet(s) is attached. 16. The certifying official shall sign and date the fonn, print his/her name, title, and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instructions searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection ofinfonnation, including suggestions for reducing this burdcn, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C.20503. EXHIBIT D Part II ACKNOWLEDGEMENT OF SUB RECIPIENT AGREEMENT To: Patricia C. Whitaker Executive Director Santa Ana Empowerment Corporation From: Subcontractor/Assignee Subcontractor/Assignee hereby stipulates that it has been provided with a copy, has read, and is familiar with all of the terms of SUBRECIPIENT's Agreement with the Santa Ana Empowerment Corporation. Subcontractor/Assignee further agrees to be bound to all of the terms and provisions of SUBRECIPIENT's Agreement with the Santa Ana Empowerment Corporation. Executed this ,;l /, day of J ~ (S c:.. . BY:~~ h-~ Name: 'S..t-.e.-r t,,"'...... .,M.~ fJL+--~ Title: G~~+-i.... J),~ EXHIBIT E Certification Reqardinq Druq-Free Workplace Requirements The certification set out below is a material representation upon which reliance is placed by the U.S. Department of Housing and Urban Development in awarding the grant. If it is later determined that the contractor knowingly rendered a false certification, or otherwise violates the requirements of the Drug-Free Workplace Act, the U.S. Department of Housing and Urban Development, in addition to any other remedies available to the Federal Government, may take action authorized under the Drug-Free Workplace Act. CERTIFICATION A. The contractor certifies that it will provide a drug-free workplace by: (a) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the contractor's workplace and specifying the actions that will be taken against employees for violation of such prohibition; (b) Establishing a drug-free awareness program to inform employees about - (1) The dangers of drug abuse in the workplace; (2) The contractor's policy of maintaining a drug-free workplace; (3) Any available drug counseling, rehabilitation, and employee assistance program; and (4) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace; (c) Making it a requirement that each employee who will be engaged in the performance of the grant be given a copy of the statement required by paragraph (a); (d) Notifying the employee in the statement required by paragraph -(a) that, as a condition of employment under the contract, the employee will - (1 ) Abide by the terms of the statement; and (2) Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five days after such conviction. . EXHIBIT F Pg.2 (e) Notifying the U.S. Department of Housing and Urban Development within ten days after receiving notice under subparagraph (d)(2) from an employee or otherwise receiving actual notice of such conviction; (f) Taking one of the following actions, within 30 days of receiving notice under subparagraph (d)(2), with respect to any employee who is so convicted - ( 1) Taking appropriate personnel action against such an employee, up to and including termination; or (2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency; (g) Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs (a), (b), (c), (d), (e) and (f). B. The contractor shall insert in the space provided on the attached "Place of Performance" form the site(s) for the performance of work to be carried out with the grant funds (including street address, city, county, state, and zip code) .the contractor further certifies that, if it is subsequently determined that additional sites will be used for the performance of work under the contract, it shall notify the U.S. Department of Housing and Urban Development immediately upon the decision to use such additional sites by submitting a revised "Place of Performance" form. Dated: &/;){. /01, I ' /2-6 -bh~ J~~ Program Operator EXHIBIT F DIVISION OF EMPLOYMENT SERVICES PLACE OF PERFORMANCE FOR CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS Name: ~ ~ );~1t-<-7 "d Name of Contractor: ~Ik...-- 51-- J6l Go- Contractor Number: Date: (.11(, J(J t I I 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): <{I; I 'lIb N- N. D-r-~\N'6 . rpe.....l""-rh.... I St-.~. A-----, S ~ 4-1--<-. C-A LA 1;)..74 , 1.2-74 I EXHIBIT F Subcontractor agrees that in addition to those agreements and obligations specified in the contract boiler plate and scope of work, it will also adhere to and obey the following provisions, assurances, and certifications. ARTICLES 1) Subcontractor assures and certifies that it will not use any funds appropriated under this agreement for religious activity or anti-religious activity, or to promote or oppose any political candidate, parties, and/or beliefs. 2) Contractor assures and certifies that where applicable, classroom training instructors are properly credentialed, and training curriculums comply with State Education Codes. 3) Subcontractor assures and certifies that any requested modification to this agreement must be submitted in writing, explaining requested changes and rationale. Subcontractor further assures that no modification will be implemented without prior written approval from the Santa Ana WORK Center. 4) Contractor assures and certifies that they are in good standing with the California Secretary of State Franchise Tax Board and Internal Revenue Service. 5) Subcontractor agrees to cooperate with any monitoring, inspection, audit, or investigations of activities related to this agreement as may be scheduled and conducted by the Santa Ana WORK Center or the Santa Ana Empowerment Corporation. 6) Subcontractor agrees to acknowledge (give credit) the Santa Ana WORK Center and the Santa Ana Empowerment Corporation as the source of funds in all oral presentations, written document, publicity, and advertisements regarding any activities that ensue from this agreement. EXHIBIT G , ACORD", CERTIFICATE OF LIABILITY INSURANCE Page 1 of 2 PRODUCER 877-945-7378 DATE 07/11/2006 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Willis North America, Inc. 26 Century Blvd. P. O. Box 305191 Nashville, TN 372305191 INSURERS AFFORDING COVERAGE NAIC# INSURED Taller San Jose 801 N. Broadway Santa Ana, CA 92704 INSURER A: American Unit Grou Ltd INSURER B: INSURER C: INSURER 0; INSURER E: C0929-QOl COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR N~~~ TYPE OF INSURANCe POUCY NUMBER "8M~':~Kf,E8hlv~ PRk'FeY.~,J;b'tf'JltON LIMITS LTR A X ~NERAL LIABILITY UNI-CGL-06-01-022 6/30/2006 6/30/2007 EACH OCCURRENCE $ 2 000 000 X OMMERCIAL GENEAAl LIABILITY ~~~~~!?E~~~~nce\ $ - CLAIMS MADE [i] OCCUR MED EXP (Anvone person) $ ~ PERSONAL & ADV INJURY $ 2 000 000 ~ GENERAL AGGREGATE $ 2 000 000 ~N'LAGG~nEfLlMrT APnSIPER: PRODUCTS - COMP/OP AGG $ POLICY ~~8i LOC ~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $ I- ANY AUTO (Eaaccidenl) I- ALL OWNED AUTOS BOOIL Y INJURY $ I- SCHEDULED AUTOS (Per person) I- HIRED AUTOS BODilY INJURY $ I- NON-DWNED AUTOS (Per accident) I- PROPERTY DAMAGE $ (Per accident) RRAGE LIABILITY AUTO ONLY - EAACCIDENT $ ANY AUTO OTHER THAN EAACC $ AUTO ONLY: AGG $ OESS LlABJUTY EACH OCCURRENCE $ OCCUR 0 CLAIMS MADE AGGREGATE $ $ ~ DEDUCT'BLE $ RETENTION $ $ WORKERS COMPENSATION AND I T~~ilfJJ~S I IOJ~- EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERlEXECUTlVE E.l. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.l. DISEASE. EA EMPLOYEE $ ~~~~~~~~~~~NS below E.L. DISEASE. POLICY LIMIT $ OTHER DESCRIPTION OF OPERATJONSJLOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS It is agreed that City of Santa Ana and Santa Ana Empowerment Corp. is included as an Additional Insured as respects to General Liability. ,\ ["flIt,:) "',' l~U AS ro rOKA-,] CERTIFICATE HOLDER '-/'-P'A' /. CANCELLATION - ,'~7fL~ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION -. DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ . . . .""~"''''')' DAYS WRmEN ] -L :;v Au,,;' :.~ \, NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR Ci ty of Santa Ana and Santa Ana Empowerment Corp. REPRESENTATIVES. 20 Civic Center Plaza, M-21, PO Box 1988 ArlQ-EWnSENTATIVE Santa Ana, CA 92702 . .j. ACORD 25 (2001J08) Coll.1684855 Tpl.520840 Cert.7520116 @ACORDCORPORATION 1988 C,Il' Page 2 of 2 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate hoider in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the tenns and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the Issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. /\TI}R{)\/;"D j.\" T'(, ~-' l,j i (./ F()j-\.;...l "~'^-.- _~L~ ,_.::..!.~:.~~~ ~=-;:--_._--- [21:1. C.it)' A.i, ";--,,-, ACORD 25 (2001/08) Coll:1684855 Tpl:520840 Cert:7520116 ADDITIONAL INSURED ENDORSEMENT FOR COMMERCIAL GENERAL LIABILITY POLICY Insurance Company: American Unity GrouP. Ltd. This endorsement modifies such insurance as is afforded by the provisions of Policy # UNI-CGL-06-0l-022 (1-14601-00-06) relating to the following: 1. The Santa Ana Empowerment Corporation and the City of Santa Ana, 20 Civic Center Plaza, PO Box 1988, Santa Ana, California 92702; its officers employees, agents, volunteers and representatives are named as additional insureds ("additional insureds") with regard to liability and defense of suits arising from the operations and uses performed by or on behalf of the named insured. 2. With respect to claims arising out of the operations and uses performed by or on behalf of the named insured, such insurance as is afforded by this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of the additional insureds. 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the company's limits of liability. The inclusion of any person or organization as an insured shall not affect any right which such person or organization would have as a claimant if not so included. 4. With respect to the additional insureds, this insurance shall not be cancelled, or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the Santa Ana Empowerment Corporation, Inc., 20 Civic Center Plaza (M- 21), PO Box 1988, Santa Ana, California 92702. (Completion of the following, including countersignature, IS required to make this endorsement effective.) Endorsement # A3 Effective 06/30/06 to 06/30107, this endorsement form as a part of Policy # UNI-CGL-06-0 1-022 (1-14601-00-06). Countersigned by . ,,":' u ,. .:.:,;.) AS TO F{)Rl\:l ~~~- .~ Authorized Representative Issued to St. Joseph Health Svstem Named Insured ACORD,. PRODUCER 877-945-7378 DATE 07/11/2006 THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. CERTIFICATE OF LIABILITY INSURANCE Page 1 of 2 Willis North America, ~nc. 26 Century Blvd. P. O. Box 305191 Nashville, TN 372305191 INSURERS AFFORDING COVERAGE NAIC# INSURED 'l'aller San Jose 801 N. Broadway Santa Ana, CA 92704 INSURER A: Hartford Insurance C an of the Midwest 37478-001 INSURER B: INSURER C: INSURER 0: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO AlL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DO' TYPE Of INSURANCE POLICY NUMBER P8k~Xi~)g~f "8k!fl,~..r,b'g'J!,.~N LIMITS LT. NS. ~NERAl LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY ~~~~~$9E~~~' $ l CLAIMS MADE D OCCUR MEDEXP(Anv~e~soo) $ ~ PERSONAL & ADV INJURY $ ~ GENERAl AGGREGATE $ nN'LAGG:nE ;~~ APMSIPER; PROOUCTS.COM~OPAGG $ POLICY JECT LOC ~UTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ~ ANY AUTO (Eaaccident) I- ALL OWNED AUTOS BODILY INJURY $ I- SCHEDULED AUTOS (PerpersOll) ~ HIRED AUTOS BODILY INJURY (Per accident) $ ~ NON.OWNEDAUTOS ~ PROPERTY DAMAGE $ (Peraccidenl) RRAGE LIABILITY . AUTO ONLY. EA ACCIDENT $ ANY AUTO OTHER THAN EAACC $ AUTO ONLY; AGG $ t~rSs LIABILITY EACH OCCURRENCE $ OCCUR D CLAIMS MADE AGGREGATE $ $ ~ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND 72WNC93300 5/31/2006 5/31/2007 X I T~~IfJHs I 10TH. A E. EMPLOYERS' UABILITY ANY PROPRIETORlPARTNERlEXECUTIVE E.L. EACH ACCIDENT $ 1 000 000 OFFICERlMEMBER EXCLUDED? E.L DISEASE. fA EMPLOYEE $ 1 000 000 Ifyes,descnbeunder E.L. DISEASE. POLICY LIMIT $ 1 000 onn SPECIAL PROVISIONS below OruER !\l?PH.() ''/ 1 ',:; f':..::) TO FOJl/,A DESCRIPTION OF OPERATlONSlLOCATlONSNEHICLESIEXCLUSIONSADDED BY ENDORSEMENT/SPECIAL PROVISIONS ----. -- -~ ~,,'\1.':',. (.., '~~'~j;..~,;dj-- i\"'",_;U: 'l,~iiV AtL;r!~W CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSU;ING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR City of Santa Ana and Santa Ana EDl.powerment Corp. 20 Civic Center Plaza, M-21, PO Box 1988 Santa Ana, CA 92702 ACORD 25 (2001/08) Co11:1684859 Tp1:504710 @ACORDCORPORATION1988 (J, t, Page 2 of 2 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy{ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement{s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement{s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer{s), authorized representative or producer, and the certificate holder. nor does it affirmatively or negativeiy amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001/08) Coll:1684859 Tpl:504710 Cert:7520120