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AGREEMENT TERMINATION
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questions.
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Signature:
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Department:
Date:
Revised 8-7-03
City of Santa Ana
Clerk of the Council
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I. SUBRECIPIENT'S OBLIGATIONS
A. Non-Profit Status - Representations and Warranties.
(a) Authority. SUBRECIPIENT is a duly organized and existing non-profit corporation
in good standing and authorized to do business under the laws of the State ofCalifomia.
SUB RECIPIENT has full right, power and lawful authority to accept the funding hereunder and
to undertake all obligations as provided herein and the execution, performance and delivery of
this Agreement by SUBRECIPIENT has been fully authorized by all requisite actions on the part
of SUB RECIPIENT.
(b) Experience. SUB RECIPIENT is a qualified provider of the services to be provided
hereunder.
(c) Familiarity With Services Required. By executing this Agreement,
SUB RECIPIENT warrants that (i) it has thoroughly investigated and considered the services to
be performed and provided hereunder, (ii) it has carefully considered how the services should be
performed, and (iii) it fully understands the facilities, difficulties and restrictions attending
performance of the services under this Agreement.
(d) No Conflict. To the best of SUB RECIPIENT'S knowledge, SUBRECIPIENT'S
execution, delivery and performance of its obligations under this Agreement will not constitute a
default or a breach under any contract, agreement or order to which SUB RECIPIENT is a party
or by which it is bound.
(e) No Bankruptcy. SUBRECIPIENT is not the subject of any current or threatened
bankruptcy proceeding.
(f) No Pending Legal Proceedings. SUBRECIPIENT is not the subject of a current or
threatened litigation that would or may materially affect SUBRECIPIENT'S performance under
this Agreement.
(g) Application Veracity. All provisions of and information provided in
SUBRECIPIENT'S application for funding submitted to CITY including any exhibits are true
and correct in all material respects.
(h) No Pending Investigation. SUB RECIPIENT is not aware that it is the
subject of any current or threatened criminal or civil action investigation by any public agency,
including without limitation a police agency or prosecuting authority, that would relate to affect
performance of the Agreement or provision of services hereunder.
B. Amount of Grant and Quarterly Disbursement. The amount granted to
SUB RECIPIENT is $ 5,000("CDBG FUNDS"), and such funds shall be expended by
SUBRECIPIENT on or before June 30, 2007. The CDBG FUNDS shall be disbursed by CITY
to SUBRECIPIENT on a quarterly basis (October, January, April and July) subject to and upon
receipt and approval of a complete quarterly activity report from SUBRECIPIENT, with the final
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payment subject to the satisfaction of the condition precedent of submittal of complete reporting
information due on or before July 15 of the applicable funding year, as hereinafter more fully set
forth. SUBRECIPIENT shall be obligated to perform such duties as would normally extend
beyond the term, including but not limited to obligations with respect to indemnification, audits,
reporting, data retention/reporting, and accounting.
C. Use of Funds. SUB RECIPIENT agrees to use all federal funds provided by CITY to
SUB RECIPIENT pursuant to this Agreement to operate said program, as set forth in "Exhibit A,"
attached hereto and by this reference incorporated herein. SUBRECIPIENT'S failure to perform as
required may, in addition to other remedies set forth in this Agreement, result in readjustment ofthe
amount of funds CITY is otherwise obligated to pay to SUBRECIPIENT hereunder.
D. Allowable Costs. SUBRECIPIENT agrees to complete said program on or before
June 30, 2007 and to use said funds to pay for necessary and reasonable costs allowable under the
federal law and regulations to operate said program. Said amounts shall include, but not be limited
to, wages, administrative costs, and employee benefits comparable to other similarly situated
employees. Other allowable program costs are detailed in the Budget, as set forth in "Exhibit B,"
attached hereto and by this reference incorporated herein. SUB RECIPIENT shall use all income
received from said funds only for the same purposes for which said funds may be expended
pursuant to the terms and conditions of this Agreement.
E. Licensing. SUB RECIPIENT agrees to obtain and maintain all required licenses,
registrations, accreditation and inspections from all agencies governing its operations.
SUBRECIPIENT shall ensure that its staff shall also obtain and maintain all required licenses,
registrations, accreditation and inspections from all agencies governing SUBRECIPIENT's
operations hereunder. Such licensing requirements include obtaining a City business license, as
applicable.
F. Zoning. SUBRECIPIENT agrees that any facility/property used in furtherance of
said program shall be specifically zoned and permitted for such use(s) and activity(ies). Should
SUB RECIPIENT fail to have the required land entitlement and/or permits, thus violating any local,
state or federal rules and regulations relating thereto, SUB RECIPIENT shall immediately make
good-faith efforts to gain compliance with local, state or federal rules and regulations following
written notification of said violation(s) from the CITY or other authorized citing agency.
SUBRECIPIENT shall notify CITY immediately of any pending violations. Failure to notify CITY
of pending violations, or to remedy such known violation(s) shall result in termination of grant
funding hereunder. SUBRECIPIENT must make all corrections required to bring the
facility/property into compliance with the law within sixty (60) days of notification of the
violation(s); failure to gain compliance within such time shall result in termination of grant funding
hereunder.
G. Separation of Accounts. All funds received by SUBRECIPIENT from CITY
pursuant to this Agreement shall be maintained in an account in a federally insured banking or
savings and loan institution with record keeping of such accounts maintained pursuant to applicable
OMB Circular A-110 requirements. SUBRECIPIENT is not required to maintain separate
depository accounts for CDBG FUNDS; provided however, the SUBRECIPIENT must be able to
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account for receipt, obligation and expenditure of CDBG FUNDS pursuant to applicable OMB
Circular A-II0 requirements.
H. Audit Report Requirements. SUB RECIPIENT agrees that if SUB RECIPIENT
receives Three Hundred Thousand Dollars ($300,000.00) or more in federal funds,
SUBRECIPIENT shall have an annual audit conducted by a certified public accountant in
accordance with the standards as set forth and published by the United States Office of Management
and Budget. SUBRECIPIENT shall provide CITY with a copy of said audit by October 1 of the
year following the program year in which this Agreement is executed.
L Record Keeping/Reporting. SUBRECIPIENT shall keep and maintain complete and
adequate records and reports to assist CITY in meeting and maintaining its record keeping
responsibilities under the CDBG REGS, including the following:
(1) Records
a. Documentation evidencing program income requirements in
conformity with 24 CFR 570.504(b((2)(i), (ii) and 24 CFR 570.503(b)(3) and 24
CFR 570.208(a)(2)(B) of the income level of persons and/or families participating
in or benefiting by the SUB RECIPIENT program.
b. Documentation of the number of persons and/or families participating
in or benefiting by the SUB RECIPIENT program.
c. Household information shall include number of persons, identification
of head of household, race/ethnicity, and income verification.
d. Documentation of all CDBG FUNDS received from CITY.
e. Documentation of expenses as identified in the Budget Proposal,
including evidence of incurring the expense, invoices for goods or services, copies
of any and all contracts or documentation pertaining to costs for subcontractors,
plus all other invoices for which CDBG FUNDS were expended, and any payments
therefor.
f. Any such other related records as CITY shall reasonably require or as
required to be maintained pursuant to the CDBG REGS.
(2) Reports
(i) Payment Request. Concurrently with the submittal of each
quarterly report, on or before the 15th day of October, January,
April and July, SUBRECIPIENT shall submit both: an original
invoice and true copies of invoices, receipts, agreements, copies
of any and all contracts or documentation pertaining to costs for
subcontractors or other documentation supporting and
evidencing how the CDBG FUNDS have been expended during
the applicable quarter.
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(ii) Quarterly Activity Report: SUB RECIPIENT agrees to keep monthly
records of all ethnic and racial statistics of persons and families benefited by
SUB RECIPIENT in the performance of its obligations under this Agreement,
including, but not limited to, the number of low and moderate income persons
and households assisted in accordance with federal income limits, the number
of female heads of households assisted, new program information and year-to-
date program statistics on expenditures, case load and activities.
J. Access to Records. CITY and the United State Government and/or their representatives
shall have access for purposes of monitoring, auditing, and examining SUB RECIPIENT's activities
and performance, to books, documents and papers, and the right to examine records of
SUBRECIPIENT's subcontractors, bookkeepers and accountants, employees and participants in
regard to said program. CITY and the United States Government and/or their representatives shall
also schedule on-site monitoring at their discretion. Monitoring activities may also include, but are
not limited to, questioning employees and participants in said program and entering any premises or
any site in which any of the services or activities funded hereunder is conducted or in which any of
the records of SUB RECIPIENT are kept. Nothing herein shall be construed to require access to any
privileged or confidential information as set forth in federal or state law.
K. Location of Records/Required Length of Record Keeping. All accounting records,
reports, and evidence pertaining to all costs, expenses and the CDBG FUNDS of
SUB RECIPIENT and all documents related to this Agreement shall be maintained and kept
available at SUBRECIPIENT'S office or place of business for the duration of the Agreement and
thereafter for five (5) years after completion of an audit in conformity with the CDBG REGS's.
Records which relate to (a) complaints, claims, administrative proceedings or litigation arising
out of the performance of this Agreement, or (b) costs and expenses of this Agreement to which
CITY or any other governmental agency takes exception, shall be retained beyond the five (5)
years until complete resolution or disposition of such appeals, litigation claims, or exceptions. In
the event SUBRECIPIENT does not make the above-referenced documents available within the city
of Santa Ana, California, SUBRECIPIENT agrees to pay all necessary and reasonable expenses
incurred by CITY in conducting any audit at the location where said records and books of account
are maintained.
L. Compliance with LawlProgram Income. SUBRECIPIENT acknowledges that the funds
being provided by CITY for said program are received by CITY pursuant to the ACT as amended
and that expenditures of these funds shall be in accordance with the ACT and all pertinent
regulations issued by agencies of the federal government, including, but not limited to, all
regulations found at Title 24 of the Code of Federal Regulations. Program income received by
SUB RECIPIENT shall be returned to CITY unless otherwise provided for in this Agreement.
SUB RECIPIENT 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.
M. Standing. SUB RECIPIENT 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 SUB RECIPIENT shall be reported immediately to CITY.
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N. Confidentiality. Without prejudice to any other provIsIOns of this Agreement,
SUBRECIPIENT shall, where applicable, maintain the confidential nature of information provided
to it concerning participants in accordance with the requirements of federal and state law. However,
SUB RECIPIENT shall submit to CITY and or HUD or its representatives, all records requested,
including audit, examinations, monitoring and verifications of reports submitted by
SUBRECIPIENT, costs incurred and services rendered hereunder.
O. Independent Contractor. SUBRECIPIENT agrees that the performance of
obligations hereunder is rendered in its capacity as an independent contractor and that it is in no way
an agency of CITY.
P. Violation of Terms and Conditions. SUBRECIPIENT agrees that if
SUB RECIPIENT violates any of the terms and conditions of this Agreement or any prior
Agreement whereby CDBG funds were received by SUBRECIPIENT, or if SUBRECIPIENT
reports inaccurately, or if on audit there is a disallowance of certain expenditures, SUB RECIPIENT
agrees to remedy the acts or omissions causing the disallowance and repay CITY all amounts spent
in violation thereof. If SUBRECIPIENT engaged in fraudulent activity to obtain and/or justify
expenditure of the CDBG funds granted hereunder, SUB RECIPIENT shall be required to reimburse
the CITY of all such funds that were obtained/spent under fraudulent circumstances.
Q. Equipment. SUB RECIPIENT agrees to maintain a record for each item of non-
expendable personal property acquired under the terms of this Agreement. Said record shall be
made available to CITY upon request. The term "non-expendable personal property" shall include
leased and purchased equipment.
R. Prohibited Use. SUBRECIPIENT hereby certifies and agrees that it will not use
funds provided through this Agreement to pay for entertainment, meals or gifts.
S. Lobbving. SUB RECIPIENT certifies that it will comply with federal law (31
U.S.C. 1352) and regulations found at 24 CFR Part 87, which provide that no appropriated funds
may be expended by the recipient of a federal contract, grant, loan or cooperative agreement to pay
any person for influencing or attempting to influence an officer or employee of any agency,
Member of Congress, or an officer or employee of a Member of Congress in connection with
awarding of any federal contract, the making of any federal grant or loan, entering into any
cooperative agreement and the extension, renewal, amendment or modification of any federal
contract, grant, loan or cooperative agreement. SUBRECIPIENT shall sign a certification to that
effect in a form as set forth in "Exhibit C," attached hereto and by this reference incorporated herein.
SUBRECIPIENT shall submit said signed certification to CITY prior to performing any of its
obligations under this Agreement and prior to any obligation arising on the part of CITY to pay any
sums to SUB RECIPIENT 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
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Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the
undersigned shall complete and submit a "Disclosure Form to Report Lobbying," in accordance
with its instructions (see C-l).
T. Financial Interest. SUB RECIPIENT agrees that except for the use ofCDBG funds
to pay salaries and other related administrative or personnel costs, no persons who exercise or have
exercised any function with respect to CDBG activities assisted under the terms of this Agreement,
or who are in a position to participate in a decision-making process or gain inside information with
regard to such activities, may obtain a financial interest or benefit from a CDBG-assisted activity of
SUB RECIPIENT , either for themselves or those with whom they have family or business ties,
during their tenure or for one year thereafter. This prohibition applies to any person who is an
employee, agent, consultant, officer, or elected or appointed official of CITY, or of
any designated public agencies, or the SUBRECIPIENT.
U. Davis-Bacon Act. All laborers and mechanics employed by contractors or
subcontractors in the performance of construction work, including alterations and repairs, in excess
of $2,000.00, financed in whole or in part with federal funds shall be paid wages at rates not less
than those prevailing on similar construction in the locality as determined in accordance with the
Davis-Bacon Act, as amended, 40 U.S.C. sections 276a - 276a-5. Any such construction contract
shall include and comply with the required contract provisions and rules set forth in 29 C.F.R. g5.5.
Further, the payroll reports (along with the "Statement of Compliance") and basic records are
required to be maintained and submitted, or made available, pursuant to 29 C.F.R. g5.5(a)(3). No
payment, advance, grant, loan or guarantee of funds shall be approved by the federal agency unless
there is on file with the agency a certification by the contractor that the contractor and its
subcontractors have complied with the provisions of 29 C.F.R. g5.5. A breach of the contract
clauses in 29 C.F.R. g5.5 may be grounds for termination of the contract, and for debarment as a
contractor/subcontractor, as provided in 29 C.F.R. g5.12. Labor standards interviews/investigations
shall be made as necessary to assure compliance [29 C.F.R. g5.6(a)(3)].
V. Drug Free Workplace. SUBRECIPIENT certifies that it has established the following
drug-free workplace policy:
1. The unlawful manufacture, distribution, dispensing, possession or use of a
controlled substance is prohibited in the workplace for any employee involved in a federally funded
program.
2. As an employee working in conjunction with a federally funded program, the
employees of SUBRECIPIENT will be required to:
a) Abide by the terms above in statement 1.
b) Notify appropriate officials of SUBRECIPIENT and CITY officials of
any criminal drug statute conviction for a violation occurring in the workplace not
later than five days after such conviction.
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3. The CITY and the United State Department of Housing and Urban
Development will be notified within ten days after receiving notice of any such violation.
4. Within 30 days of receiving such notice, appropriate personnel action will be
taken against such employee, up to and including termination.
Each such employee shall be required to participate satisfactorily in a drug abuse
assistance or rehabilitation program approved for such purposes by a federal, state or local health,
law enforcement, or other appropriate agency.
II. CITY'S OBLIGATIONS
A. Payment of Funds. Upon execution of this Agreement by SUBRECIPIENT, CITY shall
pay to SUBRECIPIENT from CDBG funds, when, if and to the extent received from HUD, for
CITY's 2006-07 CDBG program year amounts expended by SUBRECIPIENT in carrying out said
program for fiscal year 2006-07 pursuant to this Agreement up to a maximum aggregate payment
of Five Thousand Dollars ($ 5,000) in installments determined by CITY. Payments shall be made
to SUBRECIPIENT through the submission of invoices on a quarterly basis (October, January, April
and July) in a form prescribed by CITY, detailing such expenses. CITY shall pay such invoices
within thirty (30) days after receipt thereof provided CITY is satisfied that such expenses have been
incurred and documented within the scope and provisions of this Agreement and that
SUBRECIPIENT is in compliance with the terms and conditions of this Agreement.
B. Audit of Account. CITY shall include an audit of the account maintained by
SUBRECIPIENT in CITY's annual audit of all CDBG FUNDS in accordance with Title 24 of
the Code of Federal Regulations and other applicable federal laws and regulations.
C. Common Rule: Pursuant to CFR 85.40(a), the CITY manages the day-to-day
operations of each grant and sub grant supported activities. CITY staffhas detailed knowledge of the
grant program requirements and monitors grant and sub grant supported activities to assure
compliance with Federal requirements. Such monitoring covers each program, function and activity
and performance goals are reviewed periodically.
D. Environmental Review: In accordance with 24 CFR 58, the CITY is responsible for
undertaking environmental review and maintaining environmental review records for each
applicable project.
E. Performance Monitoring: CITY shall monitor the performance of the
SUB RECIPIENT against goals and performance standards required herein. Substandard
performance as determined by the CITY will constitute non-compliance with this Agreement. If
action to correct such substandard performance is not taken by the SUB RECIPIENT within a
reasonable period of time after being notified by the CITY, contract suspension or termination
procedures will be initiated.
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III. NONDISCRIMINATION
SUBRECIPIENT agrees that no person on the ground of race, age, color, national origin,
religion or sex will be excluded from participation in, be denied the benefits of, or be subjected to
discrimination under any program or activity funded in whole or in part with CDBG funds.
IV. CONFLICT OF INTEREST
Pursuant to the conflict of interest requirements set forth in 24 CFR 576.57 and OMB
Circulars 1-102 and A-IlO, SUBRECIPIENT agrees that no officer, employee, agent or assignee of
CITY having direct or indirect control of any CDBG monies granted to the CITY, inclusive of the
subject CDBG FUNDS, shall serve as an officer of SUBRECIPIENT. Further, any conflict or
potential conflict of interest of any officer of SUB RECIPIENT shall be fully disclosed in writing
prior to the execution of this Agreement and said writing shall be attached and deemed fully
incorporated as a part hereof. Notice shall be sent by SUBRECIPIENT to CITY regarding any
changes or modifications to its board of directors and list of officers.
V. SPECIAL CERTIFICATION FOR RELIGIOUS ENTITIES
If SUBRECIPIENT is a religious entity, SUB RECIPIENT hereby agrees that in connection
with the provision of the services SUBRECIPIENT shall provide with CDBG funds, in accordance
with 24 CFR 570.200(j):
A. SUBRECIPIENT shall not discriminate against any employee or applicant for
employment on the basis of religion and shall not limit employment or give preference in
employment to persons on the basis of religion.
B. SUBRECIPIENT shall not discriminate against any person applying for the services
SUB RECIPIENT agrees to provide under the terms of this Agreement on the basis of religion and
shall not limit such services or give preference to applicants for such services on the basis of
religion.
C. SUBRECIPIENT shall NOT provide religious instruction or counseling, conduct
any religious worship or services, or engage in any religious proselytizing, or exert any religious
influence in the provision of the services in said program. The parties agree that this covenant is
intended to and shall be construed for the limited purpose of assuring compliance with respect to the
use of CITY funds by SUBRECIPIENT with applicable constitutional limitations respecting the
establishment of religion as set forth in the establishment clause under the First Amendment of the
United States Constitution and Article I, Section 4 of the California Constitution, and is not in any
manner intended to restrict other activities of SUB RECIPIENT.
D. Where the services to be provided under said program are rendered on property
owned by the primarily religious entity SUB RECIPIENT, CDBG funds may also be used for minor
repairs to such property which are directly related to the cost of rendering the services under said
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program, where the cost constitutes in dollar terms only an incidental portion of the CDBG
expenditure for rendering the services under said program.
VI. PROHIBITION OF NEPOTISM
SUBRECIPIENT agrees not to hire or permit the hiring of any person to fill a position
funded through this Agreement if a member of that person's immediate family is employed in an
administrative capacity by SUBRECIPIENT. For the purposes of this section, the term "immediate
family" means spouse, child, mother, father, brother, sister, brother-in-law, sister-in-law, father-in-
law, mother-in-law, son-in-law, daughter-in-law, aunt, uncle, niece, nephew, stepparent and
stepchild. The term "administrative capacity" means having selection, hiring, supervisor or
management responsibilities.
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:
City of Santa Ana
Community Development Agency (M-25)
20 Civic Center Plaza
P.O. Box 1988
Santa Ana, California 92702-1988
TO SUBRECIPIENT:
Judith K. Murphy
Executive Director
Hotline of Southern California
P.O. Box 32
Los Alamitos, CA 90720
VIII. ASSIGNABILITY
None of the duties of, or work to be performed by, SUBRECIPIENT under this Agreement
shall be subcontracted or assigned to any agency, consultant, or person without the prior written
consent of CITY. SUBRECIPIENT must submit all subcontracts and other agreements that relate
to this Agreement to CITY. No subcontract or assignment shall terminate or alter the legal
obligations of SUB RECIPIENT pursuant to this Agreement.
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IX. HOLD HARMLESS
SUBRECIPIENT shall indemnify, defend and save harmless CITY, its officers, employees,
agents, representatives and volunteers from and against any and all damages to or for loss of use of
property and for injuries to or death of any person or persons, including property and employees or
agents of CITY, and shall defend, indemnify and save harmless CITY, its officers, employees,
agents, representatives and volunteers from and against any and all claims, demands, suits, actions
or proceedings of any kind or nature, including, but not by way of limitation, workers compensation
claims and including attorney fees and reasonable expenses for litigation or settlement, resulting
from or arising out of the negligent or wrongful acts, errors or omissions of SUBRECIPIENT, its
officers, directors, employees, agents, subcontractors and suppliers arising out of
SUBRECIPIENT's performance of this Agreement.
X. INSURANCE
A. In accordance with the provisions of Section 3300 ofthe Labor Code, if
SUBRECIPIENT has any employees it is required to be insured against liability for worker's
compensation or to undertake self-insurance. Prior to commencing performance of this
Agreement, SUBRECIPIENT agrees to obtain and maintain employer's liability insurance with
limits not less than $1,000,000 per accident. If SUB RECIPIENT has no employees, nor
workers' compensation coverage, it must execute a Declaration available from the CITY, and
update as is necessary.
B. SUBRECIPIENT shall undertake self-insurance, or shall obtain, at its sole cost, a
policy or policies of commercial general liability insurance, or equivalent form, with a combined
single limit of not less than $1,000,000 per occurrence.
Such insurance shall: (1) name the City of Santa Ana, its officers, agents,
representatives, employees and volunteers as additional insured's; (2) be primary with respect to
insurance or self-insurance programs maintained by the CITY; (3) contain standard separation of
insured's provisions; and (4) give to CITY prompt and timely notice of claim made or suit
instituted arising out of SUBRECIPIENT' s operations hereunder.
SUB RECIPIENT shall: (a) prior to exercising any right under this Agreement,
furnish properly executed certificates of insurance and additional insured endorsement to the
CITY which shall clearly evidence all coverages required above; (b) provide that such insurance
shall not be materially changed or terminated except on 30 days prior written notice to the CITY;
(c) maintain such insurance for the period covered by this Agreement; and (d) replace such
certificates for policies expiring prior to the expiration of this Agreement.
XI. REVERSION OF ASSETS
A. Upon the expiration of this Agreement, SUB RECIPIENT shall transfer to CITY any
CDBG funds on hand at the time of the expiration of this Agreement as well as any accounts
receivable attributable to the use of CDBG funds. [24 CFR 570.503(b )(8).]
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B. Any real property under SUBRECIPIENT's control that was acquired or improved
in whole or in part with CDBG funds in excess of $25,000.00 must either be:
1. Used, where CITY has given written approval, to meet one of the national
objectives stated in 24 CFR 570.208 until five (5) years after expiration of this Agreement, or for
such longer period of time as determined to be appropriate by CITY; or
2. If not used in accordance with subparagraph A above, SUB RECIPIENT
shall pay to CITY an amount equal to the current fair market value of the property less any portion
of the value attributable to the expenditure of non-CDBG funds for acquisition of, or improvement
to, the property. Such payment is program income to CITY.
C. Subject to the obligations set forth herein, title to equipment acquired under the
terms of this Agreement will vest upon acquisition in SUBRECIPIENT. When said equipment
which has been acquired in accordance with this Agreement and all applicable regulations is no
longer needed for said program, disposition of said equipment will be made as follows:
1. Items of equipment with a current per unit fair market value of less than
$5,000.00 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, in accordance with 24 CFR 85.32(e)(2).
D. SUBRECIPIENT hereby agrees, upon the demand of CITY, to execute,
acknowledge and deliver, or cause any person or entity who may have any claim to rights hereunder
or under any document, instrument or agreement executed in furtherance of the services and
activities to be performed hereunder, to execute, acknowledge and deliver, to CITY assignment(s),
quit claim deed(s) or such other and further instruments, documents and agreements as may be
necessary, in the sole and absolute discretion of CITY, to vest in CITY all of SUBRECIPIENT's
right, title and interest (if any it may have) in and to CITY, CDBG or other federal, state and/or
local accounts or program funds or allocation of funds to which CITY is or may be entitled, either
for its own account or as fiduciary or trustee for others, which were obtained for the purpose of the
performance of this Agreement or any previous agreements relating to the same subject matter or
activities as this Agreement, together with any instruments, loans, grants or advances by
SUBRECIPIENT on behalf of CITY, in furtherance of the activities hereunder or thereof.
SUBRECIPIENT's obligations and responsibilities set forth in this paragraph "XI.
REVERSION OF ASSETS," and in paragraph "XII. TERMINATION" and other requirements
pertaining to program income shall not be affected by the termination of this Agreement and shall
survive the date of termination of this Agreement for such period of time as CITY and/or Hun
deems necessary for the responsibilities, duties and obligations to be performed and completed to
the satisfaction of CITY and HUD.
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XII. TERMINATION
A. This Agreement may be terminated on thirty (30) days' written notice by either
party. In the event of such termination, SUB RECIPIENT shall only be entitled to reimbursement
for approved expenses incurred to the effective date of termination.
B. This Agreement may be suspended or terminated by CITY upon five (5) days'
written notice for violation by SUBRECIPIENT of Federal Laws governing the use of Community
Development Block Grant Funds. In the event of such suspension or termination, SUBRECIPIENT
shall only be entitled to reimbursement for approved expenses incurred up to the effective date of
suspension or termination.
C. Pursuant to 24 CFR 85.43, in the event SUBRECIPIENT defaults by failing to fulfill
all or any of its obligations hereunder, CITY may declare a default and termination of this
Agreement by written notice to SUBRECIPIENT, which default and termination shall be effective
on a date stated in the notice which is to be not less than ten (10) days after certified mailing or
personal service of such notice, unless such default is cured before the effective date of termination
stated in such notice. If terminated for cause, CITY shall be relieved of further liability or
responsibility under this Agreement, or as a result of the termination thereof, including the payment
of money, except for payment for approved expenses incurred for services satisfactorily and timely
performed prior to the mailing or service of the notice of termination, and except for reimbursement
of (1) any payments made for services not subsequently performed in a timely and satisfactory
manner, and (2) costs incurred by CITY in obtaining substitute performance.
D. The grant of funds under this Agreement may be terminated for convenience in
accordance with 24 CFR 85.44.
E. The grant of funds under this Agreement may be terminated due to the non-
performance of SUB RECIPIENT and/or failure of SUBRECIPENT to perform the work described
in Exhibits A and B or failure to meet the performance standards and program goals set forth
therein.
F. In the event this Agreement is terminated as set forth in subparagraphs XII.A.
through XII.E., inclusive, SUB RECIPIENT agrees to immediately return to CITY upon CITY's
demand and prior to any adjudication of SUB RECIPIENT's rights, any and all funds not used, and
to comply with paragraph "XI. REVERSION OF ASSETS" ofthis Agreement.
XIII. LIMITATION OF FUNDS
The United States of America, through HUD, may in the future place programmatic or fiscal
limitations on the use ofCDBG 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,
13
5/05
reduce the budget of this Agreement as a whole or as to costs category, may limit the rate of
SUBRECIPIENT's authority to commit and spend funds, or may restrict SUBRECIPIENT's use of
both its uncommitted and its unspent funds. Where HUD has directed or requested CITY to
implement a reduction in funding, in whole or as to a cost category, with respect to funding for this
Agreement, CITY's City Manager or delegate is authorized to act for CITY in implementing and
effecting such a reduction and in revising, modifying, or amending the Agreement for such
purposes. If such a reduction in funding occurs, SUBRECIPIENT shall be permitted to de-scope
accordingly. Where CITY has reasonable grounds to question SUBRECIPIENT's fiscal
accountability, fmancial soundness, or compliance with this Agreement, CITY may suspend the
operation of this Agreement for up to sixty (60) days upon five (5) days written notice to
SUBRECIPIENT of its intention to so act, pending an audit or other resolution of such questions.
In no event, however, shall any revisions made by CITY affect expenditures and legally binding
commitments made by SUB RECIPIENT 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.
XlV. EXCLUSIVITY AND AMENDMENT OF AGREEMENT
This Agreement supersedes any and all other agreements, either oral or in writing, between
the parties hereto with respect to the use of CITY's CDBG funds by SUB RECIPIENT and contains
all the covenants and agreements between the parties with respect to such employment in any
manner whatsoever. Each party to this Agreement acknowledges that no representations,
inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone
acting on behalf of any party, which are not embodied herein, and that no other agreement or
amendment hereto shall be effective unless executed in writing and signed by both CITY and
SUBRECIPIENT.
XV. LAWS GOVERNING THIS AGREEMENT
This Agreement shall be governed by and construed in accordance with the laws of the State
of California, and all applicable federal laws and regulations.
XVI. VALIDITY
The invalidity in whole or in part of any provision of this Agreement shall not void or affect
the validity of any other provision of this Agreement.
XVII. MISCELLANEOUS PROVISIONS
a. Each undersigned represents and warrants that its signature herein below has the power,
authority and right to bind their respective parties to each of the terms of this Agreement, and shall
14
5/05
indemnify CITY fully, including reasonable costs and attorney's fees, for any injuries or damages to
CITY in the event that such authority or power is not, in fact, held by the signatory or is withdrawn.
b. All Exhibits and Attachments referenced herein and attached hereto shall be
incorporated as if fully set forth in the body ofthis Agreement.
c. No delay or omission by either party hereto to exercise any right or power accruing
upon any noncompliance or default by the other party with respect to any of the terms of this
Agreement shall impair any such right or power or be construed to be a waiver thereof. A
waiver by either of the parties hereto of any of the covenants, conditions, or agreements to be
performed by the other shall not be construed to be a waiver of any succeeding breach thereof
or of any other covenant, condition or agreement herein contained.
15
5/05
IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the last date and
year written below.
ATTEST:
CITY (17AANA
( ~-
DAVID N. REAM
City Manager
PAT CIAE. HEALY
Clerk of the Council
APPROVED AS TO FORM:
JOSEPH W. FLETCHER
City Attorney
~~ (" ~
By: LISA E. STORCK
Assistant City Attorney
SUBRECIPIENT:
DATE:
~~ <;f ~
Name: Jeanne St. Clair
Title: President
Tax ID: 23-7392224
16
City of Santa Ana
Community Development Block Grant
Scope of Work
Name of Organization- Hotline of Southern California
Name of Funded Program- Hotline
Annual Accomplishment Goal
I. Total number of un duplicated clients (Santa Ana and Non-Santa Ana Residents) anticipated to be served by
the funded program, named above, during the 12-month contract period.
30.500 PERSONS
II. Number of only unduplicated Santa Ana residents to be served by the funded program, named above,
during the 12-month contract period.
3,015 PERSONS
Program and Funding Description
III. Description of Work - In the space below, describe the program to be funded during the 12-month
contract period.
The Hotline provides crisis counseling using trained volunteers who will provide non-judgmental, empathetic listening via the
telephone. In additon, they will provide current information and referral to the many agencies and community programs that can
help them with homelessness, fmancial assistance, clothing, food, legal aid, the loss of a loved one, treatment programs for alcohol
and drugs, healthcare, and mental health services. We will seek intervention if they are in crisis and notify family, friends or
healthcare professionals, if necessary.
IV. Activities funded by this grant - How will CDBG funds be used for the funded program? Narratively
describe the budget for the funded program illustrated in Exhibit B and B-1.
The Hotline will help at least 3,015 residents, individuals and families, from the City of Santa Ana in 2006-2007. The Hotline
volunteers and executive director will provide crisis counseling and current information and referral. They will seek intervention, if
required, and track clients at risk who need additional assistance. All clients will be logged into the outcomes database and tracked
to conclusion. The executive director dedicates 84% of her time to program services. She oversees the volunteers and provides
assistance on the crisis lines.
Exhibit A
Page 1 of2
Schedule of Performance
Estimate the number of only unduplicated Santa Ana residents to be served by the funded program during the
12-month contract period per quarter. (How many new Santa Ana clients will be served each quarter.)
Quarter 1: Julyl - September 30
Quarter 2: October! - December 31
Quarter 3: January 1 - March 31
Quarter 4: April 1 - June 30
753 Persons
754 Persons
754 Persons
754Persons
3015 Total number ofunduplicated Santa Ana residents to be
served. (Must equal the number for II above.)
Schedule of Invoicing
Estimate the amount of grant funds to be requested during the 12-month contract period on a quarterly basis.
Quarter 1: Julyl - September 30
Quarter 2: October! - December 31
Quarter 3 : January 1 - March 31
Quarter 4: April 1 - June 30
$ 1.250
$ 1.250
$ 1.250
$1,250
$5,000 Total Grant (Must equal the Total Program Budget
indicated on Exhibit B.)
Exhibit A
Page 2 of2
CITY OF SANA ANA
Community Development Block Grant
Outcome Tracking
IMPORTANT: The City of Santa Ana is in the process of incorporating the new BUD Performance
Outcome Tracking guidelines, therefore this section is subject to change in order to be compliant with
BUD regulations. If the situation should occur that the current tracking system is not sufficient to meet
BUD regulations an amendment to this contract will be needed.
Instructions: From the list of activities below select the activity that best describes the purpose ofthe program that will be funded
in fiscal year 06-07 by these grant funds. Two activities have multiple outcomes, therefore if "Senior Services" or "Youth Services" is
selected, please select the one outcome that best describes the purpose of the funded program. ONLY ifnone of the activities listed
adequately describe the funded program, please select that last activity "Low- and Moderate Income Services".
FulfIllment
Tracking HUD Objective to be fulfIlled HUD Outcome to be fulfilled illustrated by
HUD Indicator
Suitable Creating Specific Outcome
Activity/Program Outcome Tracking Goal Living Decent Economic A vailability/ Affordability Sustainability Indicator #
Housing bpportunitie Accessibility (Please see page 4
Environment of 4 for desc.)
4illii-Crime Services Track the reduction in educe response time to
!response time and the eriOllS crimes in the City's
Inumber of criminal ow- and Moderate-Income
D apprehended as a result. rea by at least 3 minutes
esulting in the apprehension 2
f 1.500 criminals that may X X
therwise escape.
.US-year goal to be
chieved by FY 09/1 0
air Housing Services Provide fair housing service 1. Provide fair housing
and ongoing analysis of ounseling. education and
impediments to fair housing. nforcement services to
D 7.000 Santa Ana households. X X 2
.U5-year goal to be
chieved by FY 09/10
. Annually assess actions to
liminate impediments to fai X X 2
Dusing,
lHomelessness Prevention Track assisted individuals 0% of assisted individuals
who retained their housing or md households will retain
utilities for at least 6 months :heir housing or utilities for 14
D fier assistance was t least 6 months after X X
provided. ssistance is provided.
!Emergeucy Sheller Track individuals who 0% of 12
!received support services 'ndividualslhouseholds that or
ithat were linked to one or lare provided with emergency
D more additional support shelter will transition to X X
service and/or appropriate 'nterim housing (i.e., 13
ousing. Itransitional housing),
ransitional Housing Track homeless individuals 5% of homeless individuals
who participated in jparticipating in transitional 2
transitional housing program !housing program will be X X
D that were placed in !placed in permanent housing.
pennanent housing.
upportive Services Track individuals who 0% of individuals/families
received support services receiving support services
that were linked to one or will be linked to one or more 2
D more additional support dditional support service X X
service and/or appropriate nd/or appropriate housing,
ousing.
Exhibit A-I
Page 1 of 4
Fulf'1llment
illustrated by
Trackinl!: HUD Obiective to be fulf'1lled HUD Outcomes to be fulf'1lled HUD Indicator
Suitable Creating Specific Outcome
Activity/Program Outcome Tracking Goal Living Decent Economic A vailability/ Affordability Sustainability Indicator #
Environment Housing Opportunitie Accessibility (Please see page 4
of 4 for desc.)
Senior Services 1. Track assisted senior 1. 80% of assisted senior
citizens that remained itizens will remain
D independent for at least 1 'odependent for at least 1 X X 2
ear after services were tyeaT after services are
provided, jprovided,
. Track seniors receiving 2. 90% of seniors receiving
referrals that were linked to eferrals will be linked to the
D the services sought. services sought. X X 2
Owner-Occupied Number of owners assisted hysical safety and comfort
Housing Rehabilitation to rehabilitate their primary ~ill be improved for Low
residence for the following od Moderate income
income categories: "ouseholds by improving
D Extremely Low Income Ihomes to a level that meets X X 9
Very Low Income lor exceeds HOD housing
-Moderate Income ~uality standards.
Special Needs Categories
-Large Families
rail Elderly Services Track frail elderly 0% of frail elderly
individuals that were linked individuals will be linked to 2
D to the services sought. Ithe services sought X X
Disabled Services Track disables persons Support independent living
whose independent living for 90% of disabled persons 2
D was supported by City funds. ssisted by City funds. X X
ervices for Mentally III Track individuals assisted 100% of individuals assisted
ith City resources that were with City resources will be
D provided an entry point into rovided an entry point into 2
the regional mental health he regional mental health X X
fare system and linked to at are system and linked to at
least one additional mental east one additional mental
Ihealth supportive service. ealth supportive service.
ervices for Substance Track how many individuals Provide entry into the
ddicted fwith substance addiction in !regional recovery system for
fwere provided an entry into 5 individuals with
fthe regional recovery system ubstance addiction and link
D and linked to additional Ithem to additional services. 2
services. X X
.u5-year goal to be
chieved by FY 0911 0
[Youth Services 1. Track improvement in 1. For education-based
[pre-test, post-test scores. rograms. improve pre-test 2
D ost-test scores by 50% X X
2. Track number of . Provide opportunities for
D individuals exposed to the xposure to the fine arts. X X 2
fine arts.
D 3. Track children/youth . 90% of children/youth
seeking referrals that were eeking referrals will be X X 2
linked to the services sought. inked to the services sought.
Low- and Moderate- Track program participants 90% of program participants
Income Services that were linked to services ~ill be linked to services 2
sought. sought. X X
~
Exhibit A-I
Page 2 of 4
.
Description of Outcome Tracking System:
Please describe your organization's outcome tracking system that will enable you to fulfill the outcome selected above.
All volunteers and staff taking client calls on the Hotline or making reasurrance calls to the homebound will fully record each call on
the 'Call Log'. The Executive Director or assigned staffwill review each 'Call Log' on a daily basis for accuracy and to determine
CDBG eligibility based on current HUD guidelines.
Client information includes age, gender, city, ethnicity/race, income, head of household, family size, CDBG eligibility and call
resolution. Each 'Call Log' entry is entered on a daily basis into our automated call reporting/outcomes program, JABR, The
Executive Director or assigned staff will provide written reports to the Board of Directors monthly, or as requested.
The JABR programs tracks meaningful outcomes as follows:
Meaningful Outcome # I -
Families and individuals will find the resources they need to help them with their immediate problems of depression, anxiety, substance
abuse, domestic violence, homelessness, or financial need.
Meaningful Outcome #2 -
Familes and Individuals will find the resolutions to their problems helping t provide a safe environment and create stability in their
lives.
We will ask caller to call back or we will follow-up on the calls. Clients requiring follow-up are generally high-risk, i.e. suicidal,
domestic violence, child or elder abuse. We will follow-up by making wellness or reassurance calls to the client, a family member, or
referred to program or agency. We will track clients as long as needed.
Exhibit A-I
Page 3 of 4
.
Specific Outcome Indicators
2) Public service activities
Number of persons assisted:
. with new access to a service
· with improved access to a service
· where activity was used to meet a quality standard or measurably improved quality, report the number
that no longer only have access to substandard service
9) Owner occupied units rehabilitated or improved
Total number of units:
Number occupied by elderly
Number of units brought from substandard to standard condition (HQS or local code)
Number qualified as Energy Star
Number of units brought into compliance with lead safe housing rule (24 CFR part 35)
Number of units made accessible for persons with disabilities
12) Number of homeless persons given overnight shelter
13) Number of beds created in overnight shelter or other emergency housing
14) Homelessness Prevention
· Number of households that received emergency financial assistance to prevent
homelessness
· Number of households that received emergency legal assistance to prevent
homelessness
Exhibit A-I
Page 4 of 4
. Program Year 2006-2007
Final Budget
Organization Name Hotline of Southern California
Program Name Hotline
Expenditures
Expenses Funded by Expenses Funded Total Program Total Organizational
Cate 0 Santa Ana COBG b Other Sources Bud et Bud et
Administrative Staff
Salaries & Benefits $ 4,000 $ 37,000 $ 41,000 $ 41,000
Program Staff Salaries &
Benefits $ $ $ $
Contractua I/Professional
Services: List below
1 Temp Help $ $ 500 $ 500 $ 500
2 $
3
Office Su lies $ 1,900 1,900 1,900
Rent $
Communications 1,000 $ 7,000 8,000 8,000
Utilities $
Insurance $ 3,200 3,200 3,200
Other:List below
1 Payroll Taxes $ $ 3,590 $ 3,590 $ 3,590
2 Training $ $ 2,500 $ 2,500 $ 2,500
3 Outcomes Software $ $ 1,350 $ 1,350 $ 1,350
4 Storage/Lic.&Fees $ $ 1,080 $ 1,080 $ 1,080
5 Postage/Printing $ $ 700 $ 700 $ 700
Total $ 5,000 $ 58,820 $ 63,820 $ 63,820
LIST ALL OTHER PROGRAM FUNDS THAT HAVE BEEN SECURED FOR 06-07
(Total Funds for Program must equal Total Program Budget above)
Sou rce Amount
Santa Ana CDBG $ 5,000
United Wa $ 11,800
Soro timist,Rota ,Woman's Club $ 4,500
Yamaha Motor, Boein , $ 5,000
Forest Lawn Foundation $ 2,500
Fundraisers $ 35,000
Interest Income $ 20
Total Funds for Program $ 63,820
Exhibit B
Page 1 of 1
2006-2007 Funded Personnel
.
Name of Organization:
Name of Program
Hotline of Southern California
Hotline
ADMINISTRATIVE STAFF
Position Title Annual Annual Total CDBG Funds % of time Of this time % of Total
Salary Benefits Compensation Requested for spent on percent of Compensation
this position funded time serving Eligible
nrol!Tam Santa Ana
Executive Director $ 36,000 $ 5,000 $ 41,000 $ 4,000 84% 12% 10%
$ - 0%
$ - 0%
$ - 0%
$ - 0%
$ - 0%
$ - 0%
$ - 0%
$ - 0%
Total Amount Requested $ 4.000
Must equal amount indicated on Exhbit B
PROGRAM STAFF
Position Title Annual Annual Total CDBG Funds % of time Of this time % of Total
Salary Benefits Compensation Requested for spent on percent of Compensation
this position funded time serving Eligible
nroeram Santa Ana
$ - 0%
$ - 0%
$ - 0%
$ - 0%
$ - 0%
$ - 0%
$ - 0%
$ - 0%
$ - 0%
Total Amount Requested $ -
Must equal amount indicated on Exhbit B
CONTRACTUAL/PROFESSIONAL SERVICES
Position Title Annual Annual Total CDBG Funds % of time Of this time % of Total
Contract Benefits Compensation Requested for spent on percent of Compensation
Amount this position funded time serving Eligible
nrOl!Tam Santa Ana
$ - 0%
$ - 0%
$ - 0%
$ - 0%
$ - 0%
$ - 0%
$ - 0%
$ - 0%
$ - 0%
Total Amount Requested $ -
Must equal amount indicated on Exhbit B
***Please note for personnel whose time is not directly traced to serving Santa Ana and instead a percentage is used please
confirm the percentage is accurate prior to requesting reimbursement.
Exhibit B-1
Page 1 of 1
.
.
Certification Regarding Lobbying
Certification for Contracts. Grants. Loans. and Cooperative Agreements
The undersigned certifies, to the best of his or her knowledge and belief, that:
(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the
undersigned, to any person for influencing or attempting to influence an officer or
employee of any agency, a Member of Congress, an officer or employee of Congress, or
an employee ofa Member of Congress in connection with the awarding of any Federal
contract, the making of any cooperative agreement, and the extension, continuation,
renewal, amendment, or modification of any Federal contact, grant, loan or cooperative
agreement.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to
any person for influencing or attempting to influence an officer or employee of any
agency, a Member of Congress, an officer or employee of Congress, or an employee ofa
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 sub awards at all tiers (including subcontract, 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 $10,000 and not more than $100,000 for each such failure.
Hotline of Southern California
GranteelContactor Organization
Hotline
Program Title
Jeanne St. Clair, President
Name of Certifying Officer
.J~Mw. <J.CJ~
Signature Date
EXHIBIT C
Page 1 of2
.
..
SUBRECIPIENT warrants the following:
1. SUB RECIPIENT will comply with Public Law 88-352, Title VI of the Civil Rights
Act of 1964 (42 U. S. C. section 2000 et seq.) and implementing regulation in 24 CFR
Part 1.
2. No person in the United States shall on the ground of race, color, religion, national
origin, or sex, be excluded from participation in, or be denied the benefits of, or be
subjected to discrimination under any program or activity funded in whole or in part with
community development funds made available pursuant to the ACT.
3. All laborers and mechanics, employed by contractors or subcontractors in the
performance of construction work financed in whole or in part with community
development funds shall be paid wages at rates not less than those prevailing on similar
construction in the locality as determined in accordance with the Davis-Bacon Act, as
amended, 40 U. S. C. Sections 276 a 1-5, except for individuals who perform services for
which they volunteered; do not receive compensation for such services; or are paid
expenses, reasonable benefits, or a nominal fee for such services; and are not otherwise
employed at any time in construction work.
4. SUB RECIPIENT will comply with all Federal statutes applicable to projects funded
with community development funds, except that (a) SUBRECIPIENT does not assume
CITY'S environmental responsibilities described at 24 CFR 570.604; and (b)
SUBRECIPIENT does not assume CITY'S responsibility for initiating the review process
under Executive Order 12372.
EXHIBIT C
Page 2 of2
Philadelphia Indemnity Insurance Company
COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS
Policy Number: PHPK141731
181 See Supplemental Schedule
LIMITS OF INSURANCE
$ 1,000,000 General Aggregate limit (Other Than Products - Completed Operations)
$ 1 , 000 , 000 Products/Completed Operations Aggregate limit (Any One Person Or Organization)
$ 1,000,000 Personal and Advertising Injury limit
$ 1, 000 , 000 Each Occurrence limit
$ 100,000 Damage To Premises Rented To You limit (Any One Premises)
$ 5,000 Medical Expense limit (Any One Person)
FORM OF BUSINESS: NON PROFIT ORGANIZATION
Business Description: Non Profit Organization
Agent # 17921
location of All Premises You Own, Rent or Occupy:
SEE SCHEDULE ATTACHED
Code No.
Premium
Basis
Rates
Advance Premiums
AUDIT PERIOD, ANNUAL, UNLESS OTHERWISE STAT D: N/A
Classifications
PremJ
ProdJ
Com .0
SEE SCHEDULE ATTACHED
..._~._-j-
LaG:
A'>~i5H
"".V
. '.~ j
TOTAL PREMIUM FOR THIS COVERAGE PART:
$163.00
$
RETROACTIVE DATE (CG 00 02 ONLY)
This insurance does not apply to "Bodily Injury", "Property Damage", or "Personal and Advertising Injury" which
occurs before the retroactive date, if any, shown below.
Retroactive Date:
FORM (S) AND ENDORSEMENT (S) APPLICABLE TO THIS COVERAGE PART: Refer To Forms Schedule
Countersignature Date
Authorized Representative
Philadelphia Indemnity Insurance Company
Additional Insured Schedule
Policy Number: PHPK141731
Additional Insured
CIlY OF CYPRESS, CYPRESS RECREATION PARK
DISTRICT
5275 ORANGE AVE.
CYPRESS, CA 90620
CG2026 - CA - Loe # 1
Additional Insured
CIlY OF SANTA ANA
COMMUNIlY DEVELOPMENT AGENCY
M-25
P. O. BOX 1988
SANTA ANA, CA 92702-1988
CG2026 - CA - Loe # 1
~ .., /:!:::::::.:
~~u:t-
._~,' .,~.. ..L (::
~.~.---- . ,"."" l7.'. (;',!,". t.. L-,; ",:,
.".," J~1'.d'~i~ C:~tV p'l,nc<'" ,'"
Page 1 of 1
~ Philadelphia Indemnity Insurance Company
(A Stock Company founded in 1927)
One Bala Plaza, Suite 100, Bala Cynwyd, Pennsylvania 19004
1-800-759-4961
Commercial
Li nes
Policy
THIS POLICY CONSISTS OF:
- DEClARATIONS
- COMMON POLICY CONDITIONS
- ONE OR MORE COVERAGE PARTS. A COVERAGE PART CONSISTS OF:
· ONE OR MORE COVERAGE FORMS
· APPLICABLE FORMS AND ENDORSEMENTS
e..R
BJP-190-1 (12-98)
~
Philadelphia Insurance Companies
One Bala Plaza, Suite 100, Bala Cynwyd, Pennsylvania 19004
Philadelphia Indemnity Insurance Company
COMMON POLICY DECLARATIONS
Policy Number: PHPK141731
Named Insured and Mailing Address:
HOTUNE OF SOUTHERN CAUFORNIA
PO# 32
LOS ALAMITOS, CA 90720
Producer: 17921
S.D. HINES INSURANCE SERVICES, INC
3580 E. PACIFIC COAST HIGHWAY, #8
LONG BEACH, CA, 90804
Policy Period From: 11/26/2005 To: 11/26/2006
at 12:01 A.M. Standard lime at your mailing
address shown above.
Business Description: Non Profit Organization
IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS
POLICY, \f\IE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY.
THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH A PREMIUM IS
INDICATED. THIS PREMIUM MAY BE SUBJECT TO ADJUSTMENT.
Commercial Property Coverage Part
Commercial General Liability Coverage Part
Commercial Crime Coverage Part
Commercial Inland Marine Coverage Part
Commercial Auto Coverage Part
Businessowners
Workers Compensation
PREMIUM
121.00
163.00
2,395.00
Total
$ 2,679.00
Total Includes Federal Terrorism Risk Insurance Act Coverage
7.00
FORM (5) AND ENDORSEMENT (S) MADE A PART OF THIS POLICY AT THE TIME OF ISSUE
Refer To Forms Schedule
'Om;ts_~FO"'''''_'_''-'''-agep'~n
Countersignature Date Authorized Representative
CERTHOLDER Cf""'Y
RECEIVED MAR 0 1 ~Wl6
STATE
COMPENSATION
INSURANCE
FUND
P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
ISSUE DATE: 03-01-2006
GROUP:
POLICY NUMBER: 1332857-2006
CERTIFICATE 10: 3
CERTIFICATE EXPIRES: 03-01-2007
03-01-2006/03-01-2007
CITY OF SANTA ANA
COMMUNITY DEVELOPMENT
20 CIVIC CENTER PLAZA
SANTA ANA CA 92702
SG
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the
California Insurance Commissioner to the employer named below for the policy period indicated.
This policy is not subject to cancellation by the Fund except upon 10 days advance written notice to the employer.
We will also give you 10 days advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not an insurance policy and does not amend. extend or alter the coverage afforded
by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document
with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance
afforded by the policy described herein is subject to all the terms. exclusions, and conditions. of such policy.
a:::- REPRESENTAll
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS:
~
PRESIDENT
$1,000,000 PER OCCURRENCE.
EMPLOYER
HOTLINE OF SOUTHERN CALIFORNIA (A NON-PROFIT
CORP. )
PO BOX 32
LOS ALAMITOS CA 90720
(REV.2-0S)
M0408
PRINTED
02-18-2006
. . CONSENT CALENDAR
ABSTAIN: None (0)
ABSENT: Garcia, Pulido, Solorio (3)
REPORTS
65.A. 4TH DISTRICT COURT OF APPEAL STATUS REPORT - CITY MANAGER
Dave Ream, City Manager presented an update on the 4th District Court of
Appeal, and informed the Council that Mr. Clifford Ham, Principal Architect for
the 4th District Court will give a presentation at the next televised Council
meeting.
PUBLIC HEARINGS
75.A. COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM FISCAL YEAR
2006-2007
Public hearing closed on March 6, 2006 regarding the proposed Community
Development Block Grant (CDBG) Program and Budget for Fiscal Year 2006-
2007
Legal Notice published in the Orange County Register, La Opinion, and Nguoi
Viet on February 17, 2006 and Tri-County Bulletin on February 16, 2006
Continued from the March 6, 2006 City Council Meeting by a vote of 5-0 vote
(Pulido and Bist absent)
Continued from the April 3, 2006 City Council Meeting by a vote of 7-0
Motion: 1. Approve the proposed fiscal year 2006-2007 Community Development
Block Grant Program.
SOCIAL SERVICES
1 Achievement Institute of Scientific 7,500 7,500
Studies
2 Assistance League of Santa Ana 16,000 16,000
3 Blind Children's Learning Center 18,000 18,000
CITY COUNCIL MINUTES
10
APRIL 17, 2006
.
.
PUBLIC HEARING
4 Bowers Museum 5,000 5,000
5 Boys & Girls Club of Santa Ana 27,000 2,000 29,000
6 CHCADA-La Familia 0 5,000 5,000
7 Cambodian Family, The 17,000 1,000 18,000
8 Career Beginnings of Orange County 14,000 4,000 18,000
9 Casa de Salud Family Health Clinic 10,000 10,000
10 City of Santa Ana, PRCSA-McFadden 77,000 -16,500 60,500
11 City of Santa Ana, PRCSA-Project 177,000 -42,500 134,500
Pride
12 Colette's Children's Home 0 0
13 Community Service Program, Inc 0 7,500 7,500
14 Council of Orange County Society of 0 0
St. Vincent de Paul
15 Council on Aging of Orange County 7,000 -1,000 6,000
16 Dayle Mcl ntosh Center 8,000 8,000
17 Delhi Center 0 3,000 3,000
18 EI Centro Cultural de Mexico 10,000 10,000
19 EI Sol Science and Arts Academy 0 0
20 Feedback Foundation, Inc.-Meals on 17,000 5,500 22,500
Wheels
21 Feedback Foundation, Inc.-Senior 17,000 5,500 22,500
Lunch
22 HistArt H Renaissance Inst. 10,000 10,000
23 Hope Community Services, Inc. 0 0
24 Hotline of Southern California 5,000 5,000
25 Human Options 16,000 4,000 20,000
26 Info Link Orange County 5,000 -5,000 0
27 Kidsingers 10,000 3,000 13,000
28 Legal Aid Society of Orange County 5,000 1,000 6,000
29 Mariposa Women and Family Center 6,000 6,000
30 Mercy House Transitional Living 19,000 -9,000 10,000
Centers, Inc.
31 National Council on Alcoholism & Drug 19,000 1,000 20,000
Dependence - Orange County
32 National Heritage-Academy of 6,000 4,000 10,000
International Dance
33 Orange County Bar Foundation- 6,000 6,000
Addiction
34 Orange County Bar Foundation- 11,000 2,000 13,000
Programa Shortstop
35 Orange County Crazies 10,000 1 0,000
36 Orange County High School of the Arts 7,000 -7,000 0
Foundation
37 Orange County Human Relations 12,000 -7,000 5,000
Council-Common Ground
CITY COUNCIL MINUTES
11
APRIL 17, 2006
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.
PUBLIC HEARING
Orange County Human Relations 10,000 -5,000 5,000
38 Council-Heart of the Orange
39 Orange County on Track 8,000 8,000
40 Orange County Teen Challenge 9,500 9,500
41 Orange County Youth Commission- 11 ,000 -3,000 8,000
Santa Ana Boxing
42 Relampago Del Cielo, Inc 5,000 5,000
43 Saint Joseph Ballet 36,000 9,000 45,000
44 Santa Ana Friends for the Animals 8,000 -3,000 5,000
45 Santa Ana PO-Helicopter 167,000 38,000 205,000
46 Share Our Selves-SOS 0 0
Comprehensive CARE
47 Share Our Selves-SOS Free 12,000 -2,000 10,000
Med/Dental Clinic
48 Sisters of St. Joseph of Orange-Taller 35,000 -1,000 34,000
San Jose
49 Southwest Minority Economic 8,000 2,000 10,000
Development Association
50 Think Together 13,000 -6,000 7,000
51 Thomas House Temporary Shelter 14,000 14,000
52 TKO Boxing Club 12,000 3,000 15,000
53 Vietnamese Community of Orange 12,000 12,000
County, Inc.
54 WISE Place 5,000 7,500 12,500
55 Women Helping Women 5,000 5,000
56 Women's Transitional Living Center 5,000 5,000
57 Santa Ana Unified School District 0 0
Police
TOTAL SOCIAL SERVICES 950,000 0 950,000
58 Administration 735,000 735,000
59 Fair Housing Council of Orange 72,396 72,396
County
60 General Planning 100,000 100,000
61 Section 108 Loan Repayment - Police 1,884,155 1,884,155
Holdina Facilitv
62 Fire Equipment 475,000 475,000
63 Neighborhood Sponsored 50,000 50,000
Improvements
64 Public Facilities Improvements/ADA 100,000 100,000
65 Parks and Recreation -Windsor Park 400,000 400,000
Improvements
66 Public Works -Neighborhood Street 400,000 400,000
Improvements
67 Code Enforcement 1,720,000 1,720,000
68 Paint Your Heart Out 90,112 90,112
NON SOCIAL SERVICE
CITY COUNCIL MINUTES
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APRIL 17,2006
.1 . PUBLIC HEARING
69 Rebuilding Together a.c. 26,000 26,000
70 Multi-Family Rehab Loans 103,911 103,911
TOTAL NON SOCIAL SERVICE 6,156,574 0 6,156,574
TOTAL SOCIAL SERVICE 950,000 0 950,000
7,106,574 7,106,574
2. Authorize the City Manager to submit the approved program to the
United States Department of Housing and Urban Development for the
City's fiscal year 2006-2007 allocation of Community Development
Block Grant funds, and execute the grant agreement with the United
States Department of Housing and Urban Development.
3. Direct the City Attorney to prepare and authorize the City Manager
and the Clerk of the Council to execute agreements with nonprofit
agencies and/or subrecipients awarded funds as part of the approved
program.
AGMT NO. 2006-092 - With nonprofit agencies and/or sub-recipients
awarded funds as part of the approved program.
MOTION: Christy
SECOND: Alvarez
VOTE:
AYES:
Alvarez, Bustamante, Bist, Christy (4)
NOES: None (0)
ABSTAIN: None (0)
ABSENT: Garcia, Pulido, Solorio (3)
Council member Garcia arrived at the meeting at 6:27 p.m.
Agenda Item 20.A. taken out or order
APPROPRIATION ADJUSTMENTS
20.A.
1. Approve an appropriation adjustment. (Requires 5 affirmative votes)
CITY COUNCIL MINUTES
13
APRIL 17, 2006
CERTHoLoER COPY
C-,fL, SG
STATE
COMPENSATION
INSURANCE
FUND
PD, BOX 420807, SAN FRANCISCQ,CA 94142-0807
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
ISSUE DATE: 03-01-2007
GROUP:
POLICY NUMBER: 1332857-2007
CERTIFICATE ID: 3
CERTIFICATE EXPIRES: 03-01-2008
03-01-2007/03-01-2008
CITY OF SANTA ANA
COMMUNITY DEVELOPMENT
20 CIVIC CENTER PLAZA
SANTA ANA CA 92702
SG
A-.;UJolP- 09':<-0'::<0
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the
California Insurance Commissioner to the employer named below for the policy period indicated.
This policy is not subject to cancellation by the Fund except upon 10 days advance written notice to the employer.
We will also give you 10 days advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded
by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document
with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance
afforded by the policy described herein is subject to all the terms. exclusions. and conditions, of such policy.
O:::REPRESENTATI
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS:
~
PRESIDENT
$1,000,000 PER OCCURRENCE,
-
,.
,.I,,',
(...,.,
EMPLOYER
\~
HOTLINE OF SOUTHERN CALIFORNIA
CORP. )
PO BOX 32
LOS ALAMIToS CA 90720
(A NON-PROFIT
(REV.2-05)
M0408
PRINTED 02-17-2007