HomeMy WebLinkAboutO'REILLY & ASSOCIATES 4City of Santa Ana
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AGREEMENT TERMINATION
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Please complete this form when the attached agreement is no longer in effect.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 647-6520 if you have any questions.
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NOTE: PLEASE INCLUDE ALL AMENDMENTS IF ANY. THANK YOU.
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and final payment has been made.
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Signature:
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Revised 12-07-07
INSURANCE NOT ON FILE
WORK MAY NOT PROCEED
CLERK OF COUNCIL
DATE:
O:eDa C27
Linda Mar9a~
AGREEMENT WITH
O'REILLY AND ASSOCIATES
UNDER THE WORKFORCE INVESTMENT ACT
N-2009-052
THIS AGREEMENT, made and entered into this 1St day of May 2009, by and between O'Reilly and
Associates, hereinafter referred to as "CONSULTANT", and 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,
hereinafter referred to as "CITY".
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 adults, dislocated workers and youth for entry into the labor market and to
provide job training to those individuals who are economically disadvantaged or otherwise face serious
barriers in obtaining productive employment. One goal of California's Workforce Investment System is to
provide individuals 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. CONSULTANT is experienced in implementing Layoff Aversion strategies and
working with WIA funded programs including Rapid Response and other workforce development programs.
E. CONSULTANT 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:
TIME PERIOD OF AGREEMENT
Services under this Agreement shall commence as of May 1, 2009 and all services to be performed
pursuant to this Agreement shall be completed on or before June 30, 2009. The term of this Agreement may
be extended by a writing executed by the Deputy City Manager for Development Services and the City
Attorney.
2. INDEPENDENT CONTRACTOR
CONSULTANT agrees that CONSULTANT is an independent contractor and not an employee of
CITY and all of CONSULTANT'S personnel shall be employees of CONSULTANT and not employees of
the CITY. CONSULTANT shall pay all salaries and wages, employer's Social Security taxes,
unemployment insurance and wages, and similar taxes relating to employees and shall be responsible for all
applicable withholding taxes.
CONSULTANT shall not subcontract any of the services required hereunder without the prior written
approval of the CITY.
3. SCOPE OF SERVICES
For and in consideration of the hereinafter stated payment by CITY to CONSULTANT,
CONSULTANT agrees to perform, at its own cost and expense except for the compensation specified in this
Agreement, the services specified in the scope of work attached hereto and incorporated herein as Exhibit A
to this Agreement.
4. CONSULTANT OBLIGATIONS
A. CONSULTANT 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 CONSULTANT'S services or activities, costs or other data, including but not
limited to, participants' attendance, payroll records and job duty statements.
B. 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 CONSULTANT'S
activities, performance, books, documents, papers, and records of CONSULTANT, 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 CONSULTANT 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 CONSULTANT does not make the above-referenced documents available within
the City of Santa Ana, California, CONSULTANT 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 CONSULTANT and all
documents related to this Agreement shall be kept available at CONSULTANT'S office or place of business
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
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United States Government take exception, shall be retained beyond the three (3) years until resolution of
disposition of such appeals, litigation, claims, or exceptions.
C. Without prejudice to any other section of this Agreement, CONSULTANT 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, CONSULTANT
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 CONSULTANT, costs incurred and services rendered hereunder.
D. CONSULTANT agrees to expend all funds in accordance with all applicable federal,
state and local laws and regulations. CONSULTANT also agrees to provide at CONSULTANT'S own
expense supplies and other costs of said PROGRAM.
E. CONSULTANT shall comply with the provisions of 48 CFR, Chapter 1, Parts 1-31.2,
for commercial organizations and all other applicable federal statutes and executive orders and their
implementing regulations.
F. CONSULTANT shall comply with the provisions of E.O. 12549 and 12689, requiring
compliance with the debarment and suspension requirements contained in 29 CFR Part 98.
G. CONSULTANT 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. CONSULTANT shall sign a certification to that effect in a form as set forth
in "Exhibit B," attached hereto and by this reference incorporated herein. CONSULTANT 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 CONSULTANT under the terms and conditions of
this Agreement.
H. CONSULTANT agrees to provide a drug-free work place and to execute a
certification as set forth in "Exhibit C" attached hereto and incorporated herein by this reference.
I. CONSULTANT, in accordance with the Child Support Compliance Act, recognizes
and acknowledges the importance of child and family support obligations and shall fully comply with all
state and federal laws relating to child and family support enforcement, including, but not limited to:
disclosure of information and compliance with earnings assignment orders, as provided in Chapter 8
(commencing with Section 5200) of Part 5 of Division 9 of the state Family Code; and, to the best of its
knowledge is fully complying with the earnings assignment orders of all employees and is providing the
names of all new employees to the New Employee Registry maintained by the California Employment
Development Department (EDD).
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8. CONSULTANT 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.
9. If the grant hereunder exceeds $100,000, CONSULTANT shall be in
compliance 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
CONSULTANT 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.
10. CONSULTANT may copyright any work that is subject to copyright and was
developed, or for which ownership was purchased, under an award. The Federal awarding agency(ies)
reserve aroyalty-free, nonexclusive and irrevocable right to reproduce, publish, or otherwise use the work for
Federal purposes, and to authorize others to do so.
11. CONSULTANT is subject to applicable regulations governing patents and
inventions, including government-wide regulations issued by the Department of Commerce at 37 CFR part
401, "Rights to Inventions Made by Nonprofit Organizations and Small Business Firms Under Government
Grants, Contracts and Cooperative Agreements."
6. COMPENSATION
CITY agrees to pay, and CONSULTANT agrees to accept for said services, total compensation in the
amount not to exceed Twenty Five Thousand Dollars ($25,000.00). CONSULTANT will submit a detailed
invoice evidencing services performed. Final payment by the CITY shall be within 30 days following receipt
of said invoice, subject to CITY accounting procedures.
CONSULTANT 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 CONSULTANT. 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.
5. APPLICABLE GUIDELINES
A. The parties hereto agree that CONSULTANT shall comply with all applicable federal
and state laws and regulations, including but not limited to 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. CONSULTANT also assures and certifies that:
1. CONSULTANT shall comply with any and all federal laws limiting the
political activity of employees hired under this Agreement.
2. CONSULTANT shall provide the U.S. Department of Labor and the Controller
General, by and through any authorized representative, as well as the Santa Ana Local Workforce Investment
Area's Board, access to and the right to examine all records, books, papers or documents relating to the
accounting and use of funds under this Agreement for athree-year period from and after the effective date of
this Agreement.
3. No person with responsibilities in the operation of any program under the
Workforce Investment Act grant shall discriminate with respect to any program participant or any application
for participation in such program because of race, creed, color, national origin, sex, political affiliation or
beliefs.
4. CONSULTANT shall maintain appropriate standards for health and safety in
work and transportation situations.
5. CONSULTANT shall comply with general provisions, assurances, and
certifications attached hereto as "Exhibit D" and incorporated herein.
6. Any literature distributed by CONSULTANT 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."
7. CONSULTANT certifies that all property, finished or unfinished documents,
data, studies and reports prepared or purchased by the CONSULTANT 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 CONSULTANT by the CITY and/or purchased by the CONSULTANT 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, CONSULTANT will
immediately return such tools and/or equipment to the CITY or dispose of them in accordance with the
direction of the CITY.
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7. MISCELLANEOUS PROVISIONS
A. CONSULTANT covenants that it presently has no interest, and shall not have any interest,
direct or indirect, which would conflict in any manner with the performance of services required hereunder.
B. CONSULTANT certifies that it will not discriminate against any employee or applicant for
employment because of race, religious creed, color, national origin, ancestry, physical disability, mental
disability, medical condition, marital status, sex or age, in compliance with Title VII of the Civil Rights Act
of 1964 (P.L. 83-354) and Government Code 12900, et seq.
8. HOLD HARMLESS CLAUSE
CONSULTANT agrees to indemnify, defend and hold harmless CITY, its officers, agents,
employees, and volunteers from and against any and all loss or damage, and from any and all suits, actions
and claims filed or brought by any person or persons arising out acts or omissions of CONSULTANT or of
any approved subcontractor or of the officers, agents, employees of CONSULTANT or of its subcontractors
in the performance of this Agreement.
9. INSURANCE
CONSULTANT shall obtain and maintain for the entire term of this Agreement comprehensive
professional public liability insurance, in companies acceptable to the City, authorized to issue such
insurance in the State of California. Said insurance shall consist of the following:
a. Professional Liability Insurance. CONSULTANT agrees to obtain and keep in force during the
term of this Agreement a policy of professional public liability insurance insuring the CITY and
CONSULTANT against any liability for accident, injury or death arising out of or related to 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 professional liability
insurance shall be endorsed to provide to CITY at least thirty (30) days written notice prior to cancellation.
b. Worker's Compensation Insurance. In accordance with the provisions of Section 3300 of the
Labor Code, CONSULTANT, if CONSULTANT has any employees, is required to be insured against
liability for worker's compensation or to undertake self-insurance. CONSULTANT agrees to comply with
such provisions before commencing the performance of the work under this Agreement.
c. The following requirements apply to the insurance to be provided by CONSULTANT pursuant to
paragraph a., above:
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1. A certificate of insurance, to be approved in form by the City Attorney, shall be furnished
to the City within 30 days of the execution of this Agreement.
2. Certificates and policies shall state that the policies shall not be canceled or reduced in
coverage or changed in any other material aspect without thirty (30) days prior written
notice to the City.
d. If CONSULTANT fails or refuses to produce or maintain the insurance required by this section or
fails or refuses to furnish the City with required proof that insurance has been procured and is in force and
paid for, the City shall have the right, at the City's election, to forthwith terminate this Agreement. Such
termination shall not affect CONSULTANT's right to be paid for its time and materials expended prior to
notification of termination.
10. 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,
CONSULTANT may not terminate this Agreement if undue hardship will result to any participant.
11. 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 CONSULTANT. 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 CONSULTANT 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, CONSULTANT shall act in accordance with CITY's decision unless the dispute involves a
change order.
12. BREACH -SANCTIONS
If, through any cause, CONSULTANT violates any of the terms and conditions of this
Agreement, and/or prior agreements whereby grant funds were received by CONSULTANT pursuant to this
Agreement, or if CONSULTANT reports inaccurately or if any Audit Report makes disallowances,
CONSULTANT shall promptly remedy its acts or omissions and/or repay CITY all amounts due CITY as a
result of CONSULTANT'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 CONSULTANT 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 CONSULTANT has failed to repay same or a repayment schedule has not
been made; and/or (3) terminate this Agreement by giving written notice to CONSULTANT of such
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termination in accordance the notice provision contained below.
13. NOTICES
All notices, reports and correspondence between the parties hereto respecting this Agreement shall be
in writing and deposited in the United States Mail, postage prepaid, addressed as follows:
To CITY: Clerk of the Council
City of Santa Ana
20 Civic Center Plaza (M-30)
P.O. Box 1988
Santa Ana, CA 92702-1988
Telefacsimile (714) 647-6956
With courtesy copy to:
Santa Ana Work Center
1000 E. Santa Ana Blvd., #200
Santa Ana, CA 92701
Telefacsimile (714) 565-2602
To CONSULTANT: O'Reilly & Associates
7530 Sunnywood Lane
Los Angeles, CA 90046
s
IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first
above written.
ATTEST:
Patricia E. Healy
Clerk of the Council
APPROVED AS TO FORM:
Joseph W. Fletcher
City Attorney
!.`'slit
By: Lisa Storck
Assistant City Attorney
RECOMMENDED FOR APPROVAL:
Cynthia J. Nelso ,Deputy City Manager for
Development Services
CITY OF SANTA ANA
G,x ~ ~
~' David N. Ream
City Manager
CONSULTANT:
O'Reilly and Associates
Paul O'Reilly
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EXHIBIT A
Task O'Reilly & Associates Consulting Services Fee
Work Descri tion
A 1. Research and analyze options to support the development of a
focused effort to help laid-off workers return to the workforce. $ 3,960
2. Develop agenda and prepare for and facilitate 1 planning
meeting with Economic Development andlor Santa Ana
Workforce Center management to review opportunities,
recommenda#ions and considerations and facilitate discussion
regarding options to pursue.
3. Recap notes from the planning meeting and distribute them
to the participants.
B 1. Research op#ions for developing a systema#ic approach for
identifying laid-off workers in the Santa Ana Region and
categorizing them into an occupational based talent bank. $ 6,000
2. Develop a PowerPoint presen#ation recapping the opportunities,
recommendations, and considerations for implementation.
3. Develop agenda and prepare for and facilita#e 1 planning
meeting with Economic Development andlor Santa Ana
Workforce Center management to review opportunities,
recommendations and considerations and facilitate discussion
regarding action items to pursue.
4. Recap notes from the punning meeting and distribute them
to the participants.
C 1. Research to identify Indus#ries in the Santa Ana region with job
growth or identify industries that may experience job growth as a
result of federal stimulus plans. $ 40,000
2. Analyze industry growth findings and create tables and bullet
poin# summaries of the findings.
3. Analyze options available for outreaching to these businesses
including mailings, phone, personal contact, and other ways to
identify and contact businesses in these industries.
4. Research business associations or trade groups related to these
Indus#ries and develop a list of organizations, contacts, and a
brief bullet point summary of their organization.
5. Develop a PowerPoint presentation recapping these growth
industries, outreach options, the opportunities,
recommendations, and considerations for implementation.
April 2009
Draff
6. Develop agenda and prepare for and facilitate 1 planning
meeting with Economic Development and/or Santa Ana
Workforce Center management to review opportunities,
recommendations and considerations and facilitate discussion
regarding action items to pursue.
7. Recap notes from the planning meeting and distribute them
to the participants.
D
1. Review and analyze research and planning meeting resulfs.
Develop a detailed bullet point Action Plan recapping key $5,000
tactical areas and action steps needed to implement the project,
2. Develop agenda and prepare for and facilitate 1 planning
meeting with Economic Development and/or Santa Ana
Workforce Center management to review the Action Plan and
gain consensus on implementing the plan.
3. Recap notes from the planning meeting and distribute them
to the participants.
Total for project: $ 24,950
April 2009
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Exhibit B
CERTIFICATION REGARDING LOBBYING
CERTIFICATION FOR CONTRACTS, GRANTS, LOANS
and COOPERATIVE AGREEMENTS
The undersigned certifies, to the best of his or her knowledge and belief, that:
1) No Federal appropriated funds have been paid or will be paid, by or on behalf of
the undersigned, to any person for influencing or attempting to influence an
officer or employee of an agency, a Member of Congress, an officer or employee
of Congress, or an employee of a Member of Congress in connection with the
awarding of any Federal contracts, the making of any Federal grant, the making
of any Federal loan, the entering into of any cooperative agreement, and the
extension, continuation, renewal, amendment or modification of any Federal
contract, grant, loan or cooperative agreement.
2) If any funds other than Federal appropriated funds have been paid or will be paid
to any person for influencing or attempting to influence an officer or employee of
any agency, a Member of Congress, an officer or employee of Congress, or an
employee of a Member of Congress in connection with this Federal contract,
grant, loan or cooperative agreement, the undersigned shall complete and
submit Standard Form - LLL, "Disclosure Form to Report Lobbying," in
accordance with its instructions.
3) The undersigned shall require that the language of this certification be included
in the award documents for all subawards at all tiers (including 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.
Grantee/Contractor Organization Program Title
O'Reil~Ld Associates Rapid Response
Name of Certifying Official Signature
Paul O'Reilly
EXHIBIT C
Certification Regarding Drug-Free Workplace Requirements
The certification set out below is a material representation upon which reliance is placed
by the U.S. Department of Housing and Urban Development in awarding the grant. If it
is later determined that the contractor knowingly rendered a false certification, or
otherwise violates the requirements of the Drug-Free Workplace Act, the U.S.
Department of Housing and Urban Development, in addition to any other remedies
available to the Federal Government, may take action authorized under the Drug-Free
Workplace Act.
CERTIFICATION
A. The contractor certifies that it will provide adrug-free workplace by:
(a) Publishing a statement notifying employees that the unlawful manufacture,
distribution, dispensing, possession or use of a controlled substance is
prohibited in the contractor's workplace and specifying the actions that will
be taken against employees for violation of such prohibition;
(b) Establishing adrug-free awareness program to inform employees about -
(1) The dangers of drug abuse in the workplace;
(2) The contractor's policy of maintaining adrug-free workplace;
(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 adrug-free workplace
through implementation of paragraphs (a), (b), (c), (d), (e) and (f).
B. The contractor shall insert in the space provided on the attached "Place of
Performance" form the site(s) for the performance of work to be carried out with
the grant funds (including street address, city, county, state, and zip code) .the
contractor further certifies that, 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: ~~ ~ ~
Program Operator
DIVISION OF EMPLOYMENT SERVICES
PLACE OF PERFORMANCE
FOR CERTIFICATION REGARDING DRUG-FREE
WORKPLACE REQUIREMENTS
Name: Paul O'Reilly
Name of Contractor: O'Reilly and Associates
Contractor Number:
Date: May 1 2009
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):
7530 Sunnywood Lane
Los Angeles, CA 90046
Exhibit D
Subcontractor agrees that in addition to those agreements and obligations
specified in the contract boilerplate and scope of work, it will also adhere to and
obey the following provisions, assurances, and certifications.
ARTICLES
1) Subcontractor assures and certifies that it will not use any funds
appropriated under this agreement for religious activity or anti-religious
activity, or to promote or oppose any political candidate, parties, and/or
beliefs.
2) Subcontractor assures and certifies that any requested modification to this
agreement must be submitted in writing, explaining requested changes
and rationale. Subcontractor further assures that no modification will be
implemented without prior written approval from the Santa Ana WORK
Center.
3) Subcontractor agrees to cooperate with any monitoring, inspection, audit,
or investigations of activities related to this agreement as may be
scheduled and conducted by the Santa Ana WORK Center.
4) Subcontractor agrees to acknowledge (give credit to) the Santa Ana
WORK Center in all oral presentations, written document, publicity, and
advertisements regarding any activities that ensue from this agreement.
WORKERS' COMPENSATION DECLARATION
I ~At.°~ ~`2~,,U ~~s~~~e:'~hereby affirm under penalty of perjury, the
(Name/Title)
following declaration
I certify on behalf of ~ til.i..~ ~~ ~ that during the term of my
(Organizatio Name)
contract with the (~,~, ~ ~.~~ ~j1e ,City of Santa Ana, I will not
employ any person in any manner so as to become subject to the workers' compensation
laws of California, and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply
with those provisions.
DATE: ~/a ~ /y J
By:
Name: X~Vt. (~ ~,~,~~
Title: ~~S ~ 9,~
Telephone: ~ ~~~~~ "S~~ L
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN
ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR
IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
ACORD CER
rm TIFICATE OF LIABILIT
WIA.AnINSURANCE SERVICES/PHS
251467 P: (866)467-8730 F: (877)905-0457
PO BOX 33015
SAN ANTONIO TX 78265
INSURED
Y INSURANCE DATE
I03-26-2009
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
`/~~ INSURER A: Hart f ord Casual t Ins Co
~~ ~ ~ / ' ~~ INSURER B:
O'REILLY & ASSOCIATES INSURER C:
75 3 0 SUNNYWOOD LN . INSURER D:
LOS ANGELES CA 9 0 04 6 INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED RFI nw HwF aFFni iccii~r, rn T~~ i.~~-,,,,~,......~.. . __. ._ __
rarer tit[2uIHtMtNT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATEIMAY BE SSUED ORDING
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED
HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR TYPE OF INSURANCE I POLICY NUMBER DATE MMFDD/YYE ATE (MM/DD/YYN LIMITS
GE NERAL LIABILITY
A
COMMERCIAL GENERAL LIAB
7 2 SBA A EACH OCCURRENCE $1 , 0 0 0, O O O
ILITY E4 8 6 6 0 6/ 0 5/ 0 9 0 6/ 0 5/ 10 FI
CLAIMS MADE U RE DAMAGE (Any one fire) S3 O O, 0 0 0
OCCUR
X
General Liab MED EXP (Any one person) 51 O , O O O
PERSONAL & ADV INJURY S1, O O O, O O O
GEN'L AGGREGATE LIMIT APPLIES GENERAL AGGREGATE $2 , 0 0 0, O O O
PER:
POLICY j
X
PRODUCTS -COMP/OP AGG
S2 , O O O , O O O
LOC
ECT
AU TOMOBILE LIABILITY
A ANY AUTO 72 .SBA AE4 8 6 6 0 6/ 0 5/ COMBINED SINGLE LIMIT S 1
0 0 0
O O O
ALL OWNED AUTOS 0 9 0 6/ 0 5/ 10 (Ea accident) ,
,
SCHEDULED AUTOS BODILY INJURY $
X
HIRED AUTOS IPer person)
X
NON-OWNED AUTOS """ ERR
~
BODILY INJURY
S
~O IPer accident)
S
O PROPERTY DAMA
, GE
(Per accident) S
GARAGE LIABILITY
ANY AUTO ~41
Y
AUTO ONLY - EA ACCIDENT
S
QUO
r- `,
~~O¢
O ~e7 EA ACC
R S
-
r
~ ~ AUTO
ONLYN
EXCESS LIABILITY AGG S
~G
7 ~\
OCCUR U CLAIMS MADE r
~ EACH OCCURRENCE S
PSS~S~ j ~ /~
4 AGGREGATE
S
DEDUCTIBLE
S
RETENTION $
5
S
WORKERS COMPENSATION AND WC STATU- OTH-
EMPLOYERS' LIABILITY TORY LIMITS ER
E.L. EACH ACCIDENT $
E.L. DISEASE - EA EMPLOYEE S
OTHER E.L. DISEASE -POLICY LIMIT S
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
City of Santa Ana, its officers, employees, agents, volunteers and
representatives are included as additional insured with
respects to the
liability coverage indicated under policy number 72SBAAE4866 for th
ose
operations usual to the insured.
CERTIFICATE HOLDER ADDITIONAL INSURED; INSURER LETTER: CANCELLATION
City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
Santa Ana W/O/R/K Center EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
ATTN: Lydia Morgan 30 DAYS WRITTEN NOTICE (10 DAYS FOR NON-PAYMENT) TO THE CERTIFICATE
HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPO
10 0 0 E . Santa Ana Blvd . Suite 2 O O SE NO
OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Santa Ana, CA 92701 REPRESENTATIVES.
AUTHORI D RE ENTATIVE ~~~~
/
ACf1R11 9C c r~ro~r
® ACORD CORPORATION 1988
w a1!t.~3- ~00u 1p: 3~ FAQ
Or~~l~~)/ ~ Asso~iC~~~'S
7530 Sunnywood Lane, Los Angeles, California 90D4B
Phone: 323-851-5160
E-mail: aulorelq b lobal.net
June 1q, 2gOg
Lydia Morgan
Community Development Agency
20 Civic Center Plaza
Santa Ana, GA 9709
Dear Lydia;
The City of Santa Ana was designated as "additional insured" an my comprehensive general
liability and property insurance with Hartford Insurance, policy #725BAAE4$$6. My
commercial general liability policy is paid in full for the 2009-2090 policy term.
Since my policy is paid in full, Hartford has agreed they will not cancel m
term and has provided a letter to that effect. The policy has a standard 30pday not ce of his
cancellation, which meets your requirements. I agree to notify Santa Ana W/O/R!K Center and
the City of Santa Ana if for some unusual reason the Hartford does choose to cancel the policy
and i agree to give the City of Santa Ana the 30 day required notice of cancel)atit~n.
Please calf me if there are any further questions.
Paul O'Reilly
O'Reilly ~ Associates
President
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