HomeMy WebLinkAboutORANGEWOOD CHILDREN’S FOUNDATION 3W City of Santa Ana
Clerk of the Council
AGREEMENT TERMINATION
Please complete this form when the attached agreement is no longer in effect.
Return form to the Clerk of the Council Office (M-30).
Call 647-5237 if you have any questions. 7M IMI 15 PH 2- 18
The agreement with
No. A.2008-225 was completed on C�--30._--01
and final payment has been made.
Revised 07-23-07
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INSURANCE ON FILE
WORK MAY PROCEED A-2008-225
UNTIL INSURANCE EXPIRES
CLERK OF COUNCIL
DATE: SEP 16 2008 Contract No.
AGREEMENT UNDER THE WORKFORCE INVESTMENT ACT
THIS AGREEMENT, made and entered into this 18' day of August, 2008 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 Orangewood Children's
Foundation ("CONTRACTOR").
W-I-T-N-E-S-S-E-T-H
Recitals:
A. CITY has been designated a Local Workforce Investment Area (LWIA) under
the Workforce Investment Act of 1998, Public Law 105-220 ("the Act").
B. The State of California has created the LWIA to administer the Act programs
operated by the State of California pursuant to the Act.
C. As a LWIA, CITY is entitled to receive federal funds to establish programs to
prepare economically disadvantaged youths for entry into the labor market and to provide basic skills
development to those individuals who are economically disadvantaged or otherwise face serious
barriers to succeeding in life. One goal of California's Workforce Investment System is to provide
youth with the opportunities to achieve career goals that will allow them to successfully compete in the
labor market and prepare them for higher education.
D. CONTRACTOR is experienced in operating education, occupational
development and employment programs for economically disadvantaged youths for entry into the labor
market ("said program").
E. CONTRACTOR is willing to operate said program pursuant to the Act and
California law.
WHEREFORE, for and in consideration of the respective and mutual covenants and
promises hereinafter contained and made, and subject to all the terms and conditions hereof, the parties
hereto do hereby agree as follows:
I.
CONTRACTOR'S OBLIGATIONS
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A. CONTRACTOR agrees to provide the following services pursuant to said
program, as more specifically set forth in CONTRACTOR'S program narrative contained in "Exhibit
A" and in the Statement of Work (Exhibit B), attached hereto and by this reference incorporated
herein:
CONTRACTOR'S failure to provide said services may be grounds for CITY to readjust
the level of payment to CONTRACTOR otherwise provided for hereinafter.
B. CONTRACTOR agrees to provide benefits to individuals who participate in the
activities and services funded by this Agreement ("participants") in accordance with the standards and
requirements set forth in Workforce Investment Act of 1998, Public Law 105-220.
C. CONTRACTOR agrees to perform the services set forth herein in a professional,
timely and diligent manner.
D. CONTRACTOR shall provide wages and benefits to individuals who participate
in the activities and services funded by this Agreement ("participants") in accordance with the
standards and requirements of the Act, including Section 181 of the Act.
E. CONTRACTOR shall adhere to the Labor Standards described in the Act
including Section 181 of the Act.
F. CONTRACTOR agrees to comply with the "Complaint Handling Procedures under
the WIA", attached hereto as "Exhibit C" and incorporated herein as though fully set forth in 20 CFR
§667.200, Subpart F. CONTRACTOR shall advise participants of their rights to file complaints under
the Act and the procedures for resolution of any complaints. CITY's procedures for handling
complaints alleging a violation of the Act, regulations, grants, or other agreements under the Act shall
be followed and any decision of CITY, the State or the federal government relating to the complaint
shall be binding and followed by CONTRACTOR. CONTRACTORS who are employers shall
operate a grievance system that incorporates CITY's procedures for resolution of complaints relating to
the terms and conditions of employment; these procedures shall be approved in writing by CITY.
G. As a condition of this award of financial assistance under the Act to
CONTRACTOR from CITY, CONTRACTOR assures, with respect to operation of all programs or
activities funded with funds provided pursuant to the Act, and all agreements or arrangements to carry
out such programs or activities, that it will comply fully with the nondiscrimination and equal
opportunity provisions of the Act (Section 188); the Nontraditional Employment for Women Act of
1991; Title VI of the Civil Rights Act of 1964, as amended; section 504 of the Rehabilitation Act of
1973, as amended; the Age Discrimination Act of 1975, as amended; the Americans with Disabilities
Act of 1990; and with all applicable requirements imposed by or pursuant to regulations implementing
those laws, including, but not limited to, 29 CFR part 37. The United States, the State of California
and CITY have the right to seek judicial enforcement of this assurance.
H. CONTRACTOR agrees that no participant(s) shall commence training prior to the
approval of funding pursuant to Section 123 of the Act.
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I. CONTRACTOR agrees to maintain such records and submit such reports, data and
information, on the form and containing such information, at such times as CITY may request or
require regarding the performance of CONTRACTOR'S services or activities, costs or other data,
including but not limited to, participants' attendance, payroll records and job duty statements.
CONTRACTOR agrees to forward to the Santa Ana Work Center Administrative
Office, 1000 East Santa Ana Blvd., Suite 200, Santa Ana, California 92701 a completed Workforce
Investment Act Application form (WIA EWIR) and supporting documents within 45 days of
application date; a complete Workforce Investment Act Enrollment/Registration form (WIA EWIE)
and Workforce Investment Act Goals form (WIA SWIG) must be submitted along with the WIA
EWIR; any subsequent updates to EWIE and /or EWIG must be completed within 10 days of the begin
date of activity or end date of an activity; Workforce Investment Act Youth Test Scores form (WIA
EYTS) within 30 days of application date; Workforce Investment Act Exit form (WIA EWIT) within
15 days of completion/termination of active enrollment of trainee; and the Workforce Investment Act
Follow -Up Contact Information form (WIA EWIF) within 21 days following 30, 60, 90,180, 270, and
360 days of exit.
CITY, the State of California and the United States government and/or their
representatives shall have access for purposes of monitoring, auditing and examining of
CONTRACTOR'S activities, performance, books, documents, papers, and records of CONTRACTOR
subcontractors, bookkeepers and accountants, and employees and participants related to this
Agreement. Such agencies or representatives shall also schedule on -site monitoring in their discretion.
Monitoring activities may also include, but are not limited to, questioning employees and participants
and entering any premises or onto any site in which any of the services or activities funded hereunder
are conducted or in which any of the records of CONTRACTOR 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.
All accounting records and evidence pertaining to all costs of CONTRACTOR and all
documents related to this Agreement shall be kept available at the location where CONTRACTOR
conducted the program, as well as in the County of Orange, for the duration of this Agreement and
thereafter for three (3) years after completion of an audit. Records which relate to (a) complaints,
claims, administrative proceedings or litigation arising out of the performance of this Agreement, or (b)
costs and expenses of this Agreement to which CITY, the State of California or the United States
Government take exception, shall be retained beyond the three (3) years until resolution of disposition
of such appeals, litigation, claims, or exceptions.
J. Without prejudice to any other section of this Agreement, CONTRACTOR
shall, where applicable, maintain the confidential nature of information provided to it concerning
participants in accordance with the requirements of federal and state law. Notwithstanding the
foregoing, CONTRACTOR agrees to submit to CITY, the State of California and/or the United States
Government or their representatives, all records requested for administrative purposes, including
audits, examinations, monitoring and verification of records submitted by CONTRACTOR, costs
incurred and services rendered hereunder.
K. CONTRACTOR agrees to complete in triplicate, a monthly InvoiceNoucher on
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CITY's InvoiceNoucher form, showing in detail the amount of money already expended by
CONTRACTOR hereunder, as this is a cash reimbursement contract. Accounting records must be
supported by such source documentation such as cancelled checks, paid bills, payrolls, time and
attendance records, contract and subgrant award documents [29 CFR—Subpart C, Section 97.20 (b)(6)].
CONTRACTOR agrees to submit the above -stated documents to the WIB Administrative Office, 1000
East Santa Ana Blvd., Suite 200, Santa Ana, California, 92701, by the tenth (loth) day of the month
following the month in which CONTRACTOR'S services are performed. Should CONTRACTOR fail
to deliver said documents to CITY, CITY shall have the option to cancel this Agreement by giving
CONTRACTOR ten (10) days written notice thereof. CONTRACTOR shall either return to the CITY
excess revenues over costs or use such excess revenues as program income by utilizing such program
income for additional training activities authorized under the Act.
L. CONTRACTOR agrees to expend all funds in accordance with all applicable
federal, state and local laws and regulations. CONTRACTOR also agrees to provide at
CONTRACTOR'S own expense supplies and other costs of said PROGRAM.
M. CONTRACTOR shall arrange independently for an audit that includes WIA
funds received from CITY, in accordance with the Act, 20 CFR Section 667.200 and OMB Circular A-
133. CONTRACTOR shall submit one original of each required audit report to CITY within (30) days
after the date received by CONTRACTOR. Should CONTRACTOR fail to comply with these
requirements, CITY may at its option withhold payment of funds, or disallow funds or suspend
additional grant funds.
N. CONTRACTOR shall not expend funds pursuant to this Agreement to provide
services to any participant where costs of training are paid for by any other person or entity.
O. CONTRACTOR shall comply with the provisions of Circular A-102 of the U.S.
Office of Management and Budget (OMB) and the related "Common Rule" entitled "Uniform
Administrative Requirements for Grants and Cooperative Agreements to State and Local
Government", Subpart C, paragraphs 37 and 42, Circular A-128, and all other applicable federal
statutes and executive orders and their implementing regulations, including regulations at 29 CFR Part
97.
P. CONTRACTOR shall comply with the requirements of federal regulations
found at 29 CFR 93 which provide that no appropriated funds may be expended by the recipient of a
federal contract, grant, loan or cooperative agreement to pay any person for influencing or attempting
to influence an officer or employee of any agency, member of Congress or an officer or employee of a
member of Congress in connection with 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. CONTRACTOR shall sign
a certification to that effect in a form as set forth in "Exhibit D," attached hereto and by this reference
incorporated herein. CONTRACTOR shall submit said signed certification to CITY prior to
performing any of its obligations under this Agreement and prior to any obligation arising on the part
of CITY to pay any sums to CONTRACTOR under the terms and conditions of this Agreement.
Q. CONTRACTOR agrees to provide a drug -free work place and to execute a
certification as set forth in "Exhibit E" attached hereto and incorporated herein by this reference.
R. CONTRACTOR, in accordance with the Child Support Compliance Act,
recognizes and acknowledges the importance of child and family support obligations and shall fully
comply with all state and federal laws relating to child and family support enforcement, including, but
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not limited to: disclosure of information and compliance with earnings assignment orders, as provided
in Chapter 8 (commencing with Section 5200) of Part 5 of Division 9 of the state Family Code; and, to
the best of its knowledge is fully complying with the earnings assignment orders of all employees and
is providing the names of all new employees to the New Employee Registry maintained by the
Califomia Employment Development Department (EDD).
S. CONTRACTOR agrees to comply with all applicable provisions of the ACT and
the federal regulations, including but not limited to the regulations found at 20 CFR part 629.
II.
CITY'S OBLIGATIONS
A. CITY agrees to pay to CONTRACTOR when, if and to the extent federal funds
are received under the provisions of the Act a sum not to exceed ninety-five thousand, four hundred
seventy-five dollars ($95,475) for CONTRACTOR'S performance in accordance with the payment
schedule attached hereto as "Exhibit V during the period of this Agreement. Said sum shall be paid
after CITY receives invoices submitted by CONTRACTOR as provided hereinabove.
B. CITY agrees to provide for on -site monitoring reviews of said
program operation at least twice annually. In addition, monthly desk -top reviews of pertinent
information will be conducted.
C. CITY has the right to de -obligate the funds hereunder and take such funding
back from CONTRACTOR due to any of the following reasons: (a) lack of performance by
CONTRACTOR; (b) lack of fiscal accountability of CONTRACTOR; or (c) decrease in available
funding.
III.
TIME PERIOD OF AGREEMENT
This Agreement shall commence on August 18, 2008 and all duties arising under this
Agreement shall have been performed by June 30, 2009 . The term of this Agreement may be
extended by a writing executed by the Executive Director of the Community Development Agency and
the City Attorney.
IV.
INDEPENDENT CONTRACTOR
Consultant shall, during the entire term of this Agreement, be construed to be an
independent contractor and not an employee of the City. This Agreement is not intended nor shall it be
construed to create an employer -employee relationship, a joint venture relationship, or to allow the
City to exercise discretion or control over the professional manner in which Consultant performs the
services which are the subject matter of this Agreement; however, the services to be provided by
Consultant shall be provided in a manner consistent with all applicable standards and regulations
governing such services. Consultant shall pay all salaries and wages, employer's social security taxes,
unemployment insurance and similar taxes relating to employees and shall be responsible for all
applicable withholding taxes.
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V.
WORKER'S COMPENSATION AND EMPLOYER'S RIGHTS
A. CONTRACTOR shall use appropriate funds received from CITY to provide
workers' compensation to all those hired by CONTRACTOR under this Agreement.
B. CONTRACTOR shall have the right to hire.. dismiss. or promote its employees
or contract personnel hired under this Agreement so long as its hiring or dismissal policy or standard
does not violate Title y'II of the Civil Rights Act of 1964. Fair Labor Standards Act of 1938.. or any
other applicable law. and CONTRACTOR maintains itself as an Equal Opportunity employer.
NIL
APPLICABLE GUIDELINES
A. The parties hereto agree that CONTRACTOR shall comply with all applicable
federal and state laws and regulations, including. but not limited to the Perfonnance Standards
(Exhibit B) and general program requirements described in Sections 106 and 141 of the Act (29 USC
Sections 1516 and I551) and applicable regulations. and the U.S. Department of Labor guidelines and
regulations, including amendments or revisions made during the terms of this Agreement. Said
applicable laws are hereby incorporated by reference and made as part of this Agreement as though
fully set forth herein.
B. CONTRACTOR also assures and certifies that:
I. CONTRACTOR acknowledges and confines that the U.S. Department
of Labor has established three (3) performance measures for all youth ages 14-21. Pending N'IA
reauthorization and or U.S. Department of Labor and EDD updates. CONTRACTOR agrees to
implement and shall meet any additional performance measures that may be subsequently required by
the Workforce Investment Act or by any other Federal. State. and local law.
2. CONTRACTOR shall comply with Title VII of the Civil Rights Act of
1964 (P.L. 83-354) and in accordance with Title VII of the Act. no person shall. on the grounds of race.
color. religion.. sex, age. handicap or national origin be excluded from participation in, be denied the
benefits of. or be otherwise subjected to discrimination under this Agreement.
3. CONTRACTOR shall compl} with any and all federal laws limitin" the
political activity of employees hired under this Agreement.
4. CONTRACTOR shall comply with the requirements that no program
under the Act shall involve political activities.
5. RECORD INSPECTION. CONTRACTOR shall provide the U.S.
Department of Labor and the Controller General. by and through any authorized representative, as well
as the VdIB Administrative Office, access to and the right to examine all records, books. papers or
documents relating to the accounting and use of funds under this Agreement for a three-year period
fi-om and after the effective date of this Agreement.
6. No person with responsibilities in the operation of any program under the
Act shall discriminate with respect to any program participant or any application for participation in
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such program because of race, creed, color, national origin, sex, political affiliation or beliefs.
CONTRACTOR shall maintain appropriate standards for health and
safety in work and training situations.
8. CONTRACTOR shall comply with general provisions, assurances, and
certifications attached hereto as "Exhibit G" and incorporated herein.
9. EQUAL OPPORTUNITY. Any literature distributed by
CONTRACTOR for the purpose of apprising businesses, participants, or the general public of its
programs under this Agreement shall state that its programs are supported by the City of Santa Ana and
the Santa Ana Workforce Investment Board, and shall state that the program is an "equal opportunity
employer/program" and that "auxiliary aids and services are available upon request to individuals with
disabilities."
10. Based on the population eligible to be served, or likely to be
directly affected by the WIA program or activity, the services or information may need to be provided
in a language other than English in order to allow such population to be effectively informed about or
able to participate in the program or activity. Pursuant to 29 CFR 37.35, the Contractor must take
reasonable steps to provide services and information in appropriate languages after considering the
scope of the program or activity, and the size and concentration of the population that needs services or
information in a language other than English.
11. CONTRACTOR certifies that all property, finished or unfinished
documents, data, studies and reports prepared or purchased under this Agreement, will be disposed of
in accordance with the direction of the CITY. In addition, any tools and/or equipment furnished to the
CONTRACTOR by the CITY and/or purchased by the CONTRACTOR with funds pursuant to this
Agreement, will be limited to use within the activities outlined in this agreement and will remain the
property of the United States Government and/or CITY. Upon termination of this Agreement,
CONTRACTOR will immediately return such tools and/or equipment to the CITY or dispose of them
in accordance with the direction of the CITY.
12. CONTRACTOR certifies that this Agreement does not provide for the
advancement or aid to any religious sect, church or creed, or sectarian purpose nor does it help to
support or sustain any school, college, university, hospital or other institution controlled by any
religious creed, church, or sectarian denomination, as specified by Article XVI, Section 5, of the
Constitution of the State of California, regarding separation of church and state.
13. PATENT, COPYRIGHTS AND RIGHTS IN DATA. The
CONTRACTOR will disclose to the CITY any invention, written product, computer program
developed or data assembled as a result of performance of work under this Agreement within seventy
four (74) days of invention, development or assembly. The CITY, State of California, and U.S.
Department of Labor will have the right to patent any invention and copyright any written product or
computer program or data generated by CONTRACTOR. Upon written request, CONTRACTOR will
transfer all pertinent information, specifications and right, title and interest to the designated agency.
14. INVENTIONS, PATENTS AND COPYRIGHTS.
A. Reporting Procedure. If any project produces patentable items, patent rights,
processes, or inventions in the course of work under a U.S. Department of Labor (DOL) grant or
agreement, the CONTRACTOR shall report the fact promptly and fully to the CITY. The CITY shall
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report the fact to the Grant Officer, at the DOL. Unless there is a prior agreement between the CITY
and the DOL and its representative on these matters, the DOL shall determine whether to seek
protection on the invention or discovery. The DOL and its representative shall determine how the
rightsin the invention or discovery, including rights under any patent issued thereon, will be allocated
and administered in order to protect the public interest consistent with the "Governmental Patent
Policy" (President's Memorandum for Heads of Executive Departments and Agencies, August 23,
1971, and Statement of Government Patent Policy as printed in 36 FR 16889).
B. Copyright Policy.
1. Unless otherwise provided in the terms of the grant or agreement, when copyright -
able material is developed in the course of or under a DOL Grant or agreement, the author and the
CITY which developed the work is free to copyright material or to permit others to do so. The
CONTRACTOR and the Workforce Investment Board (WIB) shall have a royalty -free, nonexclusive
and irrevocable license to reproduce, publish, use and to authorize others to use all copyrighted
material.
2. The DOL reserves a royalty -free, nonexclusive, and irrevocable license to
reproduce, publish or otherwise use, and to authorize others to use, for Federal Government purposes:
(a) The copyright in any work developed under any grant, sub -grant, or contract under a grant or
subgrant; (b) Any right of copyright to which a grantee, subgrantee or a CONTRACTOR purchases
ownership with grant support; and (c) CONTRACTOR shall comply with the requirements of 29
CFR Part 97.34.
C. Rights to Data. The DOL and the CITY shall have unlimited rights to any data
first procured or delivered under this Agreement.
15. CLEAN AIR / CLEAN WATER ACT. If the grant hereunder
exceeds $100,000, CONTRACTOR must comply with Section 306 of the Clean Air Act [(42 USC
1875(h)]; Section 508 of the Clean Water Act (33 USC 1368); Executive Order 11738 and
Environmental Protection Agency ("EPA") regulations (40 CFR Part 15) as any may now exist or be
hereafter amended. Under these laws and regulations, the CONTRACTOR assures that:
(a) No facility to be utilized in the performance of the proposed grant has been listed
on the EPA List of Violating Facilities;
(b) It will notify CITY prior to award of the receipt of any communication from the
Director, Office of Federal Activities, U.S. EPA, indicating that a facility to be
utilized for the grant is under consideration to be listed on the EPA List of
Violating Facilities;
(c) It will notify the CITY and the EPA about any known violation of the above laws
and regulations.
C. CONTRACTOR agrees to adhere to the following STANDARDS OF CONDUCT:
1. General Assurance. Every reasonable course of action will be taken by CONTRACTOR in
order to maintain the integrity of this expenditure of public funds and to avoid favoritism. This
Agreement will be administered in an impartial manner, free from errors to gain personal, financial
political gain. CONTRACTOR, its officers and employees, in administering this Agreement, will
avoid situations which give rise to a suggestion that any decision was influenced by prejudice, bias,
special interest or desire for personal gain.
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2. Employment of Former State or CITY Employees. CONTRACTOR will ensure that any of
its employees who were formerly employed by the State of California or CITY, in a position that
could have enabled such individuals to impact policy regarding or implementation of programs
covered by this Agreement, will not be assigned to any part or phase of the activities conducted
pursuant to this Agreement for a period of not less than two years following the termination of such
employment.
3. Conducting Business Involving Relatives. No relative by blood, adoption or
marriage of any executive or employee of CONTRACTOR will receive favorable treatment when
considered for enrollment in programs provided by, or employment with, CONTRACTOR.
4. Conducting Business Involving Close personal Friends and Associates.
Executives and employees of CONTRACTOR will be particularly aware of the varying degrees of
influence that can be exerted by personal friends and associates and, in administering this Agreement,
will exercise due diligence to avoid situations which give rise to an assertion that favorable treatment is
being granted to friends and associates. When it is in the public interest for CONTRACTOR to
conduct business with a friend or associate of an executive or employee of CONTRACTOR, an elected
official in the area or a voting or non -voting member of the Workforce Investment Board (WIB), a
permanent record of the transaction will be retained.
5. Avoidance of Conflict of Economic Interest. No executive or employee of
CONTRACTOR elected official in the area, or voting or non -voting member of a WIB, will solicit or
accept money or any other consideration from a third person, for the performance of an act reimbursed
in whole or part by CONTRACTOR or CITY. Supplies, materials, equipment or services purchased
with Agreement funds will be used solely for purposes asserted or allowed under this Agreement. No
voting member of the WIB will cast a vote on the provision of services or vote on any matter which
would provide direct financial benefit to that member or any business or organization which the
member directly represents.
`'II.
HOLD HARMLESS
A. CONTRACTOR shall indemnify and save harmless CITY, its officers, agents
and employees, from and against any and all damages to property or injuries to or death of any person
or persons, including property and employees or agents of CITY, and shall defend, indemnify and save
harmless CITY, its officers, agents and employees, from any and all claims, demands, suits, actions or
proceedings of any kind or nature, including, but not by way of limitation, workers' compensation
claims, resulting from or arising out of the negligent acts, errors or omission of CONTRACTOR, its
employees or subcontractors.
B. CONTRACTOR shall indemnify and save harmless CITY, its officers, agents
and employees, from and against any and all damages to property or injuries to or death of any person
or persons, including property and employees or agents of CITY, and shall defend, indemnify and save
harmless CITY, its officers, agents and employees, from and against any and all claims, demands,
suits, actions or proceedings therefore, resulting from or arising out of the intentional or malicious acts
of CONTRACTOR, its employees or subcontractors.
VIII.
INSURANCE
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1. Commercial General Liability. 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.
2. Automobile Liability Coverage. CONTRACTOR shall also obtain and maintain,
during the effective period of this Agreement, broad form automobile liability coverage with a
$1,000,000 limit unless reduced by CITY, which applies to both owned/leased and non -owned
automobiles used by CONTRACTOR employees or participants in performance of this Agreement, or,
in the event that CITY will not utilize such owned/leased automobiles but intends to require
employees; participants or other agents to utilize their own automobiles in the performance of this
Agreement, CONTRACTOR shall secure and maintain on file from all such employees, participants,
or agents as self -certification of automobile insurance coverage. Governmental entities may substitute
a certificate of self-insurance.
3. Workers' Compensation. If CONTRACTOR is an "employer", as set forth in
California Labor Code Section 3300 et seq., or utilizes participants as "employees,'as set forth in
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.
4. Equipment Coverage. CONTRACTOR shall purchase a policy or policies of
insurance covering loss or damage to any and all Equipment provided to or purchased by
CONTRACTOR in accordance with this Agreement. Said insurance shall be in the amount of the full
replacement value thereof, providing protection against the classification of fire, extended coverage,
vandalism, malicious mischief, theft, and special extended perils. Governmental entities may
substitute a certificate of self-insurance.
5. Proof of Insurance. Certificates and endorsements must be submitted and approved
by CITY prior to any work under this Agreement. CONTRACTOR understands that CITY will make
no payments under this Agreement until the required certificates and endorsements have been approved
by CITY.
IX.
CORPORATE STATUS
All corporate CONTRACTORS shall be in good standing, without suspension by the
California Secretary of State, Franchise Tax Board and Internal Revenue Service. Any change in
corporate status or suspension shall be reported immediately to CITY.
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X.
ASSIGNABILITY
None of the duties of, or work to be performed by, CONTRACTOR under this Agreement
shall be subcontracted or assigned to any agency, consultant, or person without the prior written
consent of CITY. CONTRACTOR must submit all subcontracts and other agreements that relate to
this Agreement to CITY. No subcontract or assignment shall terminate or alter the legal obligations of
CONTRACTOR pursuant to this Agreement.
XI.
LAWS GOVERNING THIS AGREEMENT
In its performance under this Agreement, CONTRACTOR shall fully comply with the
requirements of the following, whether or not otherwise referred to in this Agreement:
1. The Act and all applicable federal statutes, regulations, policies, procedures and directives,
including but not limited to, 20 C.F.R. Parts 652 and 660 through 671.
2. All applicable State statutes, regulations, policies, procedures and directives;
3. All applicable CITY policies, procedures and directives;
4. All applicable local ordinances and requirements, including use permits and licensing;
5. Court orders applicable to its operation; and,
6. The terms and conditions of this Agreement.
If any of the foregoing is enacted, amended, or revised, CONTRACTOR will comply with
such or will notify CITY after enactment or modification that it cannot so comply. CITY may
thereupon terminate this Agreement, if necessary.
XII.
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 employment of CONTRACTOR by CITY, and contains
all the covenants and agreements between the parties with respect to such employment. Each party to
this Agreement acknowledges that no representations, inducements, promises or agreements, orally or
otherwise, have been made by any party, or anyone acting on behalf of any party, which are not
embodied herein, and that no other agreement or amendment hereto shall be effective unless executed
in writing and signed by both CITY and CONTRACTOR.
XIII.
FRAUD
CONTRACTOR shall immediately report to CITY all instances and facts concerning
possible fraud, abuse or criminal activity relating to expenditure or receipt of funds under this
Agreement.
XIV.
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CONTINGENCY OF FUNDS
CONTRACTOR acknowledges that approval of and funding for this Agreement is
contingent upon State approval, and funds received or obligated from the State of California to CITY.
If such approval of funds is not forthcoming, or is otherwise limited, CITY shall immediately notify
CONTRACTOR. Within twenty (20) days of receipt of such notice, CONTRACTOR shall modify or
cease operations as directed by CITY and negotiate necessary modification to this Agreement and/or
reimbursement of costs incurred hereunder.
XV.
TERMINATION
This Agreement may be terminated by either party at its sole discretion, upon thirty (30)
days written notice to the other party. Notice shall be deemed served on the date of mailing. However,
CONTRACTOR may not terminate this Agreement if undue hardship will result to any participant.
XVI.
DISPUTES
Except as otherwise provided in this Agreement, any dispute concerning any question
arising under this Agreement shall be decided by CITY. In such a case CITY shall reduce its decision
to writing and mail or otherwise furnish a copy thereof to CONTRACTOR. The decision of the City
shall be final and conclusive unless within thirty (30) calendar days from the mailing or delivery of
such copy, CITY receives from CONTRACTOR written request to appeal said decision.
Procedures governing the appeal shall be prescribed by CITY and/or the State of
California in accordance with the Act and all corresponding regulations and OMB circulars. Pending
final disposition of the appeal, CONTRACTOR shall act in accordance with CITY's decision unless
the dispute involves a change order.
XVII.
BREACH - SANCTIONS
If, through any cause, CONTRACTOR violates any of the terms and conditions of this
Agreement, and/or prior agreements whereby grant funds were received by CONTRACTOR pursuant
to this Agreement, or if CONTRACTOR reports inaccurately or if any Audit Report makes
disallowances, CONTRACTOR shall promptly remedy its acts or omissions and/or repay CITY all
amounts due CITY as a result of CONTRACTOR's violation. For any such failures or violations,
CITY shall also have the right at its sole discretion to either: (1) discontinue program support until
such time as CONTRACTOR fulfills its obligations or remedies all violations of this agreement or
prior agreements; and/or (2) collect outstanding amounts as determined by CITY due CITY by
offsetting or debiting from current claims or invoices, if after thirty (30) days' written notice
CONTRACTOR has failed to repay same or a repayment schedule has not been made; and/or (3)
terminate this Agreement by giving written notice to CONTRACTOR of such termination in
accordance the notice provision in Paragraph XVIII herein below.
XVIII.
NOTICES
Page 12 of 14
All notices, reports and correspondence between the parties hereto respecting this
Agreement shall be in writing and deposited in the United States Mail, postage prepaid, addressed as
follows:
and,
CITY: City of Santa Ana
Manager, WIB Administrative Office
P.O. Box 1988 (M-73)
Santa Ana, CA 92702
CLERK: Clerk of the City Council
City of Santa Ana
20 Civic Center Plaza (M-30)
P.O. Box 1988
Santa Ana, CA 92702-1988
Telefacsimile (714) 647-6956
CONTRACTOR: Orangewood Children's Foundation
1575 East 17"' Street
Santa Ana, CA 92705
(714) 619-0229
Telefacsimile (714) 619-0252
XIX.
MERGER
This Agreement, together with the attachments hereto, expresses the total understanding
of the parties. There are no oral understandings of the parties or terms and conditions other than as
stated herein.
XX.
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.
XXI.
MISCELLANEOUS PROVISIONS
a. Each undersigned represents and warrants that its signature hereinbelow has the power,
authority and right to bind their respective parties to each of the terms of this Agreement, and shall
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.
Page 13 of 14
b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in
the body of this Agreement.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first
above -written.
ATTEST:
Patricia E. Heal;
Clerk of the Council
APPROVED AS TO FORM:
Joseph W. Fletcher
City Attorney
r
BY:
Lisa E. Storck
Assistant City Attorney
RECOMMEND FOR APPROVAL:
C,
Ay��—
Cynthia J. Nelso
Deputy City Manager for Development Services
CITY OF SANTA ANA, a municipal
corporation of the State of California
"CITY"
B:
David N. Ream
City Manager
"CONTRACTOR"
BY: L�
Name: Cal Winslow
Title: CEO
Tax ID #: 95-3616628
Page 14 of 14
Exhibit A
PROPOSAL NARRATIVE
1. About the Program
A. Executive Summary
1. Which WIA population will the program recruit and serve?
This project is intended to serve older, out -of -school foster/emancipated youth.
Foster/emancipated youth are considered a population with "special consideration" as
stated in this Request for Proposal (RFP).
2. Indicate how many participants to be served.
Through support and partnership with the Santa Ana WIB/Youth Council, the
Orangewood Children's Foundation will provide three peer mentors who will serve
15 older, out -of -school foster/emancipated youth.
3. Describe how this program fits in with programs currently being offered by your
agency.
The Orangewood Children's Foundation is among the, leading agencies in Orange
County serving the adolescent and young adult foster youth population. We provide
130 Independent Living Program (ILP) workshops per year for foster/emancipated
youth ages 16-21. Approximately 500 unduplicated youth participate in ILP each
year. Additionally, we provide approximately $800,000 to 250 youth per year for
college tuition and living expenses. Our transitional housing program provides for
approximately 40 emancipated youth per year and the Orangewood Resource Center
(ORC) receives about 3000 duplicated foster youth visits per year.
We currently employ approximately 27 peer mentors who work with our foster youth
clients through the ILP program, the ORC and other key programs. The peer
mentors are currently enrolled in college level studies and are all youth that have
successfully emancipated from the foster care system. Consequently, peer mentors
are well know and highly regarded by our foster youth clientele. Due to a good
amount of exposure to our services and peer mentors by current/emancipated foster
youth, The Foster Youth Liaison Project is a tremendous compliment to our current
programs.
4. Indicate which of the 10 WIA elements the program will offer.
The goals of the Santa Ana WEB/Youth Council and Orangewood Children's
Foundation are similar as we both want our youth most in need, especially
foster/emancipated youth to succeed in their education/training and employment
experiences. Our efforts are intended to lead young people to a successful transition
from adolescence to adulthood. In that endeavor, our organization will focus on the
following YSPN Elements:
• Tutoring, study skills training, and instruction, leading to completion of secondary
school, including dropout prevention strategies
• Occupational skill training, as appropriate
• Leadership development opportunities, which may include community service
and peer -centered activities encouraging responsibility and other positive social
behaviors during non -school hours, as appropriate
• Supportive Services (e.g. tools, books, clothing, etc.)
OCF/Foster Youth Liaison Project 1
Adult Mentoring for the period of participation and a subsequent period, for a
total of not less than 12 months
Follow-up services for minimum of 12 months after the completion of
participation as appropriate
5. Indicate planned outcomes.
The following outcomes will be achieved:
6. Describe the basic program approach (workshop/classroom/in the community).
The primary goal of the Foster Youth Liaison Project is to create access to WIA
services. Over the course of the project year, we will provide universal services
through the Orangewood Resource Center (ORC) to 100 foster/emancipated youth.
In addition to connecting youth to other WIA providers throughout the City of Santa
Ana and County of Orange, the Foster Youth Liaison Project will enroll 15
foster/emancipated youth in the WIA program. Peer mentors will provide intensive
case management to foster/emancipated youth at a 5:1 participant to case manager
(peer mentor) ratio. Each of the three peer mentors will be available in the ORC 15
hours per week. Depending on each participant's Individual Service Strategy, they
may utilize our other services as needed such as our independent living skills
workshops, community service activities, leadership opportunities, tutoring, etc.
7. Describe how you will conduct outreach and recruitment. Include how enrollment
goals will be met by the second quarter of the contract.
Our peer mentors will aggressively advertise and recruit for this opportunity in the
first few months of the program year to enroll 15 participants. Outreach will include
mailings to known foster/emancipated youth residing in Santa Ana, distribute
marketing material at ILP workshops, the ORC, Orange County Social Services and
YSPN sites and provide marketing information in the monthly ILP newsletters.
8. Describe collaborations/partnerships that will assist in recruitment.
The peer mentors assigned to this project will participate in Santa Ana Youth Council
activities which include: monthly Youth Council meetings and YSPN meetings and
the planning of the annual youth forum and youth job fair. They will utilize these
interactions to inform potential participants and partner agencies about the Foster
Youth Liaison Project and distribute marketing materials. Furthermore, the
Orangewood Children's Foundation will utilize its current partnerships with
community and faith base, educational, governmental, and judicial and social services
agencies to achieve the goal of serving foster youth in this project. For example, we
will utilize our relationship with the County of Orange to advertise this project in
Team, Talk, which is a quarterly publication to foster parents.
OCF/Foster Youth Liaison Project
9. Describe how adequate staffing will be maintained to ensure success of this program.
The Foster Youth Liaison Project will staff three part-time peer mentors. The peer
mentors will be currently enrolled in college level studies with a focus on counseling
and/or related fields. The peer mentors will also be youth who have emancipated
from the foster care system and have experienced success as peer mentors through
other Orangewood Children's Foundation programs. The use of part-time staff is
critical to this project. The Foster Youth Liaison Project will provide a 5 :1
participant to case manager (peer mentor) ratio as well as provide the peer mentors
with valuable work experience and training. The peer mentors will be available in the
ORC 15 hours per week. Regular announced schedules will make it easy for
participants to know when they can visit with their assigned peer mentor in the ORC.
Peer mentors will also be available for appointments. hi the case a peer mentor may
have to resign their position prior to the program year end, we will hire another
qualified peer mentor and work hard to ensure a smooth transition. Additionally, the
Education and Career Specialist who is located near the peer mentor workstation is
available as a supervisor for the Foster Youth Liaison Project peer mentors and acts
as a strong resource for the peer mentors and youth when needed.
B. Main Purpose of Program
1. Indicate what will the program accomplish and how it fits in with WIA goals.
The Foster Youth Liaison Project will increase employment/education rates,
diploma/certificate rates and literacy/numeracy rates, offer long-term support to help
foster youth with academics and occupational development and encourage further
education and training. We will serve 15 foster/emancipated youth and accomplish
the following objectives:
Participants
• Literacy/Numeracy Skill Attainment (TBD# participants will become proficient
in basic skills)
• Attainment of Diploma or Certificate (TBD# participants will attain a diploma
or certificate by the end of the third quarter after program exit)
• Entered Employment/Education Rate (TBD# participants will secure a job or
participate in post -secondary education and/or advanced training/occupational
skills training in the first quarter after program exit)
2. What is the length of the program, i.e., how much time will a youth need to be in this
program to get the full benefits of each component offered?
The length of the program is one year with one year of follow up services after
program exit. Although program participants can participate in the program for up to
one year, some participants may not need a full year to accomplish set goals.
However, it is our experience that participants enjoy and benefit from the services
offered in this program and most will participate for the complete year. The time
needed to complete each component of the program is dependent on the abilities and
motivation of each participant.
3. How often will the WIA participant need to attend the program and how often are
specific activities offered (daily/weekly/monthly)?
Activities and services are dependent on participant needs and interests and are not
time based. For example, if a participant needs to find a job the peer mentor may
OCF/Foster Youth Liaison Project 3
spend time with them on pre -employment activities. Peer mentors will be available to
meet the needs of the participants.
4. What is the frequency of staff interaction with WIA participant? Will other non-WIA
agency staff be providing elements of the program? If so, please describe.
Peer mentors will meet with participants on a regular basis, but the frequency and
duration of meetings are dependent on the needs of the participant. Each peer mentor
is available in the Orangewood Resource Center 15 hours per week and available for
appointments as needed.
In general, the peer mentors will be the primary staff providing services to program
participants. Participants may utilize other internal services such as attending
Independent Living Program (ILP) workshops that may impact their progress in the
Foster Youth Liaison Project. All contract responsibilities will be fulfilled by the
staff positions named in this proposal. Management support will be provided when
needed.
5. What services will be offered after youth exits the program?
Peer mentors will remain in contact with FYLP participants for one year after
program exit to fulfill remaining program goals, distribute incentives to participants
who meet program objectives, provide supportive services, and provide any other
general support. Peer mentors will be available in the ORC to provide assistance to
participants by appointment or when they visit the ORC.
C. Goals / Objectives and Performance Levels
1. How will service(s) be deemed necessary? List tool(s) to be used for assessment of
participant's basic skill levels. Describe pre and post testing, primary and secondary
goal determination.
Upon successful enrollment in the Foster Youth Liaison Project, participants will
complete the Test for Adult Basic Education (TABE) for Math and English. If the
results from the TABE show a participant is Basic Skills Deficient appropriate
services will be provided. The TABE will be utilized as both a pre & post test
assessment. Other participant needs will be determined in an initial interview and
subsequent meetings. Based on individual needs, participant goals will be established
in the Individual Services Strategy (ISS). The ISS will be used as a guide for
participants and peer mentors as to what goals and supportive services the participant
will need and/or pursue.
2. How will services aid in meeting the WIA performance goals?
Peer mentors will maintain case files and work with program participants to increase
placement in employment or education, attain a degree or certificate, become basic
skills proficient, offer long-term support to help participants with academics and
occupational development and encourage further education and training. They will
also provide tutoring, leadership opportunities, supportive services and mentoring and
seek feedback from participants about how we may improve program services. Peer
mentors will participate in Youth Council and YSPN meetings and activities and OCF
will provide a youth friendly environment. The availability of three part-time (each
available 15 hours per week in the ORC) peer mentors as case managers at a 5:1 ratio,
utilization of the Orangewood Resource Center (ORC), access to internal services and
resources and community partnerships are all key elements in meeting the WIA
OCF/Foster Youth Liaison Project 4
performance goals.
3. Describe how you will monitor program activity and manage for performance.
Peer mentors will meet regularly with each participant and assess progress on
program goals. They will also record program activity and participant performance in
client case files and the VOS database. Peer mentors will provide services based on
individual needs. The Foster Youth Liaison Project Supervisor will meet with peer
mentors on a regular basis to discuss participant progress, review case files and
ensure contract compliance. Also, WIA staff may perform program audits by
interviewing peer mentors and reviewing case files and may suggest changes to better
meet participant progress and contract obligations.
4. Describe how applicant plans to deliver academic assistance to raise the skill level of
youth who are basic skill deficient.
Peer mentors will deliver academic assistance in one or all of the following options.
• Peer mentors may provide tutoring to participants. They may utilize a homework
binder provided by WIA containing written resources and assignments for math
and reading
• Peer mentors may refer participants to outside tutoring resources when needed
• Peer mentors may work with participants utilizing web -based tutoring programs
5. Will the participant receive a certificate of completion or accomplishment for
participation? Will the certificate count for WIA credential attainment rate?
A certificate of completion will be provided for general participation in the Foster
Youth Liaison Project (FYLP), but will not count for WIA credential attainment. The
FYLP certificate of completions will simply serve as a form of recognition for
program completion. However, some participants may receive certificates of
completion for programs they may participate in. (dependent on individual's needs
and goals). Some certificates of completion may include a diploma, GED, higher
education degree or certificate or a completion certificate from ROP, in which case
would count for WIA credential attainment. Other certificates may not count for
WIA credential attainment.
6. How will continuous improvement be measured and conducted?
For participants who are determined to be Basic Skills Deficient, we will gage
improvement with the utilization of the Test of Adult Basic Education (TABE). The
TABE will be used as a pre and post test assessment to show literacy/numeracy gains.
The peer mentors will also gauge improvement by participant's competency during
the tutoring process. Furthermore, peer mentors will continually assess participant's
progress and success with individual and program goals. OCF will seek participant
feedback to assess program strengths and areas for improvement. Finally, SAWC
staff may review case notes, service provision, and data recording periodically
throughout the program year and may provide constructive feedback. Adjustments
will be made accordingly.
D. Program Description
1. Describe the overall services that will be made available to the WIA participant.
The Foster Youth Liaison Project will provide universal services onsite at the
Orangewood Resource Center. All foster/emancipated youth will receive universal
OCF/Foster Youth Liaison Project 5
services such as internet access to employment and training information, job leads,
and information on supportive services and other WIA funded programs. Three peer
mentors will be dedicated to this project. The primary focus of the peer mentor is to
provide support to the Orangewood Children's Foundation staff and to work with
youth as they request employment related information at the resource center. The
peer mentors will identify WIA eligible youth that request and require additional
intensive case management services. The ratio of participant to peer mentor is 5:1.
With a focus on intensive case management for a population of youth that have
multiple barriers, a total of three peer mentors will be hired for this project. The peer
mentors will assess and develop an Individual Service `Strategy (ISS) Plan for each
enrolled participant. The Foster Youth Liaison Project will provide pre -employment
services and supportive services. For those youth who are assessed to be basic skills
deficient, an individualized tutoring program will be developed. Participants may
receive tutoring services through their assigned peer mentor or through another
community base or educational entity. Peer mentors may use web -based tutoring
programs as well.
2. Describe how collaborations/partnerships will enhance program services and
outcomes.
OCF highly values collaborations and partnerships and has established a strong
network of support in our 25 year history. Working with other people and agencies is
necessary to meet the vast needs of our clientele. Although we have expertise and
resources in certain areas, we rely on other's strengths to provide knowledge and
services that are beyond our capabilities or functions. We are also able to provide
many internal resources such as tuition for higher education, support to high school
students preparing for higher education, adult mentoring, housing, independent living
skills training, etc.
By participating at the Youth Council meetings, YSPN meetings, meetings with
Social Services and foster parent meetings we plan to utilize these and other
opportunities for outreach and recruitment. Furthermore, we realize there may be
opportunities for our clients to participate in programs offered by other YSPN
providers. For example, during PY 2007/2008 one Foster Youth Liaison Project
participant graduated from Taller San Jose. Additionally, three participants were
enrolled with Taller San Jose and three more are currently on the waiting list. We
also had one participant involved with ROP.
OCF's partnerships with other agencies, educational institutions, employers, internal
programs and our youth are important for participant success and we will leverage
those resources as needed.
3. Describe how the participant flow will occur. Please see the table below.
4. Include the following categories:
Outreach /Recruitment /Eligibility Determination
Intake /Assessment
Case Management
- Program Services /Parent and Employer Involvement
Placement in Jobs or Continuing Education
Follow-up and Retention (Describe how you will continue to support youth during the
OCF/Foster Youth Liaison Project 6
follow up period. Discuss types of sources of support, services and frequency of
nn»tnnt With vnvth 1
Services
Location
Delivery Method
Responsible
And Timeline
Partner
Outreach &
• Orangewood Resource
• Presentations & Mailings
• Peer Mentors
Recruitment
Center (ORC)
• Distribution of marketing material
• Orangewood
• YSPN sites
• One on one orientations at ORC
Staff
• Social Service sites
Timeline: Ongoing, aggressive from
• YSPN Providers
7/l/08 — 12/31/08
Universal Access
Orangewood Resource
• Internet Base Service Information
Peer Mentors
Center
• Job Resources
• Independent Living Program
Workshops
Timeline: 7/l/08 — 6/30/09
Eligibility
Orangewood Resource
• Individual orientation of program
Peer Mentors with
Determination and
Center
services and requirements
the assistance of One -
Enrollment
• Collection of all eligibility
Stop
documentation
• Continued development of ISS
Timeline: 7/30/08 — 12/31/08
Intake/Assessment
Orangewood Resource
• Basic assessment of service need
Peer Mentors
Center
• TABE testing
• Development of ISS
Timeline: 7/30/08 — 12/31/08
Supportive
Orangewood Resource
• Need determined during ISS
Peer Mentors
Services
Center
• Child Care, Bus Pass, School
Books, Gas Cards, and other
services determined by client's
status and activity
Timeline: 7/l/08 — 6/30/09
Job Placement or
• Orangewood
Receive instruction and coaching in
• Peer Mentors
Continuing
Resource
presentation of materials including, but
• EDD
Education (Job
Center
not limited to:
• Orangewood
Search, Career
• ILP Workshops
• How to write a resume, how to
volunteers
Preparation, Life
interview for a job, fill out
Skills Workshops
applications, search for a job and
how to dress for success
• Educational opportunities available
through the One -stop and higher
education
• Career options related to the career
of their interest
• How to manage money by opening
a bank account and the dangers of
mismanaging credit
Timeline: 7/1/08 — 6/30/09
Literacy/Numeracy
. Orangewood
• Individualized Tutoring
• Peer Mentors
Gains
Resource
• Computerized Tutoring
• Community
Center
• Mentoring
Based or
"
• YSPN sites
Timeline: 7/l/08 — 6/30/09
Educational
Entity
OCF/Foster Youth Liaison Project
Case Management
• Orangewood Resource
• Face-to-face, one-on-one intensive
Peer Mentors
Center
case management
• Employer site
• Supportive Services provided
• Training site
Timeline: 7/l/08 — 6/30/09
Parent & Employer
• Orangewood Resource
• Facilitate inclusive sessions with
Peer Mentors
Involvement
Center
parents and/or employers as
• Employer Site
necessary to achieve goals
Timeline: 7/l/08 — 6/30/09
Program Exit
Orangewood Resource
• Prior to exiting, participants will be
Peer Mentors
Center
reviewed for their Post Assessment
results. Participants who have
chosen to exit the program prior to
completion may not be available for
assessment
• Follow up services will be
established
Timeline: 10/31/08 — 6/30/09
Follow-up &
• Orangewood Resource
• Follow-up services may include one
Peer Mentors
Retention Service
Center
or more of the following:
• Employer site
• Worksite visit, phone conversations,
• Training site
employer contact and/or any other
form of contacting the participant to
determine current status and needs
• Supportive Services may be
provided
• Continuous case management
support will be provided (frequency
is dependent on the need of the
client)
Timeline: 12 months after exit
E. Facilities
1. State location where program services will be delivered.
The Orangewood Children's Foundation (OCF) is located in Santa Ana at 1575 E.
17th Street. This location is easily accessible by bus as there are bus stops (eastbound
and westbound) directly in front of the facility. Additionally, our facility is centrally
located between 22, 55 and 5 freeways. OCF is well known to our adolescent and
young adult population ages 16 - 21 as we conduct approximately 100 ILP workshops
at this location per year. We also have approximately 2000 duplicated visits to the
ORC per year.
2. How will participant access site if not within City of Santa Ana boundaries?
Although our facility is located in Santa Ana, sometimes our clients may not be able
to get to us. Fortunately, our Foster Youth Liaison Project peer mentors are
accessible by telephone, email and they may meet a client in the field when
necessary.
3. List hours of operation?
The Orangewood Children's Foundation hours of operation are Monday through
Friday from 8:30 a.m. — 5:00 p.m. The Orangewood Resource Center (ORC) is open
OCF/Foster Youth Liaison Project
Monday through Thursday 9:00 a.m. — 5:00 p.m. and Friday from 9:00 a.m. — 1:30
p.m. Clients who make an appointment with ORC staff or peer mentors may meet
with them or utilize the ORC after hours.
4. Is the facility compliant with the Americans with Disability Act (ADA)? Base Your
answer on completion of ADA/EEO Survey (see attachment F). Describe corrective
action plan if necessary.
Yes, the Orangewood Children's Foundation facility is compliant with the Americans
with Disability Act (ADA). We have also assessed our facilities using the WIA
Nondiscrimination & Equal Opportunity Self-Evaluatioh Guide.
Discuss how Internet access will be available to program staff. List computer
programs/applications used by agency staff.
Every member of our program staff including our peer mentors involved in the Foster
Youth Liaison Project have a workstation with access to telephone, computer with
internet connection and Microsoft Office software including Excel, Power Point, Word,
Outlook, Publisher and Access. Furthermore, there are three computers with Microsoft
Office software and internet access located in the Orangewood Resource Center for our
foster youth clientele.
II. About Your Organization
A. Description of the Proposer
1. Discuss the current number of full time and part time personnel employed, average
annual operating budget and sources of revenue.
The Orangewood Children's Foundation (OCF) has a current annual operating budget of
over eight million dollars. OCF receives funding from multiple funding sources
including government grants, private and corporate donors, joint business ventures, event
fundraisers, etc. We currently employ 60 full-time employees and 38 part-time
employees including 27 part-time peer mentors.
2. How long has your organization been serving Santa Ana youth?
Orangewood Children's Foundation is a private, 501(c)3 nonprofit organization
established in 1981 to raise money to build a replacement emergency shelter for Orange
County's abused, neglected and abandoned children. The result was the Orangewood
Children's Home, which was dedicated in 1985. After completing an expansion to the
Home in 1992, the Foundation turned its attention to serving the on -going needs of these
children and their families. OCF programs assist foster children and former foster
children leaving the dependency system, strengthen at -risk families, and are designed to
prevent and break the generational cycle of abuse. Although our services are not
exclusive to foster youth residing in Santa Ana, many of our clients reside in Santa Ana.
According to the Orange County Social Services Agency, there are approximately 150
foster/emancipated youth between the ages of 16 & 21 residing in Santa Ana. These
numbers do not include homeless emancipated youth and foster youth that have been
returned to their biological parents but remain under the Juvenile Court supervision.
3. What kind of impact has your services made to the youth in the community?
- Our Fiscal Year 2006/2007 Outcomes will illustrate the impact of our client services
in a one year period:
OCF/Foster Youth Liaison Project V
Scholarships & Financial Assistance
Our Children's Trust Fund provides financial, educational and emergency assistance to
current and former foster youth, with an emphasis on those who are pursuing higher
education after emancipation (release from the dependency system at age 18).
• Over $720,000 was provided in scholarships to 241 young adults for college or trade
school. These students attended 58 schools in 8 states throughout the U.S.
• Awarded another $140,000 in other grants to 421 children and young adults seeking
assistance.
Guardian Scholars Program
A nationally recognized program that partners with local educational institutions to
provide comprehensive support and resources to former foster youth in their efforts to
gain a university, community college or trade school education.
• Supported 127 students.
• Had 26 students successfully graduate during the year, bringing the total to 104.
• Partner schools in the greater Orange County area now total 15 and include CSUF,
UCI, Orange Coast College, Hope International University, Chapman University,
American Career College, Fullerton Community College, Concordia University,
Taller San Jose, USC, UCLA, Santa Ana College, Loyola Marymount University,
Cypress College and CSU San Marcos.
Rising Tide Communities/Housing
Rising Tide offers motivated, former foster youth affordable, quality housing and a
supportive, goal -directed community for successful transition into adulthood.
• Provided transitional housing throughout the year to a total of 46 former foster youth
at Rising Tide's two apartment complexes.
• Various housing assistance and referrals were also provided to more than 90% of
additional Orangewood youth as housing continues to be their #1 issue.
Orangewood Resource Center (ORC)
The ORC is a drop in center providing guidance, assistance and access to resources
needed to become independent. Areas of focus include education, employment, career
counseling, housing and healthcare.
• Served more than 400 youth seeking assistance in a total of over 3,000 visits.
Peer Mentor Program
Provides an opportunity for former foster youth to mentor teens currently placed at
Orangewood Children's Home, youth in foster care and those accessing services at the
ORC.
• Held 13 sessions at the Home reaching approximately 260 teens and facilitated small -
group sessions at 133 ILP workshops for over 680 teens.
• Developed leadership skills for 32 Peer Mentors through training sessions and an off -
site retreat.
• Peer mentors provided case management to 12 youth through the Foster Youth
Liaison Project assisting them with occupational development.
Independent Living Program
OCF/Foster Youth Liaison Project 10
Provides workshops, special events, and support services to foster youth, ages 16 to 21, to
help them prepare for emancipation.
• Held 133 ILP workshops.
• Almost 12,000 hours of instruction were provided to over 680 teens.
Independent Living Coaches
Provides one-on-one guidance to foster youth needing extra support pre- and post -
emancipation, beginning at age 16 and up to age 21.
• Provided almost 4,500 hours of assistance to a total caseload of 232 youth.
• Provided 219 additional youth with information and referrals.
Mentor Program
Developed to provide one-on-one adult interaction for the increasing number of foster
care youth in our programs. Mentors support and encourage youth of all ages, from
kindergarten through college and beyond, especially as they transition out of the foster
care system into a life on their own.
• Have 158 mentors.
• Held 27 training sessions.
M-Power (ages 5-14)
This program was created in March, 2007, to expose foster children to experiences with a
healthy adult, allowing the child to begin seeing life's possibilities at an earlier age.
• Matched 10 children with mentors.
Bridges to Higher Education (high school students)
This program was created to increase awareness of higher educational opportunities for
foster youth. High school aged foster youth are matched with educational mentors and
participate in a variety of activities to stimulate their interest in higher education and to
increase graduation rates from high school.
• Held 4 workshops and outings for 28 youth and mentors.
• Helped 9 foster youth enrolled in the program graduate from high school.
• Increased program enrollment to 64 Orange County youth.
Transitions (ages 16-25)
This program was created to provide youth, many of whom already receive some form of
Orangewood services, with a mentor who will provide extra support and advice about
daily living, educational opportunities and career planning.
• Matched 36 youth with mentors.
California Youth Connection
A statewide organization led by current and former foster youth between the ages of 14-
24 who participate in policy development and legislative change to improve the foster
care system. Orangewood funds Orange County's CYC chapter.
• The chapter's 24 members held 11 local meetings and attended 4 statewide events.
Time Out for Parents
Coordinates short term, temporary care for children in foster care so that their foster
parents can take a break and recharge the energy necessary to care for them.
OCF/Foster Youth Liaison Project 11
• Received 1,384 requests for respite care, matching 87% with respite providers.
• Coordinated almost 75,000 hours of care for 276 children.
Orangewood Children's Home
The Foundation provides financial support, activities and mentoring for abused and
neglected children placed at Orange County's emergency shelter.
• Provided $551,500 toward the construction of a nursery and the renovation of two
cottages and over $87,800 in other support and supplies.
• Held 24 special events and activities for the children through the PALS auxiliary.
Community Programs
An array of services, offered in partnership with Orange County Social Services Agency,
the Children & Families Commission of Orange County, foundations, hospitals & other
community -based organizations, for at -risk families and their children to prevent abuse
before it starts.
• Provided support services to more than 8,444 children and their families at 14 Family
Resource Centers through Families and Communities Together (FaCT) funding.
• Provided 3,407 young children with health assessments and links to health insurance,
immunizations and primary care medical providers, through the
ProjectConnections.FRC Health Access program.
• Provided over 338 clients with 56 quality trainings and over 550 hours of individual
client assessment and support through CONNECT, focusing on strengthening
organizational practices and individual leadership skills.
B. Experience
1. Briefly outline all youth programs that your agency has operated during the last 2 years.
• Children's Trust Fund: Provides financial assistance for higher education and
special needs such as summer camp, sports programs and counseling.
• Guardian Scholars: In collaboration with local educational institutions, this
program provides scholarships and on -campus support including academic
advisement, housing, job assistance, tutoring, financial aid, and mentoring to help
former foster youth navigate the personal and academic challenges of university,
community college, or trade school.
• Rising Tide Communities: This collaborative transitional housing program offers
subsidized apartment living personal development activities, a mentor, job placement
and school assistance to prepare foster youth for a successful transition towards
independence.
• Peer Mentor Program: Young adults, once part of the dependency system and now
working or enrolled in college, work to help teens in the foster care system find their
way to success.
• Foster Youth Liaison Project: Peer mentors provide one on one case management
to foster youth to assist them with occupational development and preparation for the
labor force.
• Youth Advocate Program: Peer mentors provide support to foster youth at
Emancipation Planning Conferences and Team Decision Making meetings to ensure
the youth's voice is heard and their interests are considered in decision that will affect
their life. Youth advocates also participate in community meetings and trainings
representing the foster youth perspective.
OCF/Foster Youth Liaison Project 12
• Independent Living Program: Education, career, relationship, and daily living
skills preparation for the time when they will be released from the dependency
system.
• Independent Living Coaches: One-on-one guidance and support to help foster
youth make a successful transition to independent living.
• Orangewood Resource Center: Drop -in center for current and former Orange
County foster youth offering services they need to become independent adults,
including educational activities and resources for jobs, college, housing, health, etc.
• Transitional Housing Referral Clearinghouse: , As Orange County's referral
resource center, we support current and developing transitional housing programs for
former foster youth.
• Bridges to Higher Education: To increase high school graduation rates and
admission to college or trade schools, foster youth with academic potential for college
success receive intensive preparation for the demands and opportunities of higher
education.
• California Youth Connection: A leadership group made up of current and
emancipated foster youth —acting as Orange County's representative to this statewide
organization —who participate in policy development and legislative change in the
area of foster care.
• Time Out for Parents: Short-term care for abused, neglected and at -risk children
that allows parents and foster parents to take a break and recharge the energy
necessary to care for them.
2. What kind of experience do you have in incorporating parents, youth and employers into
your programs?
Due to the nature of the population we serve, we generally do not have access to our
client's parents. Foster youth are removed from their parents or custodians due to abuse
or neglect and are under the supervision and care of the Orange County Social Services
Agency. Many of the clients we serve reside in group homes, foster homes or with
relative care -takers.
Orangewood Children's Foundation (OCF) is diligent about engaging potential
employers, our clients and their care -takers, which may include biological parents. We
include them on our ILP newsletter mailing lists, publish program services in the Team
Talk quarterly publication from the County of Orange to foster parents and invite care-
takers to participate with our youth at ILP workshops and special events. OCF also
provides independent living skills assignments on our website, which are available to
clients and care -takers. Care -takers are encouraged to work with youth on these
assignments and some assignments require interaction with employers or potential
employers.
Some examples of our experience engaging youth, parents and employers are as follows:
Through the OCF Community Programs we serve approximately 8,500 duplicated
children and their families at 14 Family Resource Centers in Orange County per year.
The Time Out for Parents program provides respite care or short-term care for
approximately 275 children per year to give foster parents or biological parents a break to
prevent the foster parent from burning out or the biological parent from potentially being
separated from their children due to abuse or neglect. The Independent Living Coaches
OCF/Foster Youth Liaison Project 13
(ILC) provide case management to approximately 200 youth per year. In their
interactions with their clients they often engage foster parents, social workers, relative
care -takes, biological parents, group home staff and employers for client success. ILCs
also engage youth after hours and on weekends. Potential employers are often integrated
through the Independent Living Program (ILP) as we invite them to present at
workshops (workshops take place during the evenings and on weekends to make it easier
for client participation), participate at ILP Career Fair and Independent City and post job
opportunities in the Orangewood Resource Center (ORC).
OCF staff also participate in many community meetings such as the monthly Orange
County Mentoring Partnership meetings, DOVIA Volunteer Management Organization
meetings, Children's Services Coordination Committee (CSCC), CSCC Emancipation
Subcommittee, Foster Youth Services Task Force, Volunteer Coordinator Roundtable,
Vital Link meetings, and social worker and foster parent trainings, etc.
When needed, the Foster Youth Liaison Project peer mentors will engage parents (if
available), foster parents, relative care -takers, group home staff, social workers and
employers to help the participants. Peer mentors will also engage and empower the
participants by meeting with them regularly, assessing needs and helping them focus on
individual tasks for program success.
3. Describe how staff will receive training and ongoing staff development to increase staff
capacity and expertise in the field of youth development and employment.
In partnership with the Santa Ana WIB, OCF provided services to 12 foster youth in
Program Year 2006/2007 and 20 foster youth during Program Year 2007/2008 (still in
progress) through The Foster Youth Liaison Project. The peer mentors involved with this
program receive valuable training on participant enrollment and exit procedures, client
assessment, TABE testing, case recording, VOS data entry, case management strategies
and community resources including services at the Santa Ana WORK Center. The peer
mentors also participate in six trainings and one weekend retreat per year which focus on
topics such as:
• Program Values • Working with Adolescents
• Effective Listening & • Leadership
Communication Skills • Counter -Transference
• Boundaries • Identifying & Dealing with
• Problem Solving & Conflict Feelings
Resolution • Empathy
• Dealing with Emotions • 8 Commandments of Peer
• Group Facilitation Mentoring
• Team Building • Social & Business Etiquette
• Public Speaking • Understanding Child Abuse
• Resources for Youth & Neglect
• Assertiveness • Scenarios & Role Play
Three FYLP peer mentors who participated in the 2007/2008 program year will return for
2008/2009, which means trained, and experienced peer mentors will be involved from the
beginning of the new program year.
OCF/Foster Youth Liaison Project 14
4. List the positions dedicated to this proposai. Include a description of duties and time
allocation for each responsibility.
3 Peer Mentors @ .375 FTE each (Peer Mentor positions are PT 15 hours per week)
Job Duties Include:
• Participate in Santa Ana Youth Council Activities (i.e. monthly Youth Council
meetings, YSPN meetings and planning of the annual youth forum and youth job fair)
• Recruit participants and develop an Individual Service Strategy (ISS) for each
participant
• Intensive case management with a 5:1 peer mentor to participant ratio
• Case recording in the VOS database and on -site client files
• Be available 15 hours per week in the Orangewood Resource Center
• Provide pre -employment services and supportive services
• Develop an individualized tutoring program for those participants who are assessed to
be basic skills deficient
• Provide Post Assessment upon program exit and 12 months of follow-up services
1 Peer Mentor Supervisor @ .25 FTE
Job Duties Include:
• Participate in the monthly Youth Service Provider Network
• Plan and facilitate a monthly communication meeting with peer mentors (invitation
will include staff from the City of Santa Ana Workforce Investment Board)
• Meet with individual peer mentors on a regular basis to provide supervision and
support
• Be available to provide support and resources to the FYLP peer mentors and program
participants
• Assist City of Santa Ana staff during program audits
• Ensure contract compliance
1 Staff Accountant @ .05 FTE
Job Duties Include:
• Track expenditures incurred during the invoice period and prepare an invoice based
on the costs incurred as allowed by the contract.
• Assist City of Santa Ana staff during financial audits
• Attend contract meetings as needed
C. Fiscal Capacity
1. Describe the process used to capture and report fiscal data?
The OCF Accounting Department consists of five full-time employees, assisted by a full-
time Development Department employee who is responsible to collect, enter and report
on donation records of receipts from donors. All receipts are handled based on the Cash
Procedures document included in the Procurement Policies & Procedures section of this
proposal. All information for accounting is maintained in the Financial Edge Software
from Blackbaud. The Internal Controls document combined with the Check Signing
document, also included in the Procurement Policies & Procedures section of this
proposal, describe the payables and check writing functions. The staff accountant
processes all county and city billing for government contracts based on monthly reports
from .ihe general ledger. At month end closing entries and accruals are completed by
various accounting staff members and reports are issued to the Board of Directors via the
OCF/Foster Youth Liaison Project 15
Finance Committee. An annual budget is being designed for the upcoming fiscal period
starting July 1, 2008 and will assist in capturing the fiscal plan against the actual results.
2. Attach a copy of the procurement policies and procedures.
OCF's Procurement Procedures are included in this proposal.
3. What systems are used to ensure fiscal accountability and appropriate expenditures, and
planned costs?
Budgeting is used to determine planned costs and monthly reporting against budget to
determine how we are doing compared to plan. All expenditures should be built into the
budget process and additionally require supervisory approval prior to payment.
Secondary approval occurs during the check signing process. Also, OCF's contracts with
the County of Orange are audited by the Orange County Social Services Agency each
year and our agency is audited annually by independent, external auditors.
4. Describe invoicing process and list staff assigned to task.
Accounting staff run reports of expenditures incurred during the invoice period and
prepare an invoice based on the costs incurred as allowed by the contract. A draft of the
invoices as prepared, are reviewed by the program staff who are directly responsible for
the contract prior to submission to the particular agency.
5. Describe how agency's financial stability is not dependent on WIA funds.
The Orangewood Children's Foundation's (OCF) financial stability is not dependent on
WIA funds. This organization has been in existence for over 25 years with a current
annual operating budget of over eight million dollars. OCF receives funding from
multiple funding sources including government grants, private and corporate donors, joint
business ventures, event fundraisers, etc. Additionally, we own our facility and lease
available space to tenants which greatly contributes to the cost of our mortgage and
utilities.
6. Submit most recent/2 years of audited financial statements (see attachment G).
OCF's most recent 2 financial audited financial statements are included in this proposal.
D. Subcontracting
Subcontracting client services/activities is not permissible under this contract. However if
planning to subcontract non -client services, identify subcontracts role and estimated cost for
services.
The Orangewood Children's Foundation is not planning to subcontract non -client
services.
OCF/Foster Youth Liaison Project 16
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HANDLING
UNDER THE
WORKFORCE INVESTMENT ACT
SANTA ANA
WIA
Santa Ana Local Workforce Investment Area
July 1, 2001
Table of Contents
I .
Information Regarding Complaints......................................................
Complaints .............................................2
A. Nondiscrimination and Equal Opportunity Comp ......••••••
1. Policy Statement.......................................................
........................
2. Civil Rights ..
..................................
........... ...............
3. Nondiscrimination Laws under WI
4. How to File Your Complaint ........................................................
B. Criminal Complaints ..........................................................
Il. General Procedures for Handling Non -Criminal Violations of the Act ................................
III. Procedures for Handling Complaints at the SDA Level ......................•..••.••••
IV. Procedures for Handling Complaints at the State Level .......................•.••
V.
Procedures for Handling Discrimination Complaints by Participants ............................••.•.•.•••. 15
VI. Procedures for Handling Handicap ...............
Complaints by Participants ... ............................ 16
GLOSSARY OF WIA TERMS............................•••••
.........................................
1
I. Information Regarding Complaints
A. Nondiscrimination and Equal Opportunity Complaints
Policy Statement
In carrying out the purpose of the Workforce Investment Act (WIA), the City of
Santa Ana Local Workforce Investment Area (LWIA) will establish programs to
prepare youth and unskilled adults for entry into the labor force and to afford
job training to those individuals facing serious barriers to employment. Every
effort will be made to provide services necessary for eligible individuals to
obtain productive employment.
In implementing WIA, all contractors in the Santa Ana LWIA will foster equal
opportunity and non-discrimination, as provided in State and Federal equal
opportunity and non-discrimination laws including, but not limited to:
• Title VI of the Civil Rights Act of 1964
• Title VII of the Civil Rights Act of 1964
• The Age Discrimination Act of 1975, as amended
• Section 503 of the Rehabilitation Act of 1973
• Section 504 of the Rehabilitation Act of 1973
• Title IX of the Education Amendments of 1972
• Section 188 of the Workforce Investment Act of 1998
In keeping with our commitment, no individual shall be excluded from
participation in, denied benefits of, subjected to discrimination under, or denied
employment, in the administration or of inconnection ationa oith ay rig nn age,A funded
handicap, or
program because of race, color, religion,sex, , n
political affiliation or belief.
Participation in programs and activities financially assisted in whole or in part
under WIA shall be open to citizens and nationals of the United States, lawfully
admitted permanent resident aliens, lawfully admitted refugee, parolees, and
other individuals authorized by the Attorney General to work in the United
States.
No individual will be intimidated, threatened, coerced, or discriminated against
because of filing a complaint, furnishing information, or assisting or
participating in any manner inan
investigraton of compliance review, hearing, or
any other activity related to the
4
Administration responsibility for this Equal Opportunity/Affirmative Action
(EOIAA) Program is delegated to the Equal Employment Opportunity (EEO)
Officer for the Santa Ana Local Workforce Investment Area. Equal opportunity
and non-discrimination, however, will only be achieved through leadership and
implementation of a viable Affirmative Action Equal opportunity gram
2. Civil Rights
No one applying for or enrolled in the Workforce Investment Act (WIA)
Programs may be discriminated against because of race, color, creed,
handicap, national origin, sex, age, political affiliation, or beliefs.
This means that - for any of the characteristics listed above:
You may not be denied the opportunity to enroll in WIA.
No benefits or services may be denied you for discriminatory
reasons.
You may not be segregated or treated any differently from other
applicants or participants, while ted; or while you are'worka g or
interviewed, counseledo
attending classes as part of the program.
You must be provided an equal chance to use all facilities
available in the program.
Fair employment practices must
pg,vpromotion,training,
all
sstaff
regard to recruiting, hiring,
compensation, benefits, layoff, and termination.
You have the right to make a complaint if you feel you have been denied any
of the above opportunities. You cannot in any way be penalized for filing a
complaint. Your WIA sponsor has established a mechanism for handling
complaints or grievances. Your complaint must be filed within 180 days. All
complaints will be handled confidentially.
3
3. Nondiscrimination Laws under WIA
Title VI of the Civil Rights Act of 1964
Prohibits discrimination on the basis of race, color, national origin, or
religion.
The Age Discrimination Act of 1975
Prohibits arbitrary discrimination against persons age 40-70.
The Rehabilitation Act of f 1973
Prohibits discrimination based on handicap.
Title IX of the Education Amendments of 1972
Prohibits discrimination in any education or training program or activity
receiving federal financial assistance.
OTHER CIVIL RIGHTS LAWS:
Title VII of the Civil Rights Act of 1964
Prohibits discrimination in employment
conditions of employmenn race, color, t aiodn,
sex, or national origin in all terms aopportunity Commission as the
establishes the Equal Employment Opp Y
administrative agency.
White House Executive Order No. 11246 as Amended by Executive
Order No. 11375
Creates the office of Federal Contract Compliance and prohibits
discrimination based on race, color, sex, religion, or national origin.
Department of Labor Secreta 's Order no. 4-73
Prohibits discrimination based on sex.
Equal Pay Act of 1963
Prohibits pay differential solely because of sex.
0
Emer/Yoncy Employment Act of 1971
Prohibits discrimination b2sed on race, creed, national origin, political
affiliation, or beliefs.
4. How to File Your Complaint
a. Put your complaint in writing.
b. Have it sworn to before a notary public, if possible. and when
C. Provides details that tell what happened, where it happened,
it happened.
d. Give the name and addresses of all persons who were present or who
had anything to do with the matter.
Complaints on the basis of race, color, or national origin, age, sex,
religion, political affiliation or belief, occurrence and
dircitizenship,
must be
filed within 180 days of the allegedccu
Director
Civil Rights Center
U.S. Department of Labor, Room N-4123
200 Constitution Ave., NW
Washington, D.C. 20210
Complaints on the basis of handicap la ntsust be filed within must b filed d 8ectdlyywith
s of
the alleged occurrence. These comp
the WIA administrative entity. The WIA administrative entity shall issue
a written decision within 30 days of the fag thecomplaint.
topthe Chief of
complaint is still unresolved, an appealY be
State Workforce Investment Division Office,
The Department of Labor, the Civil Service Commission, the Equal
Employment Opportunity Commission, and many other offices and agencies
are committed to assuring equal employment opportunities for all persons.
They will protect you.
A case may be taken to court if the other processes do not yield satisfactory
results.
You may hire your own lawyer, or if you cannot afford one, the court may
appoint one for you.
F
It is unlawful for an employer, union, or employment agency to punish you or
any witness for attempting to present the facts in a case.
YOUR CIVIL RIGHTS UNDER THE
WORKFORCE INVESTMENT ACT
Santa Ana Local Workforce Investment Area
1000 E. Santa Ana Blvd., Suite 200
Santa Ana, CA 92701
(714) 565-2600
g, Criminal Complaints
In accordance with the WIA (P.L. 105-200) anthe implementincode of complaints and geport of fraudarabuse
al
section 667.600.... Federal handling of criminalcom p
and other criminal activity. "All information ctldlaints immediately to tghfe City obSanta
or
other criminal activity shall be reported directly and m
Ana and the Secretary of Labor.
II. General Procedures for Handling Non -Criminal Violations of the Act
The following procedure is promulgated to meet the requ f ements f Title 20, f and Section
Federal Regulations, Section 667.600 through 667.640 o ti the State and
181(c) of the Act (Public Law 105.200: 2h arin Caned resolution of complaints by WIA
LWIA level for the receipt, investigation, g
participants, subrecipients, applicants for participation, or financial assistance, labor unions,
community based organizations, or any other persons.
These procedures provide for resolution of non -criminal complaints arising from the
operation of the Santa Ana LWIA.
A complaint is defined here as a written expression by grants, party shaging a g eementlation other of
the
Act, regulations promulgated under the Act, recipientg
specific agreements under the Act, including terms coditions of mployments anent of such
participants in employment training programs. All complaints,
withdrawals shall be in writing. These procedures are intended
with WIA programs Aerated
to resolve matters which
concern policies, procedures or action(s) arising in connection
by each LWIA grant recipient and subrecipient under the Act.
lega
These procedures shall not be construed as affectinge regarding termsany other labd condlitionseof
dy
outside of the WIA complaint process (i.e., disputes g
employment of any employee who is not a participant), non-WIAp rate) orint. simu ttheo sly
that a person may wish to pursue in the resolution
of a procedures do not restrict the LWIA grant recipient staff in carrying out informal discussion
n
nt staff in
procedures do not restrict the LWIA grant recipieethe formalomp complaint
discussionand resolution of any problems outside of and without resort to
procedure.
A, The following principles and rules apply to all complaints at all steps of the complaint
procedures:
1. All complaints must be made in writing within 180 days of the alleged
occurrence, except complaints alleging fraud or criminal activity.
2. All persons filing a complaint shall b ro informally rresolvepheal' or
discrimination. Good faith efforts shall be made to
complaint prior to the scheduled hearing. Complainants have the right to
withdraw their complaints (in writingmai antt tome corpect terior � hn cal defithe giencies but
complainant may amend his/her co p
not to add issues.
3. Complainants shall have the right tobe represented
he complaint process.
expense by
person(s) of their choosing at all levels of
ll
4, Upon enrollment into employment or tpincludingtnot itinacabo pof theitl
rovided
with a written description of these procedures
right to file complaints and instructions for filing.
An employer of participants, including private -for -profit employers of
participants, may use this or other complaint resolution procedures so long as
the participant is informed of the complaint
resolution compin procedure
s are they are to
follow and the time frames governing rev
A "participant', within the meaning of these procedures, is an individual who
receives employment -training services under a program funded by Santa Ana
LWIA. The Complaint Resolution Procedures contained herein (or the
alternative procedures which an employer may use) shall be available to
participants to resolve disputes regarding items and conditions of employment
of such participants in employment training programs. However, such
procedures shall not be used to resolve disputes rg grding terms and
rf on„ Pmn►nvee who is not a participant as defines
herein.
5. If a complaint does not receive a decision at the LWIA grant recipient level
within 60 days of filing the complaint or receives an unsatisfactory decision,
the complainant then has a right to request a review of the complaint by the
Governor.
7
6. Complainants must initially file and
exhaust
except where the Statehdetermines
earing
procedures prior to appealing to the State
that the LWIA grant recipient's procedures are not in compliance with the
State's procedures.
Ill. Procedures for Handling Complaints at the LWIA Level
A. Receipt of Complaints
Pursuant to the WIA regulations found at 20 CFR, Section 667.600, ad eeLWve
IA
administrative entities have the responsibility to conduct hearings he LWIA.
complaints made by individuals about the administrationentity andfprograms employe employers twh ch the
"LWIA level" encompasses LWIA administrative
administrative entity has delegated the complaint
is nre Ilwith WIA programs
n process. The following
comprise the guidelines for resolving issues a gn connection
s arising from
operated by the Santa Ana LWIA including resolutions
°f sancpoansttaken by the
actions, such as audit disallowances or the
Governor with respect to audit findings, investigations or monitoring reports.
Form and Filing of Complaint
Official filing date of the complaint is the date the written
coqual mplaint
is received.
The filing of the complaint with the Santa A hWIA
Opportunity officer shall be considered as a request for hearing and a
decision must be issued within 60 days•The alaint mustlso contain the folloe in wing
and
must be signed and dated. The complaint should
information:
a. Full name, telephone number, if any, and mailing address of the
complainant;
b. Full name, telephone number, and mailing address of the agency
involved (respondent);
C. Clear and concise statement of facts including dates constituting
alleged violation;
d. What provisions under the Act, regulations,
been violated or other agreements
under the Act, are believed to
have e. Remedy sought by the complainant; and
f. If the complainant is a privathe complic entityaint t must be corporation,
y atiohoand not zed by
natural person, the filing of p
the governing body of such entity or corporation.
4
3
The absence of any of the requested
dismissing the complaint.
information shall not be a basis for
A copy of the complaint must be sent to the respondent and both parties
notified of the opportunity for an informal resolution. At each step of the
complaint process, the complainant must be notified in writing of the next
procedural step.
Informal Conference
ve
Informal conferences will be utilized by feeences shall notSanAna lextend thle time
complaints; however, such informal co
within which a decision must be issued after receipt
Weeks of the to of Attempts
g of
at informal resolution will commence with ( )
the complaint.
a. The EEO Officer will review the case and ascertain facts solution cant take place at time of
or to the
conference so that appropriate re
this meeting whenever possible.
b. Although the complaintant should eshould nraed ogprec� de h attend/heS right to
thi
conference, his/her failure to do o
request a hearing on the matter.
C. If mutually satisfactory resolution results
brief port for the file stating nta Ana the
concurs, the EEO Officer will write
issues and resolution. The matter shall then be considered closed.
d. If resolution does not result, the complainant shall be provided the
necessary information and assistance to request a hearing if he/she so
desires.
Request for Hearing
a. As in the case of the complaint, therequestuest for aVeearin should be put
b
in writing and be filed in person or y
oar
resolution of authorization to appeal should also be submitted when
appropriate. The request should be filed with:
Lydia H. Morgan
EEO Officer
Santa Ana Local Workforce Investment Area
1000 E. Santa Ana Blvd., Suite 200
Santa Ana, CA 92701
9
b. A hearing will be scheduled by the EEO Officer within thirty (30) days of
the date of filing of the complaint.
4. Notice of Hearing
Upon receipt of the request for hearing, the complainant and thespondent to the date
will be notified in writing of the hearing ten (10) calendar days
prior
of the hearing. The ten-day notice may be shortened with the written consent
of the parties. A decision will be issued b the Santa Ana LWIA within sixty
(60) days of the date of filing of the cop
The hearing notice shall be in writing and contain the following information:
a. The date of notice, name of the complainant, and the name of the party
against whom the complaint is filed.
b. The date, time, and place of hearing before an impartial hearing officer.
C. A statement(s) of the alleged violation(s)
d. Advise as to where information or assistance may be obtained, and the
name, address, and telephone number of the Santa Ana LWIA Equal
Employment Opportunities (EEO) Officer who can answer inquiries.
B. Conduct of Hearing
The hearing shall be conducted in an informal manner with t icltrules o p idence de the
ities should be
ov
not applicable. annecessary adjustment to the circumstancespresented.p esented.
flexibilityyto enablead 1
l . The hearing officer shall have complete independence
nna position totain facts and
ender impartial
make decisions. The hearing officer shall be
decisions and thus should not be subordinate to the Santa Ana LWIA or its
subrecipients. The hearing officer will be selected from a list of names on file
with the EEO Officer.
2. Full regard must be given to the requirements of due process to insure a fair
and impartial hearing.
3. The hearing office designated by the EEO Officer tone function
in a quastheissudicial
capacity should begin the hearing by sum 9
and should explain the manner in s alnds the proch the ring ceedinlgbe s. Sunduexplanatio'ng
sure that everyone involved unde
should be adapted to the needs of the specific situation. The hearing officer
might take testimony under oath or affirmation to give some assurance of
veracity to the hearing.
10
4. The burden of proof should be reasonable and flexible, dependent upon the
circumstances of the case involved. The hearing officer determines the order
of proof. Generally, the party making the complaint has the obligation of
establishing his or her case and should be examined first.
5. The party involved should have the right to be represented (at their own
expense) if he/he so desires. Other he/she is limited to his/her own abilities
and those of the hearing officer in obtaining testimony in the case.
6. It is important that the hearing officer obtain the fullest information for the
record. If the parties involved, or their representatives, do not know how to
ask the right or pertinent questions in Plng their right
atto ve allutherocess, it
materials
shall be necessary for the hearing officertostep nto
and relevant facts elicited.
7. The practice in informal hearings is generally not to apply strict rules of
evidence in obtaining facts. However, the quantity of evidence required to
support a decision on an issue shouldbe
sufficiently
tcredible
uldhconclude that at the ste (or
other appropriate agency), upon reviewinghe decision,
the decision is supported by substantial evidence.
8. The hearing officer should attempt to negotiate a resolution of the issue at any
time prior to the conclusion of the hearing.
g. Within ten (10) days of the conclusion of the hearing, the hearing officer will
issue a recommended decision et ntweit wriA for tdetermination. The
ing accepted rejected or
recommended decision shall b g and may
modified by the Santa Ana Workforce Investment Board.
C. Issuance of Decision
Within sixty (60) calendar days of filing of the complaint, the Santa Ana LWIA shall
issue a written decision to all parties by first class mail. The final decision shall
contain the following information:
1. The name of the parties involved.
2. A statement of the alleged violation and issues related to the alleged violation.
3. A statement of the facts.
4. The decision and the reasons for the decision.
5. A statement of corrective action, if any, to be taken.
6. Notice of the right to request, within ten (10) calendar days of receipt of the
decision, a review of the decision by the State Review Panel.
11
D. Record of Hearing
An administrative file containing support documents on the complaint resolution
process hearing conducted will be retained by the Santa Ana LWIA. The purpose of
a record is to serve as substantiation of the process followed by the Santa Ana LWIA
on the resolution of the issues and the results. This information would then be
available for subsequent review in the event the matter is raised with the State. Such
records must be retained for a three-year period after the grant has been officially
closed out.
The Santa Ana LWIA's written decision earinwill b included
, stenographer' record. note tland tape
received at the hearing, notes by the9 officer,
recordings may also be used.
E. Establishment of Complaint Procedures
In accordance with Section 667,600, each employing agency including private -for -
profit employers of participants under the Act is required to establish a complaint
procedure for resolving matters relating to the terms and conditions of employment.
Employers may operate their own grievance system or may utilize the Santa Ana
LWIA's established procedures under Section 667.600. At a minimum these
procedures must include:
1. Written notice, upon enrollment into employment training services, of the scope
and availability of such procedures. Employer's grievance procedures shall be
set forth in a written document and must meet the regulation mandate that a
complaint will be resolved with sixty (60) days from the date the complaint was
filed. A copy of employer's grievance procedure shall be provided to each
participant upon enrollment in employment training.
2. Written notice, at the time the grievance is filed, of,the procedures under which
the grievance will be processed.
3. Written notification of the disposition of the grievance and a written decision shall
be issued within thirty (30) days of the filing of the grievance unless a present and
long established grievance specifically provides other limits; and
4. Written notification of the participant's right to request a review of the employer's
decision by the Santa Ana LWIA and the State Review Panel in accordance with
Section 667.600.
12
IV. Procedures for Handling Complaints at the State Level
Section 181(c) of the Act and the WlA regulations Fthe LWIA grant
of com
the Governor to establish a State Review process paints filed at
recipient level and of complaints initially filed at the State level.
Appeals of decisions issued at the LWIA level including audit aPanel shallaetliew the sanctions
shall be reviewed by the State Review Panel. The State Review
record established at the LWIA level and shall issue a decision based on the information
contained therein.
Complaints which may be initially filed at the StateilebeheardDiv sio b(WID) y an dTpe hearing
endent
hearing officer designated by the State Workforce Investment
officer shall conduct a hearing and issue a recommended decision o the rejected State
Pan
f el by the
The
recommended decision shall be in writing and may beaccepted,
State Review Panel.
A. Form and Filing of Complaint.
Request for State Review of LWIA Level Decisions
On receipt of a complainant's request for review because of an unsatisfactory
decision, the State shall provide for an independent state review.
2. Filing of Requests for State Review
The State Review Panel shall review all LWIA level decisions when a request
for review is filed within 10 days of receipt of the adverse decision. Such
requests must be filed in writing with the Chief oft e WID Office. The request
for review should contain the following
a. Full name, address, telephone number of the party requesting the
review
b. Full name, address, telephone number of the other party
C. A copy of the decision
d. Brief statement of reasons for dreviee latory and st tutory citar the sectin of the lt ions
decision to be reviewed in g 9
e. A statement of the relief sought.
13
3. Complaintant Responsibility
It is the responsibility of thecomplainant
to resenitedein the request at the LWIA hearing ng which
r review a
written statement setting forth thep
support the requested relief.
The Chief, WID, shall mail a copy of the request for review to the other party
and to the LWIA. It shall be a the
responsibility
t efhear hearing to the Chief, WID,
the
complete record including typed record of
within ten (10) days.
B. Conduct of Hearings.
Request for Hearing at the State Level
If no decision has been issued at the LWIA level or the State has determined
an audit disallowance or imposed sanctions, the complainant may request a
hearing. The hearing officer will then issue a recommended decision to the
State's Review Panel for final determination.
2. Filing for Request for Review
The request for a State hearing shall be filed within ten (10) days after LWIA
should have issued a decision or ten (10) days after the issuance of shall be filed directly with thethe audit
Chief of
disallowance or sanction. The request
the WID in writing and should include the following:
a. Full name, address, and telephone number of the party requesting the
review
b. Name, address, and telephone number'of the LWIA
C. Copies of complaints made at LWIA level from which no decisions were
issued or sanctions imposed
d. A statement of basis for the request for hearing.
3. Evidentiary Hearing
Upon receipt of the request for a State level hearing, a hearing before a
designated hearing officer will be scheduled.
14
V.
C
FBI
The hearing will be recorded mechanically or by court reporter.
Both parties concerned will have the opportunity to present oral and written testimony
under oath, to call and question witnesses in support of his/her position, to present
oral and/or written arguments, to examine records and documents relevant to the
issue(s), and to be represented.
The hearing officer shall issue a written decision, which shall be forwarded to the
State Review Panel for final determination.
The State Review Panel may accept, reject omodify
audit disallowances, recommendation.
medatwhTchemust
decision of the State Review Panel is final except
be approved by the Secretary of Labor.
State Review Panel
The State Review Panel will consist of a paneleOfficesv one fromom
Employment Development Department: one from the Lega
WID, and one from the Director's offica•The�ies P hin thirty (30) daysael will issue a ltten of ece ptlof the
which will be sent to the appropriate p
request for State review.
Decisions issued by this panel, under the authority of the Governor, are final.
Issuance of State Review Decision,
The State review will be limited to violations relimit d to the reof the WIA, iplementing cord
regulations or the grant agreement. This review shall be
established at the LWIA hearing.
Procedures for Handling Discrimination Complaints by Participants
A. Complaints on the basis of race, color, or national origin, age,
riatexmusgio filed political
affiliation or belief, retaliation, and citizenship, PP
180 days of the alleged occurrence.
1. It is the responsibility of the Santa Ana LWIA's Equal Employment Opportunity
(EEO) Officer to determine jurisdiction ain accordance w
and to ph thenSantarA�a
and provide assistance in filing a complaint
LWIA's procedure under Section II (A).
15
No later than I80
days of alleged
discrimination
Within 10 days of
receipt of
unsatisfactory
decision or 10 days
from date LWIA
decision should have
been issued
Handling of complaints filed at LWIA level arising in
connection with WIA programs operated by LWIAs
Informal Resolution Process
Unsatisfactory Decision or LVWIA Decision not
issued within 60 days
Request for State Review
Governor's Decision issued by State Review
Panel
If no decision issued by State Review Panel
Appeal to DOL
w
0
b
2. In cases where areas of authority overlap, it is the responsibility of the EEO
Officer to advise the complainant of the existence of State, Federal and other
proper action agencies, which may also have a bearing.
ll be
3. Complainants alleging discrimination
Office of Civilis part Rghts (IOCR)mUtlS. Department
ade aware of
their right to file directly with th
of Labor and applicable procedures.
4. Complainants must file their complaint directly with:
Lydia H. Morgan
EEO Officer
Santa Ana Local Workforce Investment Area
1000 E. Santa Ana Blvd., Suite 200
Santa Ana, Ca 92701
VI. Procedures for Handling Handicap Complaints by Participants
Complaints alleging discrimination on the basis of handicap will be filed and processed
under the Department of Labor regulations implementing Section plement32 Section 504 of the Rehabilitation
Act of 1973 at 29 Code of Federal Regulations
1. Complaints must exhaust the Santa Ana LWIA's informal resolution
procedures before filing their complaint with OCR.
2. Complainants will be made aware of the 180 days requirement in which to file
his/her complaint.
A. Procedures at the LWIA Level
The complainant shall file his/her
Officdirectly ershallvith the Santa Ana invest gate and gatherlA.
Upon receipt of the complaint, the EEO
information concerning the complaint.
2. An informal conference will be held with the parties concerned in an effort to
resolve the issue(s). The complainant has the right to be present and may be
represented during the conference.
3. The Santa Ana LWIA shall issue in writing its decision to the complainant no
later than thirty (30) days after the filing of the complaint.
16
B. Procedures at the State Level
1. The complainant may appeal to the State if he/she is not satisfied with the
decision of the Santa Ana LWIA.
2. The Complainant must file his/her appeal as a request for review directly with
the Chief WID within ten (10) calendar days after the receipt of the Santa Ana
LWIA's decision.
3. The Chief-WID, shall issue a decision no later than thirty (30) calendar days
after receipt of the request for review.
4. After the complainant has received a decision or no decision has been
received from the Director of Employment Development Department (on
behalf of the Governor), the complainant has the right to appeal his/her
complaint within thirty (30) calendar days to the Office of Civil Rights (OCR)
with the Department of Labor.
17
No later than 180
days of alleged
discrimination
If no resolution reached
Unsatisfactory Decision or No Decision
Filed within 30
days of
LWIA/State
Decision or 90
days from date of
initial filing of
complaints
Day I
Day/45 Day
60 Days
GLOSSARY OF WIA TERMS
AGE DISCRIMINATION ACT - A law passed by Congress in 1975 which prohibits discrimination
on the basis of age by any program or activity receiving Federal funds.
APPLICANT - An individual who applies to a subrecipien orcontract for services provided under
WIA and who has no yet transitioned to the status of participant.
icipant's employability, a aptitudes,
ASSESSMENT -Services designed to determinetoachieve tach phe�participant's employment and related
abilities and interests and to develcp a planappropriate for the
goals; also to identify the available employment and training activities appro p
participant. Testing and counseling may also be used during the assessment process.
CHARGING PARTY CP COMPLAINANT GRIEVaNT 0ainstC�uGdeEDepavED rtmeSt oNJustice
person who charges that he/she has been discriminatedg
nondiscrimination and civil rights regulations and/or guidelines.
DISCRIMINATION - In general, a failure to treat all equally,
ndividwhether
ontclaintentional
oflor persons totreceive
the effect of an action, policy or practice which selects an
unequal treatment.
ELIGIBLE NON -CITIZEN -Lawfully admitted permatbresident,
twolrketl the
refugees, and parolees and other individuals authorizedby the Attorney General to
United States.
EMPLOYER - An employer subject to the provisions of agency
Civil Rights
ect Act of to the 19ovisions of Sec64, as ti n
including state and local governments and any FederalgeY
717 of the Civil Rights Act, as amended; and any Federal contractor or subcontractor covered by
Executive Order 11246, as amended.
GRIEVANCE - An allegation that something imposes an illegal obligation or burden or denies
some equitable or legal right, or causes injustice.
HANDICAPPED INDIVIDUAL - Any individual who has a physical or mental disability that
constitutes or results in a substantial handicap to employment.
INTAKE - Includes screening to determine eligibility; to select from eligible applicants those
individuals who are most in need and can benefit from program services; to complete procedural
requirements necessary to enroll an individual into the program and to refer those not enrolled to
other programs.
JOINT COMPLAINT - A complaint of employment discrimination covered by Title VI or the Equal
Pay Act and by Title VI or Title IX. Individual "joint complaints" are normally investigated by EEOC
unless OCR has a compelling reason to investigate. "Joint complaints" alleging discrimination in
employment and other practices and pattern or practice "joint complaints" are normally investigated
by OCR.
JURISDICTION - Authority to investigate and resolve complaints against an institution subject to a
law or statute which has been assigned to OCR for enforcement, i.e., Title VI, Title IX, etc.
PARTICIPANT - Any applicant who has: (1) Been determined eligible for participation upon intake;
and (2) Who is receiving subsidized employment, training or services (except post -termination
services) funded under the Act, following intake, except for an individual who receives only
outreach and/or intake and assessment services.
19
Exhibit D
CERTIFICATION REGARDING LOBBYING
CERTIFICATION FOR CONTRACTS GRANTS LOANS
and COOPERATIVE AGREEMENTS
The undersigned certifies, to the best of his or her knowledge and belief, that:
1) No Federal appropriated funds have been paid or will be paid, by or on behalf
of the undersigned, to any person for influencing or attempting to influence
an officer or employee of an agency,
Member Member of Congress i�ficer or
employee of Congress, or an employee o
connection with the awarding of any Federal contracts, the making of any
Federal grant, the making of any Federal loan, the entering into of any
cooperative agreement, and the extension, continuatio e loanaor
amendment or modification of any Federal contract, grant,
cooperative agreement.
2) If any funds other than Federal appropriated funds have been paid or will be
paid to any person for influencing tuber of Congregstoan olfficeeornemplcer loyeerof
employee of any agency, a Me
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.
31 The undersigned shall require that ftheall slanguage
bawa ds at all tiers certification
included in the award document o
agreements) and that all subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was
placed when this transaction was made or entered into. Submission of this
certification is a prerequisite for making or entering into this transaction imposed by
31 U.S.C. 1352. Any person who fails to file the required certification shall be
subject to a civil penalty of not less than $10,000 and not more that $100,000 for
each such failure.
Program Title
Grantee/Contactor C�ganization
L
Name of Certifying Official Signature
Certification Regarding
Debarment, Suspension, Ineligibility and Voluntary Exclusion
Lower Tier Covered Transactions
This certification is required by the regulations implementing Executive Order 12549,
Debarment and Suspension, 29 CFR Part 98, Section 98.510, Participants' Responsibilities. The
regulations were published as Part VII of the May 16, 1988, Federal Register (Pages 19160-
19211).
(Before completing certification, read instructions which are an integral part of certification)
1. The prospective primary participant, (i.e. grantee) certifies to the best of its knowledge and
belief, that it and its principals:
a. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from covered transactions by any federal department or agency;
b. Have not within a three-year period preceding this proposal been convicted or had a
civil judgment rendered against them for commission of fraud or a criminal offense in
connection with obtaining, attempting to obtain, or performing a public (federal, state or
local) transaction or contract under a public transaction; violation of federal or state
antitrust statues or commission of embezzlement, theft, forgery, bribery, falsification or
destruction of records, making false statements, or receiving stolen property.
c. Are not presently indicted for or otherwise criminally or civilly charged by a
government entity (federal, state or local) with commission of any of the offenses
enumerated in paragraph (1)(b) of this certification; and
d. Have not within a three-year period preceding this application/proposal had one or
more public transactions (federal, state or local) terminated for cause or default.
2. 'Where the prospective primary participant is unable to certify to any of the statements in this
certification, such prospective participant shall attach an explanation to this proposal.
Orangewood Children's Foundation
Grantee/Contractor Organization
Cal Winslow/ CEO �� Gl/�o �-'-✓
Name and Title of Official Authorized to Certify
On Behalf of the Grantee
April B 2008
Date
Exribit E
Certification Regarding Drug -Free Workplace Requirements
The certification set out below is a material representation upon which reliance is
placed by the U.S. Department of Housing and Urban Development in awarding the
grant. If it is later determined that the contractor knowingly rendered a false
certification, or otherwise violates the requirements of the Drug -Free Workplace
Act, the U.S. Department of Housing and Urban Development, in addition to any
other remedies available to the Federal Government, may take action authorized
under the Drug -Free Workplace Act.
CERTIFICATION
A. The contractor certifies that it will provide 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.
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: ffl
Program Operator
DIVISION OF EMPLOYMENT SERVICES
PLACE OF PERFORMANCE
FOR CERTIFICATION REGARDING DRUG -FREE WORKPLACE
REQUIREMENTS
Name: Cal Winslow
Name of Contractor: Orangewood Children's Foundation
Contractor Number:
Date:
IR
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):
Street Address City Phone Number
1575 E. 17th Street, Santa Ana CA 92705 714-619-0229
Exhibit F
BUDGET FORM
All costs related to the program activities described in the proposal must be included on the Budget Form. A budget
narrative must be attached on a separate sheet of paper for all line items marked with an * asterisk.
Administrative Program Total WIA Match/In Tota
No more than lo% Kind
allowed. ,
Salaries*
1. FYLP Peer Mentors (3 at
.375 FTE at $14.00/hr.)
2. FYLP Supervisor (.25 FTE)
$11,850
3. Staff Accountant (.05 FTE)
$2,500
Use separate sheet if necessary.
Benefits*
1. FYLP Supervisor (23%)
$2,850
2. Staff Accountant (23%)
Use separate sheet if necessary.
Total-Peersponel
Rent or user fee*
Utilities
$5,000
Phones
$5,500
$34,000
$11,850 $11,850
$2,500 $2,500
$2,850
$575 $575
$14,925 I'
$9,000
$5,000 $2,000
$5,500 $1,500
Internet fees
Parking fees
Securit,
Maintenance
$5,000
$5,000
$3,000
$7,000
Insurance
Equipment rental fees*
Vehicle lease*
$6,000
$6,000=S2,000
�'.
$7,500
Office expenses
(consurnables)
Accounting Services
Legal services
Auditing services
Indirect costs*
$1,000
$2,000
$3000
Staff traininE$1,000
$200
$200
$200
Staff travel/mileage
Participant Wages*
$15,000
$15,000
$"5600
Support services*
Participant Incentives*
$6000
$6,000
$3000
Other (list)*
Total O eratin. Expenses 2:
$43,700
$19,500
$48,800
*See Budget Form Instructions
Note: Audit Requirements
States, local governments and non-profit institutions who receive $500,000 or more in federal funds in a fiscal
year shall meet the audit requirements of the OMB Circular A-133, "Audits of States, and Local Governments
and Non -Profit Institutions."
Budget Narrative
PERSONNEL
Salaries: List each individual position dedicated to this project. List title, percentage of full time
equivalent (FTE) or the amount of time to be charged to this project.
Benefits: List each individual position dedicated to this project. ,List title, percentage of full time
equivalent (FTE) or the amount of time to be charged to this project.
Key Staff and staffing level rationale
The Foster Youth Liaison Project will staff three part-time peer mentors. The peer mentors
will be currently enrolled in college level studies with a focus on Counseling and/or related
fields. The peer mentors will also be youth that have emancipated from the foster care system
and have successfully provided mentoring services through Orangewood Children's
Foundation. The use of part-time staff is critical to this project. The Foster Youth Liaison
Project will provide a 5:1 participant to case manager (peer mentor) ratio as well as provide
the peer mentors with valuable work experience and training. This project will also provide a
Peer Mentor Supervisor who will provide oversight on client progress and peer mentor
performance and the Staff Accountant who will track program expenditures and provide
overall finance support. The following is a description of the individual positions dedicated to
this project:
3 Peer Mentors @ .375 FTE each (Peer Mentor positions are PT 15 hours per week) Peer
mentor hourly rate is $14.00 per hour. Three peer mentors at .375 FTE equals 1.125 FTE at
2340 hours is $32,760. $34,000 is designated for this line in case more peer mentor hours are
needed to serve program participants and meet program objectives.
1 Peer Mentor Supervisor @ .25 FTE/ 23% Benefits ($11,850 + $2,850 = 14,700)
1 Staff Accountant @ .05 FTE/ 23% Benefits ($2,500 + 575 = $3,075)
OPERATING EXPENSES
Rent or User Fee: Provide percent of office space that will be charged to this project. Describe
how percentage was determined.
The Orangewood Resource Center will be greatly utilized for Foster Youth Liaison Project
client services. The ORC utilized approximately 1,000 square feet of our 22,000 square feet
of space. Based on a conservative rate of $1.85 per square foot the total monthly cost for this
portion of the facility is $1,850 so for 12 months the cost is $22,200. 15 clients at an average
of two hours per week is 30 hours per week so for 52 weeks clients will utilize 1,560 hours in
one year.
Out of the ,3000 duplicated clients served in the ORC 25 percent of them are FYLP clients.
Equipment Rental Fee (equipment may not be purchased): List items that will be used for this
project. Provide percent of rental fee that will be charged to this project. Describe how
percentage was determined. N/A
Vehicle Lease (vehicles may not be purchased): Provide list of vehicles dedicated for this
project. Describe vehicle use and percentage of use that will be charged to this project. Describe
how percentage was determined. Note: CONTRACTOR shall also obtain and maintain, during
the effective period of this Agreement, broad form automobile liability coverage with a
$1,000,000 minimum limit. N/A
Indirect Cost: Provide indirect cost rate plan. N/A
Participant Wages: Describe costs directly related to individual participants such as paid
training and/or work experience. Include number of youth, hourly wage, benefits and bonuses.
Include length of activity. N/A
Support Services: Attach policies and procedures for supportive services. Policy must include
spending limits.
Supportive services are critical to the success of our participants. This target group enters our
program with multiple barriers that must be addressed before a successful outcome can be
achieved. Our program model will dedicate a significant amount of resources in the
Supportive Services line item of our budget. Although all non-WIA resources will be
explored and utilized prior to the use of WIA funds, we acknowledge that childcare, housing
and counseling services are needed and can be difficult to attain through other means.
Please see the Supportive Services Policy included in this proposal.
Participant Incentives: Indicate the type of payment, rate of payment and describe what youth
must achieve to receive the incentive.
The Foster Youth Liaison Project program model builds in incentives that help our youth
achieve goals. In addition to the performance goals set forth by the grant, our program model
has established 8 core objectives that will assist youth in becoming empowered, self-reliant
and productive adults within one year of their enrollment. Participants will be asked to
complete a minimum of 3 of the following objectives:
• Attain a driver's license
• Open a bank account and utilize it
• Register to vote
• Get a job that pays above minimum wage
• Participate in a leadership activity
• Stay alcohol and/or drug free for a minimum of 1 year
• Master basic computer skills
• Obtain a GED or complete a diploma program
Upon successful completion of at least three of the core objectives included above, participants
will be given a Target gift card valued at $100.00. Other incentives will be distributed after the
successful completion of pre -employment services and/or placement in employment or post-
secondary education, and/or achievement of a diploma or certificate and/or when they
become basic skills proficient. 15 participants may earn up to four Target gift cards at $100 per
card. Each participant can earn up to $400 in gift cards, which totals to a budgeted amount of
$6,000.
Other: This item may include fieldtrips and youth stipends. All items must be listed and
include cost details. N/A
Exhibit G
Assurances & Certifications
Selected providers will be required to sign and submit "actual" assurances and certificates as
required by the City of Santa Ana and the Workforce Investment Board on all contracts.
I recognize that I must give assurances for each item below. If I cannot, this proposal will be
automatically rejected. Please initial each box.
0 I am authorized by my Board of Directors, Trustees, other legally qualified officer, or as the owner of this
agency or business to submit this proposal.
0 We are not currently on any Federal, State of California, or local Debarment list.
0 We will provide records to show that we are fiscally solvent, if needed.
0 We have, or will have, all of the fiscal control and accounting procedures needed to ensure that WIA funds will
be used as required by law and contract.
0 We have additional funding sources and will not be dependent on WIA funds alone.
We do or will meet the applicable Federal, State, and local compliance requirements. These include, but are not
limited to:
0 Records accurately reflect actual performance.
0 Maintain record confidentiality, as required.
0 Reporting financial, participant, and performance data; as required.
0 Comply with State and Federal fiscal and program activity audits.
0 Complying with Federal and State non-discrimination provisions.
0 Meeting requirements of Section 504 of the Rehabilitation Act of 1973.
0 Meeting requirements of the American's with Disabilities Act of 1990. (submit completed survey)
0 Meeting all applicable labor law, including Child Labor Law standards.
0 Agree to provide a drug free workplace.
0 Agree to insure the City of Santa Ana through General Liability Insurance and Automobile Liability
Coverage in the amount of $1,000,000.00 policy.
0 Agree to provide all participants with Grievance Procedures.
0 Agree to insure proposer's employees through Workers Compensation Insurance
(including part-time employees)
0 Procurement policies and procedures are in place and meet federal guidelines.
We will not:
0 Place a youth in a position that will displace a current employee.
0 Use WIA money to assist, promote, or deter union organizing.
0 Use funds to employ or train of persons in sectarian activities.
0 Use funds for youth in the construction, operation, or maintenance of any part of a facility to be used for
sectarian instruction or religious worship.
0 Use WIA funds for activities that would interfere with or replace regular academic requirements for eligible
youth who are not dropouts.
0 Use WIA funds to carry out programs funded under the School -to -Work Opportunities Act of 1994 unless
the program(s) are only for youth eligible to participate under WIA.
0 Use WIA money under thus contract to purchase any equipment.
Ih y
Name
that all of the above are true.
Title
Qj
to
ACORD CERTIFICATE OF
OP ID PC DATE(MMIDDIYYYYI
LIABILITY INSURANCE OAANG-7 04/14/OB
+� THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
PRODUCER
�t�.�`F'" ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Chapman s Associates
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
License #0522024 /�
Xl(.
-" ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P. 0. Box 5955
Pasadena CA 91117-0455
INSURERS AFFORDING COVERAGE NAlC #
Phone: 626-405-8031 Fax: 626-405-0585
INSURERA a Cdq.•ny 13TYB
INSURED
16691
INSURERS o 126e1� 1
Orangewood Children's
INSUREPC B.>,ty=R.P._==eCO—
Foundation
1575 E. 17th Street
INSURER CSP neFa
Santa Ana CA 92705
I INS—— E
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPEC-TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN. THE INSURANCE AFFDRDED 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
POLICY EFFECTIVE I POLICY EXPIRATION
NSR KDD'L POLICYNUMBER DATE (MM UD I DATE IMMIDDM'I
LTR (NSRC TYPE OF INSURANCE
GENERAL UABIUTV
A X X COMMERCIAL GENERAL LIABILITY PGL766306
X CL41M5 MADE `—� OCCUR
X 'SS Professional
X 'Sex Abuse/Molest
GEWL AGGREGATE UNIT APPLIES PER
PRO-
. PDLICY JECT LOS
AUTOMOBILE LIABILITY
B ANY AUTC
ALL OWNED AUTOS
SCHEDULED AUTOS
X HIRED AUTOS
X NON -OWNED AUTOS
GARAGE LIABILITY
ANY AUTC
UCESSUMBRELLA LIABILT Y
OCCUR '� CIAIMSAIADE
02/O1/09
LIMITS
EACH OCCURRENCE 5 1000000
DAMAGETORENTED 5 50000
02/01/08 PREMISES IEAac
MED BARMY me Penon`, 5 1000
PERSONAL k ADV INJURY' S 1000000
GENERAL AGGREGATE S 3000000
PRODUCTS - COMPIOP AGG S 1000000
'Emp Ben. 100/300
COMBINED SINGLE UMI' S 1000000
PAC7575346
02/01/08 02/01/09 EAuneu
BODILY INJURY S
' j IPer persm;
�I
O.�100 I SCSI �INIURY
FY.�� PERTY DAMAGE
V (Peracclaenl
`
S
F
V AUTO ONLY EA ACCIDENT
ttDCne`I EAAcz
OTHER THAN
B
AUTO ONLY AGC
a l
S
EACH OCOURRENCE
l'^ r 1 AGGREGATE
5
1f`
\
IDS
jS
DEDUCTIBLE
5
RETENTION 5
WC BTATU- IOTH-
i,. X
I TORV LIMITS ER
WORKERS COMPENSATION AND
EMPLDYERB' LIABILITY
WEN100284002
03/01/08 03/01/09
EL EACH ACCIDEN- 15 1000000
D ANY PROPRIETORIPARTNEWEXECUTWE
E.L.DISFASE - EA EMPLOYEE 5 SOOOOOO
1 DFFICERIMEMBEREXCLUDED-
If Yes, eescnce uneei
SPECIAL PROVISIONS BeIPx
j EL. DISEASE - POLICY LIMIT s- 1000000
OTHER
I
B 1 Property Section
PAC7575346
02/01/08 02/01/09
02/01/08 02/Ol/09
EE Dishon 500,000
C Crime
CCP006190603
DESCRIPTION OF DPERATIONB I LOCATIONS I VEHICLES I EXCLUSIONS
ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
The City of Santa Ana, it's
officers, employees, agents, volunteers and
representatives are named as
an Additional Insured as respects liability
arising from the operations
of the Named Insured per
the attached Al
endorsement. Workers compensation
coverage excluded,
evidence only.
ZO days notice of cancellation
for non-payment of premium. XX
e1AAIF`C1 I ATInN
ULKI IVILAlr NULUcr% -
CITYSAN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILT. —MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
City of Santa Ana —
20 Civic Center Plaza
AUTM PREBENTAT
Santa Ana CA 92701
n acnWI I CnRPDRA I IUN 1988
ACORD 25 (2001/08)
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 negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25 (2001/08)
This Endorsement Modifies Your Policy
(Effective At Inception Unless Another Date Shown Below)
ADDITIONAL INSURED ENDORSEMENT
The insurance afforded by this policy for "bodily injury," "property damage" and/or "personal injury" shall also apply to
the "additional insured" listed below for claims, suits, and/or damages made against the "additional insured," but only to
the extent the "additional insured" is being held responsible for the acts, omissions and/or negligence of the "named
insured."
This insurance afforded shall not apply to claims, suits and/or damages arising out of the acts, omissions and/or
negligence of the "additional insured(s),"
The inclusion of the "additional insured(s)" shall not operate to increase the Company's Limit of Liability.
To the extent, if any, that this policy affords coverage to an "additional insured," the "additional insured" is subj ect to all
of the terms of the policy.
The obligation of the Company to provide coverage to an "additional insured" is further limited by the interest of the
"additional insured" as defined below.
Interest of the Additional Insured(s) Defined:
Child Placement and/or Funding
For the purpose of this endorsement, the "named insured' is the person(s) and/or party(ies) designated on the Declarations
Page of the policy or on any endorsement. The "additional insured" is the person(s) and/or party(ies) identified below.
Identity of Additional Insured(s):
City of Santa Ana, its officers, employees,
agents, volunteers and representatives
20 Civic Center Plaza
Santa Ana, CA 92701
A$ TO FORM
APPROVED
Gam; TORCK
attorney
!assistant City
(Complete this section if endorsement is added after policy is issued.)
Policy No. Endorsement No. End't Effective Date
Signature of Auth. Representative Producer No.
WW 180 (04/01)
CONSENT CALENDAR
preparation, and job placement for twenty In -School Youth in
an amount of $97,077, through June 30, 2009;
• AGMT NO. 2008-224 — With Orange County Youth
Commission to provide tutoring, mentoring, job preparation,
and job placement for In -School Youth and Out -of -School
Youth in an amount of $71,904, through June 30, 2009. The
total number of youth to be served will be negotiated by July
30, 2008;
• AGMT NO. 2008-225 — With Orangewood Children's
Foundation to provide tutoring, job preparation, and
placement for fifteen Out -of -School Youth in an amount of
$95,475, through June 30, 2009;
• AGMT NO. 2008-226 — With Santa Ana Unified School
District/ROP to provide mentoring, work experience, and
placement for thirty In -School Youth in an amount of
$163,350, through June 30, 2009; and
• AGMT NO. 2008-227 — With Taller San Jose to provide
vocational training, job preparation, and placement Out -of -
School Youth in an amount of $130,863, through June 30,
2009. The total number of youth to be served will be
negotiated by July 30, 2008.
2. Authorize the City Manager and Clerk of the Council to execute
the Memorandum of Understanding with the Santa Ana
W/O/R/K Center for the Youth Service Provider Navigator
service to June 30, 2009, and increase the funding by $254,757
(AGMT NO. 2008-228).
MOTION: Alvarez
VOTE: AYES:
NOES:
ABSTAIN:
ABSENT:
SECOND: Benavides
Alvarez, Benavides,
Tinajero, Pulido (6)
None (0)
None (0)
Bustamante (1)
Martinez, Sarmiento,
25.H. AGMTS - MEMORANDUMS OF UNDERSTANDING WITH MANDATED
ONE -STOP PARTNERS — With the following:
CITY COUNCIL MINUTES 217 AUGUST 18, 2008
CONSENT CALENDAR
25.D. AGMT NO. 2008-212 - CABLING SERVICES AND RELATED
EQUIPMENT - With Pacific Coast Cabling Inc. for a one-year period in an
amount not to exceed $150,000 per year - Finance & Management
Services Agency
25.E. AGMTS - ON -CALL SERVICES FOR WATER AND SEWER
EMERGENCIES - With Doty Bros. Construction Company (AGMT NO.
2008-213), Paulus Engineering, Inc. (AGMT NO. 2008-214) and Ken
Thompson, Inc. (AGMT NO. 2008-215), in an amount not to exceed
$130,000 each — Public Works Agency
25.F. AGMTS - ON -CALL ENGINEERING AND LANDSCAPING SERVICES -
With DMJM Harris (AGMT NO. 2008-216), URS (AGMT NO. 2008-217),
Penco Engineering (AGMT NO. 2008-218) and Psomas (AGMT NO.
2008-219) in the amount not to exceed $200,000 for each firm — Public
Works Agency
25.G. AGMTS — PROGRAM YEAR 2008-09 YOUTH PROGRAM OPERATOR
AGREEMENTS
Motion:
1. Authorize the City Manager and Clerk of the Council to execute
agreements with the following Youth Program Operators for
Program Year 2008-09 for a total of $828,073 - Community
Development Agency
AGMT NO. 2008-220 — With Christian Latino Association of
Music and Arts to provide training in music technology, work
experience, job preparation, tutoring, and job placement for
ten Out -of -School Youth in an amount of $48,230, through
June 30, 2009;
• AGMT NO. 2008-221 — With Orange County Children's
Therapeutic Arts Center to provide tutoring, job preparation,
work experience, and job placement for fifteen Out -of -School
Youth in an amount of $107,000, through June 30, 2009;
• AGMT NO. 2008-222 — With Orange County Conservation
Corps to provide on-the-job training, tutoring, job
preparation, and job placement for Out -of -School Youth in
an amount of $114,174, through June 30, 2009. The total
number of youth to be served will be negotiated by July 30,
2008;
• AGMT NO. 2008-223 — With Orange County Department of
Education to provide tutoring, career development, job
CITY COUNCIL MINUTES 216 AUGUST 18, 2008
�rw_ P-,Q � - -
acORD Ok2ANGCERTIFICATE OF LIABILITY INSURANCE OF ID - DATE{h4hUDDNYY 9
7 03 19 09
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIOP
Chapman
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
I,iconse #0522024
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
P. O. Box 5455
Pasadena CA 91117-0455
phone; 626-405--8031 ]~ax; 626-405-0585
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
INSURERA: 17onprofitar Ineuranca Allianoe
INSURER8: Everest National
Oxanaaew9od Children's
Foundations
INSURERC: cheat American Xnourance Co
16691
1575 E. 17Cth
INSURERNX Fidelity 4 Deposit Co INasyland
Santa A 92g0`Jt
INSURER E.
rW
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 W17H RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 13 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
UITSIT LTR
NSR
TYPE OF INSURAHCC
POLICY NUMBER
A R t h
DTI' IdA DD Y I
LIMITS
A
X
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMSMADE OCCUR
X Prof Liability
20091277ONPO
02/01/09
02/01/10
EACHOCCURRENCE
$ 1000000
6REfTE-Cr
PREMISEs(Eaoccurenco)
$100000
MEDEXP(Anyone poreon)
$ 20000
PERSONAL&AOVINI JURY
$ 1000000
X
Abuse Liability
GENERAL AGGREGATE
$ 3000000
GENLAGGREGATE LIMIT APPLIES PER:
POLICY JECT EX] LOC
PRODUCTS•COMPlOPAGG
S 3000000
Em l Ben
included
,A,
AUTOMOBILE
LIABILITY
ANYAL40
ALLOWNED AUTOS
SCHEDULED AUTOS
HIREOAUTOS
NON•OWNEDAUTOS
200912778HPO
e t
02/01/09
TO �y�
02/01/10
p�
COMBINEDSINGLELIMIT
(Cae"Ideno
$ 1000000
BODILY INJURY
(Per person)
$
X
BODILYINJURY
(Poraccldent)
$
X
i erax!de �AItAGE
$
OARAOELIABILANYAUTOITY
S'� AZf
ta0�
1187
LANEAACCFAACC
OTHERTHAUTO
AUTOONLY: AGG
S
$
EXCESSRIMBRELLALIABILITY
OCCUR CLAIMShTADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
$
AGGREGATE
$
S
S
$
B
WORKERS COMPENSATION AND
GhIPLOYERS' LiABILITY
ANY PROPRIEIORlPARTNERIEXECUTIVE
OFFICERIA4EMBER EXCLUDED?
styyes doscfibounder
SPEG�fALPROVISIONSbelovr
6600001013091
03/01/09
03/01/10
TORY LIIJITs X ER
E.L. EACH ACCIDENT
$ 1000000
E.L. DISEASE • EA EMPLOYE
$ 1000000
E.L. DISEASE-POLICYLIISiT
S 1000000
C
D
OTHER
Property Coverage
Crime Coverage
PAC757534603
CCP006190604
02/01/09
02/01/09
02/01/10
02/01/10
Blkt Cont $666,000
Em 1 Dash $500 000
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES! EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
The City of Santa Ana, it's officers, employees, agents, volunteers and
representatives are named as an Additional Insured as respects liability
arising from the operations of the named Insured per the attached Co 2026
@ndoxsement. Woxkers compensation coverage excluded, evidence only. 10 days
notice of cancellation for nonpayment of premium, XX
CERTIFICATE HOLDER CANCELLATION
Cvmm SHOULD ANY OFTHSAeOVEDESCRIBEOPOLIO] ES, BECANCELLED BEFORE THE! EXPIRATION
DATH THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL
City of Santa Ana IMPOSE! NO OBL90ATION OR LIABILITY OF ANY KIND UPONTHt! 1I(SUR8R. ITS AOENTS OR
20 Civic Center Plaza REPRESENTATIVES.
Santa Ana, CA 92701 nu PREs Tl,�
0
Rpr 07 2UUS 1 U r EUHM HH LHSLKJh t r HX _ P- a
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder In ileu 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 td the certificate
holder in lieu of such ondorsement(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 cariiflcate holder, nor does it
efhrmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.